2. Agenda: Infectious and
Noninfectious Conditions
Introduction to Disease (infectious/noninfectious;
acute/chronic; sanitation and medical care)
U.S. and Global Concerns (resources, poverty,
education, economics, sanitation, medical care)
Acquired and Natural Immunity
Risk Factors and Responsibilities
Dept. of Health and Human Services
Prevention/Treatment
When should you see the doctor?
Patient Rights – Anonymous vs. Confidential
Concerns Today – Diabesity, Bioterriorism
3. Introduction
History of Diseases in the United States
Comparison of U.S. Diseases with other
countries
Evolution of Epidemiology
Changes in Sanitation and Medical Care
Technological advances – our first hospital,
testing procedure for Cardiovascular
Disease, Cancer, cholesterol, diabetes
7. Risk Factors for Disease
If Disease is Contagious…what is the mode
of transmission (direct vs. indirect contact)?
If Disease is Not Contagious…what are the
risk factors (lifestyle, environment, genetics,
individual characteristics)?
What has research discovered about
disease?
Acute versus chronic disease
8. Assessing Your Disease Risks
Risk Factors You Can’t Control
Heredity
Aging
Environmental conditions
Organism resistance
9. Assessing Your Disease Risks
Risk Factors You Can Control (continued)
Stress
Nutrition
Physical activity
Sleep
Drug use
Personal hygiene
13. The Pathogens: Routes of
Transmission
Viruses
Smallest pathogens
Protein structures
Common cold
Influenza
Infectious Mononucleosis
Hepatitis (HAV, HBV, HCV)
Measles
14. The Pathogens: Routes of
Transmission
Other Pathogens
Fungi
Protozoa
Parasitic worms
Prions
15. Responsibilities with Disease
Is the disease contagious? If it is - how do
we prevent the spread? Quarantine? Modify
lifestyle or environment? Genetic testing?
Therapeutic measures?
If the disease is not contagious – how does
an individual control the disease with
medication or food or other means?
Does this individual have any restrictions?
Driving? Pregnancy? Sports? Travel?
16. Dept. of Health & Human
Services
What you may not know and what you should
know.
Your doctor can (and sometimes is required
to by law) report your condition to the Dept. of
Health and Human Services and the DMV
Federal, State and Local Laws vary
17. Prevention/Treatment of
Disease
Infectious Conditions:
1. Identify pathogen
2. Identify mode of
transmission
3. Identify behaviors
responsible for the
spread of the
pathogen
Noninfectious
Conditions:
1. Risk factors
2. Prevention
3. Treatment
4. Therapy (doctor visits,
physical therapy,
psychological care)
18. When is it time to see a
doctor?
Annual check-up –
Routine visit to your
primary care physician
or specialist, dental visit
every 6 months for
cleaning and check-up,
eye doctor, prenatal or
postnatal visits,
dermatologist,
cardiologist, oncologist
New condition – or an
awareness of an
existing condition (i.e.
depression, alcoholism,
yeast infection,
changes in a mole,
chronic or persistent
pain or discomfort
19. Patient – Doctor Relationship
What are your patient rights?
Are you seeing a doctor on a consultation
basis or to receive a prescription? This may
change your rights.
Ask your doctor what he/she has to report to
local, state and federal authorities
20. Health Concerns Today
Lifestyle Diseases (cardiovascular, cancer,
diabesity)
Psychosocial Issues (depression, road rage,
work place violence, domestic violence,
discrimination towards ethnicity,
homosexuality, right to choose)
21. Your Body’s Defenses:
Keeping You Well
Physical and Chemical Defenses
Skin
Enzymes
Body temperature
Linings of the body
22. Your Body’s Defenses:
Keeping You Well
The Immune System: Your Body Fights Back
Immunity
Antigens
Antibodies
Immunoglobulins
Humoral immune response
Cell-mediated immunity
Lymphocytes
23. Your Body’s Defenses:
Keeping You Well
Fever
Rises in temperature can be harmful if extreme
High temperatures can destroy some disease causing
organisms
Stimulates more white blood cell production
Why is it important to allow a fever to
continue, if it isn’t extreme?
