导图社区 【英文】部分媒介传播、水传播、食物传播、空气传播的传染病和其他非传染性疾病等公卫知识总结
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【英文】部分媒介传播、水传播、食物传播、空气传播的传染病和其他非传染性疾病等公卫知识总结
这个思维导图是为了我的大学的一节公卫基础课的期末考试做的，大部分是老师摘自WHO和美国CDC的内容，因为是赶工做出来的有些粗糙请多多包涵~ 以及，竖屏或电脑查看更佳~
编辑于2023-05-09 06:44:09- 美国
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SPHU1020
Vector-borne Diseases
Vector: a living organism that transmits an infectious agent from an infected animal to a human or another animal
Mechanical
Transmits microbes passively
e.g. flies, fleas
Pick up infectious agents on the outside of their bodies and transmit through physical contact
Biological
Essential part of the microbe life style
e.g. mosquitoes, ticks
Carry pathogens that can multiply within their bodies and be delivered to new hosts, usually by biting
VBD: diseases spread by anthropoid or small animal vectors
Types of VBD transmissions
Human-vector-human
Anthroponotic infections
Malaria
Dengue
Yellow fever
Zika
Single-stranded RNA virus
No vaccine
Treatment
Rest, drink fluids, take analgesics
Transmission
Mosquito bites
Sexual transmission
Vertical: mother-to-child
Anthroponoses
Humans only host
Few vector species
Nidus - at or in the home
Animal-vector-human
Zoonotic infections
Lyme disease
Prevention
No vaccine
Wear clothes that cover exposed skin, avoid areas with high grass, and if bitten, remove the tick quickly
Hantavirus disease
Chagas disease
Neglected Tropical Disease: occur in areas where poverty is the most significant factor for their occurrence
Pathogen: protozoan parasite Trypanosoma cruzi
Vector: triatomine
Feed on the blood of humans and animals
Transmission
Vectorial
Triatomines suck the blood of humans when asleep. The feces contain the parasite that enters the body when people scratches
Mother-to-child (vertical)
Transfusion, transplant
Contaminated food and drinks
In US: mostly in the South
Phases of Chagas
Acute Phase
IgM
Chronic Phase
IgG
Reactivation if immunosuppressed
(most) Arboviral disease
Plague
Pathogen
Yersinia pestis
Types
Septicemic plague
Infection of bacteria in the blood
Pneumonic plague
Pneumonic symptoms
Can be transmitted from human to human
Bubonic plague
Infection of lymph nodes
Transmission
Rats carry bacteria, fleas are vectors that transmit to humans
No vaccine
Treatment
Antibiotics
Zoonoses
Basic transmission cycle among a variety of vertebrate and vector species
Humans and some domestic animals are tangential and usually dead end hosts
Nidus - at or away from the home
VBD dynamics
Susceptible population
Migration (forced)
Vector environment
Vector
Survival, lifespan
Reproduction, breeding patterns
Biting behavior
Pathogen
Survival
Transmission
Replication in host
Mosquito Transmitted Pathogens
Arboviruses (arthropod-borne)
transmitted by anthropoid vectors, most commonly by insects such as mosquitoes and blood-feeding flies, or arachnids such as ticks
Arbovirus transmission cycle
Flaviviridae
Positive, single-stranded RNA, enveloped viruses, mostly transmitted by mosquitoes and ticks
Yellow Fever
Zika
Tick-borne encephalitis
Japanese encephalitis
West Nile Virus
Epidemiology
Detected in bird species (crows, jays)
Reporting and testing dead birds: check for WNV in the environment
Most spread to people by the bite of a infected mosquito
Cases occur during mosquito season: summer, fall
No vaccines, no medications
Symptoms
4/5 no symptoms
1/5 develop fever, headaches, body aches, joint pains, vomiting, diarrhea, rash, etc.
