logging in or signing up 6 arthropod borne infectious disease Heng Download Post to : URL : Related Presentations : Share Add to Flag Embed Email Send to Blogs and Networks Add to Channel Uploaded from authorPOINTLite Insert YouTube videos in PowerPont slides with aS Desktop Copy embed code: Embed: Flash iPad Dynamic Copy Does not support media & animations Automatically changes to Flash or non-Flash embed WordPress Embed Customize Embed URL: Copy Thumbnail: Copy The presentation is successfully added In Your Favorites. Views: 2312 Category: Entertainment License: All Rights Reserved Like it (3) Dislike it (0) Added: October 24, 2007 This Presentation is Public Favorites: 0 Presentation Description No description available. Comments Posting comment... By: hssddef (17 month(s) ago) its good ppt Saving..... Post Reply Close Saving..... Edit Comment Close By: Nakale (27 month(s) ago) it is a good ppt Saving..... Post Reply Close Saving..... 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Edit Comment Close Premium member Presentation Transcript ARTHROPOD BORNE INFECTIOUS DISEASE: ARTHROPOD BORNE INFECTIOUS DISEASE ARTHROPOD BORNE INFECTIOUS DISEASE: ARTHROPOD BORNE INFECTIOUS DISEASE MOSQUITO TICK BED-BUGS LICE SAND-FLY BLACK-FLY FLEAARTHROPOD BORNE INFECTIOUS DISEASE: ARTHROPOD BORNE INFECTIOUS DISEASE LOUSE-BORNE DISEASE OVERCROWDING POOR HYGIENE POOR SHELTER HUMANITARIAN EMERGENCIESARTHROPOD BORNE INFECTIOUS DISEASE: ARTHROPOD BORNE INFECTIOUS DISEASE SAND-FLY LEISHMANIASISARTHROPOD BORNE INFECTIOUS DISEASE: ARTHROPOD BORNE INFECTIOUS DISEASE FORMS OF INFECTION CUTANEOUS INFECTION KALA-AZAR ARTHROPOD BORNE INFECTIOUS DISEASE: ARTHROPOD BORNE INFECTIOUS DISEASE BLACK-FLY RIVER BLINDNESS Onchocerca volvulusARTHROPOD BORNE INFECTIOUS DISEASE: ARTHROPOD BORNE INFECTIOUS DISEASE MOSQUITO MALARIA DENGUE YELLOW FEVER JAPANESE ENCEPHALITIS YELLOW FEVER: YELLOW FEVER YELLOW FEVER VIRUS TYPE STRAIN FOR FLAVIVIRIDAE SUB SAHARAN AFRICA & SOUTH AMERICA Aedes aegyptiWEST NILE VALLEY ENCEPHALITIS: WEST NILE VALLEY ENCEPHALITIS ORIGINALLY ISOLATED UGANDA 1937 MORE WIDESPREAD IN RECENT YEARS FIRST REPORTED IN WESTERN HEMISPHERE USA 1999WEST NILE VALLEY ENCEPHALITIS: WEST NILE VALLEY ENCEPHALITIS NOW DISSEMINATED WIDELY IN US ALSO REPORTED IN EUROPE ENZOOTIC CYCLE BIRDS/MOSQUITOS MOSQUITO - Culex pipiens MAINTAIN TRANSMISSION IN BIRDS HUMAN INFECTION HYBRIDS OF C. pipiens WITH OTHER SPECIES Aedes aegypti : Aedes aegypti DENGUE: DENGUE VIRUS FAMILY: FLAVIVIRIDAE GENUS: FLAVIVIRUS (YELLOW FEVER/HEPATITIS C VIRUS) 40-50 NM SPHERICAL VIRUS LIPID ENVELOPE FLAVIVIRIDAE IN IRELAND: FLAVIVIRIDAE IN IRELAND HEPATITIS C VIRUSFLAVIVIRIDAE: FLAVIVIRIDAE GEMOME ABOUT 11 000 BASES ENCODES 3 STRUCTURAL PROTEINS 7 NON-STRUCTURAL PROTEINS FLAVIVIRIDAE: FLAVIVIRIDAE 3 MAJOR SUB-GROUPS Flavivirus Pestivirus (VETERINARY) Hepacivirus 3 GROUPS SHARE COMMON GENOMIC STRUCTURE DO NOT SHARE COMMON ANTIGENS FLAVIVIRIDAE: FLAVIVIRIDAE 3 