Term
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Definition
.Direct contact - rodent, someone with the disease, blood, body fluids, sexual intercouse.
.Droplet Contact - spit, cough
.Indirect Contact - hands, inanimate objects like a doorknob, fecal-oral: hands or food.
.Endogenous: autoinfection - UTI
.Airborne: droplet nuclei (smaller), fungal spores
.Vector/Insect - malaria, dengue, yellow fever, zika |
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Term
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Definition
.shoe leather - walk around and ask questions to figure it out
.what's happening - to whom, when, where and how.
.point source epidemic : all got exposed to it same time.
.person to person - same incubation period, not sick at same time.
.case control study - people who got sick vs. those who didn't. - ask what group was exposed to what. |
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Term
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Definition
.spread through direct contact through touching nose and eyes, not as much indirect and droplet.
.through the poker experiment - then couldn't touch your face. |
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Term
| Droplet vs. Droplet Nuclei |
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Definition
Droplet = spit, actual touch.
Droplet nuclei = measles/TB wafting through air. |
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Term
| Indirect Contact & Fecal-Oral Transmission |
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Definition
Hands.
.FOMITES = inanimate objects
.food and water. |
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Term
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Definition
| .autoinfection - UTI, MRSA (Staph) in football players |
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Term
| Common Source / Common Vehicle Outbreaks |
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Definition
bacteria of nurses not washing hands etc.
or klebsiella - common source patient, then indirect contact spread. |
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Term
| Long term effects of the plague: |
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Definition
Population - quick increase in birth rate, but slower recovery of population levels.
Economy - scarce labor, increasing wages. surfeit of cattle -> cattle wandering the countryside, peasants more mobile generally good wages. rent relief.
.better productivity as marginal lands were abandoned and only best fields were used.
WOMEN
.new opportunities in business and trades due to shortages of skilled workers.
.laws allowing land to be willed to daughters.
URBAN/INDUSTRY
.depression in wool cloth.
.decrease in productivity for urban crafts
TECH INNOVATION
.printing press, improved sialing, firearms, spinning wheel, improved mining - all spurred perhaps out of necessity of scarce labor?
SOCIAL AND RELIGIOUS IMPACT
.blow to church authority.
.loss of church leaders |
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Term
| Year of Wonders - effects of the plague |
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Definition
1665 PLAGUE IS A BACTERIA.
.punishment from God for sins? test of faith?
.theories of origins and spread of "plague seeds"
.women as healers vs. witches 25 yrs vefore.
.women taking control of their destiny.
Bradfords leave - rich.
Anna and Elinor become midwives - bond more than servant / mistress - class change. |
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Term
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Definition
| small parasitic organism that affects cells. |
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Term
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Definition
.a VIRUS. viruses were discovered by Pasteur.
.acute disease ( not chronic like AIDS)
.it's a systemic disease that gets into body (not mucosal that stays on skin)
.multiple organs may be affected - fever, rash
.mortality = highest in infants.
.epidemic when introduced somewhere; endemic when it has been present in an area for some time - people become immune but then babies are born and aren't immune.
.spread by droplet nuclei in Western setting, but some think just face-to-face. |
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Term
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Definition
.immune once you get it!
.variolation by skin inoculation
.abigail to john adams when she got innoculated in boston.
.rub powder from pox scab - gets a mild exposure to it |
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Term
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Definition
.smallpox during american revolution.
.smallpox can live outside body - on blankets - isolation thru quarantine towns.
.innoculation - works but is risky. if continental army troops get variolated -> debilitating. innoculation takes month.
.troops at Quebec in winter - benedict arnold retreated south. by 1777 washington decided that all recurits be variolated - luckily british didnt use it as a weapon. |
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Term
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Definition
.variolation = popular.
.milkmaids who had experienced cowpox were also immune
.Edward Jenner used a young boy and experimented with cowpox.
.smallpox vaccine - produces a full-blown, but mild virus infection - 2-10 yrs of immunity.
.vaccine was sent dried on a string to america.
.today - live attenuated vaccines = infection with resulting immunity but without the symptoms of the disease (smallpox = first of these) |
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Term
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Definition
smallpox was the first.
infection with immunity but no side effects.
advantages: effective.
disadvantages: risk to those with impaired immunity (HIV, immunosuppressive); risk of mutation; refridgeration short shelf life.
.accidental infection |
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Term
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Definition
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Term
| Why was smallpox the only one to be erradicated? |
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Definition
no animal related transmission (cowpox is minor)
we have smallpox in biosecure area. |
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Term
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Definition
.bacteria.