Mostly recover completely, but fatigue and weakness can last for weeks/months
1/150 develop a serious, fatal illness
Prevention
Using insect repellent
Wearing long-sleeved shirts and long pants to prevent mosquito bites
Dengue Virus
Virology
4 serotypes: DENV-1 to DENV-4
Enveloped viruses
Single-stranded RNA virus
Epidemiology
Endemic in tropical and subtropical climates
Transmitted by bites from mosquitoes
Dengue Fever
Pathogenesis
1 Fusion
2 Diassembly
3 Viral replication
4 Viral assembly
5 Maturation and Release
Symptoms and Phases
Febrile Phase
Symptoms usually begin at day 4-7
Last 3 - 7 days
Fever
Sudden onset
High-grade (>38.5 degrees Celsius)
Headache, retro-orbital pain, myalgia, arthralgia, nausea, vomiting, diarrhea, abdominal pain
Children: at risk for febrile seizures
Dengue Hemorrhagic Fever/Dengue Shock Syndrome
Blood vessels become damaged and leaky
Platelets in bloodstream drop
Warning signs: severe abdominal pain, persistent vomiting, marked change in temperature (from fever to hypothermia), hemorrhagic manifestations, or change in mental status (irritability, confusion, or obtundation)
Can lead to shock, internal bleeding, organ failure and even death
Early signs of shock, including restlessness, cold clammy skin, rapid weak pulse, and narrowing of the pulse pressure
Treatment
Drink plenty of fluids, get rest
Antipyretics: control temperature
Avoid aspirin and other nonsteroidal, anti-inflammatory medications: increase risk of hemorrhage
Mosquito transmitted parasites
Malaria
Epidemiology
~200 mil new infections per yr
0.5 mil deaths per yr
Endemic in all tropical regions
Mortality: 1-5% (children<5yr)
Multiple infections during lifetime
Climate impacts
Human
Particularly vulnerable: children, pregnant women
Vector
Anopheles mosquitoes
Pathogen
Parasite plasmodium falciparum/vivax
Environment
Temperature
Water availability
Humidity
Prevention Measures
Mosquito Control
DDT spraying
Carcinogenic, increase the risk of breast cancer
Integrated mosquito management (IMM)
Mosquito surveillance
Remove places where mosquitoes lay eggs and larva
Larvicide: kill larvae in standing water
Control adult mosquitoes
Monitor control efforts
Insecticide treated bed nets (ITNs)
Foodborne Infectious Diseases
Virus
Norovirus
Only infect human hosts
Hepatitis A
Vaccine available
Bacteria
Salmonella
Treatment
Most people do not need treatment; only for severe cases
Clinical forms
Gastroenteritis
Septicemia
Enteric fevers
Escherichia coli (E. coli)
Shiga toxin-producing E. coli (STEC)
Enterotoxigenic E. coli (ETEC)
Diarrheagenic E. coli
Listeria monocytogenes
Clostridium
C. botulism
Rod-shaped bacteria
Treatment
Antitoxin
C. perfringen
Campylobacter
Staphylococcus aureus
Protozoa
Toxoplasma gondii
Cryptosporidium
Giardia
Waterborne Infectious Diseases
Clean Water
Safely Managed Drinking Water:
use of an improved drinking water source that is located on premises, available when needed and free from fecal and priority chemical contamination. (WHO)
Access to Water:
Quality
Quantity
Proximity
Reliability
Cost
def. caused by ingestion of water contaminated by human or animal faeces or urine, which contain pathogenic microorganisms
Diseases related to water
Water-Borne Diseases
Diarrheal Water-Borne Diseases
Pathway:
def. >=3 loose or liquid stools per day, or more frequent than normal for the individual
3 Clinical Types of Diarrhea:
Acute watery diarrhea
Last several hours/days
Acute bloody diarrhea
dysentery
Persistent diarrhea
lasts >=14 days
Etiological Agents of Diarrheal Infectious Diseases
Bacteria
Escherichia coli
Salmonella spp.
Vibrio cholera
Biology
gram negative
curved rod
Pathogenesis
Short incubation period: 2hrs-5days
1. Enters mouth with fecally contaminated food or drink
2. Attaches to the epithelial cell of the small intestine
3. V. cholerae toxin enters the cells and prevents them from the regulated toxin enters the cells and prevents them from the regulated secretion of water and electrolytes
4. The epithelial cells pump water and electrolytes from the blood into the intestinal lumen, causing watery diarrhea.
5. Shock and death occur because of fluid loss from the circulatory system unless the fluid can be replaced
6. The bacteria exit the body with the feces
Epidemiology:
~80% infected are asympomatic
Bacteria are present in their feces for 1-10 days
Symptomatic patients:
80% mild/moderate
~20% develop acute watery diarrhea with severe dehydration
Prevention
Water filtration
3 oral vaccines available (not FDA approved)
Treatment
Oral Rehydration Treatment (ORT): 80% effective
Dukoral, SanChol, Euvichol-Plus/Euvichol: 60% effective
Protozoa
Crystoporidium parvum
Giardia duodenalis
Entamoeba hystolitica
Non-Diarrheal Water-Borne Diseases
Water-Washed Diseases
Water-Based Diseases
Water-Related Insect-Vector Diseases
Airborne Infectious Diseases
def. illnesses spread by tiny pathogens in the air
Common Cold
Rhinoviruses
Upper Respiratory Tract
proliferates in temperatures of 33-35 °C (temp. found in the nose
Epidemiology
Seasonal peaks of incidence: early fall (Sep-Nov), spring (Mar-May)
80% of common cold may be associated with rhinovirus infection
Symptoms:
stuffy or runny nose, sneezing, coughing and a sore throat. Less common, mild fever, weakness, a headache and aching joints.
