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Plague of Justinian

542 AD

250,000 dead

Procopius
     “sun’s light
     without brightness”
Silk Road
Medieval Warm Period
Medieval World Population
Climate


Agricultural
 Revolution

Few large cities
Medieval World Population
Viking Exploration
Black Rat

Litter < 20 pups
  3 - 7 x/year

Mature at 3 mos
Flea
Black rats & fleas
Yersinia Pestis
Bubonic plague
Medieval Culture
Bubonic plague
“Ring around the rosie . . “
Plague in Europe
Plague effects
 Death art
 Cemeteries & Pest houses
 Quarantine
 Latin->vernacular
 Anti-Semitism
 Laborers, women
 Sheep
Death art
Anti-Semitism
Flagellants
Clergy
Great Fire of London
1666


Change in
 architecture
Pathogenic Competition
Leprosy (Hansen’s disease)


Plague


Tuberculosis
Chinatown 1900
San Francisco 1900 -1904
Smallpox
Species jump


Ramses V
    ~1150 BC
Variola virus
 Largest & most complex
  mammalian virus

 Respiratory


 Incubation: 10-14
                days
Variola rash
Wigs and Powder
East meets West
      Why were Native Americans so vulnerable?

Isolation


Few domesticated
    animals

Famine?
Population losses
American colonies
Variolation




              John Adams
Milkmaids and cowpox
Jenner’s vaccination
Eradication (1977)
World Health Org.
 (WHO) campaign



Accidental lab
  Contamination 1978
Measles
 Respiratory virus


 8 - 12 day
  incubation

 Complications
Measles
Measles vaccine
MMR
Measles, Mumps, Rubella
2008
Avoiding Immunizations
Health insurance coverage


Autism


Personal, Religious reasons


International travel
Vector Diseases
Yellow Fever
 Jaundice


 Flavivirus


 Carried by
  Aedes aegypti
  mosquito
Yellow Fever
1793 Philadelphia




    Benjamin Rush
1878 Memphis
Post Civil War


Immigrants


El Nino


River, train depot
Spanish American War
Walter Reed


1937 vaccine
 (Max Theiler)
West Nile Encephalitis

 New York City 1999

 Crows, blue jays


 Flamingo, penguin
Spread of WNE
1999           2007
Transmission Cycle
Influenza Pandemic
    1918 - 1919
Influenza virus
Flu viruses
Types A, B, C


H -> binds to cells


N -> degrades
          mucous
Flu varieties
Epidemic Date        Deaths      Subtype
Asiatic   1889 - 90 1 million    ?H2N2?

Spanish   1918 - 9   35 million H1N1

Asian     1957-8     1.5         H2N2
                     million
Hong Kong 1968-9     1 million   H3N2
Flu transmission cycle
1918 - 1919
 3 waves


 World War I


 Secondary
 infections
Influenza virus
Orthomyxovirus


Respiratory


Fever, chills, aches
Age Profiles
Avian Flu
Avian Flu
SARS
(Sudden Acute Respiratory Syndrome)
Swine Flu 1976
Fort Dix, NJ


National
 immunization

Guillain-Barre
“Killer Fever”
Legionnaire’s
 Philadelphia
  July 1976

 Bellevue-Stratford


 34 deaths, 221 ill
Legionella pneumophila
2008


Legionnaries' claims second life at St.
  Peter's Hospital
Six adults diagnosed over last 2 weeks; chlorination process may be to
    blame

By GENE RACZ • and RICHARD KHAVKINE • September 25, 2008
Revenge of the Germs?
Tuberculosis
“White Disease”




Chopin   Keats   Dostoyevsky
TB
Bacterial


Long incubation


Airborne


Uv light
2007
Antibiotic Resistance
Nosocomial infections
MRSA
 Methicillin Resistant Staphylococcus Aureus
Penicillin
Penicillin
Fleming 1928


Florey/Chain 1945
Antibacterials
Antibiotics in food
Transduction
Transduction
Transduction
Bacteriophages
Zyvox
April 2000
Penicillin resistance
Antibiotic Resistance
Causes:
 Overprescription/unnecessary use

 Antibiotics in food/dairy

 opportunistic bugs
Waterborne Bacteria
Cholera




 Vibrio cholerae
1854
Cholera Distribution
Food-borne bacteria
Sept 2006




June 2008
Salad Bars?
Raw food



Utensils



Residual soil
Produce
Sprouts


Melons


Greens
Bacteria
Salmonella




Shigella



Campylobacter
Salmonella Typhimurium
Typhoid Mary
 (Mary Mallon
 1869 - 1938)


1906
 Oyster Bay, NY
Peanuts 2008/9
Heat products to
 70° F (not 40° F)
Poultry
Chicken recall
  (March 2008)
Antibiotics in food
Why Poultry?
Antibiotics in food


Close confinement


Chill baths


transportation
Is your dinner safe?




