Plague of Justinian

542 AD

250,000 dead

Procopius
     “sun’s light
     without brightness”
Silk Road
Medieval Warm Period
Medieval World Population
Climate


Agricultural
 Revolution

Few large cities
Medieval World Population
Viking Exploration
Black Rat

Litter < 20 pups
  3 - 7 x/year

Mature at 3 mos
Flea
Black rats & fleas
Yersinia Pestis
Bubonic plague
Medieval Culture
Bubonic plague
“Ring around the rosie . . “
Plague in Europe
Plague effects
 Death art
 Cemeteries & Pest houses
 Quarantine
 Latin->vernacular
 Anti-Semitism
 Laborers, women
...
Death art
Anti-Semitism
Flagellants
Clergy
Great Fire of London
1666


Change in
 architecture
Pathogenic Competition
Leprosy (Hansen’s disease)


Plague


Tuberculosis
Chinatown 1900
San Francisco 1900 -1904
Smallpox
Species jump


Ramses V
    ~1150 BC
Variola virus
 Largest & most complex
  mammalian virus

 Respiratory


 Incubation: 10-14
                days
Variola rash
Wigs and Powder
East meets West
      Why were Native Americans so vulnerable?

Isolation


Few domesticated
    animals

Famine?
Population losses
American colonies
Variolation




              John Adams
Milkmaids and cowpox
Jenner’s vaccination
Eradication (1977)
World Health Org.
 (WHO) campaign



Accidental lab
  Contamination 1978
Measles
 Respiratory virus


 8 - 12 day
  incubation

 Complications
Measles
Measles vaccine
MMR
Measles, Mumps, Rubella
2008
Avoiding Immunizations
Health insurance coverage


Autism


Personal, Religious reasons


International travel
Vector Diseases
Yellow Fever
 Jaundice


 Flavivirus


 Carried by
  Aedes aegypti
  mosquito
Yellow Fever
1793 Philadelphia




    Benjamin Rush
1878 Memphis
Post Civil War


Immigrants


El Nino


River, train depot
Spanish American War
Walter Reed


1937 vaccine
 (Max Theiler)
West Nile Encephalitis

 New York City 1999

 Crows, blue jays


 Flamingo, penguin
Spread of WNE
1999           2007
Transmission Cycle
Influenza Pandemic
    1918 - 1919
Influenza virus
Flu viruses
Types A, B, C


H -> binds to cells


N -> degrades
          mucous
Flu varieties
Epidemic Date        Deaths      Subtype
Asiatic   1889 - 90 1 million    ?H2N2?

Spanish   1918 - 9   35 mi...
Flu transmission cycle
1918 - 1919
 3 waves


 World War I


 Secondary
 infections
Influenza virus
Orthomyxovirus


Respiratory


Fever, chills, aches
Age Profiles
Avian Flu
Avian Flu
SARS
(Sudden Acute Respiratory Syndrome)
Swine Flu 1976
Fort Dix, NJ


National
 immunization

Guillain-Barre
“Killer Fever”
Legionnaire’s
 Philadelphia
  July 1976

 Bellevue-Stratford


 34 deaths, 221 ill
Legionella pneumophila
2008


Legionnaries' claims second life at St.
  Peter's Hospital
Six adults diagnosed over last 2 weeks; chlorination pro...
Revenge of the Germs?
Tuberculosis
“White Disease”




Chopin   Keats   Dostoyevsky
TB
Bacterial


Long incubation


Airborne


Uv light
2007
Antibiotic Resistance
Nosocomial infections
MRSA
 Methicillin Resistant Staphylococcus Aureus
Penicillin
Penicillin
Fleming 1928


Florey/Chain 1945
Antibacterials
Antibiotics in food
Transduction
Transduction
Transduction
Bacteriophages
Zyvox
April 2000
Penicillin resistance
Antibiotic Resistance
Causes:
 Overprescription/unnecessary use