Adenoviruses
Upper and Lower Respiratory Tract
Non-enveloped
Icosahedral (20) nucleocapsid
Contain a double-stranded DNA genome (linear dsDNA)
Symptoms:
common cold or flu-like symptoms, fever, sore throat
acute bronchitis (inflammation of the airways of the lungs, sometimes called a "chest cold")
pneumonia (infection of the lungs)
pink eye (conjunctivitis)
acute gastroenteritis (inflammation of the stomach or intestines causing diarrhea, vomiting, nausea and stomach pain)
Contagious after symptoms start to show
Respiratory Syncytial Virus (RSV)
Symptoms
show symptoms within 4-6 days after infected
usually appear in stages
Runny nose, Decrease in appetite, Coughing, Sneezing, Fever, Wheezing
In very young infants: irritability, decreased activity, and breathing difficulties
Almost all children have an RSV infectious by 2yrs old
Influenza
def. a respiratory disease caused by an enveloped RNA (ribonucleic acid) virus
Pathogenesis:
H (hemagglutinin) spikes attach virus to epithelial cells of respiratory mucosa and aid in viral entry into these cells
N (neuraminidase) spikes play a role in release of new virions
H and N proteins: capable of rapid evolutionary change
Lock-and-key arrangement of antigen and antibody
Biology:
Infects humans and other species
Symptoms: cold-like, headache, high fever, muscle pain, severe cough, and congestion
Highly infectious, R0=2
3 Types of Influenza Strains
Influenza A
Causes epidemics and pandemics
Infects animals, birds, humans, etc.
Influenza B
Less severe
Causes epidemics
No animal reservoir
Influenza C
Causes mild respiratory illnesses in humans
Prevention
Vaccine
Hand hygiene
Respiratory hygiene
Cleaning and disinfection of contaminated objects/surfaces
Physical barriers
Use of personal protective equipment (PPE ) in some settings (e.g., healthcare)
Treatment
Influenza antiviral drugs
Block influenza neuraminidase activity
Must be taken within 48 hours after symptoms to reduce severity of illness
Zanamivir (Relenza), Oseltamivir (Tamiflu), Peramivir
Airborne Viral Diseases
SARS
MERS
Chickenpox
Measles/Rubella
Pathogen
Measles virus (MeV) RNA Paramoxyvirus
Highly contagious (R0~12-18)
Transmission
Direct: Respiratory droplets
Prevention
Vaccination
Mumps
Hantavirus
Airborne Bacterial Diseases
Pertussis/Whopping Cough
Streptococcal Infections
Diphtheria
Tuberculosis
Airborne Fungal Diseases
Histoplasmosis
Non-Communicable Diseases
Characteristics
Complex etiology (causes)
Multiple risk factors (Several Determinants of health)
Long latency period
Non-contagious origin (non-communicable)
A prolonged course of illness
Functional impairment or disability
Measurement of health
Years of Life Lost (YLLs)
Disability Adjusted Life Year (DALY)
= YLL + YLD (Years Lived with Disability)
Cancer
Cardiovascular Diseases
Nutrition
def. Food, vitamins, and minerals that are ingested and assimilated into the body
Metabolism
Process of using food molecules as energy sources and as building blocks for our own molecules
Catabolism
Break's food molecules down, releasing their stored energy; oxygen used in catabolism
Anabolism
Builds food molecules into complex substances
Substrate Metabolism: Glucose
Brain must be continuously supplied
Liver
Glycogenolysis
Glycogen breaks down
Gluconeogenesis
Formation of glycogen in liver
Adipose tissue
Lipolysis
Metabolic flexibility
Ability to switch rapidly between substrates
Blunted shifts linked to insulin resistance
Hormonal Control
Insulin
Produced by beta cells of the pancreatic islets; It regulates the metabolism of carbohydrates, fats and protein by promoting the absorption of glucose from the blood into liver, fat and skeletal muscle cells
Glucagon
Controlling blood glucose levels. Produced by the alpha cells, in the pancreas, from where it is released into the bloodstream
Response to Environmental Stressors
Adrenaline
Epinephrine
Cortisol
Important role in helping the body respond to stress
Macronutrients
Nutrients consumed in large quantities
Consumed to obtain essential nutrients
Diet with lowest rates of chronic disease
10 – 35% of calories come from protein
20 – 35% from fat
45 – 65% from carbohydrates
1. Carbohydrates
Monosaccharides: basic unit
Sugar and starches
Dietary fiber (digestion and maintain regularity)
Indigestible polysaccharides
Soluble (lower cholesterol level) and insoluble
2. Protein
Amino acids
Structure
Nine essential amino acids can no be synthesize in the body:
histidine, isoleucine, leucine, lysine, methionine, phenylalanine, threonine, tryptophan and valine.
