ch8gch - Chapter 8 Chapter Globalization and Emerging...

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Unformatted text preview: Chapter 8: Chapter Globalization and Emerging Globalization Infectious Diseases Infectious “Epidemiologic Transition” Theory Pre-transition: low life expectancy, lots of Pre-transition: infectious disease deaths and infant mortality, high fertility high Post-transition: high life expectancy, lots of Post-transition: chronic diseases, low fertility chronic Do health transitions really follow a predictable Do model? model? What about pockets of wealth and poverty? The What “dual burden” of disease in many countries (“lifestyle disease” introduced while the infectious disease burden is still high)? infectious Globalization Globalization Discussion Groups: How would you define globalization? How do you experience globalization How during daily activities (food, clothes, music, appliances, etc.)? music, How does globalization relate to health? – What are the positive effects? – What are the negative effects? Emerging Infectious Diseases Emerging EID: a new pathogen begins to affect EID: humans or an existing pathogen changes the kind of disease it causes the – Examples: increased transmissibility, Examples: incidence, or virulence; new host; new mode of transmission; new location of Re-emerging IDs: IDs that were controlled IDs and are becoming a problem again and Risk Factors for EIDs Risk 1. Microbial adaptation and change (drug resistance) (drug Microbial 2. Human susceptibility (preterm babies, immunosuppression) (preterm Human 3. Climate / weather (floods, droughts) (floods, Climate 4. Changing ecosystems (deforestation, dam building) (deforestation, Changing 5. Economic development / land use 6. Human demographics & behavior (pop density, IDU, sex) (pop Human 7. Technology & industry (nosocomial infections) Technology 8. International travel & commerce 9. Breakdown of public health measures 10. Poverty & social inequality 11. War & famine 12. Lack of political will 13. Intent to harm (bioterrorism) Dengue Dengue Dengue a.k.a. “breakbone fever” Virus spread by Aedes aegypti mosquitoes that Virus Aedes thrive in urban environments thrive 4 serotypes – – Infection with one serotype = illness Infection with any second strain = risk of dengue Infection hemorrhagic fever (DHF) hemorrhagic Prevention: no vaccine, so must focus on Prevention: environmental control (no standing water in tires, flower pots, etc.) flower Lyme disease Lyme Bacterium (Borrelia borgderferi) spread by spread bites of infected deer ticks (Ixodes bites Ixodes scapularis) scapularis Bulls-eye rash (“erythema migrans” Bulls-eye which does not always occur) arthritis nervous system symptoms Suburban disease (people living at the Suburban edges of forests) edges Hantavirus Hantavirus Many types of hantavirus worldwide, but Many new strain (called “sin nombre”) emerged new ”) in 1993 in the southwest USA in Hantavirus pulmonary syndrome (HPS): ): Young adults developed severe, rapidYoung onset pneumonia and died Transmission: inhaling aerosolized rat Transmission: urine or feces while cleaning rural homes urine SARS SARS Severe Acute Respiratory Syndrome Caused by a corona virus Emerged in 2002-2003; started in China Emerged then spread worldwide then Highlighted need for global public health Highlighted communication systems communication West Nile Virus West Common in Nile River basin (Egypt and Common Sudan) Sudan) Spread by mosquitoes; hosts are usually Spread birds or mammals birds Appeared in the United States for the first Appeared time in 1999 in New York and quickly spread to all 48 contiguous states spread Usually asymptomatic; about 1 in 150 Usually people develop nervous system symptoms symptoms Marburg Virus Marburg Emerged in central Africa Can cause hemorrhagic fever (like ebola) Very rare transmission mode, reservoir Very unknown unknown 2005 outbreak in Angola Other EIDs Other Legionnaire’s disease: spread by Legionnaire’s aerosolizing contaminated water in air conditioners conditioners Toxic shock syndrome (TSS) E. coli O157:H7 Cholera: new outbreak begin in Peru in Cholera: 1991 and spread up the coast of central America America Drug-resistant strains Influenza: What is “normal” flu? Influenza: Respiratory disease; may cause Respiratory pneumonia pneumonia Airborne and person-to-person Risk groups: elderly, young, Risk immunocompromised immunocompromised 30,000 – 40,000 deaths in the USA in a 30,000 “normal” flu year (and 5 – 20% of the population sick) population Why are we susceptible to new flu strains?: Antigenic Drift new Influenza viruses frequently mutate Influenza (antigenic drift). Surface proteins change in ways that Surface make it difficult for our immune systems to quickly identify them and fight them off need a new flu vaccine each year need Why are we susceptible to new flu strains?: Antigenic Shift new Two very different types of flu virus that Two infect one animal can merge to create a completely new strain (antigenic shift). completely – Most common strain in humans in recent Most decades: H3N2 decades: – “Bird flu”: H5N1 What is “bird flu”? What Many flu strains are “bird flu” or “pig flu” Avian influenza H5N1 is highly contagious Avian and virulent in birds in Genetic changes may cause H5N1 to Genetic develop the ability to more easily infect humans humans Bioterrorism Bioterrorism Targets: people, animals, plants Primary goal: cause panic / fear / social Primary disruption disruption 3 categories: – A: likely agents (anthrax, botulism, etc.) – B: food and waterborne agents – C: EIDs Anthrax Anthrax Naturally occurring cases of the Naturally cutaneous (skin) form occur every year because the bacillus lives in soil and on animal hides animal “Weaponized” anthrax powder causes Weaponized” inhalation anthrax inhalation Can be treated with antibiotics (Cipro) 2001 postal attacks ...
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This note was uploaded on 09/23/2011 for the course GCH 100 taught by Professor Corso during the Fall '11 term at George Mason.

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