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Final

Study Guide for Final

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Department
Health Studies
Course Code
HLTB21H3
Professor
Caroline Barakat

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HLTA01 Notes II
Chapter 12: The Great Pox Syphillis
AKA: the disease of Naples (blamed on Italians), the French disease, the Polish disease, the
Chinese disease, the Spanish disease
Transmission: Thought to be transferred thru infectious chancre (canker)sores in mouth, rash on
skin, high sexual activity, 10-yr oscillation of syphilis epidemics, R =3, need population
Symptoms: fevers, open sores, disfiguring scars, disabling pains in the joints and gruesome
deaths
Diagnosing Syphilis: in chancre stage ± using examination of fluid from lesion, VDRL and RPR
Treatments: mercury (salivation ± produce mass amt of salvia), guaiacum resin (holy wood) from
trees, salvarsan (arsenic), Penicillin, no vaccine, is still present today
Incidence : highest in people exchanging drugs for sex, sex workers, men 5x more than women
2 Main Theories
- Columbian Theory ± brought by Christopher Columbus from America to Spain
o supported by writings of Emperor Maximilian
o skeletal finds ± bone lesions, scrimshaw patterns, saber thickening on lower limbs
of adults, notched teeth in children
o 1493 existed in a milder form, but transmission of the more virulent form
increased as there were social changes ex: sharing clothes, utensils
- Pre-Columbian Theory ± came from animals, originated in Africa and evolved from Pinta
to Yaws to Syphilis to virulent Syphilis
Spirochete Discovered
- spiral shaped bacterium, stained poorly, Treponema Pallidum
- human beings are the only natural host
- other related Treponema = cause relapsing fever and Lyme disease
- very alike gonorrhoea, venereal disease
3 Stages of Syphilis
1) primary stage ± around 21 days after initial contact, painless pea sized ulcer (chancre)
appears at site of spirochete inoculation, can appear lips, fingers, or genitals
o chancre disappears within 4-8 weeks, leaving a small inconspicuous scar
2) secondary stage ± disseminated stage ± usually develops 2-12 weeks after the chancre
stage, highly infectious stage
o this stage may be delayed for more than a year high levels of syphilis antigen,
T.pallidum is present in the blood
o skin rash, blood transfusion is rare can survive no longer than 24-28 hours in
blood bank storage conditions
3) tertiary stage ± latent stage - 2 years, no longer infectious, destructive ulcers (gummas)
appear in the skin, muscles, liver, lungs and eyes, may infect spinal cord and brain
o asymptomatic neurosyphilis, most patients die within 5yrs after showing first
signs of paralysis and insanity
www.notesolution.com
The Tuskegee Syphilis Study
- men left to degenerate under the ravages of tertiary syphilis, medical racism
Catching Syphilis
- Transmission
o primary chancre stage ± spread by active lesions on lips, genitalia or breasts
o secondary stage ± does not last long, infectious skin lesions
o latent stage ± early there are no clinical signs however individual remains
infectious
- Congenital Syphilis - can be transmitted to developing fetus via placenta blood supply
o if mother is treated within first 4 months of pregnancy, fetus will not be infected
o LIVXUYLYHVFKLOGPD\KDYH+XWFKLQVRVWULDGGHDIQHVVLPSDLUHGYLVLRQWHOOWDOH
groove across peg-shaped teeth
Social Reformers:
- viewed syphilis as a breakdown of home, morality and martial fidelity, ascribed to
promiscuity, prostitution and immigration
- was viewed as a punishment for immoral behaviour
3DUUD-point program:
1) Find he cases
2) Treat infected individuals, to prevent spread and reduce virulence
3) Break chain of transmission, tracing and treating sexual contacts
4) Mandatory premarital testing, using Wassermann test
5) Massive Public Education
Chapter 9: Smallpox Virus, the Spotted Plague
History: from domesticated animals, first found in mummified Pharaoh Ramses V had
pockmarks, trade caravans assisted in the spread of smallpox, used in germ warfare
Symptoms: incubation 12- 14 days, headache, fever, chills, nausea, muscle ache and sometimes
convulsions; then leads to characteristic rash (red areas spread into blotches across face and
arms and within hours broke out into seas of tiny pimples, then developed into blistered
heads, then into boils
Death: may occur a few days or a week after the rash appears, complications from secondary
infections, destruction of sebaceous (oil) glands, leaves pockmarks, death highest among
infants, induce abortions in all trimesters of pregnancy
Transmission: inhalation of infected droplet, direct contact or contaminated formites (inanimate
objects, blankets ± up to 2 days), is not zoonotic only exists in humans, spreads more
rapidly during winter in mild climates and during dry season in tropics
Treatment/Vaccination: individuals become immune from previous exposure, variolation, cow
pox vaccination
Genus: Orthopoxvirus, Poxviridae ± also includes cow pox, monkey pox, camel pox, chicken
pox, ectromelia (mouse pox)
www.notesolution.com
2Types:
1) Variola Minor: milder pathogen, 1% death unvaccinated
2) Variola Major: deadlier form, 30% death unvaccinated
o hemorrhagic smallpox aka black pox ± 95% death, extensive bleeding in the skin,
mucous membranes, and gastrointestinal tract
Variolation
- aka inoculation, to grafting from skin or inhaling scabs or rubbing into cut
- Jenner ± vaccine using cowpox
- glyceriQDWHGFDOI¶VO\PSK± shipping of vaccine
- Lady Mary Montague - advertised the practice of inoculation in England,
Vaccine
- does not give lifelong immunity, compared to recovery from smallpox attack
- recipient of vaccine is not infectious to others, death occurs very rarely
Eradication 1977
- no animal reservoirs
- effective methods of preserving vaccine
- vaccine easily administered
- smallpox is the first and only naturally occurring disease to be eradicated by human
intervention
Janet Parker 1978 ± last known person to die from small pox, exposed in a laboratory
Measles
AKA: still occurs in present day UK, Ireland, small fatality rate in industrialized nations
History: origin is unknown, Rhazes (900AD) ± thought they came from same cause, red rash
UHSUHVHQWHGWKHPRWKHU¶VPHQVWUXDOEORRGWKDWDFFXPXODWHVLQZRPEGLVHDVHZDV
ZHOFRPHG³ULGFKLOGRIVR-FDOOHGSRLVRQ´
Symptoms: fever, 3Cs, photophobia, Koplik spots, sore throat, rash, lesions,
Transmission: droplets and direct contact, from 4 days before until 4 days after rash appears,
highly contagious, humans are only host, dependent on a human reservoir,
Treatment: good hydration and good nutrition, vitamin A (blindness), Antibiotics, Quarantine
Vaccine: 1970, lifelong immunity from previous infections, infants protected if mother had
measles during pregnancy, weakened (attenuated-made safe) virus as effective vaccine
- is given in combination with mumps and rubella (MMR), heat and light sensitive, 2 dose
at 12 months and 4-6yrs
Genus: paramyxovirus ± group of viruses contain RNA, infects repiratory epithelium
7KRPDV6\GHQKDP¶V± GHVFULSWLRQRIKLVVRQ¶VDWWDFN
- first to clearly separate measles from small pox
- recognized complications ± cancrum oris (noma-disease destroy tissue around mouth)
and encephalitis (inflammation of brain ± others: influenza, herpes, mumps, rabies, WNV)
www.notesolution.com