MAJOR SUB-GROUPS Flavivirus Pestivirus (VETERINARY) Hepacivirus DO NOT SHARE COMMON ANTIGENS WHY IS THAT IMPORTANT? DIAGNOSTIC TESTS BASED ON ANTIBODIESFLAVIVIRIDAE: FLAVIVIRIDAE ROUTES OF TRANSMISSION MOSQUITO BORNE DENGUE TICK BORNE TICK BORNE ENCEPHALITIS(TBE) NO KNOWN ARTHROPOD VECTOR HEPATITIS C VIRUS FLAVIVIRUS: FLAVIVIRUS FLAVIVIRUS HAVE COMMON GROUP EPITOPES ON THE ENVELOPE PROTEINS WHY MIGHT THAT MATTER? ANTIBODIES TO ONE MAY REACT TO SOME DEGREE WITH ANOTHER IMPLICATIONS FOR IMMUNITY DIAGNSOTICS SEROLOGY DENGUE –THE VIRUS: DENGUE –THE VIRUS FOUR SEROTYPES DENV-1 DENV-2 DENV-3 DENV-4 DENGUE- THE VECTOR: DENGUE- THE VECTOR Aedes aegypti SMALL MOSQUITO URBAN/DOMESTICATED MOSQUITO LAYS EGGS IN ARTIFICIAL CONTAINERS VASES CAR-TYRES EMPTY PLASTIC BOTTLES WATER STORAGE CONTAINERS (BARRELLS/CISTERNS) DENGUE- THE VECTOR: DENGUE- THE VECTOR Aedes aegypti ADULT MOSQUITO RESTS INDOORS DAYLIGHT FEEDER FEMALE IS A “NERVOUS FEEDER” EASILY DISTURBED MAY BITE/PROBE SEVERAL PEOPLE DURING ONE BLOOD MEAL VIRUS MAY TRANSMIT DURING VERY BRIEF PROBE WHOLE FAMILIES MAY DEVELOP INFECTION WITHIN 24/36 HOURS FROM ONE MOSQUITODENGUE INFECTION: DENGUE INFECTION VIRAL REPLICATION OVER 3 TO 14 DAYS FOR 2- 3 DAYS IN LYMPH NODES THAT DRAIN THE REGION OF THE BITE DISSEMINATE WITHIN 2 – 3 DAYS INFECTS MONOCYTES, T CELLS & B CELLS CONSEQUENCES OF DENGUE INFECTION: CONSEQUENCES OF DENGUE INFECTION DEPENDS ON THE VIRUS STRAIN OF DENGUE VIRUS 1,2,3,& 4 BUT ALSO GENETIC DIVERSITY WITHIN EACH SEROTYPE THE HOST IMMUNE STATUS AGE GENETIC BACKGROUNDCONSEQUENCES OF DENGUE INFECTION: CONSEQUENCES OF DENGUE INFECTION ASYMPTOMATIC/ MINIMALLY SYMPTOMATIC ESPECIALLY YOUNGER CHILDREN CONSEQUENCES OF DENGUE INFECTION: CONSEQUENCES OF DENGUE INFECTION DENGUE FEVER (OLDER CHILDREN & ADULTS) 3 TO 14 DAYS INCUBATION PERIOD SUDEN ONSET OF FEVER FRONTAL HEADACE BODY ACHES NAUSEA/VOMITING JOINT PAIN RASH ENLARGED LYMPH NODES SKIN HAEMORRHAGES OR GUM & NOSE BLEEDING USUALLY SELF-LIMIITNG RARELY FATAL CONSEQUENCES OF DENGUE INFECTION: CONSEQUENCES OF DENGUE INFECTION DENGUE HAEMORRHAGIC FEVER (DHF) USUALLY IN CHILDREN < 15 YEARS INITIAL ILLNESS VERY LIKE DENGUE FEVER AROUND THE TIME THE FEVER RESOLVES SEVERE HAEMORRHAGIC MANIFESTATIONS SHOCK (CIRCULATORY COLLAPSE) FLUID FROM BLOOD LEAKS INTO TISSUE FROM THE CAPILLARIESCONSEQUENCES OF DENGUE INFECTION: CONSEQUENCES OF DENGUE INFECTION DENGUE HAEMORRHAGIC FEVER (DHF) OUTCOME IF SHOCK (CIRCULATORY COLLAPSE) IS PROFOUND AND NOT TREATED RAPID DEATH IF SHOCK IS LESS PROFOUND/EFFECTIVELY TREATED RECOVERY MAY BE RAPID CRITICAL ISSUE IN TREATMENT IS TO MAINTAIN VOLUME IN THE CIRCULATION BY INTRAVENOUS FLUIDSWHAT CAUSES DHF: WHAT CAUSES DHF IMMUNE ENHANCEMENT HYPOTHESIS PERSON PREVIOUSLY INFECTED WITH DENV1 HAS ANTIBODIES TO DENV-1 BECOMES INFECTED WITH DENV-3 ANTIBODIES TO DENV-1 BIND TO DENV-3 THE ANTI-DENV-1 ANTIBOIDES FAIL TO NEUTRALISE DENV-3 MACROPHAGES TAKE UP THE DENV-3 MORE EFFECTIVELY BECAUSE OF THE