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Emerging Diseases Escherichia coli Food-borne disese
Emerging Diseases Escherichia coli Food-borne disese
Emerging Diseases Escherichia coli Food-borne disese
Emerging Diseases Escherichia coli Food-borne disese
Emerging Diseases Escherichia coli Food-borne disese
Emerging Diseases Escherichia coli Food-borne disese
Emerging Diseases Escherichia coli Food-borne disese
Emerging Diseases Escherichia coli Food-borne disese
Emerging Diseases Escherichia coli Food-borne disese
Emerging Diseases Escherichia coli Food-borne disese
Emerging Diseases Escherichia coli Food-borne disese
Emerging Diseases Escherichia coli Food-borne disese
Emerging Diseases Escherichia coli Food-borne disese
Emerging Diseases Escherichia coli Food-borne disese
Emerging Diseases Escherichia coli Food-borne disese
Emerging Diseases Escherichia coli Food-borne disese
Emerging Diseases Escherichia coli Food-borne disese
Emerging Diseases Escherichia coli Food-borne disese
Emerging Diseases Escherichia coli Food-borne disese
Emerging Diseases Escherichia coli Food-borne disese
Emerging Diseases Escherichia coli Food-borne disese
Emerging Diseases Escherichia coli Food-borne disese
Emerging Diseases Escherichia coli Food-borne disese
Emerging Diseases Escherichia coli Food-borne disese
Emerging Diseases Escherichia coli Food-borne disese
Emerging Diseases Escherichia coli Food-borne disese
Emerging Diseases Escherichia coli Food-borne disese
Emerging Diseases Escherichia coli Food-borne disese
Emerging Diseases Escherichia coli Food-borne disese
Emerging Diseases Escherichia coli Food-borne disese
Emerging Diseases Escherichia coli Food-borne disese
Emerging Diseases Escherichia coli Food-borne disese
Emerging Diseases Escherichia coli Food-borne disese
Emerging Diseases Escherichia coli Food-borne disese
Emerging Diseases Escherichia coli Food-borne disese
Emerging Diseases Escherichia coli Food-borne disese
Emerging Diseases Escherichia coli Food-borne disese
Emerging Diseases Escherichia coli Food-borne disese
Emerging Diseases Escherichia coli Food-borne disese
Emerging Diseases Escherichia coli Food-borne disese
Emerging Diseases Escherichia coli Food-borne disese
Emerging Diseases Escherichia coli Food-borne disese
Emerging Diseases Escherichia coli Food-borne disese
Emerging Diseases Escherichia coli Food-borne disese
Emerging Diseases Escherichia coli Food-borne disese
Emerging Diseases Escherichia coli Food-borne disese
Emerging Diseases Escherichia coli Food-borne disese
Emerging Diseases Escherichia coli Food-borne disese
Emerging Diseases Escherichia coli Food-borne disese
Emerging Diseases Escherichia coli Food-borne disese
Emerging Diseases Escherichia coli Food-borne disese
Emerging Diseases Escherichia coli Food-borne disese
Emerging Diseases Escherichia coli Food-borne disese
Emerging Diseases Escherichia coli Food-borne disese
Emerging Diseases Escherichia coli Food-borne disese
Emerging Diseases Escherichia coli Food-borne disese
Emerging Diseases Escherichia coli Food-borne disese
Emerging Diseases Escherichia coli Food-borne disese
Emerging Diseases Escherichia coli Food-borne disese
Emerging Diseases Escherichia coli Food-borne disese
Emerging Diseases Escherichia coli Food-borne disese
Emerging Diseases Escherichia coli Food-borne disese
Emerging Diseases Escherichia coli Food-borne disese
Emerging Diseases Escherichia coli Food-borne disese
Emerging Diseases Escherichia coli Food-borne disese
Emerging Diseases Escherichia coli Food-borne disese
Emerging Diseases Escherichia coli Food-borne disese
Emerging Diseases Escherichia coli Food-borne disese
Emerging Diseases Escherichia coli Food-borne disese
Emerging Diseases Escherichia coli Food-borne disese
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Emerging Diseases Escherichia coli Food-borne disese

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  • 1. Emerging Diseases
  • 2. Escherichia coli Food-borne disese
  • 3. Escherichia coli
    • pathogenic strains frequent agents of infantile diarrhea – greatest cause of mortality among babies
    • causes ~70% of traveler’s diarrhea
    • causes 50-80% UTI
    • indicator of fecal contamination in water
  • 4. Escherichia coli O157:H7
  • 5. E. coli O157:H7
    • E. coli O157:H7 is one of hundreds of strains of the bacterium Escherichia coli .
