Global+Infectious+Disease

==Seven main diseases are responsible for 90% of deaths caused by infectious disease. These include HIV/AIDS, lower respirator infections, diarrheal diseases, tuberculosis, malaria, measles, and neonatal [| 2]==

First off we will look at the AIDS epidemic

 * ==how it is diagnosis==
 * ==the effects on the body==
 * ==how its transmitted==
 * ==treatment==
 * ==its economic impact==
 * ==the stigma surrounding it==
 * ==its origin==
 * ==misconceptions==

[|Wikipedia AIDS article]
AIDS stands for Acquired Immune Deficiency Syndrome 33.2 million people are now living with AIDS "World Health Organization (WHO) estimate that AIDS has killed more than 25 million people since it was first recognized on June 5, 1981" so AIDS is a fairly recent/ new disease AIDS onsets usually occurs about a decade after infection of HIV

How is AIDS transmitted?
 * HIV is generally acquired through unprotected sexual contact when one of the partners has HIV
 * HIV is spread through contact between partners with the rectal, genital, or oral mucous membranes of the other partner
 * Many believe that oral sex is without risk to sexual diseases. These people are mistaken but it is still safer then insertive or receptive sex
 * it can also be transmitted through pregnancy and child birth to the child
 * when a mom to be is treated with drugs, the risk of transmission is drastically cut
 * many women however cannot afford this in third world countries
 * there is an alternative to this treatment that is cheaper and easy to administer- there is a pill that a woman can take right when she goes into labor that cuts the transmission risk
 * rarely people can be infected through blood transfusions- hospitals screen the blood but HIV can sometimes go undetected
 * saliva is not usually a transmission concern- semen contact infection risk is much higher

What is its economic impact? What are the effects on the human body?
 * AIDS and HIV slow economic growth because it limits the human capital available- the work force decreases
 * the death rate (specifically in African countries) is rapidly increasing which is leaving more and more children orphans and homeless
 * often grandparents have to take care of these children and live in poverty
 * the people who are unable to work because they are sick also require intense medical care
 * most people in third world countries cannot afford this care
 * workers often have to take off time to care for AIDS stricken family members
 * people and nations are having an increasingly difficult time paying for treatments
 * "Symptoms of AIDS are primarily the result of conditions that do not normally develop in individuals with healthy immune systems. Most of these conditions are infections caused by bacteria, viruses, fungi and parasites that are normally controlled by the elements of the immune system that HIV damages." (Wikipedia)
 * It "affects almost every organ system," there is an increased risk for developing cancer
 * "People with AIDS often have systematic symptoms of infection like fevers, sweats, swollen glands, chills, weakness and weight loss." (Wikipedia)
 * with treatment, once AIDS sets in death usually occurs within 5 years
 * without treatment, AIDS can be fatal in a year
 * the deaths are usually caused by malingering infections that the body cannot fight off
 * they are more likely to get pulmonary illnesses than people with healthy immune systems
 * Tuberculosis is also a problem especially in countries with high HIV/AIDS rates
 * Gastro-intestinal illnesses can include: esophagus inflammation, chronic diarrhea, one cause of the weigh loss is that the intestinal tract actually absorbs nutrients differently
 * neurological illnesses: brain infections

WHO disease staging system for HIV infection and disease

 * //Stage I:// HIV infection is [|asymptomatic] and not categorized as AIDS
 * //Stage II:// includes minor [|mucocutaneous] manifestations and recurrent [|upper respiratory tract] infections
 * //Stage III:// includes unexplained [|chronic] [|diarrhea] for longer than a month, severe bacterial infections and [|pulmonary] tuberculosis
 * //Stage IV:// includes [|toxoplasmosis] of the [|brain], [|candidiasis] of the [|esophagus], [|trachea], [|bronchi] or [|lungs] and [|Kaposi's sarcoma]; these diseases are indicators of AIDS. (Direct quote from Wikipedia article on AIDS)

Male circumcision may help prevent getting HIV [|Circumcision] [|MSM transmission risk in developing countries] [|Potential new treatment "Flax Hull Lignans"] [|HIV molecular problems] [|Problems creating a vaccine] [|Statement from World AIDS Day]
 * Recent News in AIDS research:**


 * CDC classification system for HIV infection**

"In the beginning, the Centers for Disease Control and Prevention (CDC) did not have an official name for the disease, often referring to it by way of the diseases that were associated with it, for example, lymphadenopathy, the disease after which the discoverers of HIV originally named the virus.[22][23] They also used Kaposi's Sarcoma and Opportunistic Infections, the name by which a task force had been set up in 1981.[24] In the general press, the term GRID, which stood for Gay-Related Immune Deficiency, had been coined.[25] However, after determining that AIDS was not isolated to the homosexual community,[24] the term GRID became misleading and AIDS was introduced at a meeting in July 1982.[26] By September 1982 the CDC started using the name AIDS, and properly defined the illness.[27] In 1993, the CDC expanded their definition of AIDS to include all HIV positive people with a CD4+ T cell count below 200 per µL of blood or 14% of all lymphocytes.[28] The majority of new AIDS cases in developed countries use either this definition or the pre-1993 CDC definition. The AIDS diagnosis still stands even if, after treatment, the CD4+ T cell count rises to above 200 per µL of blood or other AIDS-defining illnesses are cured." //Selection from the Wikipedia article.//


