Communicable Diseases Part 3

Delta Variant

-Aka B.1.617.2 -Arose in India in Dec. 2020 -Designated Variant of Concern on May 11th, 2021 -Mutations on the spike protein that make it easier for it to infect human cells -Became dominant strain in US in July 2021 -Delta variant is about 50% more contagious that the Alpha variant, which was first identified in the U.K., which was already 50% more contagious than the original coronavirus first identified in China in 2019 -Symptoms are similar to those seen with the original coronavirus strain and other variants, including a persistent cough, headache, fever, and sore throat -Delta variant does seem to be more likely to lead to hospitalization and death, particularly among unvaccinated people ("Pandemic of the Unvaccinated") -2 doses of the Pfizer or Moderna vaccine appeared to be about 88% effective against disease and 96% effective against hospitalization with the Delta variant

Clinical Progression of HIV Infection

1) Acute Phase 2) Chronic Phase 3) AIDS

Proposed Best Practice Guidelines for Schools (HIV): I. Preparation of School Setting

1. Advisory committee on HIV-related issues should be established within each school district and should consist of health professionals, students, teachers, attorneys, and HIV-patients 2. The committee will adopt policy statements of relevance to students with HIV 3. Staff education and in-service training will be established. Issues for discussion should include prevention, transmission, mental health, and death. 4. Universal precautions, as set by OSHA (Occupational Safety and Health Administration), should be followed for dealing with blood-borne infections. 5. Education relating to prevention of HIV infection for students in grades K-12 (age appropriate).

Treatment for AIDS

1. Reverse Transcriptase (RT) Inhibitors -Prevents viral DNA from being synthesized -Example: Azidothymidine (AZT) 2. Protease Inhibitors -Inhibit HIV protease enzyme -Can't assemble viral particles -Most effective drugs to date HAART Therapy: "Highly Active Anti-Retroviral Therapy" -Combine several RT inhibitors and protease inhibitors -Helps to overcome ability of the virus to mutate to become drug resistant -Has contributed to decrease in HIV deaths -Has lowered viral load to undetectable levels in many and alleviated symptoms -May also help to prevent transmission from infected individuals 3. Fuzeon = prevents viral entry via fusion into host cells -Used for "Salvage" therapy 4. Integrase Inhibitors -Block function of integrase enzyme to insert HIV DNA into host cell chromosome

Transmission of HIV

1. Sexual Contact (about 75% of all HIV infections) -Any form of sex may spread HIV (oral, vaginal, anal) -Anal intercourse is more dangerous (more tears) -Likelihood of HIV infection is increased if person has other STDs *Probably due to open sores *Also STDs stimulate immune system - stimulated by lymphocytes easier for HIV to infect -Antiretroviral therapy may dramatically reduce transmission rates 2. IV Drug Use - share needles 3. Blood Transfusion - major means of transmission before -Now, better testing has nearly eliminated this factor in the US 4. Juvenile AIDS - Infants are at higher risk from HIV+ mothers -Approximately 30% of infants become infected unless mother is treated before birth -Most infected children die by age 6 Casual touching, contact, airborne are not mechanisms Must be contact with blood, breast milk, semen, vaginal fluid HIV+ mothers give birth to HIV children -Should never breastfeed their children (HIV in breastmilk)

Proposed Best Practice Guidelines for Schools (HIV): IV. Other

11. The school will provide access to AIDS information to parents and students. 12. School employees have the right to employment and confidentiality.

Summary of Global HIV epidemic (2016)

36.7 million people now estimated to be living with HIV During 2016... 1.8 million people newly infected 1.0 million HIV-related deaths

Proposed Best Practice Guidelines for Schools (HIV): II. The Enrollment Process

6. The student or parent will decide whether or not to inform the school district about the child's HIV status. 7. Only a few school personnel will receive information on the child's HIV status. 8. HIV status information will not be included in the school's health records for the child.

Proposed Best Practice Guidelines for Schools (HIV): III. Assurance of Appropriate Service

9. An individual's educational program will be designed based on educational needs, not HIV status. 10. In-school health services must be provided by the school.

