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Epidemiology
Epi
146
Biology
Graduate
11/23/2009

Additional Biology Flashcards

 


 

Cards

Term

-World Population

-How many in developing countries?

-How many die each year?

Definition

-6.5 billion

-5.5 billion

-60 million

Term
World life expectancy
Definition
65 years
Term
Developed countries life expectancy
Definition
76 years
Term
Developing countries life expectancy
Definition
63 years
Term
Biggest killers (7)
Definition

Cardiovascular

Cancer

HIV

Lower resp tract infect

Diarrhoeal dx

Malaria

Measles

Term
Smallpox is caused by ____; transmitted by ____
Definition

Variola virus

Transmitted by close personal contact (droplets)

Term
Two forms of Smallpox
Definition

Variola major (most common); 30% mortality

Variola minor (less common); 1% mortality

Term
Smallpox was eradicated in
Definition
1979
Term

Smallpox:

  • Incubation period
  • Symptoms
  • Can lead to more serious complication such as:

Definition

  • ~2 weeks
  • Fever, aches, vomiting, rash (with scaring)
  • Pneumonia and encephalitis

Term
Pathogen
Definition
That which produces suffering
Term
Impact of human pathogens has decreased in some population because: (5)
Definition
Food safety, hygiene, water treatment, vaccination, and drug tx.
Term
Viruses
Definition

  • Particles that infect cells of biological organisms
  • Cannot reproduce on their own and therefore hijack cellular mechanisms of the host to reproduce
  • Consist of a genome (RNA or DNA) and a protective coat (capsid)

Term
Bacteria
Definition

Unicellular micro-organisms

Term

10 diseases spread through droplet

(cough/sneeze)

Definition

 

  1. Bacterial meningitis
  2. Chickenpox/shingles: VZV/HHV3
  3. Common col (rhinovirus/coronavirus/picornavirus)
  4. Influenza
  5. Mumps
  6. Streptococcal throat
  7. TB
  8. Measles (paramyxovirus)
  9. Rubella
  10. Whooping cough

 

Term
5 diseases faecal-oral transmission (via food/water)
Definition

 

  1. Cholera
  2. Hep A
  3. Polio
  4. Rotavirus
  5. Salmonella

 

Term
6 diseases spread through sexual transmission
Definition

  1. HIV
  2. Chlamydia
  3. Genital warts
  4. Gonorrhoea
  5. Hep B
  6. Syphilis

Term
2 diseases spread through direct contact
Definition

  1. Athletes foot
  2. Impetigo (Staph. aureus)

Term
3 diseases spread vertically
Definition

  1. HIV
  2. Syphilis
  3. Hep B

Term
2 diseases that lead to search for immunosuppressing disease
Definition
Pneumocystis pneumonia and Kaposi's Sarcoma
Term
Pneumocystis is caused by ____
Definition
Pneumocystis jirovecci
Term
Pneumocystis is classified as a _____
Definition
fungus
Term
Tx for PCP; had to go through CDC; increased requests for this drug alerted to immunosupressed disease
Definition
Pentamidine isethionate
Term

Kaposi Sarcoma cause

 

Definition
HHV8 infection
Term
HIV is a _____virus which is characterised by ____
Definition

Retrovirus

Reverse Transcriptase

 

Term
HIV attacks ____
Definition
Immune system cells; makes one more susceptible to infection
Term
HIV specifically infects what
Definition
CD4+T, macrophages, and microglial cells
Term
HIV transmitted how?
Definition
Sex, blood and blood products, and vertically (mother-child)
Term
What do people with HIV dx die of? (5)
Definition

 

  • TB
  • Certain fungal infections (eg, severe candida, PCP)
  • Certain viral infections (eg, CMV, herpes simplex)
  • Toxoplasma (a parasite)
  • Certain cancers, which are themselves caused by other underlying infection

 

Term
HIV2 found primarily where?
Definition
West Africa
Term
Prevention of HIV (6)
Definition

  1. Avoid high risk sexual behaviour
  2. Make testing more available
  3. Condoms
  4. Vaginal microbicides
  5. Management of STDs
  6. Circumcision