 * HIV test**

"Many people are unaware that they are infected with HIV.[29] Less than 1% of the sexually active urban population in Africa has been tested, and this proportion is even lower in rural populations. Furthermore, only 0.5% of pregnant women attending urban health facilities are counseled, tested or receive their test results. Again, this proportion is even lower in rural health facilities.[29] Therefore, donor blood and blood products used in medicine and medical research are screened for HIV. Typical HIV tests, including the HIV enzyme immunoassay and the Western blot assay, detect HIV antibodies in serum, plasma, oral fluid, dried blood spot or urine of patients. However, the window period (the time between initial infection and the development of detectable antibodies against the infection) can vary. This is why it can take 3–6 months to seroconvert and test positive. Commercially available tests to detect other HIV antigens, HIV-RNA, and HIV-DNA in order to detect HIV infection prior to the development of detectable antibodies are available. For the diagnosis of HIV infection these assays are not specifically approved, but are nonetheless routinely used in developed countries." //Selection from the Wikipedia article.//



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Malaria • in sub-sarharan Africa malaria is the leading killer of children under the age of five. • Over three million cases and one million deaths due to malaria occur each year. • Caused by a parasite that enters the body with a bit from an Anopheles Mosquito • Symptoms: fevers with chills, back pain, headcache, sweating, weakness, nausea and anemia • Malaria affects more people living in poverty, and those who survive malaria have both social and economic consequences due to low productivity and depression • While malaria can be prevented with anti-malarial drugs, may people do not have the resources to pay or receive them • The drugs used to treat malaria have also been rendered ineffective in some areas due to the disease mutating

Severe Malaria Symptoms/Consequences • Severe malaria happens after 6-14 days of infection • Coma and death if untreated • Pregnant women and children are most vulterable • Enlarged spleen and liver • Renal failure – because of this, blackwater fever (http://en.wikipedia.org/wiki/Blackwater_fever) may occur • Cerebral ischemia (damage or dysfunction of tissue)

Disease Prevention
 * There is not malaria vaccine but there is an active field of research to find a vaccine
 * Mosquito eradication – by draining wetland breeding grounds and better sanitation, the mosquito population will drastically decline. There used to be Malaria in Southern Europe and the United States but now the problem is obsolete. The use of pesticide DDT almost completely got rid of the malaria problem in the US. In 2002 there were 1,059 cases of Malaria in the US, five of which the malaria was contracted in the US
 * The use of Mosquito Nets drastically lowers the chance of contracting malaria
 * DDT can be used to spray around the barriers of homes to prevent mosquitoes from landing there and is highly recommended by the World Health Organization (WHO) but because there have been problems as a direct result of DDT which is generally used in agriculture, there is controversy whether or not the use of DDT as malaria control is safe

Sickle Cell Disease • Genetic disease caused by sickle hemoglobin • “red blood cells change shape upon deoxygenation because of polymerization of the abnormal sickle hemoglobin” • this damages the cell membrane and can cause the cells to become stuck to the blood vessels and clog the viens • because the malaria parasite reproduces in the red blood cell, many people who have sickle cell disease are immune to malaria • when the malaria parasite tries to reproduce in the blood cell, the cell become destroyed before the daughter pararsite could emerge



Anti Malarial Drugs • chloroquine was the most popular, and cheap, “However, resistance of Plasmodium falciparum to chloroquine has spread recently from Asia to Africa, making the drug ineffective against the most dangerous Plasmodium strain in many affected regions of the world.” • Currently available anti-malarial drugs include:[63] • Artemether-lumefantrine (Therapy only, commercial names Coartem® and Riamet®) • Artesunate-amodiaquine (Therapy only) • Artesunate-mefloquine (Therapy only) • Artesunate-Sulfadoxine/pyrimethamine (Therapy only) • Atovaquone-proguanil, trade name Malarone (Therapy and prophylaxis) • Quinine (Therapy only) • Chloroquine (Therapy and prophylaxis; usefulness now reduced due to resistance) • Cotrifazid (Therapy and prophylaxis) • Doxycycline (Therapy and prophylaxis) • Mefloquine, trade name Lariam (Therapy and prophylaxis) • Primaquine (Therapy in P. vivax and P. ovale only; not for prophylaxis) • Proguanil (Prophylaxis only) • Sulfadoxine-pyrimethamine (Therapy; prophylaxis for semi-immune pregnant women in endemic countries as "Intermittent Preventive Treatment" - IPT) • Hydroxychloroquine, trade name Plaquenil (Therapy and prophylaxis)