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1

Reportable Disease

Laws and regulations of a state or jurisdiction require it to be reported

2

Notifiable Disease

Regular, frequent and timely information regarding individual cases is necessary for prevention and control the disease.

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Incidence

Number of new diagnoses per 100,000 people

4

Order of infection incidence in rate/100,000 (largest to smallest)

Common cold (25,000) Gonorrhea (104) Influenza (25) AIDS (13) Strep pneumonia (10) Measles (

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SARS

Severe Acute Respiratory Syndrome Coronavirus Nov 2002 - July 2003 Contagious pneumonia 8000 cases worldwide Came from Civets Spread from Hotel Metropole

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Swine Flu (H1N1)

Started in Mexico - 2009 Quarantine efforts Triple recombination between human and animal influenza 0.01% of world population died (250,000 deaths)

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Percent of world population that died from influenza pandemic of 1919

3%

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Percent of world population that died from influenza pandemic of 1968

0.03%

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MERS

2012 - 2014 Middle East Respiratory Syndrome Coronavirus Found in camels and bats 100 deaths worldwide

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Type-2 Diabetes

Resembles infectious condition Modification of the microbiome of experimental animas can induce T2D Differences in GI microorganisms - no specific pathogen

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Other diseases that may be due to an infectious agent

Alzheimer's MS

12

Pediculus humanus capitus (head lice) - Site of infection

Scalp - especially behind ears

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Pediculus humanus capitus (head lice) - Classic presentation

School girls sharing hair accessories

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Pediculus humanus capitus (head lice) - Treatment for patient

Insecticidal shampoo TWICE with 10 DAYS IN BETWEEN. Combing.

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Pediculus humanus capitus (head lice) - treatment for environment

Hot wash all clothes and linen. Check family and classmates.

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Pediculus humanus capitus (head lice) - Special consideration

Allergic reactions to louse saliva Secondary staph infection

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Pediculus humanus corporis (body lice) - Site

Clothing - especially seams

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Pediculus humanus corporis (body lice) - Classic presentation

Homeless person

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Pediculus humanus corporis (body lice) - Treatment for patient

Refer for services Improve hygiene

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Pediculus humanus corporis (body lice) - Treatment for environment

Discard clothing or wash plus insecticide treatment

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Pediculus humanus corporis (body lice) - Special considerations

Can transmit typhus Trench fever Relapsing fever

22

Pthirus pubis (pubic lice) - Site

Pubic hair

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Pthirus pubis (pubic lice) - Classic presentation

Sexually promiscuous

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Pthirus pubis (pubic lice) - Treatment for patient

Shave pubic hair or coat with vaseline

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Pthirus pubis (pubic lice) - Treatment for environment

Hot wash all clothes and linens Check partners and children

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Pthirus pubis (pubic lice) - Sepecial considerations

Marker for other STDs Condoms not protective

27

Spirochetes - Treponema

Syphilis Yaws Pinta

28

T. pallidum - general features

Syphilis Not visible to light microscope --> dark field Delicate, motile (corkscrew), human restricted, not culturable Transmission: sexual, blood, congenital (readily cross placenta, leads to severe secondary syphilis) Virulence based on immune evasion

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T. pallidum Pathogenesis

Penetrates abrasions and mucous membranes to enter lymphatics and blood stream. Invades CNS Surface of spirochete is non-immunogenic Down regulates Th1 cells

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Stages of syphilis

Primary: 3-6 wks, painless chancres on genitals which usually "heals" Secondary: 4-10 wks, Systemic symptoms flu-like, rash on palms and soles, condoylomata lata, high Ab titers Latent syphilis: secondary symptoms resolve but may return intermittently over time Tertiary: Gummatous syphilis - granulomatous lesions Cardiovascular syphilis - aneurysm Neurosyphilis - meningitis, meningovascular syphilis, parenchymal neurosyphilis