Chapter 13

1. Chapter 13 Immunity and Infection

2. The Chain of Infection Links in the Chain Transmitted through a chain (six links) Pathogen - disease causing microorganism Reservoir - natural environment of the pathogen: Person, animal, or environmental component Portal of Exit Means of transmission Direct transmission Indirect transmission Vectors – carrier of the pathogen from one host to another Portal of entry Penetration of the skin Inhalation through mouth or nose Ingestion New host Breaking the Chain 2

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4. Body’s Defense System 4

5. The Inflammatory Response Histamine. Dilation of blood vessels, heat, redness, and swelling. The immune response Phase 1 – Dendritic cells are drawn to the site Phase 2 – Helper T cells multiply Production of Killer T and B cells Cytokines – chemical messengers Phase 3 – Killer T cells strike Cell-mediated immune Antibody-mediated immune response Phase 4 – Last Phase – Suppressor T-cells Slow down activity 5

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7. 5 Stages of an Infection Incubation stage (bacteria or viruses multiply) Prodromal stage (contagious period) Clinical stage (biological warfare) Decline stage Recovery stage 7

8. Immunization • Vaccinations are when the immune system is given an antigen which is not considered dangerous • The body produces antibodies, which prevent serious infection against that particular disease • Vaccines are made by either weakened pathogens or killed pathogens, which still elicit the production of antibodies (active immunity), or antibodies can be injected (passive immunity) to create temporary immunity

9. Allergy: The Body’s Defense System Gone Haywire The Body’s Defense System Gone Haywire Allergies Allergens Pollen, Animal Dander, Dust mites and cockroaches, Molds, Food, Insects The Allergic response Immunoglobulin (IgE) Anaphylaxis 9

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11. Dealing With Allergies Avoidance Medication Immunotherapy “allergy shots” 11

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13. Pathogens and Disease Bacterium – Microscopic single celled organism Pneumonia (inflammation of the lungs) Meningitis (infection of the brain and spinal cord) Strep Throat and other streptococcal infections Toxic shock and other staphylococcal Tuberculosis (respiratory infection) Tickborne infections (ex: lyme disease) Ulcers (inflammation of digestive tissues) Other Bacterial infections Tetanus (affects CNS) Pertussis (“whooping cough”) Urinary tract infections 13

14. Antibiotic Treatment Actions of Antibiotics Antibiotic resistance Proper antibiotics usage Don’t take an antibiotic every time you are sick Use antibiotics as directed Never take an antibiotic without an prescription 14

15. Type of Pathogens Viruses – (parasites – take what they need) Most common contagious disease Common Cold Influenza Measles, Mumps and Rubella (“German measles”) Chickenpox, Cold Sores, and other herpes-virus infections Varicella-zoster virus Herpes simplex virus (HSV) types 1 and 2 Epstein-Barr virus (EBV) Viral encephalitis Viral hepatitis Poliomyelitis (disease of CNS) Rabies (disease of CNS) Human papillomavirus (HPV) Treatment (antiviral drugs) 15

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17. Fungal Infections • A fungus is a primitive plant • 50 of thousands of fungi cause disease among humans • Candida albicans is a common fungus found naturally in the vagina of most women, which causes infections • Other common forms are athlete’s foot, jock itch, and ringworm • Fungal infections can be deadly in people with impaired immune systems

18. Protozoan Infections • Single-celled organisms, which alternate between activity and inactivity • Common infections include: • Trichomoniasis (primarily an infection of women's vaginal and urinary tracts) • Trypanosomiasis (also known as African sleeping sickness; spread by the bite of the tsetse fly; causes an acute illness leading to death within weeks or months) • Amoebic dysentery (An acute disease caused by ingesting substances contaminated with the amoeba Entamoeba histolytica and characterized by severe diarrhea, nausea, and inflammation of the intestines)

19. Parasitic Worms • Considered the largest organism that can enter the body to cause infection • Worms, including the tapeworm and hookworm, can grow to a length of many feet, especially in the intestinal tract • Worm infections can originate from contaminated food or drink

20. Prions • Known as ‘proteinaiceous infectious particles’ • Prions lack DNA or RNA and consist of only protein • They spread by triggering normal proteins to change their structure to the abnormal, damaging form • Symptoms include behavioral changes (e.g., agitation), gradual loss of coordination and locomotive function, and, in advanced stages, weight loss, fine muscular contractions, and abnormal gait. Brain tissue becomes pitted with holes and spongy. • Examples are: • Creutzfeldt-Jakob a.k.a. ‘Mad Cow’ • Scrapie in sheep

21. SARS E. coli Hantavirus (rodent) West Nile Virus Rotavirus (gastroenteritis) Monkey Pox Ebola Avian flu H1N1 Flu (“Swine Flu”) Selected Infections of Concern

22. 2009 H1N1 Flu (Swine Flu) • 2009 H1N1 (sometimes called “swine flu”) is a new influenza virus causing illness in people. This new virus was first detected in people in the United States in April 2009. This virus is spreading from person-to-person worldwide, probably in much the same way that regular seasonal influenza viruses spread. On June 11, 2009, the World Health Organization (WHO) signaled that a pandemic of 2009 H1N1 flu was underway.

