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