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VIRUSES OF
                  PUBLIC HEALTH
                   IMPORTANCE
                                          March 2012




                          PUBLIC HEALTH
                “protecting and improving health through education and promotion of
                   healthy lifestyles and research for disease and injury prevention”



Saturday, March 3, 2012
EMERGING INFECTIONS




Saturday, March 3, 2012
EMERGING
                      INFECTIONS
Saturday, March 3, 2012
FACTORS THAT LED
                        TO EMERGENCE
                 • Introduction of the agent into a new host
                          population, originating from:
                          • environment
                          • another host species
                          • variant of an existing human infection
                 • Establishment and further dissemination
                          within the new host population

Saturday, March 3, 2012
FACTORS THAT LED
                     TO EMERGENCE
                 • Microbial adaptation
                  • Mutation
                  • Natural selection
                    • antibiotic-resistant bacteria
                  • Evolutionary progression
                 • Virulence factors
Saturday, March 3, 2012
FACTORS THAT LED
                     TO EMERGENCE
            • Human Susceptibility
             • immune status
             • nutrition
             • age
             • occupation, etc.
            • Human behavior and demographics
             • Affect disease dissemination
Saturday, March 3, 2012
FACTORS THAT LED
                     TO EMERGENCE
            •       Changing ecosystems / land use

                  •       Argentine, Bolivian hemorrhagic fever

                          •   changes in agriculture (grassland to maize) favoring rodent host

                  •       Hantaviruses

                          •   Ecological or environmental changes increasing contact with
                              rodent hosts

                  •       Rift Valley fever

                          •   agriculture, irrigation



Saturday, March 3, 2012
FACTORS THAT LED
                     TO EMERGENCE
            • Economic development
             • Dengue/DHF
               • urbanization favoring mosquito vector
             • Lassa fever
               • urbanization favoring rodent hosts, increasing exposure
             • Rift Valley fever
               • dam building
Saturday, March 3, 2012
FACTORS THAT LED
                     TO EMERGENCE
            • Technology and industry
             • Hepatitis B and C
               • transfusions, organ transplants
             • Influenza (pandemic)
               • possibly pig-duck agriculture facilitating
                          reassortment


Saturday, March 3, 2012
FACTORS THAT LED
                     TO EMERGENCE
            • International travel and commerce
             • Dengue/DHF
             • Ebola, Marburg
                • In Europe and US, importation of monkeys
             • HIV
             • Influenza (pandemic)
             • SARS
Saturday, March 3, 2012
INFLUENZA


Saturday, March 3, 2012
THE BASICS...
              •      Influenza is an acute, viral respiratory infection

              •      When to suspect?

                    •     Fever, chills, headache, aches and pains throughout
                          the body, sore throat which may lead to
                          bronchitis or pneumonia

                    •     Vomiting and diarrhea may also occur

                    •     Many deaths have been attributed to influenza


Saturday, March 3, 2012
3 TYPES




Saturday, March 3, 2012
PANDEMICS
             •       PANDEMIC: world wide spread of infection
                     occurring in many countries simultaneously
                   •      INFLUENZA PANDEMICS: occur approximately
                          every thirty years
                   •      REASON FOR OCCURRENCE: new strain of
                          the virus emerges for which people have no
                          immunity and there are no vaccines available



Saturday, March 3, 2012
Saturday, March 3, 2012
Saturday, March 3, 2012
THE ABILITY OF INFLUENZA
                        TO CAUSE PANDEMICS
                               HA - hemagglutinin

                                       NA - neuraminidase


                                   helical nucleocapsid (RNA plus
                                   NP protein)

                                       lipid bilayer membrane

                                       polymerase complex



                                   M1 protein



Saturday, March 3, 2012
THE ABILITY OF INFLUENZA TO
                   CAUSE PANDEMICS
              •       Haemagglutinin (H)

                    •     attaches the virus to
                          cells and allows the
                          viral envelope to fuse
                          with the cell membrane
                          and enter cells

              •       Neuraminidase (N)

                    •      allow the release of
                          viruses to infect other
                          cells

Saturday, March 3, 2012
ANTIGENIC DRIFT &
                   ANTIGENIC SHIFT




Saturday, March 3, 2012
ANTIGENIC DRIFT &
                   ANTIGENIC SHIFT




Saturday, March 3, 2012
LIFE CYCLE & TRANSMISSION




                              • The virus is spread by
                                inhalation or by direct
                                contact
                              • Reservoirs of infection:
                                primarily humans, but birds
                                and pigs can act as reservoirs
                              • Multiple host status = mixing
                                of flu types




Saturday, March 3, 2012
CONTROL &
           PREVENTION

    • EDUCATION
    • ISOLATION
    • VACCINATION
    • PROPER
            HYGIENE




Saturday, March 3, 2012
VACCINE (H) & CHEMOTHERAPY (N)




Saturday, March 3, 2012
VACCINE (H) &
                   CHEMOTHERAPY (N)




Saturday, March 3, 2012
Saturday, March 3, 2012
DENGUE



Saturday, March 3, 2012
THE VECTOR:
                    Aedes aegypti/albopictus




Saturday, March 3, 2012
INSIDE THE
                 MOSQUITO & INSIDE
                      YOU...




