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Francis Collins
He discovered the CTFR gene that causes cystic fibrosis, key figure in the Human Genome Project
Akiko Iwasaki
She is a researcher and advocate for research into chronic illnesses, including ME/CFS and Long COVID. Advocate for disease awareness
John Enders
Him and colleagues created a vaccine for measles (later part of MMR vaccine)
Maurice Hilleman
Him and colleagues created a vaccine for measles (later part of MMR vaccine) and MMR vaccine
Andrew Wakefield
Research fraud, created 1998 study that falsely linked MMR vaccine to autism which was discredited later
Jenny McCarthy
Actress and model and prominent figure in the anti-vax movement; claims vaccines (including MMR) are linked to autism
Jim Carrey
Actor and comedian who is anti-vax and thinks the mercury in thimerosal is harmful
Robert Koch
Announced discovery of M. tuberculosis as the bacterium that causes TB and received Nobel Prize; developed a "cure" but wasn't effective
Edward Livingston Trudeau
After catching TB, he created the Adirondack Cottage Sanatorium, an isolated area for TB patients; he thought fresh air, rest, and good nutrition could help manage TB
Emily Bissell
American social worker/activist known for introducing Christmas Seals (adhesive labels for mail) to raise funds for the fight against tuberculosis (TB)
Stephan Schwander
TB researcher who aims at understanding how air pollution affects human immunity during TB infection
Tu Youyou
Discovered "artemisinin" as a treatment for malaria and how to extract it; first Chinese Nobel laureate in physiology/medicine; first Chinese female to receive a Nobel Prize
Rachel Carson
Wrote the book Silent Spring; said that if humans continued to use pesticides (e.g. DDT) without limitations, the chemicals would damage the environment and cause cancer
Disease-Society-Science Triangle
-How do diseases change societies?
-How does human action influence disease?
-What does society expect from science?
-How does science impact society-how does science change disease
-What causes disease?
One Health
One Health is an approach that recognizes the interconnectedness of human, animal, and environmental health. It aims to promote collaboration across these disciplines to manage diseases, especially zoonotic diseases that can transfer between animals and humans.
disease classification/taxonomy
a system for categorizing diseases based on causes, body systems, and symptoms; helps in understanding disease patterns, communication among healthcare providers, and public health monitoring.
InternationalClassification of Diseases (ICD)
globally recognized system used to classify diseases and health conditions developed by World Health Organization (WHO).
ICD-10-CM vs ICD-11
ICD-10-CM (Clinical Modification) is a modified version of ICD-10 that is used by the US. The rest of the world uses ICD-11 that is more up-to-date, allows for more code combinations and greater specificity in diagnosing diseases compared to ICD-10
Classifying diseases by body systems
Body systems include: muscular, digestive, nervous, urinary, reproductive, cardiovascular, hormonal, lymphatic, respiratory, skeletal
Classifying diseases by cause (etiology)
Causes include: infectious (malaria), genetic (cystic fibrosis), environmental (bad air quality)
goiter etiology
caused by iodine deficiency that results in enlargement of the thyroid gland; the thyroid gland needs iodine to function to make hormones
nutritional deficiency disease: scurvy
caused by vitamin C deficiency and was common among sailors; sailors would lose teeth, have sunken eyes, pale skin
multifactorial diseases
diseases with multiple contributing factors such as cancer, asthma, heart disease, diabetes
#1 disease with highest mortality rate
heart disease
disease morbidity
the state of being symptomatic or unhealthy for a disease or condition
disease burden
Impact of a health problem measured by indicators such as effects on society, financial cost, morbidity, and mortality
DALYs
a DALY is the loss of one year of full health
(DALYs = Years Lived with Disability + Years Life Lost)
disease definition
the opposite of health/well-being
symptom definition
noticed by the patient (subjective)
sign definition
noticed by others, e.g. physician (objective)
Fever: sign or symptom?
sign - objective (observable)
Chills: sign or symptom?
symptom - subjective (not observable)
Headache: sign or symptom?