 Antibiotics in food/dairy

 opportunistic bugs
Waterborne Bacteria
Cholera




 Vibrio cholerae
1854
Cholera Distribution
Food-borne bacteria
Sept 2006




June 2008
Salad Bars?
Raw food



Utensils



Residual soil
Produce
Sprouts


Melons


Greens
Bacteria
Salmonella




Shigella



Campylobacter
Salmonella Typhimurium
Typhoid Mary
 (Mary Mallon
 1869 - 1938)


1906
 Oyster Bay, NY
Peanuts 2008/9
Heat products to
 70° F (not 40° F)
Poultry
Chicken recall
  (March 2008)
Antibiotics in food
Why Poultry?
Antibiotics in food


Close confinement


Chill baths


transportation
Is your dinner safe?




A=Premium Brands (Bett & Evans, Ranger, Readington Farms, Rocky, Rocky
Jr., Rosie, Springer Mount...
Contaminated Beef
Why ground beef?
Greater surface area


Parts of different cows


Kid appeal


“Make mine rare”
Beef ranches
Crowded herds


Antibiotic use


Inspections??
Beef Recall
October 2007
E. Coli O157:H7
1982 fast food burgers


1985 associated with HUS


1991 apple cider


1993 fast food burgers
Escherichia Coli
HUS
            (Hemolytic uremic syndrome)

 Destroys red blood cells




 Kidney failure




 Shiga toxin
HUS
BSE
      (bovine spongiform encephalopathy)

“Mad cow”
Beef & Byproducts
Salmonella (1984)
The Dalles, OR
Rajneeshees




Bhagwan Shree Rajneesh          Ma Anand Sheela
Biological Terrorism
Poisoned arrows


Pots with snake venom


Plague victims
Sweet Sabotage
Mandrake


“Mad Honey”


Ergot of rye
French-Indian War
Amherst
Plague as weapon
Kaffa
World War I
Gassing
 Chlorine gas


 Mustard gas


 Phosgene


 Chlorpicrin


 HCN
Gas Effects
Geneva Convention (1925)
Article 32
  “Whereas the use in war of asphyxiating, poisonous or other gases, and of all
  ana...
Second Generation
Nerve gases:
    Sarin

    Tabun

    VX

Colorless, odorless
Nerve Cells
Synapse
Nerve cells

Overstimulation -> convulsions




Blocking neurotransmitter
                   -> paralysis
Iran Iraq War
   (1980 - 1988)
Cold War
Biological vs. Chemical
More specific


Persistent, contamination


Cheap
Serratia Marescens
Yellow Rain
Bioweapons Convention
            (1969)
 “never in any circumstances to develop,
    produce, stockpile or otherwise acq...
Sverdlovsk
Desert Storm
Gulf War Syndrome

    anthrax vaccine

    chemical weapons

    depleted uranium
Aum Shinrikyo
1990 botulinium


1993 anthrax


1993 botulinium
Sarin
March 20, 1995 Tokyo Subway
2001


 9/11 WTC
October 2001
10/5/2001


Bob Stevens dies of
 respiratory
 disease
October 2001
October 2001
Anthrax
Anthrax
Koch


“Wool-sorter’s”
Spores
Natural exposure
Attacks 2001
Cleanup
Global storage
Bioterrorism agents
Class A: highly infectious
          high mortality rate
          easily disseminated

Class B: eas...
Viral Agents
Smallpox


Ebola


Hantavirus


Influenza
Smallpox
Eradicated 1977


Few vaccinated


contagious
Ebola
1st cases 1976


90% fatality rate


Bat vector?


Reston 1989
Hantavirus
1993: 12 deaths




2003:
Hantavirus
Flu
Mutations




Avian flu
Bacterial agents
 Botulinium


 Plague


 Cholera/salmonella


 Tularemia/Q fever
Clostridium Botulinum
Aum Shinrikyo


Unit 731


Botox


anaerobic
Yersinia Pestis
Black Death


Unit 731


Antibiotic resistance
 (Madagascar 1995)
Vibrio Cholerae
Rehydration


Fresh or salt
 water

Type O most
 susceptible
Salmonella
 Typhoid Mary


 The Dalles 1984


 Oct 2008:
  frozen chicken
Tularemia
“Rabbit fever”