New Variant of SARS CoV-2

A new mutant strain of the SARS CoV-2 coronavirus was detected in the Southern UK in late 2020 (Nov/Dec), which is 70% more transmissible than typically CoV-2 -Does not appear to have higher mortality rate -Unlcear whether vaccines will be effective vs. this new strain -Many countries blocked travel from the UK to prevent spread -This new strain was detected in US on Dec. 29th, 2020 in Colorado man who did NOT travel Other strains around as of March 2021 include Brazil, South Africa, California, New York

Clinical Progression of HIV Infection: Acute Phase

About first 8 weeks (2-3 months) after initial infection Initial symptoms of primary infection may be flu-like -Fever, lymphadenopathy, rash Marked drop in Helper T-Cell numbers -Coincides with viremia = increase in viral load in blood End of acute phase marked by Seroconversion: -Make anti-HIV antibodies -Can be detected by AIDS test (ELISA)

AIDS

Acquired Immune Deficiency Syndrome Caused by Human Immunodeficiency Virus (HIV) -Retrovirus -Infects Helper T-Cells in immune system -Uses Reverse Transcriptase enzyme to make a DNA copy of its RNA genome -DNA inserts into Helper T-Cell's chromosomes -Virus lies latent until that T-Cell is activated by the immune system

Shingles

After chicken pox goes aways, Varicella-zoster virus can lie latent (dormant) in the spinal nerves May reactivate later in life when immune system is compromised -old age, infection Infects sensory nerves (often on back) Causes Shingles (Herpes Zoster) -very painful infection

Hepatitis

All types cause liver inflammation & damage -could potentially lead liver cancer (types B & C) or the need for a liver transplant Chronic, slow progressing Most visible sign = Jaundice -Yellowing of skin & eyes Hepatitis B & C can cause liver cancer Vaccines exist against types A & B (not C) Not related to jaundice in infants -treat with bili-light Treat: Bed rest, inactivity Harvoni = prescription drug that can cure Hepatitis C

2012 West Nile Distribution

Almost 70 percent of the cases have been reported from eight states (Texas, California, Louisiana, Mississippi, Illinois, South Dakota, Michigan, and Oklahoma) Over a third of all cases have been reported from Texas

German Measles

Also called "3-day Measles" Caused by Rubella Virus Airborne transmission Incubation Period: 14-21 days Rare in US due to MMR vaccination

Antibody Tests

Antigen Tests - to determine if an individual has had a past infection This is a blood test to determine the presence of antibodies that appear 5+ days post-infection -Advantages: over 120 tests on the market, good tool to track speed of disease -Disadvantages: more tests are not FDA approved, quality is an issue NOTE: Because this is a novel virus/disease, as of May 2020, we don't know if the presence of antibodies in the blood provides long-term protection against future exposure to SARS-CoV-2

Clinical Progression of HIV Infection: AIDS

Appears after about 8 years (average) First indication is secondary infections (next card) -Due to immunodeficiency Major drop in Helper T-Cell numbers -< 200 cells/mm3 -responsible for immunodeficiency Coincides with major, exponential rise in viral load

West Nile Prevention

As of 2012, more than 30,000 people in US have reported sickness from West Nile Virus No human vaccine yet available, as of 2012 Primarily spread from birds by infected mosquitos Only about 1% of mosquitos tested positive in 2001-2002 Only means of prevention is to avoid mosquito bites and limit mosquito population -Insecticide (DEET) on exposed skin & clothes -Stay indoors at peak feeding times -Limit number of available mosquito breeding grounds -Install or repair window screens -Mosquito netting or cover over infant carriers -Countrywide spraying efforts (non-toxic) larvicides

Epidemiology (COVID-19): Risk Factors

COVID-19 can affect anyone As a new disease, ongoing research is being conducted to determine the risk factors for severe illness or complications Certain populations are more at risk: -Individuals aged 65 and older, especially those in a care facility -Anyone with an underlying medical condition, such as diabetes, asthma, kidney disease, pulmonary disease, blood disorders, obesity/metabolic syndrome, heart conditions -Immunocompromised individuals due to AIDS, cancer, blood or organ transplantation, and immune deficiencies for example

