Michelle PryceMicrobiology 40016 April 2009

Defining terms The impact of infectious disease

throughout history. Social, political, and/or economic

impacts of selected diseases from 2000-2009.

The future of infectious diseases Summary References Questions

Pandemic—an infectious disease that occurs over a wide geographic area and affects an exceptionally high proportion of the population (17)

Epidemic—an outbreak of sudden rapid spread, growth, or development of a disease limited to a geographical area.(15)

Infectious Disease—disease caused by an organism’s entry into the body, and the subsequent growth of the organism (16)

PANDEMICS

Typhoid fever --430BC Antonine Plague-- 165-

265AD ‘smallpox’ --2 separate outbreaks

Justinian plague-- 540-750 AD ‘bubonic plague’

Black Death --1300’s AD Typhus --1490’s Influenza-- 1510 Cholera 1-7-- 1821-1966 Influenza 1918-19

HIV 1981-present

EPIDEMICS

1800’s --plague India, Persia, Iraq

1840—Cape Town—smallpox 1900—W Africa—yellow

fever 1994—India—bubonic

plague 1997—China—avian

influenza 2002-3 China—SARS 2007—Congo-Ebola 2007-8 –Philippines--dengue

fever 2007-8 --Vietnam—cholera(23)

Explorers introduced new diseases to ‘foreign’ territories killing natives, allowing for easier conquests of new territories. (20)

Infectious diseases have been used as ‘bioterrorism agents’ as far back as Ancient Greek times (catapulting infected bodies over city walls to infect inhabitants) (20)

Catastrophic population loss is necessary to ensure human survival. A 50% population loss could be restored in less than 2 generations. (20)

2001 Anthrax Postal Scare 5 people died, 22 sickened

from inhaled anthrax spores (4)

Letters were mailed through USPS to politicians and news media

(14)

Economic Costs $200m over 5 yr

(2007-11) by USPS for anthrax test cartridges (11).

$240m for construction of biosafety level 4 labs in Boston and Galveston (8).

According to CDC, costs associated with an anthrax attack estimated at $26b per 100,000 people affected (5).

774 people died; fear of SARS led to decrease in consumer demand for travel services (2)

Speediness of transmission led to decreased social interactions and decrease in service-related interactions (2)

Psychological shock sent ripples far beyond China. (2)

Reduced foreign confidence in Chinese government to handle epidemic (22)

Loss of foreign investors’ confidence impact China’s future growth (22)

Since epidemic lasted only 6 months, it is only predicted to affect China’s economy for 10 years (2)

SARS spread quickly around the globe.

Countries such as Canada, Hong Kong, and Singapore enacted legal quarantine to prevent spread of SARS.(12)

In April 2003, US added SARS to list of diseases which CDC has authority to legally quarantine a victim. (12)

These actions probably prevented a world-wide pandemic of SARS.(13)

HIV is severely affecting armed forces of several countries (1)

AIDS is #1 killer of soldiers and police force in Africa. (1)

5000 rejected from Russian military in last 2 years. (1)

Beginning to see shortages in China and India (1)

Trained soldiers are expensive and difficult to replace

UN peacekeepers have spread HIV in certain areas which undermine trust in UN missions (1)

Failed states are inherently unstable and may resort to terrorism to finance governments (1)

An intermediate-to-severe HIV outbreak in Russia, China, and India could bring 193-259 million new cases of HIV by 2025. (1)

All 3 have nuclear weapons and governmental instability could have major political, economic, and military repercussions (1)

2008-SALMONELLA

1407 people infected with salmonella from April-August 2008 (6)

Linked to tomatoes Tomato industry lost

$200m 600 people infected with

salmonella from 9/1/08-2/8/09 (6)

Peanut Corp, LLC fined $14.6m for health violations that led to salmonella infections (10)

2006-E.COLI

199 people infected with E. coli O157:H7 in a 3 week period in Aug/Sept 2006 (7)

51% were hospitalized (7)

3 people died; 16% developed acute renal failure(7)

Costs millions to spinach producers and restaurants (7)

ANTHRAX

A crop duster could spread anthrax spores to up to 3m people in less that 3 hrs (4)

Only 5000 -8000 spores needed to infect lung (4)

Almost always fatal Overwhelm medical and

economical infrastructure of affected area

SARS

Previous handling of SARS cases indicated that appropriate measures were taken to prevent global pandemic (3)

As long as global surveillance and reporting continues, studies indicate that SARS will continue to be ‘the pandemic that could have been’ (3)

HIV

New cases will continue to appear

As more people die, infrastructure will collapse in some areas

Could be catalyst in a future nuclear war

FOOD BORNE ILLNESS

Changes in food production and supply continue to cause nation-wide infection (7)

Efforts of USDA, CDC, WHO, and other government agencies increase safety of some, but not all products. (9)

Until there are ways to monitor all commercial animal farms and vegetable farms, food borne illness will continue to be a problem.

