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3F Epidemiology FINAL > A Global Perspective: Epidemiology Of Major Global Diseases > Flashcards

A Global Perspective: Epidemiology Of Major Global Diseases Flashcards

1
Q

WHO

A

-agency of UNITED NATIONS, concerned with international public health.

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2
Q

CDC

A

Mission

  • PRTECT AMERICA from health, safety and security threats, both foreign and in the US
  • MONITOR DISEASES that start at home or abroad
  • conducts research
  • provides health information
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3
Q

Measles (Rubeola)

A
  • RESPIRATORY TRACT DISEASE caused by a virus. Rash, high temps, cough, red watery eyes
  • many complications: diarrhea, ear infections, pneumonia, encephalitis, seizures, death
  • transmits person to person through droplets from nose, mouth, throat
  • HIGHLY CONTAGIOUS
  • affects MOSLY KIDS
  • rash on head and trunk
  • no treatment, recover within 2-3 weeks
  • COMPLICATIONS WITH MALNOURSHED KIDS AND REDUCED IMMUNITY
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4
Q

Morbidity and mortality of measles

A
  • 20 MILL people affected each year
  • worldwide decrease in deaths 2000-2016. Vax, still common in many developing countries
  • preventable by vaccine, either alone, or measles-mumps-rubella
  • THERE IS NO EVIDENCE THIS VACCINE CAUSES AUTISM
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5
Q

Measles and the eye

A
  • UP TO 60,OOO CASES OF BLINDNESS worldwide per year attributed to measles
  • most in developing nations and suffer from a VITAMIN A DEFICIENCY
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6
Q

Measles in the US 1944-2007

A

1940-1960, several hundred thousands of cases in US

  • mid 1960s vax developed and cases dropped dramatically to small number
  • in 1980, there was an uptick of measles and a second dose was recommended, after that, cases back down to close to zero
  • there was an outbreak in 2014: occurred in California in Disney Land.
  • 2017 had another small outbreak. Most were unvaccinated
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7
Q

Ebola hemorrhagic fever

A
  • virus first seen in 1976
  • severe bleeding, organ failure, death
  • origin-passed from ANIMAL HOSTS-FRUIT BATS or primates. Zoonotic Disease-normally existing in animals, transmitted from vertebrates animals to humans (SARS, HIV). BATS are most common mammal-to-human source of viruses
  • now PERSON TO PERSON contact via blood and other BODILY FLUIDS (mucuous membranes)
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8
Q

Spread of Ebola

A
  • pathetically for NOSOCOMIAL (healthcare settings) tranmission
  • does not spread as easily as colds, flu, measles
  • no evidence spread though the air or water
  • cannot spread disease UNTIL SYMPTOMS APPEAR
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9
Q

Ebola virus outbreaks by year

A

Highest in 1976, 1995-2003, 2007, and very highest in 2014

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10
Q

Ebola 2014-2016 epidemic

A
  • first confirmed case MARCH 2014
  • multiple countries in west Africa. 28000 reported cases; 11,000 deaths

UNITED STATES

  • two imported cases, including one death
  • tow locally acquired cases in healthcare workers

Epidemic was over as of march 2016, BUT NEW OUTBREAK IN APRIL 2018 in Congo
-EXPERIMENTAL VACCINE has been developed and has been distributed to millions

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11
Q

TB

A
  • mycobacterium tuberculosis, attacks LUNGS
  • SPREAD THROUGH AIR-respiratory droplets-sneezing, coughing, inhalation
  • NOT spread by sharing food, touching surfaces
  • can become infected by NOT DEVELOP ACTIVE symptomatic disease
  • not contagious until active disease occurs
  • 1/4 OF THE WORLDS POPULATION is infected with TB
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12
Q

TB symptoms

A
  • persistent fought )blood included) night sweats, fever, weight loss, chills, fatigue
  • greater risk with COMPROMISED IMMUNE SYSTEMS-AIDS, DM, leukemia, kidney disease, and head or neck cancer
  • there are drug resistance strain
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13
Q

Reported TB cases US 1982-2016

A

Uptick in 1990 and now levels off and slow decline

-higher in American Indians and Alaskans and Asian populations

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14
Q

TB prevalence map

A

High in Africa, Asia

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15
Q

Ocular manifestations of TB

A
  • sSYSTEMIC SYMPTOMS NOT NECESSARY FOR OCULAR SYMPOMS
  • can affect almost any part of the eye
  • conjunctivitis, keratitis, PHLKYCTENULE, UVEITIS, iris nodules, cataract, choroiditis, retinal vasculitis, neuroretinitis
  • granulomatous anterior uveitis with MUTTON FAT KERATIC PERCIPITATES (KPs) (also caused by sarcoidosis, syphilis)
  • PHLYCTENULE: hypersensitivity reaction (also caused by staph)
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16
Q

HIV

A
  • targets iMMUNE SYSTEM, weakens defense against infections and cance r
  • AIDS is the most advanced HIV. 2-15 years to develop. AIDS DEFINED BY development of opportunistic disease and CLINICAL MANIFESTATIONS: cancer, infections
  • leading cause of death in HIV patients worldwide is TB
  • tranmission-blood, breast milk. Seem, and vaginal secretions
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17
Q

