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Infectious Disease Control

History - Drug Resistance - HIV

Zachary Green

on 28 September 2012

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Transcript of Infectious Disease Control

Antibiotics The human immunodeficiency virus (HIV) is a retrovirus that infects cells of the immune system, destroying or impairing their function. As the infection progresses, the immune system becomes weaker, and the person becomes more susceptible to infections. The most advanced stage of HIV infection is acquired immunodeficiency syndrome (AIDS). It can take 10-15 years for an HIV-infected person to develop AIDS; antiretroviral drugs can slow down the process even further. HIV/AIDS Transmission 1959 - Man in Africa dies of an unknown disease
1981 - First warning from CDC of opportunistic infections. Known as GRID.
1983 - Recommendations for preventing HIV through sex and blood transfusions released, first reported cases of AIDS in females.
1984 - Robert Gallo discovers HIV, Gaetan Dugas dies.
1985 - At least one HIV case reported from each world region
1987 - AIDS acknowledged in public for the first time.
1989 - Number of AIDS cases reaches 100,000
1994 - AIDS becomes number one cause of death for all americans aged 25-44
1995 - First protease inhibitor, saquinavir, approved by FDA, introducing an era HAART
1997 - AIDS related deaths decline more than 40%
2006 - Concluded that HIV has its origins in African chimps
2009 - Researchers at UNC Chapel Hill decode the structure of the HIV genome History Prevention Tools Antiretroviral Drugs - AZT 1987
Drug Combination Therapy - 1996
The Potential for a Cure - Berlin Patient Treatment Methods Relevance Today Future Plans Reduce Sexual Transmission
Prevent HIV Among Drug Users
Eliminate New HIV Infections
Among Children
Expand Access to Treatment
Eliminate Gender Inequalities
End Stigma and Discrimination (UNAIDS 2011 Political Declaration) Unprotected Sexual Intercourse
Transfusion of Contaminated Blood
Sharing of Contaminated Needles
Mother-to-Child Transmission - pregnancy, childbirth, and breastfeeding (WHO) (WHO Definition) Tuberculosis
(TB) Latent TB: TB bacteria that lives in the body but is not active TB Disease: when TB bacteria is active, it becomes active when the immune system cannot stop the bacteria from growing Only those with TB Disease can infect other people! Types of TB How You Get TB TB is spread through the air
Get TB from being around a person with TB disease of the
lungs or the throat who coughs, sneezes, speaks, or sings
Anyone nearby may breathe it in and become infected bacteria that normally attacks the lungs but can attack any body part such as the kidney, spine, and brain Multi-Drug Resistant Tuberculosis (MDR-TB) Multi-Drug Resistant Tuberculosis Definition: Tuberculosis that is resistant to first line drugs (FLD) Other Types of Drug Resistant Tuberculosis XDR-TB (extensively drug resistant Tuberculosis): Resistant to all First and any of the three Second Line Drugs. XXDR-TB (extremely drug resistant TB) or TDR-TB (totally drug resistant TB): was reported to have been found in 15 patients in Iran in 2009, but those terms have not officially been defined for TB. MDR-TB in The United States There were outbreaks of MDR-TB between 1970-1990
An outbreak of MDR-TB in New York in 1993 caused more notice to be taken not only in the United States, but Globally How MDR-TB is Treated The DOTS approach is used
DOTS (Directly Observed Therapy, Short Course) America -
1.2 million alive
17,000 deaths/year
50,000 new infections/year
Gay and Bisexual Men: 61% Globally -
33.4 million alive
2 million deaths/year
2.7 million new infections
97% new infections in low and middle income countries Gapminder Chart resistance of a microorganism to an antimicrobial medicine to which it was previously sensitive Antimicrobial Resistance http://www.gapminder.org/world/#$majorMode=chart$is;shi=t;ly=2003;lb=f;il=t;fs=11;al=30;stl=t;st=t;nsl=t;se=t$wst;tts=C$ts;sp=6;ti=1979$zpv;v=0$inc_x;mmid=XCOORDS;iid=phAwcNAVuyj1jiMAkmq1iMg;by=ind$inc_y;mmid=YCOORDS;iid=pyj6tScZqmEfbZyl0qjbiRQ;by=ind$inc_s;uniValue=8.21;iid=pyj6tScZqmEe1GaiYJX2qGA;by=ind$inc_c;uniValue=255;gid=CATID0;by=grp$map_x;scale=log;dataMin=194;dataMax=96846$map_y;scale=lin;dataMin=0.0095;dataMax=29$map_s;sma=49;smi=4.31$cd;bd=0$inds= Definition causing treatments to become ineffective and infections to persist. Microorganisms may develop resistance to a single or multiple antimicrobial agents
these organisms are often referred to as multidrug-resistant or MDR strains
some microorganisms have become so resistant that no available antibiotics are effective against them Multidrug-Resistant Microorganisms Mother to Child:
-Test Mother for HIV
-Deliver by C-section
-Use preventative drugs
to prevent transmission through breastfeeding,
like nevirapine