Term
What general HIV intervention strategies are possible? (6)
Definition

 

  1. Introduction of blood donor and product screening
  2. Promotion and distribution of condoms at affordable prices
  3. Peer education for high risk groups (eg, sex workers)
  4. Promotion of safer sexual behaviour at the population level
  5. Diagnosis and tx of STDs
  6. HIV voluntary counselling and testing

 

Term
More specific intervention strategies with HIV (4)
Definition

 

  1. Home-based care for people with AIDS
  2. Opportunistic infection prophylaxis (eg, Cotrimoxazole) or TB prophylaxis
  3. Prevention of mother-to-child HIV txmission
  4. ART tx for immunocompromised adults (CD4<200) and children

 

Term
~__/__ of children born to infected mothers are themselves infected
Definition
1/3
Term
Prevention of vertical HIV txmission (3)
Definition

ART during pregnancy

Delivery by C-section

Formula feeding (where possible)

Term
Prevention of HIV txmission via blood or blood products (3)
Definition

Screening of blood banks

Needle exchange

Post-exposure prophylaxis

Term
Determinants of effective outcomes of intervention (HIV) (3)
Definition

 

  • Economics: healthcare dollars per annum per capita
  • Priorities: Academic analyses of cost-effectiveness may not reflect developing world realities
  • Setting: Political openness towards HIV (good in Uganda and Senegal)

 

Term
What HIV interventions would make the most difference? (3)
Definition

  1. Prevention of new infections is the key to long term control of the pandemic 
  2. Tx of people w/AIDS and low CD4 counts also prevents some new cases
  3. Development of prophylactic vaccines & vaginal microbicides

Term
Problems of generating a prophylactic HIV vaccine (3)
Definition

  1. HIV-1 is a retrovirus with inherent error-prone transcription; ie, very high mutation rates and multiple immune escape mechanisms; large amount of sub-types and recombinants
  2. Although a small number of monoclonal antibodies exhibiting broad cross-clade neutralisation have been described, no immunogens have been able to induce such neutralising antibodies
  3. For vaccine to be effective against HIV-1, it would need to induce neutralising antibodies, as well as CD8 and CD4-T cells responses

Term
Why develop a microbicide? (3)
Definition

  1. Condoms prevent HIV, but are under the control of men
  2. For many women, esp. in the developing world, current prevention options offer little control or protection
  3. A new female-controlled effective HIV prevention method would be invaluable

Term

  • How do microbicides work?
  • Requirements for microbicide (3)
  • Delivery options for microbicides

Definition

  • Act by blocking the mechanism of cellular infection or by killing the virus pre-infection
  • Must be safe; absorption should be minimal; amount of drug needed to kill or block virus must be less than that which kills/inflames body cells
  • Gels, films, pessaries, rings

Term
HIV treatment and downsides
Definition

  1. Anti-retroviral drugs
  2. Combination of drugs that inhibit the action of reverse transcriptase
  3. Reduce viral replication and viral load, thereby reducing infectivity
DOWNSIDE: expensive and nasty side effects

Term
Side effects of ART
Definition
Hypersensitivity syndrome (fever, myalgia, malaise, n/v, upper respiratory tract infection); rash; headache; diarrhoea; pancreatitis, neuropathy; dry mouth
Term
Requirements for ART in the developing world?
Definition

  1. Must be acceptable, locale specific, and sustainable
  2. Quality assured HIV testing, CD4 count enumeration, and ART, as well as healthcare infrastructure and continuous drug supplies need to be permanently established

Term
Origin of HIV
Definition

  • Based on analysis of 1300 chimpanzee faecal samples, infection is likely to have originated in wild chimps in SE Cameroon (Sanga river)
  • Based on fixed mutation rates of the virus, the jump to humans probably happened between 1920-1950, via butchering and consumption of bushmeat

Term
Future of HIV
Definition

  • Epidemic is still spreading
  • Drug resistance is a growing problem
  • No vaccine is available
  • Control programmes are patchy

