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ANTHROP 2U03 > Midterm 3 > Flashcards

Midterm 3 Flashcards

1
Q

Malaria: mentions in history

A
  • 4700 ya: Chinese med texts
  • 2nd c BC: Chinese describe Ginghae (artemisia) plant
  • New World: quinine, medicinal bark
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2
Q

Malaria: microorganisms

A
  • Multi-cellular protozoa, genus Plasmodium spread by Anopheles mosquitoes
  • P. vivax
  • P. ovale
  • P. malariae
  • P. falciparum
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3
Q

P. vivax

A
  • Seldomly fatal
  • Most ancient, also affects apes
  • Infects young red blood cells
  • Dormant liver phase
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4
Q

P. ovale

A
  • Rarest, W Af
  • Infects young red blood cells
  • Dormant liver phase
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5
Q

P. malariae

A
  • Mild, world wide
  • 4 day fever
  • Infects old red blood cells
  • Can persist sub-clinically for many years
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6
Q

P. falciparum

A
  • Most prevalent and severe
  • Infects red blood cells of all ages –> parasitemia
  • Rapidly fatal (can -> cerebral hemorrhage/anemia)
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7
Q

Malaria: mosquitoes

A
  • Anopheles gambiae and fenestus

- Flourish in tropical, still, warm water; deforested habitats; ag; irrigation

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8
Q

Malaria: Discoverers

A
  • Charles Laveran: noticed parasites in blood

- Ronald Ross: demonstrated transmission by mosquitoe

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9
Q

Malaria: Symptoms

A

Classic cyclical presentation:

  • Cold stage
  • Hot stage
  • Sweating stage
  • Feel well -> then start over again
  • Can have many diff complications: renal failure, hypothermia, etc.
  • Characteristic of malaria, allows for historical ID
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10
Q

Malaria: causes of death

A
  • Anemia: destroys red blood cells

- Cerebral: damages brain, other vital organs

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11
Q

Malaria: life cycle

A
  • Inoculation into human, grows in liver cells
  • Infects red blood cells (clinical manifestation)
  • Differentiates sexually, ingested by mosquito
  • Starts over again
  • Complex life cycle=long evolution
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12
Q

Malaria: global distribution

A
  • Mostly poor, sub/tropical areas
  • 91% of deaths in Af, others in E Med, SE Asia
  • 86% of deaths are children (no time to develop immunity)
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13
Q

Af: why most affected by malaria?

A
  • Still slash and burn ag
  • Falciparum=most common
  • Climate: year round transmission
  • Socio-econ instability (can’t afford nets)
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14
Q

Sickle cell anemia

A
  • Long co-ev in Af -> high rates of sickle cell anemia
  • Causes blood cells to change shape (can’t inhabit)
  • Homozygous: die of anemia
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15
Q

Malaria: who is vulnerable

A
  • Children
  • Pregnant women
  • Travellers/migrants
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16
Q

NA

A
  • Was endemic, far north as Ottawa valley
  • Anopheles mosquito brought w/slave trade
  • Elimination: destroying breeding sties, screens, quinine treatment
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17
Q

Malaria Eradication Programs

A
  • WHO, 50/60s
  • Drain swamps
  • Larvacides
  • DDT spraying
  • Paris Green
  • Domestic mods w/socio econ improvements: screens, AC, safe water, indoor plumbing, nutrition, campaigns
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18
Q

Carson

A

Silent Spring

  • Malaria eradication -> huge enviro probs
  • May -> cancer
  • Led to worldwide ban but only after eradication in NA
19
Q

Roadblocks to eradicated malaria

A
  • Cultural trash -> breeding outside natural settings
  • Airport malaria
  • Politics: civil wars -> hard to treat
  • Not well funded by W agencies
20
Q

Anti-malarial agents

A
  • Chinchona: source of quinine (Peru)
  • Chloroquine: artificial quinine (extremely effective)
  • Artemisia: source of Artemnisinin (combo therapy for MDR strains)
21
Q

Origins of malaria

A

-Gorillas in W Af (Congo, Gabone, etc.)

