Global Health

What are the 2 species that cause bacillary angiomatosis

-Rochalimaea henselae - cat scratch disease (cats have rochalimaea in blood transmitted by fleas) - Rochalimaea quintana - lice carry bacteria, common in homeless trench fever in WWI

Typhoid fever symptoms include

-headache, -malaise, -fever, -constipation, -rarely diarrhea, (later rash on belly and chest, distended abdomen, tenderness, enlarged spleen)

Mary Mallon's options to decrease infection

-stop cooking, get gallbladder removed, laxatives and diaretics

How bad was 1918 flu

1 billion cases reported, 50 million dead, 2.5% mortality (25 fold more lethal than seasonal flu)

Incubation period for the flu _ to _ days, duration of symptoms are _ to _ days infectious period for adults is _ to _ days

1-3, 2-7, 3-5

What were the guideline aims for the UNAIDS group

1. reduce sexual tranmission 2. reduce IV drug user infection 3. eliminate HIV infection among children 4. reach 15 million people living with antiviral treatment (costly and risky) 5. reduce TB deaths in people living with HIV

____ is the number of deaths by AIDS in 2014

1.2 million

How many HIV virus are made by asymptomatic patients

10 bilion

There are __# of mutants of HIV a day

10 billion

SARS mortality was __%

10%, considered high for flu standards

Typhoid fever can be fatal in __% of cases

10, lower than ebola and black death

Thai vaccine trial

16000, slight success but 51 contracted HIV

US trail

19 US cities, 2 vaccines to 2500 men and transgender women, HIV genes in adenovirus, 41 vaccinated and 30 unvaccinated got HIV

How did the spanish flu begin

1918: Europe and germany involved in WW1 and spanish news papers were reporting on the flu

The influenza vaccine takes __ week(s) for protection

2

Tauberberger and Tumpey identified

2 amino acids in H not in avian and seasonal and if antigenic drift occurred it would reemerge as Spanish flu

____ number of new infection

2 million

Outbreak

2 or more people in same place with same symptoms at same time

Flea bite with yersinia pests leads to

2-8 days fever, 2-3 days buboes, 30-70% mortality

____number of children living with HIV

2.6 million (decreasing)

Drift occurred in Bird flu because

2005 strain different from 2004 strain, isolates from north and south Vietnam were different

Swine flu outbreak in what year?

2009

First American death was in what year?

2014, traveled to asia

Mortality rate of Marburg is______ treatment is______

25-90%; Supportive care, no drugs are available

Typhoid mary was quarantined on North Brother Island for

3 years

Crimean congo has ____% mortality

30

Where (what areas (rural/urban) ) was this popular in? What age?

30% in rural areas with young active adults

TB has existed since

3000 BC in Egypt

____ are the number of people living with HIV

37 million (36.9 million)

H7N9 has __% mortality

39

What countries do you see high levels of TB

3rd world and some asian countries (north Korea)

What area of US was hit with HPS?

4 corners area (colorado, utah, new mexico, arizona)

What drugs are available for influenza

4, amantadine and Rimantadine (only work for type A) Relenza and Tamiflu (work for A and B) need to take w/in 48 hours after

PreAIDS stage occurs when CD4 levels are

499 to 200

Mortality of HPS is__%

50%

Bird flu has __% mortality but is rarely transmitted from ____ to ____

50(58)% mortality, human to human

Outbreak is deemed over when you can go _____ without a reported case

6 weeks

Vaccine production takes __ to __ months and are usually _ to _%

6-9; 70-90% (30-40 in elderly)

Korea reacted to MERS

68 yo businessman gave suspicion that those were sick in hospital thousands were quarantined, Just had scare in Thailand also

There are __ steps to study a new epidemic

9

AIDS stage occurs

<200 cells/microliter

Acute stage occurs when CD4 levels are

>500 cells/microliter

Asymptomatic stage occurs when CD4 levels are

>500 cells/microliter

Each of the following is true about diagnosis and treatment of TB EXCEPT: A. A two week drug treatment is usually effective against TB B. It is recommended that patients be observed taking each dose of their drug treatment for TB C. Diagnosis includes a PPD test, which involves injecting protein into your arm D. The BCG vaccine consists of a related mycobacterium, Mycobacterium bovis

A. A two week drug treatment is usually effective against TB

The following is true of the spanish flu of 1918 EXCEPT: A. Almost all affected were newborns and the elderly. B. Named for the country whose news outlets reported the outbreak. C. Spread world wide in part by soldiers returning from World War 1 D. Kansas City was significantly affected.

