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Swine Influenza

Swine Influenza

SWINE INFLUENZA frightening you? CONCERNED about the health implications? Coughs and Sneezes Spread Diseases! Stop The Swine Flu from Spreading. Follow the advice to keep your family and friends safe from this virus and not become another victim. These simple cost free guidelines will help you to protect yourself from the swine flu.

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Pandemic Survival

This eBook shows you what it takes to survive the next pandemic. There is no doubt that in the future, the world will be hit with a huge pandemic, either from natural causes or from a terrorist attack. As you look through history, you will be hard-pressed to find any pandemic in history that has killed less than 1 million people. You do not want you or your family to be among those millions. And with the help of the information in this eBook, you have a way to survive the global pandemic that will come. Wishing it won't happen doesn't do anything Preparing for it gives you the tools to survive AND thrive. This book contains the two-pronged approach of John Hartman's years of research in figuring out how pandemics work and living through a dangerous flu outbreak. This gives you the methods to both avoid getting a virus in the first place, and how to strengthen your immune system should you come down with a virus. You don't have to lay down and die. You can fight the next pandemic.

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Avian Influenza H5N1 Virus An Emerging Global Pandemic

The specter of avian influenza emerging from Asia and spreading all over the globe is causing deeper concern by the day. As we witness the H5N1 virus evolving and becoming increasingly dangerous, a major pandemic may be unavoidable. The bird flu virus has already claimed more than 140 lives worldwide as of August 2006. Should bird flu spark a global pandemic, several hundred million people could die within a matter of weeks, which is many times the number of deaths due to AIDS so far. This pathogen is completely different from seasonal influenza virus, which kills between 1 and 2 million people worldwide in a typical year. In the worst previous pandemic of 1918, more than 20 million humans died of the Spanish flu. The current bird flu virus has emerged from a pool of animals that have previously never infected humans implying that humans do not have antibodies to combat the infection. This virus also causes severe disease and high fatality within a short time span. The only remaining...

SARSCoV Protease

Severe acute respiratory syndrome (SARS) is a respiratory illness that had a widespread dramatic outbreak in Asia, North America, and Europe in early 2003 (Lee et al., 2003). Evidence indicates that a previously unrecognized coronavirus exists, called SARS coronavirus, which is the leading hypothesis for the cause of SARS (Rota et al., 2003). It was known that the cleavage process of the SARS-CoV polyproteins by a special proteinase, the so-called SARS coronavirus 3C-like proteinase (CoV Mpro), is a key step for the replication of SARS-CoV (Fan et al., 2004). The SARS coronavirus 3C-like proteinase is considered as a potential drug design target for the treatment of SARS. Liu et al. (2005) built a flexible 3D model for SARS 3C-like proteinase by using a homology modeling and multicanonical molecular dynamics method, and they used the model for virtual screening of chemical databases. A 3D homology model of SARS 3C-like proteinase based on the structure of...

Evidencebased assessment of prognosis

Many studies about risk factors and outcomes for infectious diseases are published but the quality is variable. The best designs for assessing these are cohort studies in which a representative sample of patients is followed, either prior to developing the infection (to determine risk) or after being infected (to determine outcome). Patients should be assembled at a similar point in their illness (the so-called inception cohort ), and follow up should be sufficiently long and complete. Important prognostic factors should be measured, and adjusted for in the analysis. As with clinical trials, the outcome measures are a relative risk, absolute risk, or hazard ratio associated with a particular infection or prognostic factor. For example, to assess the outcome of patients with severe acute respiratory syndrome (SARS), one would optimally want an inception cohort of individuals who meet the case definition within several days of onset of symptoms. These individuals would then be followed...

Satellite DNAs and Associated Proteins

The class III satellite consists mostly of a 359-bp AT-rich repeat (73) located almost entirely on the X chromosome (approx 11 Mb 46). Dimers and trimers of this satellite behave as efficient scaffold-associated attached regions (SARs) (79 for a review, see ref. 80), defined as DNA restriction fragments that bind strongly to histone-depleted chromosomal scaffolds extracted from nuclei. SARs (also referred to as matrix-associated regions MARs ) are typically AT-rich sequences of several hundred basepairs and are cooperatively bound by DNA topoisomerase II (79). SARs have been found flanking a number of Drosophila genes, in some cases comapping with transcription enhancerlike sequences (81), and are postulated to define the sites where chromatin loops attach to an underlying scaffold or nuclear matrix (80). The observed cleavage of a 359-bp satellite by topoisomerase II may be important for satellite III condensation (79).

Classification of HIV and geographic distribution of HIV1 variants

Group M (for major) represents the vast majority of HIV-1 strains found worldwide and is responsible for the pandemic 10 . Variability between the three groups is estimated at 30 overall, Subtype and CRF designations have been powerful molecular epidemiological markers to track the course of the HIV-1 pandemic. Extensive efforts have been made to collect and characterize HIV-1 isolates from around the world, and a broad picture of the distribution of HIV-1 variants has emerged (Fig. 4). Globally, the predominant viral forms are subtypes A and C, followed by subtype B and the recombinants CRF01_AE and CRF02_AG 14 . The heterogenous distribution of HIV-1 variants is probably the result of founder effects. The greatest genetic diversity of HIV-1 has been found in Africa, consistent with this continent being the source of the epidemic.