    • Although most strains are harmless, this strain produces a powerful toxin that can cause severe illness.
    • E. coli O157:H7 has been found in the intestines of healthy cattle, deer, goats, and sheep.
  • 6. E. Coli 0157:H7 outbreak
    • September 28, 2006 : 187 people infected in 26 states (97 hospitalized…29 developed HUS [hemolytic-uremic syndrome])
    1-4 5-9 10-14 15 +
  • 7. Escherichia coli O157:H7
    • Escherichia coli O157:H7 is a leading cause of foodborne illness. Based on a 1999 estimate, 73,000 cases of infection and 61 deaths occur in the United States each year.
    • Infection with E. coli often leads to bloody diarrhea, and occasionally to kidney failure. People can become infected with E.coli O157:H7 in a variety of ways. Though most illness has been associated with eating undercooked, contaminated ground beef, people have also become ill from eating contaminated bean sprouts or fresh leafy vegetables such as lettuce and spinach.
  • 8. Forensic use of DNA patterns “DNA Fingerprints” The E. coli outbreak in spinach was investigated using DNA fingerprinting techniques to trace the strain of bacteria.
  • 9.   Using restriction fragment patterns to distinguish DNA from different alleles
  • 10.  
  • 11.   DNA fingerprints from a murder case
  • 12. Newer Outbreaks
    • Nestle Toll House cookie dough (E. coli) June 2009) http://www.cdc.gov/ecoli/2009/0630.html (72 cases in 30 states)
    • Ground beef (E. coli) ( July 2008) http://www.cdc.gov/ecoli/june2008outbreak/ (49 cases in 7 states)
    • Pepperoni pizza (E.coli) (Oct-Nov 2007) http://www.cdc.gov/ecoli/2007/october/103107.html (21 cases in 10 states)
    • Peanut Butter (salmonellosis) (2007)
    • http://www.cdc.gov/ncidod/dbmd/diseaseinfo/salmonellosis_2007/022207_outbreak_notice.htm (over 600 people from 47 states)
  • 13. Lyme Disease
  • 14. B. burgdorferi - Lyme disease
    • transmitted by ticks
    • complex 2-year cycle involving mice & deer
    • nonfatal, slowly progressive syndrome that mimics neuromuscular & rheumatoid conditions
    • 70% get bull’s eye rash
    • fever, headache, stiff neck, & dizziness
    • if untreated can progress to cardiac & neurological symptoms, polyarthritis
    • tetracycline, amoxicillin
    • vaccine for dogs, human vaccine discontinued
    • Prevention-insect repellant containing DEET
  • 15.  
  • 16.  
  • 17. Lyme disease
  • 18. SuperBug ?
    • MRSA: Methicillin Resistant Staphylococcus aureus
      • A strain of staph that is highly resistant to broad-spectrum antibiotics.
      • Once found almost exclusively in hospital settings the bacteria is now showing up in the wider community
      • People can be colonized by the bacteria (skin and nose primarily) and be healthy but act as carriers to spread the microbe.
      • It is thought that perhaps 25-30% of people may harbor S.aureus.
  • 19.  
  • 20.  
  • 21. MRSA-2
    • A CDC survey completed recently suggests that in 2005 there were ~ 94,000 cases of MRSA in the US and that perhaps 19,000 people died. (A higher rate than AIDS in the US)
    • 85% of the cases were in hospitals, nursing homes etc. But many are concerned about the large number of infections acquired in normal community environments.
    • Spread may be by hands (direct contact) or from contaminated surfaces.
    • Infections range from an inconsequential skin lesion to a fatal septicemia or pneumonia
  • 22. TB-Tuberculosis
  • 23. Tuberculosis (statistics-1)
    • Tuberculosis (TB) kills about two million people each year
    • One-third of the world's population is infected with TB. Five to 10 percent of people who are infected with TB become sick with TB at some time during their life
    • Each year, more than 8 million people become sick with TB
  • 24. Tuberculosis (statistics-2)
    • Between 2000 and 2020, it is estimated that:
      • Nearly one billion people will be newly infected with TB.
      • 200 million people will become sick from TB.
      • TB will claim at least 35 million lives.
  • 25. Treatment of TB
    • 6-24 months of at least 2 drugs from a list of 11
    • one pill regimen called Rifater (isoniazid, rifampin, pyrazinamide)
    • vaccine based on attenuated bacilli Calmet-Guerin strain of M. bovis used in other countries (not U.S.)
