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Human to Human Transmission of Infectious Diseases

Human to Human Transmission of Infectious Diseases. Basics of Disease Control. Control the environment Control the host Control the vector Why does this make diseases with human hosts the most legally problematic?. Factors that Affect Human Susceptibility to Infectious Diseases. Genetics

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Human to Human Transmission of Infectious Diseases

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  1. Human to Human Transmission of Infectious Diseases

  2. Basics of Disease Control • Control the environment • Control the host • Control the vector • Why does this make diseases with human hosts the most legally problematic?

  3. Factors that Affect Human Susceptibility to Infectious Diseases • Genetics • Immunologic system function • Environmental factors

  4. Genetics • Sickle cell trait • Evolutionary adaption to malaria • Damaging as sickle cell disease • HIV • Probably leprosy • Others we do not understand

  5. Environmental Factors • Factors that affect immunologic function • Nutritional status • Stress • What does this tell us about developing countries and refugee camps? • Factors that increase exposure/cause stress • Crowded housing • Poor sanitation • Poor working conditions

  6. Breaker boys in coal mine - Lewis Hine

  7. Immunosuppressive Drugs • A post 1960s phenomena • Steroids • Asthma • Arthritis • Feel good docs • Chemotherapeutic agents • Anti-rejection agents for transplants • Impact on infection dynamics

  8. Transmission Dynamics • How hard is it to catch the disease? (Contact effectiveness) • Measles • Leprosy (Hanson's Disease) • How susceptible is the population? • Immunity? • Environmental factors? • How many people are infectious carriers? • How well do the carriers mix with the general population? • Are there high risk subgroups?

  9. Tuberculosis • #1 Killer, probably for all time • Mycobacterium tuberculosis • Related to leprosy • Very hard to kill • Can lay dormant for decades • Can affect any organ system • Dangerous when it is pulmonary - you cough up the bugs and spread them

  10. Transmission • Person to person • Takes significant exposure • Medicated by fomites • Animal hosts • Milk • Still a risk for raw milk

  11. Detection • TB skin testing • Looking for antibody reaction • Not so good in immunosuppressed people • Conversion • You are infected • You may not have actively growing bugs • Confirmation • HIV test • X-ray • Treatment - 1 year of isoniazid

  12. Treatment of Active TB • Active - pulmonary infection that can spread infectious material • Treatment • Takes time to make the patient non-infectious • Much longer or never for drug resistant • Long course for cure • Incomplete treatment • drug resistant • worst case - pan drug resistance

  13. Legal Issues for TB • Detection • Treatment • Treatment failure/drug resistance

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