Home Treatment for Chicken Pox

Calamine lotion Warm bath with handful of baking soda Acetaminophen or ibuprofen -Don't give aspirin, can lead to Reye's Syndrome -vomiting and progressive sleepiness Over The Counter (OTC) antihistamines (Benadryl) OTC hydrocortisone cream

Secondary Infections Common with AIDS

Candidiasis (Thrush) Cytomegalovirus (CMV) Disease Tuberculosis Pneumocystis carinii Pneumonia (PCP) Kaposi's Sarcoma B-cell Lymphomas Cervical Cancer Two other conditions are caused directly by HIV: - AIDS Dementia -Wasting Syndrome (Cachexia)

Chicken Pox

Caused by Varicella-Zoster Virus Incubation Period = 7-21 days Highly contagious Varicella vaccination in use since 1995

Lyme Disease

Caused by the bacterium Borrelia burgdorferi Emerged in 1975 It is carried by deer ticks, which bite humans -Bacteria harbored in deer, field mice, and woodrats -Most common tick-borne disease in the US Initial symptoms: flu-like symptoms and "Bullseye" skin rash -Develop 1 week to 10 days after infection Can lead to arthritis and heart and nervous system problems in later stages Can treat with antibiotics in initial stages, not effective in later stages Prevent: avoid contact with ticks In the Northeast, the cycle of Lyme disease is a complex 2-year cycle that involves 2 principal hosts: mice and deer

Diagnostic Tests

Diagnostic tests - to determine if an individual is currently infected Types of Diagnostic tests available: 1. PCR Test = this was the first available test; it amplifies and detects viral genetic material (RNA) if present in a person's secretions collected with a swab -Advantages: accurate if sample is taken approximately 3+ days post-exposure, option of at-home saliva test limits the need for healthcare provider wearing PPE -Disadvantages: may not catch early infection, takes several days for results, rapid tests (results in less than an hour) lack accuracy 2. Antigen Test = this is a newer test that detects viral proteins (those that act as antigens) vs. genetic material -Advantages: results in a few mins, good screening tool -Disadvantages: not as accurate as PCR Test

Progression of AIDS

Extensive secondary infections as Helper T-cell number decreases -Hard to fight off due to immunodeficiency Eventually leads to death in about 9-12 years after initial infection -Usually due to a secondary infection, not HIV virus directly

Hepatitis

Few Types: 1. Hepatitis A = common where poor sanitary conditions -Fecal-oral transmission 2. Hepatitis B = via addicts with contaminated needles -Body fluids: breastmilk, sweat, semen -Considered a sexually transmitted disease (STD) -Those in hospitals at higher risk for Hepatitis B -More serious than A --> more chance of liver damage 3. Hepatitis C = common form found after blood transfusion or tattoos

AIDS History

First detected in 1981 in homosexual populations in NY, LA, San Francisco -Had rare infections like Kaposi's sarcoma and Pneumocystis carinii pneumonia (PCP) As of 2000, # reported AIDS cases in US was 688,200, of these approx. 420,000 have died -Estimated 45,000 people newly infected in 2000 -Estimated about 1 million Americans may be infected with HIV AIDS became #1 killer of Americans age 25-44 yrs. from 1993-1995 -Death rates have decreased recently due to improved treatments

Diarrhea

Frequent loose or watery stools Results from irritated bowels -Bacterial or viral infection -Parasites -Diet Changes -Nerves Call a doctor if (1) lasts a long time, (2) accompanies vomiting and fever

Vaccine for HIV?

HAART therapy is very expensive, is a very strict regimen, and has the possibility of serious side effects A vaccine would help to prevent the further spread of the virus and would be inexpensive So why is their currently no HIV vaccine? -Virus mutates frequently -Most vaccines prevent disease, not infection -HIV can lie latent and undetected -Normally AIDS progresses even in presence of antibodies -Heat killed HIV doesn't work -Safety of live, attenuated HIV vaccine? -Only infects humans, can't be tested for safety in animals

Omicron Variant (B.1.1.529)