23. 2009 H1N1 Flu (Swine Flu)

24. 2009 H1N1 Flu (Swine Flu) What are the emergency warning signs? In children: • Fast breathing or trouble breathing • Bluish skin color • Not drinking enough fluids • Not waking up or not interacting • Being so irritable that the child does not want to be held • Flu-like symptoms improve but then return with fever and worse cough • Fever with a rash In adults : • Difficulty breathing or shortness of breath • Pain or pressure in the chest or abdomen • Sudden dizziness • Confusion • Severe or persistent vomiting

25. Drug Resistance Poverty Breakdown of Public Health Measures Environmental Changes Travel and Commerce Mass Food Production an Distribution Human Behavior Factors Contributing to Emerging Infections

26. Other Immune Disorders: Cancer and Autoimmune Diseases If the immune system breaks down Getting older HIV infection Chemotherapy Autoimmune diseases Rheumatoid arthritis Systemic lupus erythmatosus (disease where a person's immune system attacks and injures the body's own organs and tissues) 26

27. Support Your Immune System How to support your immune system General guidelines • Plenty of clean water • Avoid contact with vermin • Practice safe sex • Do not use Injectable drugs • Vaccinations • Controlling Stress • Balanced diet • Enough sleep • Exercise • Don’t smoke • Moderation of alcohol • Wash your hands • Avoid contact with contagious people 27

28. Sexually Transmitted Diseases (STDs) • Also known as Sexually Transmitted Infections (STIs) • Spread of an infection from person to person mainly through sexual activity. • STDs that pose a major health threat: • Human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) • Hepatitis • Syphilis • Chlamydia • Gonorrhea • Herpes • Human papillomavirus (HPV) • CDC (2008) estimated 65 million Americans were infected with an STD, and about 19 million Americans become newly infected with an STD each year. 28

29. Populations of Special Concern for HIV infection • Most common exposure has been sexual activity between men; injection drug use, and heterosexual contact. • African American men and women are vastly overrepresented among people newly diagnosed with AIDS. • See “HIV/AIDS Among African Americans and Latinos” 29

30. Figure 13.3 Routes of HIV transmission among adults 30

31. Symptoms of HIV Infection • Few days or weeks, half the people will develop (Flu like symptoms) • Fever, fatigue, rashes, headache, swollen lymph nodes, body aches, night sweats, sore throat, nausea and diarrhea. • Specialized test HIV RNA assay. • Pneumocystis Carinii pneumonia (fungal infection). • Kaposis sarcoma (rare form of cancer) • Difficult to treat yeast infections in women • Tuberculosis 31

32. Diagnosing HIV Infection • Most common is tests for the presence of antibodies to the virus. • HIV antibody test • ELISA (first test) • Western blot (second test), Immunoflourescence assay • IF HIV-positive then check the status of the CD4-T cells. • New diagnostic test – HIV Replication Capacity. 32

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35. Chlamydia Trachomatis • Most prevalent bacterial STD in the U.S. • Bacterial infection - • Can cause sterility in men and women • WOMEN infects the cervix and to urethra, fallopian tubes & ovaries, PID, bladder infections. • MEN- Epididymitis, urethra to testes, urethritis, bladder infections, watery discharge. • Symptoms –ASYMPTOMATIC :Discharge, pain and burning while urinating, vaginal bleeding, painful intercourse, abdominal pain, nausea, fever, inflammation of rectum or cervix, swelling and pain in the testes. 35

36. Chlamydia Trachomatis • Spread - vaginal and anal intercourse, from the birth canal to the fetus • Diagnosis - Examination of tissue samples or urine • Treatment - Both partners treated fully with antibiotics • Protection - Condoms and safe sex 36

