Emerging and Re-emerging Diseases

Emerging and Re-emerging Diseases

Which killed more people: WWI (1914-1918) or the Influenza Epidemic of 1918? • 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)

Influenza “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 pandemics • 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

Tuberculosis • 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.oregon.gov

Public Health Concerns • 2-3 million deaths worldwide per year • Trend: Extensively drug-resistant strains = XDR TB • 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

MRSA • Methicillin-resistant Staphylococcus Aureus • Staph bacteria resistant to certain antibiotics called beta-lactams. • 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

Frequent Contact Crowding Defense Offense Cleanliness Antimicrobial Use Contaminated Surfaces and Shared Items Compromised Skin Factors that Facilitate Transmission (CDC, 2012)

MRSA in the news… • Newberg, Oregon… • High schooler spread MRSA through tattoos, several students infected. • 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 effects.

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 air. • Practice good hygiene • Be careful of mouse / rat droppings, urine, etc • Don’t sweep or vacuum

Emerging and Re-emerging Diseases