Term
3 current problems and issues with HIV and ideal solution
Definition

  1. Africa still struggles against debt, trade restrictions, and inadequate aid provision, with little G8 alleviation
  2. 3 by 5 missed its target, ~1.2 million of tx by end of 2005, the big players (SA, India, etc) are not delivering, but the principle is established
  3. The Global Fund is under-resourced, with estimated funding gaps of $900 million for 2006 rising to $2.1 billion by end-2007
  4. Long term commitments to AIDS funding by G8 would be ideal solution

Term
The way head in HIV tx
Definition

  • Providing ART to those who need it is necessary now and will continue to be so for the forseeable future as the millions of prevalent infections progress to clinical dx.  However, such ART will bring its own complications including drug side-effects and the generation and onward txmission of drug resistant strains
  • We must, therefore, continue to work ceaslessly on vaccines, microbicides, and other new preventative technologies

Term

 

  • TB known as:
  • Lymphatic spread
  • Skin lesions
  • Abdominal spread
  • Spine
  • Joints
  • Disseminated

 

Definition

 

  • Consumption and Phthisis
  • Scrofula
  • Lupus vulagaris
  • Tabes mesenterica
  • Pott's dx
  • Gibbus
  • Military TB

 

Term
Cause(s) of TB
Definition

 

  • Mycobacterium tuberculosis
  • In immunosuppressed people:
  • M. bovis
  • M. africanum
  • M. microti

 

Term

Transmission of TB

  • Spread how
  • Can infect how many people a year
  • At risk populations?

Definition

 

  • Spread in droplets (cough, sneeze, speak, kiss, spit)
  • Someone with chronic active TB may infect 10-15 people per year
  • "At risk" populations include those from areas where TB is common, health-care workers, drug users, and immunosuppressed people

 

Term
Primary site of TB infection is:
Definition
Lung
Term
How TB infection happens
Definition

  1. Mycobacterium reaches pulmonary alveoli
  2. Replicates within alveolar macrophages
  3. Bacteria enters dendritic cells (not replicating) and travels to lymph nodes
  4. Enters bld and spread to organs of the body
  5. Infected macrophages become surrounded by T & B lymphocytes and fibroblasts (forming a "granuloma," limiting dissemination)
  6. Granulomas can become necrotic in the centre 

Term
TB is a _____ disease
Definition
Granulomatous inflammatory
Term
Widespread TB is particularly common in ____ and ____
Definition
Infants and the Immunosuppressed
Term

__/__ world population has been exposed to TB

1 new infection per ___ worldwide

Most infections are _____

__/__ progress to active TB

Of those, __% die (_____ people annually)

Definition

1/3 (~2 billion people)

Second

latent (non-infectious

1/10

50 (1.6-2 million people)

Term

  • In 2004, there were ___ cases chronic-active TB
  • ___ new cases
  • ___ deaths
  • __% resistant to 1st-line tx
  • __% resistant to 2nd-line tx
  • Highest incidence in ___
  • Largest number of cases in ____

Definition

  • 14.6 million
  • 9 million
  • 1.6 million
  • 20%
  • 2%
  • 780 cases per 100k people
  • 1.8 million

Term

In 2004, UK TB incidence ranged from __ to ___

Definition

5/100k in rural areas

40/100k in London

Term
Factors increasing susceptibility to TB and increasing mortality amongst infected individuals (3)
Definition

  1. HIV/immunosuppression
  2. Smoking (4-fold excess risk)
  3. Diabetes

Term
Diagnosis of TB
Definition

  • Bacteria is slow, therefore difficult to diagnose by culturing infected samples
  • Active lung infection can be diagnosed by staining bacteria in sputum sample
  • Latent infection diagnosed in a non-immunised person with skin test leading to hypersensitivity to TB-derived proteins (NO USE IF VACCINATED)

Term
Treated active TB has a mortality of ___ compared to as much as ___ if untreated
Definition
5%; 67%
Term
Standard short course antibiotics TB infection:
Definition

  • 4 antibiotics for 2 months (Isoniazid, rifampicin, pyrazinamide, and ethambutol) then
  • 2 antibiotics for 4 months (Isoniazid and rifampicin)

