Presentation from the European Scientific Conference on Applied Infectious Disease Epidemiology (ESCAIDE), published by the European Centre for Disease Prevention and Control (ECDC)
Presented by Bassirou Bonfoh, Jyldyz Shigaeva and Bernd Steimann at a workshop on an integrated approach to controlling brucellosis in Africa, Addis Ababa, Ethiopia, 29-31 January 2013.
It gives all the important definitions used in infectious disease epidemiology and continues to elaborate on dynamics of disease transmission followed by prevention and control of infectious diseases.
Webinar Series on COVID-19 vaccine: Jointly organized by Malaysian Society of Infection Control and Infectious Diseases (MyICID) & Institute for Clinical Research (ICR), NIH
Speaker: Dr. Low Lee Lee, Infectious Disease Physician at the Hospital Sultanah Bahiyah, Ministry of Health Malaysia.
Zoonoses : are infections which are naturally transmitted between vertebrate animals and people.
The term zoonosis'Derived from the Greek
ZOON (animals) and NOSES (diseases)
People, animals, birds, arthropods and the inanimate environment are all involved in cycles of zoonotic infection
ICON experts give an in-depth overview of infectious disease modeling with a focus on assessment of interventions and its challenges.
The nature of communicable diseases results in unique epidemiological characteristics that must be accounted for when considering the epidemiological, clinical, and economic consequences of interventions that modify transmission. These interventions clearly include vaccines, but also drug treatments that may reduce the duration of infectiousness.
This webinar outlines the unique epidemiological characteristics of communicable diseases and demonstrates how correctly accounting for these in clinical and economic assessments of interventions can capture the full value of these interventions. Some of the challenges faced when performing these analyses are also addressed.
Key Topics Include:
- Understanding infectious disease modeling
- Why infectious disease modeling is needed
- Challenges associated with infectious disease modeling
Difference between a pandemic, an epidemic, endemic, and an outbreakBarryAllen149
The distinction between the concepts “pandemic,” “epidemic,” and “endemic” is typically dimmed, also by medical specialists. Because the definition of each term is liquid, and it varies as diseases become more or less prevalent over time. In conversation, maybe this is less important to know the exact definitions but to understand the overall condition of public health news and responses you should know the concepts.
Emerging and re-emerging diseses part2 (INCLUDES ANTIMICROBIAL RESISTANCE)Dr. Mamta Gehlawat
2nd half of my ppt on emerging and re-emerging diseases. i uploaded the first half already. pls refer to that too. this ppt has info on AIDS/HIV, ZIKA, EBOLA-MARBURG, MELIODIOSIS, CHOLERA and ANTIMICROBIAL RESISTANCE
Eradicating Smallpox Case 1Eradicating SmallpoxG.docxSALU18
Eradicating Smallpox �
Case 1
Eradicating Smallpox
Geographic area: Worldwide
Health condition: in �966, there were approximately �0 million to �5 million cases of smallpox in more
than 50 countries, and �.5 million to 2 million people died from the disease each year.
Global importance of the health condition today: Smallpox has been eradicated from the globe, with no
new cases reported since �978. However, the threat of bioterrorism keeps the danger of smallpox alive,
and debate continues over whether strains of the disease should be retained in specified laboratories.
Intervention or program: in �965, international efforts to eradicate smallpox were revitalized with the es-
tablishment of the Smallpox Eradication Unit at the World Health organization and a pledge for more tech-
nical and financial support from the campaign’s largest donor, the United States. Endemic countries were
supplied with vaccines and kits for collecting and sending specimens, and the bifurcated needle made
vaccination easier. an intensified effort was led in the five remaining countries in �973, with concentrated
surveillance and containment of outbreaks.
Cost and cost-effectiveness: the annual cost of the smallpox campaign between �967 and �979 was
$23 million. in total, international donors provided $98 million, while $200 million came from the endemic
countries. the United States saves the total of all its contributions every 26 days because it does not
have to vaccinate or treat the disease.
