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Chapter 1

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University of Toronto Scarborough
Health Studies
Caroline Barakat

Chapter 1 – The Nature of Plagues Peter Turner (commander) - Attended theAmerican 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 24 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. - 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. Aday 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. rd - 3 SARS case occurred in a female nurse who had seen pt. 1 in the intensive care unit and 4 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 the hospital or nurses who had attended pt. 4. Pt. 10 shared the same hospital room with pt. 4 for 5 days. - In less than a month, 10 pt. had SARS, six whom survived (3,4,6,8,9,10) and four whom died (1,2,5,7) - Over the next four months, the SARS survivors sowed the seeds of infection that led to more than 8000 cases and 800 deaths in 27 countries, representing every continent. - We live in an age when diseases appear to have minimal effects – we are immunized children, we treat illness with effective drugs and antibiotics, and we are well nourished. Thus, our impressions of how disease can affect human affairs have been blunted. - This, however, is an illusion: the sudden appearances of SARS, Legionnaires’disease, TSS andAIDS are simply the most recent examples of how disease can affect society. - New and old disease can erupt as spread throughout the world more quickly because of the increased and rapid movements of people and goods. (such as plans, trains, fast moving ships) - New diseases may be related to advances in technology: TSS resulted from the introduction of “improved” menstrual tampons that favoured the growth of a lethal microbe and Legionnaires’disease was the result of the growth and spread of another deadly “germ” through the hotel’s air-conditioning system. Living off Others - The “germs” that caused SARS, Legionnaires’disease, and TSS are PARASITES - Parasites organisms that grows, feeds, and is sheltered on or in a different organism and that does not contribute to the survival of its host. - Some are unable to survive on their own and require another living being got their nourishment. - Aka “feed at the table of the riches” - They obtain the resources needed for their growth and reproduction. - Parasitism is the intimate association of two different kinds of organisms (species) wherein one benefits (the parasite) at the expense of the other (the host), and as a
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