3. Fatty Acids
Types and categories
Short, medium, or long (# of carbons)
Saturated or unsaturated
Trans-fatty acids (trans fats)
Disease risk
Function
Concentrated source of energy
Component of cell membranes and signaling
Micronutrients
1. Vitamins
13 essential
Vitamin A
Deficiency leading cause of blindness
Signs: night blindness
Retinol used by rods in retina
Dairy products, carrot or bright colored vegetables
B vitamins (thiamine, riboflavin, niacin, pantothenic acid, biotin, vitamin B-6, vitamin B-12 and folate)
Vitamin C
Vitamin D
Vitamin E
Vitamin K
2. Minerals
Inorganic elements
Categories
Major minerals:
sodium, potassium, chloride, calcium, phosphorus, magnesium and sulfur
Trace minerals:
copper, manganese, fluoride, selenium, chromium and molybdenum.
Iron
Anemia
Mostly women and children
Haem iron (Fe2+) - Meat
Inorganic iron - not bioavailable
Vitamin C (ascorbic acid) helps absorb iron
Iodine
Iodine deficiency disorder (IDD)
1.9 billion people (mostly southeast Asia)
Leading cause of goiter (cretinism)
Developmental disability (intellectual disability)
Triiodothyronine (T3) thyroid hormone (brain development)
Source: salt
Zinc
Zinc deficiency
Increases risk of respiratory infections, malaria and diarrhea in children under 5 years
Nutritional Diseases
Nutrient-related diseases and conditions that cause illness in humans
Cancer and Diet
Foods or their components may cause/promote cancer.
Fat and Fatty Acids
Red Meats, fried, grilled, or smoked meats
Foods or their components may protect against cancer
Decreased Energy Intake
Fiber – Rich Foods
Folate and Antioxidant Vitamins
Obesity
Health consequences
Chronic low-grade inflammation
Contributes to systemic metabolic dysfunction
Diabetes
CVDs
Hernias, flat feet, sleep apnea, respiratory problems
Arthritis
Some cancers
Childhood Malnourishment
Kwashiorkor
Severe protein deficiency in children
Weaned children with low protein diets
Edema
Marasmus
<60% of the expected body weight
Poor nutrition leads to growth failure
Marasmic kwashiorkor
Severe acute malnutrition
Wasting and bilateral pitting edema
Diabetes
Blood sugar is too high; cells do not absorb glucose
Type 1 Diabetes
Destruction of beta cells
No insulin
Type 2 Diabetes
Cells do not respond to insulin
The pancreas doesn’t make enough insulin, or your body can’t use it effectively.
Prediabetes
Complications
Macrovascular
Microvascular
Food Access
Food Security
An individual has the right to access a safe and nutritional diet.
Food Insecurity
Factors: poverty, natural disasters, political unrest
Food = Energy (calories) + nutrients
<1800 calories
malnutrition
2000-2500 calories
normal
>3500 calories
obese
Dependence and Addiction
Substance abuse
hazardous or harmful use of psychoactive substances, including both illicit and legal substances
Neurotransmitters and Substance Abuse
The brain-signaling pathways targeted by drugs of abuse transmit dopamine and serotonin
Dopamine and Serotonin:
Chemicals that are normally involved in communication between neurons in the brain
Dopamine: "pleasure neurotransmitter", brings feelings of pleasure and provides a happiness boost based on a certain action
Serotonin is more of a stabilizer than a booster
Abused substances can influence functions modulated by either/both of these chemicals
Pathway
Addictive drugs (e.g. nicotine) activate "reward pathways" in the midbrain
This pathway normally activated by beneficial activities like eating and sex
Addictive drugs increase release of dopamine in midbrain, leading to feeling of pleasure
Mechanism of Addiction
Substances of abuse are potent stimuli that encode enduring patterns of drug-seeking behavior in the reward system
High-intensity reward activation is followed by a period of reduced activity and responsiveness, during which natural rewards are not strong enough to activate the system.