Impact: By �977, the last endemic case of smallpox was recorded in Somalia. in may �980, after two
years of surveillance and searching, the World Health assembly declared that smallpox was the first dis-
ease in history to have been eradicated.
T
he eradication of smallpox—the complete ex-
termination of a notorious scourge—has been
heralded as one of the greatest achievements
of humankind. Inspiring a generation of public
health professionals, it gave impetus to subsequent vac-
cination campaigns and strengthened routine immuni-
zation programs in developing countries. It continues
to be a touchstone for political commitment to a health
goal—particularly pertinent in light of the United Na-
tions’ Millennium Development Goals (MDGs).
But the smallpox experience is far from an uncompli-
cated story of a grand accomplishment that should (or
could) be replicated. Although the story shows how
great global ambitions can be realized with leadership
and resources, it also illustrates the complexities and
unpredictable nature of international cooperation.
The Disease
Smallpox was caused by a variola virus and was transmit-
ted between people through the air. It was usually spread
by face-to-face contact with an infected person and to a
lesser extent through contaminated clothes and bedding.The first draft of this case was prepared by Jane Seymour.
2 Eradicating Smallpox
Once a person contracted the disease, he or she re-
mained apparentl ...
Presented by Bassirou Bonfoh, Jyldyz Shigaeva and Bernd Steimann at a workshop on an integrated approach to controlling brucellosis in Africa, Addis Ababa, Ethiopia, 29-31 January 2013.
It gives all the important definitions used in infectious disease epidemiology and continues to elaborate on dynamics of disease transmission followed by prevention and control of infectious diseases.
Webinar Series on COVID-19 vaccine: Jointly organized by Malaysian Society of Infection Control and Infectious Diseases (MyICID) & Institute for Clinical Research (ICR), NIH
Speaker: Dr. Low Lee Lee, Infectious Disease Physician at the Hospital Sultanah Bahiyah, Ministry of Health Malaysia.
Zoonoses : are infections which are naturally transmitted between vertebrate animals and people.
The term zoonosis'Derived from the Greek
ZOON (animals) and NOSES (diseases)
People, animals, birds, arthropods and the inanimate environment are all involved in cycles of zoonotic infection
ICON experts give an in-depth overview of infectious disease modeling with a focus on assessment of interventions and its challenges.
The nature of communicable diseases results in unique epidemiological characteristics that must be accounted for when considering the epidemiological, clinical, and economic consequences of interventions that modify transmission. These interventions clearly include vaccines, but also drug treatments that may reduce the duration of infectiousness.
This webinar outlines the unique epidemiological characteristics of communicable diseases and demonstrates how correctly accounting for these in clinical and economic assessments of interventions can capture the full value of these interventions. Some of the challenges faced when performing these analyses are also addressed.
Key Topics Include:
- Understanding infectious disease modeling
- Why infectious disease modeling is needed
- Challenges associated with infectious disease modeling
Difference between a pandemic, an epidemic, endemic, and an outbreakBarryAllen149
The distinction between the concepts “pandemic,” “epidemic,” and “endemic” is typically dimmed, also by medical specialists. Because the definition of each term is liquid, and it varies as diseases become more or less prevalent over time. In conversation, maybe this is less important to know the exact definitions but to understand the overall condition of public health news and responses you should know the concepts.
Emerging and re-emerging diseses part2 (INCLUDES ANTIMICROBIAL RESISTANCE)Dr. Mamta Gehlawat
2nd half of my ppt on emerging and re-emerging diseases. i uploaded the first half already. pls refer to that too. this ppt has info on AIDS/HIV, ZIKA, EBOLA-MARBURG, MELIODIOSIS, CHOLERA and ANTIMICROBIAL RESISTANCE
Eradicating Smallpox Case 1Eradicating SmallpoxG.docxSALU18
Eradicating Smallpox �
Case 1
Eradicating Smallpox
Geographic area: Worldwide
Health condition: in �966, there were approximately �0 million to �5 million cases of smallpox in more
than 50 countries, and �.5 million to 2 million people died from the disease each year.
