Impending Impending Doom ! Doom ! The World Coming To An End Part III

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Impending Doom !. The World Coming To An End Part III. Disease Occurrence. Endemic – normal levels within geographic regions. Epidemic – sudden severe outbreak within a region. Pandemic – epidemic becomes widespread (worldwide). Pandemic. Global outbreak. - PowerPoint PPT Presentation

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Page 1: Impending Doom !

Impending Impending Doom !Doom !

The World Coming To An End

Part III

Page 2: Impending Doom !

Disease OccurrenceDisease Occurrence

•Endemic – normal levels within geographic regions.

•Epidemic – sudden severe outbreak within a region.

•Pandemic – epidemic becomes widespread (worldwide).

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PandemicPandemic•Global outbreak.

•Caused by new subtypes – novel pathogen.

•High person-to-person susceptibility.

•Unusually high mortality.

Cholera Pandemic Cartoon, 1883

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Epidemic versus Pandemic

•Seasonal (mainly winter)

•Known pathogen

•Elderly affected most

•Vaccine available

•Localized occurrence

•Any time of year

•Unknown pathogen

•Atypical age groups

•No proven/available vaccine

•Worldwide occurrence

Most epidemics and pandemics caused by influenza.

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InfluenzaInfluenzaThree Types

Type A

•Regular outbreaks

•Most widespread

•Responsible for pandemics

•Infects humans and animals

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InfluenzaInfluenzaThree Types

Type B

•Sporadic outbreaks

•Mainly occurs in residential communities (e.g. nursing homes)

•Infects humans only

•Can cause epidemics, have not caused pandemics

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InfluenzaInfluenzaThree Types

Type C


•Causes very mild symptoms or none at all

•Not a severe public health threat

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Influenza A VirusInfluenza A Virus•ssRNA virus

•Contains two membrane proteins

•Hemagglutinin (“H”)

- Initiates infection by binding to receptors on host cell’s membrane.

•Neuraminidase (“N”)

- Enzymatic properties of N destroy host cell receptors and allows viral infection of cell.

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Influenza A VirusInfluenza A Virus•Subtypes vary by types of H and N membrane proteins

- 15 different H proteins identified (H1, H2, etc.)

- 9 different N proteins identified (N1, N2, etc.)

•Virus identified and named by H and N membrane proteins

•Many different combinations of H and N proteins possible

•Only some Influenza A subtypes currently cause human infection

- H1N1, H2N2, and H3N2

•Others are common in animal species

•All common in avian species

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Pandemics of 20Pandemics of 20thth Century Century

Spanish Flu – 1918 – A (H1N1)

•50 million dead worldwide

•500,000 dead in U.S.

Asian Flu – 1957 – A (H2N2)

•70,000 dead in U.S.

Hong Kong Flu – 1968 – A (H3N2)

•34,000 dead in U.S.

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The Case of Harry TysonThe Case of Harry Tyson

54 year old male brought to Norfolk General Hospital

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Patient presented with:•Fever (103.2 degrees F)

•Productive cough with blood

•Sore throat

•Myalgia (General muscle pain)

•Dyspnea (Difficulty breathing) on day 5

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Subsequent Complications:•Respiratory failure on day 5 and ARDS

•Renal and Cardiac failure days 6 & 7

•Died on day 8

•Wife and son admitted on day 5

with similar symptoms

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Initial Treatment & Diagnosis

• Patient given Oseltamivir on days 5-8 with no improvement

• Wife and son also administered drug

• Son died on day 14 and mother recovered

• Initial diagnosis: Influenza with complicating secondary bacterial pneumonia

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Final Diagnosis

• Father owned chicken farm where

family worked

• Father involved in breeding hybrid chicken

– Large Asian variety with fast producing American variety

• Father imported eggs from S.E. Asia illegally

• Exposed to products of the eggs

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Suspected Pathogen: Influenza Virus A (H5N1)

• Father, Mother, and son all test positive

• Chickens test positive

• The USDA and CDC contacted

• Farm Quarantined

• Chickens Destroyed

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So, you have the flu…

Virus causes upper and or lower respiratory tract infection as the virus uses cells for lytic reproduction

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Symptoms of the Flu

• Fever

• Cough and runny nose

• Malaise with myalgia

• Headache, sore throat

• Extreme tiredness

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What is the respiratory tract?What is the respiratory tract?

