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Chapter 1

Chapter 1


Department
Health Studies
Course Code
HLTB21H3
Professor
Caroline Barakat
Chapter
1

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Plagues and Peoples
Textbook: Chapter One The Nature of Plagues
September 28, 2010.
Legionnaires Disease Outbreak Philadelphia 1976
- (1976) Peter Turner, WWII veteran, fell ill following a stay at a hotel in Pennsylvania for a
legionnaires convention.
- Early symptoms: high fever, chills, headache, and muscle ache and pains.
- Later symptoms (a few days later): dry couch, chest pains, shortness of breath, vomiting, and
diarrhea.
- Final symptoms (a week later): lungs filled with fluid and pus, confusion, disorientation,
hallucinations, and loss of memory.
- 221 others legionnaires also became ill and 33 of them including Turner died of pneumonia.
- Pathway of spread of disease: *aspiration* of bacteria (called Legionella) in *aerosolized* water
from AC, while in lobby of the Bellevue-Stratford Hotel.
- Unlike infections caused by inhalation, aspiration is produced by choking. Secretions in the mouth
get past the choking reflex and, instead of going into the esophagus and stomach, mistakenly enter
the lungs. Protective mechanisms that normally prevent aspiration are defective in older people,
smokers, and those with lung disease. The Legionnaires were perfect candidates.
And Now ....
- Since this outbreak, there have been 11,000 documented cases of Legionnaires disease annual in
the US and estimates of 100,000 with a fatality rate of 15%.
- Outbreaks have been traced to water heaters, whirlpool baths, respiratory therapy equipment, and
ultrasonic misters used in grocery stores.
A Few Years Later; Toxic Shock Syndrome (TSS)
- Mary Benton, graduate student and English TA at UCLA experienced great pain every time she
went to the washroom.
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- Her early symptoms: nausea, chills, diarrhea, headache, and a sore throat.
- Her later symptoms: high fever, high HR, red rash initially on thighs but later on face, abdomen,
and arms, low BP, conjunctivitis in both eyes, brown discharge in pelvic examination.
- She died within 48 hours while under care from multiorgan failure low BP, hepatitis, renal
insufficiency, and internal blood clots.
- Bacterium staphylococcus aerus found in vaginal sample.
TSS in General
- Symptoms: vomiting, high fever, light-headedness and fainting, sore throat, muscle ache. A day
later, rash appeared and eyes become blot-shot. Within 3 to 4 days, confusion, fatigue, weakness,
thirst, rapid pulse, skin became cool and moist, rapid breathing. Followed by sudden drop in BP.
- Gender specific disease
- From 1979 1996 in affected 5296 women, average age 22, with peak death rate of 4%.
- TSS caused by superabsorbent tampons that provided elevated vaginal temperature and neutral pH
& because tampons obstruct flow of menstrual blood and may cause reflux of blood and bacteria into
the vagina.
- Such tampons were taken off market and number of death declined dramatically.
Severe Acute Respiratory Syndrome(SARS) Outbreak 2003
- It began in 2003 when a 64 year old Chinese doctor travelled to HK and became ill.
- His early symptoms: fever, dry couch, sore throat, and headache.
- His later symptoms: difficulty breathing.
- He died hours later.
SARS in General
- Over the next four months, 8000 cases and 800 death in 27 countries and every continent.
We Are More Vulnerable than Before
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