Global importance of the health condition today: Smallpox has been eradicated from the globe, with no
new cases reported since �978. However, the threat of bioterrorism keeps the danger of smallpox alive,
and debate continues over whether strains of the disease should be retained in specified laboratories.
Intervention or program: in �965, international efforts to eradicate smallpox were revitalized with the es-
tablishment of the Smallpox Eradication Unit at the World Health organization and a pledge for more tech-
nical and financial support from the campaign’s largest donor, the United States. Endemic countries were
supplied with vaccines and kits for collecting and sending specimens, and the bifurcated needle made
vaccination easier. an intensified effort was led in the five remaining countries in �973, with concentrated
surveillance and containment of outbreaks.
Cost and cost-effectiveness: the annual cost of the smallpox campaign between �967 and �979 was
$23 million. in total, international donors provided $98 million, while $200 million came from the endemic
countries. the United States saves the total of all its contributions every 26 days because it does not
have to vaccinate or treat the disease.
Impact: By �977, the last endemic case of smallpox was recorded in Somalia. in may �980, after two
years of surveillance and searching, the World Health assembly declared that smallpox was the first dis-
ease in history to have been eradicated.
T
he eradication of smallpox—the complete ex-
termination of a notorious scourge—has been
heralded as one of the greatest achievements
of humankind. Inspiring a generation of public
health professionals, it gave impetus to subsequent vac-
cination campaigns and strengthened routine immuni-
zation programs in developing countries. It continues
to be a touchstone for political commitment to a health
goal—particularly pertinent in light of the United Na-
tions’ Millennium Development Goals (MDGs).
But the smallpox experience is far from an uncompli-
cated story of a grand accomplishment that should (or
could) be replicated. Although the story shows how
great global ambitions can be realized with leadership
and resources, it also illustrates the complexities and
unpredictable nature of international cooperation.
The Disease
Smallpox was caused by a variola virus and was transmit-
ted between people through the air. It was usually spread
by face-to-face contact with an infected person and to a
lesser extent through contaminated clothes and bedding.The first draft of this case was prepared by Jane Seymour.
2 Eradicating Smallpox
Once a person contracted the disease, he or she re-
mained apparentl ...
CASE 1 Eradicating SmallpoxABSTRACTGeographic area Worldwi.docxannandleola
CASE 1 Eradicating Smallpox*
ABSTRACT
Geographic area: Worldwide
Health condition: In 1966, there were approximately 10 million to 15 million cases of smallpox in more than 50 countries, and 1.5 million to 2 million people died from the disease each year.
Global importance of the health condition today: Smallpox has been eradicated from the globe, with no new cases reported since 1978. However, the threat of bioterrorism keeps the danger of smallpox alive, and debate continues over whether strains of the disease should be retained in specified laboratories.
Intervention or program: In 1965, international efforts to eradicate smallpox were revitalized with the establishment of the Smallpox Eradication Unit at the World Health Organization (WHO) and a pledge for more technical and financial support from the campaign’s largest donor, the United States. Endemic countries were supplied with vaccines and kits for collecting and sending specimens, and the bifurcated needle made vaccination easier. An intensified effort was led in the five remaining countries in 1973, with concentrated surveillance and containment of outbreaks.
Cost and cost-effectiveness: The annual cost of the smallpox campaign between 1967 and 1979 was $23 million. In total, international donors provided $98 million, while $200 million came from the endemic countries. The United States saves the total of all its contributions every 26 days because it does not have to vaccinate or treat the disease.
Impact: By 1977, the last endemic case of smallpox was recorded in Somalia. In May 1980, after two years of surveillance and searching, the World Health Assembly (WHA) declared that smallpox was the first disease in history to have been eradicated.
The eradication of smallpox—the complete extermination of a notorious scourge—has been heralded as one of the greatest achievements of humankind. Inspiring a generation of public health professionals, it gave impetus to subsequent vaccination campaigns and strengthened routine immunization programs in developing countries. It continues to be a touchstone for political commitment to a health goal—particularly pertinent in light of the United Nations’ Millennium Development Goals (MDGs).
