1. Introduction to Public Health Diseases

2. Classes of Diseases Vector borne illnesses Water borne illnesses
Directly communicable illnesses
Occupational and environmental illnesses
Chronic illnesses

3. Impact of Diseases Deaths in war
World War I was the first war where wounds killed more people than illness
Life expectancy
Early deaths count more
That is why it is hard to raise it once you get to 75
Communicable diseases keep the life expectancy low
Diarrheal diseases are the biggest killer of children worldwide

4. Disease agents Living parasites spirochetes amoebas bacteria virus
Environmental and Occupational
Asbestosis
Arsenic

5. Vector Borne Illness

6. Mosquito borne - Examples
malaria
spirochetes
yellow fever
virus
West Nile, St. Louis Encephalitis, etc.
Dengue fever - bone break fever
Why is mosquito borne illness consistent with a miasma?

7. Ticks, Fleas, Bedbugs - Examples
Lyme
spirochetes
deer ticks
Typhus
Bacteria
fleas - rats and other carriers
Bubonic plague
bacteria
fleas, then direct human
Ehrlichiosis
Ticks

8. Other agents Schistosomiasis (Aka: Bilharziasis) Flukes
Intermediate host - snail
Potentiated by the Aswan Dam
Trypanosomiasis
African: Sleeping sickness (Tsetse flies
American: Chagas Disease (Reduviid bugs)

9. Incidental Transmission
Polio
virus
fecal-oral transmission
Flies
get the virus on their feet when sitting on shit
carry the virus to food
How do you control flies?
Legal issues?

10. Transmission and Control of Vector Borne Illnesses
Usual model is that the mosquito carries the illness from an animal reservoir
can you control the animal?
can you eradicate the animal?
Vector
Can you control the vector?
Human behavior
Can you avoid contact with the vector?
Treatment
Can you treat the illness?

11. Malaria Control - - #1 debilitating infectious disease
The reservoir is human
Why is this a special problem?
Treatment
spirochete develops resistance
requires long term treatment
Mosquito control
drain the swamps
spray
Avoidance
repellant
bed nets
Legal Issues?

12. Water Borne Illness Cholera bacterium Vibrio cholerae
endotoxin - shuts down water reabsorption
Typhoid
Salmonella Typhi
human reservoir
Both fecal-oral
environmental and direct human spread

13. Controlling Water Borne Illness
Waste water management
Treatment
Disposal to avoid cross contamination
Oysters, any one?
Drinking water treatment
Chlorination
Making sure you only get treated water
Vaccinations
Limited value
Legal issues?