Review Sheet
The Theory of Evolution by Natural Selection
"Survival of the fittest" 1. Species are capable of reproducing faster than their resources can expand. 2. All things show variation (i.e no two things are exactly alike) 3. All individuals must struggle to survive and those with favorable variations will have an advantage over others (faster rabbit better likely to survive hence a favorable variation; Survival is vital for reproduction which is IMP) 4. Variations are heritable; favorable or unfavorable variations can be passed on from parents to offsprings 5. Successful inheritance of favorable variations over vast stretches of geologic time produces new species Darwins theory & concept of Evolution applies to populations NOT individuals (individuals cannot biologically evolve) Darwin wasn't right about everything blending—> offspring blend of 2 parents will average height for ex but everyone would be the same, hence blending was not right.
Evolutionary goal of pathogens and how this is accomplished
*Goal: ==> SURVIVE & REPRODUCE -To accomplish this goal, pathogens must: ^successfully infect a human host ^beat the host's immune system long enough to reproduce ^transmit offspring to another host (And to reproduce in ways & amounts so that offsprings survive so that they can repeat the cycle)
What is meant by "virgin soil" epidemics and how subsequent epidemics varied between urban and rural areas and why
- "Virgin soil" epidemics followed by secondary epidemics. (Would affect everyone, spreads well enough to infect people in a short period. If 70% of the population is sick, societal breakdown may occur. In the past, people would not be able to farm or work to make any food, so they would starve and die. Most adults would have had smallpox which will later infect kids, less devastating for society functioning.) -Secondary epidemics in urban vs rural areas (urban areas, too many people, so constantly going on. In rural areas, there won't be a big enough susceptibility, secondary epidemics periodically.)
Where the practice of smallpox inoculation began and how it was introduced to Europe
- Began in India around 1000 BC ^ practiced in China by 1000 (AD) ^ Practiced in Middle East by 1500 ^ Introduced in Europe in 1721 by Lady Mary Wortley Montagu (artist drew her without her scarring, like photoshop.) (She insisted her son be inoculated —>) Buying the Pox: She wanted to test inoculation so she used prisoners. 6 of them accepted and were inoculated and were fine afterwards. The royal family had orphan children come and inoculate them. All of them survived. So when this was shown to be successful, the queen wanted to inoculate all her children.
Controversies caused by "buying the pox" in both Europe and what would become the U.S.
- Inoculation gained acceptance in Europe, primarily among doctors, scientists, and the aristocracy. (Was referred to "buying the pox") Boston, 1721 Smallpox was burning through, and would occasionally be epidemics. Rich people fled. It was not endemic in North and South America so it was good for people to flee. Though inoculation was a solution, he wanted to inoculate everyone. Boilston inoculated his son and his slave. Ruled it out to be a success. - Inoculation gained acceptance in the Colonies (later to be the U.S), primarily among clergy. (Opposite of Europe, doctors in the U.S don't like it. Why? Because in Europe the queen was doing it but in the U.S a random guy was doing it. Had to do with who was using the practice and who supports it. Labels put on it, sometimes the rich really like things and sometimes the poor, it's a cultural thing.) 280 people inoculated, 6 died- Adam Winthrop, 1721 (rich person living in Boston) William Cooper, 1721/ Benjamin Franklin (had 3 biological children, one son died from smallpox, admitted he wished he gave his son inoculation. Accepting Inoculation: Became less risky. In the middle of war, all soldiers were implemented. It was controversial from George Washington. Washington's way of combating an outbreak during war. Controversy in U.S: Political cartoons, different issues people were arguing about. INdividual autonomy, my body, my choice, can go against religious beliefs. People had ideas they were sharing in newspapers, concerns that people might become cows, and girls might take bulls for lovers. Led to a lot of controversy.
How smallpox compares to the plague
- Persinia pestis vs virus ^ Vector born disease, through fleas vs airborne and human spread, doesn't hang in air long ^ Pandemic and epidemic, never been endemic vs endemic through much of the time, then epidemic in north and South America, as populations increase becomes more endemic as well Europe, Asia, and Africa vs all over the world Industrial Revolution, enovate technologically, have to build things and grow things due to less people, leads to printing press, protestant revolution, some changes in governing structure, England end of feudal system vs Vaccination for smallpox, real medical advances, inoculation was a nice change and adaptation but vaccination was completely safe, development of rabies, measles, chickenpox, other diseases prevented by vaccines, changed how history is played out Plague pushed navigation which allowed for European colonization; disease plays into that How can it be prevented today? Antibiotics vs palliative care Plague can be prevented by avoidance of rodents and fleas and getting rid of them, having hygienic living conditions, changes in expectations and attitudes VS vaccine, quarantine for smallpox (doesn't work for plague due to vector spread being the concern) Chances of exposure right now is very low, right now smallpox doesn't exist in the world but it can be a weapon.
The contributions made by Charles Darwin and Alfred Russel Wallace
-Charles Darwin the father of psychology correctly hypothesized sent to Cambridge, interest in plants, got degree in Theology, took ship to voyage and travel, lasted 5 years collected samples of plants and animals and sent them back to England. Saw a large amount of variation in samples of tortoises and types of birds. Compared beak size, which varied from island to island, beak size was related to their diet, smaller beaks ate berries and softer foods, bigger beaks ate seeds and nuts, harder foods. If an island had berries, beaks were smaller, hence birds adapted to the environment, food resources available. After the Beagle... - Darwin published articles as well as 3 books about his travels, but he did not publish the theory that he was developing about evolution - Until he was about to be scooped.. -Alfred Russel Wallace: agreed with Darwins Theory presented (1858-1859) & published original data he gets credit and not Wallace. ?? evolution by natural selection & disagreed with Darwin about the significance of sexual selection he prompted Darwin to publish his own piece
Infectious Diseases: -Clinical, medical, and epidemiological classifications of infectious diseases and who uses them
-Clinical: diseases classified according to the most common or important clinical manifestation or organ system primarily affected EX: Diarrhea, Respiratory, Cardiovascular, Central Nervous System (Who would be likely to use this classification? Doctors) -Microbiological diseases classified according to the characteristics of the causative organism EX: Bacterial, Viral, Fungal, Parasite (Who would be likely to use this classification? Biologists/Microbiologists; scientists) -Epidemiological: diseases classified according to their means of transmission EX: ^contact: direct, indirect ^food-borne ^vector-borne (Who would be likely to use this classification? Epidemiologists, those that try controlling the spread of diseases; anthropologists interested in social aspects of disease, so want to know how diseases spread, etc)
Disease & Culture: Definition of etiology, therapeutic modality and medical systems
-Etiology The cause(s) of a disease —>Etiologies are culturally dependent ^understanding of the body (body—>machine) ^understanding of health and sickness (Etiology directly leads to treatment) -Therapeutic Modality An intervention used to heal someone or prevent disease/illness —>also culturally dependent (may do spiritual procedures depending on culture/practical component as well; no health insurance, alternative treatments) ^Etiology ^Available resources within environment -Medical Systems: How different cultures think about disease and healing and how they organize themselves toward a treatment —> 2 general types: ^personalistic ^naturalistic
Definition of food/water -borne diseases and the example of cholera
-Food/water-borne diseases: Diseases that occur due to the ingestion of contaminated food or water (mostly with fecal matter —> fecal-oral diseases) Ex: Botulism, Cholera, Hepatitis A, Jacob Diseases (don't need to know all of them for test) *Cholera: -Responsible pathogen: Vibrio Cholera (don't need to know names of this) -Mode of transmission: ingestion of contaminated food/water -Symptoms: ^profuse water diarrhea ^occasional vomiting ^Rapid dehydration which can lead to renal failure (kidneys shut down) (50% morality rate if not treated but if treated mortality rate is 1%, very treatable) -Treatment/Prevention: ^Oral rehydration ^Antibiotics ^Maintain clean water supplies (cholera preventable, not common in the U.S due to our culture & complementary water supplies, etc)
