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1. Case Study 4 Unsuspecting Honeymooners
2. Dengue Viral disease
Same family as W. Nile virus
Aedes mosquito vector
Also transmits yellow fever
CDC recommends using DEET
Geographic spread similar to malaria
4. Epidemiology 4 different strains allow for multiple epidemics to occur at once
A major out break happens ~ 5 years
Feb 2002 a serious outbreak in Rio De Janeiro, affected ~ one million people but only killing sixteen.
With treatment mortality rate can be as low as 1 in 1000
5. Rio de Janeiro
6. Favelasrio is one of the most violent cities on Earth with 18 homocides/day Pop ~ 14 mil
Denisty 328 people/km2
Pghs density:
2324 people/km2
7. Why call it dengue The term "dengue" is a Spanish attempt at the Swahili phrase "ki denga pepo", meaning "cramp- like seizure caused by an evil spirit". It emerged during a Caribbean outbreak in 1827-1828.
8. 1. Definitions
Bradycardia: slow heart rate >60 bpm
Hypotension: low bp
Lymphadenopathy: abnormal enlargement of the lymph nodes
Cervical lymph Nodes: in neck
Inguinal lymph nodes: in groin
Albuminuria: presence of albumin in the urine
Petechiae: small purplish spot on a body surface
9. What do your lymph nodes do? Filters out bacteria and viruses
Youve got 500-600
Spleen and tonsils do similar jobs
10.
Jasons WBC: 2,840/ L
Marys WBC: 3,600/ L
Normal WBC: 4,50011,000/L
They are low
Leukocytosis: abnormally large increase in number of WBC in the blood, often occurring during an acute infection or inflammation.
Leukopenia: abnormally low number of leukocytes in the circulating blood.
No leukocytosis, Yep Leukopenia
11. If you were an epidemiologist charged with controlling dengue fever, what important steps might you take?
Whats an epidemiologist do? Tracks the spread of disease.
Check hospital records for reported cases of Dengue
Create awareness, but isnt that tricky
Require blood tests as part of passports
12. If you were a government employee charged with writing a tourist advisory statement on dengue fever for people traveling in the Caribbean what precautions would you advise tourists to take?
13. 4. Would the invasion of a cell by viruses increase, decrease, or have no effect on the osmolarity of a cell.
Increases particles whether theyre salts or viruses decreases the concentration of water. If there is a higher extra cellular concentration of water than intra cellular then water will flow down its conc. gradient and the cell will swell hypotonicly
14. 5. Why are cells with the highest metabolic rate, like neurons and muscle cells, the most severely affected by mitochondrial cytopathy?
Because mitochondria is the site of glycolysis and the Krebs cycle which make energy transferring ATP
15. Do you think parasitic worms and arthropods are prokaryotes or eukaryotes
Prokaryotes: no membrane bound organelles. Circular DNA
Eukaryotes: membrane bound organelles, chromosomal DNA
Theyre Eukaryotes
16. 7 . Explain why children never inherit Kearns-Sayre syndrome from their fathers.
Kearns-Sayre: a mitochondrial cytopathy. Since all the sperms mitochondria dont survive in the egg all of a childs mtDNA comes from its mother.
Rare: Less than 200,000 people in the U.S. Have it
It hurts
It doesnt kill you, but reduces
life expectancy
17. You are an epidemiologist charged with investigating and putting a stop to repeated outbreaks of giardiasis in an old run-down urban public school. Discuss the hypothesis you would form and the investigations you would undertake.
Giardiasis (beaver fever) affects 200 mil world wide.
Common cause of gastroenteritis
Fecal-oral transmission
18. Whats an epidemiologists to do Consider the following statements
Smoking has been consistently linked to health problems such as lung cancer and coronary heart disease in several large prospective studies, this link has been deemed causal by a complex process of induction, consensus, and modeling.
Smoking may kill you.
19. First is more accurate, but second will have more of an impact on public.
Is one more scientific than the other?
Epidemiologists are advocates for public health.
There is a scientific as well as political aspect
20. Arr. Beware the dengue fever of the Caribbean