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anth 319 midterm review quizlet

Terms in this set (56)

Epidemic
is a disease that increases dramatically in both incidence and prevalence in a short period of time Ex: Bubonic Plague, measles, and small pox.
Pandemic
is an epidemic for a longer period of time on a larger scale. Ex: flu, H1N1 and HIV
Endemic
a disease that is always present in a given area maintained in a population, they are common diseases that happen at a steady rate Ex: chicken pox and colds
Disease
Objective. Is a measurable, pathological reason for alteration of "normal" functions. There are 6 major types: malnutrition, infection, genetic, chronic, injury, psychological or behavioral.
Illness
Subjective. It is a sufferers interpretation of disease; understood and treated in a particular social and cultural context; how a person feels.
Infectious disease
A disease caused by a microorganism or other agent that enters the body of an organism; communicable.
There are 4 classes of infectious pathogens: bacteria (meningococcal infection), virus (chicken pox, HPV), fungus (oral thrush), Helminth (schistosomiasis - parasite)
Chronic disease
A disease that reoccurs over a long period of time; non communicable; Is developed by an individual (ex: high blood pressure, arthritis, respiratory diseases like emphysema, high cholesterol.)
Innate immunity
Phagocytosis; genetically inherited, not specific to particular parasites. Thing that happens first and fastest. The same for if you cut yourself or if you come across the flu. Biology: Phagocytes the most common macrophage activate and surround the pathogen with toxins and reveal the epitopes to lymphocytes so they can remove it.
Acquired immunity
conferred after contact with a disease (specific to that parasite). Its specific and has a memory, requires more energy and therefore time than innate immunity. B-cells recognize antigens on the pathogen and create a receptive antibody. T-cells destroys pathogen when it is brought to the surface of the cells.
Vaccination
non-infectious forms of pathogens whose purpose is to allow the body to become immune to the disease. Inactivated pathogen injection to build immunity without the side effects of having the activated disease. Creates antibodies and a memory of infection, and the memory helps protect from disease if re-exposed to the pathogen in the future.
Adaptations to disease
Physiological: examples include skin and mucus.
Genetic: examples include HLA (human leukocyte antigen) and sickle cell heterozygousness.
Developmental: breastfeeding gives infants passive antibodies and some T & B cells, so their immune system's aren't totally open to disease
Cultural: examples include eating fava beans as fava beans contain powerful oxidants, much eating of which can destroy malaria pathogens by limiting oxygen levels in cells
Zoonoses
Any disease or infection that is naturally transmissible from vertebrate animals to humans. Those vertebrae tend to be the reservoir. Can be any class of pathogen (virus, bacteria, etc)and can include direct transmission or through vectors. There are >250 zoonotic diseases. 61% of infectious diseases are zoonotic
75% of emerging diseases are zoonotic
Examples: Ebola
SARS
West Nile virus
Hantavirus
Host
The human (or other organism) that is infected.
Causal agent
The organism that causes the disease
ex. Virus, bacteria, Fungi
Vectors
organisms (usually an arthropod) which transmit the causal agent from one infected host to a new host. Tends to get disease from small animal (tick, flea, mosquito). Example = malaria, lyme disease
Virulence
harm done by a pathogen to the host following an infection; "Harm" can be specific signs and symptoms or a reduction in host fitness; varies dramatically among pathogens.
Mode and Chance of Transmission determine virulence.
Pop. size and mobility, environmental changes and social behaviors determine modes and chances.
*more virulent = less chance of transmission--> host to host
From vector to host however, this can increase the chance of transmission with malaria.
*less virulent = greater chance of transmission→ from host to host
Pathogens
infectious agents; microorganisms that cause diseases
Edge effect
when forests are fragmented and it causes people to come into more contact with the animals since the animals home has shrunk or it is causing the animals to spread out into the urban areas causing humans to have more contact with animals (e.g. lyme disease, Hanta virus)
Antigenic drift
These are small changes in the virus that happen continually over time. Antigenic drift produces new virus strains that may not be recognized by the body's immune system. This process works as follows: a person infected with a particular flu virus strain develops antibody against that virus. As newer virus strains appear, the antibodies against the older strains no longer recognize the "newer" virus, and reinfection can occur. This is one of the main reasons why people can get the flu more than one time. In most years, one or two of the three virus strains in the influenza vaccine are updated to keep up with the changes in the circulating flu viruses. So, people who want to be protected from flu need to get a flu shot every year. (CDC)
Modes of transmission
The method of which a pathogen infects its host: Airborne, Waterborne, vector-borne, physical contact, or fecal-oral.