A. Almost all affected were newborns and the elderly.

Differences between bird flu and swine flu include the following EXCEPT: A.Bird flu has high human mortality (~50%); swine flu has relatively lower mortality (<10%) B. Bird flu affects mostly humans, swine flu affects mostly pigs C. Swine flu is human transmissible, bird flu is not D. The seasonal flu vaccine protects against swine flu, but not bird flu

A. Bird flu has high human mortality (~50%); swine flu has relatively lower mortality (<10%)

Each of the following is a learning objective from Biol319 EXCEPT: A. Describe the genes within a microbe that contributes to its pathogensis B. Compare and contrast the major new and reemerging infectious diseases in the world today C. Name and describe causative agents of these diseases D. Discuss the factors (social, economic, geographic) that contribute to the emergence of these diseases

A. Describe the genes within a microbe that contributes to its pathogenesis

Major public Health responses to a new disease includes each of the following EXCEPT: A. Develop a test tube model of the disease B. Develop a diagnostic test C. Develop a treatment for patients D. Develop a vaccine to prevent new infections

A. Develop a test tube model of the disease

The epidemic on HIV is A. Growing B. Decreasing

A. Growing

Most men in the US get HIV/AIDS from: A.Men having sex with men B. Heterosexual sex C. IV drug users D. Aerosols

A. Men having sex with men

The following are true of Antigenic Drift EXCEPT: A. People can have pre-existing immunity to a new virus despite the mutations in the new virus. B. An updated flu vaccine is needed yearly because of mutations in the flu virus C. RNA viruses are prone to mutations D. Can result from assortment of the RNA segments in the virus

A. People can't have pre-existing immunity to a new mutated virus

Each of the following is true about seasonal flu EXCEPT: A. Rarely human transmissible. B. RNA virus, subject to antigenic shirt and drift C. Cycles between northern and southern hemispheres, so it is in South America, Australia, Africa during summers here in the US. D. Characterized and typed by two surface proteins, H and N

A. Rarely human transmissible, flu's main mode of transmission is human to human

The following are HOST factors important for the HIV life cycle EXCEPT: A. Ribosomes B. Coreceptors CCR5 and CXCR4 C. CD4 HIV receptor D. Reverse transcriptase

A. Reverse transcriptase

Factors that contributed to Black Death in the 1300s include each of the following EXCEPT: A. Student populations in local universities B. Fast ships and trade routes to china C. Rats, fleas, and humans living together D. Religious pilgrimages

A. Student populations in local universities

Treatment for HIV has changed since 70's-80's with the drug use of

AZT that interferes with reverse transcriptase

AIDS stands for

Acquired Immunodeficiency Syndrome

ARDS can occur from complications of

Acute respiratory distress syndrome from disturbing respiratory lining, Influenza (causes hospitalization, death)

Specific HPS symptoms include:

Acute respiratory distress syndrome, shock and cardiovascular instability, capillary leak syndrome, as well as fever with chills, muscle aches, headache

Arrange in chronological order: Asymptomatic, AIDS, Acute, PreAIDS

Acute, Asymptomatic, PreAIDS, AIDS

How do we know HIV emerged in Africa?

Africa has the most divergence, having the disease the longest

4 phrases to avoid HPS

Air out, Seal out (dime size), Trap out, Clean out NO VACUUM

HPS is associated with what country

America; Couple in 1993 die within days of each other

Salmonella is both ____ and _____; gram ___

Anearobic and aerobic; negative

2 viruses enter 1 cell and can create a genome that can infect either of the originating virulent population

Antigenic Shift (swine flu for example)

A hybrid virus with genes from 2 different (associated) viruses is an example of

Antigenic shift

H5N1 began in (country)_______

Asia; poultry

HFRS is associated with what country? What does it affect?

Asian version affects the Kidneys (Renal Syndrome)

What age usually affected by HPS?

Average age 33

H5N1 is known as

Avian influenza (bird flu)

Typhoid mary was a A. Maid B. Cook C. House mom

B. Cook

After coming back to society Mary worked as A. Science Researcher B. Cook at hospital C. Daycare worker

B. Cook at hospital -_-

Each of the following is true concerning HIV antiretroviral therapy EXCEPT: A. The reverse transcriptase inhibitor AZT dramatically reduces transmission of HIV from mother to child. B. Current drugs can eliminate the virus from the body. C. Drugs can inhibit fusion, reverse transcription, or protease maturation of the virus D. Most patients in 2016 receive a combination of drugs with different modes of action

B. Current drugs can't eliminate the virus from the body

Each of the following is a consequence of Black Death EXCEPT: A. Fall of nepotism (passing positions of authority to your children) B. Fall of technology C. Rise of the middle class D. Rise of capitalism

B. Fall of technology

Each of the following is true about current Flu vaccines EXCEPT: A. Each year, the Center for Disease Control predicts which viruses will cause seasonal flu and directs the vaccine manufacturers to make a vaccine to those viruses. B. If you get the flu within two weeks of receiving the vaccine, it was caused by the vaccine. C. Vaccine is safe and recommended for pregnant women D. There is a new method of making vaccine that does not involve fertilized chicken eggs

B. If you get the flu within 2 weeks of receiving the vaccine it was caused by the vaccine.

Since January 2014, which of the following has killed the most people: A. Ebola B. Influenza C. Typhoid D. Plague

B. Influenza

Each of the following is a part of the HIV life cycle EXCEPT: A. Reverse transcription into DNA B. Rolling circle replication of the genome C. Integration into the host cellular genome D. Fusion of the virus to the cell membrane

B. Rolling Circle replication of the genome.

Vaccine for TB

Bacillus Calmette-Guerin live attenuated bacterium, 120 million doses annually, Mycobacterium bovis (cow)

Negative strand RNA must first..

