PRINCIPLES OF PANDEMICS Flashcards
DIFFERENCES BETWEEN AN ENDEMIC/OUTBREAK/EPIDEMIC AND PANDEMIC?
ENDEMIC: OBSERVED CASES ARE EXPECTED, A CONDITION HAS A STEADY RATE AMONG A POPULATION
OUTBREAK: INCREASE IN CASES, NOT EXPECTED, USUALLY CONCERNS A SMALL GEOGRAPHICAL AREA
EPIDEMIC: OUTBREAK OVER A LARGER GEOGRAPHICAL AREA
PANDEMIC: AN EPIDEMIC WITH A GLOBAL SPREAD
WHAT WAS THE MOST SEVERE PANDEMIC OF THE 20TH CENTURY?
THE SPANISH FLU
DESCRIBE THE SPANISH FLU PANDEMIC:
- MOST SEVERE IN RECENT HISTORY WITH WORLDWIDE SPREAD IN 1918-1919
- CCA 500 MILLION INFECTED
- CCA 50 MILLION DEATHS
- HIGH PREVALENCE IN <5, 20-40 AND 56+ YEAR OLDS
- INTERVENTIONS: NON PHARMACEUTICAL (ISOLATION, QUARANTINE, HYGIENE, DISINFECTANTS..); NO VACCINE, NO ANTIVIRALS, NO ANTIBIOTICS (ALTHOUGH ANTIBIOTICS CAN’T HELP TREAT THE FLU AS IT IS A VIRAL INFECTION, PEOPLE WITH FLU CAN DEVELOP A BACTERIAL INFECTION BECAUSE OF THEIR COMPROMISED IMMUNE SYSTEM)
NAME THE INFLUENZA PANDEMICS IN THE 20TH AND THE 21ST CENTURY?
SPANISH FLU (1918-1919) ASIAN FLU (1957-1958) HONG KONG FLU (1968) SWINE FLU (2009-2010)
2 INFLUENZA PANDEMICS OF THE 20TH AND THE 21ST CENTURY THAT WERE CAUSED BY THE SAME VIRUS?
SPANISH FLU AND SWINE FLU
WHEN WAS INFLUENZA FIRST ISOLATED AND SHOWN TO BE A VIRUS?
1930
TIMELINE OF THE FLU VACCINATION IN THE UK?
1960s: SEASONAL VACCINE IN UK FOR HIGH RISK GROUPS
2000: SEASONAL VACCINE IN THE UK FOR THE 65+ YEAR OLDS
2013: VACCINE IN THE UK FOR CHILDREN
WHAT DOES THE ‘BLACK DEATH’ REFER TO?
IN THE MIDDLE AGES, ‘BLACK DEATH’ WAS A BUBONIC PLAGUE PANDEMIC FROM 1346 TO 1353 CAUSING OVER 50 MILLION DEATHS
ORIGIN OF THE WORD ‘QUARANTINE’?
- DERIVED FROM THE ITALIAN WORDS ‘QUARANTA GIORNI’ WHICH MEANS 40 DAYS
- DURING BLACK DEATH (BUBONIC PLAGUE PANDEMIC), EUROPE WAS PARTICULARLY AFFECTED, ONE OF THE FIRST COUNTRIES BEING ITALY
- IN 1348, VENICE BECAME THE FIRST CITY TO CLOSE ITS PORTS TO INCOMING VESSELS
- THOSE THAT DID GET ADMITTED WERE SUBJECT TO 30 DAYS ISOLATION, LATER 40 DAYS, AND THAT’S HOW QUARANTINE GOT ITS NAME
IMPACTS OF BLACK DEATH (BUBONIC PLAGUE PANDEMIC IN THE MIDDLE AGES)?
- LARGE SOCIAL AND ECONOMIC EFFECTS
- PSYCHOLOGICAL EFFECTS: FAITH IN RELIGION DECLINES, SOME LIVED WILD, IMMORAL LIVES AS THEY HAD A PERCEPTION OF SOON, UNAVOIDABLE DYING
- PEOPLE BEGAN TO HATE POVERTY AND THEIR ‘BETTERS’
- EXTREME INFLATION
- GOODS IN SHORT SUPPLY
- WORKERS MORE EMPOWERED BECAUSE THE SHORTAGE MADE THEM ABLE TO CHOOSE WHO TO WORK FOR
BLACK DEATH/BUBONIC PLAGUE PANDEMIC WAS CAUSED BY?