"Sit and wait" pathogens
Being able to live outside a host for long periods of time until coming into contact with a new host. Smallpox TB and Anthrax can survive for years outside of a host on surfaces and in soil.
Epidemiological Transition Model
Pestilence of Famine-->
Receding Pandemics-->
Degenerative
& Man-made disease
Flaws: suggests unilinear movement
increased suffering is at the goal end
we'll think that there will be a delay in the onset of chronic
diseases.
Emerging/Re-emerging infectious disease
Clinically distinct conditions whose incidence in humans has increased. May be due to the introduction of a new agent, the recognition of an existing disease that has gone undetected, or a change in the environment that provides and epidemiological bridge. Re-emergence may be used to describe the reappearance of a known disease after a decline in incidence.
Prevalence
the number of people affected by the disease at a given point in time
Incidence
the number of new cases of a disease in a population
Morbidity
effects of a disease on health & prevalence of disease in population
Mortality
Measured by death; it is the rate of the population that are infected by a disease that die from the disease
Herd immunity
Occurs when the proportion of people immune to an infection is sufficiently high so that transmission of the infection to susceptible individuals is greatly reduced.Immunity can be from vaccination or genetics. Helps to protect those who are susceptible and cannot be immunized (e.g. immuno-compromised, pregnant women, & newborns.) Decreases the number of carriers. Depending on the specific disease 80-100% of people need to be immunized. Ex. measles, smallpox.
Drug resistance
random mutations in diseases that make them resistant to the form of treatment being used and they survive and replicate. Can be heightened from the over use of antibiotics or wrong antibiotics or antivirals.
"Structural violence"
a non physical violence imposed by powerful upon the weak, structures the victims living situation such that his/her choices in life are limited. Can include: poverty, gender, education, racism; affects individuals but not within their control. Decisions made by people in power can be the cause of this. "Violence" because imposed by the powerful and reinforced by the culture itself. Important because of historical development (over extended period of time).

Ex. Haiti's poverty exists because of historical progress, not because anything Haitians did during one time. To be recognized on the global scale, France demanded that Haiti pay France all the money it would have gained with their slave industry. Just paid off in the 20th century. All of this caused widespread poverty in Haiti.
Social determinants
ex structural violence on an individual scale, poverty, gender and race are structural factors that can affect people's health. Generally talking about an isolated set of factors limited to a particular family or individual.
Culture
shared beliefs,common knowledge, traditions and rituals. Sometimes used to blame people for their own misfortune.
Globalization
more contacts with other countries (increased interconnectedness) of goods and ideas, more waste, more international commerce. Global spread of ideas ex pandemics and sedentism
Malaria
Vector-borne tropical disease that causes over 1 million deaths annually.High prevalence in children. Considered the original 'emergent' disease - appeared for the first time in humans long ago but only in recent history rapidly increased in incidence.One of the top three killers among communicable diseases. Constitutes a large part of the global burden of disease with 300 to 500 million clinical cases each year. Burden is unevenly distributed and affects poor populations much more than others. Ninety percent of malaria mortality occurs in Africa, and Sub-Saharan Africa in particular has remarkably high rates of transmission. Each of the four forms of malaria that currently infects humans has a close relative that infects primates, suggesting that malaria evolved within early hominid populations. Many ecological, social, historical and evolutionary factors influence the spread, virulence and eradication of malaria.Duffy negative genetic mutation - can't get P.vivax without duffy anitgen receptor on RBCs. Hurts countries economically.
Polio
Considered a success in disease history, but not totally eradicated. (still endemic in Afghanistan, Nigeria, and Pakistan and India)
Has flu-like symptoms/ virus passed through oral/ fecal route so
it's hard to tell who is infected, and don't know if you're passing it on. The vaccine isn't distributed well, people have myths about it. Vaccine that must be refrigerated. So it's harder to administer in the field.
Smallpox:
Eradicated! No asymptomatic carriers, obvious/specific symptoms (.very easy to tell who has it) Only human reservoir - (human-human transmission) Easy-to-administer, cheap vaccine
HIV/AIDS
structural violence (Farmer)
leading cause of death in adults worldwide
symptoms are overlooked at first, but highest viral loads in the first 10 weeks.
Factors include condom use, circumcision, viral type, viral load, and previous STI.
Can't reproduce outside of a host because it only contains RNA
It mutates very quickly so it becomes resistant to many drugs, must be treated with a cocktail of ARTs.
Tuberculosis
structural violence (Farmer)
Mycobacterium Tuberculosis bacterial disease.