Be copied by RNA dependent DNA polymerase

Unusual treatments occurred such as

Berlin experiment with bone marrow transplant with CCR5 mutation (successful), bone marrow transplant without mutation wasn't successful

Many ____ were killed to prevent the spread of bird flu in hong kong

Bird (poultry)

Quarantine was considered in US with what flu?

Bird flu (bush)

Bolivian Hemorrhagic is also called ____ ____ carried by ____

Black Typhus; Mice

How is HIV transmitted

Blood, semen, mucus correlated with number of partners, STDs,trans-placental, breast milk,

SARS was identified in what circumstances?

Businessman IDed by Ubani traveled to Guondong Province in southern china (both died)

The total number of people living with HIV/AIDS is approximately: A. 3.7 million B. 11.2 million C. 37 million D. 112 million

C. 37 million

Each of the following is correct correlation EXCEPT: A. RNA dependent RNA polymerase and RNA virus replication B. DNA dependent DNA polymerase and DNA replication C. DNA dependent RNA polymerase and protein translation D. RNA dependent DNA polymerase and HIV

C. DNA dependent DNA polymerase

All is true for haunta virus except: A. animal reservior in US deer mice droppings B. Lung disease most common in western hemisphere C. Best to vacuum cabins before sleeping in D. Kidney disease is most common in asia

C. Do NOT vacuum cabins

The following is true concerning women in the US and HIV/AIDS except: A. A majority of women were infected by heterosexual sex B. A majority of HIV/AIDS infected women are black C. Female infections with HIV/AIDS outnumbers male infections. D. Are more likely to get HIV from their male partner than to give HIV to their male partner.

C. Female infections with HIV/AIDS outnumbers male infections

Each is true about MERS except: A. Mortality is 36% and falling B. Outbreak in South Korea due to family care for infected C. Originated in India Animal Reservoir in Camels

C. Originated in india, primitive cases of MERS was seen in Saudi Arabia, Quatar, and Jordan

The following is true about TB in the US EXCEPT: A. More common in homeless populations B. More common in states with large immigrant populations. C. Very uncommon in Native Alaskan populations. D. More common in people born outside the US

C. Very uncommon in Native Alaskan

How does HIV virus recognize host cells

CD4 receptor proteins on surface of WBC, CCR5, CXCR4 act as "coreceptors", CCR5 - early, CXCR4 - later

Cytomegalovirus

CMV herpes like DNA virus, attack eyes, colon, throat, causes blindness, protease inhibition for HIV can increase chance of CMV retinitis

PreAIDS Opportunistic infections are

Candida, Oral hairy leukoplakia

Disease

Cell damage, loss of health by a specific agent

The black death probably began in _____ with the opening of the ____

China in 1320's; silk trail

H7N9 is mostly in

China, those working with poultry

John snow was able to eliminate ___ via removing an infected pump handle

Cholera in an area

What animal is SARS found in

Civet cats (badger like) and Horseshoe Bats

SARS transmission from animal reservoir is suggested form

Civet cats being eaten in Asia, horseshoe bats also food

Another asian contribution is

Cock fighting

How do Hemorrhagic Viruses function

Collapse of the blood system with bleeding from mouth, nose, eyes and profound prostration mortality/death rate viruses 20-70%

Syndrome is

Collection of symptoms/ collection of agents causing similar symptoms

SARS is a ____ virus using what genetic make up?

Coronavirus, RNA

What if spanish flu came back?

Could treat with bacteria, vaccine would be too late for most (takes 6 months)

what laws were made to protect from the Spanish Flu?

Couldn't have more than 20 people in a room, closed churches and schools, elevators and telephone booths sterilized daily, 7100 deaths

The folloowing is true about Mycobacterium tuberculosis EXCEPT: A. One of the top 3 infectious disease killers in the world B. Acid fast bacterium C. Slow growing D. Destroyed by white blood cells (phagocytes)

D. Destroyed by WBC

Epidemiology terms include the following EXCEPT: A. Endemic - disease present at constant rates in a country B. Pandemic - disease at higher rates throughout the world C. Morbidity - loss of health, loss of normal function D. Epidemic - disease introduced from into a new country from somewhere else

D. Epidemic; that is the disease at higher rates than expected in a country

The 2014 Ebola outbreak was unique compared to previous outbreaks in each of the following ways EXCEPT: A. No Stockpile of resources B. Found in major cities, not rural villages C. West Africa instead of central Africa D. Had 10 fold higher mortality

D. Had 10 fold higher mortality

Various hemorrhagic diseases are thought to be spread by all EXCEPT: A. Rats B. Monkeys C. Bats D. Ticks

D. Ticks

DNA viruses use a _____ dependent _____ polymerase to replicate

DNA dependent DNA polymerase

What enzyme makes RNA using DNA template strand?