Different relationships humans can have with organisms like bacteria, viruses, etc. within these options what pathogens are
-Pathogens: Organisms like bacteria, viruses, Protozoa and so on rely on human hosts to survive. Possible relations of organisms with human hosts ^Symbiosis (helps humans —> positive & neutral) ^Mutualism (benefit to host & organism —> positive & positive) ^Commensalism (host neutral, positive for organism) ^Pathogenicity (positive negative —> hurts host but helps organism —>pathogens) Organisms (bacteria, viruses, etc) that create pathogenic processes in their human hosts
Personalistic Medical Systems vs Naturalistic Medical Systems
-Personalistic Medical Systems: Medical systems that explain sickness as the result of supernatural forced directed at a patient (etiology a supernatural force; angry spirit, evil eye, etc..) ^Causation: active agent (someone directly caused the situation, not randomly something other than bacteria contributing to illness) ^Diagnosis: primary concern (who & why; healers, priests, etc diagnose ^Treatment: secondary concern- often socially based (witchcraft) _Naturalistic Medical Systems: Medical systems that explain sickness in terms of natural forces. (Things that exist in nature) ^Causation: nature, equilibrium loss ^Diagnosis: secondary concern-patient generally self-diagnosed, informs healer ^Treatment: primary concern, non-religious/magically based ( biomedicine-self treatment; Chinese medicine, etc)
Definitions of adaptation and types of adaptation
Adaptation: the evolutionary process whereby a population becomes better suited to its environment. Types: Types: - Genetic (changes in gene/population to better adapt to environment, start to see bigger beaks more often than small; we tend to adapt behaviorally, humans don't have a genetic advantage, if we go to Antarctica we can wear more suitable clothes to help us keep warm, wear less clothes in hot places, etc -Developmental Adaptation: (physiological changes that occur due to environmental stimuli; 400 ft above sea level in San Marcos TX; if we go 10,000 ft, the elevation provides less air, harder to breathe but those that grew up in those high elevations have increased blood cells and rib cages is rounder and bigger, our body adapts to the environment, those that haven't grown up there are at a disadvantage - Physiological Adaptation: (pre-programmed, we all have the capacity to do this ex: Antarctica, say we don't have a jacket, we'll immediately get super cold, but our body does things to warm us up like shiver, etc. or if we go into someone's house and we sense a bad smell at first but once we're there for an extended period of time that smell goes.) - Behavioral (Cultural) Adaptations: (Umbrellas, heated/cooled transportation, AC, etc. not seen with other animals; some animals may be able to respond to severe environmental changes but humans respond very well to those environmental stimuli)
Definition of airborne diseases and the example of bacterial meningitis
Airborne Diseases: Diseases that are spread via inhalation of contaminated air Ex: Bacterial meningitis, influenza, tuberculosis, covid-19 -Bacterial Meningitis -Responsible pathogen: Nisseria Meningitis -Mode of transmission: inhalation of infected respiratory droplets -Symptoms: ^often sublinical (80-90%; might feel like a cold) ^fever, vomiting, stiff neck, petechial rash (red-purple rash) ^sudden prostration and coma -Treatment/Prevention: ^Antibiotics ^Vaccination ^Prevent overcrowding (needs to be treated within 24 hrs, can have harmful consequences; quick progression; college freshman required to get meningitis vaccine due to overcrowding on campus and dorms; if you can't put chin to chest then you're at risk of meningitis bc it'll hurt to do that due to infection in spinal fluid)
Definition of fomites including what makes a 'good' and 'bad' fomite *including what cultural practices contribute to or reduce the incidence of each of these diseases*******************
An inanimate object that is capable of spreading and transferring a disease, good one is smooth hard surfaces, to prevent disease, use cash because it's soft, so less capable of spreading disease than a credit card. Soft is bad
Definition of (direct) contact diseases and the example of syphilis
Contact Diseases (direct) Diseases spread by direct contact (i.e skin or sexual contact) Ex: Ebola, HIV/AIDS, Leprosy, Syphilis *Syphilis -Responsible pathogen: Treponema pallidum -Mode of transmission: sexual contact, or contact through birth (congenital syphilis) -Symptoms: ^Primary lesion, generally painless ^secondary rash, sometimes fever, muscle aches, fatigue ^tertiary damage to skin, bones, and organs (will kill person if left untreated) -Treatment/Prevention: ^Antibiotics ^Abstinence before marriage/after marriage, fidelity, need to wear protection—> practice safe sex with condoms) Image: Skull reshaped and damaged syphilis can progress to treasury syphilis, affects brain tissues, non-treatable until penicillin comes in. Tesgigi syphilis study.
Anthropological definitions of culture and societies and how they compare
Culture: learned and shared ways of behaving & thinking (shared ideas about the world) Societies: an organized group of individuals with specific boundaries (like time or geographical boundaries) or criteria of membership (like things you can do or not) Ex: Texas; include a culture or cultures (U.S multicultural) / Large societies often include micro cultures.
Disciplines that contributed to the development of evolutionary biology
Geology: Evolution during the Renaissance period Theory of human evolution Uniformatism, geological processes today are the same as before was criticized -Paleontology developed microscopes was able to see cells—> fossils were once living things suggesting age of earth was older than generally believed -Taxonomy and Systematics This goals were to put natural world in order from simple to complex -Demography unchecked population increase; people who survive were most successful -Evolutionary biology inheritance of acquired characteristics Tall mom & dad —> tall child wasn't quite right, can't modify body if you lose arm doesn't mean child will lose arm
The contributions made by Alexandre Yersin, Paul-Louis Simone, and Waldemar Haffkine
Identification and Treatment -Alexandre Yersin (the plague bacteria named after him→ Yersin, showed that it was a bacterial disease, in 1894) -Paul- Louis Simond (Was able to demonstrate that fleas were the vectors, had rat infected with plague, another rat wasn't, the fleas hopped to the other rat once the infected rat died) -Waldemar Haffikine (In 1896, the British Government asked for a vaccine for the plague, he had developed a vaccine for cholera which was a live vaccine with an entire pathogen, which was more dangerous, it was effective, reduced incidents by 50%, not enough today to get vaccine passed. You can give someone a case of the plague if the vaccine was messed up, needing little doses. This was treatable with antibiotics which didn't come out until years later.)
Definition of smallpox inoculation and the results of this process
Inoculation: (Not the same as vaccination) - Infecting healthy individuals with smallpox to produce a mild case of the disease. ^ Exposure through skin (get someone sick and get a needle and the fluid or pus for the pustules then take that needle and scratch it into the arm of someone that hasn't had smallpox before.) ^ Exposure through nose (insufflation) (sniff into nose) (The one with skin is better because it's airborne, putting it through the skin is better because you have more control as to how much you put) Results: - Mild Case of smallpox with pustules centering around inoculation site - Lifelong immunity against smallpox - In some cases death (if wasn't done well) - Possibility to spread smallpox to others... (Death rates from inoculation were about 1%, whereas the death rates in Europe were 15% and 30% for children)
Why we know that Y. Pestis is responsible for earlier plague cases and why modern plague strains seem to be less virulent than we saw in the first two pandemic
Is Y. pestis really the culprit? -Alternative suggestions: ^Anthrax ^Unknown hemorrhagic virus (like Ebola) -Paleomicrobiology ^SNA testing of tooth pulp from plague victims ^Y. pestis present - Other explanations? Pathogens need to find their sweet spot, and don't want to kill their host all the time because if we all die they will die too. Biological selection going on, populations that are left are less susceptible to the plague, survival of the fittest. Taking out fleas when there's a flea problem.