symptom - subjective (not observable)
normativist beliefs
Normativists focus on how cultural context influences what we consider a disease (diseases are social constructions)
naturalists beliefs
Naturalists emphasize a biological basis and rely on objective criteria for defining disease (objective scientific matter)
disease etymology
the origins of how a disease got its name; came from old French word 'desaise' which means "discomfort"
WHO guidelines on naming COVID variants
WHO renamed COVID variants after Greek letters to avoid confusion with scientific names and to prevent discrimination (mainly against Chinese)
eponyms
a person after whom a discovery, invention, place, etc., is named or thought to be named (Alzheimer's Disease, Wilm's tumor)
infection
Invasion by and multiplication of pathogenic microorganisms in a bodily part or tissue
subclinical disease
no noticeable signs or symptoms (inapparent infection)
clinical disease
signs and symptoms are apparent/observable
preclinical disease
disease that is not yet clinically apparent but is destined to progress to clinical disease
local infection
infection limited to a small area of the body (body part or organ)
systemic infection
infection spreads to several sites and tissue fluids usually in the bloodstream
focal infection
when infectious agent breaks loose from a local infection and is carried to other tissues
primary infection
initial infection within a patient
secondary infection
infections that follow a primary infection, often by opportunistic pathogens
opportunistic pathogens
pathogen that can cause disease when the host's immune system is compromised
acute infectious disease
disease in which symptoms develop rapidly and that runs its course quickly
chronic infectious disease
disease with symptoms that develop slowly and last a long time
latent infectious disease
disease that appears a long time after infection
communicable infectious disease
disease transmitted from one host to another
contagious infectious disease
communicable disease that's easily spread
non-communicable infectious disease
disease arising from outside of hosts or from opportunistic pathogen
types of direct transmission of disease
touch, bodily fluids, direct projection of droplet spray
types of indirect transmission of disease
fomites (inanimate objects), airborne, waterborne/foodborne transmission (pathogens on water, food), fecal contamination of food/water
function of N95/KN95 masks
reduce airborne transmission of disease
surface disinfectants and hand sanitizers
reduce the spread of infections by killing or removing pathogens from surfaces and hands, preventing the transmission of diseases through contact with fomites
size of virus-laden droplets and aerosols
larger aerosols are within 5-100 μm, larger droplets are larger than 100 μm
S-I-R compartment model of disease
S = Susceptible: not yet infected
I = Infectious: capable of spreading
R = Recovered/removed: immune; no spreading
R0 (basic reproduction number)
Represents how many people in an unprotected population an initial case (infected individual) could pass the disease along to
factors that influence R0 value
Duration of infectious period
Probability of infecting susceptible individual during one contact
Number of susceptible individuals contacted per unit of time
herd immunity
The resistance of a group to an attack by a disease to which a large proportion of the members of the group are immune (in the recovered/removed group)
how vaccination affects populations (S-I-R)
vaccination moves individuals from the Susceptible group to Recovered/Removed
childhood diseases (vaccine-preventable) list
Measles, Mumps, Rubella, Polio, Whooping Cough, Diphtheria
Groups most at risk of measles complications
Children younger than 5 years of age; Adults older than 20 years of age; Pregnant women; People with compromised immune systems, such as from leukemia or HIV
MMR vaccine
vaccination to protect against mumps, measles and rubella
Disneyland measles outbreak
in 2014, a person infected with measles spread the virus to unvaccinated visitors, causing many outbreaks across many states
epidemic prevention using R0 via herd immunity
calculate (1 - 1/(R0)) * 100 to find what percentage of a population would need to be immune (herd immunity)
measles herd immunity with R0
R0 for measles is 12-18. For the higher bound, do (1 - 1/(18)) * 100 and find that 94% of a population would need to be immune (vaccinated) to prevent an epidemic.