DNA dependent RNA polymerase

Why is creating a cure for HIV so unlikely

DNA is inserted into cell's genome where it is maintained for life of cell

EBV is what kind of virus

DNA virus

Kaposis sarcoma is a ____ virus also known as

DNA; KSHV/KSV related to herpes treated with radiation, chemotherapy, antivirals

Animal reservoir in HPS

Deer mouse, dropings (peromyscus maniculatus) easily aerosolized

What are concerns of HIV vaccination

Don't want killed, inactivated or attenuated HIV (too risky) recombinant DNA, subunit, protein, DNA

High CD4 Tcell levels keeps the viral load

Down

Hosts of haunt are

Droppings of Mice, rats, squirrels, chipmunks, not humans

Antibody testing can be done with

ELISA test or Western

How'd the plague affect Europe

Economically, politically, socially

MERS reservoir is

Egyptian tomb bats, mainly juvenile camels

SARS was higher in mortality of what age group

Elderly and those 45-64

HIV/AIDS is an A. Pandemic B. Epidemic C. Pulmonary disease

Epidemic

Oral Hairy leukoplakia is caused by

Epstein-barr virus which also causes mono

True/false: The plague kills rodents

FALSE

T/F: The Spanish flu began in spain

FALSE!

True/False RNA is very stable

FALSE! Less stable than DNA

T/F: Duesberg was a scientist that identified the HIV virus

False! Duesberg didn't believe that HIV caused AIDS

What symptoms are found in Lassa Fever

Fever, aches, pains, Multi-organ failure, lungs, heart, GI tract, nerves

Specific HFRS symptoms

Flank and abdominal pain; along with fever, chills, weakness, fatigue mortality less than 10%

A new way to produce vaccine being produced is called

Flublok, rapid production, HA viral proteins grown in insect cells

Pneumocystis is what kind of infection

Fungus/yeast, everyone has pneumocystis

What is the HIV viral cycle

Fusion with cell and releasing RNA inside, RNA is uncoded via gag protein, reverse transcribed into DNA that enters the nucleus and is inserted to the host cell genome that then treats it as any part of genome which can be transcribed to RNA and translated to virulent proteins to assemble more HIV virions

Marburg outbreak occurred first in____ in_____ (animals)

Germany; green monkeys imported from Africa

Other bird flus have been

H10N8, H3N8, H5N8, H9N2

The 3 most popular flue types in humans are

H1N1, H1N2, H3N2

HAART therapy is helping but

HIV resistance is developing to HAART

Where are the 2 types of HIV most common

HIV1 - most places in the world, 2 - more significant in Africa, wasting or sliming disease.

How do HPS and HFRS differ?

HPS: America, Lungs, High mortality HFRS: Asia, Kidneys, Low mortality

What sexually transmitted diseases?

HPV, syphilis, hepatitis

Arrange these in the order they arrived: MERS, Hanta, SARS

Hanta, SARS, MERS

The Hanta virus began in (Country)

Hantann River China

Ebola is apart of what type of virus?

Hemorrhagic Viruses

What is HAART? When was it introduced?

Highly Active AntiRetroviral Therapy two RT inhibitors plus one protease inhibitor, effective in about 70% of patients, restoration of immune system, elimination of Opportunistic infections

Mary was found to be a ___ after death

Horder

Treatment of Hanta are

ICU, ventellator, antivirals full recovery if caught early

Why was Mary so Stubborn

Immigrant (irish) lower class citizen, inconsistent stool results, woman

What is the most lethal infectious disease in US right now?

Influenza

First wave of US infected what state

Kansas at fort riley, poor heating, poor sanitations

What viruses are classified as Hemorrhagic Virus

Lassa Fever, Ebola, Marburg/Green Monkey disease

Lassa Virus first case in what country

Lassa Nigeria

Why did the first plague die out

Low transportation (disconnecting towns), no good rodent population, population was small

Tuberculosis affects what part of the body?

Lungs

Is found with CD$ below 50

MAC

In general the dominant gender with HIV has been

Men

MERS had preference for what group of people

Men (possibly because found more in camel care)

What population do you typically see infected with HIV

Men found to have infection more

Immigrants from what countries are more of the TB seen from

Mexico, Philippines, India

Swine flu started in what country

Mexico, two cases later confirmed in California

Plague of justinian

Mid 500's, loss of population, end of western empire, no mention after 767

MERS started where?

