Other Infectious Diseases

What disease killed 300-500 million people worldwide but has since been eradicated from the human population?

Smallpox Progression: Rash Pus-filled blisters Disfiguration and/or blindness Death rate = 30% Man with smallpox; Public Health Images Library. Source: CDC

Variolation: The Earliest Smallpox Immunization

Who invented smallpox variolation? The first vaccine Edward Jenner 1749 - 1823

The smallpox vaccine Fatal complications are rare: Made with cowpox virus Side effects: red spot, pustules, scabs, leaves a scar. Fever is common, swelling. Fatal complications are rare: 1 death per million vaccines

The World Takes Action 1967: WHO announces global smallpox eradication program. Still 15 million new cases a year then 1977: Last reported naturally occurring case in Somalia. Smallpox is the only disease totally eradicated in humans

Smallpox: Bioterrorism Agent? Routine vaccination discontinued in 1972 Vaccines controversial today Project BioShield Act of 2004

Recognize this? Ring around the rosy, A pocket full of posies, Ashes… Ashes, We all fall down! Written in London in 1665

Plague ended in 1666 Great fire of London finally killed the rats The brown rat, house rat, sewer rat, Norway rat = carriers of Bubonic Plague

Bubonic Plague = Black Death

Black Death Gangrene caused by plague

Plague in the U.S. CDC

Plague in Oregon 13 cases reported in Oregon (5 fatal) since 1970. Mostly spread from fleas of infected rodents.

e. coli E. coli normally live in the intestines. Most strains of e. coli are harmless Harmful e. coli are transmitted through contaminated food, water, or contact with infected person.

E. coli symptoms Severe stomach cramps Diarrhea (usually bloody) Vomiting Fever (low grade) Treatment / Prevention

Salmonella

Salmonella continued 42,000 cases reported every year. Causes diarrhea, fever, abdominal cramps A result of contaminated food, water, or contact with infected animals.

Botulism Caused by Clostridium botulinum bacteria Rare but serious – causes paralysis if left untreated. Five types of botulism: Foodborne Wound Infant Adult intestinal Iatrogenic

Botulism Symptoms include: Antitoxin is available for treatment Double vision, blurred vision, drooping eyelids, slurred speech, difficulty swallowing, dry mouth, muscle weakness. Antitoxin is available for treatment

Botulism prevention Proper food handling Botulism’s not all bad…. Especially in food preservation Be wary of dented, bulging cans Botulism’s not all bad….

Malaria Caused by parasite Transmitted by mosquito Once injected into the human, the parasite grows and multiples first in the liver and then the red blood cells.

Malaria in the U.S. & World About 1,500 cases reported every year in the U.S. From travelers and/or immigrants Malaria considered eradicated from U.S. in 1950’s. 3.3 billion people diagnosed worldwide Thrives in tropical and subtropical areas.

Influenza Symptoms Fever Cough Sore throat Runny or stuffy nose Muscle or body aches Fatigue Headaches

Preparing for next crisis

Influenza Impact Flu seasons vary from year to year About 20% of US population infected every year Higher among susceptible populations Three main types of flu virus: Types A, B & C Type A causes the greatest morbidity and mortality Example: H1N1 (2009 Epidemic)

Influenza Pandemics Since the late 19th century, four occurrences of pandemics 1889-1891; 1918-1920; 1957-1958; 1968-1969 2009; H1N1 Was that the pandemic for our time?? Type A cycles every 50-100 years What’s different about Type A influenza?

Tuberculosis 20-33% world’s population is infected with TB Majority of the above = “Dormant TB” Can be dormant for 30 years Only 5-10% will become “active” TB

TB continued TB bacteria produces nasal discharge, coughing, sneezing Airborne

TB and Oregon Public.health.oregon.gov

MRSA Methicillin-resistant Staphylococcus Aureus Staph bacteria resistant to certain antibiotics called beta-lactams. Often appears as pustule or boil May think of a spider bite at first.

MRSA continued HA-MRSA = Health care acquired More serious and potentially deadly CA-MRSA = Community acquired Anyone is at risk

Factors that Facilitate Transmission Crowding Defense Offense Frequent Contact Antimicrobial Use Compromised Skin Contaminated Surfaces and Shared Items Cleanliness (CDC, 2012)

MRSA in the news… Newberg, Oregon… High schooler spread MRSA through tattoos, several students infected. Mainly spread through unclean needles.

MERS-CoV Middle East Respiratory Syndrome Coronavirus April 2012 – present Currently under investigation SARS-like virus Symptoms: fever, cough, shortness of breath

Others in the news… Ebola Flesh-eating disease Mad cow

More infectious diseases Kissing disease African Sleeping Sickness

Misc Acne Ulcer Bad breath

Giardia

Hepatitis HAV HBV HCV U.S. Stats 25,000 new infections/yr Transmission Ingestion of fecal matter Contact w/ infectious body fluids Contact w/ infected blood Severity Usually no lasting damage, rarely fatal Most fully recover; Some develop liver disease; ~3,000 die / yr 60-70% develop chronic liver disease; 1-5% will die from liver cancer Vaccine? Vaccine available No vaccine Symptoms Fever, fatigue, loss of appetite, nausea, vomiting, abdominal pain, joint pain, jaundice 43, CDC, 2012

HIV Human Immunodeficiency Virus = The cause of AIDS AIDS = the end-stage of HIV disease What exactly is HIV / AIDS? How does it affect the immune system?

HIV About 30-40 million people worldwide are living with HIV How many of those live in the US? Approximately 1 million Approximately 1 in 5 of them don’t know they have HIV

HIV in Oregon

HIV testing ELISA, confirmed with Western Blot Positive P24 antigen test Home tests Recently approved

Anything new? Prevention campaigns The Affordable Care Act of 2010 Reduce number of new infections Increase access to care Reduce HIV-related disparities 2013 Budget Estimated $28.4 billion for domestic and global HIV/AIDS activities Prevention campaigns

Other STIs Gonorrhea Syphilis