Scientific Attention to the Social Environment in the Nineteenth Century

Social factors because the role of human contact was so obviously critical to understanding disease transmission. But attention to the etiological influence of the social environment would not resurface until the third and fourth decades of the twentieth century, when chronic diseases such as cancer, heart disease, and diabetes began to dominate the industrialized world's disease profile. Chronic diseases were not as easily explained by single-cause models. In addition, national governments faced increasing pressure to provide adequate health services, so they began to sponsor research on how to design, provide, and assess medical care and prevention programs. Chronic disease epidemiology and community medicine thus helped to revitalize research on the health effects of society and culture, although contagious disease epidemics, like the influenza pandemic of 1918-1919, also helped to rekindle research interest in the host and environment (Gordon 1953 61, Kolata 1999).

Processing MHC presentation

Lectin-dependent HIV-1 attachment to cells can be prevented by interfering with lectin expression or by targeting domains in the lectin required for efficient ligand recognition. Alternatively, carbohydrate structures in HIV-1-gp120, which are recognized by relevant lectins, are targets for intervention. Down-modulation of lectin expression can be achieved by specific siRNA 82, 110 and by sanglifehrin A 111 , an immunosuppressant that diminishes C-type lectin expression on DCs. However, issues with delivery (siRNA) and possible unwanted side effects (sanglifehrin A) need to be addressed. Several inhibitors that impede the interaction of DC-SIGN with HIV-1 or other viruses have been described. A synthetic, branched molecule that presents 32 man-nose residues on its surface has been shown to inhibit HIV-1-gp120 binding to DC-SIGN 112 and to block DC-SIGN interactions with reporter viruses bearing the Ebola virus glycoprotein 113 , a well-established DC-SIGN ligand 114, 115 . The...

Challenges To Traditional Veterinary Programs

Veterinarians are under pressure either to provide cheaper diagnostic treatment services for endemic cases or to train herd personnel to diagnose and treat these cases. The veterinarian needs to evaluate interventions and success of outcomes, and to monitor the incidence of cases. Care must be taken that should a new disease emerge in the herd, the veterinarian is notified and appropriate steps are taken to ensure it is not a pandemic disease or a zoonotic disease risk.

The Singapore Contribution in the Battle against the Severe Acute Respiratory Syndrome

Severe acute respiratory syndrome (SARS) emerged in November 2002 in Guangdong Province, China. The disease finally spread to more than 30 countries, with more than 8,000 people infected worldwide. Under the coordination of the World Health Organization, laboratories from all over the world, including Singapore, worked together to identify and characterize the causative agent. SARS first reached Singapore in mid-March 2003 and by the end of the outbreak more than 230 probable cases of SARS were recorded in the small island-nation. Subsequently, the contribution of research from Singapore to understanding this potentially lethal infection and its causative agent has been significant. This review aims to record the contribution made by researchers in Singapore to the current understanding of SARS, including the epidemiology in the Singapore setting. Also the development of diagnostic tests such as antibody detection and polymerase chain reaction will be discussed. Finally, a summary of...

Chapter Questions

Imagine that you are planning to visit a country that is experiencing an epidemic of avian flu. Travelers returning from affected countries are being screened, and you don't want to be stopped at customs or to be quarantined. What steps can you take to ensure that you are safe and that you will be able to get through customs quickly on your return trip Where would you look for information

InVitro Toxicity Testing of Air Contaminants

A practical approach for in-vitro respiratory toxicity testing has been proposed by the European Centre for the Validation of Alternative Methods (ECVAM) 17 . This systematic approach is initiated with the consultation of existing literature, evaluating the physico-chemical characteristics of test chemicals, and predicting potential toxic effects based on SARs. The physico-chemical characteristics of chemicals such as molecular structure, solubility, vapor pressure, pH sensitivity, electrophilicity and chemical reactivity are important properties that may provide critical information for hazard identification and toxicity prediction 24, 34 .

Where to Go from Here

With deep knowledge of local health effects of many economic development endeavors and approaches, as well as local systems of meaning, medical anthropologists are in a position to encourage novel ways of promoting just, equitable development. The dimensions of the global AIDS pandemic, which has in the course of the past two decades become the leading single infectious cause of young adult death in much of the world, brings the shortcomings of past approaches into sharp relief.

Vibrio parahaemolyticus

Like V. cho erae (and several other aquatic organisms described later), V. parahaemo yticus is an aquatic organism that thrives in shallow coastal waters. Deep-sea fish do not tend to harbor the organism and usually become contaminated in fish markets. Precooked frozen shrimp may be contaminated and cause FP if served without further cooking, as in a seafood cocktail. Vibrio parahaemo yticus FP is associated with raw, undercooked, or contaminated seafood and is especially common in Japan and probably other countries in which seafood is a staple of the diet. Contamination from raw to cooked seafood is a common cause. The incidence of V. parahaemo yticus FP has increased in many Asian countries and the United States since 1996, and this is thought to be caused by a pandemic clone. Diarrhea, abdominal pain, and nausea are the predominant symptoms. The diarrhea can be severe, with blood or mucus in the stool. Vomiting is a less common feature, but fever can occur. The incubation period...

Infection and humoral immunity

Variability is the key feature of the influenza A viruses. This depends on two, separate mechanisms. Antigenic drift (see above) gives rise to variants of existing epidemic strains which are sufficiently different from their predecessors to escape neutralization by the Ig pool available in the population at risk. The more profound change associated with 'antigenic shift' may result from a chance dual infection with a human and an animal influenza A virus. Re-assortment of the segmented genomes of the two viruses can then lead to the emergence of a novel pandemic strain, for which there is no pre-existing antibody in humans. Such reassortants are readily generated experimentally.

