1. Appropriate Responses To Infectious Disease
Anthropology 393 – Cultural Construction of HIV/AIDS
Josephine MacIntosh
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2. Modes of Disease Transmission
Vector-borne: transmitted via non-human hosts such as mosquitos, lice, fleas etc
West Nile virus
Avian influenza
Malaria
Typhus
Bubonic plague (McGrath, 1991)
plague, West Nile
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3. Modes of Disease Transmission
Direct contact: transmitted via respiration, fecal-oral contact or sexual contact (there is no non-human vector)
Measles
Syphilis
Most influenzas
Chickenpox
HIV/AIDS (McGrath, 1991)
plague, West Nile
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4. Modes of Disease Transmission
Environmental contamination: transmitted via contact with pathogens living in food, water, air, or on items such as contaminated clothing or needles
Cholera
Typhoid
Salmonella
HIV/AIDS (McGrath, 1991)
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5. Recall… with HIV
Blood transfusion is the most efficient route for HIV infection
Sexual transmission is the most common route for HIV infection
Most HIV/AIDS transmissions are the result of direct contact, although some infections are the result of environmental contamination (e.g. dirty needles)
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6. Case Reproduction
The degree to which secondary cases are generated from primary cases depends on the transmission efficiency of the infectious agent
Transmission efficacy is an expression of the probability that an uninfected, susceptible individual will come in contact with an infected individual, multiplied by by the possibility that transmission will occur during such contact
(Anderson, 1996)
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7. Recall… Classical epidemic curve is bell-shaped
Steepness of slope is a measure of infectivity or contagion
Length of the curve describes duration of epidemic
Highly infectious diseases (like measles):
Short period of infectiousness (generally 2 weeks)
Relatively short duration (typically 6 months to a year)
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8. But… Not so with HIV/AIDS Marked by elongated curve
Lengthy period of infectivity, enduring over generations
Several distinct peaks
As it moves through different populations (MSMs, IDUs, etc)
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9. Appropriate Biological Responses
Elimination of the source of infection
Including vector populations, pathogenic organisms, sources of environmental contaminants
Elimination of adequate contact
Between sources of infection, susceptible hosts and susceptible vectors
Reducing infectivity
Of vectors, hosts, or environments
Reducing host susceptibility
(McGrath, 1991)
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10. Appropriate Social Responses
Appropriate: cause little social disruption
Inappropriate: cause much social disruption
Inappropriate responses may increase the biological impact by increasing incidence of disease
Common social responses
Flight
Adoption of extraordinary measures
Scapegoating, social ostracism
(McGrath, 1991)
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11. Improve Public Health Biologically appropriate interventions:
Eliminate source of infection and/or
Eliminate contact with source and/or
Reduce infectivity and/or
Reduce susceptibility
Socially appropriate interventions:
Limit social and economic disruption
Promote stability along prevention/care continuum
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12. Appropriate Responses?
Eliminate source of infection
Genocide of those infected
Eliminate contact with source
Use of latex condoms
Universal precautions
Partner notification
Restrict travel, impose quarantine, or jail terms
Mandatory testing, involuntary follow-up testing
Deny traditional rituals like funerals & marriage
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13. Appropriate Responses?
Reduce infectivity
Large scale distribution of drugs, as proposed in the World Health Organization ‘3 by 5’ plan (WHO, 2003)
See:
Provision of vaccines (when they become available) to ‘at risk’ populations (WHO, 2003)
Reduce susceptibility
Dietary supplements (i.e. selenium)
See: Foster, Harold (2001). “What Really Causes AIDS”. Trafford: Victoria. Online:
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