1. Other Infectious Diseases

2. What disease killed million people worldwide but has since been eradicated from the human population?

3. Smallpox Progression: Rash Pus-filled blisters
Disfiguration and/or blindness
Death rate = 30%
Man with smallpox; Public Health Images
Library. Source: CDC

4. Variolation: The Earliest Smallpox Immunization

5. Who invented smallpox variolation?
The first vaccine
Edward Jenner

6. The smallpox vaccine Fatal complications are rare:
Made with cowpox virus
Side effects: red spot, pustules, scabs, leaves a scar. Fever is common, swelling.
Fatal complications are rare:
1 death per million vaccines

7. The World Takes Action
1967: WHO announces global smallpox eradication program.
Still 15 million new cases a year then
1977: Last reported naturally occurring case in Somalia.
Smallpox is the only disease totally eradicated in humans

8. Smallpox: Bioterrorism Agent?
Routine vaccination discontinued in 1972
Vaccines controversial today
Project BioShield Act of 2004

9. Recognize this?
Ring around the rosy, A pocket full of posies, Ashes… Ashes, We all fall down!
Written in London in 1665

10. Plague ended in 1666 Great fire of London finally killed the rats
The brown rat, house rat, sewer rat, Norway rat = carriers of Bubonic Plague

12. Bubonic Plague = Black Death

13. Black Death
Gangrene caused by plague

14. Plague in the U.S.
CDC

15. Plague in Oregon 13 cases reported in Oregon (5 fatal) since 1970.
Mostly spread from fleas of infected rodents.

16. e. coli E. coli normally live in the intestines.
Most strains of e. coli are harmless
Harmful e. coli are transmitted through contaminated food, water, or contact with infected person.

17. E. coli symptoms Severe stomach cramps Diarrhea (usually bloody)
Vomiting
Fever (low grade)
Treatment / Prevention

18. Salmonella

19. Salmonella continued 42,000 cases reported every year.
Causes diarrhea, fever, abdominal cramps
A result of contaminated food, water, or contact with infected animals.

20. Botulism Caused by Clostridium botulinum bacteria
Rare but serious – causes paralysis if left untreated.
Five types of botulism:
Foodborne
Wound
Infant
Adult intestinal
Iatrogenic

21. Botulism Symptoms include: Antitoxin is available for treatment
Double vision, blurred vision, drooping eyelids, slurred speech, difficulty swallowing, dry mouth, muscle weakness.
Antitoxin is available for treatment

22. Botulism prevention Proper food handling Botulism’s not all bad….
Especially in food preservation
Be wary of dented, bulging cans
Botulism’s not all bad….

23. Malaria Caused by parasite Transmitted by mosquito
Once injected into the human, the parasite grows and multiples first in the liver and then the red blood cells.

24. Malaria in the U.S. & World
About 1,500 cases reported every year in the U.S.
From travelers and/or immigrants
Malaria considered eradicated from U.S. in 1950’s.
3.3 billion people diagnosed worldwide
Thrives in tropical and subtropical areas.

25. Influenza Symptoms Fever Cough Sore throat Runny or stuffy nose
Muscle or body aches
Fatigue
Headaches

26. Preparing for next crisis

27. Influenza Impact Flu seasons vary from year to year
About 20% of US population infected every year
Higher among susceptible populations
Three main types of flu virus: Types A, B & C
Type A causes the greatest morbidity and mortality
Example: H1N1 (2009 Epidemic)

28. Influenza Pandemics
Since the late 19th century, four occurrences of pandemics
; ; ;
2009; H1N1
Was that the pandemic for our time??
Type A cycles every years
What’s different about Type A influenza?

29. Tuberculosis 20-33% world’s population is infected with TB
Majority of the above = “Dormant TB”
Can be dormant for 30 years
Only 5-10% will become “active” TB

30. TB continued TB bacteria produces nasal discharge, coughing, sneezing
Airborne

31. TB and Oregon
Public.health.oregon.gov

32. MRSA Methicillin-resistant Staphylococcus Aureus
Staph bacteria resistant to certain antibiotics called beta-lactams.
Often appears as pustule or boil
May think of a spider bite at first.

33. MRSA continued HA-MRSA = Health care acquired
More serious and potentially deadly
CA-MRSA = Community acquired
Anyone is at risk

34. Factors that Facilitate Transmission
Crowding
Defense
Offense
Frequent Contact
Antimicrobial
Use
Compromised Skin
Contaminated Surfaces
and Shared Items
Cleanliness
(CDC, 2012)

35. MRSA in the news… Newberg, Oregon…
High schooler spread MRSA through tattoos, several students infected.
Mainly spread through unclean needles.

36. MERS-CoV Middle East Respiratory Syndrome Coronavirus
April 2012 – present
Currently under investigation
SARS-like virus
Symptoms: fever, cough, shortness of breath

37. Others in the news…
Ebola
Flesh-eating disease
Mad cow

38. More infectious diseases
Kissing disease
African Sleeping Sickness

39. Misc
Acne
Ulcer
Bad breath

40. Giardia

41. Hepatitis HAV HBV HCV U.S. Stats 25,000 new infections/yr
Transmission
Ingestion of fecal matter
Contact w/ infectious body fluids
Contact w/ infected blood
Severity
Usually no lasting damage, rarely fatal
Most fully recover;
Some develop liver disease; ~3,000 die / yr
60-70% develop chronic liver disease; 1-5% will die from liver cancer
Vaccine?
Vaccine available
No vaccine
Symptoms
Fever, fatigue, loss of appetite, nausea, vomiting, abdominal pain, joint pain, jaundice
43,
CDC, 2012

42. HIV Human Immunodeficiency Virus = The cause of AIDS
AIDS = the end-stage of HIV disease
What exactly is HIV / AIDS?
How does it affect the immune system?

43. HIV About 30-40 million people worldwide are living with HIV
How many of those live in the US?
Approximately 1 million
Approximately 1 in 5 of them don’t know they have HIV

44. HIV in Oregon

46. HIV testing ELISA, confirmed with Western Blot
Positive P24 antigen test
Home tests
Recently approved

47. Anything new? Prevention campaigns The Affordable Care Act of 2010
Reduce number of new infections
Increase access to care
Reduce HIV-related disparities
2013 Budget
Estimated $28.4 billion for domestic and global HIV/AIDS activities
Prevention campaigns

48. Other STIs
Gonorrhea
Syphilis