When and where smallpox evolved as a human pathogen and why
Killed more people throughout the years than the plague. Killed more people than all the wars combined. Also had a substantial impact on societies around the world. Big deal throughout human history. - Likely evolved from an animal pox virus in Africa thousands of years ago. (Humans exposed to certain animals with smallpox, later became human disease) - Became endemic in human populations after the advent of agriculture. (More people living together, spreading increasing. Would kill about 30% of the population)
Definition and types of means of transmission
Means of transmission: -Options ^Food/water-borne (unclean food/water digested) ^Airborne (sneeze & cough, talk, sing, yell) ^Vector-borne (insects or animals, like malaria through mosquitos) ^Contact (touching, not washing hands after) -Pathogens that fail to successfully transmit to a new host go extinct
Responses to the London epidemic of 1665
Outbreak in London, during trade, rat infested ships Plague death increasing, the wealthy people in London flea, so city is depopulated, some authorities and poor people remain. Digging mass graves, "plague pit" People still thought that plague was spread through bad air Suspicion that cats and dogs also spread the virus → started to slaughter the cats and dogs, which was a bad idea because those were rat predators, which makes the plague even worse since rats weren't dying. Painted red crosses, public marking, actively trying to prevent people to leave their house, which was a bad idea because rats can still go in and out of the homes, but it increases the likelihood that spread would stay within the home, mnemonic plague increases. Their were problems like starving to death or dying due to thirst, etc. From a medical standpoint, patients were also bled, bad idea because it can weaken the immune system and immune function, body needs to produce more blood so immune shifts focus to do that instead of fighting off the virus. Recommended smoking, but nothing was effective, the vacuum was filled with the plague doctors. Plague doctors, not trained but tended to be rich and poor, treat people for the plague. They wore a heavy protected suit to cover them from head to toe, a mask filled with herbs and other stuff to purify air for themselves. Didn't have to touch patients, they bled their patients, some took an onion and heated it in the fire until it was liquid and applied that to people's libidos, pain was really bad, nothing they did was helpful. (15th century) The mayor of London ordered fires, to get off strong odors to purify the air. Winter kills the fleas, tempers down flea population so the epidemic will end, killing 20% of the population. The vast majority were London's poor.
Long-term outcomes of the 'Black Death' in Europe
Outcomes: -Church lost influence in a lot of areas. Church was challenged. Protestant revolution. -Better working conditions, especially in England. Due to the loss of people. -A new style of art, literature, and narratives. Also, more of an interest in medicine and science, which was the beginning of the Renaissance period. -Accepting more people to renovate, forced innovation to occur, like machines, etc. real technological advances, and changes that will allow Europe to become world explorers. Legal changes, changing roles of women, can be witnesses at court, etc.
The plague epidemic in Galveston in 1920, including how the outbreak was handled and how infected persons were treated
Plague In Galveston: -Occurred in 1920, 18 cases with 10 deaths -How was this outbreak handled? Getting rid of the rats, went through the city and cleared them out, went through houses and rat-proofed them. Used cyanide. Was successful and stopped quickly since they acted on it quickly, they understand how it spread. -How were infected people treated? Antibiotics weren't developed yet, but the vaccine was given, and a development of an anti-plague serum, both were semi-effective, not what we would use today, now we use antibiotics. Disease played out way differently, due to a better understanding of the plague and how one can get affected.
What plague is like in the world today, including why it is now endemic (at least in rodent populations) in the U.S
Plague Today Almost 33,000 cases worldwide and about 2,000 deaths, the majority came from Africa (availability of technology and infrastructure, economical differences, primarily affecting poor people.)
Plague and bioterrorism, including when plague was used as a bioweapon and if this is something we need to be concerned about today
Plague and Bioterrorism -History ^ Siege at Kaffa, 1346 ^ Japanese bombing of China, 1941 - Attempts at weaponizing plague in the U.S and U.S.S.R. during the cold war. - Should we be concerned? Agent found in nature and in laboratories, easily spread in pneumonic form, possibly high mortality rate What about pathogen evolution?
During the 300(ish) year period of the second plague pandemic in Europe how medical systems responded including what was thought to be the cause of plague and what were common treatments
Plague and medical systems During the Black Death and subsequent outbreaks of plague in Europe: - What was often thought to be the cause of the plague? Bad air -What were common treatments? Air purification, isolation, fire, supernatural belief. Accusations of witchcraft, etc. So the solution is genocide to Jewish communities → personalistic. Medical pluralism, balancing out the liver when sleeping, witchcraft, many things that people tried, used multiple medical systems → medical pluralism -Was anything effective? Fleeing the cities wasn't harmful, but nothing really helping bc people didn't understand the disease.
The plague epidemic in San Francisco from 1900-1904, including who was blamed for the outbreak, the actions of Joseph Kinyoun and Henley Gage and the ultimate result of the outbreak
Plague in San Francisco -Occurred 1900-1904 (areas that had ship travel, ship ports, so there was concern in Washington that plague was happening in China, wanted to pay attention to it, and knew about ports in SF. -Who was Joseph Kinyoun? He was sent to keep an eye on this, and plague was identified in SF. He wanted to stop the spread, one of the first things he wanted was for the ships to hold yellow flags to be inspected, people didn't like it because it affected business. While this happens, other things blow up in his face. -What ethnic group was implicated in the outbreak? Chinese, Chinese Inclusion Act, unable to buy property, become citizens, they were excluded. First outbreak in Chinatown, outbreak in port where many Chinese worked. People thought it was a diet issue, hence prejudices occurred. So they wanted to quarantine all of China, which made news, SF didn't want to hurt their reputation, lawsuits were filed, Chinese people won lawsuits, Gage retreats, a lot of animosity between him and the Chinese. Finally he imposes quarantine in Chinatown, leading to all of SF to be quarantined. Killing people at a much lower rate. -Who was Henry Gage? Governor, trying to cover it up, wanted Kanyoun to be kicked out. Had many newspapers on his side, denied the plague, spent 100,000 dollars on a campaign, sent people to Washington to make a secret deal to tell people that plague allegations were false. Gage will accuse Kanyoun of manufacturing the whole thing, shifting blame on him. Local businesses don't like restrictions on business. Becomes a mess → long-term consequences. -Ultimate result of the outbreak? Western U.S has an endemic plague due to the spread of rodents that weren't taken care of. Started capturing rats and cleaning up the city so it gets a bit better. After an earthquake leads to another plague, focus on rats again. For various regions of the Chinese community hiding the plague and sick individuals, why low infection rate? Comes down to species of fleas that was different from China in Europe, those fleas weren't good at regurgitating the bacteria, difference in fleas contributed to how the plague was played out, less deaths and spread due to this. Plague carried by squirrels, endemically People died because the disease wasn't caught early. Most people that get infected with plague are due to their pets because they play or catch squirrels, so they get infected and can share that with their host family. Mnemonic plague is deadly if not caught early. Don't let pets play with dead animals, especially squirrels or bats.