1871 England Joseph Lister experimented with the antibacterial action on human tissue on what he called Penicillium glaucium 1928 England Sir Alexander Fleming discovered enzyme lysozyme and the antibiotic substance penicillin from the fungus Penicillium notatum 1897 France Ernest Duchesne healed infected guinea pigs from typhoid using mold (Penicillium glaucium) 1877 France Louis Pasteur postulated that bacteria could kill other bacteria (anthrax bacilli) Antibiotic resistance in the United States costs an estimated $20 billion a year in excess health care costs, $35 million in other societal costs and more than 8 million additional days that people spend in the hospital Antibiotics should only be used when they would be useful
Do not use leftover antibiotics, or antibiotics that were prescribed to someone else
Finish the entire antibiotic course that was prescribed
Choose narrow over broad spectrum antibiotics when the bacteria causing the infection is known Prevention Infectious Disease Control What is an
infectious Disease? But wait, An infectious disease or communicable disease is caused by a biological agent such as by a virus, bacterium or parasite.
Infectious diseases are the invasion of a host organism by a foreign replicator, generally microorganisms, often called microbes, that are invisible to the naked eye. BACteria Every single person in a room adds 37 million bacteria to the air every hour In 55 minutes for roughly 60 people in class that's 34 million bacteria per person... A total of 2,074,000,000 bacteria Not all bacteria are bad.
But prevention of the disease causing is key. WASH YOUR HANDS! A History 1346 - Bubonic Plague Asia to Europe
1530 - Fracastoro suggests syphilis spreads through intimate contact by seeds, linked also through the air.
1683- Leeuwenhoek through microscope visualized bacteria
1769 - 1st vaccine for smallpox by Jenner
The Germ Theory Late 1800's by Koch & Pasteur
Koch - TB bacteria
Pasteur - Pasteurization
Heating of milk to kill microorganism 1890's Viruses discovered Very Brief Nosocomial Diseases An infection acquired in a hospital by a patient who was admitted for a reason other than the infection. •Complications from nosocomial infection affect over 1.4 million people around the world.
•Consequences of these infections include: Increased length of stay at hospital
Increased financial burden on patients, family, employers, and government
Increased use of drugs for treatment
Need for isolation
DEATH 1870 England Sir John Scott Burdon-Sanderson observed that culture fluid covered with mold did not produce bacteria 1875 England John Tyndall explained antibacterial action of the Penicillium fungus to the Royal Society Actinomycosis
Adenovirus Infection
Allergic Bronchopulmonary Aspergillosis (ABPA)
Amoebic Dysentery
Antibiotic-associated Colitis-C Difficile
Athlete's Foot
Atypical Pneumonia (Mycoplasma and Viral)
Avian Influenza
Bacterial Endocarditis
Bacterial Meningitis
Bacterial Vaginosis
Botulinum Toxin
Cat Scratch Fever
CMV Infection
Cold Sores
Colorado Tick Fever
Common Cold
Congenital Syphilis
Dengue Fever
Diabetic Foot Ulcer
Eastern Equine Encephalitis
Ebola Hemorrhagic Fever
Erythema Infectiosum
Genital Herpes
Genital Warts
Group B Streptococcal Disease
Hand, Foot, and Mouth Disease
Hantavirus Infection
Herpes Simplex 1
Japanese Encephalitis
Jock Itch
Legionnaire's Disease
Lyme Disease
Methicillin-Resistant Staph Infection Molluscum Contagiosum
Mosquito-Borne Viral Encephalitis
Neonatal Sepsis
Pandemic (H1N1) 2009 Influenza
Peritonsillar Abscess
Plantar Warts
Pneumocystis Pneumonia
Respiratory Syncytial Virus
Rheumatic Fever
Rocky Mountain Spotted Fever
Scarlet Fever
Seasonal Influenza
Septic Arthritis
Septic Shock
St. Louis Encephalitis
Strep Throat
Tinea Capitis
Tinea Nigra
Toxic Shock Syndrome
Traveler's Diarrhea
Typhoid Fever
Urinary Tract Infection
Urinary Tract Infection UTI
Urinary Tract Infections In Childhood
Vancomycin-Resistant Enterococci Infection
Viral Gastroenteritis
Viral Meningitis
Viral Pharyngitis
Viral Upper Respiratory Tract Infections
West Nile Virus
Western Equine Encephalitis
Whooping Cough
Yellow Fever A few infectious diseases... The best treatment is often on a case by case basis. (isoniazid, rifampicin, fluoroquinolone, amikacin, capreomycin, kanamycin) The World Health Organization calls for all countries to have proper diagnosis and treatment plans as well as accessibility to Second Line Drugs
The WHO also requests the Second Line Drug use be strictly enforced to prevent the future issues with TB strains mutating further What Should Be Done Through Sexual Contact:
-Get tested regularly
-Use protection such as condoms
Through Exchange of Blood:
-Only receive injections from reliable sources
- Always use a new sterile needle Eww! (What we're wearing.)
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