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History of Infectious Disease

History of Infectious Disease. What disease killed 300-500 million people worldwide but has since been eradicated from the human population? Smallpox 1157 BC; Egyptian pharaoh Ramses V mummy has smallpox lesions. Smallpox. Progression: Rash Pus-filled blisters

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History of Infectious Disease

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  1. History of Infectious Disease

  2. What disease killed 300-500 million people worldwide but has since been eradicated from the human population? • Smallpox • 1157 BC; Egyptian pharaoh Ramses V mummy has smallpox lesions.

  3. Smallpox • Progression: • Rash • Pus-filled blisters • Disfiguration and/or blindness • Death rate = 30% Man with smallpox; Public Health Images Library. Source: CDC

  4. Queen Elizabeth 1 • Had smallpox in 1562 Source: Google images

  5. Variolation: The Earliest Smallpox Immunization • Take pus from a lesion and put into vein or scratch in arm of a healthy person. • Amount of virus varied, and some would die. • George Washington had his army “variolated” during America’s War of Independence

  6. Who invented smallpox variolation? • The first vaccine Edward Jenner 1749 - 1823

  7. Edward Jenner • Physician who heard milkmaids say they never got smallpox if they had cowpox • In 1796, put pus from cowpox into cut on boy; 8 weeks later exposed him to smallpox. • Slow acceptance, then widely adopted • Vacca = latin word for “cow”

  8. The smallpox vaccine • Vaccine made with cowpox virus • Causes body to produce antibodies that protect against smallpox • Side effects: red spot, pustules, scabs, leaves a scar. Fever is common, swelling. • Fatal complications are rare: • 1 death per million vaccines

  9. The World Takes Action • 1967: WHO announces global smallpox eradication program. • Still 15 million new cases a year then • 1977: Last reported naturally occurring case in Somalia. • Smallpox is the only disease totally eradicated in humans

  10. Smallpox: Bioterrorism Agent? • Virus kept in labs in US, Russia & France • Russian scientists claimed they could make smallpox in large amounts in “scatter bombs.” • Later: Where did the Russian scientists go? • May not know for days – until symptoms happen • Today 50% of U.S. never vaccinated • Routine vaccination discontinued in 1972 • Boosters needed at 10 years • After 9/11/01, 150 million vaccines ordered • Controversial

  11. Project BioShield Act of 2004 • Feb 2008: • DoD switched to new “biodefense vaccine.” • Grown in lab cell cultures (monkey kidney cells) instead of on cow skin. • Similar to old vaccine but advanced production capabilities. • Used only for those at “high risk”. • CDC emergency-stockpiled ~200 million Goal: Develop a second generation smallpox vaccine

  12. Recognize this? Ring around the rosy, A pocket full of posies, Ashes… Ashes, We all fall down! Written in London in 1665

  13. Great Plague of London 1665 • Bubonic Plague • Ring around the rosy = dark-ringed red spots in the skin from infected flea bites. • Pocket full of posies = belief that disease carried by putrid-smell of the lesions made people carry posies close to their nose • Ashes…Ashes = Bodies were cremated (not the norm in those days) • All fall down = death • 60% of London died

  14. Plague ended in 1666 • Great fire of London finally killed the rats • The brown rat, house rat, sewer rat, Norway rat = carriers of Bubonic Plague

  15. Bubonic Plague = Black Death

  16. Black Death Gangrene caused by plague

  17. Plague, continued • Excessive sneezing of plague sufferers led Pope Gregory VII to coin “God Bless You” as a holy response when someone sneezes. • Plague (bacteria) infects both people & rodents. • Fleas (vector) transmit to people. • Infected people transmit by coughing, sneezing, close talking • Came closest to wiping out the human race. • 50 million people died from 1347-1352 • (~50-60% of Europeans)

  18. The Last Plague Epidemic in US • San Francisco 1907-1908 • After the 1906 earthquake • Homeless rats and homeless people • Anti-rat campaign lasted 4 years • 25 cents per rat

  19. Plague today? • Plague does still exist in parts of the world • WHO reports 1,000 – 3,000 cases per year • Usually where infected rodents live close to humans • Recent outbreaks: Russia, China, Kenya, Zaire, Bolivia • Have there been any human cases in the U.S.?

  20. Plague in the U.S. CDC

  21. Plague in Oregon • 13 cases reported in Oregon (5 fatal) since 1970. • Mostly spread from fleas of infected rodents. • In the news over the summer.

  22. Plague and Bioterrorism • WWII: Japanese army dropped plague-infected fleas over China. • Both US and Soviet Union developed techniques to aerosolize the Plague bacteria. • Pneumonic Plague = most severe threat • Most deadly form – rapid symptoms and close to 100% fatality rate. • Vaccine (3 doses) is for bubonic plague only • With antibiotic treatment = 50% fatality rate • Because of delayed treatment

  23. Typhoid Fever • Caused by Salmonella – typhi (bacteria) • Mostly spread through water • Also food and from other infected people • 10% death rate in early 1900’s • Clean water supply prevents typhoid; there is also a typhoid vaccine • Carrier = person who has a disease-causing organism on their skin or in their body. • Carriers may not be sick, but can spread disease if come in contact with others.

  24. Typhoid Mary • 6 of 11 people in a house got typhoid fever in 1906 • Bad water & food ruled out; Mary refused to be tested • Mary tested against her will when 22 more people got typhoid • Mary put into isolation, released after 3 years.

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