But the smallpox experience is far from an uncomplicated story of a grand accomplishment that should (or could) be replicated. Although the story shows how great global ambitions can be realized with leadership and resources, it also illustrates the complexities and unpredictable nature of international cooperation.
THE DISEASE
Smallpox was caused by a variola virus and was transmitted between people through the air. It was usually spread by face-to-face contact with an infected person and to a lesser extent through contaminated clothes and bedding.
Once a person contracted the disease, he or she remained apparently healthy and noninfectious for up to 17 days. But the onset of flulike symptoms heralded the infectious stage, leading after two or three days to a.
The viruses coexist for approx. 300 million years with the humans. Sometimes viruses can infect people on a large scale. But how was the current pandemic possible?
Global warming is causing extreme weather events that have led to an increase in infectious diseases. The new climate can support epidemiological vectors for longer periods of time, creating more favorable conditions for replication and the emergence of new vectors.
In the case of emerging infectious diseases, it is considered that there is a border that has already been crossed. Viruses normally have a native area (their "reservoir") from which they should not be pushed out. This creates a dangerous intimacy, with "hotspots" that include locations such as markets, which become real hotbeds of epidemics.
DOI: 10.13140/RG.2.2.26974.87364
Christian Walzer
POLICY SEMINAR
Virtual Event - COVID-19: The role of the agriculture-ecosystem health interface
AUG 18, 2020 - 09:30 AM TO 11:00 AM EDT
Past and future of eradication and elimination of different diseases. How to plan for elimination and eradication. What are the diseases can be eliminated? OPV to IPV shift!
What role does urbanization have to play in the changing epidemiology and emergence of infectious diseases? These slides accompanied my interactive lecture taken as a part of the Environmental Health module of the MPH course for the students at the Indian Institute of Public Health, Delhi.
Similar to Eradication of smallpox in 20th Century: an unrepeatable success?, David Heymann - HPA, UK (ESCAIDE 2010) (20)
Summary slides on the epidemiological situation in the EU/EEA.
2018 surveillance data.
Report and ppt slides available from: http://bit.ly/HIVAIDSsurv18
Presentation during the 17th European AIDS Conference (EACS) 2019 looking at the status of HIV pre-exposure prophylaxis PrEP in Europe..
Presenter: Teymur Noori, European Centre for Disease Prevention and Control (ECDC)
Presentation from the opening session of the 17th European AIDS Conference (EACS) 2019, Basel, Switzerland.
Presenter: Anastasia Pharris, European Centre for Disease Prevention and Control.
ECDC symposium "Responding to two of the main STI threats of our time: syphilis and antimicrobial resistant Neisseria gonorrhoeae"
Presentation by: Otilia Mårdh
Presented at: IUSTI 2019, Tallinn
Hepatitis E is one of the most common causes of acute hepatitis in the EU/EEA but currently not notifiable at EU level.
This presentation summarises ECDC's work on the topic and survey results on hepatitis E on 2005 to 2015 data.
Any questions? Contact press@ecdc.europa.eu
This presentation summarises the main data from the ECDC Annual epidemiological reports 2017 on chlamydia, gonorrhoea, lymphogranuloma venereum, (congenital) syphilis
Providing an overview on data, trends and summary of findings on the hepatitis B and C surveillance data from EU/EEA countries for the year 2017:
Find ECDC's Annual Epidemiological reports online: http://bit.ly/ECDCAER
HIV transmission remains a major public health concern and affects more than 2 million people in the WHO European Region.
These ECDC slides summarise findings from the report which is available via http://bit.ly/WAD_18
Presentation at European Harm Reduction Conference
Bucharest, 21 November 2018
Author Anastasia Pharris, European Centre for Disease Prevention and Control (ECDC)
What is the current situation of HIV in Europe and Central Asia?
How can we more effectively prevent new infections?