BOUND ANTIBODY WHAT CAUSES DHF: WHAT CAUSES DHF IMMUNE ENHANCEMENT HYPOTHESIS MORE INTENSE INFECTION OF MACROPHAGES/MONONUCLEAR CELLS MORE PRODUCTION OF CYTOKINES/VASOACTIVE SUBSTANCES BY MACROPHAGES/MONONUCLEAR CELLS GREATER DEGREE OF VASCULAR PERMEABILITYWHAT CAUSES DHF: WHAT CAUSES DHF GENETIC VARIABILITY OF DENV HYPOTHESIS MUTATIONS IN VIRAL GENOME RESULT IN DIVERSITY OF VIRUS SOME MUTATIONS RESULT IN VIRUS WITH INCREASED ABILITY TO CAUSE SEVERE DISEASE LABORATORY DIAGNOSIS OF DHF: LABORATORY DIAGNOSIS OF DHF HOW? REMEMBER ONLY 2 THING 1. VIRUS/BITS OF VIRUS 2. HOST RESPONSELABORATORY DIAGNOSIS OF DHF: LABORATORY DIAGNOSIS OF DHF ANTIBODY DETECTION ACUTE SAMPLE (WHEN ILLNESS STARTS) CONVALESCENT SAMPLE (TAKEN AT/NEAR END OF ILLNESS) IgM ELISA BECOMES POSITIVE ABOUT DAY 5 OF ILLNESS IgG DETECTION (HAEMAGGLUTINATION-INHIBITION) WHAT DOES IgG MEAN? LABORAOTRY DIAGNOSIS OF DHF: LABORAOTRY DIAGNOSIS OF DHF ANTIBODY DETECTION ACUTE SAMPLE (WHEN ILLNESS STARTS) CONVALESCENT SAMPLE (TAKEN AT/NEAR END OF ILLNESS) HIGHER LEVEL OF ATIBODY IN CONVALESCENT SAMPLE COMPARED WITH ACUTE SAMPLE LABORAOTRY DIAGNOSIS OF DHF: LABORAOTRY DIAGNOSIS OF DHF VIRUS ISOLATION TISSUE CULTURE NUCLEIC ACID DETECTION REVERSE TRANSCRIPTION & PCRTREATMENT OF DENGUE VIRUS INFECTION: TREATMENT OF DENGUE VIRUS INFECTION SUPPORTIVE NO SPECIFIC ANTI-VIRAL TREATMENTCONTROL OF DENGUE: CONTROL OF DENGUE VACCINE NONE CURRENTLY AVAILABLE BUT 3 LIVE ATTENUATED VACCINES UNDER DEVELOPMENT ALSO CHIMERIC VIRUS VACCINES 6 TETRAVALENT CANDIDATE VACCINES IN OR NEAR CLINICAL TRIALS THE PEDIATRIC DENGUE VACCINE INITIATIVE (BILL & MELINDA GATES FOUNDATION)SPREAD OF DENGUE: SPREAD OF DENGUE 40% OF GLOBAL POPULATION AT RISK ESTIMATED 50 MILLIION INFECTIONS PER YEAR ENDEMIC IN > 100 COUNTRIES GLOBAL DISTRIBUTION OF DENGUE: GLOBAL DISTRIBUTION OF DENGUESPREAD OF DENGUE: SPREAD OF DENGUE SPREAD IN RECENT DECADES BEFORE 1971 ONLY 9 COUNTRIES HAD EXPERIENCED DHF EPIDEMICS BY 1995 > 30 COUNTRIES HAD EXPERIENCED EPIDEMICS SPREAD OF DENGUE: SPREAD OF DENGUE WHY THE SPREAD? MAY BE MULTIPLE FACTORS INCREASED AIR TRAVEL INCREASED URBANISATION INCREASED PLASTIC REFUSE (WATER TRAP BREEDING SITES) IS CLIMATE CHANGE A FACTOR? CLIMATE CHANGE: CLIMATE CHANGE UN INTERGOVERNMENTAL PANEL ON CLIMATE CHANGE http://www.ipcc.ch/ WMO WORLD METEOROLOGICAL ORGANIZATION UNEP UNITED NATIONS ENVIRONMENTAL PROGRAMME ESTABLISHED IN 1988 CLIMATE CHANGE: CLIMATE CHANGE UN INTERGOVERNMENTAL PANEL ON CLIMATE CHANGE (IPCC) FIRST IPCC ASSESSMENT REPORT 1990 SECOND ASSESSMENT REPORT 1995 THIRD ASSESSMENT REPORT 2001 FOURTH ASSESSMENT REPORT 2007CLIMATE CHANGE: CLIMATE CHANGE UN INTERGOVERNMENTAL PANEL ON CLIMATE CHANGE (IPCC) SUMMARY FOR POLICY MAKERSCLIMATE CHANGE: CLIMATE CHANGE ATMOSPHERIC CONCENTRATIONS OF CO2 METHANE AND NITROUS OXIDE FAR EXCEED PREINDUSTIAL LEVELS CO2 FOSSIL FUEL USE & LAND USE CHANGE METHANE & NITROUS OXIDE AGRICULTURECLIMATE CHANGE: CLIMATE CHANGE CO2 280ppm PRE