HLTB21H3 Lecture Notes - Lecture 6: Emerging Infectious Diseases, Epidemiological Transition, Evolutionary Ecology

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25 Nov 2013
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Lecture 6- Oct 24
Anthropogenesis of Disease
Agriculture…and social classes with differential access to resources
Initiating of social classes: people stratified by what they did, relatively
wealth in terms of land, or political influence, their social power, reputation.
etc.
that stratification is significant because it means now that different people
have differential access to resources
Now, everyone tends to have equal access to resources
Social Inequality
Armelagos et a. 2005: 756
Concept of macro parasitism to understand the changing pattern of
inequality: when organisms appropriate others as continuing sources of food
and energy, we can characterize that relationship as parasitism
Social stratification within societies and between them is an evolutionary
strategy that we consider ‘macroparasitism’
Urbanization
Accompanied by disease
Numerous epidemics in Europe from 16th century onward (influenza, plague,
tuberculosis, smallpox, measles, cholera)
Intricately tied to undernutrition, SES, hygiene
Population aggregation
Trade (economic dev.) and travel
Heightened inequality
Demographic Transition
Picture/Graph How disease changed over time (refer to reading)
We can track overtime the major cultural events (Neolithic revolution) and how
we can think of people in relation to the cultural events.
We see greater inequality, creation of elites-> they don’t really exist for the city
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We get a more significant divergence in the wealth
The elite level of health suddenly keeps increasing-> they have most access to
resources (food, health, etc.)
Cities: Toronto has more government jobs so they have higher pay than other
cities
Elites in cities: Cities allow, much more so than in rural areas, allow elites to
gather wealth-> a lot of stuff going on in cities. Cities are trade.
So we DO have a divergence
Cities are able to accumulate wealth
A lot of inequality in Egypt
Pharaoh on top, Vizier, nobles and Priests, Scribes and soldiers,
Craftsmen, Slaves
The Second Epidemiological Transition
Significant decline in infectious disease mortality within developed countries
(coinciding with industrialization, mid-19th century, Europe, N. America)
1. Replacement of the common infectious diseases by non-communicable diseases
and injuries as the leading causes of death
2. A shift in peak morbidity and mortality from the young to the elderly
3. A change from a situation in which mortality predominates the epidemiological
panorama to one in which morbidity is dominant
“Diseases of Modernization”
CHRONIC Non-Infectious DISEASES
Cancer HypertensionHeart DiseaseDiabetes MellitusObesity (adiposity)
Affective Disorders (psychosocial)
DietActivity level Mental stress Behavioural practices Environmental pollution
The Third Epidemiological Transition
Persistence of Chronic Non-Infectious Diseases, Newly Emergent & Re-Emergent
Infectious Disease
Infectious diseases notable for
1) many new diseases causing mortality being detected;
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2) increased incidence and prevalence of previously controlled (re-emergent)
infectious diseases;
3) many re-emergent pathogens evolving into drug-resistant strains
The interaction of:
1) Social change
2) Demographic change
3) Environmental change
4) Microbial adaptation
“Deliberately Emerging Infectious Diseases”
Three categories of Risk for Bioterror Agents:
A) Six most lethal agents (top priority): anthrax (bioterror weapon -. Could
cataastrophicaly kill mills of people; the concentrated anthrax in powder form
which makes is much more dangerous than in its natural form), smallpox, plague,
tularaemia, viral haemorrhagic fevers, clostridial botulinum toxin
B) and C)Agents that include food-borne and water-borne organisms that
incapacitate but usually do not kill
Factors in Disease Re-/Emergence
Interaction of:
1. Social/Economic/Technological change (human behaviour)
2. Demographic change
3. Ecological/environmental change
4. Microbial adaptation and change
5. Breakdown in public health measures and medical malpractice
These are all Anthropogically created.
Anthropogenic Factors in Disease
(Lebarbenchon et al. 2008)
Biological change within human hosts
Biological change among non-human hosts (domesticated and wild):
livestock production, encroachment
Medical interventions (hospital ecosystems, nosocomial infections)
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