Term
TB DOTS-regime
Definition
Directly Observed Therapy, Short-Course
Term
Side effects of TB drugs
Definition
Neuropathy, rashes, itching, fever, hepatitis
Term

MDR-TB

  • Highest rates in:
  • Associated with:
  • Can develop during ___ due to___

Definition

  • Baltic states, Argentina, India, and China
  • Associated with poor or failing TB control programmes (also seen in NY in the '90s)
  • Can develop during the tx of sensitive TB due to non-compliance

Term

XDR-TB

 

  • Epidemic in ___
  • First report
  • How many cases/year estimated in 2008
  • Most frequent where
  • In US, __% of MDR met criteria for XDR
  • In Latvia, __% of MDR met criteria...

 

Definition

 

  • KwaZulu-Natal in South Africa recently
  • First report of 52/53 cases, all died within 16 days of sputum collection; all in previously untreated people; most were HIV infected as well
  • 40,000 cases (WHO)
  • Former Soviet Union and parts of Asia; found in all regions of the world
  • 4%
  • 19%

 

Term
TB Vaccination
Definition
BCG (Bacille Calmette-Guerin)
Term
BCG derived from ___
Definition
Live, bovine, tuberculosis bacillus
Term

BCG vaccine trial in UK

  • __% effective
  • First trial
  • 1966 US trial in Alabama showed __% efficacy
  • 1979 trial in South India showed __ effect
  • Duration of protection?
  • Most effective in preventing ___

Definition

  • 60-80% effective; elsewhere-no effect
  • First trial was conducted in 1956-1963 in school children (84% efficacy after 5 years)
  • 16%
  • no effect
  • Unclear
  • Military TB or TB meningitis (especially in infants); effect on pulmonary TB less clear

Term
Reasons for variable efficacy of BCG vaccine? (4)
Definition

 

  1. Background prevalence of TB
  2. Background prevalence of non-tuberculous mycobacterium
  3. Interference of other parasites
  4. Genetic variation (host or bacterial)

 

Term

Worldwide BCG vaccine programmes

  • US
  • UK
  • India

Definition

  • None
  • Universal vaccination 1953-2005
  • Universal vaccination since 1948

Term
BCG vaccine most effective in preventing:
Definition
Leprosy
Term
Definition of Pandemic
Definition

Derived from the Greek

Pan = all

demos = people

Term
WHO definition of a pandemic (3)
Definition

 

  1. Emergence of new (or variant dx)
  2. The dx is infectious to humans and causes severe illness
  3. The agent spreads easily and sustainably in human population

 

Term

Typhus caused by

Where is this endemic?  How spreads to humans

Definition

Rickettsia

Mice and rats; spread to humans via mites, fleas, and lice

Term

Typhus has a ___ vector

Dx also known as 

Definition

Arthropod vector that flourishes in unhygienic conditions

"Camp fever" or "Jail fever"

Term

Typhus symptoms

Treatable with

Vaccine available?

Typhus controls what populations?

Definition

High fever and delirium

Antibiotics

Vaccine available

Controls rats and mice populations

Term
Typhoid fever caused by:
Definition
Salmonella typhi
Term

Antonine Plague

 

  • Historical accounts written by ___
  • Probably describing 

 

Definition

 

  • Greek physician Galen in 165-180
  • Smallpox or measles
  • He describes the plague as "great" and of long duration and mentions fever, diarrhea, and inflammation of the pharynx, as well as a skin eruption, sometimes dry and sometimes pustular, appearing on the ninth day of the illness. 