BY A BACTERIUM CALLED YERSINIA PESTIS
DESCRIBE THE PATHOGEN: YERSINIA PESTIS?
- BACTERIUM, USUALLY FOUND IN SMALL MAMMALS LIKE RATS AND THEIR FLEAS (VECTOR = RAT FLEA)
- ZOONOTIC; CAN TRANSMIT FROM ANIMALS TO HUMANS BY BITE OF INFECTED FLEAS, DIRECT CONTACT WITH INFECTED TISSUES AND/OR INHALATION OF INFECTED RESPIRATORY DROPLETS
- CAN BE TREATED WITH ANTIBIOTICS
- gram-negative, non-motile, coccobacillus bacterium without spores, facultative anaerobe
2 MAIN CLINICAL FORMS OF PLAGUE CAUSED BY YERSINIA PESTIS AND THEIR FATALITY?
BUBONIC (CHARACTERISED BY BUBOES; SWOLLEN LYMPH NODES) AND PNEUMONIC
- BOTH CAN BE VERY SEVERE
- CASE FATALITY RISK OF 30-60% FOR BUBONIC
- ALWAYS FATAL FOR UNTREATED PNEUMONIC PLAGUE
CRITERIA FOR PRIORITIZATION OF PATHOGENS (IN RESEARCH) WITH PANDEMIC POTENTIAL?
- HUMAN TRANSMISSION
- MEDICAL COUNTERMEASURES
- SEVERITY
- HUMAN/ANIMAL INTERFACE
- PUBLIC HEALTH CONTEXT
- POTENTIAL SOCIETAL IMPACTS
- EVOLUTIONARY POTENTIAL
- OTHER FACTORS
WHAT ARE THE CURRENT WHO PRIORITY DISEASES? (BASED ON THEIR PUBLICH HEALTH RISK DUE TO THEIR EPIDEMIC POTENTIAL)
- COVID 19
- CRIMEAN CONGO HAEMORRHAGIC FEVER
- EBOLA VIRUS DISEASE AND MARBURG VIRUS DISEASE
- LASSA FEVER
- MIDDLE EASTERN RESPIRATORY SYNDROME CORONAVIRUS (MERS Co-V) AND SEVERE ACUTE RESPIRATORY SYNDROME (SARS)
- NIPAH AND HENIPAVIRAL DISEASES
- RIFT VALLEY FEVER
- ZIKA
- DISEASE X
(NOT AN EXHAUSTIVE LIST, DOESN’T INDICATE THE MOST LIKELY CAUSE OF THE NEXT EPIDEMIC, LIST REGULARLY UPDATED)
CONTRIBUTING FACTORS TO INCREASING PANDEMIC RISKS?
- GLOBAL TRAVEL (INTERNATIONAL FLIGHTS MADE DISEASE SPREAD EASY; 4.2 BILLION PEOPLE TRAVELLED BY AIR IN 2018)
- URBANISATION (MORE CROWDING, INCREASING NUMBER OF PEOPLE IN SMALL PLACES, CITIES OVERPOPULATED)
- CLIMATE CHANGE (INCREASES RISK OF EXTREME EVENTS, LIKE FLOODING, WHICH ARE OFTEN ASSOCIATED WITH INFECTIOUS DISEASE AS IT INFLUENCES PATHOGENS AND THEIR VECTORS)
- INCREASED HUMAN-ANIMAL CONTACT (AS PEOPLE MOVE INTO NEW AREAS, AS WELL AS THE NATIONAL AND INTERNATIONAL TRADE IN WILDLIFE)
- HEALTH WORKER SHORTAGES (MAY LEAVE HEALTH SYSTEMS MORE VULNERABLE TO INFECTIOUS DISEASE OUTBREAKS. ESP IN LMIC)
WHICH ANIMAL DID SARS-CoV-2 CAUSING COVID 19 ORIGINATE FROM? HOW HAS THIS BEEN DETERMINED?
FROM BATS (DETERMINED THROUGH GENETIC DATA)
ORIGINS OF SEVERE ACUTE RESPIRATORY SYNDROME (SARS) AND MIDDLE EASTERN RESPIRATORY SYNDROME (MERS)?
SARS: 2002; ORIGINATED FROM BATS, BUT THEN PASSED THROUGH CIVET CATS AND ONTO HUMANS
MERS: 2012; MAY HAVE ORIGINATED FROM BATS, BUT WAS IN DROMEDARY CAMELS FOR A LONG TIME BEFORE IT WAS ABLE TO INFECT HUMANS