INDUSTRIAL (RANGE OVER LAST 650 000 YEARS 180-300) 379 PPM 2005 FOSSIL FUEL USE & LAND USE CHANGE METHANE 715ppb PRE INDUSTRIAL (RANGE OVER LAST 650 000 YEARS 320-790) 1774 IN 2005CLIMATE CHANGE: CLIMATE CHANGE “Warming of the climate system is unequivocal” 11 OF THE LAST 12 YEARS RANK AMONG THE 12 WARMEST YEARS SINCE RECORDS BEGAN IN 1850CLIMATE CHANGE: CLIMATE CHANGE SNOW COVER AND ICE EXTENT HAVE DIMINISHED GLOBAL AVERAGE SEA LEVEL HAS INCREASED AT AN AVERAGE RATE OF 1.8 mm/YEAR FROM 1961-2003 FROM 1993-2003 RATE WAS 2.4 TO 3.8 mm/YEAR SEA LEVEL HAS RISEN BY 0.17 M IN 20TH CENTURYCLIMATE CHANGE: CLIMATE CHANGE “MOST OF THE OBSERVED INCREASE IN GLOBALLY AVERAGED TEMPERATURES SINCE THE MID 20TH CENTURY IS VERY LIKELY DUE TO THE OBSERVED INCREASE IN ANTHROPOGENIC GREENHOUSE GAS CONCENTRATIONS.”CLIMATE CHANGE: CLIMATE CHANGE IRELAND ENVIRONMENTAL RTDI PROGRAMME 200-2006 CLIMATE CHANGE INDICATORS FOR IRELANDCLIMATE CHANGE & HEALTH: CLIMATE CHANGE & HEALTH LICE TYPHUS RELAPSING FEVERCLIMATE CHANGE & HEALTH: CLIMATE CHANGE & HEALTHCLIMATE CHANGE & HEALTH: CLIMATE CHANGE & HEALTH LICE TYPHUS RELAPSING FEVERCLIMATE CHANGE & HEALTH: CLIMATE CHANGE & HEALTH LICE TYPHUS RELAPSING FEVERVECTOR BORNE DISEASE: VECTOR BORNE DISEASE LARGE BURDEN OF HUMAN DISEASE HUMAN ACTIVITY IMPACTS ON VECTOR NUMBERS VECTOR DISTRIBUTION SOCIAL STRUCTURE IMPACTS ON EXPOSURE TO VECTORS OUTCOME OF INFECTIONVECTOR BORNE DISEASE: VECTOR BORNE DISEASE WHO HUMAN INDUCED CLIMATE CHANGE MAY CAUSE 150 000 DEATHS/YEAR MAINLY FROM 1. DIRECT:HEAT WAVES & DROUGHTS 2. INDIRECT: INFECTIOUS DISEASEVECTOR BORNE DISEASE: VECTOR BORNE DISEASE CLIMATE & DENGUE El Nino Southern Oscillation (ENSO) REVERSAL OF CURRENTS IN PACIFIC LINKED TO DENGUE FEVER DENGUE HAEMORRHAGIC FEVER VECTOR BORNE DISEASE: VECTOR BORNE DISEASE CLIMATE CHANGE & MALARIA CONFLICTING RESULTS CLIMATE CHANE & CHOLERA LINKS BETWEEN CHANGING PATTERNS OF RAINFALL AND INCREASED CHOLERA IN BANGLADESH Koelle K. Nature 2005; 436:696-700 VECTOR BORNE DISEASE: VECTOR BORNE DISEASE CLIMATE CHANGE & MALARIA CONFLICTING RESULTS CLIMATE CHANE & CHOLERA LINKS BETWEEN CHANGING PATTERNS OF RAINFALL AND INCREASED CHOLERA IN BANGLADESH Koelle K. Nature 2005; 436:696-700 VECTOR BORNE DISEASE: VECTOR BORNE DISEASE http://www.ehponline.org CLIMATE CHANGE AND MOSQUITO BORNE DISEASE Reiter P. 2001;109 “The natural history of mosquito-borne diseases is complex, and the interplay of climate, ecology, vector biology and many other factors defies simplistic analysis. The recent resurgence of many of these diseases is a major cause for concern, but it is facile to attribute this resurgence to climate change.”READING: READING http://www.who.int/globalchange/en GLOBAL ENVIRONMENTAL CHANGE Dengue: an escalating problem. Gibbons RV, Vaughn DW BMJ. 2002;324:1563-1566 http://www.who.int/mediacentre/factsheets/fs117/en/ http://www.scidev.net CLIMATE CHANGE IN AFRICA You do not have the permission to view this presentation. In order to view it, please contact the author of the presentation.
