Week 14: Infectious Disease

What is typically the difference between upper and lower respiratory tract infections?

upper = pathogen usually viral

lower = pathogen usually bacterial

What happens after “catching” an upper respiratory tract pathogen?

• virus enters, begins replicating in nasopharyngeal epithelium

• immune system senses presence of virus

  • mucus glands activated

  • inflammation

  • bronchial constriction

• symptoms include fever, sore throat, sneezing, congestion, & cough

How does our brain know that we are sick and need to rest?

neurons in the throat sense prostaglandins made by immune cells and send signal to the brain

What is the best approach to dealing with URTIs?

PREVENTION!!

• behavioral strategies: handwashing, regular exercise, and stress reduction

• immunizations: seasonal flu shots

Describe the pharmaceutical best known to treat influenza infections?

oseltamivir

• must be given to patients within 48 hours of infection to be efficacious

• can also be used to prevent influenza infection in high-risk patients

• questionable aspects: does not reduce hospitalizations, benefits might not outweigh risks, use is leading to viral resistance

Describe 5 supplements used to manage URTIs

• andrographis

  • anti-inflammatory, anti-viral, & analgesic properties

• coneflower/echinacea purpurea

  • root & flower used

  • anti-viral activity

• honey

  • cough relief & reduces inflammation/irritation

• vitamin C

  • reduces duration of colds

  • how its consumed matters: Vitamin C-rich foods thought to give better benefit than supplement

• Zinc

  • reduces duration of colds

  • requires frequent early dosing to see effect

What is Human Immunodeficiency Virus (HIV)?

• a double-stranded RNA virus

• requires entry into host cells to complete life cycle

• once infected, patients almost never clear the virus → lifelong infection

Explain how contracting HIV eventually leads to immunodeficiency

• HIV has an affinity for CD4 T cells

  • when viral DNA integrates, it triggers signal for cell to die by apoptosis

• infection will generate compensatory immune response, but antibodies not effective against pathogens

• asymptomatic phase

  • CD4 T cells continue to be destroyed, but still have enough to be immunocompetent

Define AIDS

Acquired immunodeficiency syndrome (AIDS)

• a result of the gradual extinction of CD4 T cells after HIV infection

• when CD4 count falls below 200 cells/ul blood

What is one pre-exposure prophylaxis (PrEP) treatment for HIV?

Truvada (emtricitabine & tenofovir)

Describe the typical post-exposure prophylaxis (PEP) regimen for HIV

• start ART within 72 hours of exposure

• combination of 2-3 drugs, taken for 28 days post exposure

Describe 2 lifestyle changes to improve health after HIV infection

• smoking cessation

  • contributes to inflammatory environment cased by infection, inhibiting CD4 cell function & increasing risk of opportunistic infections

• nutrition

  • HIV is associated with involuntary decrease in body weight

  • high protein, high calorie, macronutrient diets are generally recommended

Describe 2 supplements used to manage HIV infection

• silymarin (found in milk thistle)

  • known to increase liver function in alcohol-related liver damage

• multivitamins

  • found to reduce progression of AIDS (maintain CD4 cell count & lower viral load)

Describe urinary tract infections (UTIs)

• bacterial colonization of the bladder following infection in urethra (80% caused by E. coli)

• infection can spread to kidneys

• infection causes long-lasting changes to bladder urothelium, which increases susceptibility to subsequent infections

Describe 3 integrative therapies for UTIs

• diet

  • good overall health = stronger immune system

• garlic & onions

  • garlic = antimicrobial properties, possibly due to allicin

  • onions = contain allicin

• fluids

  • more fluid = more frequent voiding of bladder = less accumulation of bacteria

What are 3 supplements that prevent UTIs?

• probiotics

  • maximize colonic health tor educe reservoir for bacteria

• Vitamin C (ascorbic acid)

• Uva Ursi

  • active compound = arbutin

  • converts to hydroquinone and makes urine alkaline

  • toxicity when used long term

What is Operation Quack Hack?

launched by FDA with the goal of preventing sale of fake COVID-19 cures, illegitimate test kits, and substandard respirators/masks

Which of the following are snake oils?

• goldenseal/hydrastis canadensis

• slippery elm

• povidone iodine

• elderberry

• cranberry

• carrageenan

• hydrastis canadensis

• povidone iodine

• elderberry