1. Vibrio cholerae Asiatic or Epidemic Cholera

2. Readings Question #1 Describe the Vibrio cholerae bacterium. Where is it found?

3. Outbreaks no major outbreaks in U.S. since 1911 sporadic: 1973-1991 1991: South America – Peru – 1,099,882 cases and 10,453 deaths (1991-95) 1992: new strain – Bangladesh and India – 1 case in U.S. 2010: Haiti (confirmed 10/21/10)

4. Symptoms of Cholera “rice-water” stools viscous blood sudden onset, incubation: 6 hrs- 5 days violent vomiting No fever abdominal cramps, nausea, dehydration, shock 1 million organisms

5. Progression of Disease

6. Diagnosis isolated from feces recovered from foods pathogenic and non-pathogenic forms exist test for presence of cholera enterotoxin

7. Treatment of Cholera water and electrolyte replacement – oral rehydration therapy – sodium chloride, sodium bicarbonate, potassium chloride and dextrose – intravenous rehydration tetracycline untreated – 50% mortality rate death occurs from dehydration and loss of essential electrolytes

8. Bacillus anthracis 1877 isolated by Robert Koch Readings question #2: List 5 characteristics of the Bacillus anthracis bacterium.

9. People at Risk handle animals, hides, wool, and other animal products goat hair and handicrafts containing animal hides from the Middle East infection initiated by endospores 2 exotoxins: edema toxin and lethal toxin capsule does not stimulate a protective response

10. Readings Question #3 What are the 3 forms of anthrax that affect humans?

11. Treatment of Anthrax antibiotics ciprofloxacin and doxycycline preventive doses of antibiotics (60 days) vaccination of livestock – live attenuated human vaccine: inactivated form – 6 injections over 18 months – Annual boosters

12. Diagnosis of Anthrax isolation and identification from a clinical speciman

13. Biological Weapons “the use of living pathogens for hostile purposes” 14 th century: 1346 Tartar army catapulted “plague-ridden” bodies over the walls of Kaffa (Ukraine) - Kaffa “fell” and survivors escaping introduced the “plague” to Europe (began the plague pandemic from 1348 – 1350)

14. U.S. Epidemic Intelligence Service formed in 1951 (after start of Korean War) served as early warning system important role in combating epidemics and tracking outbreaks of disease 1940s-1960s: research on biological weapons – develop vaccines or treatments

15. Biological Weapons 2001: U.S. Postal Service – Bacillus anthracis – gave rise to a new term:“bioterrorism” new vaccines being developed & existing vaccines stockpiled for use when needed military personnel and first-responders are vaccinated if biological agents are a “risk”

16. Bordetella Whooping Cough (Pertussis) – 2 basic toxins: 1) tracheal cytotoxin - damages ciliated cells 2) pertussis toxin - systemic symptoms small children: violence of coughing can break ribs infants: irreversible damage to the brain occasionally occurs adults: misdiagnosed as bronchitis

17. Diagnosis of Pertussis clinical signs and symptoms throat swab culture culture on special media rapid tests available

18. Treatment of Pertussis Erythromycin Antibiotics render the patient noninfectious. Immunity following recovery is good. DTap Vaccine: 1996, minimal side effects - lowered annual cases - fewer than 10 deaths/year - effectiveness wanes after 12 years of age - elderly and infants