Flu-like symptoms


Ticks/flies = vector
Q(uery) Fever
Cattle, sheep, goats


Disinfectant
 resistant
Chimera
Biological Chimera
Organism produced from the
 combination of genetic materials from
 two or more pathogens
Mission Impossible II
Russian
 Supervirus
Gene Splicing
Genetic Engineering
 Fluorescent
  animals

 Super Salmon


 Golden Rice
Veepox
1990 Vector
 VEE
 Venezuelan
 equine
 encephalomyelitis

+   smallpox
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ERMslides2

  1. 1. Plague of Justinian 542 AD 250,000 dead Procopius “sun’s light without brightness”
  2. 2. Silk Road
  3. 3. Medieval Warm Period
  4. 4. Medieval World Population Climate Agricultural Revolution Few large cities
  5. 5. Medieval World Population
  6. 6. Viking Exploration
  7. 7. Black Rat Litter < 20 pups 3 - 7 x/year Mature at 3 mos
  8. 8. Flea
  9. 9. Black rats & fleas
  10. 10. Yersinia Pestis
  11. 11. Bubonic plague
  12. 12. Medieval Culture
  13. 13. Bubonic plague “Ring around the rosie . . “
  14. 14. Plague in Europe
  15. 15. Plague effects  Death art  Cemeteries & Pest houses  Quarantine  Latin->vernacular  Anti-Semitism  Laborers, women  Sheep
  16. 16. Death art
  17. 17. Anti-Semitism
  18. 18. Flagellants
  19. 19. Clergy
  20. 20. Great Fire of London 1666 Change in architecture
  21. 21. Pathogenic Competition Leprosy (Hansen’s disease) Plague Tuberculosis
  22. 22. Chinatown 1900 San Francisco 1900 -1904
  23. 23. Smallpox Species jump Ramses V ~1150 BC
  24. 24. Variola virus  Largest & most complex mammalian virus  Respiratory  Incubation: 10-14 days
  25. 25. Variola rash
  26. 26. Wigs and Powder
  27. 27. East meets West Why were Native Americans so vulnerable? Isolation Few domesticated animals Famine?
  28. 28. Population losses
  29. 29. American colonies
  30. 30. Variolation John Adams
  31. 31. Milkmaids and cowpox
  32. 32. Jenner’s vaccination
  33. 33. Eradication (1977) World Health Org. (WHO) campaign Accidental lab Contamination 1978
  34. 34. Measles  Respiratory virus  8 - 12 day incubation  Complications
  35. 35. Measles
  36. 36. Measles vaccine
  37. 37. MMR Measles, Mumps, Rubella
  38. 38. 2008
  39. 39. Avoiding Immunizations Health insurance coverage Autism Personal, Religious reasons International travel
  40. 40. Vector Diseases
  41. 41. Yellow Fever  Jaundice  Flavivirus  Carried by Aedes aegypti mosquito
  42. 42. Yellow Fever 1793 Philadelphia Benjamin Rush
  43. 43. 1878 Memphis Post Civil War Immigrants El Nino River, train depot
  44. 44. Spanish American War Walter Reed 1937 vaccine (Max Theiler)
  45. 45. West Nile Encephalitis  New York City 1999  Crows, blue jays  Flamingo, penguin
  46. 46. Spread of WNE 1999 2007
  47. 47. Transmission Cycle
  48. 48. Influenza Pandemic 1918 - 1919
  49. 49. Influenza virus
  50. 50. Flu viruses Types A, B, C H -> binds to cells N -> degrades mucous
  51. 51. Flu varieties Epidemic Date Deaths Subtype Asiatic 1889 - 90 1 million ?H2N2? Spanish 1918 - 9 35 million H1N1 Asian 1957-8 1.5 H2N2 million Hong Kong 1968-9 1 million H3N2
  52. 52. Flu transmission cycle
  53. 53. 1918 - 1919  3 waves  World War I  Secondary infections
  54. 54. Influenza virus Orthomyxovirus Respiratory Fever, chills, aches
  55. 55. Age Profiles
  56. 56. Avian Flu
  57. 57. Avian Flu
