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Public Health 150 > 9. Infectious Diseases 10/30 > Flashcards

9. Infectious Diseases 10/30 Flashcards

1
Q

Impact of infectious diseases 14th century

A

Europe-Plague kills 20-45% of the world’s population

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2
Q

Impact of infectious diseases 1831

A

Cairo-13% of population succumbs to colera

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3
Q

Impact of infectious diseases 1854-56

A

Crimean war-deaths due to dysentery were 10 times higher than deaths due to casualties

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4
Q

Impact of infectious diseases 1899-1902

A

Boer war-deths due to dysentery were 5 times higher than death due to casualties

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5
Q

Hantavirus

A

Hantavirus risk factor: contact with deer mouse droppings.

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6
Q

Factors in Promotion of Infectious Disease

A

Agent-virus, bacteria, parasite, prion, etc.
Host-genetic profile, mmune capactiy, poverty, nutritional status
Environmetn-biologic and chemcial polllution, climate chang, deforestation

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7
Q

The chain of infection

A

Etiologic agent
Reservoir-Humans, Animals, Environmetn (e.g. soil)
Portal of exit
Mode of transmission-Direct, indirect, intermediate host.
Portal of entry.
Susceptible host

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8
Q

Portals of entry/exit of infectious agents

A

Respiratory-influenza, common cold agents, measels
Genitoourinary-sexually transmitted agents
Alimentary trach(gut)-Campylobacter, chloera, salmonella
Skin-Streptococci, percutaneous(vector borne diseases e.g. arboviruses
Wyw-C. tachomatis
Transplacental-cytomegalovirus, HIV
Route of entry and exit not necessarily the same for a single agent e.g. HIV, schistosomasisis.

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9
Q

Microbial threats

A

Newly recognized agents (SARS, acinetobacter).
Mutation of zoonotic agents that cause human disease (e.g., H5N1, H1N1).
Resurgence of endemic diseases (malaria, tuberculosis).
Persisting disease(measles, polio)

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10
Q

Mutation of zoonotic agents that cause human disease

A

Mutation of zoonotic agents that cause human disease

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11
Q

Resurgence of endemic diseases

A

(malaria, tuberculosis).

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12
Q

Persisting disease

A

(measles, polio)

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13
Q

Microbial threats

A

development of drug-resistant agents (tuberculosis, gonorrhea).
Recogition of etiologic role in chroic diseases (Chlamydia causing repiratory and heart disease; HIV and hert disease)
Use of infectious agents for terrorism adn warfare(anthrax)

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14
Q

The leading causes fo death in the world in 2011

A
  1. Ischaemic heart disease.

2. Stroke

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15
Q

The leading causes fo death in the world in 2000

A
  1. Ischaemic heart disease.

2. Stroke

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16
Q

Newly identified infectious diseases and pethogen

A

MERS-CoV, H1N1, Avian influenza (human cases), SARS, Nipah virus, H5N1

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17
Q

Disease Emergence adn re-emergence:causes

A

Genetic/Biologic factors.-Host an agnt mutations.-Increased survival of susceptibles.
Human Behavior-political, social, economic
Physical environmental factors-crowding
Ecologic factors-climatic changes, deforestation, etc.

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18
Q

Factors contributing to emergence or re-emergence of infectious disease

A

Human demographic change by which persons begin to live in previously uninhabited remote areas of the world and are exposed to new environmental sources of infecitous agents, insects adn animals. unsustainble urbanization causes breakdowns of sanitary adn other public health measures in overcrowded cities (e.g., slums).

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19
Q

Factors contributing to emergence or re-emergence of infectious disease (2)

A

Economic development and changes in the use of land, including deforestation, reforestation, adn urbanization.
Global warming-climate changes cause cahnges in geographical distribution of agents and vectors.
Changing human behaviors such as increased use of child-care facilitesm sexual and drug use behaviours, and patterns of outdoor recreation.
Social inequality.

20
Q

Factors contributing to emergence or re-emergence of infectious disease (3)

A

International travel and commerce that quickly transport people and goods vast distances.
Changes in food processing and handling, including foods prepared from many different individual animals and countries and transported great distances

21
Q

Factors contributing to emergence or re-emergence of infectious disease (4)

A

Evolution of pathogentic infectious agents by which they may infect new hosts, produce toxins, or adapt by responding to changes in the host immunity. (e.g. influenza, HIV)
Development of resistance by infectious agents such as Mycobacterium tuberculosis and Neisseria gonorrhoeae to chemoprophylactic or chemotherapeutic medicines.

