Public Health Ii - Communicable Diseases

Front 1

Communicable diseases are due to:

Back 1

transmission of an infectious agent

often, but not always results in overt manifestations.

Front 2

Communicable diseases can occur as:

Back 2

-sporadic cases
-endemics
-epidemics
-pandemics

Front 3

Define sporadic cases

Back 3

localized, not widespread

Front 4

Define endemics

Back 4

present at low levels in the population

Front 5

Define epidemics

Back 5

at higher than expected level

Front 6

Define pandemics

Back 6

epidemic at a global scale

Front 7

Communicable diseases responsible for _______ of deaths in the world.

Back 7

1/3

Front 8

What is the epidemic theory?

Back 8

Mass action priniciple

Front 9

Define mass action principle

Back 9

rate of spread of an epidemic thru a population depends on rate of contact b/t infectious individuals and susceptibility.

Front 10

What influences the rate of spread?

Back 10

1)infectivity
2)gradient of infection
3)herd immunity

Front 11

Define infectivity

Back 11

period when a disease is infectious, is different for different diseases

Front 12

Define gradient of infection

Back 12

symptoms: a symptomatic to death

Front 13

Define herd immunity

Back 13

threshold immunity for different diseases

Front 14

Give two example of herd immunity.

Back 14

1) diptheria 50-60% of population must be vaccinated to protect those that are not
2) Measles 80-95%

Front 15

Disease outbreaks are reported to whom?

Back 15

CDC (center for disease control)

Front 16

What does the CDC publish?

Back 16

MMWR

Front 17

What is the MMWR?

Back 17

Mortality and Morbidity Weekly Report

Published by the CDC

Front 18

What is it called when outbreaks of disease are reported?

Back 18

Surveillance

Front 19

Name the modes of transmission

Back 19

1) person-to-person
2) vectorborne
3) common vehicle
4) zoonoses

Front 20

Name the types of person-to-person transmission.

Back 20

1) indirect transmission
-fomites and aerosols
2) direct transmission
-STD's

Front 21

Define vectorborne

Back 21

diseases transmitted by an insect

Front 22

Name the 2 vectorborne modes of transmission.

Back 22

1) biological life cycle transfer
2) passenger transfer

Front 23

Define biological life cycle transfer

Back 23

infectious agent requires vector for its lifecycle

Front 24

Give an example of a biological life cycle transfer.

Back 24

Malaria

Front 25

Define passenger transfer

Back 25

infectious agent transported by the vector

Front 26

What is a common vehicle mode of transmission?

Back 26

spread by food or water

Front 27

What is a zoonoses mode of transmission?

Back 27

primarily found in animals

Front 28

How are infectious diseases controlled?

Back 28

1) enhance host resistance
2) interupt transmission
3) personal measures

Front 29

How do you enhance host resistance?

Back 29

-overall wellness
-immunization
-good nutrition

Front 30

How do you interupt transmission of a disease?

Back 30

-detect and treat diseases
-isolation (cases) and quarantine (contacts)
-chemoprophylaxis
-vector control
-pure water

Front 31

Name personal measures used to control infectious diseases.

Back 31

-condoms
-wash hands
-gloves

Front 32

How is Influenza transmitted?

Back 32

person-to-person INDIRECT

Front 33

What is influenza?

Back 33

a viral respiratory tract infection

Front 34

Why is identification of influenza important?

Back 34

-widespread morbidity
-spreads quickly (can become epidemic)
-seriousness of its complications (esp. pneumonia)
-virus easily mutates (novel strain) & can lead to pandemics

Front 35

How are the infectious agents named?

Back 35

named for protein spikes (H & N)

Front 36

What does "H" stand for in a protein spike with Influenza?

Back 36

Hemagglutinin

Front 37

What does "N" stand for in a protein spike with influenza?

Back 37

Neuraminidase

Front 38

Name the 3 types of Influenza viruses.

Back 38

Type A
Type B
Type C

Front 39

Which type of Influenza virus is responsible for epidemics and pandemics?

Back 39

Type A

Front 40

Which type of Influenza virus is SOMETIMES responsible for epidemics?

Back 40

Type B

Front 41

Which type of Influenza virus is responsible for localized outbreaks?

Back 41

Type C

Front 42

Where did the word Influenza come from?

Back 42

Named "influence" by the Italians.

Described by Ancient Greeks

Front 43

How often do pandemics occur?

Back 43

3-4x a Century

Front 44

What year was the 1st documented pandemic?

Back 44

1580

Front 45

The pandemic which occurred in the year 1580 spread from _____ to _____.

Back 45

Asia ------> Europe

Front 46

What was the outcome of the 1580 pandemic?

Back 46

Killed 10% of population in 1 week in Rome.

Front 47

Name the pandemic that occurred in the 21st century.