Presentation by Anastasia Pharris,
European Centre for Disease Prevention and Control (ECDC)
at Glasgow HIV Drug Therapy Conference
28 October 2018
Data and trends from the ECDC Annual Epidemiological reports for 2016 on:
Chlamydia (http://bit.ly/AERch16)
Lymphogranuloma venereum (http://bit.ly/AERLGV16)
Gonorrhoea (http://bit.ly/AERsy16)
Syphilis (http://bit.ly/AERsy16)
Congenital syphilis (http://bit.ly/AERcs16)
See also: https://ecdc.europa.eu/en/annual-epidemiological-reports
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These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfJim Jacob Roy
Cardiac conduction defects can occur due to various causes.
Atrioventricular conduction blocks ( AV blocks ) are classified into 3 types.
This document describes the acute management of AV block.
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
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ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
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Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
4. November 20104
Deaths (millions)
< 5 years old> 5 years old
0
0.5
1.0
1.5
2.0
2.5
3.0
3.5
ARI
AIDS
Diarrhoea
TB
Malaria
Measles
Smallpox 1967
Leading infectious causes of death in low-income countries2008 (estimates), with deaths from smallpox, 1967
5. November 20105
Factors that uniquely favoured smallpox eradication
Vaccineheat-stable, inexpensive to manufacture, easy to administer, effective when used within 4 days of exposure, protects with single inoculation, and safe from birth
Clinical diagnosis easy:every infection clinically expressed, characteristic rash distribution
Transmission:mainly face to face by droplet, not through environmental contamination
Immunity: permanent with no carrier state
No animal reservoir:human infection only
6. November 20106
Differential diagnosis of smallpox
SMALLPOX
CHICKENPOX
At time of rash
2–4 days before the rash
FEVER
RASH
Pocks in several stages
Pocks at same stage
Appearance
Rapid
Slow
Development
More pocks on body
More pocks on arms & legs
Distribution
Usually absent
Usually present
On palms & soles
Very uncommon
More than 10%
DEATH
7. November 20107
Smallpox vaccine: an effective, yet imperfect tool1967 vaccination incidents in US alone:
•9 deaths
•4 permanent disabilities
8. November 20108
Smallpox, 1967: endemic in 31 countries or territoriesEndemic
Importation
Status of smallpox 1959
Probably endemic in 59 countries or territories
9. November 20109
Smallpox eradication: field strategies, 1967–1978
Search:
–house to house
–market
–public gatherings/festivals
Containment:
–isolate patient
–vaccinate household members/contacts
–vaccinate 30 neighbouring households
–+vaccinate rest of village/ neighbouring villages
11. November 201011
Simplified containment: smallpox eradication, 1967–1978
Multipuncture vaccination by bifurcated needle
12. November 201012
Contribution for Global Eradication Programme, 1967–1979 (US$ 300 million) Countries/territories that contributed in cash or in-kind to the WHO Special Account for Smallpox Eradication
Additional bilateral support:
Council of Arab Ministers Fund, OXFAM, Tata Iron & Steel,
UNDP, UNICEF … and others
15. November 201015Smallpox eradication:a cost effective decrease in human death and suffering
In 1967
–cost in livesover 1.5 million
–cost to the worldUS$ 1,400 million
–cost for vaccination in USA alone US$ 92.8 million
•9 deaths
•4 permanent disabilities
1967–1979
–cost of eradication:US$ 300 million
USA saves equivalent of its investment in WHO smallpox eradication campaign every 26 days
16. November 201016
Lessons learned: smallpox eradication
Disease eradication saves lives and decreases human suffering; is costly, especially at the end stage when disease occurs among those populations with least access to health care; is of necessity “vertical”; and cannot be completed without strong international partnership
17. November 201017
The Birmingham outbreak of smallpox, 1978: the last human cases
19. November 201019
Lessons learned: smallpox eradication
Disease eradication saves lives and decreases human suffering; is costly, especially at the end stage when disease occurs among those populations with least access to health care; is of necessity “vertical”; and cannot be completed without strong international partnership
As long as live virus exists there is a chance of smallpox transmission to humans
21. November 201021Human monkeypox, 1970–1995
Zoonosis (squirrels)
Sporadic West and Central Africa
72% of cases animal contact / 3% secondary attack rate
3 generations maximum, occurred in 8% secondary outbreaks
Case fatality: 10%
Rare in persons above 15 years of age
22. November 201022
1980: is human monkeypox a threat to smallpox eradication?
