Current Threats to Public Health

1. Current Threats to Public Health HIV/AIDS

2. HIV--- Human Immunodeficiency Virus HIV is the virus that causes the disease, AIDS. HIV belongs to a special group of viruses called retroviruses. It infects the body’s immune system cells and destroys them, leading to the disease known as AIDS. What is it?

3. What is it? • AIDS—Acquired Immunodeficiency Syndrome • AIDS reduces the effectiveness of the immune system and allows opportunistic pathogens to take over the body.

4. What is it? No one ever dies of AIDS, they die of other diseases or illnesses that happen because the immune system has been destroyed. AIDS patients usually die from Kaposi’s sarcoma (a cancer that Tom Hanks’ character had in Philadelphia) or pneumocystis (a very bad form of pneumonia) or AIDS dementia complex (brain deterioration). These are illnesses that healthy people do not get!

5. The symptoms of AIDS are shown on the diagram. If you present these symptoms, a special blood test called an ELISA is done to determine if HIV is present. What are the symptoms?

6. How does it destroy the Immune System? • HIV attaches to and destroys special white blood cells known as T-cells. • T-cells identify and “eat” pathogens that invade our bodies. • T-cells also notify another type of white blood cells, B-cells, to make antibodies against invaders so if/when they come back, the body is better prepared. • Without T-cells and B-cells, essentially the immune system is wiped out.

7. B-Cell (left) and T-Cell (right) The T cell sends chemicals called cytokines to stimulate B cells to make antibodies.

8. Many ways: Direct Contact (sexual): usually through contact with semen, pre-ejaculate or vaginal secretions. How is it transmitted?

9. How is it transmitted? 2) Direct Contact (with infected blood): can be due to sharing needles through drug use or insulin applications. Also has happened due to tainted blood being allowed to be given to patients in need of blood transfusions.

10. 3) Vertical Transmission: Unfortunately, HIV can travel via a pregnant mother to her fetus in the last weeks of pregnancy. Fortunately there is only a 1 in 4 chance of successful transmission. How is it transmitted?

11. Anyone who has casual, unprotected sex. Anyone who shares needles for any purpose. Anyone who received blood products in Canada in the 1980s. Who is at risk?

12. 1) Abstinence from any sexual behaviour and intravenous drug use. How do we prevent ourselves from getting HIV/AIDS?

13. How do we prevent ourselves from getting HIV/AIDS? • If you do have sex, make sure it is safe sex. • Use a condom (with nonoxynol-9) and know the sexual history of the person you are sleeping with. • If you engage in sex with multiple partners over a short time period, please visit the local public health unit and get tested for STDs to ensure you are safe. • If you are using needles for drug use or insulin injections or tattooing, do not share needles!

14. Treatment • There is no cure for HIV or AIDS at present. • The HIV virus can be slowed down by using antiviral drugs such as AZT which slow down the spread of HIV through the body, but do not fully stop it. • Over time, the HIV virus becomes immune and a different mix of antiviral drugs are needed to slow it down.

15. Because there is no cure! The mortality rate for anyone who has AIDS is 100%. You will die, some earlier than others, but in the end you die earlier than a normal, healthy person. It is decimating Africa and now spreading outward through Asia and Europe. Why should we be concerned?

16. What about Canadians? • The number of Canadians living with HIV continues to grow. At the end of 2005, an estimated 58,000 people were living with HIV infection. • 27% of Canadians infected with HIV did not know!

17. AIDS was first reported in 1981 in Los Angeles, but has since been suspected of deaths occurring during the 60s and 70s. It has become a problem in developing nations since the mid-1990s and now pushing through in many developed nations. As of 2009, it is estimated that over 33.3 million people are HIV positive (74% of them living in sub-Saharan Africa) When did it become a problem?

18. When did it become a problem?

19. After waiting almost 25 years, PHAC and the federal government launched the “Federal Initiative to Address HIV/AIDS in Canada” in January of 2005. What was the Public Health Agency of Canada’s Response?

20. Its main goals are: Prevent the acquisition and transmission of new infections; Slow the progression of the disease and improve quality of life; Reduce the social and economic impact of HIV/AIDS; Contribute to the global effort to reduce the spread of HIV and mitigate the impact of the disease. What was the Public Health Agency of Canada’s Response?

21. Leading Together • Canada had a plan in place to combat AIDS/HIV from 2005 until 2010. • http://www.leadingtogether.ca/pdf/Mini_Leading_Together_web_e-1.pdf • Currently, there is no document about Canada’s mandate for AIDS.

22. Canadian HIV Vaccine Initiative (CHVI) • CHVI has been a 5 year collaboration between the Canadian government and the Bill and Melinda Gates foundation. • It represents a significant contribution to the global search for an HIV vaccine.

23. What are some common questions about the HIV/AIDS Vaccine? • Why do we need an HIV vaccine? • Over 33.3 million people in the world have AIDS or are HIV positive. More than a quarter do know it! (estimated at 27%). • Vaccines are the safest and globally accessible way to preventing the spread of a viral disease. • A vaccine for HIV will save millions of lives and save countries millions of dollars in health care.

24. What are some common questions about the HIV/AIDS Vaccine? • How long before there is a vaccine against HIV? • Current estimates based on the amount of funding at present put a one dose, effective vaccine about 10 years away. • Many scientists however believe that due to the complexity of the HIV virus, a vaccine may not be 100% effective at prevention.

25. What are some common questions about the HIV/AIDS Vaccine? • Can you get AIDS from casual contact? • NO! Hugging, shaking hands, playing sports, doing Yoga, etc… with someone infected with HIV or someone who has AIDS will not transfer the disease onto you. • You cannot get it from a mosquito either, so don’t even go there!