Shaken Optimism about Modern Medicine

Parsons believed, along with many scientists in the 1960s and 1970s, that modern medicine verged on conquering all major infectious diseases, at least for societies with effective systems of sanitation and public health. The appearance in the 1980s of the human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS) has shaken such optimism. It has now become clear that humankind faces a major pandemic that, despite modern science and technology, will take scores of millions of lives globally (WHO). Twenty years of research has failed to produce an effective vaccine. New antiretroviral medications are extending the life and health of many patients with HIV AIDS, but not all patients are helped, and how long the others will benefit remains unclear (IAPAC). In the meantime, many patients do not receive the new treatments because they have not been diagnosed, are not willing to face the consequences of an HIV AIDS diagnosis, lack access to care or means of paying for...

Endogenous Cannabinoid Structureactivity Relationships

Cannabinoid structure-activity requirements (SAR) literature has primarily focused on CB1-receptor affinities of fatty acid ethanolamides, such as AEA and its analogs. Recently, however, Sugiura has begun to develop an SAR for 2-AG and its analogs based on a functional assay of Ca2+ mobilization (Sugiura et al., 1999 Sugiura and Waku, 2000). Because of their difference in basis, each of these SARs will be presented separately here.

Emerging and reemerging viral diseases

While this book was in preparation, there was a sharp reminder of the ever-present threat of emerging viral diseases, in the form of a new viral disease called severe acute respiratory syndrome (SARS). The outbreak of this disease began in Guangdong province in southern China in November 2002. The Chinese authorities were heavily criticised for not reporting the extent of the outbreak until some 3 months later, by which time cases were appearing in many parts of the world, illustrating the role of increased intercontinental travel in the spread of such a disease. At its peak in April 2003, over 1000 new cases of SARS were being reported per week. The cause of SARS was quickly identified as a member of the Coronaviridae (single-stranded RNA viruses). Transmitted by droplets from coughs and sneezes, it produces flu-like symptoms, but has a mortality rate of around 4 percent. Strict public health measures were brought into force, including restrictions in flights to and from affected...

The Supply Crisis in Transplantation

One of the most promising, and controversial, sources for new organs for humans are xenotransplants from other species, particularly baboons and pigs. Many individuals are very strongly opposed to raising animals for the sole purpose of harvesting their organs for humans, viewing it as inhumane. Another area of controversy, particularly concerning baboon donors, is the possibility of spreading unknown diseases into the human population. There are already established precedents for viral diseases jumping from primates to humans, such as the AIDS virus (HIV), Ebola virus, and the hantavirus. Consequently, there is a fear that xenotransplantaion could unleash a new plague upon humans. More and more xenotransplant research is moving toward the use of pigs, since it is very much less likely that a pig virus could

Conclusion Is Cholera a Signpost

The epidemic of SARS cost China, Hong Kong, and Taiwan billions of dollars in lost revenue in only the first two months. In each of these instances epidemics revealed particular rifts in society poor versus rich, gay versus straight, sorcerers versus afflicted, Hindu versus Muslim, West versus East. Although cholera transmission and treatment reveal particular components of human behavior and thought, other modern epidemics have their own stories to tell AIDS, lung cancer, Mad Cow Disease, SARS, or any of dozens of other diseases also reveal how human groups are organized, ranked, managed, and sustained or exterminated over time. To explore this issue fully, and to learn what is unique and what general,

Research on Implanted Embryos and Fetuses

Many clinical procedures that are now routinely employed in obstetrical practice were first tested on pregnant women and fetuses in anticipation of birth. One early therapy was the use of exchange transfusions to overcome Rh incompatibility between a pregnant woman and her fetus. The worldwide epidemic of HIV infection and AIDS provided the context for important research affecting fetuses in the 1990s. In one groundbreaking randomized clinical trial, the antiviral drug azidothymidine (AZT) was administered to HIV-infected pregnant women in an effort prevent the transmission of infection to their fetuses, and was found to reduce the risk of vertical transmission by 66 percent (Sperling et al.).

Use of QSAR and Physico Chemical Exclusion Rules to Predict Skin Irritation Potential

The evaluation on behalf of the ECB includes first, the compliance of the rule-base with the OECD principles on (Q)SARs second the derivation of the (Q)SAR rules and finally, the external validation of these rules, including an assessment of the suitability of the dataset used for validation. the rule-base fulfils the OECD principles on (Q)SARs for the largest part

Epidemiology Of Cholera

V. cholerae is the causative agent of cholera, an acute dehydrating diarrhea that occurs in epidemic and pandemic forms. 2,3 Cholera has been recognized as one of the ''emerging and reemerging infections, threatening many developing countries.'' Several recent events that mark the epidemiological importance of the disease include the reemergence of cholera in Latin America in 1991, the explosive outbreak of cholera in Rwandan refugees in Goma and Zaire, 3 and the emergence of V. cholerae in the Indian subcontinent during 1992. 6,7 All pandemics, except for the seventh pandemic, which originated in Indonesia, arose from the Indian subconti

Molecular Epidemiology

Molecular typing methods have been used to study the epidemiology of V. cholerae. While analyzing the nucleotide sequence of asd gene in V. cholerae, Karaolis et al. 8 demonstrated that the sixth and seventh pandemic strains and the U.S. Gulf coast V. cholerae O1 isolates may have derived from nontoxigenic strains, and postulated that horizontal gene transfer occurred in V. cholerae, resulting in the emergence of a new pathogenic strain. The use of gene probes to study restriction fragment length polymorphism (RFLP) in the ctxAB genes and their flanking DNA sequences, which are part of a larger genetic element (CTX element), indicated that the U.S. Gulf coast isolates of toxigenic V. cholerae O1 are clonal and different from other seventh pandemic isolates. 2- The diversity of CTX genotypes in V. cholerae O139 was reported, which may have resulted from the duplication of CTX prophage. 3 However, the toxigenic O139 strains prevalent in two endemic areas in India, including Calcutta and...

