Emerging and Re-emerging Diseases

Which killed more people: WWI (1914-1918) or the Influenza Epidemic of 1918?World War I (1914 – 1918) death toll:

8-10 million worldwide

1918 Influenza Epidemic death toll:40 million worldwide~500,000 US deaths (including 70,000 soldiers)

Influenza “There was a little bird

its name was Enza.I opened the window

and in-flu-enza.”

Influenza SymptomsFever CoughSore throatRunny or stuffy

noseMuscle or body

achesFatigueHeadaches

Preparing for next crisis

Influenza ImpactFlu seasons vary from year to year

About 20% of US population infected every yearHigher among susceptible populations

Three main types of flu virus: Types A, B & CType A causes the greatest morbidity and

mortalityExample: H1N1 (2009 Epidemic)

Influenza PandemicsSince the late 19th century, four

occurrences of pandemics1889-1891; 1918-1920; 1957-1958; 1968-

19692009; H1N1

Was that the pandemic for our time??

Type A cycles every 50-100 years

What’s different about Type A influenza?

Flu PreventionSeason cycle in late fall, winter and early

springWash hands frequently

TuberculosisHas it been eradicated?

No20-33% world’s population is infected with

TBMajority of the above = “Dormant TB”

Can be dormant for 30 yearsOnly 5-10% will become “active” TB

Pulmonary TB

TB continuedTB bacteria produces nasal discharge,

coughing, sneezingAirborne

TB and Oregon

Public.health.oregon.gov

Public Health Concerns2-3 million deaths worldwide per

yearTrend: Extensively drug-resistant

strains = XDR TBEx: TB treatment 6-10 months = $900Ex: XDR TB treatment = $200,000

High-end antibiotics given through IV in hospital

Preventing TuberculosisKnow your risk

Higher risk populations: close contact, foreign-born, low-income or homeless, health care workers, infants, children, and persons who inject drugs.

Practice good hygiene

MRSAMethicillin-resistant Staphylococcus Aureus

Staph bacteria resistant to certain antibiotics called beta-lactams.

Often appears as pustule or boilMay think of a spider bite at first.

MRSA continuedHA-MRSA = Health care acquired

More serious and potentially deadly

CA-MRSA = Community acquiredAnyone is at risk

Contaminated Surfacesand Shared Items

Frequent Contact

Cleanliness

Crowding

Compromised Skin

Factors that Facilitate Transmission

Antimicrobial Use

(CDC, 2012)

MRSA in the news…Newberg, Oregon…

High schooler spread MRSA through tattoos, several students infected.

Mainly spread through unclean needles.

West Nile VirusSeasonal epidemic – summer through

fall

Symptoms:Most people (about 80%) will have no

symptomsApproximately 19% will have mild symptoms

Fever, headache, body aches, nausea, vomiting, swollen lymph nodes

About 1% of population will become severely infectedNeck stiffness, stupor, disorientation; may lead to permanent

neurological effects.

WNV PreventionAvoid mosquitoes!

Use repellantWear long sleevesAvoid being out when mosquitoes are activeHave good screens on windowsBeware of standing water

WNV and Community HealthCommunication from health educators is

vital.Unfortunately, we’re not getting the message

out.

Patient education works!

Also in the news….Hantavirus in Yosemite National Park, Summer

2012

Hantaviruses are a group of viruses carried by some rodents.Deer mouse, white-footed mouse, rice rat and

cotton rat.

In every state except Alaska and Hawaii.

Symptoms: Fever, severe muscle aches,fatigue, respiratory issues.

Hantavirus preventionHantavirus is spread

through the air.

Practice good hygieneBe careful of mouse /

rat droppings, urine, etcDon’t sweep or

vacuum