Middle east, appeared to be H to H in low levels

Another issues other than poultry is

Migratory birds that travel to Alaska with Asian birds

Western

More sensitive - separate HIV proteins on gel and compare genes of patient with protein

Fallowing are true about SARS except: A. Mortality is 50% B. Origninated in CHina C. Animal reservoir civic cats/bats D. Pandemic lasted some years then vanished

Mortality is 10%

Is there an animal reservoir for HIV ?

NO! no infection can be caught by animals

The plague caused rise to universities by

Need for people to up education and work, dying people donated to universities, people didn't want to travel so local institutions

Relenza and Tamiflu inhibit

Neraminidase in influenza, resistance growing over 20%

Why 1347?

New species of rat in europe, High population density, better ships for year-round trade, lasted until 1700

Why did it go away?

New species of rat more "people shy", great fire of london (less thatched roof use), more stone buildings

Concerns of H1N1 were

New strain, no prior immunity, young children (elderly had partial immunity)

Why can't vaccines be given to children younger than 6 months

No immune system to properly build antibodies against vaccine

The spanish flu was popular among what age of people

Normal healthy men (20-40) (trench warfare)

Influenza spends winter time in

Northern hemisphere

How do you know if you have the flu or a cold

Not stuffy nose, sneezing and soar throat (cold);Flu is fever, headache, fatigue

How did Soper figure out Mary was infected?

Noticed record of typhoid outbreaks associated with this woman

Other corona viruses that appeared in 60's

OC-43 and 229E

What can distort the central dogma

Pathogens (yeasts, parasites, bacteria)

What plague caused death within 24-36 hours?

Plague Septicemia (bloodstream invasion) 100% fatal

HIV proteins are

Pol - polymerase, Gag - core, Env - envelope surface, small proteins - control virus

HIV 1 originated in what reservoir

Probably chimpanzees in central africa (Cameroon, 1950)

What 2 diseases can be caused by candida

Pseudomembranous and erythemathous candidiasis; no testing needed just open mouth

Diagnosis

Purified Protein Derivative, Chest x-rays

What places in Middle east affected by MERS

Quatar, Jordan, Saudi Arabia

Hanta is what kind of virus?

RNA (slopy, error prone)

An RNA virus will use _____ dependent ___ polymerase to replicate

RNA dependent DNA polymerase

Influenza is what kind of virus? what does it use for replication?

RNA virus, uses RNA dependent RNA polymerase

Timing of stages in HIV

Rapid progression (about 10%) - AIDS within 2-3 years of infection Normal progression - AIDS within 5-10 years after infection Slow progression (10-20%) - No AIDS even 10-20 years after infection

Lassa is carried by _____ transmitted through ______

Rats; feces/urine

Merck vaccine trial

Recombinant DNA in an adenovirus vector; 3000 participants (1/2 placebo); people became HIV positive (49 vs 33)

Prevention

Report disseased, kill flocks of birds

MERS affects what part of body

Respiratory and Kidney problems

Ine inhibition indicates

Retroviral inhibition

HIV is what kind of virus?

Retrovirus - makes DNA from RNA;

What antiviral drug is available to treat Lassa Fever symptoms?

Ribavirin can control the virus

What increased exposure in Asia of HFRS

Rice/Wheat harvest due to rodents eating grain

Infected reservoir of bubonic plague is various

Rodents

TB in western states incluede

Seattle homeless population, cost 2.1 million/ year on outbreak, san fran cisco maternity ward, Emory university hospital in ATL, TB in Dublin prison (ireland), Kansas City Kansas (2011), Florida in 2012 (13 deaths)

What bad choices of 2014 encouraged spread of influenza

Selected viruses not effected, andtigenic drift (strain mutated)

Herpes Zoster also known as

Shingles, latent chicken pox

What countries are included in the Lassa Belt?

Sierra Leone, Guinea, Nigeria, Liberia (LNSG)

Why'd HPS outbreak occur in 1993?

Significant rainfall, large piñon nut crop, large rapidly multiplying deer mouse population (more excreta and more accidental human infections)

What strain was isolated in rodents of 4 corners area?

Sin Nombre strain

HIV 2 virus originated in what reservoir

Sooty mangabey monkey of west Africa more like SIVsm than like HIV1

Side effects of influenza vaccine can be

Soreness at site, Guillain-Barre syndrome (temporary CNS paralysis)

You see TB in US in what states?

South west, South, upper east place with larger proportion of immigrants Also alaska and hawaii have higher amounts of immigrants with TB

What other countries have been dramatically affected by the plague

Spain (3 plagues), China,

Where do you find the most HIV infections

Sub saharan Africa and Russia

Andtigenic Shift

Sudden, drastic change in antigenicity, No pre-existing immunity, lead to pandemic

Influenza is in southern hemisphere in what seasons?

Summer months

Why were authorities so stubborn

Super found first US carrier (documented), perfect longitudinal study, wouldn't be missed, culture clash

Influenza contains ___ proteins which are...