  58. 58. SARS (Sudden Acute Respiratory Syndrome)
  59. 59. Swine Flu 1976 Fort Dix, NJ National immunization Guillain-Barre
  60. 60. “Killer Fever”
  61. 61. Legionnaire’s  Philadelphia July 1976  Bellevue-Stratford  34 deaths, 221 ill
  62. 62. Legionella pneumophila
  63. 63. 2008 Legionnaries' claims second life at St. Peter's Hospital Six adults diagnosed over last 2 weeks; chlorination process may be to blame By GENE RACZ • and RICHARD KHAVKINE • September 25, 2008
  64. 64. Revenge of the Germs?
  65. 65. Tuberculosis
  66. 66. “White Disease” Chopin Keats Dostoyevsky
  67. 67. TB Bacterial Long incubation Airborne Uv light
  68. 68. 2007
  69. 69. Antibiotic Resistance Nosocomial infections
  70. 70. MRSA  Methicillin Resistant Staphylococcus Aureus
  71. 71. Penicillin
  72. 72. Penicillin Fleming 1928 Florey/Chain 1945
  73. 73. Antibacterials
  74. 74. Antibiotics in food
  75. 75. Transduction
  76. 76. Transduction
  77. 77. Transduction
  78. 78. Bacteriophages
  79. 79. Zyvox April 2000
  80. 80. Penicillin resistance
  81. 81. Antibiotic Resistance Causes: Overprescription/unnecessary use Antibiotics in food/dairy opportunistic bugs
  82. 82. Waterborne Bacteria Cholera Vibrio cholerae
  83. 83. 1854
  84. 84. Cholera Distribution
  85. 85. Food-borne bacteria Sept 2006 June 2008
  86. 86. Salad Bars? Raw food Utensils Residual soil
  87. 87. Produce Sprouts Melons Greens
  88. 88. Bacteria Salmonella Shigella Campylobacter
  89. 89. Salmonella Typhimurium Typhoid Mary (Mary Mallon 1869 - 1938) 1906 Oyster Bay, NY
  90. 90. Peanuts 2008/9 Heat products to 70° F (not 40° F)
  91. 91. Poultry
  92. 92. Chicken recall (March 2008)
  93. 93. Antibiotics in food
  94. 94. Why Poultry? Antibiotics in food Close confinement Chill baths transportation
  95. 95. Is your dinner safe? A=Premium Brands (Bett & Evans, Ranger, Readington Farms, Rocky, Rocky Jr., Rosie, Springer Mountain Farms, Wegmans Premium, Wild Harvest; B=Perdue; C=Foster Farms; D=Supermarket Brands (Albertson's, Big Bear, Cub Foods, Dominick's, Giant Eagle, Giant Gold Star Meats, Jewel, Publix, Safeway, Shaw's, Stop & Shop White Gem, Tops, Trader Joe's, Wegman's; E=Pilgrim's Pride; F=Tyson
  96. 96. Contaminated Beef
  97. 97. Why ground beef? Greater surface area Parts of different cows Kid appeal “Make mine rare”
  98. 98. Beef ranches Crowded herds Antibiotic use Inspections??
  99. 99. Beef Recall October 2007
  100. 100. E. Coli O157:H7 1982 fast food burgers 1985 associated with HUS 1991 apple cider 1993 fast food burgers
  101. 101. Escherichia Coli
  102. 102. HUS (Hemolytic uremic syndrome)  Destroys red blood cells  Kidney failure  Shiga toxin
  103. 103. HUS
  104. 104. BSE (bovine spongiform encephalopathy) “Mad cow”
  105. 105. Beef & Byproducts
  106. 106. Salmonella (1984) The Dalles, OR
  107. 107. Rajneeshees Bhagwan Shree Rajneesh Ma Anand Sheela
  108. 108. Biological Terrorism Poisoned arrows Pots with snake venom Plague victims
  109. 109. Sweet Sabotage Mandrake “Mad Honey” Ergot of rye
  110. 110. French-Indian War Amherst
  111. 111. Plague as weapon Kaffa
  112. 112. World War I
  113. 113. Gassing  Chlorine gas  Mustard gas  Phosgene  Chlorpicrin  HCN
  114. 114. Gas Effects