24. Your Body’s Defenses:
Keeping You Well
Pain
Response to either direct or referred pain
Most often accompanied by inflammation
Vaccine
Vaccination and T- and B-cell memory
Acquired immunity
Natural immunity
26. Emerging and Resurgent
Diseases
Tiny Microbes: Lethal Threats (continued)
Hantavirus
Bioterrorism: The New Global Threat
West Nile Virus
SARS
HIV/AIDS
27. Noninfectious Diseases
Chronic Lung Diseases
Dyspnea
Chronic obstructive pulmonary diseases
(COPDs)
Allergy-Induced Respiratory Problems
Antigen or allergen
Production of antibodies
Hypersensitive reaction
Release of histamines
29. Noninfectious Diseases Hay Fever
Example of COPD
Asthma
Long-term chronic inflammatory disorder
Blocked airflow to the lungs
Air pollutants, particulates, smoke can trigger an
asthma attack
Most common chronic disease of childhood
#1 cause of hospitalization and absenteeism
30. Noninfectious Diseases
Emphysema
Gradual destruction of alveoli
Difficult to exhale
Victim struggles to take in air
Chest cavity expands over time (barrel-chest)
31. Noninfectious Diseases
Bronchitis
Inflammation of bronchial tubes
Reduced air flow from the lungs
Acute bronchitis – 95% of cases are viral
Chronic bronchitis has a mucous laden cough
Cigarette smoking is often the cause of chronic
bronchitis
32. Noninfectious Diseases
Sleep Apnea
Affects 5% of the general population
Periodic episodes of breathing cessation for 10
seconds or longer
Causes restless sleep, high blood pressure,
sleepiness during waking hours, CVD
Prevention: reduce alcohol use, change sleeping
position, schedule, medicinal interventions
34. Neurological Disorders
Seizure Disorders
Epilepsy
1% of Americans are epileptic
Types of seizures:
Grand mal
Petit mal
Psychomotor
Jacksonian
36. Gender-Related Disorders
Endometriosis
Tends to effect women age 20-40
Symptoms:
Severe cramping
Irregular periods
Fatigue
Painful intercourse
Characterized by abnormal growth and development
of endometrial tissue
37. Digestion-Related Disorders
Diabetes
Pancreas’ role
Diabetes mellitus
Hyperglycemia
Type I
Type II
Gestational diabetes
Risk factors
Controlling diabetes
38. Digestion-Related Disorders
Peptic Ulcers
Lesion or wound in body tissue
Chronic
Occur in the stomach lining or duodenum
Helicobacter pylori
40. Musculoskeletal Diseases
Systemic Lupus Erythematosus (SLE)
Immune system attacks the body
Destroys or injures organs
Low Back Pain (LBP)
80% will experience LBP
41. Musculoskeletal Diseases
Chronic Fatigue Syndrome (CFS)
Feeling tired all the time
Possible psychological roots
Repetitive Stress Injuries (RSIs)
24% of work injuries
Carpal tunnel most common
45. Keys to Reducing STIs
Education
Early diagnosis
and treatment
Prevention
46. Do we effectively teach
sexuality in K-12 schools?
Explain the human body to children in an honest
and informative approach.
Explain the natural hormonal urges for sex, but
also stress the risks and responsibilities.
Your children will undoubtedly observe your
ideology towards sex, relationships, religion and
any prejudice towards other groups
(homophobic, ethnic discrimination, sexual
orientation, etc.). We learn to love and
appreciate from our parents. This is an
awesome responsibility we far-reaching social
47. SEXUAL IDENTITY
Sexual Identity
Gonads
Puberty
Hypothalamus
Pituitary Gland
Secondary Sex
Characteristics
Gender
Gender Roles
Gender Identity
Gender Role
Stereotypes
Androgyny
Socialization
48.