Surface; H - hemagglutinin and N - neuraminidase

What are the 3 biggest killers of the world

TB, Malaria, AIDS

T/F: HIV doesn't kill you, the opportunistic infections that your immune system can't fight does

TRUE

Diagnosing HIV

Test for HIV 1 and 2 in blood banks, (viral load, highly sensitive), personal tests (usually for HIV 1, only antibody)

The tragedy of typhoid Mary was made worse by each of the following EXCEPT: A. Availability of treatment that was never administered to Mary B.An over-zealous investigator C. Mary's refusal to believe the "science" D. Mary's return to cooking (in a hospital) after her first release

The availability of treatment that was never administered to Mary

What states have higher rates of HIV

The south, DC, California, Nevada

Reservoir is different in that

They are not affected/killed by the virus able to maintain life with the pathogen. No physical sign of pathogen.

Why do you see an increase with younger population today? "second wave"

Think virus is controllable, those that have been on antiviral drugs grow resistant and more virulent strain passed

Crimean congo is ____ borne and found in ____?

Tick borne; live stock

What is trivalent and quadrivalent

Trivalents have 3 different strains, Quadrivalent contains 4 different strains, 2 As and Bs,

T/F: Swine flu became Dominant flu of 2009

True!

True/False: Yersinia is a young disease (only causing disease for 5,000 to 10,000 years)

True!

When CD4 count falls below 200 WBC what will you see

Tuberculosis, Pneumocystis carinii, Kaposi's Sarcoma

Which type of influenza causes the most problems

Type A

Mary Mallon is also known as

Typhoid Mary

Boss man McGee is seen as the "____ ____" of what disease

Typhoid mary of HIV, from STL, knowingly infected 67 partners

Which test for HIV is more sensitive and more exact?

Viral load test

Who was involved with the craze of swine flu?

WHO announcing pretense and MEDIA explosion

Plague is now endemic in

Western US, Canada and Mexico

Is swine flu apart of seasonal vaccine?

Yes!

Does south America have Hanta virus?

Yes, more western

Hanta is a ___ disease causing disease in humans having an animal reservoir that is asymptomatic or symptomatic

Zoonotic

Spread from animals to human transmission is

Zoonotic

Salmonella infection of GI tract lasts

a few days

Safest form of HIV protection

abstinence

Pneumonic plague is spread by

aerosols (sneezing, coughing) 100% fatal

Typical set up of influenza vaccine contains

always an A and a B strain

Epidemic

an increase in number of cases of a disease over that rate usually not found (ebola 2014)

The disease gets transmitted through

animals infected with the disease by bats or bats infecting a person

H7N9 is

another bird flu, doesn't kill the birds

The plague can be treated with _____ if caught early

antibiotics

Typhoid fever can be treated by

antibiotics and vaccinations

Most personal tests test for presence of _____

antibodies

OraQuick tests for

antibodies of HIV, 20 minute home test, diffuses across HIV proteins from saliva

What treatments available for candida

antifungals, precription, resistance was a problem before HAART

What treatment is available for shingles?

antivirals like acyclovir

blastomyces

associated with swamps, found on skin

H3N2 has what components

avian, swine, and human components, 18 cases in US

Prevent Hanta (HPS) is

avoid rodent urine, feces areas, keep buildings/ cabins clean (no rubish), remove debris

Rochalimaea causes

bacilliary angiomatosis on blood lymph, spleen, genitals

Ebola virus found in____ (animals)

bats (fruit bats)

The biggest plague outbreak was

black death

Effects on jews on the plague

blamed for poisoning wells, pope came to aid, strousburg government

Aphthous ulcers

blisters - oral and genital (speck, flake blister), cause unknown, 3% of AIDS patients, treatment - thalidomide (problem in pregnancies, terrible drug)

Salmonella are able to survive white blood cells by

block fusion with lysosome and WBC

Ebola is spread by

body fluids (sweat, blood, saliva); airborne only in lab (normally no)

The Marburg disease is spread through

body fluids, airplanes are a concern as a model of transmission

MERS is like SARS because

both are coronaviruses, those with antibodies for SARS had some similar to MERS but not exactly (Cross-reactive to SARS)

New rules formed from researching bird flu include

carefully monitored in lab, concern about aerosol mutations

Cryptococcal meningitis

cause yeat/fungus cryptococcus neoformans, associated with bird droppings and soil, lung to brain infection

double "shift" is

change in H and N at the same time

Labor shortage affected by plague by

cheaper land, bougoise higher wages paid for unwanted jobs

The plague that almost was occurred in

china via expansion of 1850

The plague caused rise of :

cities, food surplus, capitalism, rise in protestanitism/reformation, anarchy lead to democracy in the west

ELISA test

coat plastic dish with HIV proteinand patient sera added - if positive antibodies will recognize protein and after washing (antibodies stay in tact) and flooding with stain signal will appear on well