 

Term

Plague of Justinian

  • Named after whom
  • Spreads from __ to __ then __
  • Cut the european population by ___
  • Probably ___

Definition

  • Byzantine emperor Justinian I
  • Spread from Egypt to Constantinople and then in waves across Europe
  • 50%
  • Bubonic Plague

Term
Historical pandemics (3)
Definition

  • 430 BC - Peloponnesian War (Typhoid fever killing 1/4 of Athenians)
  • 165-180 Antonine Plague (Smallpox? Killed >5million)
  • 541-570 Plague of Justinian (Bubonic plague)

Term

Vibrio Cholera

  • Type of bacteria
  • Secretes __
  • Causes __
  • Fatality?
  • Patients require what
  • Spread via __
  • Easily controlled by __ and __
  • Most recent outbreaks in __

Definition

  • Gram negative
  • Enterotoxin
  • Extreme diarrhoea
  • Rapidly fata - can cause hypotension within 1 hour of symptom onset and death within 3 hours (more usually, death occurs in 18-20 hrs)
  • Urgent rehydration
  • Contaminated water
  • Good sanitation and water tx
  • Afghanistan, Iraq, Zimbabwe

Term
What is in oral rehydration thx
Definition

  • Sodium 75 mmol/L
  • Glucose 75 mmol/L
  • Potassium 20 mmol/L
  • Chloride 65 mmol/L
  • Citrate 10 mmol/L

Term
Why must sugar be present in oral rehydration thx along with salt?
Definition
Salt absorption is coupled with sugar in the intestine via the SGLT1 transporter
Term
What drinks should be specifically avoided in ORT?
Definition

  • CAFFEINE: diuretic effect
  • HIGH SUGAR DRINKS: hypertonicity has a diuretic effect

Term
Bubonic plague is characterised by __ and can turn to ___
Definition

Buboes (necrotic lymph nodes), purpura (subepidermal haemorrhages), and acral necrosis (gangrene of the extremities)

 

Can turn to pneumonic plague

Term

Total number of deaths from bubonic plague

Deaths in europe

How many separate epidemics?

Definition

75 million

20-30 million (1/3 to 2/3 of the population)

At least 100

Term

Yersinia pestis

 

  • Bacteria description
  • Normally a disease of
  • Human infecction occurs
  • Human infection takes the form of (3)
  • Treated how
  • Vaccine?

 

Definition

 

  • Gram negative, anaerobic bacterium
  • Dx of rodents and fleas
  • When bitten by an infected flea (that was carried by an infected rat)
  • Pneumonia, septicemia, bubonic plagues
  • Combination of antibiotics
  • Vaccine of limited use was withdrawn by FDA due to side-effect profile

 

Term

Xenopsylla cheopis

  • How bacteria works

Definition

  • Bacteria multiplies in the flea, forming a plug blocking the stomach
  • It starts to starve, and so bites voraciously
  • After feeding, it vomits bacteria into the wound, infecting the rat
  • Rodent deaths often precede a human epidemic
  • if an infected flea bites a human, it can cause infection

Term

Xenopsylla Cheopis

  • Pathology

Definition

  • Infection travels from the wound to lymph nodes
  • Causes haemorrhagic inflammation of lymph nodes (causing a 'bubo')
  • Can lead to septicaemia (if untreated, always fatal)
  • If the lungs are infected, it can cause "pneumonic plague" (with this comes the possibility of human-to-human txmission)
  • Bacteria secretes several toxins, including one that causes beta-andrenergic blockage

Term

SARS

  • Caused by
  • Caused "near pandemic" when
  • How many cases identified
  • How many died
  • Symptoms (what are they) occur when

Definition

  • Corona virus (RNA virus)
  • 2003-4
  • 8096
  • 774 (~10%)
  • SOB (eventually resp. dx), malaise, myalgia, and fever occur 3 days post-infection

Term
Spread of SARS
Definition

  • Probably started in Guangdon Province, China in Nov. 2002
  • Picked up by the "Global Public Health Intelligence Network" (WHO)
  • Became prominent when an American became sick on a flight from China (died)
  • Cases occured in Toronto, Vancouver, SF, Ulan Bator, Maila, Singapore, Hanoi, Taiwan, HK, and several other Chinese provinces

Term

Influenza

  • Caused by
  • Transmitted by
  • Kills how many?
  • Mini-epidemics occur ___ and affect ___

Definition

  • Virus
  • Droplets; very infectious
  • 250k-500k people annually
  • Every year, 5-15% of the pop.