Saturday, March 3, 2012
TRANSMISSION




Saturday, March 3, 2012
PATHOGENESIS
           1.The virus is inoculated into
           humans with the mosquito saliva.

           2.The virus localizes and replicates
           in various target organs, for
           example, local lymph nodes and the
           liver.

           3.The virus is then released from
           these tissues and spreads through
           the blood to infect white blood
           cells and other lymphatic tissues.

           4.The virus is then released from
           these tissues and circulates in the
           blood.


Saturday, March 3, 2012
PATHOGENESIS
         5.The mosquito ingests blood
         containing the virus.

         6.The vir us replicates in the
         mosquito midgut, the ovaries,
         nerve tissue and fat body. It then
         escapes into the body cavity, and
         later infects the salivary glands.

         7.The vir us replicates in the
         salivar y glands and when the
         mosquito bites another human,
         the cycle continues.

Saturday, March 3, 2012
WHY
                          DENGUE
                            HAS
                          EMERGED




Saturday, March 3, 2012
PREVENTION & CONTROL




Saturday, March 3, 2012
HIV


Saturday, March 3, 2012
THE VIRUS




Saturday, March 3, 2012
LIFE
                          CYCLE




Saturday, March 3, 2012
DRUGS FOR HIV ARE
                  BASED ON ITS LIFE
                       CYCLE




Saturday, March 3, 2012
HOW YOU CAN
                            GET IT..




Saturday, March 3, 2012
DISEASE COURSE




Saturday, March 3, 2012
HEPATITIS


Saturday, March 3, 2012
Saturday, March 3, 2012
Saturday, March 3, 2012
Saturday, March 3, 2012
HEPATITIS B



                          HEPATITIS C




Saturday, March 3, 2012
Saturday, March 3, 2012
Saturday, March 3, 2012
Saturday, March 3, 2012
SARS


Saturday, March 3, 2012
THE OUTBREAK
            • In November 2002, highly contagious and severe
                    atypical pneumonia were observed in the
                    Guangdong Province of southern China
            • The virus was spread to Hong Kong in February
                    2003 by a doctor who died 10 days after
                    admission into local hospital = a mysterious
                    death
            • Similar outbreaks occurred at different local
                    communities subsequently

Saturday, March 3, 2012
THE HOT ZONES




Saturday, March 3, 2012
SEVERE ACUTE
                     RESPIRATORY SYNDROME
                             (SARS)

             •       Cause : SARS CoV

             •       Highly infectious

             •       Mainly affects adults

             •       Superspreading events important in transmission
                     process

             •       No reports of transmission occurring before onset
                     of symptoms

Saturday, March 3, 2012
Saturday, March 3, 2012
Saturday, March 3, 2012
NATURAL
                          RESERVOIRS




Saturday, March 3, 2012
TRANSMISSION
                     • Evidence of person to person
                          transmission
                     • Close contact with body fluids
                          (especially respiratory droplets )
                     • Contaminated hands, clothes,
                          equipment; environment may also be
                          important


