HLTB21H3 Study Guide - Final Guide: Toxic Shock Syndrome, Carboxymethyl Cellulose, Sexually Transmitted Infection

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20 Apr 2012
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Chapter 1 – The Nature of Plagues
Peter Turner (commander)
- Attended the American Legion convention in Philadelphia
- Stayed at Bellevue-Stratford hotel
-Two days after the convention, Turner fell ill with a high fever, chills, headache, and
muscle aches and pains dismissed the symptoms as “summer cold”
-Few days later dry cough, chest pains, and shortness of breath, vomiting, and diarrhea.
-With in a week his lungs filled with fluid and pus, and he experienced confusion,
disorientation, hallucinations, and loss of memory
- Died from pneumonia
-Called the Legionnaires’ disease
-Statistical studies of Legionnaires’ disease showed that all who became ill had spent a
longer period of time in the lobby of the Bellevue-Stratford Hotel than those who
remained healthy
-Air was implicated as the probable pathway of spread of the disease, and that the
infection resulted from aspiration of bacteria called Legionella in aerosolized water from
either cooling towers or evaporative condenser
- Aspiration is produced by choking unlike infection caused by inhalation
- Secretions in the mouth get past the choking reflex and, instead of entering the esophagus
and stomach, mistakenly enter the lungs.
- Protective mechanism are defective in older people, smokers, and those with lung disease
- 11,000 documented cases annually in the united Stats and estimates as high as 100,000,
with fatality rate of 15%
- These outbreaks have been traced back to water heaters, whirlpool baths, respiratory
therapy equipment and ultrasonic mister.
Mary Benton
- English composition teaching assistant at UCLA
-Spent the previous day celebrating her 24th birthday, but by evening she was doubling
over in pain every time she went to the bathroom
- Mary is healthy and active and figured that she had an infection or was suffering from
overheating; she became concerned as her symptoms worsen.
-By the time she saw her physician, she had nausea, chills, diarrhea, headache, and a sore
throat. Had high fever, fast heart rate 178 beats/min., and red rash, initially on her thighs
but becoming more diffuse over her face, abdomen, and arms. Her blood pressure had
fallen to 84/50, she had conjunctivitis in both eyes, and her chest x-ray was normal, but
pelvic examination revealed a brownish discharge.
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- Administrated antibiotic, oxygen, and intravenous fluids but none were effective and her
condition deteriorated over the next 48 hours.
-She died of multi-organ failure – low blood pressure, hepatitis, renal insufficiency, and
internal blood clots.
-Found from the vaginal sample, contained the bacterium called Staphylococcus aureus
-Died from TSS (Toxic Shock Syndrome)
-The source of Mary’s infection, and the possibility that it might be spread through the
population as a sexually transmitted disease (STD)
- Starts with vomiting and high fever followed by light-headedness and fainting, the throat
felt fore, and the muscles ached. A day later, a sunburn-like rash appeared, and the eyes
became blood shot. Within 3-4 days, victims suffer confusion, fatigue, weakness, thirst,
and a rapid pulse. This was followed by the sudden drop in blood pressure; if it remained
low enough for a long enough period, circulatory collapse produce shock.
-TSS is a gender specific disease – Female. Linked to the use of certain types of tampons,
especially those containing cross-linked carboxymethyl cellulose with polyester foam,
which provided a favourable environment for the toxin-producing S.aureus. Elevated
vaginal temperature and neutral pH, both of which occur during menses, were enhanced
by the use of these superabsorbent tampons.
- Tampons obstruct the flow of menstrual blood and may cause reflux of blood and bacteria
into the vagina.
SARS
-2003 outbreak of SARS (severe acute respiratory syndrome) had all the element of a
plague panic, curtailed travel and commerce, and economic collapse.
- Began with 64 years old Chinese physician (pt.1) when he traveled to Hong Kong to
attend a wedding and became ill.
-He had a fever, a dry cough, a sore throat, and a headache. Later on he had difficulty in
breathing and went to seek medical attention.
-Given antibiotic, oxygen, anti-inflammatory drugs but none were effective and several
hours later, he suffered respiratory failure and died.
- His brother in law (pt.2), who was in contact with him for only 10 hours later suffered
from the same condition and was hospitalized. He died 3 weeks later.
- Lab test shown that pt. 1 and pt. 2, were negative for the Legionnaires’ disease,
tuberculosis, and influenza.
-3rd SARS case occurred in a female nurse who had seen pt. 1 in the intensive care unit and
4th case was a 72 years old Chinese-Canadian businessman who had returned to Hong
Kong for a family reunion. He stayed overnight in the same hotel and on the same floor as
the Pt.1. Pt. 5 was the nurse who attended Pt. 2, and the pt.6, 7, 8, 9 were either visitors to
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