Disease causation as this occurs as an interaction between a host, an infectious agent and the environment, including examples of the environment as described in class
Pyramid: Agent/Pathogens Host (humans; how healthy the population is, some regions healthier than others) Environment (clean water, nutrition, clean environment influences host, physical environment attributes; cold, humidity, processed foods, etc.
Why was the second plague pandemic often called "Black Death?
Referred to as the black death, due to infection of yusenia peris where you turn black due to death of organs & tissues, black death used in 16th century due to the darkness, gloom, and terror surrounding the pandemic, describing the lived experience at that time & not necessarily the black degeneration of organs and hands like seen in an image.
Personalistic and naturalistic understandings of what caused smallpox, how it should be treated/prevented and what treatment/preventions were effective, not harmful of harmful to infected persons.
Responses to Smallpox: - Personalistic medical systems ^cause: supernatural forces ^ This led to the worship of deities including: —> Tametomo (Japan) —> Shitala Mata (India) —> St. Nicaise (Europe) (Didn't hurt anyone) And also superstitious practices... -Naturalistic medical systems: ^ Cause: bad air or an imbalance of bodily humors ^ Treatments: —> Bleeding (very common) —> Drinking curative concoctions —> "Red Treatment" (began in Japan and spread throughout Asia and Europe, red symbolizing the feeling of fire and the redness. They would expose people to much red, wrap up in red blankets and sit next to fire, put people in a red room, eat and drink red things, wear red. Queen Elizabeth was treated this way. (All these treatments can hurt and lead to death) Preventions -Quarantine -Inoculation (lead to development to how we deal with diseases) OUTCOMES: Smallpox killed a lot of people in Africa, Asia and Europe through the 20th century. (Bertha E. Whitney, etc. image- killed a lot of people) Smallpox also disfigured many people in these areas (some people preferred to hire people who had smallpox, social mobility occurred due to it. What smallpox does to North and South America).
Immediate responses to the 'Black Death' in Europe
Responses: -Significant death tolls -Whipping themselves, the Catholic church and pagans, and other denominations. So you see religious salutary. -Scapegoating, Jewish populations. Many rich people are indebted to Jewish moneylenders. So it is a way to get rid of them. Committing genocide. -Abandoning children, different treatments: switch sides to not overheat the liver, naturalistic. Treating people with concoctions and using natural remedies like human poop, etc. They believed the disease was spread by wind. -People lose their morals, either becoming very religious or living it up and partying. -Escaping and fleeing to the countryside or other places. -Panic, staying at home/isolation. -Chinese scapegoating too. Discrimination. Persecution.
-Anthropological definitions of sickness, disease and illness and how they compare
Sickness: all unwanted variation in physical, social, and psychological dimensions of health (taking a more expansive view on disease; broader issues related to sickness) 2 major types: disease and illness. Disease: Clinical (medical system), outward manifestations of altered physical function or infection example: go to doc, describe symptoms, likely to have disease, can go to diff docs, & there's a shared understanding of what those symptoms mean/is -Still culturally based—some diseases don't fit cross-culturally; some diseases are culturally specific - Medicalization (process of condition are identified and treated, shared, understanding >diagnose & treat; ex: ADD, in American society ADD not a normal behavior so need a diagnoses for accommodations, but in other countries this may be a good thing based on the culture) Medicalization: -Onanism & drapetomania (second one is a slave diagnosis when they tried to run away, not a today thing) -Ovary disease (old), ERT (new) (first one to remove ovaries some to prevent aging; second one is Estrogen Replacement Therapy) -Obesity -ADD, ADHD (some diseases are culturally important, in Japan for ex laziness was diagnosed as a disorder) (diff than disease) Illness: The human experience & perception of alteration in health, informed by broader social & cultural dimensions. Shared cultural/clinical definitions of sickness/own experience of sickness *Can you have a disease without illness and illness without disease? YES -Schistosomiases in young African boys, exposure to snails —> lukewarm travel to organs & destroy tissue —> fatal, no cure Young boys thought their pee blood was like a period but for boys, they thought it was normal so they didn't have the perception that they were sick (illness) -Fibromyalgia in the U.S: middle aged white women (20 years ago) had the same type of symptoms; all that is common it was a disease wasn't recognized as a medical condition, so they prescribed the women antidepressants; hence the women became depressed due to the diagnoses thinking it was a sign of depression—> physiological conditions are much more difficult (Lyme disease was something similar —> controversial; illness identity but don't have a disease)
Epidemiological transition, including reasons for this to occur
The process by which the pattern of mortality & disease is transformed from 1 of high mortality among infants & children, in addition to episodic famines & epidemics affecting all age groups, to one of degenerative & man-made diseases affecting primarily the elderly. Ex: cancer, lung-cancer —> exposure to smoking Graph: most people aren't dying from infectious diseases, leading cause of death is non-infectious like cancer and heart disease, etc. The switch occurs due to different living conditions. U.S started taking sanitization, etc. more seriously 1950's development of antibiotics, medical advancements, vaccines, etc Has the transition occurred equally in all areas? Socioeconomic status: clean water supply/system, infrastructure for good sanitization systems, some communities lack those systems hence it's not equal in all areas Some areas/states/countries are more developed.
Adult Pertussis
whooping cough coughing so bad, broken vessel on faces, vomiting, etc. can lead to death for kids under 1 yo Can be exposed to pathogen as an adult even though you weren't vaccinated. —> Symptoms not too serious, can be like cold common subclinical infection in the U.S because its so mild, you don't have see a doctor and can get misdiagnosed.
The results of the smallpox eradication campaign
- Vaccine was 100% effective - Socially the smallpox was not stigmatized (not shamed for because it was an equal opportunity disease, people didn't want to cover it up, really possible to track down every single case.) - 1967 effort to eradicate smallpox began in earnest (2 million deaths, most areas were pool, lacked infrastructure and tended to have poor reporting of cases due to poor infrastructure) - Focus was on the 5 regions where smallpox remained endemic (Brazil, western central Africa east and southern africa, So Indian subcontinent and Indonesia) - Initial strategy: mass vaccination - Secondary strategy: surveillance and containment - According to Tucker, what obstacles were faced in India? Monumental effort, needed more man-power, religious beliefs and political beliefs didn't permit many to want to get vaccinated, hence the use of unethical measures ^ The last case of smallpox occurred in 1977 in Somalia (last person in the world to have this case) ^ May 8, 1980 WHO declared the world was free of smallpox (were in labs) ^ Destruction of all samples was planned for 1999.. —> samples weren't destroyed and we have no idea where it is. They're still in labs.