    • Success rate of vaccination ~80% in children and 20-50% in adults.
  • 26. Directly Observed Therapy (DOT) …to assure that medication is actually taken
  • 27. MDR (multiple-drug-resistant) TB
    • Most TB patients do not complete their full 6-9 month regimen. The TB bacillus becomes resistant due to incomplete, erratic or inadequate treatment. –
    • Often a few months into a cumbersome and lengthy treatment process, patients feel better and may stop treatment altogether.
    • Up to 20% of TB cases are drug-resistant in TB hot-spots –
    • 4% of TB cases globally are resistant to at least one drug –
    • MDR-TB could be growing as rapidly as 400,000 cases each year
  • 28. MDR (multiple-drug-resistant) TB
  • 29. Papillomavirus
  • 30. Papillomavirus
    • papilloma – benign, squamous epithelial growth or wart
    • caused by 40 different strains of HPV
    • Common warts (seed warts) – on fingers, etc
    • plantar warts – on soles of feet
    • genital warts – prevalent STD
    • transmissible through direct contact or contaminated fomites, autoinnoculation (self-spread)
    • Incubation – 2 weeks – more than a year
    • For most people the virus goes away on its own
  • 31. Papillomavirus Common wart Plantar wart Genital wart
  • 32. Genital warts
    • most common STD in US?
    • over 6 M new cases each year
    • 20+ million carriers (U.S.) of one of the 5 types of HPV associated with genital warts
    • strong association with cervical & penile cancer
    • CDC estimates sexually active people have a 50% chance of catching HPV during a lifetime
  • 33. HPV Vaccine
    • For girls and women 9-26 years of age
    • Three doses
      • Initial
      • 2 month booster
      • 6 month booster
    • For prevention only…not a treatment
  • 34. Influenza
  • 35. Influenza type A
    • acute, highly contagious respiratory illness
    • Seasonal (potential for pandemics)
    • among top 10 causes of death in US
    • respiratory transmission
    • binds to ciliated cells of respiratory mucosa
    • causes rapid shedding of cells, stripping the respiratory epithelium, severe inflammation
    • fever, headache, myalgia, pharyngeal pain, shortness of breath, coughing
    • Several drugs are available for treatment: amantadine, rimantadine, zanamivir & oseltamivir
    • annual vaccine
  • 36. Vaccination for “seasonal flu”
    • There are two types of vaccines:
    • The "flu shot" — an inactivated vaccine (containing killed virus) that is given with a needle, usually in the arm.
    • The nasal-spray flu vaccine — a vaccine made with live, weakened flu viruses that do not cause the flu (sometimes called LAIV for “live attenuated influenza vaccine” or FluMist®). LAIV (FluMist®) is approved for use in healthy* people 2-49 years of age who are not pregnant.
    • Each vaccine contains three influenza viruses-one A (H3N2) virus, one regular, seasonal A (H1N1) virus , and one B virus. The viruses in the vaccine change each year based on international surveillance and scientists' estimations about which types and strains of viruses will circulate in a given year.
    • About 2 weeks after vaccination, antibodies that provide protection against influenza virus infection develop in the body.
    • Seasonal flu peaks in the U.S. in Jan and Feb
  • 37. 2009 H1N1…”swine flu”
  • 38. INFLUENZA
    • Is an Avian Flu pandemic on the way??
  • 39. Avian Flu
  • 40. Avian Flu
  • 41. NOVA Science NOW Pandemic flu video (2006) http://www.pbs.org/wgbh/nova/sciencenow/3302/04.html
  • 42. Avian Flu
    • Pandemic viruses appear as the result of antigenic shift, which causes new combinations of proteins on the surface of the virus. If the new virus spreads easily from person to person a pandemic can result.
  • 43. Avian Flu
    • Culling of infected Poultry
  • 44. Is a Pandemic coming????
    • Nations with confirmed cases of H5N1 avian flu
  • 45. Coronavirus
  • 46. Coronavirus
    • relatively large RNA viruses
    • common in domesticated animals
    • 3 types of human coronaviruses have been characterized
      • HCV causes a cold
      • an enteric virus
      • Severe Acute Respiratory Syndrome (SARS)
  • 47. Coronaviruses SARS (severe acute respiratory syndrome)
    • 2003 Outbreak…
    • 8,098 people worldwide became ill, 774 died. Spread to 30 countries before the outbreak was contained.