Identified in Southern Africa in Nov. 2021 First US case identified on Dec. 1st, 2021 By late December, omicron became most abundant form of COVID in the US More contagious than Delta variant Replicates 70 times more rapidly in lungs than other variants Many studies suggest less severe symptoms -cough, fatigue, congestion, and runny nose as the most common symptoms 3rd mRNA vaccine booster recommended for all adults over 15 Increased masking mandates

COVID Vaccines

In Dec. 2020 Pfizer, then Moderna applied for and received Emergency Use Authorization by the FDA -Both mRNA vaccines with around 94% effectiveness requiring 2 shots -Pfizer received FULL FDA approval on August 23rd, 2021 1. First Phase = Health care workers, and nursing home residents and workers 2. Second Phase = Adults 75 & older, and First Responders 3. Third Phase = Adults 65 & older, and Adults with High-Risk Conditions One dose of Johnson & Johnson vaccine approved for Emergency Use Authorization by FDA in Feb. 2021 Astra Zeneca (Oxford) vaccine approved for emergency use in other countries, but not US as of August 23, 2021

West Nile - Clinical Symptoms in US Strain

Incubation period = 3-14 days 80% of infected individuals are asymptomatic About 20% develop West Nile Fever -Symptoms: fever, headache, body aches, nausea, skin rash, lymphadenopathy -Flu-like symptoms usually last about 3-6 days Less than 1% (1 in 150) develop severe infection -Virus enters blood, then crosses blood/brain barrier -Encephalitis, meningitis, or meningoencephalitis -Symptoms: high fever, headache, stiff neck, disorientation, tremors, convulsions, muscle weakness, paralysis, coma -3-15% fatality in those with severe infection -Most in elderly -Takes several weeks to recover from -Neurological effects may be permanent -Most susceptible are people over 50 -Due to weakened immune systems

US Outbreak of West Nile Virus

Initial breakout in NYC in 1999 By 2002, spread to almost every state Peak time for infections: Late August - Early September -Though infections can occur anywhere b/w July 13 - December 7 -Usually at dawn & dusk

Rotavirus

Most common in infants and young children Can be spread by hands, objects, food or water contaminated with feces from an infected person Incubation Period = 2 days Symptoms: fever, vomiting, watery diarrhea, abdominal pain -vomiting and diarrhea may last 3-8 days Dehydration is a major concern Good hand washing recommended to prevent spread Treatment: maintain hydration Vaccine is available for children

2012 West Nile Outbreak

Largest to date in US Due to warm winter and drought conditions As of 10/16/12, 48 states reported either human, bird or mosquitoes infected with WNV Total of 4,531 human cases, 183 deaths -4% Mortality rate -2,293 cases (51%) were "neuroinvasive" -Causing encephalitis or meningitis -2,238 cases (49%) were "non-neuroinvasive"

Dehydration

Main fear with diarrhea Signs: -Decreased amount of tears, if any -Thirst -Lips and mouth dry -Less urine (want at least 3 wet diapers per day for infants) -Shortness of breath Need to drink plenty of fluids

COVID-19: Disease Manifestations (continued)

Multisystem Inflammatory Syndrome in children (MIS-C) with exposure to SARS-CoV-2 First reported in April 2020 in the United Kingdom (UK) in children who either tested positive for the virus or had an epidemiological link Symptoms include: -Persistent fever -Hypotension -Rashes -Multiorgan involvement (kidneys, heart, GI, vasculature, neurologic) -Inflammation Symptoms present weeks after (often asymptomatic) exposure to the virus As of May 2020, the risk for contracting MIS-C are unknown

Constipation

NOT contagious Hard stool Lower abdominal pain Chronic constipation may indicate an underlying problem

Pinworm

Nematode worm (Enterobius vermicularis) Most common worm disease in kids (5-15% prevalence in US) Life Cycle: -Eggs are ingested -Eggs hatch in appendix -Mature into adult worms in about 1 month -Adults mate in intestines -Females lay eggs at human's anus, causing intense anal itching -Eggs are sticky and adhere under fingernails or on objects -Eggs ingested from contaminated food or water, or self-inoculation Symptoms: itching at anus, disrupted sleep, nausea, abdominal discomfort, diarrhea