A=Premium Brands (Bett & Evans, Ranger, Readington Farms, Rocky, Rocky
Jr., Rosie, Springer Mountain Farms, Wegmans Premium, Wild Harvest;
B=Perdue;
C=Foster Farms;
D=Supermarket Brands (Albertson's, Big Bear, Cub Foods, Dominick's, Giant
Eagle, Giant Gold Star Meats, Jewel, Publix, Safeway, Shaw's, Stop & Shop
White Gem, Tops, Trader Joe's, Wegman's;
E=Pilgrim's Pride;
F=Tyson
Contaminated Beef
Why ground beef?
Greater surface area


Parts of different cows


Kid appeal


“Make mine rare”
Beef ranches
Crowded herds


Antibiotic use


Inspections??
Beef Recall
October 2007
E. Coli O157:H7
1982 fast food burgers


1985 associated with HUS


1991 apple cider


1993 fast food burgers
Escherichia Coli
HUS
            (Hemolytic uremic syndrome)

 Destroys red blood cells




 Kidney failure




 Shiga toxin
HUS
BSE
      (bovine spongiform encephalopathy)

“Mad cow”
Beef & Byproducts
Salmonella (1984)
The Dalles, OR
Rajneeshees




Bhagwan Shree Rajneesh          Ma Anand Sheela
Biological Terrorism
Poisoned arrows


Pots with snake venom


Plague victims
Sweet Sabotage
Mandrake


“Mad Honey”


Ergot of rye
French-Indian War
Amherst
Plague as weapon
Kaffa
World War I
Gassing
 Chlorine gas


 Mustard gas


 Phosgene


 Chlorpicrin


 HCN
Gas Effects
Geneva Convention (1925)
Article 32
  “Whereas the use in war of asphyxiating, poisonous or other gases, and of all
  analogous liquids materials or devices, has been justly condemned by the
  general opinion of the civilized world; and
 Whereas the prohibition of such use has been declared in Treaties to which the
  majority of Powers of the world are Parties; and
 To the end that this prohibition shall be universally accepted as a part of
  International Law, binding alike the conscience and the practice of nations;
Second Generation
Nerve gases:
    Sarin

    Tabun

    VX

Colorless, odorless
Nerve Cells
Synapse
Nerve cells

Overstimulation -> convulsions




Blocking neurotransmitter
                   -> paralysis
Iran Iraq War
   (1980 - 1988)
Cold War
Biological vs. Chemical
More specific


Persistent, contamination


Cheap
Serratia Marescens
Yellow Rain
Bioweapons Convention
            (1969)
 “never in any circumstances to develop,
    produce, stockpile or otherwise acquire or
    retain:
(1) Microbial or other biological agents, or
    toxins whatever their origin or method of
    production, of types and in quantities that
    have no justification for prophylactic,
    protective or other peaceful purposes;
(2) Weapons, equipment or means of delivery
    designed to use such agents or toxins for
    hostile purposes or in armed conflict.
Sverdlovsk
Desert Storm
Gulf War Syndrome

    anthrax vaccine

    chemical weapons

    depleted uranium
Aum Shinrikyo
1990 botulinium


1993 anthrax


1993 botulinium
Sarin
March 20, 1995 Tokyo Subway
2001


 9/11 WTC
October 2001
10/5/2001


Bob Stevens dies of
 respiratory
 disease
October 2001
October 2001
Anthrax
Anthrax
Koch


“Wool-sorter’s”
Spores
Natural exposure
Attacks 2001
Cleanup
Global storage
Bioterrorism agents
Class A: highly infectious
          high mortality rate
          easily disseminated

Class B: easily treated
          lower mortality
Viral Agents
Smallpox


Ebola


Hantavirus


Influenza
Smallpox
Eradicated 1977


Few vaccinated


contagious
Ebola
1st cases 1976


90% fatality rate


Bat vector?


Reston 1989
Hantavirus
1993: 12 deaths




2003:
Hantavirus
Flu
Mutations




Avian flu
Bacterial agents
 Botulinium


 Plague


 Cholera/salmonella


 Tularemia/Q fever
Clostridium Botulinum
Aum Shinrikyo


Unit 731


Botox


anaerobic
Yersinia Pestis
Black Death


Unit 731


Antibiotic resistance
 (Madagascar 1995)
Vibrio Cholerae
Rehydration


Fresh or salt
 water

Type O most
 susceptible
Salmonella
 Typhoid Mary


 The Dalles 1984


 Oct 2008:
  frozen chicken
Tularemia
“Rabbit fever”


Flu-like symptoms


Ticks/flies = vector
Q(uery) Fever
Cattle, sheep, goats


Disinfectant
 resistant
Chimera
Biological Chimera
Organism produced from the
 combination of genetic materials from
 two or more pathogens
Mission Impossible II
Russian
 Supervirus
Gene Splicing
Genetic Engineering
 Fluorescent
  animals

 Super Salmon


 Golden Rice
Veepox
1990 Vector
 VEE
 Venezuelan
 equine
 encephalomyelitis

+   smallpox

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