1. Emerging and Re-emerging Diseases

2. Which killed more people: WWI (1914- 1918) or the Influenza Epidemic of 1918? World War I (1914 – 1918) death toll: 8-10 million worldwide 1918 Influenza Epidemic death toll: 40 million worldwide ~500,000 US deaths (including 70,000 soldiers)

3. Influenza “There was a little bird its name was Enza. I opened the window and in-flu-enza.”

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

5. Preparing for next crisis

6. 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)

7. Influenza Pandemics Since the late 19 th 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?

8. Flu Prevention Season cycle in late fall, winter and early spring Wash hands frequently

9. Tuberculosis Has it been eradicated? No 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

10. Pulmonary TB

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

12. TB and Oregon Public.health.oregon.gov

13. Public Health Concerns 2-3 million deaths worldwide per year Trend: Extensively drug-resistant strains = XDR TB Ex: TB treatment 6-10 months = $900 Ex: XDR TB treatment = $200,000 High-end antibiotics given through IV in hospital

14. Preventing Tuberculosis Know your risk Higher risk populations: close contact, foreign-born, low- income or homeless, health care workers, infants, children, and persons who inject drugs. Practice good hygiene

15. 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.

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

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

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

19. West Nile Virus Seasonal epidemic – summer through fall Symptoms: Most people (about 80%) will have no symptoms Approximately 19% will have mild symptoms Fever, headache, body aches, nausea, vomiting, swollen lymph nodes About 1% of population will become severely infected Neck stiffness, stupor, disorientation; may lead to permanent neurological effects.

20. WNV Prevention Avoid mosquitoes! Use repellant Wear long sleeves Avoid being out when mosquitoes are active Have good screens on windows Beware of standing water

21. WNV and Community Health Communication from health educators is vital. Unfortunately, we’re not getting the message out. Patient education works!

22. Also in the news…. Hantavirus in Yosemite National Park, Summer 2012 Hantaviruses are a group of viruses carried by some rodents. Deer mouse, white-footed mouse, rice rat and cotton rat. In every state except Alaska and Hawaii. Symptoms: Fever, severe muscle aches, fatigue, respiratory issues.

23. Hantavirus prevention Hantavirus is spread through the air. Practice good hygiene Be careful of mouse / rat droppings, urine, etc Don’t sweep or vacuum