Mad Cows & Brits with holes in their brains

(& other infectious diseases)

Mad Cows & Brits with holes in their brains

(& other infectious diseases)

Lecture 3

Dulai - FIB - 2008

Lecture 3

Dulai - FIB - 2008

Comeback DiseasesComeback Diseases

Infectious diseases such as Cholera Rheumatic fever Plague

though still quite rare, are on the rise and are threats to be reckoned with.

For example, cholera, Vibrio comma , is turning up in the shellfish population, mainly on the U.S. Gulf Coast.

It's usually transmitted to humans when they eat undercooked shellfish.

Infectious diseases such as Cholera Rheumatic fever Plague

though still quite rare, are on the rise and are threats to be reckoned with.

For example, cholera, Vibrio comma , is turning up in the shellfish population, mainly on the U.S. Gulf Coast.

It's usually transmitted to humans when they eat undercooked shellfish.

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Vibrio comma

Revisiting!Revisiting!

Likewise, outbreaks of such maladies of yesteryear as Measles Mumps Diphtheria Tuberculosis Syphilis

are on the rise.

Likewise, outbreaks of such maladies of yesteryear as Measles Mumps Diphtheria Tuberculosis Syphilis

are on the rise.

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Why?Why?

Lax use of drugs by patients Because parents, doctors and public health

authorities have failed to mount the effort needed to make sure everyone susceptible to preventable diseases, regardless of economic status, is vaccinated.

Even people who have been properly immunized are being stricken.

Population Growth and overcrowding

Lax use of drugs by patients Because parents, doctors and public health

authorities have failed to mount the effort needed to make sure everyone susceptible to preventable diseases, regardless of economic status, is vaccinated.

Even people who have been properly immunized are being stricken.

Population Growth and overcrowding

What next?What next?

It is common knowledge amongst scientists that IT IS NOT IF, BUT WHEN, the next major pandemic will be coming.

Millions, if not hundreds of millions, may die! What will it be?

Influenza Ebola TB MSRA Prions

It is common knowledge amongst scientists that IT IS NOT IF, BUT WHEN, the next major pandemic will be coming.

Millions, if not hundreds of millions, may die! What will it be?

Influenza Ebola TB MSRA Prions

Lets quickly consider these examples…

Lets quickly consider these examples…

InfluenzaInfluenza

Agent: Virus which attacks our cells. What can the stupid flu do to me? I am healthy and strong I live in a country with a lot of wealth I have nothing to fear…

…or so you think!

Agent: Virus which attacks our cells. What can the stupid flu do to me? I am healthy and strong I live in a country with a lot of wealth I have nothing to fear…

…or so you think!

Influenza - learn from historyInfluenza - learn from history

Flu pandemics tend to occur on a regular basis 1918 1957 1968 ?2008-9

The disease bears little resemblance to the the ‘flu’ - except at the molecular level

The virus gets its start when one of the many strains which constantly circulates in wild and domestic birds evolves into a form that infects humans

Flu pandemics tend to occur on a regular basis 1918 1957 1968 ?2008-9

The disease bears little resemblance to the the ‘flu’ - except at the molecular level

The virus gets its start when one of the many strains which constantly circulates in wild and domestic birds evolves into a form that infects humans

Hybrid strainHybrid strain

The bird strain then exchanges genes with the native human flu strain to produce a novel germ - that is highly contagious!

Some of these strains are mild Others, which mutate faster than the immune

system can defend against, cause severe and/or fatal illness

It is predicted that the next pandemic has the potential to claim more lives in a single year than AIDS has in the last 25 years!…

The bird strain then exchanges genes with the native human flu strain to produce a novel germ - that is highly contagious!

Some of these strains are mild Others, which mutate faster than the immune

system can defend against, cause severe and/or fatal illness

It is predicted that the next pandemic has the potential to claim more lives in a single year than AIDS has in the last 25 years!…

WarningsWarnings

Epidemiologists have warned that the next pandemic could sicken 1/3 people on the planet

Killing 10,000,000 to 100,000,000 people It would spare no nation, no race, no

income group There will be no way to avoid it!