MMR/autism controversy
The MMR vaccine was thought to cause autism due to a fraudulent research study by Andrew Wakefield so people were avoiding it
CA SB277
California passes Senate Bill 277 (SB277) in 2015: eliminates religious and personal belief exemptions (nonmedical) to vaccine requirements for children entering school
Impact of COVID-19 pandemic on measles worldwide
Due to the pandemic in 2021, 40 million children missed a measles vaccine dose, leading to 128,000 measles deaths that year
impact of tuberculosis throughout history
evidence of TB was found in an Egyptian mummy dating to about 600 BC
different names for tuberculosis
Phthisis - ancient Greece
Scrofula (TB of lymph nodes in neck) - Middle Ages
King's Evil (cured by the Monarch's touch) - Middle Ages
White plague (paleness) - 1700s
Pott's disease (TB of spine) - 1799
Consumption (weight loss) - 1800s
Koch's disease (Robert Koch)
TB and the Industrial Revolution
Due to severe overcrowding, poor air quality, unhygienic conditions, and poor ventilation, TB was rampant (cause of 25% of all deaths)
Old suspected causes (etiologies) for TB
Thought to be hereditary (since it occurred among family)
Thought to be vampires
World TB Day is on...
March 24th
Sanatoriums and the sanatorium movement
Sanatoriums were facilities where TB patients were treated with fresh air, rest, and good nutrition. They were meant to isolate TB patients from the general population, preventing the spread of the disease and providing a healthier environment to aid in recovery.
U.S. public healtheducation about TB
People were told to simply cover coughs and sneezes. TB death rates in the US declined as the 20th century went on.
National Tuberculosis Association/American Lung Association
Launched massive education campaign known as the "crusade" against tuberculosis. Their message was that TB is a communicable disease that can be prevented by careful hygiene
Christmas Seals
Christmas Seals are special stamps sold during the holiday season to raise funds for the fight against tuberculosis (TB). Introduced in the U.S. in 1907 by Emily Bissell, the campaign supported sanatoriums, public health education, and research.
public spitting and tuberculosis
Public spitting was strongly frowned upon in the 20th century, as tuberculosis is transmitted in this way
Mycobacterium species list
M. tuberculosis, M. bovis (causes TB in cattle and can also infect humans), and M. leprae (causal agent of leprosy)
alveoli
tiny sacs of lung tissue specialized for the movement of gases between air and blood
alveolar macrophage
immune system cell of the alveolus that removes debris and pathogens
phagocytosis
Cell eating (alveolar macrophages engulf TB bacteria and try to kill them, but due to TB's waxy cell wall, it survives)
mycolic acids
waxy cell wall of M. tuberculosis bacteria that protects it from alveolar macrophages
granuloma/tubercle
a collection of macrophages trying to wall off the infected alveolar macrophage
Tuberculin skin test (TST)
Used to determine past or present tuberculosis infection present in the body. This is based on a positive skin reaction to the introduction of a purified protein derivative (PPD) of the tubercle bacilli, called tuberculin, into the skin.
TB Blood Test Interferon-gamma release assays (IGRAs)
Preferred method for people who have received the TB vaccine (BCG) and people who have a difficult time returning for a second appointment to read TST
chest x-ray for active pulmonary TB diagnosis
Used to differentiate between active pulmonary TB and latent TB
Cavitation
Cavitation in the lungs is a condition where a hollow space forms within the lung tissue as seen in a chest X-Ray
Computer-Aided Detection software (CAD)
World Health Organization recommends using CAD to interpret chest X-rays for TB screening
sputum (phlegm) smear
A sputum smear is a laboratory test that examines a sputum sample under a microscope to detect the presence of bacteria (TB) but can have false-negative results
Ziehl-Neelsen (acid-fast) staining
A method to identify bacteria in a sputum smear by staining bacteria with a bright red color against a blue background.
sputum culture
sputum culture is a lab test to find germs (such as TB bacteria) that can cause an infection. A sample of sputum is added to a substance that promotes the growth of bacteria (takes 2-6 weeks)
nucleic acid amplification tests (NAATs) of sputum
Recommended by WHO; NAATs are used to diagnose tuberculosis (TB) by detecting the genetic material (DNA) of tuberculosis in a sputum sample. These tests provide a rapid and accurate diagnosis, helping to confirm TB infection faster than culture methods.
major antibiotics for latent and active TB (RIPE)
Rifampin
Isoniazid
Pyrazinamide
Ethambutol
pill burden
term used to describe the number of pills a patient takes and its associated burden (360 for RIPE)