Term

Influenza virus

  • Virus description
  • Causes what
  • People are infectious ___ before symptoms
  • Txmission via ____
  • Annual epidemics arise because ___

Definition

  • RNA virus
  • Generalised illness and pneumonia
  • 1-2 weeks p/infection a/symptoms
  • Droplets
  • virus constantly changes so that the immune system is faced w/a slightly new version every year

Term
Antigenic Drift
Definition
Random mutations in the genes of a virus drives antigenic drift,[1][2] a process that changes the antigens of the virus. As these changes accumulate it may help the virus to evade the immune system since antigens are what the immune system recognizes. Antigenic drift can lead to a loss of immunity or vaccine mismatch.
Term
Antigenic Shift
Definition
Antigenic shift is the process by which at least two different strains of a virus (or different viruses), especially influenza, combine to form a new subtype having a mixture of the surfaceantigens of the two original strains. The term antigenic shift is more often applied specifically (but is not limited) to the influenza literature, as it is the best known example (e.g. visna virus in sheep)[1]. Antigenic shift is a specific case of reassortment or viral shift that confers aphenotypic change.
Term
Major flu epidemics are caused by
Definition
antigenic shift
Term

Cause of Malaria

Transmitted how?

Definition

 

  • protozoan parasite
  • Txmitted by female Anopheles mosquito

 

Term

Vaccine for malaria?

Treatment?

Definition

 

  • No vaccine available
  • Can be treated with derivatives of quinine or artemisinin

 

Term
Physician that observed parasites in rbcs in people with malaria
Definition
Charles Louis Alphonse Laveran
Term
Physician that identified the first human dx caused by a protozoa
Definition
Charles Louis Alphonse Laveran
Term
Physician who showed that malaria parasites were transmitted by mosquitoes and identified the parasite in salivary glands of insects fed on infected birds
Definition
Sir Ronald Ross
Term
Hx of malaria tx
Definition

  • First effective tx was the bark of the cinchona tree (contains quinine)
  • Used by locals to control malaria
  • Jesuits introduced it to Europe in the 1640s

Term
Hx of blood stage of malaria
Definition

 

  • Bld stage of malaria was recognised in the 19th and early 20th century
  • Latent form of the dx (in the liver) was recognised in the 1980s
  • Explained why "cured" people could have recurrent episodes years later, in the absence of new exposure

 

Term

Epidemiology of malaria

 

  • Cases of fever/year
  • Affects __ per year
  • Kills __ per year
  • Most death occur in ___ where
  • One death every ___
  • __% of world population "at risk"

 

Definition

MOST CASES RURAL

  • 400-900 million cases of fever annually
  • 515 million people/year
  • 1-3 million/year (85-90% in s-Saharan Africa)
  • Most deaths occur in children <5 in sub-Saharan Africa (preggers also vulnerable)
  • 30 seconds
  • 40%

 

Term
Symptoms of Malaria
Definition

  • Fever, shivering, arthralgia, vomiting, anaemia
  • If severe: convulsions, coma, and death; cerebral ischaemia, hepatomegaly, and renal failure
  • Cyclical coldness, followed by rigor, then fever
  • Splenomegaly
  • Children can display neurological symptoms
  • Symptoms occur 6-14 days p//infection
  • Long term can cause cognitive impairment in children

Term
Latent dx of Malaria
Definition
Latent disease in the liver can cause recurrence up to 30 years p//infection
Term
Cause of Malaria
Definition

(P.=plasmodium)

P. falciparum

P. malariae

P. ovale

P. vivax

Term
Most common infection in malaria is caused by
Definition
P. vivax (80% of cases)
Term
Infection by __ in malaria causes the most deaths
Definition
P. falciparum (15% of infections but 90% of deaths)
Term
Primary hosts and txmission vectors for malaria
Definition

  • Female Anopheles mosquitoes (only female feeds on bld)
  • Inject parasite from infected human blood whilst feeding
  • Carry sporozoites in salivary gland

Term
Malaria parasite protected in humans
Definition

Because it hides in rbcs or in the liver. 