6 arthropod borne infectious disease Heng Download Post to : URL : Related Presentations : Share Add to Flag Embed Email Send to Blogs and Networks Add to Channel Uploaded from authorPOINTLite Insert YouTube videos in PowerPont slides with aS Desktop Copy embed code: Embed: Flash iPad Dynamic Copy Does not support media & animations Automatically changes to Flash or non-Flash embed WordPress Embed Customize Embed URL: Copy Thumbnail: Copy The presentation is successfully added In Your Favorites. Views: 2312 Category: Entertainment License: All Rights Reserved Like it (3) Dislike it (0) Added: October 24, 2007 This Presentation is Public Favorites: 0 Presentation Description No description available. Comments Posting comment... By: hssddef (17 month(s) ago) its good ppt Saving..... Post Reply Close Saving..... Edit Comment Close By: Nakale (27 month(s) ago) it is a good ppt Saving..... Post Reply Close Saving..... 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Edit Comment Close Premium member Presentation Transcript ARTHROPOD BORNE INFECTIOUS DISEASE: ARTHROPOD BORNE INFECTIOUS DISEASE ARTHROPOD BORNE INFECTIOUS DISEASE: ARTHROPOD BORNE INFECTIOUS DISEASE MOSQUITO TICK BED-BUGS LICE SAND-FLY BLACK-FLY FLEAARTHROPOD BORNE INFECTIOUS DISEASE: ARTHROPOD BORNE INFECTIOUS DISEASE LOUSE-BORNE DISEASE OVERCROWDING POOR HYGIENE POOR SHELTER HUMANITARIAN EMERGENCIESARTHROPOD BORNE INFECTIOUS DISEASE: ARTHROPOD BORNE INFECTIOUS DISEASE SAND-FLY LEISHMANIASISARTHROPOD BORNE INFECTIOUS DISEASE: ARTHROPOD BORNE INFECTIOUS DISEASE FORMS OF INFECTION CUTANEOUS INFECTION KALA-AZAR ARTHROPOD BORNE INFECTIOUS DISEASE: ARTHROPOD BORNE INFECTIOUS DISEASE BLACK-FLY RIVER BLINDNESS Onchocerca volvulusARTHROPOD BORNE INFECTIOUS DISEASE: ARTHROPOD BORNE INFECTIOUS DISEASE MOSQUITO MALARIA DENGUE YELLOW FEVER JAPANESE ENCEPHALITIS YELLOW FEVER: YELLOW FEVER YELLOW FEVER VIRUS TYPE STRAIN FOR FLAVIVIRIDAE SUB SAHARAN AFRICA & SOUTH AMERICA Aedes aegyptiWEST NILE VALLEY ENCEPHALITIS: WEST NILE VALLEY ENCEPHALITIS ORIGINALLY ISOLATED UGANDA 1937 MORE WIDESPREAD IN RECENT YEARS FIRST REPORTED IN WESTERN HEMISPHERE USA 1999WEST NILE VALLEY ENCEPHALITIS: WEST NILE VALLEY ENCEPHALITIS NOW DISSEMINATED WIDELY IN US ALSO REPORTED IN EUROPE ENZOOTIC CYCLE BIRDS/MOSQUITOS MOSQUITO - Culex pipiens MAINTAIN TRANSMISSION IN BIRDS HUMAN INFECTION HYBRIDS OF C. pipiens WITH OTHER SPECIES Aedes aegypti : Aedes aegypti DENGUE: DENGUE VIRUS FAMILY: FLAVIVIRIDAE GENUS: FLAVIVIRUS (YELLOW FEVER/HEPATITIS C VIRUS) 40-50 NM SPHERICAL VIRUS LIPID ENVELOPE FLAVIVIRIDAE IN IRELAND: FLAVIVIRIDAE IN IRELAND HEPATITIS C VIRUSFLAVIVIRIDAE: FLAVIVIRIDAE GEMOME ABOUT 11 000 BASES ENCODES 3 STRUCTURAL PROTEINS 7 NON-STRUCTURAL PROTEINS FLAVIVIRIDAE: FLAVIVIRIDAE 3 MAJOR SUB-GROUPS Flavivirus Pestivirus (VETERINARY) Hepacivirus 3 GROUPS SHARE COMMON GENOMIC STRUCTURE DO NOT