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Emerging and Re-emerging Diseases
Which killed more people: WWI (19141918) or the Influenza Epidemic of
 World War I (1914 – 1918) death toll:
 8-10 million worldwide
 1918 Influenza Epidemic death toll:
 40 million worldwide
 ~500,000 US deaths (including 70,000 soldiers)
“There was a little bird
its name was Enza.
I opened the window
and in-flu-enza.”
Influenza Symptoms
 Fever
 Cough
 Sore throat
 Runny or stuffy nose
 Muscle or body aches
 Fatigue
 Headaches
Preparing for next crisis
Influenza Impact
 Flu seasons vary from year to year
 About 20% of US population infected every year
 Higher among susceptible populations
 Three main types of flu virus: Types A, B & C
 Type A causes the greatest morbidity and mortality
 Example: H1N1 (2009 Epidemic)
Influenza Pandemics
 Since the late 19th century, four occurrences of
 1889-1891; 1918-1920; 1957-1958; 1968-1969
 2009; H1N1
 Was that the pandemic for our time??
 Type A cycles every 50-100 years
 What’s different about Type A influenza?
Flu Prevention
 Season cycle in late fall, winter and early spring
 Wash hands frequently
 Has it been eradicated?
 No
 20-33% world’s population is infected with TB
 Majority of the above = “Dormant TB”
 Can be dormant for 30 years
 Only 5-10% will become “active” TB
Pulmonary TB
TB continued
 TB bacteria produces nasal discharge, coughing, sneezing
 Airborne
TB and Oregon
Public Health Concerns
 2-3 million deaths worldwide per year
 Trend: Extensively drug-resistant strains = XDR
 Ex: TB treatment 6-10 months = $900
 Ex: XDR TB treatment = $200,000
 High-end antibiotics given through IV in hospital
Preventing Tuberculosis
 Know your risk
 Higher risk populations: close contact, foreign-born, low-
income or homeless, health care workers, infants, children, and
persons who inject drugs.
 Practice good hygiene
 Methicillin-resistant Staphylococcus Aureus
 Staph bacteria resistant to certain antibiotics called beta-
 Often appears as pustule or boil
 May think of a spider bite at first.
MRSA continued
 HA-MRSA = Health care acquired
 More serious and potentially deadly
 CA-MRSA = Community acquired
 Anyone is at risk
Factors that Facilitate Transmission
Frequent Contact
Compromised Skin
(CDC, 2012)
Contaminated Surfaces
and Shared Items
MRSA in the news…
 Newberg, Oregon…
 High schooler spread MRSA through tattoos, several students
 Mainly spread through unclean needles.
West Nile Virus
 Seasonal epidemic – summer through fall
 Symptoms:
 Most people (about 80%) will have no symptoms
 Approximately 19% will have mild symptoms
 Fever, headache, body aches, nausea, vomiting, swollen lymph nodes
 About 1% of population will become severely infected
 Neck stiffness, stupor, disorientation; may lead to permanent neurological
WNV Prevention
 Avoid mosquitoes!
 Use repellant
 Wear long sleeves
 Avoid being out when mosquitoes are active
 Have good screens on windows
 Beware of standing water
WNV and Community Health
 Communication from health educators is vital.
 Unfortunately, we’re not getting the message out.
 Patient education works!
Also in the news….
 Hantavirus in Yosemite National Park, Summer 2012
 Hantaviruses are a group of viruses carried by some rodents.
 Deer mouse, white-footed mouse, rice rat and cotton rat.
 In every state except Alaska and Hawaii.
 Symptoms: Fever, severe muscle aches,
fatigue, respiratory issues.
Hantavirus prevention
 Hantavirus is spread through the
 Practice good hygiene
 Be careful of mouse / rat
droppings, urine, etc
 Don’t sweep or vacuum