  • 48. SARS
  • 49. Coronavirus- SARS
    • Global Spread…
    • Feb 21,2003 …infected medical doctor from Guangdong Province spent a night at a Hong Kong hotel. 12 people staying at or visiting that floor of the hotel became infected.
    • These travelers then dispersed the disease to other countries worldwide
  • 50. SARS Dispersal Superspreaders 144 of Singapore’s 206 cases linked to contact with just 5 individuals
  • 51. Palm civets (SARS reservoir??) Did the SARS epidemic start in Guangdong Province, China as a “civet meal”? Water rat at a market Masked Palm Civet at market
  • 52. Cost of SARS
  • 53. Togaviruses (Flavivirus subcategory)
    • Dengue
      • “ breakbone fever” severe pain in muscles and joints. Infections usually mild, but dengue hemorrhagic shock can be lethal
      • Concern over possible spread to the continental U.S.
    • Yellow Fever
      • Fever, headache, muscle pain, may progress to organ failure and death.
      • Mosquito control has greatly decreased its impact
    • West Nile
      • Emerging concern in U.S.
  • 54. Dengue Distribution of Aedes aegypti (red shaded areas) in the Americas in 1970, at the end of the mosquito eradication program, and in 1997 American countries with laboratory-confirmed hemorrhagic fever (red shaded areas), prior to 1981 and from 1981 to 1997.
  • 55. Dengue
  • 56. West Nile
    • It is estimated that about 20% of people who become infected with WNV will develop West Nile fever.
    • Symptoms include fever, headache, tiredness, and body aches, occasionally with a skin rash (on the trunk of the body) and swollen lymph glands.
    • illness can be as short as a few days, but even healthy people have reported being sick for several weeks.
    • About 1 out of 150 infected people develop serious disease. Encephalitis. Meningitis.
    • Incubation period 2-15 days
  • 57. West Nile Virus-1999-2001
  • 58. West Nile Virus-2002
  • 59. West Nile Virus – 2004 (march 3 rd )
  • 60. West Nile Virus – 2005 (Jan 11 Th ) For all of 2007, more than 1,200 cases of severe West Nile illness were reported, and 124 deaths. The peaks occurred in 2002 and 2003, when severe illnesses numbered nearly 3,000 and deaths surpassed 260.
  • 61. West Nile Virus - Life Cycle
  • 62. HIV
    • Worsening Epidemic
      • 25 million Africans have HIV
      • United Nations warns that the next two decades could see 89 million new cases
      • Up to 10% of the continent’s population
  • 63.  
  • 64. AIDS
    • first emerged in early 1980s
    • HIV-1 & HIV-2 are not closely related
    • HIV viruses may have originated from a monkey/chimpanzee viruses
    • 1959 first documented case of AIDS
    • HIV is found in blood, semen, & vaginal secretions.
    • HIV is transmitted by sex, sharing needles, and mother to child.
    • HIV does not survive long outside of the body.
  • 65. HIV
    • attacks the T helper cells & macrophages
    • first signs of AIDS are opportunistic infections such as Pneumocystis carinii pneumonia (PCP) and cancers such as Kaposi sarcoma
  • 66. Risk categories
    • homosexual or bisexual males – 45% of U.S. cases
    • intravenous drug users – 30%
    • heterosexual partners of HIV carriers – 11%
    • blood transfusions & blood products – since testing, no longer a serious risk
    • inapparent or unknown risk – 9% - (unexplained risk due to patient denials, death, unavailability)
    • congenital or neonatal – 5%, can be reduced with antiviral drugs
    • medical & dental personnel – 1/500 chance from needlestick accident
  • 67. Progression of HIV disease
    • initial infection – mononucleosis-like symptoms that soon disappear
    • asymptomatic phase 2-15 years (ave. 10)
    • antibodies are detectable 8-16 weeks after infection
    • HIV destroys the immune system
    • when T4 cell levels fall below 200/  L symptoms appear including fever, swollen lymph nodes, diarrhea, weight loss, neurological symptoms, opportunistic infections & cancers
  • 68. Opportunistic infections
  • 69. Kaposi sarcoma of arm
  • 70. HIV
    • treatments
      • inhibit viral enzymes: reverse transcriptase, protease, integrase
      • inhibit fusion of virus to host cell
      • inhibit viral translation
    • no vaccine
    • prevention
      • monogamous sexual relationships
      • condoms
      • universal precautions (in handling of needles, blood products etc.)

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