Endemic

commonly distributed in a region, common infection

What issues come with HIV testing

compulsory (military, sex offenders, commercial sex workers (CSW - prostitutes), should parents know, jobs, health insurance

First step of studying a new epidemic is to

confirm existence of outbreak

Why afraid of bird flu

could shift to H to H transmission, no immunity to H5N1

TB in the US is on the

decline

AZT was great because

delayed onset of AIDS, side effects, single drug was easy to use, decreases mother to newborn transmission GREATLY (24% vs 8%)

How do people die from AIDS

depletion of CD4 T cels start at 1000-2000 microliter and end less then 50 increase opportunistic infections

Crypto treatmen is

difficult to treat once in brain, resistance, need prevention after

OIs appearing below 100 CD4

dimorphic fungi: able to exist as hyphae in ground, yeast in blood, blastomyces

DALY

disability adjusted life years, measure of morbidity and mortality associated with disease

PCP can be treated by

drugs, easy resistance, aerosolized drugs

Age group more likely to get disease

elderly, Native Hawaiian and pacific islander population

Recovery means

eliminated or suppressed the agent with immunity from new infection, with no immunity possible reinfection

White blood cells ____ typhoid pathogen

engulf

What issues came with multitherapies

expensive, non-compliance, difficult to remember, counteracting side effects

Typhoid fever is spread via

fecal oral contamination (salmonella, food poisoning)

Late phase

fever, drop in CD4 cells,high levels of virus, stop making WBC and full blown AIDS progresses,

Yersinia pestis (bubonic plague) transmitted by

fleas

Diagnosis for Hanta include

flu symtpoms, white cell count drops, exposure to mouse dropings

Salmonella enteric is a ____ borne illness

food borne

Histpplasmosis

found in blood, from bird dung, found more in midwest/eastern

Coccidioides

found more in US and South america, in ground, spores under ground and aerosolized

Does antigenic shift occur in bird flu?

from birds to humans, if became human to human it'd be terrible

Once in humans Lassa may be spread

from one human to another

Penicillium marneffei

fungus, related to fungus that produces penicillin, found in SE Asia, skin infection

What targets can drugs focus on to fight HIV virus

fuzeon (fusion of cell), CCR5 blocker, reverse transcription, integration, protease inhibitors in maturation of virus

Salmonella enterica causes

gastroenteritis,

Symptoms of Ebola include

general malaise, organ failure, rapid demise (7-14 days) high fatality (no treatment but supportive therapy)

Pandemics of flu tend to be

genetic shift

Treatment/Prevention of MERS

grow virus in pig/bat cells, model virus to develop vaccine, vaccinate camels (more juveniles shedding virus) immunize newborn camels

Vaccines are produced by

growing in chicken egg, inactivate, kill through chemical means, purified and test it

Infection

growth of the agent within a host resulting in damage and disease

Colonization

growth or persistence of agent w/o disease

Prevention of swine flu

hand washing, masks on patients (not uninfected)

Case def'n for SARS was

having pneumonia with no known cause ARDS, traveled to Guondong or had contact with someone, after feb 1, 2003 you were suspected high risk

Crimean Congo is what kind of virus

hemorrhagic

Acute phase of HIV

high levels of virus, highly infectious, no antibodies to test positive for (too soon)

What reasons should you not get vaccinated

history of GBS, illness with fever, previous reaction to vaccine, allergic to eggs

Crypto comon in

homeless and city dwellers

Where do you find HPS

homes, barns, storage, old cars, garages, wood piles (abandoned areas with rodents living freely)

Pasteur and Koch were able to

identify yersinia and its reservoir using the studies of their students leading to increased ship care

TB in Kansas city seen in

immigrants and Homeless

Treatment of MAC

in 50% of late AIDS treated by antibiotics

2014 Ebola differs because it was also found

in West Africa with the Lassa Belt

Pneumocystis resides

in lungs

Net effect of plague resulted in

increased standard of living.capitalistic society emerged and western civilization developed

Bacilliary angiomatosis means

induces growth of blood vessels causing nodules

MERS r factor being less than 1

infected people infect less than 1 other (won't be pandemic)

Influenza named from

influence of cold

TB works by

inhibiting lysosomal fusion with phagocytosis cells allowing it to survive in WBC

What complications arise with an HIV vaccine

its an RNA virus, diverse, infects CD4 cells part of immune response, integrates into genome, short time from infection to integration

Economic affects of plague

jobs opened up (death of those that worked or migration out of town), higher lethargy about jobs, increased dead priests and doctors encouraged people to branch out in work abilities

Population effects of plague

killed 1/3 of population then another

HFRS mortality was

less than 15% fatal

SARS lasted about __ year(s)

less than a year

Pneumocystis is most common _______ OI in patients

life-threatening

Chronic carriage

long term effects, could be reactivated., colonization (candida)