SHARE COMMON ANTIGENS FLAVIVIRIDAE: FLAVIVIRIDAE 3 MAJOR SUB-GROUPS Flavivirus Pestivirus (VETERINARY) Hepacivirus DO NOT SHARE COMMON ANTIGENS WHY IS THAT IMPORTANT? DIAGNOSTIC TESTS BASED ON ANTIBODIESFLAVIVIRIDAE: FLAVIVIRIDAE ROUTES OF TRANSMISSION MOSQUITO BORNE DENGUE TICK BORNE TICK BORNE ENCEPHALITIS(TBE) NO KNOWN ARTHROPOD VECTOR HEPATITIS C VIRUS FLAVIVIRUS: FLAVIVIRUS FLAVIVIRUS HAVE COMMON GROUP EPITOPES ON THE ENVELOPE PROTEINS WHY MIGHT THAT MATTER? ANTIBODIES TO ONE MAY REACT TO SOME DEGREE WITH ANOTHER IMPLICATIONS FOR IMMUNITY DIAGNSOTICS SEROLOGY DENGUE –THE VIRUS: DENGUE –THE VIRUS FOUR SEROTYPES DENV-1 DENV-2 DENV-3 DENV-4 DENGUE- THE VECTOR: DENGUE- THE VECTOR Aedes aegypti SMALL MOSQUITO URBAN/DOMESTICATED MOSQUITO LAYS EGGS IN ARTIFICIAL CONTAINERS VASES CAR-TYRES EMPTY PLASTIC BOTTLES WATER STORAGE CONTAINERS (BARRELLS/CISTERNS) DENGUE- THE VECTOR: DENGUE- THE VECTOR Aedes aegypti ADULT MOSQUITO RESTS INDOORS DAYLIGHT FEEDER FEMALE IS A “NERVOUS FEEDER” EASILY DISTURBED MAY BITE/PROBE SEVERAL PEOPLE DURING ONE BLOOD MEAL VIRUS MAY TRANSMIT DURING VERY BRIEF PROBE WHOLE FAMILIES MAY DEVELOP INFECTION WITHIN 24/36 HOURS FROM ONE MOSQUITODENGUE INFECTION: DENGUE INFECTION VIRAL REPLICATION OVER 3 TO 14 DAYS FOR 2- 3 DAYS IN LYMPH NODES THAT DRAIN THE REGION OF THE BITE DISSEMINATE WITHIN 2 – 3 DAYS INFECTS MONOCYTES, T CELLS & B CELLS CONSEQUENCES OF DENGUE INFECTION: CONSEQUENCES OF DENGUE INFECTION DEPENDS ON THE VIRUS STRAIN OF DENGUE VIRUS 1,2,3,& 4 BUT ALSO GENETIC DIVERSITY WITHIN EACH SEROTYPE THE HOST IMMUNE STATUS AGE GENETIC BACKGROUNDCONSEQUENCES OF DENGUE INFECTION: CONSEQUENCES OF DENGUE INFECTION ASYMPTOMATIC/ MINIMALLY SYMPTOMATIC ESPECIALLY YOUNGER CHILDREN CONSEQUENCES OF DENGUE INFECTION: CONSEQUENCES OF DENGUE INFECTION DENGUE FEVER (OLDER CHILDREN & ADULTS) 3 TO 14 DAYS INCUBATION PERIOD SUDEN ONSET OF FEVER FRONTAL HEADACE BODY ACHES NAUSEA/VOMITING JOINT PAIN RASH ENLARGED LYMPH NODES SKIN HAEMORRHAGES OR GUM & NOSE BLEEDING USUALLY SELF-LIMIITNG RARELY FATAL CONSEQUENCES OF DENGUE INFECTION: CONSEQUENCES OF DENGUE INFECTION DENGUE HAEMORRHAGIC FEVER (DHF) USUALLY IN CHILDREN < 15 YEARS INITIAL ILLNESS VERY LIKE DENGUE FEVER AROUND THE TIME THE FEVER RESOLVES SEVERE HAEMORRHAGIC MANIFESTATIONS SHOCK (CIRCULATORY COLLAPSE) FLUID FROM BLOOD LEAKS INTO TISSUE FROM THE CAPILLARIESCONSEQUENCES OF DENGUE INFECTION: CONSEQUENCES OF DENGUE INFECTION DENGUE HAEMORRHAGIC FEVER (DHF) OUTCOME IF SHOCK (CIRCULATORY COLLAPSE) IS PROFOUND AND NOT TREATED RAPID DEATH IF SHOCK IS LESS PROFOUND/EFFECTIVELY TREATED RECOVERY MAY BE RAPID CRITICAL ISSUE IN TREATMENT IS TO MAINTAIN VOLUME IN THE CIRCULATION BY INTRAVENOUS FLUIDSWHAT CAUSES DHF: WHAT CAUSES DHF IMMUNE ENHANCEMENT HYPOTHESIS PERSON PREVIOUSLY INFECTED WITH DENV1 HAS ANTIBODIES TO DENV-1 BECOMES INFECTED WITH DENV-3 ANTIBODIES TO DENV-1 BIND TO DENV-3 THE ANTI-DENV-1 ANTIBOIDES FAIL TO NEUTRALISE DENV-3 MACROPHAGES