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SPHU 1020: Cell, Individual, and Community Final Study Guide

by: Claire Jacob

SPHU 1020: Cell, Individual, and Community Final Study Guide SPHU 1020

Marketplace > Tulane University > SPHU 1020 > SPHU 1020 Cell Individual and Community Final Study Guide
Claire Jacob

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This study guide consists of in-class notes on the concepts that Professor Cropley wanted us to focus on!
Cell, Individual & The Community
Dickey-Cropley, Lorelei
Study Guide
Public, health, Viruses, HPV, MRSA
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This 8 page Study Guide was uploaded by Claire Jacob on Monday May 2, 2016. The Study Guide belongs to SPHU 1020 at Tulane University taught by Dickey-Cropley, Lorelei in Summer 2015. Since its upload, it has received 88 views.


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Date Created: 05/02/16
SPHU 1020 Final Review 25 points Review in class “questions of the day” HIV/AIDS  Factors that facilitated HIV moving from simians to humans→  o HIV mutated in 1930s from a form exclusive to apes to one that could live  in humans  genetic studies link HIV to the chimpanzee Pan troglodytes o such diseases that move from one species to another are known as  zoonoses  ebola and TB both examples of other zoonoses o 1st well­documented case of AIDS occurred in an African man in 1959;  he was diagnosed decades after his death  HIV exits its host cells by budding Tuberculosis (TB)  Treatment and Specific control programs (DOTS) o Multiple drug resistant (MDR) and extremely drug­resistant (XDR) TB  MDR resistant to at least 2 first line drugs, isoniazid and rifampin  XDR rare; resistant to isoniazid, rifampin and at least 3 second­ line drugs o Prevention  Vaccine   The BCG vaccine for tuberculosis is controversial o Vaccine consists of attenuated (weakened) live  tubercle bacilli o Protection rate is about 80% in children and less  than 50% in adults o Protection is not life­long, lasting only 5­15 years o Those vaccinated will test positive for the tuberculin skin test  New approaches utilizing recombinant DNA technologies  in vaccine development are promising for the future o DOTS implementation  Needs to be adopted by more countries o Improved social conditions  Many in the world live in abject poverty and suffer from a lack of  clean water, malnutrition, and inadequate housing conditions o Directly Observed Treatment, Short­course  5 elements:  1. Political commitment with increased and sustained  financing  2. Case detection through quality­assured bacteriology  3. Standardized treatment with supervision and patient  support  4. An effective drug supply and management system  5. Monitoring and evaluation system, and impact  measurement HPV  Specific control programs (vaccination) HPV Vaccine  Because this vaccine is related to sex, it is less accepted… it’s also not  mandated  Most effective when given before the onset of sexual activity Vaccine admin  Recommend vaccine for girls and women ages 9 to 26; ideally, prior to onset of  sexual activity  Administered in 3 doses over 6 months  Cost issues­ $360 per 3 dose regimen  Covered by most forms of insurance Acceptability  75% of girls in the US as of 2010 were not vaccinated for HPV  Evidence suggests high degree of acceptability by physicians, gynecologists,  patients, and parents  Issue/ concern on the part of some parents that use will increase sexual activity  Issue of mandating vaccine in the states; no state currently has such a stature  A study of nearly a million girls in Sweden and Denmark eradicates showed no  serious side effects MRSA Community acquired vs. Hospital acquired Methicillin­resistant Staphylococcus aureus (MRSA)  Bacteria have become resistant to various antibiotics o MRSA is a special methicillin resistant strain of “staph”  HA­MRSA o First recognized in the 1970s causing epidemics in healthcare setting  leading to endemic status; now leading cause of nosocomial infections in  US  Now associated with ill persons in health­care infections Community­associated MRSA  Community associated MRSA is a new strain presenting from community in  persons without traditional risk factors for MRSA o Can be see in young, healthy adults o Common cause of skin and soft tissue infections occurring in previously  healthy adults and children