Back 47

H1N1 Swine Flu

Front 48

Name the pandemics which occurred in the 20th Century.

Back 48

Hong Kong Flu (1968)
Asian Flu (1957)
Spanish flu (1918)

Front 49

Deaths resulting from Hong Kong Flu?

Back 49

0.75-1.0 Million

Front 50

Deaths resulting from Asian Flu?

Back 50

1-1.5 Million

Front 51

Deaths resulting from Spanish Flu?

Back 51

Over 50 million

Front 52

Fatality rate of Hong Kong Flu?

Back 52

0.1-0.5%

Front 53

Fatality rate of Asian flu?

Back 53

0.1-0.5%

Front 54

Fatality rate of Spanish Flu?

Back 54

2-10%

Front 55

When did spanish flu occur?

Back 55

During WWI (1918)

Front 56

Spanish Flu (H1N1) was thought to have killed ________ people in ______ weeks.

Back 56

25 million
25 weeks

Front 57

What types of people were targeted by the Spanish Flu?

Back 57

young and healthy

Front 58

First wave of Spanish Flu?

Back 58

Spring 1918 in Kansas
Military Barracks
Many Deaths

Front 59

Second wave of Spanish Flu?

Back 59

Late Summer/Fall 1918 in the US
Partially spread thru war bond drives and parades & thru troop ships
-675,000 deaths in the US

Front 60

Occurrence of Spanish Flu?

Back 60

-widespread
-occurs almost annually as epidemic (Type A)
-occasionally occurs as an epidemic from Type B or Type A&B
-rarely as a pandemic (Type A)
-250,000-500,000 deaths per year worldwide (most old)
-35,000 deaths/yr in US

Front 61

What is the primary reservoir of Spanish Flu?

Back 61

Humans

Front 62

Where would you find Type B Spanish Flu?

Back 62

Only found in humans

Front 63

Where would you find Type A Spanish Flu?

Back 63

mammals and birds

Front 64

MOT of spanish flu?

Back 64

-fomites
-infectious droplets

Front 65

What's the susceptibilty of Spanish flu becoming a pandemic?

Back 65

If there is a novel strain

Front 66

What is the susceptibility of spanish flu becoming an epidemic?

Back 66

-some may have antibodies
-immunizations
-different susceptiblity

Front 67

Is spanish flu reportable?

Back 67

Not reportable.
-only for deaths and pediatric ICU

Front 68

What is the treatment for Spanish Flu?

Back 68

anti-viral medications

Front 69

What is an anti-viral medication for spanish flu?

Back 69

Tami-flu

Front 70

Personal hygiene for prevention of spanish flu?

Back 70

-washing hands
-cover your cough
-social distancing

Front 71

Bird Flu is also known as:

Back 71

Avian Flu

Front 72

What is the WHO definition of a pandemic?

Back 72

1) Novel infectious agent
2) Must make humans sick
3) Easy human to human transmission

Front 73

What is the infectious agent of Spanish Flu?

Back 73

H1N1

Front 74

What is the infectious agent of Avian Flu?

Back 74

H5N1

Front 75

Where did Avian flu originate?

Back 75

SE Asia

Front 76

What is the fatality rate of Avian flu?

Back 76

60%

Front 77

Avian flu was originally transmitted from _______ to ______ and ________________ transmission has been demonstrated.

Back 77

Animals to Humans
Human-to-human

Front 78

What would happen if bird flu becomes like the spanish flu?

Back 78

-CDC estimates 100 million deaths worldwide
-kill the young like spanish flu (cytokine storm)
-4 of 8 genes of bird flu show same mutations as Spanish flu

Front 79

What is the Government's response to bird flu?

Back 79

1) keep the virus out
2) keep virus from spreading
3) keep the virus infrastructure up and running

Front 80

Of those infected with TB, how many people do NOT develop the disease?

Back 80

90% (Latent TB)

Front 81

Of those infected with TB, how many develop the disease?

Back 81

10% (Active TB)

Front 82

Describe those who become infected with TB but do not develop the disease.

Back 82

-No symptoms
-Not contagious
-usually skin test (+)
-decrease in immunity can convert latent into active TB

Front 83

Describe those who become infected with TB and develop the disease.

Back 83

-symptoms
-can pass it to others
-skin test (+)

Front 84

What is the infectious agent of tuberculosis?

Back 84

Mycobacterium tuberculosis

Front 85

Name 3 AKA for TB

Back 85

1) White Plague
2) White Death
3) Consumption

Front 86

What association was founded in the early 1900's to combat TB?

Back 86

American Lung Association

Front 87

What was considered the disease of the poor?

Back 87

Tuberculosis

Front 88

Which disease has been around since prehistoric man?

Back 88

Tuberculosis

Front 89

Who started the 1st Sanatorium in the US in the 1800's?

