Bio 1 lecture

SDJacinto
Institute of Biology, University of the
Philippines, Diliman

Definition
"New, re-emerging or drug resistant infections
whose incidence in humans has increased
within the past two decades or whose incidence

threatens to increase in the near future." [US

Institute of Medicine Report, 1992]

Causative agents..
The fact that many kinds of disease are related to
microorganisms was unknown until the middle of
the 19th Century, by the time of Pasteur.

Doctors often relied on toxic compounds like

arsenic and mercury that could kill bacterial cells,
but were also very harmful to the normal cells of the
infected person.

We learn about the

afflictions of our
ancestors by studying
human remains, art, and
literature.

Head of Pharaoh Rameses V

showing eruptions strongly
suggestive of smallpox

www.collphyphil.org/ emerging_dis/emdsmain.htm

Although many viral diseases

remained unconquered, effective
vaccines prevented some of the
most frightening ones.
The success of antibiotics
after World War II led to the
impression that bacterial
infections could be easily
cured.

The case of poliomyelitis in

England and Wales

Another success story

*January 1, 1967 WHO Intensified Smallpox Eradication
Campaign
Vaccination
Success in 1977

"Infectious Diseases are more easily prevented and

more easily cured than any other major group of
disorders..." ( Harrison's Principles of Internal
Medicine 10th ed., 1983).
Much of the industrialized world basked in a
feeling of invulnerability, assuming that heart
disease and cancer were the major health
problems left to conquer.

*1957-65 WHO Problems with Malaria

Eradication
DDT, Chloroquin, --Malaria control
abandoned by 1974
Problem arising from the solution
DDT pollution
Mosquito resistance,
Chloroquin resistance

Today we view infectious disease with

greater respect. The victories of the past are
seen in perspective with the emergence of
HIV/AIDS and at least 30 other new
infections.
Old foes (tuberculosis, rabies, malaria, and
pneumonia) are evading traditional therapies
and are now on the comeback.
Infectious diseases are the leading cause of
death in the world !!! and the third leading
cause of death in the United States.

1980s = End of optimism

Resurgence of malaria + cholera +
tuberculosis
AIDS ? HIV
+ African diseases: Ebola, Marburg
+ Legionnaires, Toxic Shock Syndrome
+ 36 others since 1980!
Globalisation: SARS

Deadly microbes can now easily infect us

due to

Rapid population increase

Urbanization
Change in lifestyle

Re-emerging disease- Tuberculosis

www.chstm.man.ac.uk/.../ hs2151/lecture-8.htm

Why are they re-emerging?

Microbe: MDR (multi drug resistant) strains
Medicine: Less effective drugs
Public health: BCG vaccine (Bacillus Calmette-Guerin)

coverage down
Infection: Importation by immigrants

Reemerging (Reinventing?) the bubonic

plague

http://en.wikipedia.org/wiki/Black_Death

Effect of plague on population

www.biology.eku.edu/ RITCHISO/317notes3.html

Emerging diseases
Influenza
SARS Severe Acute Respiratory Syndrome
(Feb 2003)
AIDS ( Acquired Immunodeficiency

Syndrome)
Hemorrhagic fever
Lyme disease
E. coli 0157:H7
Bird Flu

Emerging Disease- AIDS

-Caused by lentivirus
-Carries RNA

-Attacks the immune system

-Person dies of opportunistic diseases

www.chstm.man.ac.uk/.../ hs2151/lecture-8.htm

www.wramc.amedd.army.mil/ fieldmed/emerging.cfm

Ebola Reston virus caused severe illness

and death in monkeys imported to
research facilities in the U. S. and Italy
are from the Philippines!!

www.cdc.gov/.../spb/ mnpages/dispages/ebola.htm

Sexually Transmitted Diseases-also caused

by microbes
Bacterial vaginosis
Chlamydia (Chlamydia trichomatis)

Gonorrhea (bacteria Nesseria gonorrhea- in reproductive tract, urethra

of men and women, eyes, mouth, throat, anus)

Human papillomavirus (HPV) most common-types are the wart causing and cancer causing HPV
Pelvic inflammatory disease- (PID) secondary to other STDs-can lead
to serious consequences including infertility, ectopic pregnancy (a
pregnancy in the fallopian tube or elsewhere outside of the womb),
abscess formation, and chronic pelvic pain.
Syphilis- caused by the bacterium Treponema pallidum; called the
great imitator because so many of the signs and symptoms are
indistinguishable from those of other diseases. In 2006, 64% of the
reported syphilis cases were among MSM
Trichomoniasis -caused by protozoan parasite, Trichomonas vaginalis.
The vagina is the most common site of infection in women, and the
urethra (urine canal) is the most common site of infection in men.

