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Lecture

Cholera.doc

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Department
Health Studies
Course
HLTB21H3
Professor
Caroline Barakat
Semester
Fall

Description
Until 19 Century Miasmatists  Believed disease was caused by bad vapors one would have to inhale and that would cause disease  referred to a bad odour from those vapors.  Pettenkofer refused germ theory which was Germ Theory: there was an X factor in the air and Y factor in the soil. The uniting of X and Y caused the disease Contagionist believe… - infection caused by contact with person to person - *focus on the people that supported the contagion theory (names on the slide). * - People didn’t want to believe this theory because it seemed conservatism. It involved quarantining people, which people didn’t necessarily improve of. -Epidemiology  7 pandemics are still ongoing today 1) 1816-1821: cholera spread through out to the world in early 19 century 2) a 1829- 1851: lot happened in social transformation in second pandemic. A lot was done in terms of public health and sanitation measures in general 7) 1961. ongoing up to present day but believes to be the end of the pandemic Map of Cholera 2002-2003  solid blue colors are cases of cholera that came from the region and blue dots are imported cases ie: NA limited to imported cases Graph: Countries/areas reporting Cholera and cases reported by year 1993- 2003(WHO 2004)  1993-2003 1) about over 80 countries reported cholera and this went down by half in 2003 2) right side of axis is the total reported cases There is cyclic pattern of cholera (line graph). Reported Cases 2004-2007 MAP  resurfaced in NA 1) died down in European northern hemispheres 2) differences in southern and central Africa Spatial patterns play a big role in finding the role of cholera in 10 century able to see affects of pandemics through spatial patterns. Map Cholera, areas, reporting outbreaks 2007-2009  areas of outbreaks in 2007 –2009 yellow :outbreaks black: imports outbreaks Much less outbreqks than in 2004-2007 Example of spatial patterns. Slide 7 graph-Number of cases reported in Canada 1995-2004 Not many cases Trends goes down, but for the most part its cyclic Its mostly imported cases of cholera Etiology th  5 pandemic huge outbreak of cholera in Egypt  vibrio cholera was the agent of disease in order for vibro to cause damage it has to be infected with two viruses 1) that gene causes people to excrete fluids out of the body, through diarrhea in order for strain to be effective it needs that gene that causes the diarrhea two viruses needs to be used 1) ABILITY TO enter bacteria 2) the toxin coding virus itself IS important Infection with Cholera  These excretions are sent to the environment and anyone in contact with those microbes are at risk.  NOT restricted to consumptions. People can bathe in the water, but consumption is the most common route.  Microbe tends to live on surfaces  letal not lethat Picture – Slide 10  Cholera is classic example of the epi triad Agent, host ,environment Cholera has an environmental resevoir Microbe sits in biological surfaces, in those bacteria on the slide An imbalance in the enviroment make it available for infection Once environmental conditions change it can either cause 1) more cases 2) or die down the cases Picture slide 11  some kind of contact of occurs or consumption of contaminated waters. Once its inside the host two things can happen. a) gastric barriers allow cholera to come into the system, and produce toxins b) or gastric barrier may stop or kill the villi There believes to be some kind of barrier that has an affect 2) Transfer of viblio, colonize, grow, and if they have the virus that has codes for the toxin, it releases the toxin It is secreted in digestive system, and it gets excreted through diarrhea, and the blood becomes thin As a result one experiences shock, dehydration eventually dies Clinical Manifestation- Less than 10% of ill persons develop typical cholera with severe dehydration is based on current knowledge of cholera before the rate of was a lot higher Symptoms  severe diarrhea Diagnosis and treatment  1880’s they didn’t know how to treat, which caused a worse effect (in readings).  prof thinks its amazing that there are a lot of advances in science and public health from Cholera in 1832******* (1832 is significant) Giving them added liquids helped them. Application of IV helped patients  NOW there is a ORT (oral rehydration salts) and food based ORT Main cause of death is dehydration therefore its treated by rehydration Microbes will eventually die and gastric fluids will do its job, when injected with fluids and salts Antibiotics shows there is a shortening in the diseases and lower intensity, but its not know if its natural or antibiotics help. Underlying causative Factors  urbanization houses were close together, no sewage, not much hygiene  industrialization population growth leading to crowding in cities. They let sewage go into the water and water is used as bathing , drinking and used as sources of water. Through this it makes its way to certain hosts. Incidents were associated with bad hygiene and sanitation problems Water gets into the water systems Social disruption  authoratatives and higher up believed poor people need to get cleaner they blamed the poor people.  poor people believed they were experiments  clergy men blamed the authoritarians and poor people PICTURE shows what happened around graveyard, and poor people thoughtthe bodies were used for science,
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