Back 89

Dr. Edward Trudeau (physician)

Front 90

Where was the first Sanatorium located?

Back 90

Saranac Lake, NY

Front 91

When were antibiotics discovered?

Back 91

1940's

Front 92

Who discovered Mycobacterium tuberculosis?

Back 92

Koch

Front 93

When is World TB Day?

Back 93

March 24th

Front 94

When did Koch discover the bacteria causing TB?

Back 94

late 1880's

Front 95

When was the vaccine for TB developed?

Back 95

1920's

Front 96

What fraction of the world's population is infected with TB?

Back 96

1/3

Front 97

How many new infections of TB are there every year?

Back 97

9 million

Front 98

How many deaths/yr result from TB?

Back 98

2 million

Front 99

Where do most infections and deaths occur from TB?

Back 99

Asia and sub-Saharan Africa

Front 100

What is considered to be a re-emerging disease due to drug resistance?

Back 100

Tuberculosis

Front 101

What is MDR-TB?

Back 101

multidrug resistant tuberculosis

Front 102

What percentage of new infections of TB are MDR-TB?

Back 102

5%

Front 103

What percentage of new cases in former Soviet Union are MDR-TB?

Back 103

15-22%

Front 104

What is XDR-TB?

Back 104

extensively drug resistent tuberculosis

Front 105

What is the leading killer of HIV+ people?

Back 105

Tuberculosis

Front 106

What fraction of everyone with TB are co-infected with HIV?

Back 106

1/3

Front 107

There is a parallel pandemic of ___________ & ____________.

Back 107

TB and HIV

Front 108

What is the reservoir for TB?

Back 108

Humans

Front 109

What is the MOT of TB?

Back 109

airborne droplets

Front 110

What does the susceptibility of TB depend on?

Back 110

length of exposure

Front 111

Regarding the immune system, if an individual is HIV+ and has latent TB, the chance of latent TB converting to active TB increases from _____ to ______.

Back 111

10% to 50%

Front 112

Is TB reportable?

Back 112

Yes

Front 113

How is TB being prevented and controlled?

Back 113

-treatment (latent and active TB)
-TB control programs in institutions
-vaccine

Front 114

Public health issue with STDs

Back 114

1) presence of any STD (ulcerative or non-ulcerative) increases the chance of aquisition of transmission of HIV.
2) women bear burden of 2 of the most commonly reported STDs
3) racial disparity (especially blacks)

Front 115

What are the 2 most commonly reported STDs?

Back 115

1) chlamydia
2) gonorrhea

Front 116

STDs are linked to?

Back 116

Socioeconomic status
-education
-access to health care
-reporting bias

Front 117

____________cases of STDs/yr worldwide

Back 117

340 million

Front 118

Most individuals who become infected with STDs are between the ages of ______ and ______.

Back 118

15-49

Front 119

How many cases of STDs/yr in the US?

Back 119

19 million

Front 120

STDs cost the US how much per year?

Back 120

$16 Billion

Front 121

Of the 19 million cases of STDs in the US, 1/2 occur in _____ to ______ year olds.

Back 121

15-24

Front 122

_____ out of _____ American girls have an STD (age 15-19).

Back 122

1 out of 4

Front 123

____ out of ____ black american girls (age 15-19) have an STD.

Back 123

1 out 2

Front 124

LA is #1 for which 2 STDs?

Back 124

1) chlamydia
2) syphilis

Front 125

LA is #3 for which STD?

Back 125

gonorrhea

Front 126

General prevention and control of STDs

Back 126

-education and health promotion (abstinence, safe sex, and monogamy)
-control STDs in sex workers
-test for HIV when any other STD is present
-partner notification (test, treat, notify)

Front 127

What type of infection is syphilis?

Back 127

Bacterial infection

Front 128

What are the different types of stages of syphilis?

Back 128

1) primary
2) secondary
3) tertiary
4) latent

Front 129

Primary stage of syphilis

Back 129

-presence of a painless chancre at point of infection
-lasts up to 3 weeks
-chancre goes away with or without treatment

Front 130

Secondary Stage of syphilis

Back 130

-lesions, fever, rashes, swollen lymph nodes
-lasts up to 1 yr
-symptoms go away with or without treatment

Front 131

Which stage of syphilis presents with no symptoms?

Back 131

latent stage

Front 132

Tertiary stage of syphilis

Back 132

enters body systems especially the CNS

Front 133

Congenital syphilis characteristics

Back 133

1) Hutchinson's teeth
2) Saddle Nose
3) Perforated palate

Front 134

What is the infectious agent of syphilis?

Back 134

Treponema pallidum

Front 135

When did the first epidemic of syphilis occur?

Back 135

late 1400s

Front 136

What year did the Tuskegee Experiment begin?

Back 136

1932

Front 137

Who began the Tuskegee Experiment?