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Respiratory Tract FunctionRespiratory Tract Function

• Gas exchange- Take in oxygen and expel carbon dioxide

• Sound- Movement of gas through mouth and over larynx

and pharynx allows sound production

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Respiratory Tract MicrobesRespiratory Tract Microbes

• Normal Flora

- Regular inhabitants- Rarely cause disease

Staphylococci sp. Cultured from Mr. Styer’s throat.

Gram negative cocci and gram positive rods from Ms. Shepard’s throat.

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Respiratory Tract MicrobesRespiratory Tract Microbes• Nose

– Staphylococcus spp.– Staphylococcus aureus– Staphylococcus epidermidis

• Mouth and Oropharynx– Staphylococcus epidermidis– Streptococcus pneumoniae– Other Streptococcus spp.– Neisseria spp.– Haemophilus spp.– Anaerobic bacteria– Yeasts

Staphylococcus aureus

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Respiratory Tract InfectionsRespiratory Tract Infections

• Respiratory tract constantly exposed to outside environment.

• Exposure to many airborne microbes.

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Respiratory Tract DefenseRespiratory Tract Defense

• Physical barriers URT– Mucus

– Cilia

• Physical barriers LRT– Phygocytosis – killer white blood cells

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Respiratory Tract PathogensRespiratory Tract Pathogens

• Upper Respiratory Tract– Viruses

• Corona viridae

• Adeno viridae

• Rhino viridae

– Group A Streptococcus– Corynebacterium diptheriae– Bordetella pertussis

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Respiratory Tract PathogensRespiratory Tract Pathogens

• Lower Respiratory Tract– Viruses

• Influenza


• Haantavirus

– Bacterial Pneumonia• Streptococcus pneumoniae

• Mycoplasma pneumoniae

• Pseudomonas aeruginosa

• Legionella pneumophila

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The Monster That Looms: H5N1• Currently unable to transmit human-to-human (as

seen with H1, H2 & H3 strains)• Infection only with direct contact with infected

animal• Can infect across breeds: birds and mammals• Causes atypical immune response

– “Cytokine Storm” that body cannot handle– Fluid (blood) fills the lungs as body fails – Secondary infections are rampant – Seen in the “Spanish Flu” of 1918

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Review and Reflection

• Differentiate Epidemic and Pandemic outbreaks:

• Give the parts and function of each part of the respiratory tract:

• Give our typical respiratory tract defense against infection:

• List two non-pathogenic and two pathogenic respiratory tract microbes:

• Describe how an H2N2 strain of virus differs from an H5N2 strain. For which one is there a vaccine available?

• Describe what is meant by a secondary bacterial infection and how would a hospital test for this?

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Writing Prompt

• Write a one page, double-spaced essay on what you think would happen if there was, in fact, an influenza AH5N1 outbreak. How would we react to the threat both locally and globally ? What would we have to do to contain the disease, yet survive as a society? Examine the effect on things like the economy, travel, as well as on everyday life such as school and grocery shopping. Be thoughtful and creative!

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CitationsCitationsCenters for Disease Control and Prevention (2005). Information About Influenza Pandemics [Internet]. Fact Sheet [cited July 28, 2005] http://www.cdc.gov/flu/avian/gen-info/pandemics.htm

Centers for Disease Control and Prevention (2005). Key Facts About Influenza and Influenza Vaccine [Internet]. Fact Sheet [cited July 28, 2005] http://www.cdc.gov/flu/keyfacts.htm

Centers for Disease Control and Prevention (2004). Update on Avian Influenza A (H5N1) [Internet]. Health Alert Network. [cited July 28, 2005] www.phppo.cdc.gov/han/archivesys/viewmsgv.asp?alertnum=00209

Images UsedCholera Pandemic Picture http://www.authentichistory.com/images/postcivilwar/cartoons/1883_cholera_pandemic_cartoon.html

Portrait of Harry Tysonhttp://ring.uvic.ca/98oct16/EXEC.html

Chicken Imageshttp://dailyjournal.tripod.com/nov2002.htm

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Tim Styer and Katie Shepard

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