Definitions of genes, alleles, genotype and phenotype
-Gene: the basic unit of inheritance - offsprings obtain genes from their parents (2 copies of each gene; was a groundbreaking insight) - Allele: one or more alternative forms of a gene (can have tall allele or short) - For simple traits alleles are either dominant or recessive (recessive is not expressed of dominant trait present) Tall—> dominant + Short—> recessive = 1 tall allele and 1 small allele = tall offspring because of the dominant allele - Combinations of genes from parents lead to individuals being homozygous or heterozygous for those traits (homo=same type of allele; hetero=different forms of the allele) -Genotype: the genetic makeup (genes) of an organism; what all different genes/alleles you have looks like - Phenotype: the physical expression of the genotype (related to genotype but also depends on environment) ex: tall, short, wrinkly, etc Environment can also effect phenotype ex: not enough sunlight for nutrients to help grow or fish in fish tank, fish wont get big due to the environment (phenotype= genotype + environment
Examples of genetic, developmental, physiological, and behavioral adaptations to disease:
-Genetic: Sickle cell allele (co-dominant with red blood cells, flat and curved, if heterozygous, risk of of 2 types; sickle RBC don't go into all tissues, capillaries (can get stuck & block), big enough for 1 RBC at a time, not good at carrying O2. Homozygous results in anemia & death, at early age if untreated; horrible evolutionary, bad mutation; In africa, 20-30% of gene pool, high amount in malaria, makes you immune to malaria (spread through mosquitos) major killer of children (homo)in those areas, anyone who's hetero won't die of sickle cell and malaria, it will kill homo. Mutation in sickle gene, gave advantage to hetero carriers, hence kept due to its advantagen; lactose intolerant people is an example of genetic adaptation - Physiological adaptation to disease: -Immune response Innate immunity (structures that keep harmful things out, cough, sneeze, mucous trap, etc) ^External barriers and inflammatory response -Acquired Immunity ^Immune response —> Memory B cells that we respond to very quickly acquired that immunity. - Passive Immunity ^Breast feeding, etc (passed on, babies receive antibodies, helps infants protect against diseases; flu, measles, etc. antibodies passed on to infant) plasma for immune system (from healthy person; one of the methods with covid can take antibodies from someone and give it to someone else) -Behavioral Adaptation: nutrition, vaccines, quarantine, washing hands, etc. sanitation, antibiotics immune systems function well in environments with those resources.
Definition of infectivity and virulence and the evolutionary tradeoff pathogens face between the two
-Infectivity: The ability of a pathogen to invade and reproduce in a host (i.e cause disease) ex: measles, flu, cold —>infectious and easy to get Tuberculosis—>hard to get (how they transmit determines how infectious they are; airborne is more infectious then others for ex) (Flu/Ebola—>Covid original strain—>HIV—>Covid delta—>chicken pox—>measles..etc) -Virulence: The harmfulness of a pathogen (what level does it kill? —> directly related to how organism reproduces) The more pathogens, the more virulence; threshold to kill host (plague-pit image) & the less virulent —> more chance for transmission (virus survive and can continue survival pattern) (motor transmission is the deciding factor as to whether virus will be virulent or not; Rabies —> extremely deadly —> through contact) -Evolutionary tradeoff Virulence or transmission? (Competition among pathogens) *Natural selection determines level of virulence -Possible because: ^multiple strains of pathogens exist ^Pathogens evolve very quickly (& compete with each other; short generation times)
Phases of virulence evolution including examples of diseases that would fit into each phase
-Phase 1: 1st contact, usually by accident, pathogen is not adapted to human hosts. (Pathogen in contact with you but incapable of infecting you but can infect your pet) ^Virulence is often extremely high ^Ex: Ebola, rabies (doesn't spread from human to human; used to be 90% death rate but then it became less dangerous the more it spread) -Phase 2: establishment with new host species (humans), virulence is far from the optimal level ^Virulence is too high or too low ^Ex: AIDS (different strains, contact disease, more virulent due to sexual partners change every 6 months so if people had less sexual partners it would be less virulent bc it wouldn't want to go extinct; AIDS—> people usually died within 1-2 years when diagnosed, but now it takes longer for one to die) -Phase 3: the pathogen is established in a host species (humans) and has evolved to achieve optimum virulence. -Virulence is optimum and generally related to means of transmission ^Airborne: less virulent (ex: cold, flu) ^Waterborne: more virulent (ex: Cholera) ^Vector-borne: more virulent (ex: Malaria) ^Contact (sexual): less virulent (ex: syphilis)
When and where the three plague pandemics occured
-Plague of Justinian 541-542 (dates for eastern Europe, western Asia) -Black Death 1346-1353 (dates for Europe) -Third Pandemic 1855-1959 The Roman empire fell. Western & Eastern country, gateway between Asia and Europe, now Hungary, Turkey, etc Justinian wanted to reconquer the Roman empire. Ships from Egypt also carried plague infected rats, rats had fleas, disease spread and half of the city's population got sick. Scholars at the time said about 5-10,000 people died every day for a month, no one to bury the dead. They were put in lockdown, no one allowed in and no one allowed out, those stuck at the city ran out of food, hence turned on the empress because they thought she was responsible so they were ready to overthrow the kingdom. Half of the population had died, they stopped people from dying for a while but didn't stop the spreading of the rats, the outbreak reached Ireland & other places. Groundhog carried the disease, Constantinople ⅓ to ½ of population were lost due to this pandemic, around 250,000,000 people died, this led to loss of towns & cities 1750 was the last case of the plague being observed. (I Am Legend Movie)
Plague: Responsible pathogen and modes of transmission
-Responsible pathogen: Yersina pestis (bacterial disease, may come up in test) -Primary mode of transmission: vector-borne (specifically fleas; The flea gets infected with bacteria, in mid-gut and esophagus, makes flea incapable of eating, hence making fleas agitated so they bite everything they can, but can't get anything in yet they transfer the bacteria and infects & spreads other organisms) Not really a human disease, it needs to have the fleas to be spread. Another animal is involved: rodents, which serve as reservoirs, concerned with black plague rats. Reservoir hosts can continually carry the pathogen and survive, but spread the disease to other organisms. Black rats which are key players in pandemics are immune to yersinia pestis, and don't die. The flea bites the rat, infecting organisms, then when the flea bites people, the disease is spread. Can get rid of the vector or the reservoir, easier to get rid of rats, but need to get rid of either one to rid of the disease. -Secondary mode of transmission: air-borne Droplets spread of plague, much less common than the flea spread.
How smallpox vaccination changed in the 20th century and the results of widespread smallpox vaccination
-Today all states have laws mandating vaccination (still supported even tho challenges several time in the past, ethical due to public's benefit) Vaccination in the 20th century: - Process... (not getting injection, just giving it under skin, ends up in a blister on vaccination sight which ends up with a scar, visually apparent. ) ^ Vaccine production standardized (no arm-to-arm transfer) later became transportable due to the development of coolers and fridges, etc. (Pathogen evolution, pathogens evolve and adapt according to how they're being used or spread) Results: - 3-5 years of immunity (had to be vaccinated every several years) - Minor and major side-effects (not as safe as other vaccines, wide spread skin infections could happen, likely to happen with people who have skin conditions like eczema or leukemia or a weak immune system. Needed to be careful with the process, can also lead to eye infections and so on) Result of Vaccination: - Evolution/spread of Variola minor - Significant decrease in cases and deaths, but big difference between: industrialized or non-industrialized countries (Smallpox outbreaks, vaccine campaigns, push in 1940's for vaccination, in 1949 last outbreak in Texas, was controlled and contained through ongoing vaccination, same trends in other industrialized countries. Poverty = lack of infrastructure in countries like India, Bangladesh, etc. Still endemic is some of those areas)
Smallpox: Responsible pathogen and mode of transmission:
Biology of smallpox: Responsible pathogen: variola virus (contains other pox varieties, example monkeypox, etc, same genus as smallpox) It's a large virus genome, looks like an 8, largest virus known to exist, can be seen in a microscope. Almost like the size of bacteria. Primary mode of transmission: air-borne (after prolonged, face-to-face contact). Not going to hang in the air, falls down relatively quickly. Usually have to have close contact, within 6-7 ft from an infected person. Like hanging out with someone for some time, in their house. Caretakers are most likely to get smallpox. Cannot get it from the grocery store. Secondary mode of transmission: indirect contact (fomites and infected body fluids) Bedding and closing, skin cells contagious, may have scabs etc, hence can spread smallpox. Heat kills the virus, and cannot live outside of the host for long. If infected and is put in the dryer it will die. Tertiary mode of transmission: air-borne (after short, temporary contact). Like closed space where air is circulated, like elevators or buses. Not common way to spread smallpox. Smallpox is a HUMAN DISEASE (spreads from person to person).