49. Secondary Sex Characteristics
Males
Low pitch voice, facial/body hair, muscular
development
Females
Increase breast and hip size, body/pubic hair
50. Gonads
The reproductive organs (sex organs) in a
male (testes) or a female (ovaries).
Developed at 8 weeks of fetal life.
51. Puberty
The period of sexual maturation. Sequence
of events leading to the development of the
secondary sexual characteristics and fertility.
Age of onset is 10-16 years old with the
hypothalamus, pituitary glands and gonads.
52. Hypothalamus
Control center of brain which signals pituitary
gland with GnRH (gonadotropin-releasing
hormone). Initiates our fertility capability.
65. Candida (Yeast infection)
75% of women get it
Common causes: antibiotics,
menstruation, pregnancy,
diabetes, hygiene, clothing
66. Chlamydia
Pathogen: bacterial
Prognosis: curable
If not treated: infertility
Scaring of the fallopian
tubes and possibly
pelvic inflammatory
disease
Leading cause of
infertility among couples
Women do not have any signs
or symptoms most the time –
Men generally do – so Men
tend to get treated – Women in
general contract infection
easier than men do to surface
area exposed.
Treatment/Prevention
The best type of prevention is
not having sex – however
when you are ready to have
sex – communication is very
important and a visit to the
doctor’s office for STD testing
67.
68.
69. Gonorrhea
Incidence rose 9% in
1998
Milky-white discharge in
men, painful urination
Men – 80% have s/s
Women – 80% don’t
have s/s
Women – slimy yellow-
green discharge from
vagina or urethra
Oral sex – throat infection
Rectal sex
Incidence correlated with
alcohol consumption
Dual therapy with
Chlamydia
Eye infections
70. Primary Syphilis
Pathogen:
Bacteria (Spirochete)
Distinct stages
Any organ may be involved
Primary syphilis –
appearance of small painless
red pustule on skin or
mucous membrane 10 – 90
days after exposure – lesion
may appear anywhere on
body where contact with
pathogen occurred – most
often the anogenital region
This painless red pustule
quickly erodes forming a
painless, bloodless ulcer,
called a chancre, exuding
fluid filled with spirochetes
– heals spontaneously
within 10-40 days.
The secondary stage –
occurs 2 months later –
spirochetes have increased
in number and spread
throughout the body
71. Secondary Syphilis
S/S:
General malaise
Anorexia nervosa
Nausea/fever
Headache/alopecia
Bone and joint pain
Rash that does not itch
Flat white sores in mouth and throat
Highly contagious at this stage – can be spread
by kissing
72. Tertiary Syphilis
Appearance of soft rubbery tumors called gummas that
ulcerate and heal by scaring
Gummas may develop anywhere on the body – eyes,
lungs, liver, stomach, or reproductive organs
Tertiary syphilis may be painless or may be very painful
Tissues and structures of the body may be damaged –
including the CNS, myocardium, valves of the heart may be
damaged or destroyed
The culminating effects may be mental insanity and/or
severe physical disability and premature death
75. Genital Warts
HPV pathogen
Pinkish-white lesions
Raised clusters on
penis or scrotum or
labia, cervix or around
anus
In women this can
cause precancerous
changes on cervix
Treatment/Prevention
Gels, cryotherapy,
surgical removal
Warts need not be
present to infect partner
84. AIDS / HIV
Most devastating infectious disease in the past 80 years
Since 1999 58.6% of reported cases have died
Annual cost $20,000 per person
Annually by public & private $13 billion
AIDS is caused by a virus (HIV) that attacks the helper T cells
of the immune system
People lose the ability to fight off infections
Opportunistic infections – Pneumocystis carinii pneumonia,
Kaposi’s sarcoma, toxoplasmosis within the brain, wasting
syndrome, cervical cancer, recurrent TB
85. Human Immunodeficiency Virus (HIV)
Chronic disease that progressively damages
the body’s immune system
Asymptomatic period ranges from 2 to 20
years
virus can be passed on to others during this time
AIDS is diagnosed when number of CD4 T
cells (helper T cells) falls to certain level or
marker conditions appear
86.