who have not had prior contact with health­ care settings  Differs from HCA­MRSA o More virulent o More likely to express Panton­Valentine leukocidin, a highly destructive  bacterial toxin o Less likely to exhibit drug resistance to multiple antibiotics o Appears to spread by close contact  Have evolved separately in community based on genetic differences  Necrotizing fasciitis, also known as “flesh­eating bacteria”, can result from MRSA CA­MRSA  Outbreaks have been described in US and internationally  Infection rates rising o 30­37% of all hospitalized MRSA patients  Los Angeles: most common cause of CA skin/soft tissue infections requiring emergency room care  Common in contact sports because they easily acquire skin lesions 75­80% of antibiotics consumed in the US are used in livestock Meningitis  Risk factors and college students o Epidemiology US  Carried by 5­10% of the population  About 10% of carriers dont show signs and symptoms  Yearly about 3000 people in US infected with the bacteria and  1/10 people die  Highest rate of disease among infants <1 year of age  Common among college freshman and military recruits  College students in dorms  Similar age, diverse geographic backgrounds, crowded  living conditions  97% of cases sporadic (background endemic disease) 3%  outbreaks  Seasonal­ peak in December/January  Louisiana has some of the highest rates  Vaccines available when there’s an epidemic Waterborne diseases Differentiate characteristics among common waterborne diarrhea­causing  organisms: eg. risk factors Staphylococcal food poisoning  Caused by staphylococcus aureus o Most common type of food poisoning o Found in human nasal passages o Found in human nasal passages o Heat stable enterotoxin o s/s: abdominal cramps, N/V/D, fever rare  Symptoms appear within a few hours, very severe Foodborne and Waterborne infection: Salmonellosis  Caused by several species of g­ bacilli in the genus Salmonella o Sources: infects eggs (ovaries of healthy hens infected)  May also contaminate meats, seafood, and fresh fruits and  vegetables  Iguanas, lizards, snakes, and turtles are carriers of a variety of  salmonella species  Crows may harbor salmonella in feces  s/s: o Gastroenteritis Salmonella causes Typhoid Fever Shigellosis:  Caused by species of Shigella, a g­ bacillus  About one million annual deaths in developing countries  Transmission via fecal­oral route  Shiga toxins very destructive  S/S gastroenteritis, and possibly dysentery  Infectious dose is very low  TX: oral or IV rehydration and possibly antibiotics Cholera   Lives in brackish water  “Rice diarrhea” Rotaviruses  About 200,000 ER visits a year in the US  Very common cause of diarrhea, especially in young children  S/S flu­like symptoms before diarrhea (fever, cough, and vomiting) watery or  semi­liquid stools typically look like yogurt mixed in water o Mild to moderate dehydration o Fever­ moderate grade  Easy to transmit   Low lethality  Vaccines are available Hepatitis A  Globally ~1.4 million cases of hepatitis A yearly  Transmitted through ingestion of contaminated food/ water, or direct contact with  an infectious person  Assoc. With lack of safe water and poor sanitation  Epidemics can cause significant economic loss o Impact on food establishment identifid with the virus  S/S fever, malaise, loss of appetite, diarrhea, nausea, abdominal discomfort,  dark­colored urine and jaundice o Appx 50% of cases subclinical o Not everyone shows s/s  Recovery usually complete without chronic infection o Can take weeks/ months for people to return to ordinary life  Rarely fatal, but s/s debilitating and fulminant hepatitis Hepatitis E  Similar to Hep A  Yearly, ~20 million Hep E infections, over 3 million acute cases, 56,000 hepatitis  E­related virus  Transmitted via fecal­oral route, esp. Contaminated water  Uncommon in US; found worldwide, prevalence highest in East and South Asia  China produced and licensed the first vaccine, not yet approved Leptospira  Zoonotic disease/ domestic animals  Problem in tropical countries, rare in US  Responds to antibiotics o If untreated can infect several organs >death o Flu­like symptoms: high fever, chills, H/A, muscle aches  Humans infected from exposure to water contaminated with infected animal urine o Animal handlers at risk Influenza Difference between Antigenic drift and Antigenic shift Type A (most implicated in