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CH. 10 PART 1 Introduction to Infectious Disease CH. 9 REVIEW (NON-INFECTIOUS DISEASES OF RESPIRATORY AND CARDIOVASCULAR SYSTEMS) Experimental vs. Epidemiological Evidence Experimental Epidemiological • • • Direct causative link between an action (ie smoking) and a disease (ie lung cancer) Two types of experimental evidence linking smoking and lung cancer: – – • Tumor development in humans similar to tumor development in animals exposed to cigarette smoke Carcinogens identified in tar • • • Other examples – – – – – Dogs exposed to filter-tipped cigarettes= no cancer (but still showed pre-cancerous changes) Dogs exposed to non-filtered cigarette smoke developed cancer Smoking machines (simulate inhalation patterns) collect oily, black build up from cigarette smoke and analysis of this tar show carcinogens Carcinogens of tar painted on the skin of mice lead to cancerous growths on the mice Experiments on cells grown in cultures and exposing cells to carcinogens and analyzing behavior and changes • • • • Epidemiology is the study of diseases in populations of humans or other animals, specifically how, when and where they occur can never prove causation cannot prove that a specific risk factor actually causes the disease being studied Can only show that this risk factor is associated (correlated) with a higher incidence of disease in the population exposed to that risk factor Higher the correlation = the more certain the association (but it cannot prove the causation) Data collected about people’s habits (ie smoking) and their health Large groups of people used Researchers look for correlations between smoking and particular disease (such as coronary heart disease) Coronary Heart Disease (CHD) • • • Disease of coronary arteries that supply the heart with oxygenated blood…leads to malfunctioning heart Long term degenerative disease Three forms: – Angina pectoris shortage of oxygenated blood to the heart but NO death of heart tissue; main symptom is sever chest pain during exertion – Heart attack (myocardial infraction) blood clot in moderately large portion of coronary artery; heart muscle dies b/c of no oxygen – Heart Failure blockage of main coronary artery; heart weakens and cannot pump efficiently • • • Leading cause of long-term illness and death in US and EU Affects affluent countries Governments have taken steps to reduce these statistics – Lifestyle changes (exercise, low-animal fat healthy diets, no smoking – Death rates have dropped in last 25 years (reasons unknown) • Finland, US, Australia 1st set of Treatments for CHD • Drugs to lower BP • Drugs to decrease risk of blood clotting • Drugs to prevent abnormal heart rhythms • Drugs to reduce retention of fluids • Drugs to reduce cholesterol concentration in blood 2nd treatment of CHD • Coronary artery by-pass operation • Use blood vessel from chest, arm, or leg to replace diseased vessel • New vessel carries blood from the aorta to another part of the heart(past the blockage) • Multiple by-passes may be necessary • By-pass surgeries increased drastically (3x) in UK in 1980s 3rd treatment of CHD • • • • • • • • • Complete heart transplant Last resort Difficulty finding donors Must have matching tissues (genetic markers) so immune system of recipient doesn’t attack heart Heart-lung transplants more effective than heart only transplants Drugs are taken to suppress immune system (unpleasant side effects) Expensive Decision of who receives hearts (should the person who has continued smoking receive a heart over someone who has listened to their doctor and started living a healthy life style) Primary health care can be used to reduce this expensive cost 1st CHD Prevention: Screening for CHD • Screen population for individuals at risk of developing CHD – High blood pressure – High cholesterol concentration in blood – Heart rhythm during exercise • Doctors can screen on a regular basis – Regular monitoring of blood pressure • Advice given to those at risk to stop smoking, eat healthier, and exercise Prevent CHD by Lowering High BP • Medications – Stanins- drug that lowers blood cholesterol • Reduce salt intake • Diet changes not always successful 2nd Way to Prevent CHD: Healthy Lifestyle • Advertising & Public health education to: – Healthy lifestyle at an early age – Encourage aerobic exercise • Involves changing diet, reducing alcohol intake, and stop smoking • Exercising reduces blood pressure Mortality Rate of CHD and Stroke • Began to decrease in 1970’s • Why? – – – – Decrease