unit 3.1.3: communicable diseases (cont.)

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Influenza

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105 Terms

1

Influenza

an enveloped virus and an RNA virus

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spherical

Influenza:

Etiology

Shape of the Capsid

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antigenic glycoprotein, neuraminidase, and hemagglutinin

Influenza:

Etiology

Genetic makeup of the Capsid

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4

A

Influenza:

Etiology

Least stable with antigenic drift and antigenic shift of the H and N antigens producing new strains responsible for epidemics

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Hemagglutinin (HA) and Neuraminidase (NA)

Influenza:

Etiology

Subtype A

Classified into subtypes based on combinations of ___

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A(H1N1) and A(H3N2)

Influenza:

Etiology

Subtype A

Currently circulating in humans

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Type

Influenza:

Etiology

Subtype A

A/Beijing/262/95

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Site of isolation

Influenza:

Etiology

Subtype A

A/Beijing/262/95

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Culture number

Influenza:

Etiology

Subtype A

A/Beijing/262/95

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Year

Influenza:

Etiology

Subtype A

A/Beijing/262/95

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B: B/Yamagata and B/Victoria

Influenza:

Etiology

broken down into lineages

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C

Influenza:

Etiology

Most stable, Low pathogenicity (subclinical infection)

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Antigenic Drift

Influenza:

Etiology

mutation in the genes of the Influenza virus and would lead to changes in the surface antigens

<h2><span class="heading-content">Influenza:</span></h2><h3><span class="heading-content">Etiology</span></h3><p>mutation in the genes of the Influenza virus and would lead to <u><strong>changes</strong></u> <strong>in the surface antigens</strong></p>
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Antigenic Shift

Influenza:

Etiology

  • from the strains of two or more different viruses and they combine to form another subtype

  • newly formed subtype will have a mixture of different surface antigens or the antigenic glycoproteins

<h2><span class="heading-content">Influenza:</span></h2><h3><span class="heading-content">Etiology</span></h3><ul><li><p>from the <strong>strains of</strong> <strong>two or more different viruses and they combine</strong> to form another subtype</p></li><li><p>newly formed subtype will have a <u><strong>mixture</strong></u> <strong>of different surface antigens or the antigenic glycoproteins</strong></p></li></ul>
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15

lasts about 5 days

Influenza:

Symptoms

Uncomplicated illness

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Pneumonia sequelae

Influenza:

Symptoms

main cause of mortality especially in high risk individuals

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  • Respiratory droplets

  • Direct contact

  • Highly infectious

Influenza:

Epidemiology

Transmission

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1 to 5 days

Influenza:

Epidemiology

Incubation Period

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2 days before onset of symptoms to 5 days after

Influenza:

Epidemiology

Period of Communicability

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A(H1N1) Swine Flu (2010)

Influenza:

Epidemiology

Occurrence & Distribution

  • originated in Mexico in 2009

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1918 Spanish Flu: Influenza A

Influenza:

Epidemiology

Occurrence & Distribution

  • responsible for pandemics and regular seasonal outbreaks

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rainy seasons

Influenza:

Epidemiology

Occurrence & Distribution

  • In Tropics

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winter months

Influenza:

Epidemiology

Occurrence & Distribution

  • In Temperate Climates

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PCR (RT-PCR)

Influenza:

Diagnosis

method of choice

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Antiviral Agents

Influenza:

Treatment

formulated through the use of the causative agent of the virus; the genetic makeup of the virus will be fragmented and part of the virus will be tested to create an agent to combat the virus

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Vaccination

Influenza:

Prevention & Control

most effective way to prevent disease

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WHO Global Influenza Surveillance and Response System (GISRS)

Influenza:

Prevention & Control

continuously monitors influenza viruses in humans and updates composition of influenza vaccines twice a year

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Personal Protective Measures

Influenza:

Prevention & Control

  • Regular hand washing

  • Good respiratory hygiene

  • Early self-isolation

  • Avoiding close contact

  • Avoiding touching one’s eyes, nose, or mouth

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Coronavirus (COVID-19)

causes respiratory infections and it spreads from one person to the other through droplets