outbreak and epidemics) versus Type B Animals’ role (avian, swine, pig blender) Malaria 4 plasmodium species, focus on falciparum Treatment and control (mosquito nets) Features of P.falciparum cases  Potentially fatal disease for non­immune individuals o Cerebral malaria can occur o Can progress very rapidly to severe malaria causing high mortality  (despite treatment) o People in endemic areas usually mount some degree of protective  immunity against life threatening complications  Incubation period: may be prolonged by immunity, chemoprophylaxis, and partial  treatment  s/s and physical findings are non­specific o ⅓ patients afebrile when first examined o May have mild s/s similar to vivax o May lack paroxysm Cancer Infectious agents What causes cancer?  Cancer is caused by both external factors and internal factors that occur from  metabolism (chemical processes occurring within a living cell or organism that  are necessary for the maintenance of life) o External factors include: tobacco, chemicals, radiation, and infectious  organisms  Lymphomas can be triggered by the Epstein­Barr virus, which also causes mononucleosis  Damaging env agents (mutagens) include radiation, viruses,  chemicals in air o Internal factors include: genetic, inherited mutations, hormones, immune  conditions, and other mutations Infections and Cancer  Infections can raise a person’s risk of cancer in 3 different ways o Some viruses directly affect the genes inside cells that control their  growth. These viruses can insert their own genes into the cells causing  the cell to grow out of control o Some infections can cause long­term inflammation in a part of the body.  This can lead to changes in the affected cells and in nearby immune cells, which can eventually lead to cancer Some cancer are caused by viruses or bacteria  `2 million new cancer cases attributable to infections o Higher in less developed countries  Helicobacter pylori, hep B and C, and HPV responsible for 1.9 million cases,  mainly gastric, liver, and cervix uteri cancers  In women, cervix uteri cancer accounted for about ½ of infection­related burden  of cancer  In men, liver and gastric cancers accounted for more than 80%  Around 30% of infection­attributable cases occur in people younger than 50 There are genetic components Emerging Infectious Diseases Factors involved in the emergence of infectious diseases Urbanization is spreading these infectious diseases. Overcrowding. Poor sanitation.  Ecological disturbances  Deforestation and human intrusion into remote ecosystems contribute to EIDs  Increased contact with animals and insect vectors o I.e. HIV/AIDS  Migration of displaced animals and vectors into villages o Examples: chagas’ disease, rabies, leishmaniasis, schistosomiasis, etc. Microbial Evolution and adaptation Human Behavior and Attitudes  Complacency: medical advances have led to false assumption that prevention  and control are no longer necessary o Threatened resurgence of AIDS o Lack of compliance with immunization regimens  Human migration: about 190 million people live outside their native countries o Internally displaced persons lack water, shelter, food, and hygiene, all  leading to increases in infection o Refugees transmit infectious diseases from their native lands to those  with whom they come in contact in overcrowded refugee camps Climate name change Bioterrorism Why is it used, which preferred Biological Warfare and terrorism  Terrorism: deliberate use of, or threatened use of, violence to achieve political,  religious or ideological objectives  Biological weapons are deliberately used to produce disease to incapacitate or  kill individuals or produce mass casualties Anthrax Bacillus anthracis most likely biological weapon  Thought to be in arsenal of at least 10 countries o Iraq had produced 8,000 liters of weaponized anthrax spores  Genetically engineered strains of anthrax probably exist  B anthracis spores easily disseminated by bombs, artillery shells, etcc  Spores resistant to heat and chemicals so they are hard to kill, can remain in soil  for 50+ years  Inhalation anthrax high mortality rate (99% if untreated) o Antibiotics may be effective if administered within 24­48 hours  Anthrax vaccine has several drawbacks o Many shots over a number of years and may not be able to protect  against aerosol


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