Treatment for German Measles

No treatment available No fever or pain to treat

Treatment of constipation

Plenty of liquids Foods with fiber - rice, whole grain bread Fruits and vegetables -Prunes and figs especially Mild laxative (Miralax), oil (mineral), glycerin suppositories, enema -ASK Pediatrician

Treatment of Diarrhea

Plenty of liquids - water, Gatorade or Pedialyte (electrolytes), diluted fruit juice -Don't eat anything until diarrhea slows down Bland foods - once diarrhea slows up -BRAT Diet: bananas, rice, applesauce, toast Check Temperature -Reduce fever with acetaminophen or ibuprofen Wash hands to prevent spread Probiotics and yogurt can help replenish with good bacteria Imodium, Pepto-Bismol if child is old enough -ASK Pediatrician

COVID-19: Entry into the Host

Portals of entry include: -Nasal and oral passages of the respiratory tract -Conjunctiva of the eyes passing through nasolacrimal duct -Oral cavity and esophagus

Clinical Progression of HIV Infection: Chronic Phase

Presence of anti-HIV-1 antibody Asymptomatic Can be passing HIV to others without knowing it Virus actively infecting lymphoid organs Slow decrease in Helper T-Cell count Viral plasma load relatively stable -Kept in check by T-Cells and antibodies

Prevention of COVID: Personal Safety

Prevention - Personal Safety -In the absence of a vaccine against SARS-CoV-2, the best way to avoid becoming ill is to avoid exposure to the virus Avoidance Involves: -Washing hands often (more at least 20 seconds) -Use a hand sanitizer of >60% alcohol when washing is not an option Maintaining a safe distance from others outside the home >6 feet Covering the mouth and nose with cloth a mask in public places to avoid spread from yourself to others Clean and disinfect frequently touched surfaces often Self-isolation if sick for 14 days

Prevention of COVID: Public Safety

Prevention - Public Safety -Before areas can safely open to the public, a disinfection plan must be implemented to prevent the spread in areas that typically host high numbers: schools, public transit, aviation, shops, restaurants, churches, etc. 1. Natural Methods -Studies have shown that SARS-CoV-2 lasts hours to days (one study suggests a maximum of 7 days on the outer layer of mask) on surfaces, less in the sunlight -Leaving items untouched for over 24 hours, or outside in direct sun can reduce the risk of transmission via a fomite 2. Disinfection -The EPA has an approved list of disinfections for removal of the virus from most surfaces, particularly frequently touched surfaces such as doorknobs, light switches, ATM machines, faucets, etc. -If approved disinfectants aren't available, dilute bleach or 70% alcohol is recommended 3. Ultraviolet (UV) Radiation -UV radiation in the range of 240-280 nm is an effective germicide for removing airborne viruses and those on surfaces -Inactivation results from destruction of nucleic acids due to the formation of thymine dimers that prevent replication and transcription -This method has been used effectively in hospitals for many years, in the advent of SARS-CoV-2, authorities in other public places such as schools, offices, and mass transit are using the technology as a means of disinfection

Prevention of COVID: Safety for Healthcare Professionals

Prevention - Safety for Healthcare Professionals -Healthcare providers caring for COVID-19 patients are at greater risk for contracting and spreading the virus -A higher level of personal protective equipment (PPE) is necessary for those who risk daily workplace exposure -Appropriate care must be taken when putting on or taking off the PPE which includes: -N95 facemask (filters out 95% of airborne pathogens) -Eye protection -Gloves -Gown

Prevention of COVID: Vaccines

Prevention - Vaccines -Under normal circumstances, vaccine development typically takes >15 years from exploration to clinical use -In the case of a global pandemic, with a novel virus, the development is fast-tracked and often involves eliminating stages of testing in animals -Within the first 6 months of the COVID-19 pandemic, vaccine testing in humans began, largely due to head start from previous coronavirus research -Certain steps cannot be rushed, such as the wait to see whether antibodies against the virus develop in response to the foreign agent being introduced into the body -The goal is to induce production of antibodies that bind to the virus, effectively blocking entry into the host cell. -As of May 2020, there are over 100 COVID-19 vaccines in development