37. Gonorrhea • 350,000 new cases reported to the CDC in 2006. • 5.5% increase over 2005. • Bacterial infection -Can cause sterility, arthritis and heart problems • PID, can cause ectopic pregnancy, premature labor and still birth, arthritis, and rashes • Gonococcal conjunctivitis • Eye infection of a infant that can cause blindness if not treated • Symptoms – • Women - Asymptomatic - Frequent burning urination, menstrual irregularities, pelvic pain, discharge. • Males – thick yellow-white discharge, painful urination. 37

38. Gonorrhea • Spread - Vaginal, anal and oral sex. • Diagnosis - Microscopic exam of discharge. • Treatment - Oral antibiotics - People often have chlamydia at same time. • Protection - Condoms and safe sex. 38

39. Pelvic Inflammatory Disease(PID) • Progressive infection that harms a women’s reproductive system. Can lead to sterility, ectopic pregnancy and chronic pain - treated or not. • Caused by Chlamydia and gonorrhea. • Symptoms - long and painful periods, discharge, spotting, low abdominal pain, fever, chills, nausea, vomiting, pain during intercourse. 39

40. Pelvic Inflammatory Disease(PID) • Treatment - Antibiotics, bed rest, sexual abstinence and maybe surgery to remove scarring • Diagnosis - Pelvic Exam, cultures, laparoscopy • Protection - Condoms and safe sex Pelvic inflammatory disease is an infection which passes from the vagina (A) through the uterus (B) to other parts of the pelvis. 40

41. Human Papillomavirus (warts) • More than 80% of sexually active individuals will have been infected with HPV by the age of 50. • Vaccine • Is not a treatment for HPV for girls or women who are infected with HPV. • Symptoms • Small bump on the skin or a large, warty growth • Cauliflower-like mass • May cause irritation and bleeding • How is it spread • Diagnosis • Appearance of the lesions • Women who are positive should have a Pap test very 12 months • Treatment • Removed by cryosurgery, electrocautery or laser surgery • Protection 41

42. Genital Herpes • 1 in 5 adults in the U.S. has genital herpes • Two forms - Herpes simples virus-1 and -2. • HSV 1 (Type 1) is associated with cold sores and fever blisters. • Oral-labial herpes • 50-80% of U.S. adults have antibodies to HSV-1 • HSV 2 (Type 2) • Usually occurs during adolescence and early adulthood • Between 18 -25 years old • Approximately 22% of adults have antibodies to HSV 2 • Remains in the body for life. • Symptoms – 90% have no symptoms • Recurring rash, pain ulceration's. • Primary outbreak - pain and discomfort around infected area, itching, burning during urination. • 2-20 days after infection - may years before outbreak. 42

43. Herpes • Spread - Touching, sexual intimacy - including kissing, vaginal, oral and anal sex • Diagnosis - Examination of sores and culturing of fluid taken from sores • Treatment - No cure - symptoms are relieved by drugs • Protection - Refrain for sex during out break • HSV-1 and 2 can cause miscarriages or still births along with serious health issues of newborns 43

44. Hepatitis B Virus (HBV) • Can cause liver disease and death • Inflammation of the liver • Preventable with vaccination. • Transmission - Semen, saliva, blood and urine • Symptoms - Extreme fatigue, headache, fever, hives, lack of appetite, nausea, vomiting, tenderness in lower abdomen • Diagnosis and Treatment • Blood Test • No cure • Prevention 44

45. Syphilis • 7000-10,000 new cases of early syphilis in the U.S. • Syphilis organism remains in the body for life and leads to disfigurement, neurological disorders, or death. • Effective antibiotics and condom use. • Symptoms – • Primary phase- 3 weeks - 90 days - painless sores and wet ulcers (chancre) and swollen glands. • Secondary Phase - 3-6 weeks - up to 2 years body rash, mild fever, fatigue, sore throat (Flu like symptoms), and hair loss. • Late phase (tertiary)- Damage to organs and nervous system. • Diagnosis and Treatment • Examination of infected tissues and with blood tests • Treated by antibiotics 45

46. Other STD’s • Trichomoniasis • “Trich” • Single-celled organism • Bacterial vaginosis (BV) • Abnormal vaginal discharged caused unhealthy species of normal vaginal bacteria • Pubic Lice “Crabs” • Contagious parasitic infections • Scabies (mites) • Contagious parasitic infections 46

47. What You Can Do • Education. • Diagnosis and Treatment • Get vaccinated • Be alert for symptoms • Get tested • Inform your partners • Get Treated • Prevention • Use a barrier defense. • Know your potential partner. • Ask: Are you ready to have sex? 47

48. Connect Assignment • Chapter 13 Connect Assignment Due Tuesday, April 13th