Respiratory syncytial virus

To avoid a possible outbreak in 1976 of swine influenza (the viral subtype which caused the 1918 influenza pandemic in which an estimated 20 million people died), a rush program was instituted in the USA to vaccinate many millions of US citizens with a vaccine containing this serotype. The vaccine went through the usual tests during which it was administered to many volunteers. But in a total of 41.5 million people who finally received the vaccine, about 500 cases of Guillain-Barre syndrome occurred in vaccinees within a few weeks of vaccination, an incidence of about 1 80 000 recipients. The chances of detecting such a relationship in clinical trials is negligible. This relationship had not been seen previously or since, and it has been speculated that such an effect might only be seen in an extremely large, rushed program.

Background And Historical Significance

Although food microbiology is a relatively young scientific field, foodborne and waterborne pathogens have been recognized for almost 200 years. Vibrio chol-erae consists of several serogroups, with V. cholerae Ol being the etiologic agent of the disease cholera, which has been documented as far back as 1817, the time of the first known pandemic. In 1854, the organism was first described and the connection between cholera and drinking water was hypothesized. The hypothesis was later proven, when in 1883 Robert Koch sampled suspect pond water and isolated the bacillus (Murray et al., 1999). In 1992, the serogroup V. cholerae 0139 Bengal was identified during an epidemic in India. In addition to these serogroups, other non-01 0139 V. cholerae have been identified and are collectively referred to as nonagglutinating vibrios (NAGs) (Jay, 2000). It is estimated that toxigenic V. cholerae are responsible for 49 cases of foodborne disease in the United States annually, with a case fatality...

The Origins and Meanings of Disease Pattern Categories

Disease clusters offer another opportunity to see the interplay among person, place, and time. Yet the very concept of a cluster depends partly on a series of political and social conventions. The way that boundaries are drawn around administrative space can determine the denominator. For example, six cases of childhood leukemia counted within a residential block looks more like a cluster than six cases in a census tract or town. These conventions also affect which diseases are thought to be rare, based, for example, on individuals or governments deliberately misleading people about disease status. Social interactions may influence whether knowledge of common diseases is shared in the first place (illness reported within members of a church or students in a school versus illness unknown because it occurs among isolated or marginalized individuals). Finally, political and social conventions influence the period of time over which a cluster is studied, as well as the duration and...

Contribution to Disease

Luxol Multiple Sclerosis

JC virus (JCV), a human polyomavirus closely related to BK virus and simian virus 40 (SV40), is the cause of the fatal demyelinating disease progressive multifocal leukoencephalopathy (PML), the only human disease known to be caused by infection with JCV. JCV infects 80 or more of the world's population, with initial infection occurring predominantly during childhood. The target of this ubiquitous virus is the myelin-producing oligodendrocyte. The virions can be detected in the nuclei of infected oligodendrocytes in a dense, crystalline arrangement called inclusion bodies. Prior to the AIDS pandemic, PML was a relatively rare disease affecting primarily immunosuppressed cancer patients with lymphoma or leukemia and transplant recipients receiving immunosuppressive therapy. It has been estimated that PML now occurs in about 5 of HIV-1-infected AIDS patients and is a major cause of death. Treatment of PML has been elusive. Some AIDS patients with PML receiving high-intensity...

Colonialism Early Post Colonialism and Health

The appearance of colonial medicine in Indonesia began late in the Dutch colonial enterprise. Boomgaard (1993) notes that the popularity of shots in Java began with the anti-yaws campaigns after 1900, and left a lasting impression of the efficacy of scientific medicine on local medical perception and practices in colonial Indonesia. These public health campaigns in conjunction with the Javanization of medical personnel, particularly in the Dokter Djawa schools that provided medical training for the natives, and increasing urbanization, was the context from which the Dutch Colonial Public Health Service in 1925 was launched (Boomgaard, 1993). Many scholars agree that early in the 20th century scientific models of health and disease, especially as these models pertain to hygiene and germ theory, made their way into the consciousness of certain segments of the Indonesian population, most likely through public health campaigns aimed at eradicating malaria, cholera, typhoid fever,...

Communicating about Risk Menace and Safety

Equivalent rifts exist between the number of cases of some diseases and their perceived menace. The real number of cases of disease that are major news items such as anthrax, West Nile virus, and Ebola virus is much smaller than the total of deaths from the major killers like lung cancer and heart disease in industrialized settings, and childhood infectious diseases, malaria, and AIDS in developing countries. In sum, epidemiology is known and remembered by the public far more for its claims and metaphors than for its specific data about relative risk and incidence rates.

