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

 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

 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

 Routine vaccination discontinued in 1972  Vaccines controversial today  Project BioShield Act of 2004

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

CDC

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

 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.

 Severe stomach cramps  Diarrhea (usually bloody)  Vomiting  Fever (low grade)  Treatment / Prevention

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

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

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

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

 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.

 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.

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

 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)

 Since the late 19 th century, four occurrences of pandemics › ; ; ;  2009; H1N1 › Was that the pandemic for our time??  Type A cycles every years  What’s different about Type A influenza?

 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 bacteria produces nasal discharge, coughing, sneezing › Airborne

Public.health.oregon.gov

 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.

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

Contaminated Surfaces and Shared Items Frequent Contact Cleanliness Crowding Compromised Skin Antimicrobial Use (CDC, 2012)

 Newberg, Oregon… › High schooler spread MRSA through tattoos, several students infected. › Mainly spread through unclean needles.

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

 Ebola  Flesh-eating disease  Mad cow

 Kissing disease  African Sleeping Sickness

 Acne  Ulcer  Bad breath

 Giardia

HAVHBVHCV U.S. Stats25,000 new infections/yr 43,000 new infections/yr 17,000 new infections/yr TransmissionIngestion of fecal matter Contact w/ infectious body fluids Contact w/ infected blood SeverityUsually 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 SymptomsFever, fatigue, loss of appetite, nausea, vomiting, abdominal pain, joint pain, jaundice CDC, 2012

 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?

 About 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

 ELISA, confirmed with Western Blot  Positive P24 antigen test  Home tests › Recently approved

 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

 Gonorrhea  Syphilis