87. The Transmission of HIV
HIV lives within cells and body fluids (blood and blood
products, semen, vaginal and cervical secretions, breast
milk)
Spread in three ways
certain sexual activities
direct contact with infected blood (via needle-sharing
or transfusions)
from infected mother to fetus or through
breastfeeding
89. Treatment and Prevention
No known cure for HIV infection
New drugs can extend life
nucleoside analogs
protease inhibitors
Prevention
making careful choices about sexual activity
not sharing needles
practicing abstinence or using condoms
90.
91.
92.
93. Unintended Pregnancy
First Year of Use
Method – Typical use
Norplant .05%
Male sterilization .15%
Depo-Provera .30%
Female sterilization .50%
Copper T IUD .8%
Progestasert IUD 2.0%
Oral contraceptives 5%
Oral – combination .1%(p)
Oral – progestin only .5%(p)
Spermicides 26% - 6%
Chance 85%
Method – Typical use
Male condom (latex) 14% -
3%
Withdrawal 19% - 4%
Diaphragm w/spermicide
20% - 6%
Sponge 20% - 9%
Cervical cap 20% - 9%
Female condom 21% - 5%
FAM 25%
Calendar alone 9%(p)
Combination of FAM 2%(p)
94.
95.
96.
97.
98.
99.
100.
101.
102.
103.
104.
105.
106.
107.
108.
109. Should a woman be able to obtain an abortion in the
following circumstances? Chapter 7, pg.179
1. Her life is endangered.
2. Her physical health is endangered.
3. The pregnancy was caused by rape or incest.
4. Her mental health is endangered.
5. The baby is physically or mentally impaired.
6. The woman or family cannot afford to raise the
child.
110. Should a woman be permitted to have an
abortion during the following stages of
pregnancy?
Chapter 7, pg.179
1. In the first three months
2. In the second three months
3. In the last three months
111. Views on Abortion
Gallup Organization, 2003
Should a pregnant woman be able
to obtain an abortion in the
following circumstances?
YES
1. Her life is endangered. 85%
2. Her physical health is endangered.
77%
3. The pregnancy was caused by rape or
incest. 76%
4. Her mental health is endangered.
63%
5. The baby is physically or mentally
impaired. 56%
6. The woman or family cannot afford to raise
the child 35%
Health 11 W,F
1pm
Spring 2005
YES NO N/C
1. 76% 18% 6%
2. 76% 18% 6%
3. 82% 12% 6%
4. 65% 29% 6%
5. 70% 24% 6%
6. 41% 53% 6%
112. Views on Abortion
Gallup Organization, 2003
Should a woman be permitted to
have an abortion during the
following stages of pregnancy?
YES
1. In the first 3 months 66%
2. In the second 3 months 25%
3. In the third 3 months 10%
Health 11 wed. night
6:45pm class – YOUR
responses:
YES NO N/C
1. 82% 12% 6%
2. 29% 59% 12%
3. 18% 76% 6%
113. Abortion Risk
Chapter 7, pg.187
Risk of Death
1. Legal abortion
Before 9 weeks 1 in 262,800
9-12 weeks 1 in 100,000
13-15 weeks 1 in 34,400
After 15 weeks 1 in 10,200
2. Illegal abortion 1 in 3,000
3. Pregnancy and childbirth 1 in 10,000
Sources: Hatcher, R.A., et.al., 1998. Contraceptive Technology, 17th rev.ed. New
York: Ardent Media; Carlson, K.J., S.A. Eisenstat, and T. Ziporyn. 1996. The
Harvard Guide to Women’s Health. Cambridge, Mass.: Harvard University
Press.