Conclusion Of Critical Medical Anthropology

Type 2 diabetes is rapidly becoming a worldwide epidemic as populations adopt modernized or Westernized lifestyles. Evolutionary evidence for the selective advantage of diabetes thrifty genotypes and phenotypes predisposes humans to the deleterious and diabetogenic effects of contemporary culture. Recent dietary changes are characterized by an abundance of calorically dense, sugary and fatty foods with low fiber content. In addition, labor-saving, energy-efficient daily activity patterns reduce caloric needs and energy expenditure. The result is a high prevalence of obesity, insulin resistance, hyperglycemia, and other physiological abnormalities comprising Syndrome X.

Caveats for the Diagnosis of Secondary Undernutrition

Undernutrition due to disease and dysfunction obviously requires establishment of the following (1) the existence of deficiencies and (2) that factors other than underconsumption are influencing the deficiency states. The body composition standard is a body mass index (BMI) of

ESIMS for Linking Lowaffinity Ligands

The low hit rates for RNA targets in traditional HTS assay formats can be traced to difficulties in detecting and accurately measuring low-affinity interactions between small molecules and the RNA. We have developed a high-throughput MS-based assay that directly measures ligand affinities of 0.01-1000.0 M for RNA targets. In contrast to traditional HTS assays, the MS-based assay accurately quantifies binding affinity, stoichiometry, and specificity over a wide range of ligand KD values. This highly quantitative information allows a pattern of SARs to emerge, even among relatively weak binders, and guides elaboration to higher-affinity compounds.

Popular and Professional Ideas about Risk

Medicine Clinical Epidemiology Cartoons

In some ways people do not seem to do a very good job at estimating the health risk posed by their environment or their behavior. They are anxious about (unlikely) large disasters with catastrophic consequences and forget about (quite probable) exposure to more common but smaller-scale accidents or health problems. That is, they worry more about dying in an airplane crash than dying in their car on the way to the airport, and they think nuclear radiation causes more cancer than radon gas. They are more concerned about the risks of their children having peanut allergies than of being obese. The media make much of new diseases such as West Nile virus, Lyme Disease, or SARS but do not sensationalize the real mass murderers called heart disease and cancer.

Antigenic variation in HIV

Recombination between isolates of different clades makes its own contribution to the range of strains found in the global pandemic of AIDS. It is calculated that at least 10 of reported HIV-1 strains represents mosaic (recombinant) forms of the viral genome, i.e. bearing sequence characteristics of two different genetic subtypes. This can occur at any point along the genome and recombination breakpoints have been mapped in the LTR, structural and regulatory genes. For example, subtype E viruses mainly found in South-East Asia are really recombinant viruses composed of genetic material from subtype A and from an undefined parental subtype. The existence of recombinant viruses suggests that HIV-1 strains of different clades can coexist in the one individual, resulting in viable infectious progeny viruses of mixed genetic background, all of which adds to the dynamic and unstable nature of the HIV-1 epidemic worldwide and to the difficulties of designing an all-purpose vaccine.

Antigenic shift and drift in the influenza viruses

Antigenic shift involves replacement of at least the hemagglutinin gene via genetic exchange with an avian or animal virus. The new shift variant can cause a pandemic, as no neutralizing antibodies are present in the human population. There is evidence for genetic reassortment between human and animal influenza viruses in vivo. A shift virus which emerged in 1968 contained a human neuraminidase gene, but the hemagglutinin was 98 homologous at the nucleotide level with an avian influenza A virus. It is believed that new pandemic strains are produced by co-infection of pigs with avian and human influenza virus strains.

Projects Integrating Anthropology and Epidemiology

Studies of how the changing social and cultural environment affects human health will continue to be of critical importance for the foreseeable future. No single discipline can develop the complex models needed to account for the interplay between the individual and the environment and the rise of diseases such as AIDS, SARS, E. coli O157-H7, and antibiotic-resistant tuberculosis. As we will see in Chapter 6, interdisciplinary collaboration to treat and prevent these diseases is just as critical as the collaborative work undertaken to understand their burden and their causes.

Threats to Health among the Urban Poor

The population density found most often in closely inhabited urban centers and settlements is a critical condition for epidemics such as the plague, measles, influenza, poliomyelitis, tuberculosis, and the HIV AIDS pandemic to thrive, spread, and exist at endemic levels (Armelagos, Ryan, & Leatherman, 1990). The devastating spread of HIV AIDS through both urban and rural areas of the world has been further facilitated by factors including migration for employment, and the interconnection between sex work, and high-mobility occupations such as truck driving (e.g., Decosas & Padian, 2002 Voeten, Egesah, Ondiege, Varkevisser, & Habbema, 2002). Large-scale societies with high birth rates permit a rapid production and replacement of disease hosts (Schell, 1996). Because of the dense concentration of people in urban centers, sanitation has been a past problem for now-industrialized countries, and remains a persistent problem for less developed countries. Although all urban dwellers are...

Developments in Medicine

Course of attempting to gain as near as possible full control over the modern causes of death. Medical advancements in surgical techniques, nuclear medicine, medications, and the like do offer great promise for sustaining human life at a high level of vitality throughout the later years. Yet, if this advanced medicine is restricted to only those who can afford it, and if inequalities of health provision (Hertzman, 2001) are not addressed, then the general picture of health will not likely improve for a substantial number of humans. Beyond that, much of the world still must contend with childhood diarrhea, malaria, and infectious diseases. HIV AIDS has reached crisis levels in some countries, while outbreaks of the ebola virus and bubonic plague are distinct threats.