COVID Epidemiology

Public Health Pandemic Control -Effectively managing a pandemic involves 4 coordinated response measures: 1. Testing the population with speed and accuracy 2. Isolation of infected individuals 3. Contact tracing - identifying those who have been exposed to the virus 4. Quarantine = restricting movement of those who were expected

Symptoms of German Measles

Rash - looks like large patches of redness -Not series of spots like in measles -Starts on face (behind ear) -Moves down and covers body in 24 hours Slight (mild) fever Enlarged lymph nodes on neck Lasts 3-4 days ("3 day measles") Should remain at home Complications very rare

symptoms of chicken pox

Rash - small itchy red bumps -Progress to thin-walled blisters -Appear in new patches every 3-4 days -Usually starts on trunk and back, then spreads to face and legs -When blisters broken --> crusts and scabs -If scratch opens, it can get infected or form scars Fever = the more rash, the higher the fever Chicken pox remains infectious until all blisters are scabs and there are no new blisters in 24 hours

COVID-19: Virus Transmission

SARS-CoV-2 can be transmitted from animal to human (direct contact) and human-to-human (droplet) Human-to-human transmission of the virus is primarily through droplets that may travel up to 6 feet from person-to-person, through coughing, sneezing, or talking Studies suggest that the virus can become aerosolized and travel farther, remaining viable for up to 3 hours, confirmed in October 2020 by the CDC. Indirect transmission via a fomite is also a concern since the virus can remain viable on surfaces such as plastic, for up to 3 days Viral particles have been found in fecal samples and there is accumulating evidence for fecal-oral transmission. Population-dense areas, large public gatherings, and facilities such as prisons, cruise ships, and senior living centers provide ideal conditions for the spread of the virus.

COVID-19

SARS-CoV-2 coronavirus (severe acute respiratory syndrome virus Coronavirus 2) -COrona Virus Disease-2019 (COVID-19) -Cases began in Wuhan, China in early December 2019 -The WHO declared COVID-19 a Public Health Emergency of International Concern (PHEIC) on January 30th, 2020 -Declared a Pandemic by WHO on March 11, 2020 -Declared National Emergency in US on March 13, 2020 -Strain that infected Western US came from China -Strain that infected Eastern US came in from Europe

West Nile Virus

Spread by mosquitoes (primarily Culex genus) First isolated in Uganda in 1937 Initial outbreak in US occurred in 1999 in NYC Transmission cycle b/w mosquitos & birds -At least 110 species of birds have been found to be infected (especially crows & blue jays) Humans and horses are incidental ("dead end") infections -Neither are reservoirs

Zika Virus

Spread through mosquito bit -can also be passed through sex with infected man or across placenta from infected mother to fetus Symptoms include: fever, rash, joint pain, and conjunctivitis (red eyes) -symptoms usually last for several days to one week People usually don't get sick enough to go to the hospital, and they very rarely die of Zika Can cause microcephaly (small head) or other severe brain defects in developing fetus -kills developing nerve cells On February 1, 2016, the World Health Organization (WHO) declared Zika virus a Public Health Emergency of International Concern (PHEIC) Prevention: Avoid traveling to infected areas, avoid contact with mosquitos, using latex condoms (according to public health officials) Blood or urine test can detect infection

COVID-19: Disease Manifestations

Stage 1: Asymptomatic state -Incubation time: median = 4-5 days, range = 2-14 days -Virus is detected by a nasal swab and is shed by the host in droplets -Virus propagates, mild innate immune response initiated Stage 2: Upper airway and conducting airway response -Robust immune response -Clinical manifestations of disease appear 2-14 days post-exposure and include cough, fever, shortness of breath, chills, muscle pain, loss of taste and/or smell, sore throat, nausea, diarrhea -Up to 80% of COVID-19 cases will be either asymptomatic or will arrest at this stage Stage 3: Hypoxia, progression to acute respiratory distress syndrome (ARDS) within 8-12 days -Critical care/hospitalization necessary -Approximately 15% of COVID-19 patients require oxygen and 5% ventilation -Manifestations include pneumonia, difficulty breathing, persistent chest pain/pressure, confusion, inability to stay awake, bluish lips or skin. -Oxygen levels fall as lungs become filled with fluid, white blood cells, mucus, and cellular debris. -Cytokine storm leads to dramatic drop in blood pressure, leaky blood vessels, formation of bloods clots, organ failure.

