BOD- Mycobacterium tuberculosis

Gram positive, Acid Fast

organism
Worldwide the single
most common chronic
bacterial infection
~1.5 million annual
deaths
Primary postprimary
Vaccination or Diagnosis
(tuberculin test)
Isonicotonic acid
hydrazide-for 9 months!
Epidemiology Part II
 Controls against Reservoirs
Vertebrate reservoirs difficult to control
Hard to vaccinate wild animals
*Book is in error* Control methods are being used
against rabies
Recombinate vaccine-released into the wild!
Insect/arthropod control
Can be done.
Reed, Panama canal
Drain wetlands? Consequences
Insecticides? Consequences
Control of Direct Contact.
There are multiple
ways to control
spread of organisms
SARS brought out the
masks especially in
China, Japan and
even in Canada
 Control
Probably the #1
instrument that has
prevented water born
infections is
Cholera, Dysentery,
Hepatitis, Polio,
Typhoid fever and a
host of other
pathogens are
controlled through
proper hygiene
 Food safety
Food borne diseases still exist, but are
fairly uncommon in the US
Pasteurization of milk and tuberculosis
Proper food preparation in canning and
botulisms
Use of preservatives
Immunization
Smallpox-eradicated
Childhood:
Diptheria,Tetnus,
Pertusus, Measles,
Mumps, Rubella,
Polio
Hepititis B
Tuberculosis
Yellow fever
Girls HPV
 Quarantine
Isolation of infected individuals
Smallpox, Cholera, Plague, Yellow fever,
typhoid fevor,relapsing fever, SARS,
Hemorrhagic fevers

SARS
Chinas answer
Anthrax and how it SAVED lives in America
 Surveillance
Different Agencies.
Worldwide WHO and CDC
USA, CDC
States-some good, some not
Mike Osterholm
 What infectious diseases are
monitored in the US?
~40 bacterial disease, 17 viral, and 4
eukaryotic diseases
Additionally surveillance is also active to
detect Emerging Infections and to monitor
drug resistance forms.
Potential Bioterrorism agents have also
been developed Real-time PCR in
subways etc.
1793
Philadelphia: more than 4,000 residents died from yellow fever.
1832
JulyAug., New York City: over 3,000 people killed in a cholera epidemic.
Oct., New Orleans: cholera took the lives of 4,340 people.
1848
New York City: more than 5,000 deaths caused by cholera.
1853
New Orleans: yellow fever killed 7,790.
1867
New Orleans: 3,093 perished from yellow fever.
1878
Southern states: over 13,000 people died from yellow fever in lower Mississippi Valley.
1916
Nationwide: over 7,000 deaths occurred and 27,363 cases were reported of polio
(infantile paralysis) in America's worst polio epidemic.
.
1916
Nationwide: over 7,000 deaths occurred and 27,363 cases were reported of polio
(infantile paralysis) in America's worst polio epidemic.
1918
MarchNov., nationwide: outbreak of Spanish influenza killed over 500,000 people
in the worst single U.S. epidemic.
1949
Nationwide: 2,720 deaths occurred from polio, and 42,173 cases were reported.
1952
Nationwide: polio killed 3,300; 57,628 cases reported.
1957
Nationwide: an Asian flu outbreak killed 70,000 before it was completely eradicated.
1981Dec. 2005: total estimated cases: 988,376; total estimated AIDS deaths: 550,394
1993-Milwaukee, Wis.: one of Milwaukee's water treatment plants became contaminated
with cryptosporidium and killed more than 100; 403,000 cases reported.
2009
H1N1, also known as Swine Flu, breaks out more than 70 countries. The CDC reports,
22 million Americans had contracted SF, 98,000 required hospitalization, and about
3,900 people died from H1N1-related causes.
2010-California: outbreak of whopping cough causes death ten infant deaths; 9,477 cases.
2012-Nationwide: a meningitis outbreak traced back to contaminated steroid medication
shipped to 23 states killed 36; 500 cases reported.
 Eradication
Smallpox-10 years to eradicate finished
1980
River Blindness (Africa)-Close
Polio-Gone in the Western hemisphere
Rabies- targeted
Leprosy (Hansens disease)-targeted. US
cases in Hawaii and Louisiana
 Traveler Immunizations
A Partial list
Yellow fever (Virus) Tropical/Subtropical
Cholera Central Africa, SE Asia, Malta
Plague Sporadic mountainous locations
worldwide
Hepatitis A-Specific Tropical locations
Hepatitis B-Many locations worldwide
Typhoid fever Many locations worldwide
Emerging & Reemerging Infections
How can there be new Infections?
Changes in Human behavior i.e.. HIV
Changes in Human Technology i.e.. Drug resistance
Change in land use i.e.. Lymes disease, Malaria
Microbial adaptations i.e.. Staph infections
Break down public health i.e.. TB and USSR
Economic development i.e.. SARS
International Travel i.e.. West Nile
Abnormal Natural Disasters i.e.. Cholera outbreaks
Bioterriorism
 Organisms that acquire virulence
factors
Virulence factors-defined
Bacteria infected with phage
E.coli O157 Shigella toxin
Corynebacterium diptheriae- Diphtheria toxin
Bacteria that pick up plasmids
Staph. aureus R factors
Yersinia pestis- coagulase factors
Transposons
Vibrio cholerae -Cholera toxin
 Biological Weapons
What makes a useful weapon?
Easy to store and transport
Easy to grow, relatively cheap
Highly effective, not fastidious
Many potential types
Against Humans
Against Crops
Against Livestock
Against machinery?
 Natural organisms, Smallpox, Anthrax,
Hemorrhagic fevers (Marsburg, Ebola),
Plague

Genetically modified-Enhanced resistance

to antibiotics, enhanced virulence factors
(Smallpox-Ebola), Novel activities
 In 1346, the bodies of
Mongol warriors of the
Golden Horde who had
died of plague were
thrown over the walls of
the besieged Crimean
city of Kaffa
It has been speculated
that this operation may
have been responsible for
the advent of the Black
Death in Europe.[
 2001 was not the first Bioweapon
attack in the US
1984, Oregon- Rajneeshees, followers of
Bhagwan Shree Rajneesh
To win the county election plot
Planned to sicken the population in the
town of The Dalles with Salmonella food
poisoning
Put in Salmonella in drinks, in grocery
foods and 10 restaurant salad bars
700 people got sick