115. Different Kinds of Love
Liking (intimacy only)
Infatuation (passion only)
Romantic (intimacy and passion)
Fatuous (passion and commitment)
Empty (commitment only)
Companionate (intimacy and commitment)
Consummate (all three elements)
116. Relationships
Chapter 4 – pg.103
1. Cohabitation – About 5% of all American households - 4
million heterosexual couples and 1.5 million gay/lesbian
couples live together. By age 30, half of all men and women
have cohabited.
2. Most Americans will marry sometime in their lives – 75% of
men and women are married by age 30 and 95% by age 65
3. Marriage has been found to be beneficial for both sexes –
lower mortality rates, higher sexual satisfaction and higher
income.
4. More than half of couples who live together marry after 3
years and 75% after 5 years.
5. Cohabiting couples most likely to marry were: women over
the age of 25, the woman had a religious affiliation, and the
woman’s parents remained married during her childhood.
117. Sexually Transmitted
Infections
History
Also called STDs, or venereal diseases
20 known types of STIs
16.2 million cases in 1999 (CDC)
Possible Causes: Why Me?
Moral stigma
Casual attitude toward sex
Ignorance about infections/symptoms
119. Sexually Transmitted
Infections Chlamydia
4 million infected annually
Many display no symptoms
Secondary damage can lead to sterility
Pelvic Inflammatory Disease (PID)
Describes a number of infections of the
uterus/fallopian tubes/ovaries
Can result from untreated infections
Nonsexual causes: excessive douching, substance
abuse, smoking
121. Sexually Transmitted
Infections
Syphilis
Caused by a bacterial organism
Spirochete known as Treponema pallidum
Stages: primary, secondary, latent, late
Treatment: antibiotics (penicillin)
Pubic Lice
“Crabs”
Small parasites which deposit eggs in pubic hair
122. Sexually Transmitted
Infections
Genital HPV
Genital warts
Among most common STIs
Two types: full-blown and flat warts
Tendency for dysplasia, changes in cells that can lead
to precancerous conditions
123. Sexually Transmitted
Infections
Candidiasis (Moniliasis)
Yeast-like fungus caused by Candida albicans
Symptoms: severe itching, burning, swelling
Trichomoniasis
Caused by a protozoan
Half of American men and women carry this organism
Many remain symptom-free
124. Sexually Transmitted
Infections
General Urinary Tract Infections
Sexual transmission
Can also be caused by invading organisms in the
genital area
Herpes
Family of infections
Sores and eruptions of the skin
Genital Herpes: herpes simplex virus
Preventing herpes
125. Sexually Transmitted
Infections
HIV/AIDS
Global health problem
Over 18 million have died of AIDS
14 million struggle with the disease
A Shifting Epidemic
Newly found indicator of virus: drop in CD4s, the
master immune cell
Improved reporting/accuracy
126. Sexually Transmitted
Infections
Women and AIDS
Women > risk with infected partner
Women represented 43% of cases in 2000
Transmission of HIV
Fluid exchange
Engaging in high risk behaviors
Receiving a blood transfusion prior to 1985
Injecting drugs
Mother-to-infant transmission (perinatal)
127. Sexually Transmitted
Infections
Symptoms of HIV
Incubation time varies greatly
Infants and newborns at risk since immune system
not fully developed
For HIV positive adults, AIDS will develop in 8-10
years with no treatment
128. Sexually Transmitted
Infections
Testing for HIV Antibodies
Blood test known as ELISA
Western blot – follows 2 positive ELISA
These tests detect antibodies
Even with antibodies, not all develop AIDS
129. Sexually Transmitted
Infections
New Hope for Treatment
New drugs slow progression of virus
Medication is very expensive
Multi-drug treatment exceeds $20,000 per year
Preventing HIV Infection