PowerPoint Presentation EpidemiologyPowerPoint演示文稿流行病学.pptVIP

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PowerPoint Presentation EpidemiologyPowerPoint演示文稿流行病学.ppt

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PowerPoint Presentation EpidemiologyPowerPoint演示文稿流行病学

* * * * * * * Cholera from Space Cholera and Sea Surface Temperature Cholera in the 1990s Cholera O139 emerges in Asia Different O (coat) antigen, 99% genetic identity O antigen is how human immune system recognizes and protects against V. cholerae More people susceptible Cholera Antibiotic Resistance Cholera is becoming resistant to several antibiotics * * * * * * * * * * * * * * * * * * * * * * * * * * * * Cholera bacterium Vibrio cholerae Toxin alters sodium pump in intestinal cells resulting in fluid loss Cholera 1800s Cholera: the Disease Entry: oral Colonization: small intestine Symptoms: nausea, diarrhea, muscle cramps, shock Infant with Cholera First Cholera Pandemic Why does an epidemic end? Second Cholera Pandemic Cholera New York 1830s John Snow and the Pump Handle John Snow and cholera in 1854 London John Snow John Snow is credited by many with developing the modern field of epidemiology London in the 1850’s Germ theory of disease not widely accepted People lived in very crowded conditions with shared water and toilets facilities outside Water Supply London 1850’s John Snow’s Observations People with cholera developed immediate digestive problems: cramps, vomiting, diarrhea Face, feet, hands shriveled and turned blue; died in less than a day Probably spread by vomiting and diarrhea Cholera Epidemiology Comparison of pump location with cholera deaths, first 3 days of epidemic in 1854 Cholera Epidemiology Of 83 people, only 10 lived closer to a different pump than Broad Street Of these 10, 5 preferred taste of Broad Street water and 3 were children who went to nearby school Cholera Epidemiology Snow convinced neighborhood council to let him remove handle from water pump on Broad Street - # new cases declined dramatically Many on council not convinced by his evidence Snow Index Case Snow Index Case Index case is first person to become ill 40 Broad Street – husband and infant child became ill Wife soaked nappies in bucket and emptied it into the water tan