Abnormal Microbial Infection

Indeed, within the past millennia, microbial disease has proven to be a formidable adversary, one that has the potential to decimate the human population if left unchecked. During the Middle Ages and extending into the nineteenth century, diseases such as bubonic plague, cholera, and typhoid swept through Europe, causing massive mortality. The influenza pandemic at the end of World War I, for example, killed more people than the war itself.

Thymidylate Synthase Proof of Principle

Screens with chemically similar fragments showed that, although substitutions around the aromatic moiety and in the stereochemistry of the proline residue preserved the fragments conjugation strength, the proline residue itself was essential. Crystallography of N-tosyl-d-proline covalently linked to TS explained these SARs the proline residue sits snugly within a hydrophobic pocket and one of the sulfonamide oxygen atoms makes a hydrogen bond to Asn 177 on the enzyme, but the phenyl ring is in a relatively open area (Fig. 14.3).

Cholera Disease History

While cholera is an ancient disease, it continues to emerge and re-emerge. In 1991, the cholera epidemic that began in Peru and for two years spread across South America, was the first time in 100 years that cholera was diagnosed on that continent. Before it was over, more than 9,000 people had died and many more were sickened by it (Guthman, 1995). During an earlier cholera pandemic, a London physician named John Snow identified the mode of transmission. In his classic 1853 study, Snow demonstrated that a single source of water was implicated in the cholera outbreak in a particular neighborhood. The people who became sick drank water from a common public water source, the Broad Street pump. Others living in the same neighborhood did not become sick when they used water sources other than the Broad Street pump. Snow decided that the water being pumped from the Broad Street well was contaminated and had the pump handle removed. Within days the number of cases was reduced, and the...

Anthropological Contributions to the Study of Cholera

Outbreak investigations are a classic method in epidemiology they have determined the causes of new epidemics such as Legionnaires' disease, Hantavirus, Ebola virus, SARS, and E. coli O157 H7. An outbreak investigation is designed primarily to identify the sources of unusual diseases or unusual numbers of cases of disease, as well as to prevent additional cases (Reingold 1998). The steps in an epidemiological outbreak investigation include finding cases, verifying diagnoses, and comparing rates with background expectations interviewing both cases and controls about onset and exposure establishing causes and developing measures of control. Disease outbreaks are almost always newsworthy and a topic of great public concern. The public reads many sensational tales of disease and heroism, real and imagined, with titles like The Coming Plague, The Hot Zone, Outbreak, The Demon in the Freezer, The Andromeda Strain, and Plague Time. But there are other, somewhat less thrilling, stories to be...

Current Vegetarian Eating Patterns and Practices

Meatless and vegetarian eating patterns and life styles are growing in popularity today. They continue to be fostered by a greater availability and variety of meat alternatives and analogs for animal products. There is also a good deal of favorable publicity about phytochemicals with supposedly beneficial health effects. At the same time, concerns about the healthfulness of animal foods have been triggered by publicity on the bovine spongiform encephalopathy (BSE) epidemic in the UK, a later epidemic of hoof and mouth disease in cattle, and most recently an epidemic of SARS spread from animals to people. Worries about saturated fat trans fat coronary artery disease links, dietary fat and cancers, food safety, and other factors probably also contributed to the increased prevalence of vegetarian eating.

Hantavirus Pulmonary Syndrome

Hantavirus pulmonary syndrome (HPS) was first noticed in the southwestern United States in 1993 by physicians treating victims with symptoms frightfully similar to those of Ebola (Section 12.7.9). Patients were suffering from an initial fever followed by the abrupt onset of acute pulmonary edema and shock. This outbreak involved 53 infections, with 32 fatalities. A rapid, systematic epidemiological study eventually determined that the responsible agent was a hantavirus, with the deer mouse as the principal reservoir. Infection usually stems from inhalation of aerosolized dried mouse feces or urine.

Viral Hemorrhagic Fevers

The term ''viral hemorrhagic fever'' (VHF) describes a variety of viral diseases which are characterized by fever and bleeding in humans. This syndrome is caused by RNA viruses belonging to the families Filoviridae (Ebola virus and Marburg virus), Arenaviridae (Lassa virus, Junin virus, Machupo virus, Guanarito virus, and Sabia virus), Bunyaviridae CCHF virus, Rift Valley fever (RVF) virus, and Hantaviruses , and Flaviviridae (yellow fever virus and dengue virus). After transmission from their reservoir host or vector to humans, these viruses cause an acute infection and there is no evidence of chronic courses. The clinical symptoms in the early phase of a VHF are very similar irrespective of the causative virus and resemble a flu-like illness or a common enteritis. Headache, myalgia, gastrointestinal symptoms, and symptoms of the upper respiratory tract dominate the clinical picture. Hepatitis is also common. Therefore, especially in the early phase, virological testing is of utmost...

Cholera in Latin America A Sociocultural History of Disease

Cholera has spread to large portions of the world seven times since the first decade of the nineteenth century, in pervasive epidemics called pandemics. During the present seventh pandemic two major types of cholera are circulating in the world, Classic and El Tor, each with different levels of virulence (probability of infection given exposure). Cholera returned to Latin America in the form of the El Tor type in January 1991 the last previous epidemic on the South American continent had occurred in 1895. By the end of 1995, five years after the epidemic began in Peru, more than 1.3 million cases and 11,000 deaths had been reported in Latin America (Ackers et al. 1998). Cholera has become a major public health threat in the region and is now considered endemic there, meaning a self-sustaining epidemic. Capable of killing quickly and readily transmissible, cholera inspires understandable fear among individuals, national governments, and international health authorities. It signifies...

