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Lecture 5

This document is an introduction to public health that discusses the history and current state of infectious diseases. It covers how diseases like plague, smallpox and tuberculosis were previously major killers but were largely conquered by the 1960s through immunization and antibiotics. However, new diseases like HIV/AIDS, Ebola, and antibiotic-resistant bacteria have emerged due to factors like human activities, international travel and improper antibiotic usage. The response to emerging infections requires improved surveillance, new vaccines and drugs, and control of diseases spread through animals and vectors.

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Saad
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19 views

Lecture 5

This document is an introduction to public health that discusses the history and current state of infectious diseases. It covers how diseases like plague, smallpox and tuberculosis were previously major killers but were largely conquered by the 1960s through immunization and antibiotics. However, new diseases like HIV/AIDS, Ebola, and antibiotic-resistant bacteria have emerged due to factors like human activities, international travel and improper antibiotic usage. The response to emerging infections requires improved surveillance, new vaccines and drugs, and control of diseases spread through animals and vectors.

Uploaded by

Saad
Copyright
© © All Rights Reserved
Available Formats
Download as PPTX, PDF, TXT or read online on Scribd
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5th session

Introduction to Public Health

Presented by
Kherailah Khodeda
2nd Class
1st semester
2023-2024

11/14/2023 1
The “Conquest” of Infectious Diseases
Infectious Diseases- Major Killers in Past
• Bubonic plague- “Black Death”
• Tuberculosis
• Smallpox
• Cholera
• Typhoid fever
• Typhus fever
• Yellow Fever
• Diphtheria
• Measles
• Influenza

11/14/2023 2
Infectious Diseases Were “Conquered”
by 1960s
• Immunization
• Antibiotics
Infectious Agents
• Bacteria- tuberculosis, cholera, typhoid, tetanus, diphtheria,
dysentery, syphilis, streptococci, staphylococci
• Virus- smallpox, poliomyelitis, hepatitis, measles, rabies,
AIDS, yellow fever
• Parasites- malaria, cryptosporidiosis, giardiasis, roundworms,
tapeworms, hookworms, pinworms

11/14/2023 3
Chain of Infection
• Pathogens (infectious agent)
• Reservoir
• Means of transmission
• Susceptible host
• Interrupt chain of infection at any link

11/14/2023 4
Means of Transmission

• Aerosol
• Touching contaminated object and putting hands to
mouth, nose, or eyes
• Contaminated water or food: fecal-oral route
• Vectors
• Sexual contact

11/14/2023 5
Interrupting Chain of Infection
• Kill pathogen with antibiotics
• Eliminate reservoir
• Prevent transmission
o Wash hands
o Quarantine
o Condom
• Increase resistance of host by immunization

11/14/2023 6
Public Health Measures
• Epidemiologic surveillance
• Contact tracing
• Immunization and treatment of identified patients to prevent further
spread
• Quarantine if necessary
Examples
• SARS- controlled by classic public health measures
• Rabies
o Surveillance of wildlife
o Immunization of dogs
o Post-exposure prophylaxis

11/14/2023 7
Eradication

• Possible if no non-human reservoir and a vaccine


exists
• Smallpox eradicated in 1977
• Polio eradicated from Western Hemisphere
o Now only in a few countries
o Religious opposition in some countries
• Measles is next target ( Now no longer endemic in
U.S.)
11/14/2023 8
Fear of Vaccines
• Rumors of vaccines causing autism, SIDS
• Side effects do exist for some vaccines
• Some parents refuse to accept risks
• Herd immunity- lost if many people do not get
vaccinated
• Pharmaceutical companies reluctant to develop
vaccines
o Low profits
o Risk of lawsuits
11/14/2023 9
The Resurgence of Infectious Diseases
HIV/AIDS
• First recognized in U.S. in 1981. Now a world-wide
killer
• Caused by a retrovirus
• Attacks the immune system
• Screening test recognizes antibodies
• Can measure viruses in the blood
• Now many drugs are available, but no cure

11/14/2023 10
HIV/AIDS Transmission
• Sexual contact
o Homosexual- most common in U.S.
o Heterosexual- most common around the world
• Sharing needles
o Intravenous drug use
o Medical use of unsterile needles
• Mother to infant
o Prenatal or during birth
o Breast feeding
• Blood transfusions
11/14/2023
o No longer in U.S. 11
Where Did HIV Come from?
• Probable originated in Africa
• Cross-species transmission from Monkeys or apes
• Spread in human populations due to disruption of
traditional lifestyles
• Spread to Western countries due to changing
patterns of sexual behavior and international travel

11/14/2023 12
Other Emerging Viruses
• Ebola
• Monkey pox
• Hantavirus
• Other hemorrhagic fevers
• West Nile Virus
• SARS

11/14/2023 13
Factors that Lead to Emergence of New
Infectious
• Human activities that cause ecological damage and
close contact with wildlife
• Modern agricultural practices
• International travel
• International distribution of food and exotic animals
• Breakdown of social restraints on sexual behavior
and intravenous drug use

11/14/2023 14
Influenza

• Virus is constantly mutating


• Vaccine must be changed frequently
• New, lethal strains appear periodically
• Epidemic of 1918-1919 killed 20 million to 40
million worldwide
• Concern about bird flu in Asia

11/14/2023 15
New Bacterial Threats

• Legionnaire’s Disease
• Lyme Disease
• Streptococcus A
• E.coli O157:H7 in food
• Antibiotic resistance
o From improper medical care use
o Use in agriculture

11/14/2023 16
Tuberculosis

• Leading cause of infectious-disease death


worldwide; one third of world population is infected
• There was a resurgence in U.S. in early 1990s
• Much higher from people with HIV
• Transmitted by aerosol
• 50 % fatality rate from untreated TB

11/14/2023 17
Tuberculosis, CTD

• Antibiotics are effective, but must be taken for


several months
• Improper use of antibiotics leads to resistance,
including multidrug resistance, when mortality rate
can be 50 %
• Directly observed therapy works- best approach to
preventing antibiotic resistance

11/14/2023 18
Prions

• Creutzfeld-Jacob disease (CJD)- sporadic, in older


people
• Bovine spongiform encephalopathy (BSE) or ‘mad
cow disease’ in Britain
• New variant CJD in Britain in younger people,
thought to be caused by eating infected beef
• Regulations have been tightened on animal feed

11/14/2023 19
Public Health Response to Emerging
Infections

• Global surveillance
• Improve public health capacity
• Veterinary surveillance
• Reduce inappropriate use of antibiotics
• Need for new vaccines
• Need for new antimicrobial drugs
• Control of vector-borne and animal-borne diseases

11/14/2023 20
Threats of Bioterrorism

• Approach to bioterrorism is the same as that for


natural disease outbreaks
• Will probably first be recognized by surveillance
• Best defended against by same methods as natural
outbreaks

11/14/2023 21
Thank you for your attention

11/14/2023 22

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