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.

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 at Kaffa – began the plague pandemic for 1348 - 1350 1925: 100 countries – Sino-Japanese War (1937-1945) – canisters of fleas carrying Yersinia pestis dropped on China

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

15. “Operation Sea-Spray” September 27 and 27, 1950 Serratia marcescens over San Francisco and Florida (Panama City and Key West) non-pathogenic, reddish coloration September 29: 11 patients (1 died) Pneumonia January 2008: recall of pre-filled heparin-lock flush solution

16. Serratia marcescens production of red pigment damp conditions: bathrooms complete eradication is difficult dirt, “sterile places”, biofilm of teeth hospital settings: catheters, saline irrigation solutions, sterile solutions urinary and respiratory tract infections in hospitals conjunctivitis, keratitis, endophthalmitis, tear duct infections resistant to several antibiotics

17. Biological Weapons 1972: 100 countries 1979: Bacillus anthracis in Sverdlovsk – explosion resulting in 100 deaths in 2 weeks 1984: The Dalles, Oregon – Salmonella enterica 2001: U.S. Postal Service – Bacillus anthracis – “bioterrorism”

18. 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

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

20. 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