The contribution made by Gregor Mendel
Born in 1822 Eastern Europe Czech Republic born to poor family didn't have opp to go to school was interested in natural world. became Catholic monk and continued studying plants, was conducting experiments of garden peas (during Darwins time) Overtime he noticed how "traits'' like seed color and shape variation throughout the years Got lucky to eat with specific things Genes (discrete units)
Cell-mediated immunity vs Antibody-mediated immunity
Cell- mediated immunity: -Acts against intracellular antigens (viruses, mycobacteria, fungi, and Protozoa) - Helper T cells: alert killer T cells - Killer T cells: attacks antigens directly & kills associated cells Antibody-mediated immunity: (outside of infected cells, in blood) - Acts against circulating antigens (gram positive and gram negative bacteria, viruses) - antibody producing plasma cells: Aid in cell destruction (most imp component in system) - Memory B cells: protect against future infections, primary immune response; 10-14 days to get rid of invading pathogens, doesn't reach 100% efficacy because of memory B cells, body recognizes immune can reach max efficacy to get rid of it immediately, like chicken pox, not likely to get it again, vaccines prompt body to react & engage, memory B cells against a virus. Measles vaccine exposes it so if you get infected you fight it off fast due to past exposure from the vaccine. (Measles erases immune system which can later be problematic)
Definition of (indirect) contact diseases and the example of measles
Contact Diseases (Indirect) Diseases spread by indirect contact (i.e fomites, blood, or body fluid) (hard things like credit cards are better at spreading) Ex: common cold, chicken pox, measles, smallpox Measles: -Responsible pathogen: Morbillivirus spp. -Mode of transmission: primarily inhalation of infected respiratory droplets but can also occur through direct or indirect contact with infected nasal or throat secretions -Symptoms: ^Fever, cough, runny nose, red eyes, and sore throat ^Blotchy red rash ^Pneumonia, encephalitis (brain infection can lead to blindness & death) -Treatment/Prevention: ^Vaccination ^Isolation of sick individuals Image: red rash, human disease Young children, 90% of population infected back in the day But after vaccines cases dropped Exposure to air, environmental being around people, cultural vaccinations prevent
The Immune system: Basic definition plus the three "lines of defense" as described in class, including specific details on the tissue/cells involved in each of these processes.
Definition: System of biological structures & processes within an area that protects against pathogens. External barriers: - Act as the "1st line of defense" - continuous closed barriers between inside and outside of body - Includes skin & mucous membranes of digestive, respiratory, and genitourinary tracts (cuts, wounds, burns —> problematic, skin largest organ in body & when compromised it can be fatal and one can die from infections due to burn and some wounds. Mucous physically traps bacteria and flushes them out of body. Cold and dryness makes it more susceptible to get you more sick, plus might get you inside more around people. The Inflammatory Response: - Acts as a second line of defense, after pathogens penetrate external barriers (like mosquito bite) Purposes: 1. Prevent further invasion by walling off, destroying or neutralizing invading pathogens 2. Repair Injuries (Limited to vascularized tissue—> teeth, non-vascularized) Stages: 1. Cellular Response 2. Vascular Response 3. Phagocytosis Common Symptoms: heat, swelling, redness, & pain. The third and final line of defense: The Immune Response: - Begins after phagocytosis is complete, body displays particular pathogens after macrophage - Recognition of antigens as "non-self" by receptors in blood, lymph or tissue exudate sets up a chain of immune responses 2 types: - Cell-mediated immunity - Antibody-mediated immunity (humoral immune response)
Intro: What is disease - Types of disease, i.e infectious vs non-communicable and examples of each
Disease: Any deviation from or interruption of the normal structure or function of any body, part, organ, or system that is manifested by a characteristic set of symptoms and signs Infectious —> disease resulting from the infection, presence or growth of pathogenic biological agents in an individual host ogranism Example: Influenza, cold, HIV, Covid-19 Non-communicable disease —> disease which is non-infectious & non-transmissible among people Example: MS & lupus, heart disease, etc. cannot spread from person to person
Examples of early evidence for smallpox
Early evidence of smallpox: - Mummy of Ramses V (1157 BC) - Early writings from India and China (1200-1000 BC) - Possible cause of: ^ Plague in Athens during the Peloponnesian War ^ Plague in Rome that killed Emperor Marcys and accelerated the decline of the Roman Empire (180 AD) ^ Plague in Mecca that decimated Abyssinian army - Spread through contact between societies Example: crusades and Europe
The contribution made by Edward Jenner
Edward Jenner: Vaccination. Jenner was a country doctor, and noticed a group that didn't get it..milk maids. Cowpox related viruses can sometimes affect humans. Primarily affects cows. Jenner decided to run an experiment, which is not ethical today. He decided to take material from pustules and inoculate them on a boy and exposed James to smallpox, but James never got sick, he was immune to smallpox. Vaccination came from the idea of cows, you're exposing them to something similar to smallpox. Not giving people the actual disease but something similar that the body can fight off and become immune to smallpox. Fixes all problems of inoculation. His results weren't being published so he published his research on his own. People began to read this and he was then recognized and vaccination was embraced and codified by law.
Epidemiological definitions of endemic, epidemic, and pandemic
Endemic: disease occurring at a constant rate, affecting about the same number of people in a population over a given period of time (pretty stable) Ex: flu, cold Epidemic: an increase in a disease over its expected endemic pattern Ex: Covid-19 (0 people to millions of people) can have it all over the place —> at TXST, in U.S, etc. Pandemic: an epidemic occurring over a very wide area & usually affecting a large proportion of the population(s) Ex: Covid-19, Spanish flu (peak) 1982-> most lethal for age 20's while covid most lethal for elders.
How smallpox vaccination was enforced in Europe and the U.S
Enforcement of Vaccinations: - According to Baxter what happened in England? (Parents who didn't vaccinate their children can be imprisoned, etc. Religious and other exemptions. Process of people objecting, Vaccination Law) - In the U.S: ^ Massachusetts 1809 ^ Mas compulsory school requirement 1855 (children more vulnerable to the disease, smallpox becoming endemic hence kids or more susceptible, also sort of way to catch people to keep vaccination rates up) ^ 1905 U.S Supreme Court upheld the right of states to pass and enforce compulsory vaccination laws.