22
Q

Cholera: micro organism

A
  • Bacteria Vibrio cholerae
  • Diff strains code for diff enterotoxins (-> flushing, fluid loss)
  • Biotypes: Classical, El Tor
  • Genetics: most pathogenic strains are 01 (^), also 0139
  • Evolution through horizontal gene transfer (switching genes, recombo)
23
Q

Cholera: symptoms

A
  • Abdominal fullness, lack of appetite
  • Circulatory collapse (sunken image)
  • Vomitting
  • Rice water stools
24
Q

Cholera: recovery and fatality

A
  • Oral rehydration therapy (effective, cheap)
  • Healthy carriers: shed back into water
  • MR: treated <1%, untreated 50-75%
25
Q

Cholera: transmission and reservoirs

A
  • Contamination of water/food
  • Ppl/water: only major reservoirs
  • Disease of social disparity: poverty (drinking water), developing economies (lack of infrastructure)
26
Q

Cholera: origins

A
  • Unclear, associated w/growing pop density (could have been around before)
  • Ancient descriptions: Sanskrit, Chinese, Egyptian
  • Hard to distinguish f/other diarrheal diseases
27
Q

Early sanitation and cholera

A
  • Rome: sewers and aqueducts, latrines well constructed (prob no cholera)
  • Medieval Eur: very poor sanitation (tout a la rue, limited access to clean water)
28
Q

Cholera: early endemic foci

A
  • Late 15th c: Bengal region of India/Bangladesh

- Early 1800s: Ganges and Brahma Rivers (great diversity of vibrio here = origins?)

29
Q

Initial spread of cholera (outside India)

A
  • Likely began in 1817 near Calcutta
  • Associated w/British imperialism, globalization
  • Moved to Europe after 1830s
30
Q

Pandemics of cholera outside India: rough dates, types

A
  • First 4 (starting 1817): unknown biotypes
  • 5 and 6: 01 classical
  • 7 (1961+): El Tor
  • 8: 0139
31
Q

Second cholera pandemic: background, reached NA

A
  • Industrial rev -> growth of slums, couldn’t manage sanitation
  • Reached NA by 1831, Ham by 1832
32
Q

Role fracturing societies: 2nd pandemic

A

-Associated w/filthy places, inhabitants -> social unrest (ex: Paris)

33
Q

Responses to 2nd cholera pandemic:

A
  • Maritime quarantines: opposition
  • Pre-mature burial
  • Helpless therapies: bloodletting, smoke
  • Public health: med journals, sanitary surveillance
34
Q

Cholera: third pandemic

A
  • Waterborne transmission proposed (John Snow) but not accepted
  • Emphasis on sanitary improvements
35
Q

Cholera, third pandemic, Philadelphia

A
  • Densely populated, between two rivers
  • Doesn’t show on skeleton, but museum had gut samples (base of all known classical strains, origins during humidity drop in India, setting on waterways
36
Q

Cholera, 7th pandemic

A
  • Spread f/Bay of Bengal, several waves
  • El Tor
  • Less virulent, but can survive longer out of water (fruit, etc.)
  • About socio-econ disparity
37
Q

Cholera: Peru

A
  • 1991 +
  • El Tor Biotype
  • Relatively low case fatality rate (<1%): info, oral rehydration therapy
38
Q

Peru: Causative Factors

A
  • Rapid urban growth –> shanti towns (lacked housing, water, sanitation, untreated waste going into water)
  • Econ crisis and structural poverty
  • Declining public health
  • Sewage as fertilizer when water is scarce (-> spread)
  • El Nino: warming -> increase in zoo plankton that carry it
39
Q

Cholera: what does/doesn’t work for treatment

A

Doesn’t:

  • Repressive controls (quarantine) –> hidden cases
  • Mass immunization: $, short term

Does:

  • Safe water, excreta disposal
  • ID, investigation, case reporting (facilitated by good labs, public health systems)
  • Access to social, econ resources
40
Q

Peru: costs of cholera outbreak

A
  • 300k cases that year
  • Low case fatality
  • Econ loss: $770m (tourism, trade embargoes)
41
Q

Background to Haiti cholera outbreak

A
  • Structural poverty: 80% below poverty line
  • Decades of political violence (no infrastructure)
  • Poor sanitation, access to safe water
  • Post-earthquake: no cholera
42
Q

Haiti: type of cholera

A
  • El Tor, sero group 01

- Particularly virulent, higher fatality rate

43
Q

Haiti: how did it spread

A
  • Traced f/UN base house in Meille, outbreak coincided w/their arrival
  • W/in two months, consumed entire country
  • Denied by UN, there for imperialist reasons (failed state, security risk)

ANTHROP 2U03 (3 decks)

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