Epidemiologists have warned that the next pandemic could sicken 1/3 people on the planet

Killing 10,000,000 to 100,000,000 people It would spare no nation, no race, no

income group There will be no way to avoid it!

My government will have a vaccine for me.

My government will have a vaccine for me.

So I will be just fine.

…will you?So I will be just fine.

…will you?

Asian Bird Flu is doing the roundsAsian Bird Flu is doing the rounds

Hard to predict when it will come Conditions are ripe at this time There is a fierce strain of avian flu killing

people in Asia, and infecting birds in a rapid westward lunge towards Europe

Influenza A (H5N1) does not pass readily from person to person - not yet!!!!

The virus is evolving and the birds are beginning their migrations…

What can we do?

Hard to predict when it will come Conditions are ripe at this time There is a fierce strain of avian flu killing

people in Asia, and infecting birds in a rapid westward lunge towards Europe

Influenza A (H5N1) does not pass readily from person to person - not yet!!!!

The virus is evolving and the birds are beginning their migrations…

What can we do?

DefenseDefense

Our best bets

1. Surveillance

2. Vaccines

3. Containment

4. Medications

Our best bets

1. Surveillance

2. Vaccines

3. Containment

4. Medications

Remember the Alamo KatrinaRemember the Alamo Katrina The government had a great plan for a

hurricane hitting the Texas coast It failed to implement properly It has a great plan for the ‘bird flu’ too Can they stick to their plans if the same

workers are downed by the flu?

The government had a great plan for a hurricane hitting the Texas coast

It failed to implement properly It has a great plan for the ‘bird flu’ too Can they stick to their plans if the same

workers are downed by the flu?

Case in point…Case in point…

Jakarta, Indonesia

They HAD a plan too…

Jakarta, Indonesia

They HAD a plan too…

FLU Strain H5N1FLU Strain H5N1

Late June - In a wealthy suburb of Jakarta, a 8-year old daughter of government auditor falls ill.

She gets antibiotics, but gets worse June 28th - She is hospitalized July 4th - Her father and sister fall ill too July 9th - Sister dies July 12th - Father dies

Late June - In a wealthy suburb of Jakarta, a 8-year old daughter of government auditor falls ill.

She gets antibiotics, but gets worse June 28th - She is hospitalized July 4th - Her father and sister fall ill too July 9th - Sister dies July 12th - Father dies

H5N1 continuedH5N1 continued

July 13th - doctors alert US Navy medical base July 14th - the girl dies July 14th - techs isolate and ID H5N1 form blood

samples July 22nd - Government acknowledges that there is a

problem. Hospitals prepare for an outbreak. - Over 30 days elapsed - containment window would

have closed. Luckily - This time it was a false alarm.

July 13th - doctors alert US Navy medical base July 14th - the girl dies July 14th - techs isolate and ID H5N1 form blood

samples July 22nd - Government acknowledges that there is a

problem. Hospitals prepare for an outbreak. - Over 30 days elapsed - containment window would

have closed. Luckily - This time it was a false alarm.

Use Vaccines to Control FluUse Vaccines to Control Flu Vaccines have worked to almost eradicate

smallpox and polio BUT, this tactic will not work with influenza

(unless we have a major advance in vaccine technology)

Why? It takes about 6 months to make vials of vaccine One will need two injects of vaccine 4 weeks apart -

primer and booster Add it up and it would take about 8 months to get

immunity from the start of the pandemic

Vaccines have worked to almost eradicate smallpox and polio

BUT, this tactic will not work with influenza (unless we have a major advance in vaccine technology)

Why? It takes about 6 months to make vials of vaccine One will need two injects of vaccine 4 weeks apart -

primer and booster Add it up and it would take about 8 months to get

immunity from the start of the pandemic

Vaccines - Who will get them?Vaccines - Who will get them?