Humans with smallpox vaccination appeared protected against human monkeypox infection
Smallpox vaccination discontinued with certification
Reservoir of virus in nature: rodents/monkeys in tropical rainforests West and Central Africa
Sporadic breaches in species barrier between rodents and humans
Secondary/tertiary transmission usually among unvaccinated contacts
23. November 201023
Epidemiological investigation of monkeypox in unvaccinated cohort, West and Central Africa, 1981- 1982
Serosurveys and facial scar surveys in children with no vaccination scar
–Côte d'Ivoire, Sierra Leone, Congo and Democratic Republic of Congo
–children < 15 years of age, verified absence of vaccination scar
10, 653 children without vaccination scar examined, blood specimen obtained
–no serum antibody to orthopox virus detected
–no facial scarring observed
Conclusion: replacement epidemiology not occurring
Source: WHO
24. November 2010 24
0
10
20
30
40
50
60
70
80
Feb
Apr
Jun
Aug
Oct
Dec
Feb
Apr
Jun
Aug
Oct
Confirmed
Suspect
1996 1997
Human monkeypox outbreak, Democratic
Republic of Congo, 1996 – 1997 (N-511)
Source: WHO
25. November 201025Human monkeypox, DRC 1970-2002: possible increase post vaccine cessation
0
50
100
150
200
250
300
350
4001970
1975
1980
1985
1990
1995
2000
Number of cases
26. November 201026
Is human monkeypox epidemiology changing as smallpox herd immunity wanes?
Indice
1970 -1995
1996 -2008
% infections > 15 years
Rare
85%
Index case with animal contact
72%
23%
Secondary attack rate
3%
46%
Transmission chains (generations)
3 generations from 8% of index cases
9 generations from 16% of index cases
Case fatality rate
10%
10%
Conclusion: intensified surveillance must continue
Source: WHO
28. November 201028
Smallpox eradication: the risk continues
Major increase in human monkeypox incidence 30 years after smallpox vaccination campaigns cease in the Democratic Republic of Congo
Anne W. Rimoin,ab1 Prime M. Mulembakani,c Sara C. Johnston,d James O. Lloyd Smith,be Neville K. Kisalu,f Timothee L. Kinkela,c Seth Blumberg,be Henri A. Thomassen,g Brian L. Pike,h Joseph N. Fair,h Nathan D. Wolfe,h Robert L. Shongo,i Barney S. Graham,j Pierre Formenty,k Emile Okitolonda,c Lisa E. Hensley,d Hermann Meyer,l Linda L. Wright,m and Jean-Jacques Muyemben
Source: Proc Natl Acad Sci U S A. 2010 September 14; 107(37): 16262–16267.
Comparison of active surveillance data in the same health zone from the 1980s (0.72 per 10,000) and 2006–07 (14.42 per 10,000) suggests a 20-fold increase in human monkeypox incidence.
Vaccinated persons had a 5.21-fold lower riskof monkeypox as compared with unvaccinated persons (0.78 vs. 4.05 per 10,000)
Improved surveillance and epidemiological analysis is neededto better assess the public health burden and develop strategies for reducing the risk of wider spread of infection .
29. November 201029
Human Immunodeficiency Virus (HIV), first identified in 1981: 2008 estimates
32 million infections living with HIV 2 million deaths
1984: smallpox vaccine cannot safely
be used in HIV-infected persons
30. November 201030
Lessons learned: smallpox eradication
Disease eradication saves lives and decreases human suffering; is costly, especially at the end stage when disease occurs among those populations with least access to health care; is of necessity “vertical”; and cannot be completed without strong international partnership
As long as live virus exists there is the chance of smallpox transmission
The interaction of previously unrecognized infectious diseases may close the window of opportunity to eradicate and/or threaten eradication
31. November 201031
Reports of virus outside WHO repositories 2000: real or perceived threat?