Circulating rbcs can be destroyed in the spleen

Parasite infected cells stick to the bld vessel wall (to avoid spleen) - can cause strokes in cerebral malaria.

Term
Dx-ing Malaria
Definition

  • Most reliable and cheap method of dx-ing involves microscopy of a blood specimen
  • Thick film - very sensitive at detecting malaria (lrg vol of blood)
  • Thin film allows for species identification
  • Antigen detection in bld is also used (but expensive)
  • Dx is often made based on symptoms

Term
Tx of malaria
Definition

  • Emergency and requires hospitalisation
  • Can be cured using drugs
  • Most drugs are based on quinine or artemisin (derived from the plant Artemisia annua)
  • Many drugs can be used for prophylaxis and at higher doses for tx
  • Resistance is a problem (as is counterfeit drugs)

Term
Prevention of Malaria (3)
Definition

  1. Prophylatic drugs
  2. Mosquito eradication
  3. Prevention of mosquito bites

Term
Elimination of mosquitos (3)
Definition

  1. Drainage of standing water (but ag. irrigation is becoming more common)
  2. Widespread use of pesticides (DDT was the most effective)
  3. Local use of insecticides in the home

Term
Prevention of mosquito bites (3)
Definition

 

  1. Appropriate clothing
  2. Insect repellent
  3. Bed nets (most bites occur at dusk and through the night; nets more effective if treated with insecticide)

 

Term
Burkitt Lymphoma - physician who saw 2 children with swelling in 4 angles of the jaw
Definition
Denis Parsons Burkitt
Term
Occurrences of Burkitt's lymphoma
Definition

  • In hyperendemic areas, dx found in Black, Asian, and European children and less commonly in children with Sickle dx
  • Not at altitudes >300 mils 1000 miles south of the equator nor at altitudes >5000 at the equator
  • Not when average temp <60F
  • Not when annual precipitation <20 inches
  • Most where faliciparum malaria is holoendemic
  • Not in malarious areas when anti-malarial interventions in place

Term
EBV Characterisation
Definition

  • Herpes-like virus first seen within lymphoid cells from Uganda children
  • 9% of malignant BL tumours in tropical regions since shown to contain EBV
  • EBV virus also found in pts with non-malignant dx (glandular fever) in the west
  • In temperate zones: EBV in adolesence
  • In Africa: EBV very early in life, often before one year old

Term
Prevention of Burkitt's lymphoma (2)
Definition

  • Use of insecticides in the home
  • Use of bed nets (80% reduction in risk)

Term
Steps in preventing infectious diseases (5)
Definition

  1. Identification of cases
  2. Isolation
  3. Treatment
  4. Understand transmission and intervene in the lifecycle of the pathogen
  5. Vaccination (primary prevention)

Term
Vaccine type for typhoid
Definition
Killed whole organism
Term

Vaccine type for BCG

Definition
Attenuated organisms with reduced pathogenicity
Term

Vaccine type for diphtheria and tetanus

Definition
Toxoid: for some dxes, it is not the infection that is dangerous, but rather the toxin it produces - denatured toxin proteins are used to evoke immune response
Term

Vaccine type for Influenza, Hep B, HPV, and Strep. pneumonia

Definition
Surface molecules
Term

Vaccine type for salk polio virus

Definition
Inactivated virus (killed by heat or formaldehyde)
Term

Vaccine type for measles, mumps, rubella

Definition
Attenuated virus
Term
Cases of vaccination that reduced rates by 99.9-100%
Definition
Diphtheria, measles, mumps, pertussis, poliomyelitis, rubella, tetanus
Term
Secondary effects of Hep B vaccine
Definition
Hepatitis, cirrhosis, and liver cancer and declining as well
Term
Two types of polio vaccines
Definition

Sabin - live, attenuated virus, oral

Salk - inactivated virus, injected

 

Since 1979, there have been 8 cases/year contracted b/c of the vaccine.  Salk vaccine has thus been reintroduced, even though it's harder to use