Syphilis patients

news.bbc.co.uk

www.clinicalvirology.org

www.adhb.govt.nz

What about cancer?

Xenoestrogens and breast cancer

Organochlorides suspected xenoestrogens
possibly affecting female and male population
(http://www.fwhc.org/health/xeno.htm)

Biological warfare (BW)

Employment of biological agents to produce
casualties in man or animals or damage to

plants.
Human exposure to these agents may occur
through inhalation, skin (cutaneous) exposure,
or ingestion of contaminated food or water.
Following exposure, physical symptoms may be
delayed and sometimes confused with naturally
occurring illnesses.
Biological warfare agents may persist in the
environment and cause problems some time
after their release.

History of BW
BW attack took place in the Black Sea port of Kaffa

(now Feodossia, Ukraine) in 1346. Rats and their

fleas carried disease to attacking Tartar soldiers.
Between 1754 and 1767 when the British infiltrated
smallpox-infested blankets to unsuspecting American
Indians during the French and Indian war.
1932, the Japanese began experiments on human
beings at Unit 731 outside Harbin, Manchuria, China.
At least 11 Chinese cities were attacked with the
agents of anthrax, cholera, shigellosis, salmonella,
and plague, and at least 10,000 died during their
gruesome experiments; reportedly dropped fleas over
China and stockpile anthrax for fragmentation bombs

http://images.google.com.ph/imgres?imgurl=http://english.china.com/zh_cn/culture_history/news/11020710/20070321/imag
es/14000738_2007032111154427107400.jpg&imgrefurl=http://english.china.com/zh_cn/culture_history/news/11020710/20070
321/14000738.html&h=720&w=960&sz=139&hl=tl&start=5&um=1&tbnid=rjugboMsWSLVWM:&tbnh=111&tbnw=148&prev=/im
ages%3Fq%3DUnit%2B731%26um%3D1%26hl%3Dtl%26sa%3DN

US and BW
The United States started an offensive biological

warfare program at Camp Detrick (today Fort Detrick)

in Frederick, Maryland in 1943. Ten years later, the
defensive program began.
In 1969, the U.S. had weaponized the agents causing
anthrax, botulism, tularemia, brucellosis, Venezuelan
equine encephalitis, and Q fever.
These were soon destroyed after President Nixon
unilaterally ended the U.S. offensive biological
warfare program
1972 the U.S. signed the Biological Weapons
Convention stating that it would never develop,
produce, stockpile, acquire, or retain BW agents or
the means to deliver them.

The Black Maria was the first laboratory facility built to

accommodate top secret research. Scientists completed
interior equipment intstallation
www.detrick.army.mil/ cutting_edge/chapter07.cfm

BW in more recent history

By 1991, the Iraqis had weaponized anthrax, botulinum

toxin, and aflatoxin.Fortunately, these were not used

during Desert Shield or Desert Storm. The United Nations
destroyed the final remains of the Iraqi offensive program
in 1996.
in 1995, the Aum Shinrikyo cult, that released sarin nerve

gas in a Japanese subway, was found to possess

rudimentary biological weapons including anthrax,
botulism, and Q fever.
Use of ricin toxins, anthrax

Advantages of Biological Warfare

BW agents can cause large numbers of casualties

with minimal logistical requirements.

Perpetrators can escape long before BW agents
cause casualties, due to the incubation periods of the
agents.
Weapons are easy and cheap to produce and can be
used to selectively target humans, animals, or plants.
The costs of conventional weapons ($2000), nuclear
armaments ($800 M), and chemical agents ($600)
would far outstrip the bargain-basement price of
biological weapons ($1) to produce 50% casualties
per square kilometer (1969 dollars).

Disadvantages of using BW agents

hazards to the user,
their dependence on optimal weather
conditions for effective dispersal,

their possible inactivation by solar irradiation

and other climatic conditions (BW attacks
would most likely occur late at night or early in
the morning when agents would be less likely to
undergo inactivation by ultraviolet radiation).

Diseases/agents

Smallpox (Variola virus)

Anthrax (Bacillus anthracis)
Plague (bubonic, Yersinia pestis)
Brucellosis suis from various animals, flu like
symptoms

Tularemia (Francisella tularensis)-plague like

transmissible via rodents
Botulism caused by potent protein neurotoxins
produced by Clostridium botulinum

What are CDCs doing?

Stockpiling antibiotics to treat infected
people
Coordinating a nation-wide program where
states share information about different
diseases
Creating new education tools and
programs for health professionals, the
public, and the media.

The End