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Description
HLTA01 Notes II Chapter 12: The Great Pox Syphillis AKA: the disease of Naples (blamed on Italians), the French disease, the Polish disease, the Chinese disease, the Spanish disease Transmission: Thought to be transferred thru infectious chancre (canker)sores in mouth, rash on skin, high sexual activity, 10-yr oscillation of syphilis epidemics, R =3, need population Symptoms: fevers, open sores, disfiguring scars, disabling pains in the joints and gruesome deaths Diagnosing Syphilis: in chancre stage using examination of fluid from lesion, VDRL and RPR Treatments: mercury (salivation produce mass amt of salvia), guaiacum resin (holy wood) from trees, salvarsan (arsenic), Penicillin, no vaccine, is still present today Incidence : highest in people exchanging drugs for sex, sex workers, men 5x more than women 2 Main Theories - Columbian Theory brought by Christopher Columbus from America to Spain o supported by writings of Emperor Maximilian o skeletal finds bone lesions, scrimshaw patterns, saber thickening on lower limbs of adults, notched teeth in children o 1493 existed in a milder form, but transmission of the more virulent form increased as there were social changes ex: sharing clothes, utensils - Pre-Columbian Theory came from animals, originated in Africa and evolved from Pinta to Yaws to Syphilis to virulent Syphilis Spirochete Discovered - spiral shaped bacterium, stained poorly, Treponema Pallidum - human beings are the only natural host - other related Treponema = cause relapsing fever and Lyme disease - very alike gonorrhoea, venereal disease 3 Stages of Syphilis 1) primary stage around 21 days after initial contact, painless pea sized ulcer (chancre) appears at site of spirochete inoculation, can appear lips, fingers, or genitals o chancre disappears within 4-8 weeks, leaving a small inconspicuous scar 2) secondary stage disseminated stage usually develops 2-12 weeks after the chancre stage, highly infectious stage o this stage may be delayed for more than a year high levels of syphilis antigen, T.pallidum is present in the blood o skin rash, blood transfusion is rare can survive no longer than 24-28 hours in blood bank storage conditions 3) tertiary stage latent stage - 2 years, no longer infectious, destructive ulcers (gummas) appear in the skin, muscles, liver, lungs and eyes, may infect spinal cord and brain o asymptomatic neurosyphilis, most patients die within 5yrs after showing first signs of paralysis and insanity www.notesolution.com
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