Back 137

Tuskegee Institute of US public health service

Front 138

Who were recruited in the Tuskegee Experiment?

Back 138

poor, uneducated black men with syphilis

Front 139

What was the purpose of the Tuskegee Experiment?

Back 139

to study the progression of syphilis

Front 140

When did the Tuskegee Experiement end?

Back 140

1972

Front 141

What was the fallout of the Tuskegee Experiment?

Back 141

establishment of Instituional Review Boards
-Informed consent

Front 142

How was the Tuskegee experiment unethical?

Back 142

-after discovery of antibiotics, no change in study (no subject received antibiotics)
-some subjects died
-passed on syphilis to females

Front 143

In what country did the US inject people with Syphilis?

Back 143

Guatemala (1940s)

Front 144

Occurrence of syphilis

Back 144

-12 million infections/yr worldwide
-in US from 1990-2000 decrease of 90% in cases
-in US 2000-present increase especially in MSM (men who have sex with men)

Front 145

MOT of Syphilis?

Back 145

1) sexual contact during primary and secondary lesions
2) transplacental

Front 146

Is Syphilis reportable?

Back 146

Yes

Front 147

What type of infection is Gonorrhea?

Back 147

bacterial infection

Front 148

What are the symptoms men get who are infected with gonorrhea?

Back 148

purulent discharge

Front 149

What are the symptoms women get who are infected with gonorrhea?

Back 149

-asymptomatic or mild symptoms
-if left untreated, increase risk for PID

Front 150

What is the infectious agent of gonorrhea?

Back 150

Neisseria gonorrhea

Front 151

What is the street name for gonorrhea?

Back 151

"the clap"

Front 152

What is the occurrence of gonorrhea?

Back 152

-62 million infections/yr worldwide
-in US over 350,000 cases/yr
(actual # is more like 700,000+)
-drug resistant strains develop

Front 153

MOT for gonorrhea?

Back 153

-sexual contact
-perinatal transmission

Front 154

What does perinatal transmission of gonorrhea cause in newborn?

Back 154

bacterial conjunctivitus (opthalmia neonatorum)

cure: eyedrops --->antimicrobial

old method: silver nitrate drops

Front 155

Is gonorrhea reportable?

Back 155

Yes

Front 156

What type of infection is chlamydia?

Back 156

bacterial infections

Front 157

Symptoms experienced by men with chlamydia?

Back 157

50% are asymptomatic

Front 158

Symptoms experienced by women with chlamydia?

Back 158

-75% are asymptomatic
-if left untreated, increased chance of PID by 40%

Front 159

What is the infectious agent for chlamydia?

Back 159

Chlamydia trachomatis

Front 160

What is the occurrence of chlamydia?

Back 160

-92 million cases/yr worldwide
-in the US 1.2 million cases/yr (true number is 3x higher)

Front 161

What is the #1 reported bacterial STD in the US?

Back 161

Chlamydia

Front 162

MOT of chlamydia?

Back 162

-sexual contact
-perinatal transmission

Front 163

What can happen to a newborn whose mother is infected with chlamydia?

Back 163

opthalmia neonatorum

treatment: eyedrops

Front 164

Prevention and control of Chlamydia

Back 164

-reportable
-treatment
-sexually active females under 25 (annual screening recommended)
-sexually active females 25 and older (annual screening based on risk factors)

Front 165

What type of infection is Herpes?

Back 165

viral infection

Front 166

How is herpes identified?

Back 166

sores/blisters in genital region

Front 167

What are the infectious agents for herpes?

Back 167

Herpes Simplex Virus
-HSV-1 (oral)
-HSV-2 (genital)

Front 168

What is the occurrence of herpes in the US?

Back 168

-50-90% have HSV-1 antibodies (Primary infection under age 5)
-16% have HSV-2 Antibodies (primary infection when adults)
-1 out of 4 adults in NYC have genital herpes

Front 169

MOT for herpes

Back 169

sexual contact

Front 170

Is Herpes reportable?

Back 170

No

Front 171

Prevention and control of herpes

Back 171

-not reportable
-antivirals
-C-section if outbreak occurs to prevent eye infection in baby

Front 172

Identification of HPV

Back 172

-precancerous changes, cancer
-genital warts
-most are asymptomatic

Front 173

What is the infectious agent of HPV?

Back 173

Human papilloma virus
-some strains infect genitals
-only a few strains cause warts

Front 174

What's the occurrence of HPV?

Back 174

-most prevalent STD in US
-75-80% of sexually active people will acquire it at some point in their lives

Front 175

What is the most prevalent STD in the US?

Back 175

HPV

Front 176

What's the MOT for HPV?

Back 176

sexual contact

Front 177

Preventions and control of HPV

Back 177

-not reportable
-wart removal
-pap smears
-vaccine