.does best in brackish water.
.get 3-5 gallons of rice-water diarrhea.
.tenting of the skin.
.huge global burden.
.7 pandemics on indian subcontinent
.london cholera epidemics.
.thames = polluted, dead.
.JOHN SNOW - disease confined to gut, probably due to ingestion- mapped it, it was around a building - Broad Street pump.
.looked at cases and non-cases and whether they were at the broad street pump - case control.
.haiti cholera outbreak in 2010.
.O blood type and cystic fibrosis - less susceptible to cholera. |
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Term
| Richard Cash & Cholera ORT |
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Definition
Oral Rehydration Therapy (ORT)
.therapy had to be cheap, deliverable by professionals.
.rice water = basically salt water. need to give isotonic salt. and elctroclytes.
.packets but need standard measurements.
.evidence based interventions - women mothers.
.listen to the people - keep it simple.
.cholera vaccine = only lasts 4 years - hard to get it out there to these countries - valuable but not #1 way to minimize deaths. |
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Term
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Definition
.affects the poor.
.MDG and SDG - end TB by 2030.
.HIV / TB co-infection.
.limited avail of reliable diagnostic tests.
.MDR and XDR TB (resistant)
.contributing factors of TB: health services - delayed diag, incorrect treatment, pathogen-drug resistant, environment-crowding, poor ventilation, prisons; host - smoking, HIV, malnutrition.
.transmission DROPLET NUCLEI - airborne. most are infected with reactivated TB - survives in there for a while.
.LATENCY - reactivation due to old age, HIV
.most poor places - risk-based and symptom-based screening = all that's available, no skin tests - hard. |
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Term
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Definition
antibiotics, etc.
.not a sexy disease, doesn't have advocates like HIV
.antibiotic resistance due to maltreatment
WHY NOT A BETTER VACCINE?
.challenge to develop vaccine for disease with re-infection that doesn't prevent ongoing latent infection |
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Term
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Definition
fashionable to be thin, pale and consumptive.
John Keats.
fall, Ophelia.
.reality - poverty of TB = really bad. industrial revolution - terrible conditions, prisons, malnutrition => worse cases of TB. principle cause of children's death. |
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Term
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Definition
.bacteria
.origin = bouline from cows.
.transmission = droplet nuclei, airborne.
.types - latent and active. latent = 95%.
.ingested by macrophages in immune system - keeps it dormant.
.not infectious when it is dormant in people.
.not symptomatic - don't know you have it.
.mysterious what causes it to become active - compromised immune system - HIV, environment.
.treatment = ANTIBIOTICS ->resistant: MDRTB XDRTB.
.SYMPTOMS - cough up blood, fever, absess of lung, weightloss.
.abides by beauty standards - beautiful death. |
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Term
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Definition
.respiratory infection VIRUS.
.sudden onset.
.TRANSMISSION: large droplets & some small droplets.
.unique because influenza virus changes from year to year = "drift"
.from birds
.influenza vaccines - killed component vaccines. the live attenuated vaccine is not recommended.
.vaccines are adjusted yearly.
.need to prepare for influenza - space, supplies, staf, security, systems. |
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Term
| Pale Horse Pale Rider - influenza |
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Definition
1918 - dramatic dip in life expectancy due to war and influenza.
body = at war.
dream: horse and rider = death, but she recognizes him.
.high fever = hallucinations. debilitating. time=warped. sees doctors doing odd things. romanticized hazy love story. inside her head - outside world = happening but warped.
.war = time also warps bc of chaos and the unknown. body at war. caskets = from influenza not war. homefront = just as bad. |
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Term
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Definition
.bacteria.
.HIV outbreak coincided with syphilis.
.diagnosis: difficult to cultivate - doesn't grow in media labs. diagnostic tests.
.21 days after sexual exposure - painless ulcerated sore.
.latency
.congenital syphilis.
.tried mercury - now penicilin |
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Term
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Definition
.not told they had syphili, but "bad blood"
.no consent - modest benefits - burial fee, free aspirin,
.only blacks were used - resulted in complete revamp of regulations of human experimentation.
.they insisted that racial differences increased syph in men.
, |
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Term
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Definition
Driver Diagrams & PDSA
.aim: how much, by when, for whom?
.main drivers: calories in, calories out.
.PDSA: plan, do , study, act. |
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Term
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Definition
conflict -> migration.
=> refugee camps - close quarters leads to infectious diseases.
.health systems: across borders, diff systems.
.syrian population - 20% immigrant, hard to control.
.movement transfers disease and infection. |
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