SPHU 1020: Contact diseases and HPV
SPHU 1020: Contact diseases and HPV SPHU 1020
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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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