22
Q

Factors contributing to emergence or re-emergence of infectious disease (5)

A

Resistance of the vectors of vector-borne infectious diseases to pesticides.
Immunosuppression of persons due to medical treatments or new diseases that result in infectious diseases caused by agents not usually pathogenic in healthy hosts (e.g. leukemia patients)

23
Q

Factors contributing to emergence or re-emergence of infectious disease (6)

A

Deterioration in surviellance systems for infectious diseases, including laboratory support, to detect new or emerging disease problems at n early stage (e.g. Indonesian resistance to “scientific colonialism”
Illiteracy limits knowledge and implementation of prevention strategies.
Lack of political will-corruption, other priortities

24
Q

Portals of entry/exit fo infectious agents

A

respiratory, Genitourinary, Alimentary track(gut), Skin, Eye, Transplacental

25
Q

Newly recognized agents

A

SARS, Aceinetobacter

26
Q

Mutation of zoonotic agents that cause human disease

A

H5N1, H1N1

27
Q

Resurgence of endemic diseases

A

malaria, tuberculosis

28
Q

Persisting diseases

A

measles, polio

29
Q

Newly identified infectious disesaes adn pathogens

A 
2012 MERS-Cov
2009 H1N1
2004 Avian influenza (human cases
2003 SARS
1999 Nipah virus
30
Q

Disease emergence and re-emergence: causes

A

Genetic/ biologic factors, Human behavior, Physical environmental factors, ecologic factors

31
Q

Factors contributing to emergence or remergence of infectious diseases

A

human demographic change, unsustainable urbanization, economic development, global wrming, changing human behaviours, social inequality, international travel and commerce, cahgnes in food processing and handling, evolution of pathogenic infectious, resistance by infectious agents, resistance of the vectors, immunosuppression persons, deterioration in surveillance systems, Illiteracy, Lack of policitcal will,Biowarfare/bioterrorism, war, civil unrest, Famine, Manufacturing strategies,

32
Q

Strategies to reduce threats

A

develop political will and funding, Improve global early response capacity.
IMPROVE GLOBAL SURVEILLANCE, improve global surveillance, use of vaccines, Decrease inappropriate drug use, improve vector and zoonotic control, development of predictive models based on.. establish priorities, reduce potential for rapid spread, develop more feasible control strategies.

33
Q

Basic elements in preparedness

A

Internation Health Regulations, Interntional–WHO

Global Outbreak Alert and Response Network (GOARN). Global Public Health Information Network (GPHIN),

34
Q

Daily Flow of GPHIN information

A

1) scanning global news
2) Filtering and sortign process
3) review for relevancy

35
Q

Essential factors for disease eradication

A

Knowledge of its epidemiology and transmission patterns/mode
Availability of effective tools for diagnosis, treatment and prevention
Knowledge of local cultural and political characteristics
Community acceptance and mobilization
Political will and leadership
Adequate and sustained funding

36
Q

ROLE OF THE PUBLIC HEALTH PROFESSIONAL

A

Establish surveillance for:
-Unusual diseases
-Drug resistant agents
Assure laboratory capacity to investigate new agents (e.g., high-throughput labs)
Develop plans for handling outbreaks of unknown agents
Inform physicians about responsible antimicrobial use

37
Q

VIROLOGY OF INFLUENZA

A

Subtypes:
A - Causes outbreak
B - Causes outbreaks
C - Does not cause outbreaks

38
Q

Immunogenic Components of the Influenza Virus

A

Surface glycoproteins, 15 hemagglutinin (H1-H15), nine neurominidases (N1-N9)
H1-H3 and N1N2 established in humans
Influenza characterized by combination of H and N glycoproteins
1917 pandemic - H1N1
2004 avian influenza - H5N1
2009 H1N1
Antigenic mix determines severity of disease
Human response specific to hemagglutinin and neurominidase glycoproteins

39
Q

Antigenic drift

A

Antigenic drift - results of errors in replication and lack of repair mechanism to correct errors

40
Q

Antigenic shift

A

reassortment of genetic materials when concurrent infection of different strains occurs in the same host

41
Q

CLINICAL OUTCOMES OF INFLUENZA INFECTION

A 
Asymptomatic
  Symptomatic
	Respiratory syndrome - mild to severe
   Gastrointestinal symptoms
   Involvement of major organs - brain, heart, etc.
	Death
42
Q

Factors Influencing the Response to Influenza

A 
Age
Pre-existing immunity (some crossover)
Smoking
Concurrent other health conditions
Immunosuppression
Pregnancy
43
Q

Characteristics of H5N1Avian Influenza

A
  1. Highly infectious and pathogenic for domestic poultry
  2. Wild fowl, ducks asymptomatic reservoir
  3. Now endemic in poultry in Southeast Asia
  4. Proportion of humans with subclinical infection unknown
  5. Case fatality in humans is >50%
44
Q

Intervention Strategies (H5N1)

A 
Culling (killing of infected flocks)
Innovative surveillance strategies
	-Identification and analysis of human to
        human clusters
	-Characterization of strains
		*Necessity for vaccine development
			(Science 304:968-9, 5/2004)
Vaccination of bird handlers (vaccine being developed)
Vaccination of commercial bird flocks
45
Q

Barriers to H5N1 Control

A

Reservoir in wild birds and ducks
Economic impact of culling of poultry stocks
Popularity of “wet markets” promotes transmission within poultry and to other species (e.g., pigs)
Resistance to antivirals and vaccines
Mistrust of rich nations

46
Q

STRATEGIES TO PREVENT FLU (1)

A 
OVER MOUTH AND NOSE WHEN SNEEZING
WASH HANDS FREQUENTLY WITH SOAP AND WATER OR ALCOHOL
AVOID TOUCHING EYES, NOSE AND MOUTH
AVOID CONTACT WITH SICK PEOPLE
AVOID CROWDED CONGESTED ENVIRONMENTS

Public Health 150 (19 decks)

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