Updated WHO guidance
Industry scaled up smallpox vaccine production
Industrialized countries stockpiled smallpox vaccine/vaccinia immune globulin
Intensified research on new, safer vaccines, anti-virals and diagnostics in USA and Russia
34. November 201034
Lessons learned: smallpox eradication
Disease eradication saves lives and decreases human suffering; is costly, especially at the end stage when disease occurs among those populations with least access to health care; is of necessity “vertical”; and cannot be completed without strong international partnership
As long as live virus exists there is the chance of smallpox transmission
The interaction of previously unrecognized infectious diseases may close the window of opportunity to eradicate and/or threaten eradication
Vaccine stockpiles must be maintained post-eradication: justifying eradication on cost savings from stopping vaccination no longer feasible
36. November 201036
Human monkeypox by date of onset,
Illinois, Indiana, Kansas, Missouri, Ohio
and Wisconsin, 2003
37. November 201037Lessons learned: smallpox eradication
Disease eradication saves lives and decreases human suffering; is costly, especially at the end stage when disease occurs among those populations with least access to health care; is of necessity “vertical”; and cannot be completed without strong international partnership
As long as live virus exists there is the chance of smallpox transmission
The interaction of previously unrecognized infectious diseases may close the window of opportunity to eradicate and/or threaten eradication
Vaccine stockpiles must be maintained post-eradication: justifying eradication on cost savings from stopping vaccination no longer feasible
Research and development of safer vaccines and anti-viral or bacterial drugs must be continued post-eradication/countries must be prepared
A system must be in place for continued surveillance, investigation and containment post-eradication
38. November 201038
Severe Acute Respiratory virus, 2003
Suspected animals in the chain
of transmission
The SARS Coronavirus
41. November 201041Index case for international spread, Hong Kong, 2003
Source: WHO
Global spread of SARS from Chinese medical doctotr,
Metropole Hotel, Hong Kong
43. November 201043
SARS: cumulative number of probable cases worldwideas of 25 June 2003(N = 8 460 cases, 808 deaths)
China (5327) Singapore (206)
Hong Kong (1755)
Viet Nam (63)
Europe: 9 countries (37)
Thailand (9)
Brazil (3)
Malaysia (5)
South Africa (1)
Canada (250)
USA (75)
Colombia (1)
Kuwait (1)
Korea Rep. (3)
Macao (1)
Philippines (14)
Indonesia (2)
Mongolia (9)
India (3)
Australia (5)
New Zealand (1)
Taiwan (686)
Russian Fed. (1)
Japan (1)
44. November 201044Strategies that contained SARS outbreaks, 2003
Case identification (active surveillance)
Case isolation/hospital infection control
Contact tracing
Surveillance/quarantine of contacts
International travel recommendations based on epidemiological evidence
Element of good fortune: did not spread to countries with weakest health systems
46. November 201046
SARS, post-containment cases 2004
Singapore 1laboratory accidentrecovered, no human to 2004human transmission
Taiwan1laboratory accidentrecovered, no human to 2004human transmission
China >4laboratory accident(s) serious illness requiring 2004respirator, human to human transmission, deaths
51. November 201051
No reservoir in nature
Easy-to-administerand effective vaccine
Feasibility of eradication proven in industrialized countries
Up to 600 –1000 asymptomatic infections for each child with paralysis
Polio eradication: scientific basis for eradication
52. November 201052
World Health Assembly Resolution: polio eradication by year 2000
1. DECLARES the commitment of WHO to the global eradication of poliomyelitis by the year 2000;
2. EMPHASIZES that eradication efforts should be pursued in ways which strengthen the development of the Expanded Programme on Immunizationas a whole, fostering its contribution, in turn, to the development of the health infrastructure and of primary health care; FORTY-FIRST WORLD HEALTH ASSEMBLY GENEVA, 2-13 MAYWHA41.28 Global eradication of poliomyelitis by the year 2000
53. November 201053Specialised Reference Laboratory
Regional Reference Laboratory
National/ Sub-national LaboratoryClinical/laboratorysurveillance of acute flaccid paralysis
55. November 201055Routine childhood immunization
Routine childhood immunization in national immunization programmes
High level advocacy and political engagement
56. November 2010 56
Region DPT3
estimate
Type 1
(60%)
Type 3
(90%)
Global 73% 44% 65%
AFR 49% 29% 44%
AMR 89% 54% 80%
EMR 70% 42% 63%
EUR 93% 57% 83%
SEAR 68% 41% 61%
WPR 88% 53% 79%
Weak national immunization programmes
Routine Polio
Coverage, by Region
58. November 201058
2002: 100 countries
2002: 100 countriesNational and subnational camapaigns, polio endemic countries, 2006 -2009
National immunization campaigns
59. November 201059
District infected with wild polio virus type 1
District infected with wild polio virus type 3
District infected with more than one type of wild poliovirusWild Poliovirus infected districts, 10 May –09 Nov 2010
60. November 201060
Circulating Vaccine-Derived Polio Virus, 2000-2010-
-
* circulating Vaccine
-
derived poliovirus (
cVDPV
) is associated with 2 or more cases of AFP.