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SARS-CoV

COVID-19

2003

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MERS-CoV

COVID-19

2012

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SARS-CoV-2

COVID-19

2019

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solar corona

COVID-19:

Etiology

widely-spaced projections or spikes on the outer surface of the envelope

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Severe Acute Respiratory Syndrome

COVID-19:

Etiology

SARS-CoV (2003)

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Middle East Respiratory Syndrome

COVID-19:

Etiology

MERS-CoV (2012)

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Coronavirus Disease 2019: Severe Acute Respiratory

Syndrome Coronavirus 2

COVID-19:

Etiology

COVID-19 Virus

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bats: amplified in palm civets

COVID-19:

Etiology: Origin

SARS-CoV (2003)

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bats: widespread in camels

COVID-19:

Etiology: Origin

MERS-CoV (2012)

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bat to a pangolin

COVID-19:

Etiology: Origin

COVID-19 Virus

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  • Respiratory symptoms

  • Fever

  • Malaise

  • Chills

  • Headache

  • Dry cough

COVID-19:

Symptoms

Early Symptoms

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acute respiratory distress, requiring ventilatory support

COVID-19:

Symptoms

abnormal chest radiographs

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  • Pneumonia

  • Severe Acute Respiratory Syndrome

  • Kidney Failure

  • Death

COVID-19:

Symptoms

Severe Cases

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Coronavirus-associated Enteritis

COVID-19:

Symptoms

have not been clearly described

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Basic Reproduction Number of Diseases

COVID-19:

Epidemiology

basic measure to track the infectiousness of the disease

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PCR (RT-PCR): preferred

COVID-19:

Diagnosis

Nucleic Acid Detection

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Serodiagnosis

COVID-19:

Diagnosis

Serology

  • acute and convalescent sera is one means of confirming

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serum

COVID-19:

Diagnosis

Serology

  • ELISA specimen

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Shepherd’s crook morphology

Ebola:

Etiology

”U” or “6” shape

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Reston virus

Ebola:

Etiology

cause disease in primates

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Filovirus

Ebola:

Etiology

highly virulent and require maximum containment facilities for laboratory work

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bats (fruit bats)

Ebola:

Etiology

Natural/Reservoir Hosts

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Filovirus

Ebola:

Symptoms

appear to be immunosuppressive

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  • Direct contact

  • Contaminated needle and syringes

  • saliva and through large droplets

Ebola:

Epidemiology

Transmission

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viral hemorrhagic fevers is 25-90%

Ebola:

Epidemiology

Mortality Rate

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50%

Ebola:

Epidemiology

Fatality Rate

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2013-2016 West African Outbreak

Ebola:

Epidemiology

Outbreaks

  • Major ebola outbreak in Guinea

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WHO declared the epidemic an international public health emergency

Ebola:

Epidemiology

Outbreaks

  • 8 Aug 2014

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Sudan Outbreak

Ebola:

Epidemiology

Outbreaks

  • first known outbreak of EVD

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Zaire Outbreak

Ebola:

Epidemiology

Outbreaks

  • second outbreak (Democratic Republic of the Congo)

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village’s headmaster

Ebola:

Epidemiology

Outbreaks

  • First person with the disease

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White blood & Oral fluid

Ebola:

Diagnosis

Specimen

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  • Low white cell count

  • Platelet count

  • Elevated liver enzymes

Ebola:

Diagnosis

Laboratory Findings

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Experimental Ebola Vaccine: rVSV-ZEBOV

Ebola:

Treatment

Not yet out in the market because it is still in the experimental process

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Mosquitos of Aedes group

Dengue:

Vector

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  • Aedes aegypti

  • Aedes albopictus

Dengue:

Vector

Species responsible for transmission and spread of Zika, Chikungunya

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Aedes albopictus

Dengue:

Vector

  • it can withstand cold temperatures

  • black color and with distinctive white markings

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stagnant water, old tires, empty tins or others that can collect water

Dengue:

Vector

breeding grounds for mosquitoes

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  • Sudden-onset fever

  • Headache

  • Mouth and nose bleeding

  • Muscle and joint pains

  • Vomiting

  • Rash

  • Diarrhea

Dengue:

Symptoms

Febrile Phase

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  • Hypotension

  • Pleural effusion

  • Ascites

  • Gastrointestinal bleeding

Dengue:

Symptoms

Critical Phase

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  • Altered level of consciousness

  • Seizures

  • Itching

  • Slow heart rate

Dengue:

Symptoms

Recovery Phase

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Herman’s Rash

Dengue:

Symptoms

  • acute stage of the infection

  • blanches when the back is pressed with the finger

  • “Classic island of white in a sea of red”

  • small red spots on the skin

  • starts on the arms and legs and spreads to the rest of the body

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Zika

Dengue:

Symptoms

Mostly mild and people can recover without severe hospitalization

  • Guillain-Barre syndrome

  • Microcephaly

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Chikunguya

Dengue:

Symptoms

Severe joint pains

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increased 30-fold over the last 50 years

Dengue:

Epidemiology

Incidence

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~50 to 100 million infections

Dengue:

Epidemiology

annually in >100 endemic countries

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3.9 billion

Dengue:

Epidemiology

at risk of infection with Dengue viruses

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ubiquitous

Dengue:

Epidemiology

appearing or found everywhere

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“Asian” Genotypes of DENV-2 and DENV-3

Dengue:

Epidemiology

associated with severe disease accompanying secondary Dengue infections

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Severe Dengue

Dengue:

Epidemiology

first recognized in the Philippines and Thailand in the 1950s during Dengue epidemics

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rainy season (May-Nov)

Dengue:

Epidemiology

Philippines

Peak Transmission

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0.55%

Dengue:

Epidemiology

Philippines

Case Fatality Rate

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Climate

Dengue:

Epidemiology

one important driver of the current distribution and incidence of Dengue

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Temperature

Dengue:

Epidemiology

most important predictor of distribution

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high fever (40°C or 104°F) and two accompanying symptoms

Dengue:

Symptoms

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Positive tourniquet test & Low white cell count

Dengue:

Diagnosis

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PCR (RT-PCR)

Dengue:

Diagnosis

Nucleic Acid Detection

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NS1 (nonstructural protein 1)

Dengue:

Diagnosis

Viral Antigen Detection

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ELISA

Dengue:

Diagnosis

Antibody Testing (Serological test)

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Breeding of fish: Guppies

Dengue:

Vector Control

Biologic Control

  • eliminate mosquitoes from larger containers used to store potable water

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Indoor Residual Spraying

Dengue:

Vector Control

Chemical Control

  • Application of long-acting chemical insecticides on the walls and roofs

  • short period of time

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Space Sprays

Dengue:

Vector Control

Chemical Control

  • Massive, rapid destruction of adult vector population

  • emergency situations to suppress an ongoing epidemic

  • aircraft, vehicle, hand-held equipment

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Environmental Modification

Dengue:

Vector Control

Environmental Management

  • Improvement of water supply and water-storage systems

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Environmental Manipulation

Dengue:

Vector Control

Environmental Management

  • Mosquito-proofing

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Changes to Human Habitation or Behavior

Dengue:

Vector Control

Environmental Management

  • Mosquito screening & repellants

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“Kung Walang Lamok, Walang Dengue”

Dengue:

Vector Control

Mag 4S Kontra Dengue by the DOH

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June 15, 2018

Dengue:

Vector Control

Asean Dengue Day

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Dengvaxia® (CYD-TDV)

Immunization

Developed by Sanofi Pasteur

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seropositive individuals

Dengvaxia®:

persons who have had a previous dengue virus infection -- efficacious and safe

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seronegative individuals

Dengvaxia®:

first natural dengue infection after vaccination -- increased risk of severe dengue

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Wolbachia

Dengue:

  • A natural bacteria present in up to 60% of insects, including some of the mosquitoes, (the primary species responsible for transmitting the virus to humans) but not usually found in aedes mosquitoes

  • Self-perpetuating intracellular bacteria with disease blocking action

  • mosquito resistant to dengue virus

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