TAKE UP THE DENV-3 MORE EFFECTIVELY BECAUSE OF THE BOUND ANTIBODY WHAT CAUSES DHF: WHAT CAUSES DHF IMMUNE ENHANCEMENT HYPOTHESIS MORE INTENSE INFECTION OF MACROPHAGES/MONONUCLEAR CELLS MORE PRODUCTION OF CYTOKINES/VASOACTIVE SUBSTANCES BY MACROPHAGES/MONONUCLEAR CELLS GREATER DEGREE OF VASCULAR PERMEABILITYWHAT CAUSES DHF: WHAT CAUSES DHF GENETIC VARIABILITY OF DENV HYPOTHESIS MUTATIONS IN VIRAL GENOME RESULT IN DIVERSITY OF VIRUS SOME MUTATIONS RESULT IN VIRUS WITH INCREASED ABILITY TO CAUSE SEVERE DISEASE LABORATORY DIAGNOSIS OF DHF: LABORATORY DIAGNOSIS OF DHF HOW? REMEMBER ONLY 2 THING 1. VIRUS/BITS OF VIRUS 2. HOST RESPONSELABORATORY DIAGNOSIS OF DHF: LABORATORY DIAGNOSIS OF DHF ANTIBODY DETECTION ACUTE SAMPLE (WHEN ILLNESS STARTS) CONVALESCENT SAMPLE (TAKEN AT/NEAR END OF ILLNESS) IgM ELISA BECOMES POSITIVE ABOUT DAY 5 OF ILLNESS IgG DETECTION (HAEMAGGLUTINATION-INHIBITION) WHAT DOES IgG MEAN? LABORAOTRY DIAGNOSIS OF DHF: LABORAOTRY DIAGNOSIS OF DHF ANTIBODY DETECTION ACUTE SAMPLE (WHEN ILLNESS STARTS) CONVALESCENT SAMPLE (TAKEN AT/NEAR END OF ILLNESS) HIGHER LEVEL OF ATIBODY IN CONVALESCENT SAMPLE COMPARED WITH ACUTE SAMPLE LABORAOTRY DIAGNOSIS OF DHF: LABORAOTRY DIAGNOSIS OF DHF VIRUS ISOLATION TISSUE CULTURE NUCLEIC ACID DETECTION REVERSE TRANSCRIPTION & PCRTREATMENT OF DENGUE VIRUS INFECTION: TREATMENT OF DENGUE VIRUS INFECTION SUPPORTIVE NO SPECIFIC ANTI-VIRAL TREATMENTCONTROL OF DENGUE: CONTROL OF DENGUE VACCINE NONE CURRENTLY AVAILABLE BUT 3 LIVE ATTENUATED VACCINES UNDER DEVELOPMENT ALSO CHIMERIC VIRUS VACCINES 6 TETRAVALENT CANDIDATE VACCINES IN OR NEAR CLINICAL TRIALS THE PEDIATRIC DENGUE VACCINE INITIATIVE (BILL & MELINDA GATES FOUNDATION)SPREAD OF DENGUE: SPREAD OF DENGUE 40% OF GLOBAL POPULATION AT RISK ESTIMATED 50 MILLIION INFECTIONS PER YEAR ENDEMIC IN > 100 COUNTRIES GLOBAL DISTRIBUTION OF DENGUE: GLOBAL DISTRIBUTION OF DENGUESPREAD OF DENGUE: SPREAD OF DENGUE SPREAD IN RECENT DECADES BEFORE 1971 ONLY 9 COUNTRIES HAD EXPERIENCED DHF EPIDEMICS BY 1995 > 30 COUNTRIES HAD EXPERIENCED EPIDEMICS SPREAD OF DENGUE: SPREAD OF DENGUE WHY THE SPREAD? MAY BE MULTIPLE FACTORS INCREASED AIR TRAVEL INCREASED URBANISATION INCREASED PLASTIC REFUSE (WATER TRAP BREEDING SITES) IS CLIMATE CHANGE A FACTOR? CLIMATE CHANGE: CLIMATE CHANGE UN INTERGOVERNMENTAL PANEL ON CLIMATE CHANGE http://www.ipcc.ch/ WMO WORLD METEOROLOGICAL ORGANIZATION UNEP UNITED NATIONS ENVIRONMENTAL PROGRAMME ESTABLISHED IN 1988 CLIMATE CHANGE: CLIMATE CHANGE UN INTERGOVERNMENTAL PANEL ON CLIMATE CHANGE (IPCC) FIRST IPCC ASSESSMENT REPORT 1990 SECOND ASSESSMENT REPORT 1995 THIRD ASSESSMENT REPORT 2001 FOURTH ASSESSMENT REPORT 2007CLIMATE CHANGE: CLIMATE CHANGE UN INTERGOVERNMENTAL PANEL ON CLIMATE CHANGE (IPCC) SUMMARY FOR POLICY MAKERSCLIMATE CHANGE: CLIMATE CHANGE ATMOSPHERIC CONCENTRATIONS OF CO2 METHANE AND NITROUS OXIDE FAR EXCEED PREINDUSTIAL LEVELS CO2 FOSSIL FUEL USE & LAND USE CHANGE METHANE & NITROUS OXIDE