Classification And Identification

Yersinia enterocolitica and Yersinia pseudotuberculosis are included in the genus Yersinia. These species were formerly included in the genus Pasteurella and later placed into the genus Yersinia, named in honor of the French bacteriologist A. J. E. Yersin, a discoverer of the plague bacillus (1). Y. pseudotuberculosis was the first species identified in this genus (2). This organism was described in 1889 as a disease in guinea pigs. However, Y. pseudotuberculosis has shown to be the ancestor of Y. pestis, which was the cause of pandemic plague already during 541-767 AD (3). The Y. enterocolitica was identified in 1939 and named by Frederiksen in 1964 (4). The genus Yersinia is presently composed of 11 species, three of which can cause disease in humans and animals Y. enterocolitica, Y. pseudotuberculosis, and Y. pestis (5-8).


Yersinia pestis microevolution and origin Alexandre Yersin is credited with isolating the causative agent for plague (his namesake, Yersinia pestis) in 1894 (Perry and Fetherston 1997). As the announcement of the discovery was being made, the third pandemic of plague, this time originating in China and spreading along shipping routes that intersected Hong Kong, was underway (Achtman et al. 1999). The death toll from plague, at least during recorded history, has been estimated at approx. 200 million (Perry and Fetherston 1997). A large proportion of these fatalities occurred during the three pandemics that swept through different portions of the known world (i) the Justinian plague from 541 to 544 ad in the Mediterranean basin, Mediterranean Europe, and the Middle East (ii) the European Black Death from 1347 to 1351 ad (followed by epidemic cycles until the nineteenth century) and (iii) the pandemic begun in the Yunnan province of China around 1855 that subsequently spread via...


Like the Darwin's finches, plague bacteria, and Louisiana irises, influenza viral types evolve through a combination of genetic exchange and natural selection (Ghedin et al. 2005). In particular, 'The introduction and subsequent spread in the human population of influenza A viruses with a novel hemagglutinin (HA) or a novel HA and neuraminidase (NA) subtype results from a sudden and major change in virus antigenicity . Pandemic strains contain new HA or NA genes derived from animal influenza A viruses. Influenza A viruses of 15 recognized HA subtypes and 9 NA subtypes are known to circulate in birds and other animals, creating a reservoir of influenza A virus genes available for genetic reassortment with circulating human strains .' (Subbarao et al. 1998). The NA and HA mutations often arise and accumulate in a reservoir outside the human host. Recombination among these different viral lineages may then lead to a viral pathogen that is transferable, and highly pathogenic, to humans...

Aspects of Place

Two biological anthropologists, Lisa Sattenspiel and Ann Herring (1998), demonstrated these complex relationships when they studied historical data describing the 1918-1919 influenza epidemic in northern Canada in isolated Hudson's Bay Company posts linked by rivers. They used census data, company records of visits, and mortality records to help reconstruct both the visiting patterns among three trading posts and the spread of the epidemic. Mathematical models helped them to simulate what would have happened to the severity and timing of the epidemic if it had started at one or another of the three sites, if contact rates differed within communities and between communities, and if rates of travel differed among communities. They showed that the severity of the epidemic was determined primarily by contact rates within communities, whereas the timing of the epidemic was affected by contact rates within communities and by mobility patterns between communities.

Vibrio cholerae

Background Cholera appears to have originated in India. It first spread to Asia in 1817-1823, the first pandemic. The second pandemic reached Europe in 1826-1837, and subsequent to this there were five additional pandemics. The most recent began inexplicably in 1961 with a mild strain, the el Tor biotype, which had been endemic in Indonesia since 1937. More recently, it has become endemic in areas of South America. Vibrio cholerae 0139 is a new strain that emerged in the Indian subcontinent in 1992.

Diagnostic Issues

Symptoms of hyperactivity and inattention were suspected to be caused by the influenza epidemic that occurred after World War I, when postencephalitic behavior manifestations in children included extreme examples of hyperactivity and inattention. This led to the suggestion that these symptoms were due to organic brain damage. The concept of inattention and hyperactivity being part of a spectrum with less intense manifestations secondary to subtle injuries became known as the syndrome of 'minimal brain damage' in the 1960s. However, the lack of clear evidence for brain damage eventually resulted in a shift to a more descriptive labeling of the disorder. This is reflected in the American Psychiatric Association classification system (DSM) defining the 'hyperkinetic reaction of childhood.' The same disorder was

Hemorrhagic Fever

Viruses causing viral hemorrhagic fever (VHF) are highly infectious by the aerosol route, cause high morbidity, and are easily grown in cell culture. RNA viruses causing Ebola and Marburg (filoviruses), Lassa, Argentine, Bolivian, Venezuelan, Brazilian, Rift Valley, and Congo-Crimean hemmorhagic fevers are felt to be possible threats. Common to all these illnesses is an acute febrile illness, characterized by malaise, prostration, and signs of vascular permeability. Findings of conjunctival injection, hypotension, flushing, petechial hemorrhages, and mucous membrane, neurologic, pulmonary, and hematopoietic involvement are seen. Some unique differences among these agents exist. Lassa fever, for example, is characterized by fewer hemorrhagic and neurologic complications. RVF classically presents with retinitis and hepatitis. Congo-Crimean hemorrhagic fever and Marburg Ebola may cause profound DIC and hemorrhage. The diagnosis is made at a diagnostic laboratory with highest level (BL-4)...