in saturated fat and smoking within the population Better emergency rooms in hospitals Improvements in treatments of heart attack patients Maternal nutrition (epidemiological evidence) • Higher birth weight associated with lower blood pressure in middle age people • High weight at age 1 is associated with lower risk of diabetes AND low levels of LDL cholesterol in blood • THEREFORE: – Better maternal nutrition in the early and middle 20th century = better protected later generations – CHD is more common among the low socioeconomic populations that the affluent populations » Think about locations of fast food restaurants in inner cities vs. suburban neighborhoods Disease • Illness or disorder of the body or mind that leads to poor health • Associated with a set of symptoms • Infectious vs. non-infectious • Pathogens – Cause infectious disease/Communicable diseases – Usually microorganisms – Viruses, bacteria, fungi, protists Infectious disease • Caused by pathogens • Short vs. long lived • Spread various ways – Direct contact (pathogen only survives inside human) – Indirect contact (food, water, feces, animals and insects) • Carriers – People that can spread the pathogen while they do not have the disease themselves (or show symptoms of the disease) – Difficult to trace as the source of infection Transmission Cycle • Way the pathogen passes from one host to another • Control methods – Attempts to break transmission cycle by removing conditions that favor the spread of the pathogen – Can only be used when the cause of disease and method of transmission are known and understood • Causative agents – Agents that cause disease – Example of control method: Vaccination • • • • Makes us immune Pathogens cannot live in us Pathogens cannot reproduce Pathogens cannot spread to others Terms to Know • Incidence – Number of people who are diagnosed with a specific disease over a certain period of time (usually a week, month, or year) • Prevalence – The number of people who have the disease at any one time • Mortality – Death rate from a specific disease • Vector – An organism which carries a disease from one person to another or from an animal to a human • Endemic – Diseases that are always in populations – Ex. Tuberculosis (entire human population) – Ex. Malaria (tropical regions) • Epidemic – When there is a sudden increase in the number of people with the disease in a region • Pandemic – When there is a sudden increase in the number of cases of a specific disease throughout a continent or the world Infectious Disease Group Activity Period 1 • Teams of 5 (assigned by teacher) – 4 teams total • Team needs to select a team leader • Each person on your team needs to pick a number 1-5 • Follow Guidelines for Team Session 1 Period 5 • Teams of 5 (assigned by teacher) – 3 teams total – One team will have six people • Team needs to select a team leader • Each person on your team needs to pick a number 1-5 • Follow Guidelines for Team Session 1 Disease JigSaw 1. 2. 3. 4. 5. 6. Cholera Malaria HIV/AIDS Tuberculosis Measles Small pox Information to Discuss and Collect About Each Disease • Pathogen/causative agent – Different strains (if applicable) • • • • • • • • • • • • • • • Type of pathogen Method of transmission Incubation Period Site of Action of Pathogen Global Distribution Method of Diagnosis Signs and Symptoms (Clinical Features) Method of Diagnosis Treatments Prevention Control Efforts of the Disease Annual Incidence Worldwide Annual Mortality World Wide Global Distribution Extra information Relevant to Infectious Disease • Team Session: 10 minutes • • • • Disease JigSaw Meet with your team Select team leader Team leader needs to record the name of each team member and the disease they are covering Team needs to discuss how they will record/share information when they return from their breakout session • Breakout sessions: 25 minutes • All the 1’s, 2’s, 3’s, 4’s, and 5’s will meet together at assigned locations 1. 2. 3. 4. 5. 6. Table 1 Hallway by front door of classroom Hallway by back door of classroom Table 3 Table 5 Front of classroom (desks) – Use various resources; PRIMARY resource is textbook, but you should also use the revision guide, internet, etc. – Figure out the fast strategy to gather the information about the disease within your group • Team Session Part 2: minutes – Each member needs to “TEACH” their other team members about the infectious disease they became an expert in – You will be graded by your team members on how well you present the information to them!