AGRICULTURECLIMATE CHANGE: CLIMATE CHANGE CO2 280ppm PRE INDUSTRIAL (RANGE OVER LAST 650 000 YEARS 180-300) 379 PPM 2005 FOSSIL FUEL USE & LAND USE CHANGE METHANE 715ppb PRE INDUSTRIAL (RANGE OVER LAST 650 000 YEARS 320-790) 1774 IN 2005CLIMATE CHANGE: CLIMATE CHANGE “Warming of the climate system is unequivocal” 11 OF THE LAST 12 YEARS RANK AMONG THE 12 WARMEST YEARS SINCE RECORDS BEGAN IN 1850CLIMATE CHANGE: CLIMATE CHANGE SNOW COVER AND ICE EXTENT HAVE DIMINISHED GLOBAL AVERAGE SEA LEVEL HAS INCREASED AT AN AVERAGE RATE OF 1.8 mm/YEAR FROM 1961-2003 FROM 1993-2003 RATE WAS 2.4 TO 3.8 mm/YEAR SEA LEVEL HAS RISEN BY 0.17 M IN 20TH CENTURYCLIMATE CHANGE: CLIMATE CHANGE “MOST OF THE OBSERVED INCREASE IN GLOBALLY AVERAGED TEMPERATURES SINCE THE MID 20TH CENTURY IS VERY LIKELY DUE TO THE OBSERVED INCREASE IN ANTHROPOGENIC GREENHOUSE GAS CONCENTRATIONS.”CLIMATE CHANGE: CLIMATE CHANGE IRELAND ENVIRONMENTAL RTDI PROGRAMME 200-2006 CLIMATE CHANGE INDICATORS FOR IRELANDCLIMATE CHANGE & HEALTH: CLIMATE CHANGE & HEALTH LICE TYPHUS RELAPSING FEVERCLIMATE CHANGE & HEALTH: CLIMATE CHANGE & HEALTHCLIMATE CHANGE & HEALTH: CLIMATE CHANGE & HEALTH LICE TYPHUS RELAPSING FEVERCLIMATE CHANGE & HEALTH: CLIMATE CHANGE & HEALTH LICE TYPHUS RELAPSING FEVERVECTOR BORNE DISEASE: VECTOR BORNE DISEASE LARGE BURDEN OF HUMAN DISEASE HUMAN ACTIVITY IMPACTS ON VECTOR NUMBERS VECTOR DISTRIBUTION SOCIAL STRUCTURE IMPACTS ON EXPOSURE TO VECTORS OUTCOME OF INFECTIONVECTOR BORNE DISEASE: VECTOR BORNE DISEASE WHO HUMAN INDUCED CLIMATE CHANGE MAY CAUSE 150 000 DEATHS/YEAR MAINLY FROM 1. DIRECT:HEAT WAVES & DROUGHTS 2. INDIRECT: INFECTIOUS DISEASEVECTOR BORNE DISEASE: VECTOR BORNE DISEASE CLIMATE & DENGUE El Nino Southern Oscillation (ENSO) REVERSAL OF CURRENTS IN PACIFIC LINKED TO DENGUE FEVER DENGUE HAEMORRHAGIC FEVER VECTOR BORNE DISEASE: VECTOR BORNE DISEASE CLIMATE CHANGE & MALARIA CONFLICTING RESULTS CLIMATE CHANE & CHOLERA LINKS BETWEEN CHANGING PATTERNS OF RAINFALL AND INCREASED CHOLERA IN BANGLADESH Koelle K. Nature 2005; 436:696-700 VECTOR BORNE DISEASE: VECTOR BORNE DISEASE CLIMATE CHANGE & MALARIA CONFLICTING RESULTS CLIMATE CHANE & CHOLERA LINKS BETWEEN CHANGING PATTERNS OF RAINFALL AND INCREASED CHOLERA IN BANGLADESH Koelle K. Nature 2005; 436:696-700 VECTOR BORNE DISEASE: VECTOR BORNE DISEASE http://www.ehponline.org CLIMATE CHANGE AND MOSQUITO BORNE DISEASE Reiter P. 2001;109 “The natural history of mosquito-borne diseases is complex, and the interplay of climate, ecology, vector biology and many other factors defies simplistic analysis. The recent resurgence of many of these diseases is a major cause for concern, but it is facile to attribute this resurgence to climate change.”READING: READING http://www.who.int/globalchange/en GLOBAL ENVIRONMENTAL CHANGE Dengue: an escalating problem. Gibbons RV, Vaughn DW BMJ. 2002;324:1563-1566 http://www.who.int/mediacentre/factsheets/fs117/en/ http://www.scidev.net CLIMATE CHANGE IN AFRICA