The smallpox eradication campaign, including why this was possible, when it occurred, the different strategies involved and obstacles faced by the eradication terms
Eradication: - 1953 WHO resolution to eradicate smallpox - Possible for several reasons: ^ Smallpox virus was: —> Stable (not dealing with pathogen so genetically different that makes it hard to keep up with flu or cold) —> Always caused acute disease (going to get smallpox no matter what, very distinctive, can't be mistaken) —> Only spread person to person (human disease, cannot be present in a rat population, cannot spread super easily) —> Not spread easily so cases could be isolated (quarantine can stop disease progression)
Definition of "red treatment"
Exposure to heat or red things, like the Queen Elizabeth example where people were wrapped in red blankets, sat by fires, were in red rooms, etc
How plague was introduced to Europe during the second plague pandemic
Siege at Kaffa, 1347 Killing huge portion of Asian people India is depopulated, Syria & Armenia covered with dead. Kaffa trading city of Europe, known now as Mongolia, Mongolian army got sick with plague and spreading it in Kaffa, so the besieging army got sick and wanted to get home, but took the bodies of the soldiers that died, many fled back to Italy → biological warfare Fleas don't bite cold bodies, and the dead won't spread the plague. The rats are what matter, they spread it. Hence, a pandemic in Italy occurred. Tartars and Genoes -Subsequent outbreaks of plague Epidemics occurred in Europe until the 18th century (baseline occurrence rate, continually occurring.) Death rates in these outbreaks were 10-20% (the disease has become less deadly) Death rates were always highest in cities. (more likely to die from plague in the city instead of countryside) Maybe due to sanitation, more rodents in the city, people are closer together and packed in, mnemonic plague will spread really well. Lots of poor people crammed together, so in terms of access to food, the poor have less access, so poor immune system, other diseases spread too, to the mortality rate is higher, immune function getting worse.
Definition of Medical Pluralism
Simultaneous practice of multiple treatments (involves biomedicine, praying, & home remedies to try get better) likely to happen with people who can't get help; so they try acupuncture, massage therapy, reiki, etc.
Smallpox and bioterrorism, including when smallpox was used as a bio weapon and if this is something we need to be concerned about today
Smallpox and bioterrorism: - Should we be concerned? ^ Death rate is still 20-30% ^ Would impact everyone ^ Can't get an antibiotic like one for plague. ^ When millions of peoples sick at same time...we won't have enough supplies and resources to help everyone. ^ Protocols in place, big public health response to stop this. ^ Mass purposeful event can leave us at risk
Smallpox as it occurred in North and South America, including explanations for why smallpox was so devastating to "new world" populations.
Smallpox in North and South America: - Introduced to Hispaniola (and other Caribbean islands) by Europeans and African slaves) (Christopher Columbus voyage) - 1518 outbreak: 50% of native population died (similar to Black Death in Europe) Smallpox among the Aztecs - 1519: Hernando Cortes sought to conquer the Aztecs. (Small army, less than 500) - 1512: Cortes tried again Devastation of smallpox: (1525, caused civil war) (In 1616, smallpox killed 90%. Pilgrims wrote about this and said that natives were all dead from smallpox, though it was an act of God.) (Read the readings related to this, on Canvas) (DIfferences between Black plague in Europe and Latin America: Industrial evolution, innovations, they develop technology, greater interest in mechanics and engineering which leads to the Renaissance. In Latin America, they were being colonized and invaded by others—> which is the big difference. They are invaded by people immune to the disease, hence wiping out populations in North and South America.) Hypotheses Riley article: - Societal breakdown - Malnutrition - Genetics - Social practices (Body cannot fight off smallpox if one is malnourished. Genetic argument, worse for type A or type B blood. Suggests societal practices, South American population it was common to have people sleeping in the same places which would have spread smallpox pretty well.) Other possibilities: -Concurrent infections -Evolution of genetic resistance in old world populations.
Smallpox as it occurred in Africa, Asia, and Europe
Smallpox in the Africa, Asia and Europe: - Smallpox was an equal opportunity disease (affected everyone, even the rich) - Famous cases ^ Queen Elizabeth I of England (lived) left her bald and scarred ^ Emperor Kangxi of China (lived) was immune to it because he already got it before, ruled for 61 years, one of China's greatest emperors. ^ Tsar Peter II of Russia (died) ^ King Louis XV of France (died) By the 18th century, smallpox had replaced plague as the most deadly disease in Europe.
The stages of infection and definitions for each of these stages, i.e latent period, incubation period, communicability period, and disease period
Stages of Infection: -Incubation period begins when infected with pathogen ends when disease symptoms present between getting infected and seeing symptoms (i.e the period btw exposure to an infection and the appearance of the fist symptoms) - Disease period starts as soon as incubation period ends showing symptom ends when symptoms go away or you die; can be subclinical or can be overt (like Mary). Pathogens want to reproduce and have their offspring infect other people. - Latent period, starts with infection and ends when pathogens can be shut (i.e from time of being infected to time of becoming infectious) - Communicability period is the length from acquiring infection, during which infection can be communicable (transmitted) to someone else (Incubation period shorter than latent period, big gap that doesn't show symptoms hence people keep going out and getting other people sick. Period of communicability is longer than both the incubation and latent period)
What are the differences between smallpox and chickenpox?
Symptom Differences between smallpox and chickenpox - Rash is limb-centric in smallpox, trunk-centric in chickenpox - Pustules are the same size in smallpox, different sizes in chickenpox - Smallpox rash is preceded by a severe illness (prodromal phase) (Rash comes first in chickenpox, not as severe) One last characteristic of smallpox... Once you've had smallpox (any type) and recovered, you have lifelong immunity to the disease.
How was the third pandemic different than the first two plague pandemics?
The 3rd Pandemic -Began in China in 1855, lasted until 1959 -The first pandemic that was a true pandemic -Killed over 12 million people (majority of mortality was from China and India, because they were really big populations, crowded areas, lots of poor people undernourished, and bad living conditions.) It helped us understand the historical epidemiology and distribution of the plague; having documented outbreaks of the third pandemic can enable comparisons with historical ones, pre-antibiotic era
Physical and social environment factors that contributed to the second plague pandemic in Europe
The Black Death (second plague pandemic) Referred to as the black death, due to infection of yusenia peris where you turn black due to death of organs & tissues, black death used in 16th century due to the darkness, gloom, and terror surrounding the pandemic, describing the lived experience at that time & not necessarily the black degeneration of organs and hands like seen in an image. . Setting the stage: Physical environment - Colder and wetter than normal weather from 1345-47 resulted in widespread food shortages (important because when you don't have enough foodt o eat, your immune system get sicker quicker, healthier people deal with it better) (Europe at this time is heavily populated, maxed out the amount of people can live there, then a food shortage occurs, etc) - Social environment: - Widesprea travel, including travel by ship (travel helps spread plagues) - general lack of sanitation (didn't have sewage systems, which allows for rats to come and spread the bacteria or parasite) - Large, generally malnourished populations centered in urban areas (people cramming together, making fleas easily capable of spreading the disease) -marked inequality (rich had food and were able to leave and not cram together, poor people mostly suffered)
The Infectious Process; i.e contamination, infection, and colonization/sub-clinical infection/infectious disease, including examples of all three options at the end (colonization, etc)
The Infectious Process: 1. Contamination: (exposure to pathogens (most don't make it in body), can be through cough, sneezing next to you) 2. Infection (gets through external barrier without inflammatory response, find a nest and reproduce) 3. (A) Colonization (carrier state) —> no physiologic response happens, no symptoms of feeling sick, can be exposed to others, a carrier carries a disease without knowing Ex: Typhoid Mary—> she was a cook, family she worked for got a bad fever & so did the other families she worked for, plus one person died, this disease can be fatal; she was asymptomatic) (B) Subclinical Infection —> gets sick but can be misdiagnosed because symptoms aren't too harsh or that concerning (Adult Pertussis) (C) Infectious disease present getting a virus and throwing up
Types of plague, i.e bubonic, pneumonic and septicemic, including the causes of the different types and the symptoms and outcomes of the different types
Types of Plague: -Bubonic: infection of the lymph nodes (most common) -Pneumonic: infection of the lungs -Septicemic: infection of the blood Bubonic plague symptoms: Begins 2-6 days after infection -High fever, headache, extreme exhaustion -Bubo: swollen lymph gland, typically in the neck, armpit, or groin region. -Purple rashes due to hemorrhaging under the skin -Vomiting, coughing, acral necrosis, extreme pain (dying tissues) -Delirium, coma ^ Death in 50-60% of cases (7-14% mortality rate with vaccines, usually not treated fast enough and misdiagnosed hence it's too late) (Image looks like a gulf ball in lymph nodes.) Pneumonic plague symptoms: Begins in 2-7 days ( if occurring as the result of bubonic plague) or 1-2 days (if occurring as a primary infection) -high fever, headache, extreme exhaustion -Rapidly developing pneumonia Chest pain severe cough bloody sputum ^Death in 95-100% cases ( death rate still 50%) Septicemic plague symptoms: Begins 1-1.5 days after infection (infection inside blood vessel, bacteria directly into blood system) -High fever -Abdominal pain, vomiting, diarrhea -Organ failure due to ischemic necrosis -Bleeding due to clotting problems, low blood pressure (bleeding from everywhere) ^ Death in 100% cases (treated in the first 24 hours, 15% may live) So fast in killing someone
Types of smallpox, i.e ordinary with a discrete rash, ordinary with a Confluent rash, malignant, hemorrhagic, and modified caused by V. Major and smallpox caused by V. Minor, including the causes of the different types and the symptoms and outcomes of the different types.