  115. 115. Geneva Convention (1925) Article 32 “Whereas the use in war of asphyxiating, poisonous or other gases, and of all analogous liquids materials or devices, has been justly condemned by the general opinion of the civilized world; and  Whereas the prohibition of such use has been declared in Treaties to which the majority of Powers of the world are Parties; and  To the end that this prohibition shall be universally accepted as a part of International Law, binding alike the conscience and the practice of nations;
  116. 116. Second Generation Nerve gases: Sarin Tabun VX Colorless, odorless
  117. 117. Nerve Cells
  118. 118. Synapse
  119. 119. Nerve cells Overstimulation -> convulsions Blocking neurotransmitter -> paralysis
  120. 120. Iran Iraq War (1980 - 1988)
  121. 121. Cold War
  122. 122. Biological vs. Chemical More specific Persistent, contamination Cheap
  123. 123. Serratia Marescens
  124. 124. Yellow Rain
  125. 125. Bioweapons Convention (1969)  “never in any circumstances to develop, produce, stockpile or otherwise acquire or retain: (1) Microbial or other biological agents, or toxins whatever their origin or method of production, of types and in quantities that have no justification for prophylactic, protective or other peaceful purposes; (2) Weapons, equipment or means of delivery designed to use such agents or toxins for hostile purposes or in armed conflict.
  126. 126. Sverdlovsk
  127. 127. Desert Storm Gulf War Syndrome anthrax vaccine chemical weapons depleted uranium
  128. 128. Aum Shinrikyo 1990 botulinium 1993 anthrax 1993 botulinium
  129. 129. Sarin March 20, 1995 Tokyo Subway
  130. 130. 2001  9/11 WTC
  131. 131. October 2001 10/5/2001 Bob Stevens dies of respiratory disease
  132. 132. October 2001
  133. 133. October 2001
  134. 134. Anthrax
  135. 135. Anthrax Koch “Wool-sorter’s”
  136. 136. Spores
  137. 137. Natural exposure
  138. 138. Attacks 2001
  139. 139. Cleanup
  140. 140. Global storage
  141. 141. Bioterrorism agents Class A: highly infectious high mortality rate easily disseminated Class B: easily treated lower mortality
  142. 142. Viral Agents Smallpox Ebola Hantavirus Influenza
  143. 143. Smallpox Eradicated 1977 Few vaccinated contagious
  144. 144. Ebola 1st cases 1976 90% fatality rate Bat vector? Reston 1989
  145. 145. Hantavirus 1993: 12 deaths 2003:
  146. 146. Hantavirus
  147. 147. Flu Mutations Avian flu
  148. 148. Bacterial agents  Botulinium  Plague  Cholera/salmonella  Tularemia/Q fever
  149. 149. Clostridium Botulinum Aum Shinrikyo Unit 731 Botox anaerobic
  150. 150. Yersinia Pestis Black Death Unit 731 Antibiotic resistance (Madagascar 1995)
  151. 151. Vibrio Cholerae Rehydration Fresh or salt water Type O most susceptible
  152. 152. Salmonella  Typhoid Mary  The Dalles 1984  Oct 2008: frozen chicken
  153. 153. Tularemia “Rabbit fever” Flu-like symptoms Ticks/flies = vector
  154. 154. Q(uery) Fever Cattle, sheep, goats Disinfectant resistant
  155. 155. Chimera
  156. 156. Biological Chimera Organism produced from the combination of genetic materials from two or more pathogens
  157. 157. Mission Impossible II Russian Supervirus
  158. 158. Gene Splicing
  159. 159. Genetic Engineering  Fluorescent animals  Super Salmon  Golden Rice
  160. 160. Veepox 1990 Vector VEE Venezuelan equine encephalomyelitis + smallpox

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