Saturday, March 3, 2012

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Ph viruses eac for finals

  • 1. VIRUSES OF PUBLIC HEALTH IMPORTANCE March 2012 PUBLIC HEALTH “protecting and improving health through education and promotion of healthy lifestyles and research for disease and injury prevention” Saturday, March 3, 2012
  • 3. EMERGING INFECTIONS Saturday, March 3, 2012
  • 4. FACTORS THAT LED TO EMERGENCE • Introduction of the agent into a new host population, originating from: • environment • another host species • variant of an existing human infection • Establishment and further dissemination within the new host population Saturday, March 3, 2012
  • 5. FACTORS THAT LED TO EMERGENCE • Microbial adaptation • Mutation • Natural selection • antibiotic-resistant bacteria • Evolutionary progression • Virulence factors Saturday, March 3, 2012
  • 6. FACTORS THAT LED TO EMERGENCE • Human Susceptibility • immune status • nutrition • age • occupation, etc. • Human behavior and demographics • Affect disease dissemination Saturday, March 3, 2012
  • 7. FACTORS THAT LED TO EMERGENCE • Changing ecosystems / land use • Argentine, Bolivian hemorrhagic fever • changes in agriculture (grassland to maize) favoring rodent host • Hantaviruses • Ecological or environmental changes increasing contact with rodent hosts • Rift Valley fever • agriculture, irrigation Saturday, March 3, 2012
  • 8. FACTORS THAT LED TO EMERGENCE • Economic development • Dengue/DHF • urbanization favoring mosquito vector • Lassa fever • urbanization favoring rodent hosts, increasing exposure • Rift Valley fever • dam building Saturday, March 3, 2012
  • 9. FACTORS THAT LED TO EMERGENCE • Technology and industry • Hepatitis B and C • transfusions, organ transplants • Influenza (pandemic) • possibly pig-duck agriculture facilitating reassortment Saturday, March 3, 2012
  • 10. FACTORS THAT LED TO EMERGENCE • International travel and commerce • Dengue/DHF • Ebola, Marburg • In Europe and US, importation of monkeys • HIV • Influenza (pandemic) • SARS Saturday, March 3, 2012
  • 12. THE BASICS... • Influenza is an acute, viral respiratory infection • When to suspect? • Fever, chills, headache, aches and pains throughout the body, sore throat which may lead to bronchitis or pneumonia • Vomiting and diarrhea may also occur • Many deaths have been attributed to influenza Saturday, March 3, 2012
  • 14. PANDEMICS • PANDEMIC: world wide spread of infection occurring in many countries simultaneously • INFLUENZA PANDEMICS: occur approximately every thirty years • REASON FOR OCCURRENCE: new strain of the virus emerges for which people have no immunity and there are no vaccines available Saturday, March 3, 2012
  • 17. THE ABILITY OF INFLUENZA TO CAUSE PANDEMICS HA - hemagglutinin NA - neuraminidase helical nucleocapsid (RNA plus NP protein) lipid bilayer membrane polymerase complex M1 protein Saturday, March 3, 2012
  • 18. THE ABILITY OF INFLUENZA TO CAUSE PANDEMICS • Haemagglutinin (H) • attaches the virus to cells and allows the viral envelope to fuse with the cell membrane and enter cells • Neuraminidase (N) • allow the release of viruses to infect other cells Saturday, March 3, 2012
  • 19. ANTIGENIC DRIFT & ANTIGENIC SHIFT Saturday, March 3, 2012
  • 20. ANTIGENIC DRIFT & ANTIGENIC SHIFT Saturday, March 3, 2012
  • 21. LIFE CYCLE & TRANSMISSION • The virus is spread by inhalation or by direct contact • Reservoirs of infection: primarily humans, but birds and pigs can act as reservoirs • Multiple host status = mixing of flu types Saturday, March 3, 2012
  • 22. CONTROL & PREVENTION • EDUCATION • ISOLATION • VACCINATION • PROPER HYGIENE Saturday, March 3, 2012
  • 23. VACCINE (H) & CHEMOTHERAPY (N) Saturday, March 3, 2012
  • 24. VACCINE (H) & CHEMOTHERAPY (N) Saturday, March 3, 2012
  • 27. THE VECTOR: Aedes aegypti/albopictus Saturday, March 3, 2012
  • 28. INSIDE THE MOSQUITO & INSIDE YOU... Saturday, March 3, 2012
  • 30. PATHOGENESIS 1.The virus is inoculated into humans with the mosquito saliva. 2.The virus localizes and replicates in various target organs, for example, local lymph nodes and the liver. 3.The virus is then released from these tissues and spreads through the blood to infect white blood cells and other lymphatic tissues. 4.The virus is then released from these tissues and circulates in the blood. Saturday, March 3, 2012
  • 31. PATHOGENESIS 5.The mosquito ingests blood containing the virus. 6.The vir us replicates in the mosquito midgut, the ovaries, nerve tissue and fat body. It then escapes into the body cavity, and later infects the salivary glands. 7.The vir us replicates in the salivar y glands and when the mosquito bites another human, the cycle continues. Saturday, March 3, 2012
  • 32. WHY DENGUE HAS EMERGED Saturday, March 3, 2012
  • 36. LIFE CYCLE Saturday, March 3, 2012
  • 37. DRUGS FOR HIV ARE BASED ON ITS LIFE CYCLE Saturday, March 3, 2012
  • 38. HOW YOU CAN GET IT.. Saturday, March 3, 2012
  • 44. HEPATITIS B HEPATITIS C Saturday, March 3, 2012
  • 49. THE OUTBREAK • In November 2002, highly contagious and severe atypical pneumonia were observed in the Guangdong Province of southern China • The virus was spread to Hong Kong in February 2003 by a doctor who died 10 days after admission into local hospital = a mysterious death • Similar outbreaks occurred at different local communities subsequently Saturday, March 3, 2012
  • 50. THE HOT ZONES Saturday, March 3, 2012
  • 51. SEVERE ACUTE RESPIRATORY SYNDROME (SARS) • Cause : SARS CoV • Highly infectious • Mainly affects adults • Superspreading events important in transmission process • No reports of transmission occurring before onset of symptoms Saturday, March 3, 2012
  • 54. NATURAL RESERVOIRS Saturday, March 3, 2012
  • 55. TRANSMISSION • Evidence of person to person transmission • Close contact with body fluids (especially respiratory droplets ) • Contaminated hands, clothes, equipment; environment may also be important Saturday, March 3, 2012