Thomas Model

Thomas and co-workers (1996) were the first to report a comparative molecular field analysis (CoMFA)-quantitative structure-activity relationship (QSAR) derived pharmacophore model for AEA and its analogs (Thomas et al., 1996). These authors used MD studies to explore the conformations of AEA that present pharmacophoric similarities with the classical cannabinoid, A9-THC (4). A J-shaped or looped conformation of AEA was identified that had good molecular volume overlap with A9-THC (4) when (1) the carboxyamide of AEA was overlaid with the pyran oxygen (O-5) in A9-THC, (2) the head group hydroxyl of AEA was overlaid with the C-1 phenolic hydroxyl group of A9-THC, (3) the five terminal carbons of the AEA fatty acid acyl chain were overlaid with the C-3 pentyl side chain of A9-THC, and (4) the polyolefin loop of AEA was overlaid with the tricyclic ring system of A9-THC. Thomas et al. (1996) supported their use of a J-shaped conformation for AEA by citing synthetic results for the...

Dutch elm disease

Similar to the alder tree pathogen, the spread of Dutch elm disease has been marked by introgres-sive hybridization and hybrid lineage formation. Specifically, Brasier and Kirk (2001) defined two subspecies of the organism recognized as the cause of the present-day Dutch elm disease pandemic, the ascomycete fungus Ophiostoma novo-ulmi. The two subspecies, O. novo-ulmi novo-ulmi and O. novo-ulmi americana were originally designated as Eurasian and North American variants, respectively. Brasier and Kirk (2001) hypothesized that these two subspecies might have arisen through two separate hybrid subspeciation events. In particular, they posited that after its origin in Eurasia, O. novo-ulmi hybridized with Eurasian Ophiostoma ulmi and that O. novo-ulmi introduced into North America in the 1940s might have hybridized with the North American O. ulmi, giving rise to O. novo-ulmi americana. Consistent with this hypothesis was the observation of diagnostic differences between the two...


Oral iodized oil Although efficacious, injections of iodized oil have largely been replaced by oral iodized oil owing to the concern over the AIDS pandemic and use of needles as well as the higher cost of supplies (syringes) and personnel (skilled injectors). Oral delivery of iodized oil appears to be as effective as intramuscular injection but is less costly, carries no infection risk (through a contaminated needle), is painless, and can be administered by untrained personnel. Oral iodized oil is considered to be safe for pregnant women and can be given at any time during pregnancy however, it appears to protect against moderate and severe neurological abnormalities in the infant only when given during the first two trimesters. The best outcomes are likely to occur when supplementation is given during the first trimester, but even if it is given in late pregnancy or to the infant after birth slight improvements in brain growth and developmental quotients, but not neurological status,...


In the domain of public health care, for example, Yasnoff, Overhage, Humphreys, and LaVenture (2001), see a demand for a continual stream of information to be transmitted electronically from a wide variety of sources regarding the health status of every community, to be collected, analyzed, and disseminated. Through the use of intelligent electronic health records, they argue, automated reminders could be presented to clinicians for individually tailored preventive services, immediate feedback on community incidence of disease could be available, and public health officials could activate specific surveillance protocols on demand. Furthermore, customized, individualized prevention reminders could be delivered directly to the general public. Such a proposal could easily be extended to an international level, whether in public health or other areas, such as occupational and environmental health. Similarly, a surveillance system at a national level could be created to guard against major...


Serologic tests for Mycoplasma pneumoniae include enzyme-linked immunosorbent assay (ELISA), complement fixation, and cold agglutinins for Chlamydia pneumoniae they include microimmunofluorescence and for Legionella spp. immunofluorescence assay.66 However, results from serologic tests to diagnose atypical pathogens often return after the patient has been discharged and do not impact the treatment plan.67 This is particularly challenging for SARS where real-time diagnosis is needed.


E-consumers can also benefit from being informed of breakthroughs in dealing with public health problems as well as potential symptoms arising from unknown exposures to hazardous bacteria, other dangerous biological agents, or threats due to bioterrorism (for example, anthrax). Medical problems that are on the minds of a growing number of both Americans and Canadians include AIDS HIV, SARS, West Nile virus, mad cow disease, and avian flu. Many people turn to the Internet and other media for authoritative information about these life-threatening diseases. Knowing as much as possible about the vectors, symptoms, and treatment of these potentially threatening ailments is the best medicine knowledge is power, and access to information may eventually offer some protection or, when no protection is available, at least the comfort of understanding the scope of the problem.


Ebola and Marburg viruses can be detected by Filovi-ridae-specific primers binding to the polymerase gene. These primers target sites that are highly conserved among the virus family 4 and were applied in PCRs of conventional and real-time format (Table 1, PCR 1-3). The glycoprotein gene of Ebola virus is used as a target to detect all four subtypes of Ebola virus (Zaire, Sudan, Ivory Coast, and Reston), but not Marburg virus (Table 1, PCR 4). 4 Furthermore, real-time PCRs in the glycopro-tein gene for differentiating Zaire and Sudan strains, as well as for detecting Marburg virus, are available (Table 1, PCR 7 and 8). 7,8 PCR tests targeting the nucleoprotein gene detect and differentiate Ebola subtypes Zaire and Reston (Table 1, PCR 5 and 6). However, differentiation between filovirus species or subtypes is not required in the clinical situation. Sensitivity studies have been mainly carried out using the polymerase gene-specific PCR. The clinical sensitivity of this PCR was 100 in...