Term
Problems of vaccine development (3)
Definition

  1. Most vaccines elicit formation of neutralising antibodies rather than provoking cell-mediated immunity
  2. This is fine for diseases caused by toxins, extracellular bacteria, and viruses that pass through blood to reach the tissue or origin (polio, rabies)
  3. Many infections, including parasites, are intracellular and so out of reach of antibodies (malaria)

Term
How many HIV vaccines were unsuccessful in clinical  trials
Definition
2
Term
Infections are the biggest killers of __ & __
Definition
Children and young adults
Term
___ deaths from infections per year (__/__ in developing countries)
Definition
>13 million
Term
__/__ of the world population lives on <$1/day
Definition
1/3
Term
__/__ of children are malnourished
Definition
1/3
Term

__/__ of children are not fully immunised before their first birthday

Definition
1/5
Term

__/__ lack access to essential drugs

Definition
1/3
Term
Infectious diseases effect on industrialised countries (4)
Definition

  1. Immunisation slips leading to explosive epidemics (e.g., 1996 polio epidemics in Greece and Albania)
  2. Air travel and immigration facilitate txport of infections from one continent to another
  3. Increased drug resistance
  4. Emergence of new pathogens

Term
Six diseases cause 90% of infectious dx deaths
Definition

  1. HIV
  2. Pneumonia
  3. TB
  4. Diarrhoeal dxs
  5. Malaria
  6. Measles

Term

Pneumonia

  • Killer of children?
  • __% of deaths occur in developing countries
  • Who is effected most?

Definition

  • Kills more children than any other infectious dx
  • 99% of the deaths from pneumonia occur in developing countries
  • Affects children of low birth weights or those with immune systems damaged by malnutrition or other conditions

Term

Diarrhoea

  • More than ___ deaths annually
  • Dx leads to __
  • __ bouts of illness a year in children alone
  • Burden is highest in areas ___
  • What affects both adults and children; which affect mainly children

Definition

  • More than 2 million deaths annually
  • Leads to rapid fluid loss and death
  • 1.5 billion bouts of illness a year in children alone
  • Burden is highest in areas with poor sanitation
  • Cholera and dysentery affects both adults and children; typhoid and rotavirus mainly affect children

Term

Malaria

  • Kills __ annually
  • Over __ cases globally each year
  • __/__ of all childhood deaths in sub-Saharan Africa
  • Symptoms
  • Detail economic cost

Definition

  • Kills 1-2 million people annually
  • Over 275 million cases globally each year
  • 1/5 of all childhood deaths in sub-Saharan Africa
  • High fever, convulsions, breathing difficulties, and death
  • In Nigeria, amongst subsistence farmers, 1/3 of all income is used to pay for malaria tx

Term

Measles

  • Contagious?
  • How many deaths in 1998
  • Responsible for child deaths? 
  • Dx effects if not death

Definition

  • Most contagious human dx
  • 900,000 deaths in 1998
  • Responsible for more child deaths than any other microbe
  • Also causes blindness, deafness, brain/lung damage, and stunted growth and development

Term

Lymphatic filariasis

  • Cause of long-term disability?
  • What causes
  • Affects how many people; how many are at risk; how many are severely disabled
  • Causes what

Definition

  • Second only to mental illness as the leading cause of long-term disability
  • Mosquito-borne parasitic worm
  • Affects about 120 million people; a billion are at risk; >40 million are severely disabled
  • Causes gross enlargement of the limbs and genitals in addition to damage to internal organs

Term

Schistosomiasis

  • What causes
  • Causes what
  • __ people infected; ___x that at risk
  • Spread by what

Definition

  • Schistomoa (parasitic worm)
  • Causes chronic UT dx and can lead to cirrhosis of the liver and cancer
  • 200 million people infected; 3x that at risk
  • Spread by water snails
  • ·      Fresh water becomes contaminated by Schistosoma eggs when infected people urinate or defecate in the water; the eggs hatch if certain types of snails are present in the water; these parasites grow/develop in the snail; after the parasite leaves, it can survive for about 48 hours; can enter the skin of people wading, swimming, bathing, etc in contaminated water

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