Public Health Module (not in trans)

" Let the welfare of the people be the supreme law "

Salus populi : suprema lex esta

John Snow

The " George Washington " of public health

John Snow

Man of many interests , a physician to Queen Victoria , and a mathematician

an external agent , a susceptible host , and an environment

epidemiologic triad or triangle

eosinophilia-myalgia syndrome

L-tryptophan contaminant responsible for

carpal tunnel syndrome

physical forces such as repetitive mechanical forces associated with

Agent

Reservoir / Carrier

Source of Entry

Invade host

Susceptible Host

Factors for Development or Spread of Infectious Disease

Age

Gender

Occupation

Race

Marital status

Genetic profile

Disease Causation: HOST Characteristics

Biologic

Types of AGENTS: bacteria , virus , molds

Chemical

Types of AGENTS: poison , alcohol

Physical

Types of AGENTS: trauma , fire

Housing

ENVIRONMENTAL Factors: crowding , noise

Air

ENVIRONMENTAL Factors: temperature , humidity

cows and pigs

brucellosis from

sheep

anthrax from

swine

trichinellosis / trichinosis from

rabbits

tularemia from

bats, raccoons, dogs, and other mammals

rabies from

birds

Zoonoses newly emergent in North America: West Nile encephalitis from

prairie dogs

Zoonoses newly emergent in North America: monkeypox from

Direct contact

Portals of Entry Example: Kissing , sexual contact , skin - to - skin contact

Droplet

Portals of Entry Example: Organism on large respiratory droplets that people sneeze , cough , drip , or exhale

Indirect contact

Portals of Entry Example: Contact with contaminated surfaces , clothing etc

Vector

Portals of Entry Example: Bite from disease - carrying ticks , fleas , mosquitoes

Vehicle

Portals of Entry Example: Eat / drink contaminated food / drink , transfuse infected blood , fomites ( bedding , infected tatoo needle )

Airborne

Portals of Entry Example: Organism on dust particles or small respiratory droplets

Use of barrier ( condom , clothing dressing )

Control Measures Direct contact

Respiratory etiquette

Control Measures Droplet

Hand hygiene , sanitizing infected surfaces

Control Measures Indirect contact

Vector control

Control Measures Vector

Proper hygiene and sanitation , cook food / boil water , etc.

Control Measures Vehicle

Respiratory etiquette , isolation ( if necessary )

Control Measures Airborne

propels dust and microorganisms

Cilia lining the respiratory tract

lysozyme

an enzyme that attacks bacterial cell wall

inhibits bacteria

Acidity of GI tract as well as the vagina

Nutrients

chemical substances found in food that are needed for life

Recommended Dietary Allowance (RDA)

have been recognized universally as the standards for levels of nutrients recommended in our diet

Estimated Average Requirements (EAR)

is the intake that meets the estimated nutrient needs of half of the individuals in a specific stage and gender group

Adequate Intake (Al)

used when sufficient scientific evidence is unavailable to estimate an average r equirement

Tolerable Upper Intake Level (UL)

used to indicate the maximum intake by an individual that is unlikely to pose risks of adverse health effects in almost all healthy individuals in a specified group

Dietary Reference Intakes (DRI)

generic terms to refer to four different sets of data e.g. RDA, EAR, AI, UL

Calcium

Essential role in blood clotting , bone / tooth formation

Chromium-

Maintain Normal Glucose level

Iron

Component of hemoglobin and numerous enzymes , prevents microcytic hypochromic anemia

Manganese

Involved in the formation of bone , enzymes in amino acid , cholesterol and CHO metabolism

Nickel

May serve as a cofactor of metalloenzymes in microorganisms

Molybdenum

Cofactor for enzyme involved in catabolism of sulfur , amino acids , purines and pyridines , found in Legumes , grain products and nuts

Boron

No clear biologic function in humans ; Fruit based beverages and products , potatoes , legumes , milk , avocado peanuts butter

Copper

Components of enzymes in iron metabolism

Arsenic

Found in dairy products and the inorganic form is toxic

Fluoride

Inhibits the initiation and progression of dental caries and stimulates new bone formation

Phosphorus

Maintenance of pH , storage and transfer of energy and nucleotide synthesis

Magnesium

Cofactor for enzyme systems and common

Zinc

Component of multiple enzymes and proteins; involved in regulation of gene expression