There is capacity to make about 300 million doses per year More capacity on the way but still have other problems too Make flu vaccine or pandemic vaccine - cannot make both at

the same facility Delays and shortages will abound Who will get them first?

Government works Police Health works Teachers Elderly & infants Ill people Will YOU?

There is capacity to make about 300 million doses per year More capacity on the way but still have other problems too Make flu vaccine or pandemic vaccine - cannot make both at

the same facility Delays and shortages will abound Who will get them first?

Government works Police Health works Teachers Elderly & infants Ill people Will YOU?

EBOLAEBOLA

The new “jungle fever”The new “jungle fever”

EbolaEbola

Ebola is both the common term used to describe a group of viruses

…and the common name for the disease which they cause, Ebola fever

Thought to be transmitted by the fruit bat Ebola hemorrhagic fever

Vomiting, diarrhea, general body pain, internal and external bleeding, and fever.

Mortality rates are generally high, ranging from 50% - 90%, with the cause of death usually due to shock or organ failure - one of the most virulent viral diseases known to humankind

Ebola is both the common term used to describe a group of viruses

…and the common name for the disease which they cause, Ebola fever

Thought to be transmitted by the fruit bat Ebola hemorrhagic fever

Vomiting, diarrhea, general body pain, internal and external bleeding, and fever.

Mortality rates are generally high, ranging from 50% - 90%, with the cause of death usually due to shock or organ failure - one of the most virulent viral diseases known to humankind

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Ebola - InfectiousEbola - Infectious

Among humans, the virus is transmitted by direct contact with infected body fluids - sex

or to a lesser extent, skin or mucus membrane contact

The incubation period can be anywhere from 2 to 21 days, but is generally between 5 and 10 days

Monkeys - seems to be airborne, not humans- yet! Transmission of the Ebola virus has also occurred

by handling ill or dead infected chimpanzees.(Did we not blame them for giving us HIV/AIDS too!)

Among humans, the virus is transmitted by direct contact with infected body fluids - sex

or to a lesser extent, skin or mucus membrane contact

The incubation period can be anywhere from 2 to 21 days, but is generally between 5 and 10 days

Monkeys - seems to be airborne, not humans- yet! Transmission of the Ebola virus has also occurred

by handling ill or dead infected chimpanzees.(Did we not blame them for giving us HIV/AIDS too!)

TuberculosisTuberculosisTB for tubercle bacillusTB for tubercle bacillus

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Chest X-ray of Patient

TB - ‘The comeback kid’TB - ‘The comeback kid’

Today about 5000 people die of this once thought conquered disease!

It is caused by a bacteria Primarily attacks the lungs, although it can

also attack a number of other locations - nerves, blood, lymph, genitals, skin, etc.

Symptoms include chest pain, coughing up blood, and a productive, prolonged cough for more than three weeks.

Today about 5000 people die of this once thought conquered disease!

It is caused by a bacteria Primarily attacks the lungs, although it can

also attack a number of other locations - nerves, blood, lymph, genitals, skin, etc.

Symptoms include chest pain, coughing up blood, and a productive, prolonged cough for more than three weeks.

TB - ‘The comeback kid’TB - ‘The comeback kid’

Over 20% of the cases are now drug resistant in many countries

With a further 4% requiring 2nd line treatments

Will it be the next ‘BIG ONE’?

Over 20% of the cases are now drug resistant in many countries

With a further 4% requiring 2nd line treatments

Will it be the next ‘BIG ONE’?

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MRSAMRSAMethicillin-resistant

Staphylococcus aureusMethicillin-resistant

Staphylococcus aureus

MRSAMRSA

MRSA is characterized by antibiotic resistance to all penicillins including methicillin and other narrow-spectrum

penicillin antibiotics.

MRSA was discovered for the first time in 1961 in the UK, but it is now widespread in the hospital setting.