Types of smallpox: (don't need to know) -VAriola minor (alastrim) -VAriola major: Ordinary -Discrete rash -Confluent rash -Malignant -Hemorrhagic -Modified Ordinary Smallpox symptoms: -90% of naturally occurring cases (caused by VAriola major, very long disease, takes a month) -Begins 7 to 17 days after infection (very mobile because you don't feel sick right away) 1. Prodrome phase (2-4 days): high fever, malaise, head and body aches, sometimes vomiting. 2. Early rash phase (4 days): rash appears on tongue and in mouth, the rash spreads to all parts of the body, this develops into bumps that become pustules. (Becomes the most contagious, face-centered disease, deep within the skin, fills in with fluid, distinguishing characteristic of the dimple/donut look.) 3. Pustular rash phase (5 days): pustules become hard and fever returns (like a BB gun, cannot pop like a pimple) 4. Pustules and scab phase (5 days): pustules leak to form a crust and then scab (will be less infectious through the air, the fever will drop) 5. Resolving scab phase (6 days): scabs fall off leaving marks on the skin that eventually become pitted scars. ^Note the length of the infection (22-24 days). ^Death in 30% of cases (usually the result in pneumonia, the pustules also happening internally, can have fluid in lungs that can be fatal.) -Some people reported that the pustules were uncomfortable and hurt, felt like they were on fire, once they burst the pustules gave a rotting odor. Complications: -Blindness, arthritis and permanent scarring -Confluent rash (pustules so close together, they merge together, sheets of skin, problem that sheets of skin can then detach from the body which can lead to infection due to the loss of skin, like burn cases. Death rates are higher, 60% or more. Malignant smallpox symptoms: -5-10% of naturally occurring cases (mostly infecting children) -Similar to ordinary smallpox except: ^ Prolonged and severe prodromal phase ^ Lesions appear slowly and remain flush with the skin ^ Lesions are not filled with fluid and are velvety to the touch ^ Death is a 100% fatal Hemorrhagic smallpox symptoms: - 2 % of naturally occurring cases - Early fulminating form ^ Hemorrhaging occurs during days 2-3 of the prodrome phase * Late for: ^ Occurring 8-10 days after smallpox symptoms occur, symptoms are then similar to the early fulminating ^ Death rate 100% Modified smallpox symptoms: - Occurs primarily in previously vaccinated individuals - Similar to ordinary smallpox except: ^ Prodromal phase is less severe ^ Lesions are fewer in number, evolve more quickly and are more superficial * Death in 0% of cases - Occurs when individuals are infected with VAriola minor instead of VAriola major. - Similar to ordinary smallpox except: ^ All phases are less severe, including fever and the amount of pustules ^ No complications, including severe skin loss ^ Death in 1% of cases
Definition of smallpox vaccination and the results of this process
Vaccination: - Results: ^ Immunity against smallpox ^ No risk of smallpox infection from the vaccination ^ No risk of smallpox spread from the vaccination. Problems: - How to get the vaccine ^ Pick your cow... (can run out of cows, some would infect cows purposefully) ^ Arm-to-arm spread (get someone infected from a cowpox virus and take material from that person's arm, was a common solution. Took orphans and did inoculation, unethical now, problems with this virus includes spreading bodily fluids with others, so if you get blood mixed in with other materials that can lead to serious complications and worse viruses.) Some vaccines did not take (evolving which is a problem) No lifelong immunity (limited to 5-10 years so needed to revaccinate)
Definition of vector-borne diseases and the example of schistosomiasis
Vector-borne diseases: Diseases transmitted by a vector (an animal commonly or insect or spider that's also infected with disease) Ex: Dengue, Lyme Disease, Malaria, Schistosomiasis *Schistosomiasis: -Responsible pathogen: Schistosoa -Mode of transmission: contact with water containing free swimming larval forms that have developed in snails Symptoms: ^Diarrhea, abdominal pain, enlarged spleen ^Bloody urine ^Liver & kidney failure (untreated leads to death) -Treatment/Prevention: ^No treatment ^Kill the snails ^Avoid contact with contaminated water Image: extreme swelling in internal organ (common in particular areas of the world, Africa and poor countries, snail environment in rivers cultural —> not seeing kid urine In U.S we have pesticide control that kill those snails but other countries don't have such resources, hence may not impact developed countries which may be why their is not vaccine or cure found)
How means of transmission and level of virulence are often linked and how human behavior can influence pathogen evolution
Virulence is optimum and generally related to means of transmission airborne —> less virulent waterborne —> more v vector-borne —> more v contact (sexual) —> less v _Antibiotic Resistance: ^Characteristics that make bacteria susceptible to antibiotics developed prior to the development of antibiotics ^Some bacteria are naturally resistant to antibiotics ^The use/overuse of antibiotics can select for those resistant strains... (most antibiotics given to animals and not people; can end up in strain that are completely antibiotic resistant—> will experience disease like olden days that didn't have antibiotics)
Definition of zoonotic diseases and the example of trichinosis
Zoonotic Diseases: Diseases of animals that can be transferred to humans Ex: Hantavirus, Psittacosis, Rabies, Trichinosis *Trichinosis: -Responsible pathogen: trichinella sp. (seasonal warms) -Mode of transmission: eating undercooked meat containing Trichinella cysts (mostly found in pork, especially wild boar, bear, etc) -Symptoms: ^Nausea, heartburn, and diarrhea ^As larvae migrate - edema, muscle pain, fever, and weakness ^Occasionally myocarditides (heart), encephalitides (brain and spine) or pneumonia (blood) -Treatment/Prevention: ^Anti-parasite medication ^Fully cooked meat ^Preventative measures when raising and slaughtering pigs (not deadly, but very unpleasant, uncommon in U.S Cultural practices: eating animals that cause this In Middle East, not likely bc pork prohibited in U.S, very careful in meat production industry)