Leading cause of death in HIV patients

A

TB

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18
Q

HIV prevalence in the world

A 
South Africa most prevalent 
South America 
Mexico 
Asia 
Australia
19
Q

Mortality of HIV

A

1.1 million worldwide deaths in 2015

20
Q

Reduction in incidence of HIV

A

New cases

  • 2001-3.4mill
  • 2013-2.1mill
21
Q

Proportion of cases by race over time of HIV

A

Whites on the decline, but started with the highest prevelance in the 80s
AA on the rise
Hispanic very slight rise

Asian, American Indian/Salamanca, and Hawaiian have virtually no cases

22
Q

Ocular manifestations of AIDS

A
  • kaposi sarcoma on conjunctiva
  • toxoplasmosis
  • HSV, HZV
  • fungal infections
  • syphilis
  • TB
  • CMV** RETINITIS
  • choroiditis
  • acute rental necrosis
  • uveitis
  • COTTON WOOL SPOTS. Infarction of the NFL, swells. In the presence of no other retinal findings

**All are much less common now with treatment

23
Q

ZIKA

A

Virus transmitted by mosquito

  • this VECTOR also trnamits yellow fever, dengue, and other tropical diseases
  • may be transmitted by a mosquito biting an infected person then transferring infecte blood by biting an uninflected person
  • increased risk at lower altitudes

Also transmitted DIRECLTY through sexual contact

Discovered in 1947** in Uganda, small outbreaks occurred for decades,

May, 2015 BRAZIL, large increase in cases

24
Q

Zika symptoms

A
  • relatively MILD EFFECT on adults. 20% have symptoms
  • fever, rash, joint pain
  • can be confirmed with blood or urine test
  • no vaccine or cure: give palliative care

When occurs in pregnancy, can be passed to fetus and cause MICROCEPHALY. More likely EARLY in pregnancy

25
Q

MICROCEPHALY

A
  • virus destroys brain, skull collapses on part that was destroyed
  • permanent physical and intellectual disabilities
26
Q

Zika in Brazil. Control

A
  • 95% fewer cases in may 2017
  • insecticides to 20 million homes
  • released genetically modified mosquitos to mate with carriers
27
Q

US symptomatic ZIKA cases reported

A

2015: 6 cases, ALL in travelers returning from affected areas
2016: 5102 cases. FLORIDA and TEXAS transmitted locally via mosquito, sexually and unknown persons to person
2017: 140 cases
2018: 20 cases

TOTAL SO FAR 2461 cases in pregnant women as of may 2018

28
Q

FLORIDA and Zika

A

Cautionary zones and no go zones for pregnant women

-the have been removed June 2, 2017

29
Q

Ocular findings of Zika

A
  • conjunctivitis
  • RETINA AND CHOROID (primarily noted in congential cases). Pigment mottling, chorioretinal atrophy

NO EVIDENCE OF TRANSMISSION THOUGH TEARS

30
Q

Zika travel guidelines

A

Consult the CDC

Some cautionary areas on the map you can see

31
Q

Control of Zika

A
  • present mosquito bites
  • avoid mosquito locations: REMOVE STNADING WATER where they breed; MOIST buckets, bowls, plants, flower pots; Dark humid places, under sinks
  • bite MORE LIKELY DURING THE DAY
  • insecticide
  • GMO mosquitos to mate with Zika virus mosquitos. Offspring die
  • control blood supply
  • vaccine development
32
Q

Non infectious global epidemic: DM

A
  • lack of or ineffective use of INSULIN

- beta cells in pancrease produce insulin, enables cells to absorb GLUOCSE to produce energy

33
Q

Type I diabetes

A

Autoimmune disease

  • body attacks beta cells resulting in ABSENCE OF INSULIN
  • typically childhood onset
34
Q

Type II Dm

A

Insulin is present but body “resistant” to it

  • typically adult onset
  • 90% DIABETICS worldwide
  • risk factors: sedentary lifestyle, obesity
  • but can convert to type I as beta cells become destroyed in effort to compensate by producing more insulin
35
Q

Glucose cannot get into the cells, increases in blood

A

HYPERGLYCEMIA

36
Q

Diabetes incidence and prevalence

A
  • world wide prevelance of 8.5%***
  • US=9.4%***
  • 84 MILLION** HAVE PREDIABETES (1/3 of american adults). Increased risk of heart disease and stroke

US incidence diabetes
-1.7 million NEW cases per year

37
Q

Ethnic group with high prevalence of DM

A

Native Americans

38
Q

Global projections of diabetes 2010-2030

A

51% increase worldwide

39
Q

Mortality < 60 of diabetes world wide

A

Higher all over the world

40
Q

Incidence in US of diabetes in last few years

A

DECREASE in INCIDENCE not prevalence

Exercise, diet, awareness

41
Q

Ocular signs of DR

A

Traditional RD
Iris neo
PRP

42
Q

Diebetes and obesity

A

Risk factor

Ecological data

43
Q

BMI and Risk for DM II

A

As one goes up, the other does too

-relative risk increases with BMI

44
Q

Risk factors for the diabetes epidemic in Asia

A
  • Asians have lower rates of overweight and obesity than their western counterparts, using conventional definitions
  • despite lower BMI, some Asian countries have similar or even higher prevalence of diabetes than western countries. These data confirm that the risk of type II DM starts at a lower BMI for Asians than for Europeans

3F Epidemiology FINAL (5 decks)

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