MRSA is commonly termed a superbug. MRSA infection can be fatal.

MRSA is characterized by antibiotic resistance to all penicillins including methicillin and other narrow-spectrum

penicillin antibiotics.

MRSA was discovered for the first time in 1961 in the UK, but it is now widespread in the hospital setting.

MRSA is commonly termed a superbug. MRSA infection can be fatal.

Natural floraNatural flora

Staphylococcus bacteria are normally found on the skin or in the nose of about one-third of the population

If you have staph on your skin or in your nose but aren't sick, you are said to be "colonized" but not infected with MRSA

Healthy people can be colonized with MRSA and have no ill effects, however, they can pass the germ to others.

Staphylococcus bacteria are normally found on the skin or in the nose of about one-third of the population

If you have staph on your skin or in your nose but aren't sick, you are said to be "colonized" but not infected with MRSA

Healthy people can be colonized with MRSA and have no ill effects, however, they can pass the germ to others.

MRSA…MRSA…

Enters through Nose Cuts IV sites Urinary tract Infections

About 5 times the risk of dying over those that do not get it.

Costs more to treat too, as you have to spend about 3X longer in the hospital.

Enters through Nose Cuts IV sites Urinary tract Infections

About 5 times the risk of dying over those that do not get it.

Costs more to treat too, as you have to spend about 3X longer in the hospital.

Common placeCommon place

Cases are now being reported outside the hospital setting - in communities

This has huge implications for us. Will we reach a point where we will have

no further antibiotics left to treat this infection - the bacteria is evolving very fast!

Cases are now being reported outside the hospital setting - in communities

This has huge implications for us. Will we reach a point where we will have

no further antibiotics left to treat this infection - the bacteria is evolving very fast!

Finally… HELLO I’M BACK!Finally… HELLO I’M BACK!

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WATCH ME…WATCH ME…

PrionsPrions

“ATTACK OF THE KILLER PROTEINS”

“ATTACK OF THE KILLER PROTEINS”

At a slaughter house near you…At a slaughter house near you…

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MAD COW DISEASEMAD COW DISEASE

BSE - Bovine Spongiform Encephalitis Spongy Brain Disease

Makes cows mad Known as Creutzfeldt-Jakob disease

(CJD) in man

BSE - Bovine Spongiform Encephalitis Spongy Brain Disease

Makes cows mad Known as Creutzfeldt-Jakob disease

(CJD) in man

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proteinaceous infectious particleproteinaceous infectious particle

Watch and learnWatch and learn

Whilst watching the video answer the following questions please:

1. How old was the first patient?

2. What did the natives of Papua New Guinea eat that caused them to get ‘kuru”?

3. How did it get into cows?

4. What is the cause of BSE?

5. What happens to the patients brain?

Whilst watching the video answer the following questions please:

1. How old was the first patient?

2. What did the natives of Papua New Guinea eat that caused them to get ‘kuru”?

3. How did it get into cows?

4. What is the cause of BSE?

5. What happens to the patients brain?

Group QuestionsGroup Questions

Group QuestionsGroup Questions

1. If you were a health worker, how would you change your habits after today's lecture?

2. Do you believe that killer diseases are inevitable?3. As we become more and more parasitic on other species, what

could be some of the outcomes? Discuss and then outline at least three possibilities.

4. Some say that the best way to control the human population is to allow these diseases to run their course. What do you think?

5. Downer Cattle & the meat factory in the news in California. Now do you understand why downer cattle are not allowed into the human foodchain.

6.

1. If you were a health worker, how would you change your habits after today's lecture?

2. Do you believe that killer diseases are inevitable?3. As we become more and more parasitic on other species, what

could be some of the outcomes? Discuss and then outline at least three possibilities.

4. Some say that the best way to control the human population is to allow these diseases to run their course. What do you think?

5. Downer Cattle & the meat factory in the news in California. Now do you understand why downer cattle are not allowed into the human foodchain.

6.