Selenium

Defense against oxidative stress and regulation of action , and the oxidation status of vitamin C and other molecules

lodine

Components of the thyroid hormones ; and prevents goiter and cretinism

Thiamine / B1 :

Coenzyme in the metabolism of carbohydrates and branched chain amino acids

Folate / Folic Acid

metabolism of nucleic acids ; prevents megaloblastic anemia

Lack of folate/folic acid

AE : neurologic complication

Vitamin A

Required for normal vision gene expression , reproduction , embryonic development and immune function

Biotin

Coenzymes in synthesis of fat , glycogen , and amino acids

Vit . B12

Also called as cobalamin / Coenzyme in nucleic acid metabolism ; prevents megaloblastic anemia

Vitamin E :

Non specific chain breaking antioxidant ; also called alpha tocopherol

Vitamin B2

Coenzymes in numerous redox reactions ; also called riboflavin

Choline

Precursor for Acetylcholine , phospholipids and betaine

Pantothenic Acid

Coenzyme in fatty acid metabolism

Niacin

Coenzyme or cosubstrate in many biological reduction and oxidation reactions - thus required for energy metabolism

Vitamin K :

Coenzyme during the synthesis of many proteins involved in blood clotting and bone metabolism , common source green leafy vegetables

Vitamin D

Maintain serum calcium and phosphorus concentrations , called calciferol

Vitamin C

Cofactor for reactions requiring reduced copper or iron metalloenzyme and as a protective antioxidant

Vitamin B6

Coenzyme in the metabolism of amino acids , glycogen and spingoid bases

lodine Deficiency Disorders ( IDD )

lack of iodine in the body which results in goiter , mental retardation , deaf mutism , difficulty in standing or walking normally and stunting of the limbs

Iron Deficiency Anemia ( IDA )

deficiency wherein hemoglobin concentration is below normal level which results in short attention span reduced ability to learn and irritability

inability to see in dim light

night blindness

xerophthalmia

dryness of the eyes

photophobia

sensitive to bright light

Vitamin A Deficiency ( VAD ) -

Lack may result to night blindness, xerophthalmia, photophobia, total blindness , rough dry skin membranes of the nasal mucosa , low body resistance , and poor growth

Beri - Beri

weight loss , emotional disturbances , impaired sensory perception, weakness pain in the limbs , and periods of irregular heart rate

polished white rice

Lack of Vitamin B1 ( Thiamine ) Diet :

Beri - Beri

Lack of Vitamin B1 ( Thiamine ) disease

Scurvy

Vitamin C Deficiency disease

Vitamin C

required for correct collagen synthesis in humans

Vitamin C Deficiency Scurvy

Formation of spots on the skin , spongy gums and bleeding from all mucous membranes

Vitamin D Deficiency

Rickets

Vitamin D deficiency; lack of adequate calcium in the diet may also lead to rickets

Softening of bones in children potentially leading to fractures and deformity

malnutrition

starvation and famine during early stages of childhood

deficiency in Vit D

Osteomalacia caused by

Total Fat

Energy source and when found in foods , is a source of n - 6 and n - 3 polysaturated fatty acids

Proteins

Serves as the major structural component of all cells in the body and functions as enzymes , in membranes , as transport carriers , and as some hormones

n - 3 polyunsaturated fatty acids

Involved with neurological development and growth structural

n - 6 polyunsaturated fatty acids ( Linoleic Acid ) :

Essential component of structural membrane lipids , involved with cell signaling , and precursor of eicosanoids

n - 6 polyunsaturated fatty acids Linoleic Acid

Required for normal skin function

Total Fiber

Improves laxation reduces risk of coronary heart disease , assists in maintaining normal blood glucose level

Carbohydrates

Source of kilocalories to maintain body weight

Kwashiorkor

Inadequate intake of protein in the presence of adequate intake of calories .

Kwashiorkor

Symp : edema , skin lesions , depigmented hair , anorexia , enlarged fatty liver and decreased albumin concentration

Kwashiorkor

Seen in children after weaning at about year of age , when their diet consists predominantly of carbohydrates

Marasmus

Protein - Calorie Malnutrition

Marasmus

Results from chronic deficiency of calories and can occur in the presence of adequate intake of protein

Marasmus

Usually occurs in children under 1 year of age when the mother's breast milk is supplemented with thin gruels of native cereals which are usually deficient in proteins and calories