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SPHU 1020: Contact diseases and HPV

by: Claire Jacob

SPHU 1020: Contact diseases and HPV SPHU 1020

Marketplace > Tulane University > Public Health > SPHU 1020 > SPHU 1020 Contact diseases and HPV
Claire Jacob

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About this Document

Staphylococcus infections and human Papilloma Virus
Cell, Individual & The Community
Dickey-Cropley, Lorelei
Class Notes
Public Health, staphylococcus, HPV
25 ?




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This 4 page Class Notes was uploaded by Claire Jacob on Sunday April 10, 2016. The Class Notes belongs to SPHU 1020 at Tulane University taught by Dickey-Cropley, Lorelei in Summer 2015. Since its upload, it has received 27 views. For similar materials see Cell, Individual & The Community in Public Health at Tulane University.

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Date Created: 04/10/16
Bacterial Contact Diseases: Staph ● Staphylococci are g+ cocci; normal flora of skin, mouth, nose and throat ● Have a characteristic “grape­like: microscopic evaluation ● Have a thick cell wall Staphylococcus aureus ● Virulence factors include ○ Bacterial surface proteins that facilitate binding to host tissues and hinder the host’s immune response ○ Enzymes that are directly toxic to host cells ○ “Superantigens” that can induce an overwhelming systemic  inflammatory response syndrome ● At any one time up to 50% of persons are asymptomatic carriers of  Staphylococcus aureus bacteria ● Clinical disease due to S aureus results from complex interaction of bacterial  virulence and host susceptibility factors ● Staph can cause: skin and soft tissue infections ○ Minor skin infections (pustules, small boils) that can be treated  without antibiotics ○ Serious skin infections ■ Can lead to amputation­ MRSa ○ Bloodstream infections ○ Pneumonia Other infection associated with S. aureus include ● Impetigo: superficial blister that produces an oozing highly infectious yellow  discharge ● Scalded skin syndrome causes blistering skin due to an exfoliative toxin ● Toxic shock syndrome (TSS): strains that secrete TSS exotoxin ○ High fever, N/V, peeling of skin and a dangerous drop in B/P that  leads to life­threatening shock ● Endocarditis ● Pneumonia ● Surgical site, prosthetic and intravascular device infections ● Toxin­associated gastroenteritis ● Folliculitis ● Cellulites ● Soft tissue abscesses ● Necrotizing fasciitis osteomylitis ● Discitis ● Septic arthritis Methicillin­resistant Staphylococcus aureus (MRSA) ● Bacteria have become resistant to various antibiotics ○ MRSA is a special methicillin resistant strain of “staph” ● HA­MRSA ○ 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 ○ Can be see in young, healthy adults ○ Common cause of skin and soft tissue infections occurring in  previously healthy adults and children who have not had prior contact with  health­care settings ● Differs from HCA­MRSA ○ More virulent ○ More likely to express Panton­Valentine leukocidin, a highly  destructive bacterial toxin ○ Less likely to exhibit drug resistance to multiple antibiotics ○ 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 ○ 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 is used in livestock Transmission ● 5 Cs ○ Crowding ○ Contact­frequent skin­to­skin ○ Compromised skin ○ Contaminated items ○ Lack of Cleanliness Prevention ● Covering infections to prevent spread ● Cleaning and disinfection should be performed on any surfaces that the infection  might have come into contact with ● Use an antibacterial soap Treating CA­MRSA ● Infections are treatable ● Prompt resolution of infections require: ○ Early recognition ○ For mild skin and soft tissue infections, surgical incision and  drainage is often curative; obtain cultures if possible ○ Antimicrobial therapy is warranted for more serious, deep seated  infections or rapidly spreading infections ■ Vancomycin Antibiotics that can be used against S aureus include but a particular colony can be resistant to  some or all of these antibiotics HPV: Human Papilloma Virus ● Many people are not visibly infected ● Evades immune system by:  ○ No release of inflammatory cytokines ○ downregulating cellular immune response ○ Poor response of antibody ● End result: persistent asymptomatic infection that may lead to premalignant  cellular reactions ● Diagnosis and treatment ○ Diagnosed based on the appearance of lesions ○ Often detected during routine PAP tests ○ Special tests can detect HPV and distinguish among the more  common strains, including those that cause most cases of cervical cancer ○ Treatment focuses on reducing the number and size of warts Cervical Cancer ● Over 500,000 cases diagnosed annually worldwide with 260,000 deaths; in the  US, 19,710 cases and 3,700 deaths ● Cervical cancer is 2nd leading cause of death among women worldwide ● Prevention of cervical cancer can be accomplished with use of an effective HPV  vaccines ○ PAP test is highly effective screening test for this cancer ■ All sexually active women ages 18­65 should be  tested regularly 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


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