Morbidity

loss health, malaise, loss of normal function incapacitation by disease

Mortality

loss of life

Asymptomatic phase of HIV

lower, but constant viral levels, body has made antibodies, generally good health, could last for years and still making virus

H5N1 affects what part of the body

lungs

Hanta infects the _____ system by

lungs, breathing in droppings of infected rodents

HPS targets what body part

lungs, liquify lungs

yersinia gets into the body and is filtered into _____; they are able to survive in ____ and eventually invade _____ ______

lymph nodes; white blood cells; blood stream

What cells contain CD4 receptors

macrophages, t-helper cells, nerve cells, dendritic cells

What is the highest risk for spreading HIV and AIDS

men having anal sex with men

What was found in Merck trial

men were uncercumsized

What water borne parasites are HIV infected people susceptible to

microsporidia, Isospora

Symptoms of Marburg:

multiorgan hemorrhaging (which is rare for other diseases)

MAC is

mycobacterium avid complex related to TB found in water, soil, causing blood stream infection (lung infection in healthy)

What pathogen causes TB

mycobacterium tuberculosis, acid fact very slow growing

yersinia pestis is gram

negative rod

Does influenza effect pregnant women

no

AIDS definition

now: HIV positive and CD4 count less than 200 microliter, or AIDS opportunistic infection

Incidence

number of new infected

Kaposis sarcoma is disease found of

older men of mediterranean or jewish descent

Cryptosporidiosis is a

parasitic protozoan, found in intestines, avoid contaminated water

Transmission of TB typically passed on from

parents to children and remain latent in children lungs for years or decades or can be reactivated

Challenges to control TB

patience compliance, reinfections, rapid progression, high infectious patients, drug resistance, developing countries, high rates of ongoing transmission

if yersinia pestis infect the lungs it is referred to as

pneumonic plague

Drift of HIV

polymerase makes mistakes

Symptoms of TB

productiv, prolonged cough, chest pain, coughing up blood, constipation, fever

Vir indicates what kind of inhibition

protease inhibitor

Symptoms of spanish flu lead to

rapid pneumonia, death in 1-2 days, blue face

Quasispecies population

rapidly developing, 1 mutation per genome, generates constant mutations, new variants escape immune surveillance

Shift of HIV

recombination between RNAs or virus

Toxoplasma gondii

related to malaria, protozoa, targets brain and lungs, most common CNS infection, associated with cats!

HFRS treated with

ribavirin

Typhoid is caused by

salmonella typhi

What food borne bacteria are HIV infected people susceptible to

salmonella, listeria, necrotizing periodontitis

Case definition

similar set of symptoms found in related patients used to deduce the root of a pathogen

How could HIV emerge from SIV

slaughter of monkeys to feed and cuts on butchers could have been transmission

Antigenic Drift

slight changes in, gradual accumulation of point mutations, high error rate of viral RNA polymerase, new variants appear yearly (reason 50 yo is more resistant than 20 yo)

Grnaulomas are

small infected WBC form granulomas

Cryptosporidiosis identified by

spores, causes months of explosive diharrea in HIV patients

The silk trail

started by marco polo, led to shipping silk from China to Europe on boat

What to avoid with Toxoplasma gondii

steak tartar, pregnant women and cat litter, in HIV treatment effective but need continuous prevention

Short term effects of the plague

tension between groups (healthy/sick, rich/poor etc), death rituals were abandoned

To test for HIV RNA or DNA you can

test for viral load - (PCR) or branch (detect about 500 RNA)

The pilgrimage encouraged plague spread through

their roman indulgence trip (having to go through Europe) causing gates to be put up

Human exposures

those traveling or living in Asia and visiting live markets or farms

Second wave of Spanish flu occurred in what area?

throughout the world

Mongol armies encouraged plague infection by

throwing plague infected bodies into Kaffa (italian city) causing them to flee the city taking infection

incubation period

time from acquiring the agent to the time that symptoms are observed

Prevalence

total number of cases old and new

T/F: TB is also seen more in african american females in kansas city

true

If you lack CCR5 chemokine receptor how does this affect your ability to contract HIV

unable to contract HIV, do not have the coreceptor

Drugs used for TB

usually 6 months 4 drugs: DOTS directly observed therapy, SA self administered, Later drugs: DR. MDR. XDR.

Vaccine of swine flu was not very...

wasn't effective and needed to double the dose and had to ration the vaccine

Jeff Taubenberger and Terry Tumpey argued

wasn't risky because many people had spanish flu immunity with anti flu drugs available for us and used tissue sample of dead infected

Flagellanti are those that

whipped themselves thinking the plague was caused by sin (open wounds)

Pandemic

world wide epidemic

Candida albicans

yeast/fungus related to bakers yeast, dimorphic (90-95% of AIDS patients will have candidiasis

Black plague is caused by

yersinia pestis

Why did so many die from spanish flu

young adults were moving around and mixing up

TB affects mostly what age group

young adults, more likely to be seen traveling