Amoebic Dysentery (Amoebiasis ) Alex, Jeb, and Brendan

Diagnosis Daignosis: Amebiasis Reference Slide Parasite 4 Options: Giardia, Malaria African Sleeping Giardia Amebiasis

Symptoms Fever Body aches Diarrhea Acute abdominal pains Dyhdration Mild head aches Disease symptoms Loose Stool Stomach Pain Stomach Cramping

Treatment Antibiotics Lifestyle Changes: Refugee Camps

Cells Infected Large Intestine Stool If Left Untreated: Diarrhea Liver

Transmission of Amoebiasis Caused by Entamoeba histolytica Life cycle : Ingestion Excystation Cysts Out of body Vectors 1. ent-a-ME-ba his-to-LI-ti-ka Poor/developing countries In USA, immigrants 1-4 weeks after contact has symptoms 2. Ingest a mature cyst, and it will find its way to the lumen It is asymptonatic here However, it may make its way to other parts of the intestine and cause damage (histolytica refers to histo, tissue, and lytic, cell destruction (like lytic cycle in viruses) Excystation: cysts become trophozoites Trophozoits make more cysts (1 is less mature, 4 is fully mature)[refers to # of nuclei] Matrue cycts leave the body through fecal matter Out of body: Cysts have large cell walls thatc an orotect them They can survive stomach acid and out-of-body danegrs Vectors: contaminated food and water Fecal matter even traces (Such as on uncleaned toilets) to mouth can be a method of transmission Also, contaminated fertilizer

Preventative Measures Individual vs. Community Individual Present and near future Future Trips Community Practices New installations Iodine tablets Estimated 50 million people have it worldwide (wiki) Individual preventive measures similar to community Present and near future: make sure to wash ands well, clean toilets Not to share items like towels, clothes For future trips: Make sure to wash hands often Don’t eat raw vegetables Don’t drink water or use ice cubes that does not follow below (includes sodas) Boil all water, maybe pass through a 1 micron or less filter, then put in iodine tablets THEN HIT THE THING FOR IODINE TABLETS Try to use a proper bathroom if one is available Preventive Measures (community) Make sure water isn’t contaminated Washing hands before touching food/doing something involving fecal matter (such as changing a diaper) Clean bathrooms often Don’t share things like towels In “endemic areas” Don’t eat raw vegetables Don’t drink water or use ice cubes that does not follow below Install bathrooms in refugee camps Try to use food that is packaged, from aid workers Get iodine tablets for the water

Information on outbreaks Cysts Outbreak danger Vaccine A cyst Cysts are very hardy; they can survive weeks in the ground and stomach acid However, boiling water, iodine tablets and filters can get rid of them The disease can be a major outbreak, primarily in poorer areas 90% of people who have it show no symptoms No one is immune and everyone is at risk; there are no known vaccines or shots for it (however, scientists have some ideas on how to make one, by using genetic principles to try to shut down key genomes in the microbe)

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Amoebiasis: A Historical Perspective

Geographical Distribution Temperate-Tropical Sub-Tropical Africa Geographical distribution is mostly temperate, tropical and sub-tropical Map shows that it is everywhere Especially dominant in Africa, developing world Common in U.S. as well Point out that where he visited is in zone

Populations at Risk Developing Countries All People Tropics Morocco Everyone at risk for disease Especially those in developing countries Much more prevalent in developing countries, like Mozambique, where refugee camp is Graph shows percent of people in Morocco (another African and developing country) Talk about open toilets Especially in refugee camp, not great, close quarters No running water, easy contamination Morocco

Cases World Wide Tropics 500,000,000 (10%) 50,000,000 (10%) Lifetime Cure Rates Mr. Duane Causes about 20 deaths in U.S. annually 10-20 thousand people have it annually in U.S. Approx 500 million (a little less than 10% world population) carry protozoan Only about 1-10% of people diagnosed with disease each year Up to 50 million annual cases Most cases, non malignant, pass through body in 12-18 months Malignant cases, usually lasts for 1-4 weeks with treament Cure rates are 86-93% If untreated, can lead to serious and potentially fatal liver damage Cycles, symptoms may subside, but pathogens still in body Mr. Duane was diagnosed with disease, said it was a very unpleasant experience

Past Cases and Future Outlook Chicago No Vaccine Similar trends Recent outbreak was in Chicago, where over 100 cases were reported Sixteen reported dead Could spread to other cities, as 100,000 people exposed to disease All developing countries will have trouble, and epidemics are common in the developing world No vaccine, so cases certainly won’t go down Will continued to be handled case by case But generally in developed world, things under control Epidemics will not likely spring up unexpectedly in developed world Developing countries will always have problems

Amoebic Dysentery (Amoebiasis )