NTD 1 Flashcards
SARS
Dr and nurses catch it and die - infection uncontrollable and spreads
SARS-CoVs (severe acute respiratory syndrome coronavirus)
genome sequencing shows that genome of similar bat virus is almost identical
epidemic stopped by isolation - quarantine, get 1st symptom before it can be transmitted
fruit bats are eaten
unreported mortality in China - isolated hospitals
West nile virus
first in US in NY state in 1999 caused >19000 illness >750 deaths in US by 2009 mosquito work for vaccine is underway
HIV
similar to primate virus
immunotherapeutic treatment - triple therapy - target 3 genes
multiple introductions into humans
HIV 1 - human virus, mutation rate at each side along genome, back circulate when separated
in chimp SRV - RNA - no checks in replication
can’t get vaccine
malaria
evolutionary history of malaria
closest similar species chimp
few 1000yrs old
source wild animals
MERS
middle east respiratory syndrome coronavirus
livestock v domestic
high fatality rate
cases in Britain through travellers
no antiviral/vaccine - just have to let it run its course
Ebola
no commercial market for medication - companies serve western European virus
CEPI - Bill gates - develop vaccine for rare disease
manufacturing capability 1/3 of what needed to vaccinate all children for common viruses
internet surveillance - unusual events in space and time
isolate people who have contact trends
immunotherapies
trial vaccines but no vaccine because of the lack of commercial market
genetically stable virus
prosper in area of conflict - no health measures
Zika
brain fails to develop
forest in Uganda - where first found
common in tropical belt
sexually transmitted
difficult to produce vaccine - because autoimmune so risk a lot of adverse effects
trigger autoimmune response against neural cells
modulate human immune system pathway
need to prevent being bitten by a mosquito
reservoir in primates
1st trimester risk of microcephaly (brain failing to develop properly) 1%
2nd and 3rd trimester - negligible
risk of Gillian-Barre syndrome 4 in 100000 in adults - Autoimmune attacking nerve cells
Vaccination
have risks
US make you have vaccines to attend primary school
people see the risks of vaccines and delay having them
correlation between MMR and autism - websites designed to cause anxiety
in order to protect the community there has to be a basic level of immunity - have to encourage vaccinations
Measles
increasing outbreaks
vaccination rate should be 95-97% now it is 84%
pockets of outbreak in London - especially among communities where English isn’t the first language
pneumococcal infection
17 strains in vaccines - commonest strain in seral illness
human papilloma virus - many strains but all stable
vaccine provide strong selective force
strain replacement
rare cases are as important we just haven’t seen enough of them
NTD
give drugs freely to places where they need them
small protein production gene protrude in immune system - no acquired immunity - drug treatment required forever so need a vaccine - commercial market not viable
medical surveillance - internet surveillance and internet surveillance, report in newspaper and radio - unusual morbidity, people in Nigeria determine cause - this discovery phase could be the most difficult phase
what is generation time
average time from birth of female until she gives birth
Influenza a
trillion gene rotations
arms race in favour of the pathogens
modern medicine removes natural selection and puts it into our hands
generation of a vaccine
time from drug proof of principle to on market = 15yrs
for vaccine 10yrs
phase 1 - safety
phase 2 - evidence and efficacy
phase 3 - expensive, drug into clinical trial, complications
describe the disease-poverty cycle
> 1billion people live on
what are the 14 neglected tropical diseases
Protozoan: Human African Tyopanosomiasis (HAT) Chagas Disease Leishmaniasis Bacterial: Buruli Ulcer leprosy trachoma - eye infection Helminth: ascariasis hookworm infection trichuriasis schistosomiasis lymphatic filariasis onchocerciasis dracunculiasis podoconiosis
where has the highest prevalence of 9 of the NTD
sub Saharan Africa
90% schistosomiasis - used to be in china and south America
Asciariasis, hookworm and trichuriasis - intestinal worms, prevalent globally
what is mass drug administration
MDA
possible if: drugs are safe and effective, inexpensive or donated, diagnosis is difficult inaccurate or expensive and unpleasant
test sample - depending ion results offer MDA to sample or whole pop
target school aged children - annually
>1billion people treated in 2017