At the same time, altered gene transcription results in the accumulation of long-lived intracellular proteins that sensitize the reward system.
Small environmental or chemical stimuli can reactivate addictive behaviors even after long periods of abstinence.
Some of the substance-induced changes occur at the epigenetic level and may be transmitted to descendants
Tolerance
Decreased effect of drug
Need for higher or repeated doses for the same effect
Acute (during single exposure)
Chronic (from repeated use)
Dependence
Adverse effects associated with stopping use of drug
Adverse effects are alleviated by taking the drug
Teratogen Effects
Agent or substances that may cause birth defects due to a toxic effect on an embryo or fetus that causes an abnormality following fetal exposure during pregnancy or can increase the chance of a congenital defect occurring
Smoking
Smoking and NCDs
Smoking and Pregnancy
Smoking and Diabetes
Alcohol
Moderate Alcohol Consumption
Binge Drinking
Alcohol and NCDs
Alcoholic Liver Diseases
3 main forms
Fatty liver
Alcohol metabolism leads to fat accumulation in the liver (steatosis)
Alcoholic hepatitis
Linked with inflammatory cytokines, oxidative stress, and toxicity of acetaldehyde
Cirrhosis
Chronic inflammation leads to fibrosis (scarring) and eventual liver failure
Opioid
The Opioid Epidemic
6 Most Addictive Opiates
Heroin
Fentanyl
Morphine
Vicodin
Oxycodone
Methadone
3 Waves of Opioid Deaths
1. Rise in Prescription Opioid Overdose Deaths
2. Rise in Heroin Overdose Deaths
3. Rise in Synthetic Opioid Overdose Deaths
One Health
One Health Triad
Healthy People
Healthy Animals
Healthy Environment
2 Major Areas
Antimicrobial Resistance
Zoonotic Infectious Diseases
e.g. Rabies Virus
Family: Rhabdoviridae
Negative, single-stranded RNA virus
Transmission: direct contact with infected saliva or nervous tissues
usually through broken skin or mucous membranes in the eyes, nose, or mouth
Exposure from infected animal most common, aerosolized rabies and organ transplant less common
Symptoms
Early: flu-like
Progression: neurologic symptoms and death
99% fatal when symtpoms appear
Prevention
Prevention with vaccination, prompt wound care, post exposure prophylaxis
Vaccination for animals, vaccination for humans (after exposure)
All mammals can get rabies
e.g. Leptospirosis
Pathogen
Bacteria: Leptospira
Transmission
Spread through urine of infected animals, which can contaminate water and soil (especially rodents)
Transmitted through direct contact with infected urine or contaminated water and soil
Outbreaks: generally occur after contact with contaminated water
e.g. Hurricane, Floods
Symptoms
wide range, can be mild but severe cases can develop liver or kidney failure, and/or meningitis
Treatment
Antibiotics
Prevention
Minimize exposure
Vaccination
Bioterrorism
the intentional release of viruses, bacteria, or other germs that can sicken or kill people, livestock, or crops (CDC)
e.g. Anthrax
Pathogen
Bacillus anthracis
Gram positive, rod shaped bacterium
Bacteria produces spores, which exist naturally in the environment
Naturally have a worldwide distribution
Generally a disease of herbivorous animals
Transmission
Contact with animals or animal products contaminated with spores
Contact with skin or mucous membranes
Inhalation
Ingestion
Injection
Disease Epidemiology
Mortality rate
Ranges from 4-90%, depending on route of entry
e.g. Foot and Mouth Disease
Pathogen
Aphthovirus in family Picornaviridae
The most contagious transboundary animal disease
Not transmissible to humans
Significant economic losses are produced by its high morbidity and export trade restrictions imposed on affected countries
Affects cloven-hoofed animals
Cattle, swine, sheep, goats, etc.
Domestic and wildlife species
Symptoms
blisters on feet, tongue, and in/around mouth
Loss of appetite, depression, growth reduction, milk reduction
Nearly 100% morbidity, low mortality
Eradicated from North America currently
If an outbreak occurred in US, disease would spread quickly
Domestic and wildlife species highly susceptible
Billions of dollars lost within one year
Prevention
USDA creating vaccine bank to contain potential outbreak