Epidemiology
The study of disease in populations
Florence Nightingale
The lady of the lamp, was one of the first epidemiologists and was active during the Crimean War. Fought for decontamination of hospital equipment to prevent infections
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Epidemiology
The study of disease in populations
Florence Nightingale
The lady of the lamp, was one of the first epidemiologists and was active during the Crimean War. Fought for decontamination of hospital equipment to prevent infections
Diptheria and tetanus
Vaccinated against in the United States
Ebola
Dangerous in close contact because it is very infectious
CDC
Responsible for keeping track of diseases nationwide. Mandates that cases of certain diseases get reported to the government
CDC MMWR
Morbidity mortality weekly report
Prevalence
Number of existing cases in a population
Incidence
Number of new cases over a certain time period (also known as case rate or mortality rate)
Mortality rate
Number of deaths in a population because of a certain disease
States with high Hepatitis C incidence
Arizona, Louisiana, Virginia
What is causing the increase in malaria cases?
As global temperatures rise, the mosquitos that act as a vector's habitats are growing, making more people vulnerable to infection
Point-source epidemic
Infectious agents come from a single causative source
Common-source epidemic
Results from common exposure to a single source of infection that can occur over time
Propagated epidemic
Infectious agent is communicable (spreads from person to person) and is sustained over time
Why do we do quarantine and do social distancing?
To prevent spikes of cases that would overwhelm the hospital system
Pandemic
Spread of an epidemic over continents
Outbreak
Larger than expected increase in cases within a certain area
Epidemic
Affects a large number of people within a localized region/population
Endemic
A disease that is commonly found within a particular region and has established itself there
Exposure usually leads to ______
Immunity
Herd immunity
Immunity in a large enough amount of the population that the pathogne in unable to find enough hosts to survive
Why is it a bad idea to rely on herd immunity for the COVID-19 crisis?
The death rate is too high, it is unclear how long the epidemic will go on for, and there is no evidence that exposure leads to immunity after recovery
Index case
The first patient found in an epidemiological investigation (the case that starts an outbreak)
Sporadic disease
Cases are reported at random intervals at random locations
Gaetan Dugas
Mistakenly considered patient zero for HIV in the United States. he became hunted and ostracized
Endemic region
One where there is a steady frequency in a long time period of a disease. There may be outbreaks at irregular intervals
Emerging Infectious disease (EID)
A newly identified pathogen (such as COVID-19)
Reemerging disease
A disease thought to be under control reappears
Examples of reemerging diseases
Tuberculosis, yellow fever, Dengue fever
Bioterrorism
The intentional or threatened use of microorganisms or toxins to cause death in humans, livestock, plants, etc.
Examples of bioterrorism throughout history
-Assyrians putting ergot into enemies wells
-British/French/American soldiers giving smallpox blankets to Native Americans (intentionally and unintentionally)
-Hannibal throwing venomous serpents onto enemy ships
-Tartars catapulting their own dead, plague-ridden soldiers into a besieged city
Geneva Convention
International legislation originally signed in 1928 (and updated since) that prohibits the use of biological agents during was
Categories of biological defense disease agents
Category A (highest priority), Category B (moderate), Category C (lowest priority)
Infection
A microorganism that has penetrated the host's body and is multiplying
Pathologic state
The cumulative effects of infection damage to our health
Disease
Deviation form health
Infectious disease
Disruption of tissues or organs caused by microbes or their products (e.g. toxins)
Flora
Organisms populating our bodies
Resident/normal flora
Microbes that co-exist with us in a stable (differs from person to person)
Fecal transplant
Used in people with Crohn's disease or those with colon/gut cancers, or in those with damaged intestines. Helps reestablish their gut flora
Transient flora
May occasionally be present, but not present throughout our lifetimes (such as microbes picked up during travel)
Opportunistic flora/endogenous infection
May or may not be normal, but can be pathogenic when the microbes enter a place they do not normally inhabit (such as going septic)
Incubation
Time of infection until symptoms begin (can often still transmit the disease at this point as a carrier)
Prodromal stage
Earliest symptoms, but still mild
Height of infection/period of invasion
The most sick the patient will be from an infection
Convalescent period
Immune system begins to defeat pathogen and reduce symptoms (can be with the help of drugs)
Signs
What can be observed
Examples of sign
Fever, rash, redness
Symptoms
What the patient is feeling
Examples of symptoms
Chills, headaches, pain, heat
True/false: viruses are harder to make antibiotics for
True
Why are antibiotics harder to make antibiotics for?
