1. Epidemiology Lab

2. Cup #____--Data Table 1-My partners 123 INFECTED PERSONS123 Data table 2- Classmate’s partners Bellringer- Copy these tables on page14

3. Epidemiology Lab 1.Record the number of your cup on data sheet #1. 2.Date #1: Move around the room & exchange names and cup numbers with one classmate. Write this information in Data table 1. 3.Exchange body fluids by giving some of yours, and taking some of theirs. -Technique: all/all/half 4. We will do this twice more as a group— Do Not go “dating” without direction to do so

4. INFECTED PERSONS123 Acquired ImmunoDeficiency Syndrome—Data Table 2

5. ANALYSIS Questions Write Questions & Answers under your data tables 1.How is this simulation similar to the spread of AIDS? 2.Who was the original carrier in the class? 3.What does AIDS stand for? 4.What does HIV stand for? 5.Do all people who have HIV look sick? 6.How is HIV spread? 7.Why is it important to know all the contacts your partner has had before you? 8.How would the number of contacts affect the percentage of infected individuals? 9.In this model, how could you have prevented yourself from being infected?

7. Knowledge About STDs Among Americans

8. 8 Genital Ulcer Diseases – Does It Hurt? Painful –Chancroid –Genital herpes simplex Painless –Syphilis –Lymphogranuloma venereum –Granuloma inguinale Sores

9. 9 Primary Syphilis - Clinical Manifestations Incubation: 10-90 days (average 3 weeks) Chancre –Early: macule/papule  erodes –Late: clean based, painless, indurated ulcer with smooth firm borders –Unnoticed in 15-30% of patients –Resolves in 1-5 weeks –HIGHLY INFECTIOUS Sores

10. 10 Secondary Syphilis Rash Sores Source: Florida STD/HIV Prevention Training Center

11. 11 Secondary Syphilis: Generalized Body Rash Sores Source: CDC/NCHSTP/Division of STD Prevention, STD Clinical Slides

12. 12 Secondary Syphilis Rash Sores Source: Florida STD/HIV Prevention Training Center

13. 13 Secondary Syphilis Rash Sores Source: Cincinnati STD/HIV Prevention Training Center

14. 14 Secondary Syphilis Sores Source: Diepgen TL, Yihune G et al. Dermatology Online Atlas

15. 15 Genital Herpes Simplex - Clinical Manifestations Direct contact – may be with asymptomatic shedding Primary infection commonly asymptomatic; symptomatic cases sometimes severe, prolonged, systemic manifestations Vesicles  painful ulcerations  crusting Recurrence a potential Diagnosis: –Culture –Serology (Western blot) –PCR Sores

16. 16 Epidemiology of Genital Herpes One of the 3 most common STDs, increased 30% from late 70s to early 90s 25% of US population by age 35 Complications: neonatal transmission, enhanced HIV transmission, psychosocial issues Sores

17. 17 Do Patients Want to Know? 92.4% wanted to know if they were infected 90.8% wanted to know if their partners were infected 65% expected the test as part of STD screening Sores Source: International Herpes Management Forum, 1999

18. 18 “Drips” Gonorrhea Nongonococcal urethritis Chlamydia Mucopurulent cervicitis Trichomonas vaginitis and urethritis Candidiasis

19. 19 Gonorrhea - Clinical Manifestations Urethritis - male –Incubation: 1-14 d (usually 2-5 d) –Sx: Dysuria and urethral discharge (5% asymptomatic) –Dx: Gram stain urethral smear (+) > 98% culture –Complications Urogenital infection - female –Endocervical canal primary site –70-90% also colonize urethra –Incubation: unclear; sx usually in l0 d –Sx: majority asymptomatic; may have vaginal discharge, dysuria, urination, labial pain/swelling, abd. pain –Dx: Gram stain smear (+) 50-70% culture –Complications Drips

20. 20 Normal Cervix Drips Source: Claire E. Stevens, Seattle STD/HIV Prevention Training Center

21. 21 Chlamydia Cervicitis Drips Source: St. Louis STD/HIV Prevention Training Center

22. 22 Mucopurulent Cervicitis Source: Seattle STD/HIV Prevention Training Center Drips

23. 23 Chlamydia trachomatis More than three million new cases annually Responsible for causing cervicitis, urethritis, proctitis, lymphogranuloma venereum, and pelvic inflammatory disease Direct and indirect cost of chlamydial infections run into billions of dollars Potential to transmit to newborn during delivery –Conjunctivitis, pneumonia Drips

24. 24 C. trachomatis Infection (PID) Drips Source: Patton, D.L. University of Washington, Seattle, Washington Normal Human Fallopian Tube Tissue PID Infection

25. 25 HPV Warts on the Thigh Source: Cincinnati STD/HIV Prevention Training Center HPV and Cervical Cancer

26. 26 HPV and Cervical Cancer Infection is generally indicated by the detection of HPV DNA HPV infection is causally associated with cervical cancer and probably other anogenital squamous cell cancers (e.g. anal, penile, vulvar, vaginal) Over 99% of cervical cancers have HPV DNA detected within the tumor Routine Pap smear screening ensures early detection (and treatment) of pre-cancerous lesions GARDASIL helps protect against 2 types of HPV that cause about 75% of cervical cancer cases, and 2 more types that cause 90% of genital warts cases. HPV and Cervical Cancer

27. 27 Possible HPV on the Tongue Source: Cincinnati STD/HIV Prevention Training Center HPV and Cervical Cancer