Cases with less than 10
nt
genetically related to these outbreaks and cases of ambiguous V
accine
-
derived Poliovirus (
aVDPV
) are not reported here.
Figures exclude VDPV from non
-
AFP source. Figures may include different chains of transmission
.
Data in WHO/HQ as of 14 Sep 2010
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
Nigeria
VDPV 2
1
21
68
63
153
11
2-Jul-05
26-Jul-10
Afghanistan
VDPV 2
0
3
10-Jun-10
2-Jul-10
DR Congo
VDPV 2
14
4
5
22-Mar-08
30-Jun-10
Ethiopia
VDPV 3
0
1
5
27-Apr-09
17-May-10
India
VDPV 2
0
15
1
14-Jun-09
18-Jan-10
Somalia
VDPV 2
1
4
0
29-Jun-08
24-Dec-09
Guinea***
VDPV 2
0
1
0
6-May-09
Ethiopia
VDPV 2
3
1
0
4-Oct-08
16-Feb-09
Myanmar
VDPV 1
1
4
9-Apr-06
6-Dec-07
Niger***
VDPV 2
2
28-May-06
3-Oct-06
Cambodia
VDPV 3
1
1
26-Nov-05
15-Jan-06
Indonesia
VDPV 1
46
9-Jun-05
26-Oct-05
Madagascar**
VDPV 2
1
4
3
13-Jul-05
China
VDPV 1
2
13-Jun-04
11-Nov-04
Philippines
VDPV 1
3
15-Mar-01
26-Jul-01
DOR/Haiti
VDPV 1
12
9
12-Jul-00
12-Jul-01
** Madgascar: two different outbreaks (2001/02 and 2005)
*** Niger 2006 and Guinea 2009 cVDPVs are linked to the Nigeria outbreak
Last case
Country
Type
cVDPV
First case
61. November 201061
Laboratory specimens: risk of poliovirus infection after eradication
Polio virus widespread in laboratories throughout the world:
–Known wild poliovirus
–Known Sabin poliovirus
–Potential infectious materials (wild and Sabin poliovirus)
–Wild and Sabin poliovirus used in production of inactivated polio vaccine (IPV)
63. November 201063
Yellow fever (2.0%)
Poliomyelitis (0.0%)
Measles (44.0%)
Neonatal tetanus (11.0%)
Whooping cough (17.0%)
Diphtheria (0.2%)
Haemophilus influenza
type b (26%)
Source: WHO
Mortality from vaccine preventable diseases,
2000, children<15 years
64. November 201064
Measles elimination strategy, 2001
Strengthen routine immunisation system to increase measles vaccination coverage of children 9 months of age
Conduct measles vaccination campaign before season of transmission on annual or less frequent basis
65. November 201065
Evolution of Measles Control Goals
Mortality
Reduction
Regional
Elimination
?
Global
Eradication
Immunization
coverage