What disease killed 300-500 million people worldwide but has since been eradicated from the human population?

Progression:› Rash› Pus-filled blisters› Disfiguration and/or

blindness› Death rate = 30%

Man with smallpox; Public Health ImagesLibrary. Source: CDC

The first vaccine

Edward Jenner 1749 - 1823

Made with cowpox virus Side effects: red spot, pustules, scabs,

leaves a scar. Fever is common, swelling. Fatal complications are rare:

› 1 death per million vaccines

1967: WHO announces global smallpox eradication program.› Still 15 million new cases a year then

1977: Last reported naturally occurring case in Somalia.› Smallpox is the only disease totally

eradicated in humans

Routine vaccination discontinued in 1972

Vaccines controversial today

Project BioShield Act of 2004

Ring around the rosy,A pocket full of posies,

Ashes… Ashes,We all fall down!

Written in London in 1665

Great fire of London finally killed the rats

The brown rat, house rat, sewer rat, Norway rat = carriers of Bubonic Plague

Gangrene caused by plague

CDC

13 cases reported in Oregon (5 fatal) since 1970.

Mostly spread from fleas of infected rodents.

E. coli normally live in the intestines.› Most strains of e.

coli are harmless› Harmful e. coli are

transmitted through contaminated food, water, or contact with infected person.

Severe stomach cramps

Diarrhea (usually bloody)

Vomiting Fever (low grade)

Treatment / Prevention

42,000 cases reported every year.

Causes diarrhea, fever, abdominal cramps

A result of contaminated food, water, or contact with infected animals.

Caused by Clostridium botulinum bacteria

Rare but serious – causes paralysis if left untreated.

Five types of botulism:› Foodborne› Wound› Infant› Adult intestinal› Iatrogenic

Symptoms include:› Double vision, blurred vision, drooping

eyelids, slurred speech, difficulty swallowing, dry mouth, muscle weakness.

Antitoxin is available for treatment

Proper food handling› Especially in food preservation

› Be wary of dented, bulging cans

Botulism’s not all bad….

Caused by parasite› Transmitted by mosquito

› Once injected into the human, the parasite grows and multiples first in the liver and then the red blood cells.

About 1,500 cases reported every year in the U.S.› From travelers and/or immigrants› Malaria considered eradicated from U.S. in

1950’s. 3.3 billion people diagnosed worldwide

› Thrives in tropical and subtropical areas.

Fever Cough Sore throat Runny or stuffy

nose Muscle or body

aches Fatigue Headaches

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)

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?

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

TB bacteria produces nasal discharge, coughing, sneezing› Airborne

Public.health.oregon.gov

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.

HA-MRSA = Health care acquired› More serious and potentially deadly

CA-MRSA = Community acquired› Anyone is at risk

Contaminated Surfacesand Shared Items

Frequent Contact

Cleanliness

Crowding

Compromised Skin

Antimicrobial Use

(CDC, 2012)

Newberg, Oregon… › High schooler spread MRSA through

tattoos, several students infected.› Mainly spread through unclean needles.

Middle East Respiratory Syndrome Coronavirus› April 2012 – present› Currently under investigation

› SARS-like virus

› Symptoms: fever, cough, shortness of breath

Ebola

Flesh-eating disease

Mad cow

Kissing disease

African Sleeping Sickness

Acne

Ulcer

Bad breath

Giardia

HAV HBV HCV

U.S. Stats 25,000 new infections/yr

43,000 new infections/yr

17,000 new infections/yr

Transmission Ingestion of fecal matter

Contact w/ infectious body fluids

Contact w/ infected blood

Severity Usually no lasting damage, rarely fatal

Most fully recover; Some develop liver disease; ~3,000 die / yr

60-70% develop chronic liver disease; 1-5% will die from liver cancer

Vaccine? Vaccine available

Vaccine available

No vaccine

Symptoms Fever, fatigue, loss of appetite, nausea, vomiting, abdominal pain, joint pain, jaundice

CDC, 2012

Human Immunodeficiency Virus = The cause of AIDS

AIDS = the end-stage of HIV disease

What exactly is HIV / AIDS?› How does it affect the immune system?

About 30-40 million people worldwide are living with HIV› How many of those live in the US?

Approximately 1 million

› Approximately 1 in 5 of them don’t know they have HIV

ELISA, confirmed with Western Blot Positive P24 antigen test Home tests

› Recently approved

The Affordable Care Act of 2010› Reduce number of new

infections› Increase access to care› Reduce HIV-related

disparities

2013 Budget› Estimated $28.4 billion

for domestic and global HIV/AIDS activities

Prevention campaigns

Gonorrhea

Syphilis