Less things to target: no ribosomes, cell walls, etc
Chemotherapy
Using a chemical compound to treat a condition (not just cancer)
Oetze/ice man
Man from 3300 BC, found with birth fungus on a string that indicates that his civilization had knowledge of disinfectants and coagulants
Alexander Fleming
Discovered penicillin, which others later isolated and became the first known antibiotic
True/false: microbistatic medications are preferred to microbicidal in most cases
False
Microbicidal
Kills microbes
Microbistatic
Inhibits growth of microbes with the goal of letting the immune system kill the remaining ones
Antagonist
When an antibiotic acts against other antibiotics used and/or the patient's immune system
Chemotherapeutic drug
Any chemical used in the treatment, relief, or prophylaxis of a disease
Prophylaxis
Use of a drug to prevent imminent infection of a person at risk
Antimicrobial chemotherapy
The use of chemotherapeutic drugs to control infection
Antimicrobials
All-inclusive term for any antimicrobial drug, regardless of its origin
Antibiotics
Substances produced by the natural metabolic processes of some microorganisms that can inhibit or destroy other microorganisms
Semisynthetic drugs
Drugs that are chemically modified in the laboratory after being isolated from natural sources
Synthetic drugs
Drugs produced entirely by chemical reactions within a laboratory setting
Narrow-spectrum (limited spectrum)
Antimicrobials effective against a limited array of microbial types
Broad-spectrum (extended spectrum)
Antimicrobials effective against a wide variety of microbial types
What is a con of using broad-spectrum antimicrobials?
Wiping out the person's natural flora, leaving them prone to secondary infections
Why are ribosomes a good target for antimicrobials?
Bacteria have different ribosomes than we do
Quinolones
Inhibit DNA gyrase, preventing replication
Sulfonamides/sulfa drugs
Block pathways and inhibits cellular metabolism
Tetracycline
An extremely wide spectrum antibiotic
Bacitracin
Antibiotic produced by Bacillus bacterium, used in things like Neosporin
Vancomycin
Very effective medicine on the WHO essential medicines list, but can be dangerous in quantities that are too high (flushed skin)
Hapten
An incomplete antigen that has to bind to a carrier protein in order to be recognized and attacked by the immune system
Z pac/azithromycin
Orally taken antibiotic that is becoming more popular; is time released so doses are effective for a long time. Interferes with bacterial ribosomes
Aminoglycosides
Made of a amino acid sugars; broad spectrum antibiotic produced by naturally occurring bacteria
Sulfonamides
Modern synthetic antimicrobial drug that interferes with folic acid metabolism (effects synthesis of RNA, DNA, amino acids). Often used to treat shingellosis and UTIs
True/false: people are often sensitive or fully allergic to sulfonamides
True
Black box warning
Warning label in the box of a drug that makes sure you're aware of the potential side effects before taking it
Drugs that affect nuclei acids
Fluoroquinolones
Fluoroquinolones
Inhibit DNA unwinding enzymes or helicases, thereby stopping DNA transcription.Can have severe side effects such as seizures, dizziness/nausea, nerve and muscle function, and brain function
Drugs that affect the membrane
Polymyxins
Polymyxins
Interact with membrane phospholipids; distort the cell surface and cause leakage of protein and nitrogen bases, particularly in gram negative bacteria. Act as a surfactant, prevent a smooth phospholipid bilayer from forming
What makes viruses hard to treat?
-Can be transmitted without symptoms
-Are very hard to detect
-Difficult to treat
Antigenic shift
Two or more strains of a virus combine to form a subtype (similar to horizontal gene transfer), often leading to a more virulent form of the virus
True/false: antigenic shift are the only way viruses can undergo horizontal gene transfer
True
H1N1
A flu virus that affected those around college age only; resulted from a antigenic shift involving influenza and swine flu
Antiviral drugs - inhibition of virus entry
Works on receptor fusion/uncoating inhibitors
Tamiflu
Common antiviral drug that often makes people sick and often isn't effective
Antiviral drugs - inhibition of nucleic acid synthesis
Prevent the virus from building its genome
Ribavirin
Inhibits nucleic acid synthesis
Antiviral drugs - inhibition of viral assembly/release
Inhibits protease that stops the virus from adding its DNA to the success
Amphoterrible
When the amphotericin medication makes us feel worse than the infection itself
Amphotericin
Most common antifungal medication, isolated from Strep. Bonds to a sterol, which is toxic to our cells as well
WHO Priority Pathogens List
Ranks pathogens as Priority 1 (critical/highest), Priority 2 (high), and priority 3 (medium)
True/false: many modern antibiotics have gone through multiple generations of development
True
How antibiotic resistant forms of bacteria are naturally selected
1. A large bacteria of population is present, some of them being resistant
2. Bacteria get bathed in antibiotics and most of the normal bacteria die
3. Resistant bacteria die and become more common
4. Eventually, the entire infection evolves into a resistant strain
Transposons
Jumping genes; short strands of DNA capable of moving from one location to another within a cell's genetic material