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Lecture 5

ANTC67 – W5.docx

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University of Toronto Scarborough
Larry Sawchuk

ANTC67 – W5 Which of the following statements is incorrect: A passive immunity can protect the infant under six months against all infectious diseases B virgin soil populations are communities which lack herd immunity C with the advent of diphtheria vaccination, croup no longer presents a health concern in all human populations D cholera in Gibraltar in the 19th century shows that cholera mortality was neither homogenous over time nor homogenous at the intra-population level E all the above are true - A is the correct answer. - C is also kind of right, prof worded it wrong Pettenkofer and Snow had similar views on the transmission of cholera. One major difference between the two views is: A The importance of the soil B The importance of SES of the people C The density of the population D The presence of live stock in close proximity to the houses E The amount of rainfall - The right answer is A Lecture Morality Rate in Gibraltar - Your assignment has to have X, Y, and points - You need to have death rate – the straight line tells us that things are declining over time. The average. - The bold lime gives us confidence limits. This is the level of variation that we can expect to see from one year to the next. It is normal 95% confidence. Anything below or above the bold line is considered to be unusual. Statistically we call it an outlier. nd rd th th - There are series of pandemic that struck this location. 2 , 3 , 4 , 5 – 2 of pandemics lie within 95% percentile and 2 outside. That means not all epidemics are homogenous and their impact. Specifically in 1834 and 35 these are considered moments of crisis and mortality. This is significant impact on population on mortality – background mortality. You can see that cholera occurred in 2 other points – 1840 and 50s. But again this was within the norm. Then the last on in 1885 within the norm as well. - When was the cholera discovered? Approx. 1882 or 1883 by Robert Coch. This pandemics occurred before we have firm understanding what was happening in the disease. Epidemic is epidemic but doesn’t mean you have the same level of impact. Cholera Death Rates in Gibraltar 1865 Group Cholera death rate Military 15.6 Civilians 23.3 Convicts 63.5 - Rates expressed per 1000 living - Figures from Sutherland 1867 - We are looking at overtime, then stop time, and look at one particular point and within the community. And the experience is not necessarily the same - There is a difference in 3 communities, and ask yourself why the differences Cholera Death Rates in Gibraltar 1865 By religion Group Population Cholera Deaths Cholera Death Rate Catholic/Anglican 13307 340 25.55 Jewish 1443 12 8.32 - Effects of SES and/or - Talmudic Literature (Jewish law) advising on dietary practices and food hygeien (protective) for example… - If we compared catholic/Anglican and Jewish death rate there is a huge difference - Talmudic Literature  gives part of the answer. - Why is there different? Is this difference statistically significant or coincidental? It IS significant. - Then why are Jews in better health during the cholera epidemic? o SES – better housing, better health o Talmudic *** is various religious groups have different precepts of how we should live our lives. In most religions there is a bible that tells you this is the way you should behave.  Dietary processes – what would be some things you don’t want to consume during cholera epidemic? Seafood and fish from Bacteria water. So for example shellfish should be boiled o Another community that has similar kind of book is Quran, the bible, etc. Influenza 1918 Crude Mortality Rate by Month 3.5 Gibraltar: 1918 vs 1919-22 3.0 1918 2.5 1919-22 2.0 Second Wave 1.5 First Wave Crude mortality per 1000 living 0.5 0Jan Feb Mar Apr May JuneJuly Aug Sep Oct Nov Dec Month - Not in all communities that were not isolated appears to be common universal phenomenon. In 1989 most population went thru at least 2 waves of epidemic of influenza. In some communities 3. - The red dotty line tells you what normal conditions were like in terms of mortality experience during flu periods 1919-22. The baseline you expect in terms of mortality from the flu. You will see that this was dramatically different in 1918. The first waves only had few deaths, so didn’t make people think that much. However there was a huge impact on population in the second wave. Phenomenally significant rise in blue deaths. - In the Silverton assignment we might see something like this. When is death nd occurring? 2 wave is occurring in the fall. In fall it is chilly and rainy – more people are indoors so more people share a space so there could be associated with the seasons. Male crude mortality rate Male Crude Mortality Rate: Gibraltar 1919-22 50 _1918 40 _1919_22 30 20 Mortality rate per 1000 living 10 0<5 10-14 20-24 30-34 40-44 50-54 Age - One of the questions: As you get older a lot of people are dying - During 1918 there was access mortality for 35-39 year old males. That peak was not as high as old people but remarkably different what existed in forehand Female crude mortality rate Female Crude Mortality Rate: Gibraltar 50 40 30 _1919-22 20 Mortality rate 1000 living 10 0 <5 10-14 20-24 30-34 40-44 50-54 Age - Highest mortality is greater in females - Mortality overall lower than male. - Point: Older men and younger women are in greater risk. - Pattern of mortality is not same between male and female - Note: When you are doing 2 graphs, try to keep the graphs the same axis points so they are comparable - W shape in graph - What happens to woman when she is pregnant? Their immune system goes down because they are carrying a child and their immune system is dampened. - Noymer and Garenne looked at the role of turberculosis and got rather famous. Use as the reference for the assignment to the graphs *** Yellow Fever – demographic consequence - Influenza has ability to morph into different forms. I got flu when I got flu last year, because it changes slightly. Periodically you can dramatic shift in antigen influenza and it is completely different. It was like nothing else before. Now we will talk about another virus caused disease yellow fev
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