Prevention of AIDS

The best way to avoid AIDS is to not become infected with HIV No IV drug use or sharing needles Abstain from sex (recommended by Church) For those with more lax moral standards, public health officials recommend mutual monogamy and condom use -Catholic Church does not condone condom use for any reason -Condoms are not 100% effective at birth control or preventing HIV infection -Electron microscope study has shown that nearly 1/3 of condoms tested leaked HIV-sized particles and some had holes that were 50-times the size of the HIV virus Avoid activities that may tear tissues -example: anal intercourse NO sex with prostitutes

Rubella WARNING!

Very important that pregnant women avoid exposure to children suspected of having German measles (GM) If she's never had GM or does not have sufficient immunity, the baby might get infected thru the placenta Can cause serious complications in fetus: deafness, cataracts, heart defects, growth retardation, encephalitis -Potentially deadly -The earlier in the pregnancy that the fetus is exposed, the more serious the complications

Treatment of COVID: Convalescent Plasma

Treatment - Convalescent Plasma -Extracting plasma from recovered patients and donating it to sick individuals has been carried out for over 100 years for a variety of disease including measles, polio, and Ebola -In March 2020, the FDA allowed treatment using donated plasma for patients suffering from life-threatening COVID-19 -The FDA considers it "promising" but not yet "safe and effective" -While the treatment is still considered experimental, anecdotal reports from patients state their condition improved significantly after the plasma was transfused.

Treatment of COVID: Drugs

Treatment - Drugs Some therapies have been suggested as being hopeful: 1. Remdesivir -The antiviral drug showed promise against SARS and MERS, also coronavirus, it works by targeting RNA-dependent RNA polymerase -Emergency Use Authorization (EUA) by FDA for COVID-19, FDA approval for COVID-19 in Oct. 2020 2. Antibody Preparations from Ely Lilly and Regeneron have been granted EUA for COVID-19 3. Dexamethasone -Steroid has shown to improve recovery of ventilated patients by 30% 4. Chloroquine/hydroxychloroquine -There is limited evidence to suggest that these antimalarial drugs effectively treat patients with COVID-19 -Some studies point to cardiac complications when used in stage 3 COVID-19

Pre-exposure Prophylaxis (PrEP)

Truvada (tenofovir and emtricitabine) is a pill that can be taken by high risk individuals prophylactically to prevent permanently contracting HIV -Both drugs are nucleoside reverse transcriptase inhibitors (NRTIs) If taken consistently can reduce the risk of contracting HIV by 92%, when combined with safe sex practices

HIV Testing

Two tests are currently being used to detect HIV infections 1) the ELISA test indicates if the patient has anti-HIV antibodies -It may take from 2-32 months for HIV antibodies to develop; therefore, there is a possibility of a false negative ELISA test. 2) the Western blot is administered for confirmation of a positive ELISA test and indicates if HIV proteins are present in the patient -The Western blot is more precise and clearly shows either HIV positive or negative.

Epidemiology (COVID-19): Statistics

When a pandemic is ongoing, the data changes daily As of July 7th, 2020 Number of Cases: US = 2,886,267 Globally = 11,500,302 Numbers of Deaths: US = 129,811 Globally = 535,759 As of August 5, 2020: Number of Cases: US = 4,748,806 Globally = 18,354,342 Numbers of Deaths: US = 156,311 Globally = 696,147 As of October 17th, 2020: Number of Cases: US = 8,028,332 Globally = 39,442,444 Numbers of Deaths: US = 217,918 Globally = 1,106,181 As of January 21, 2021: Number of Cases: US = 20,960,096 Globally = 85,091,012 Numbers of Deaths: US = 356,005 Globally = 1,861,005 As of April 6, 2021: Number of Cases: US = 30,596,830 Globally = 131,837,512 Numbers of Deaths: US = 554,420 Globally = 2,862,664 As of May 8, 2021: Number of Cases: US = 32,446,915 Globally = 156,496,592 Numbers of Deaths: US = 577,857 Globally = 3,264,143