lecture 10

L1 0 Plagues w itho ut germ sI nfluenza deficient dise ase s - Hidd en hun ger dise ases - som e date back to the 15 thcentury th - most are spe cific to the 19 century -- time when the germ theory won the battle - one germ, one disease theory Pellagra - Red Plague - red rash on the neck, the body - first described in Ppain in 1735 - pelle agra - Italian for skin rou gh - appe ars first as a skin rash, skin then crusts and peels away Clinical symptoms -- 4 Ds: derm atitis, diarrh ea, dementia, death - 1909 epidem ic in the US, reported in 26 states - 1912 high fatality rat es, 40% in South America - 20 thcentury 3 million cases in the US and 100 000 deaths - belief that pellagra was an infectious disease specific to the poor - by 1939 , evidence established that disease was due to niacin-deficiency (a water soluble B vitamin - vitamin B3) - niacin needed for norm al oxidative metabolism of sugars bread enrichmen t 1943 - less than half of original deaths, 1948 - mandatory enrichment in 22 states Beriberi - White ri ce plague - 1616 as a neurological disord er charac terized by paral ysis of the hands and feet - kakke meaning leg disease - white rice -- observed to be related to an increase in prevalence of beriberi - early 1900s -- Eijkman (Dutch scientist) established that