Infectious disease had shaped the course of history.

Infectious disease has an effect on political policy.

Economic costs of dealing infectious disease are astronomical.

Ill-prepared societies are at risk for extinction due to aftermath of large-scale infectious disease outbreaks.

1. Feldbaum H, Lee K, Patel P (2006) The National Security Implications of HIV/AIDS. PLoS Med 3(6): e171 doi:10.1371/journal.pmed.0030171

2. Keogh-Brown, Marcus Richard, Richard Davis Smith.“The economic impact of SARS: How does the reality match the predictions?” 2008 Health Policy DOI: 10.1016/j.helathpol.2008.03.003.

3. Knobler, Stacey (ED). Learning from SARS: Preparing for the next disease outbreak. Lee, Jong-Wha and Warwick McKibbin“Estimating the Global Economic Costs of SARS” pg 92-99.

4. Learner, K Lee and Brenda Wilmoth, Ed.“Anthrax, Terrorist Use as a Biological Weapon.” World of Microbiology and Immunology. Gale Cengage, 2003. enotes.com 2006. accessed April 2009.

5. Learner, K Lee and Brenda Wilmoth Ed. “The Economic Impact of a Bioterrorist Attack” World of Microbiology and Immunology. Gale Cengage, 2003. enotes.com 2006. accessed April 2009.

6. Maki, Dennis G, MD. “Coming to Grips with Foodborne Infection—Peanut Butter, Peppers, and Nationwide Salmonlla Outbreak” N Engl J Med vol360:949-953. March 5, 2009 Number 10.

7. Maki, Dennis G, MD. “Don’t Eat the Spinach—Controlling Food Borne Infectious Disease” N Engl J Med. Vol 355:1952-1955 November 9, 2006.

8. Richardson, Louise, PhD. “Buying Biosafety—Is the price right?” N Engl J Med vol 350: 2121-2123. May 20, 2004

9. Sandler, Robert, James Everhart, Mark Donowitz, Elizabeth Adams, Kelly Cronin, Clifford Goodman, Eric Gemmen, Shefali Shah, Aida Avdic, Robin Rubin. “The Burden of selected digestive disease in the United States”. J Gastroenterology. May 2002. vol 122, issue 5, pg 1500-1511).

10. www.associatedpress.com. April 9, 2009. 11. “www.bio-medicine.org/biology-technology-1 “Cephid enters into

5-yr agreement with Northrup Grumman for the purchase of Anthrax Test Cartridges for use in USPS Biohazard Detection Systems” August 16, 2007. accessed April 2009.

12 www.cdc.gov/agent/anthrax.htm 13. www.cdc.gov /nciod/sars/quarantineqa.htm 14. www.fbi.gov 15. www.merriam-webster.com/epidemic 16. www.merriam-webster.com/infectious disease 17. www.merriam-webster.com/pandemic 18. www.nctm.org/resources 19. www.

nlm.nih.gov/medlineplus/severeacuterespiratorysyndrome.htm 20. www.nonprophet.typepad.com 21. www.pandemicflu.gov 22.

www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.0030171 23. www.123explore.com

1. What are the 3 pathways for HIV/AIDS to impact US national Security? Choose 1 and describe how it impacts national security. The three pathways are strategically important people, strategically

important states, and peripherally important states/regions. Soldiers and peacekeeper are strategically important people. If they can

no longer perform their job due to sickness or death, governments are left vulnerable to attacks from rogue operators.

China, Russia, and India are strategically important states. They represent three of the largest populations in the world. Each has the capacity to deliver nuclear attacks. Should their government fail, a potential nuclear war could erupt. These areas are also home to known separatist groups who currently have issue with the governments. Political instability could give these groups a reason to attack.

2. True or False. The Center for Disease Control can legally quarantine a suspected victim of SARS. TRUE, the CDC is empowered to detain, medically examine, and/or

conditionally release persons suspected of carrying a communicable disease—list updated in 2003 to include SARS.

3. How has infectious diseases shaped history. Several answers Throughout history infectious diseases have ended wars. The

invading armies brought with them disease endemic to their area. This diseases were unleashed on a new population, killing the native population. Infectious diseases have shaped Ancient Greek history, Early Eurpoean history, the Middle Ages, and colonization of new lands.

Infectious disease has managed human population. Several times, an epidemic has killed ¼-1/2 of current population. Infectious disease has kept Earth’s resources usable by managing its population.

4. The CDC estimates an anthrax bioterrorism attack will cost _______ per ______ people affected.

A. $15 million/1 million B. $42 million/100,ooo C. $153 million/ 1000 D. $26 billion/100,000