It infects macrophages causing the immune system to generate a response to damage the lungs
Latent → can't spread to others, don't feel sick, normal chest X-ray. 90% have latent form.
Active → feel sick, can spread it, need treatment, noticeable in X-rays and spectum samples.
If you become immuno-compromised (like with HIV), your latent TB can turn active. Aerosol transmission and contact with sit and wait material. Mostly pulmonary but can also affect bone and skin. It is protected by a fatty acid.
Schistosomiasis
Endemic to 74 countries and it affects an estimated 200 million people worldwide.It mostly commonly affects women, children, and fishermen because the transmission is through water.
Initial symptoms include: fever, chills, sweating, headache, diarrhea
Those with high number of flukes have liver and intestinal damage:
Immune system is hyper-sensitive to eggs and builds up granulomas which can cover intestines and liver. This damage leads to fluid build-up and abdominal swelling. Prevalence increases with dams and the development of rice farming and water management systems promoted growth of snails in China and SE Asia. In China it is considered reemerging disease.
Lyme disease
Deforestation, changes in land use, and patterns of water use may alter ecosystems and bring humans into contact with new and re-emerging diseases It was first identified in the United States in 1975 It is cause by the deer tick. Deer tick have 3 feeding stages: larvae, nymph, adult. Larvae:Tick eggs are laid in the spring and hatch as larvae in the summer. Larvae feed on mice, birds, and other small animals in the summer/fall. When a young tick feeds on an infected animal, the tick takes bacteria into its body along with the blood meal, and it remains infected for the rest of its life.
Nymphs: After 1st feeding, the larvae become inactive as they grow into nymphs. In spring, nymphs seek blood meals to grow into adults. When nymph feeds, it can transmit bacterium to a new host (animal or a human). Most human illness occurs in late spring and summer when nymphs are most active and human outdoor activity is greatest. Adult Tick: Adult ticks feed on large animals or humans.
In spring, adult female ticks lay eggs on the ground. Deer do not become infected by adult ticks, but deer are important in transporting ticks and maintaining tick populations.
Symptoms - Affects multiple body systems and produces a range of symptoms. Incubation is from several days to years
First stage includes fever, headache, muscle ache and rash (80% of cases) Large red flat circles.
Second stage includes cardiac and neurological symptoms
Untreated symptoms can worsen causing arthritis and neurological damage.
Prevalence in U.S.~20,000 new cases reported each year & most common vector-borne disease in the United States
Kuru
Caused by prion, which is a neurodegenerative protein
Transmission has been facilitated by cannibalism in Fores people In death rituals men did not eat the brain where the protein resides, but women and children did. (Men ate "choice meats" like muscles.)
Associated to "mad cow disease," BSE, CJD and Scrapie.
Chagas Disease (kissing bug)
Caused by protozoa Trypanosoma cruzi
Transmitted by reduviid bug - lives in thatch, and in thatch-roofed mud houses. Associated with the poor, because of vector's necessary living conditions. Acute stage: Immediate reaction. Causes swelling of the eye or mouth, tiredness, fever, rash, loss of appetite.Is chronic: 10 to 20 years after infection.
Severe untreated cases can cause enlarged heart and digestive tract, which Can result in heart failure. Little effective therapy (toxic drugs/low cure rates)
Hantavirus
Carried by rodents - zoonosis In NA they are some deer mice, white-footed mice, rice rats, and cotton rats.Some hantaviruses can cause a rare but deadly disease called hantavirus pulmonary syndrome (HPS) Any man, woman, or child who is around mice or rats that carry harmful hantaviruses can get HPS. People get HPS when they breath in hantaviruses rodent urine and droppings that contain a hantavirus are stirred up into the air,or touch mouse or rat urine, droppings, or nesting materials that contain the virus and then touch their eyes, nose, or mouth.One can get HPS from a mouse or rat bite. In the United States, there has never been a case in which a person with HPS has given the disease to another person. (vector diseases, zoonoses) There is no effective treatment once it gets into the lungs. If people get HPS, they will feel sick 1 to 5 weeks after they were around mice or rats that carried a hantavirus.
Symptoms include: Fever
Severe muscle aches
Fatigue
After a few days they will have a hard time breathing. Sometimes people will have headaches, dizziness, chills, nausea, vomiting, diarrhea, and stomach pain. Is endemic in the four corners area of the southwest.
What roles do environmental and ecological changes play in the patterns of disease worldwide? (ex. Deforestation, urbanization, road building, etc.)
example-malaria, deforestation, tires and pollution created breeding grounds, Rice paddies in Thailand - also another area with malaria. The rice paddies allow for buildup of water, forming more mosquito breeding grounds.
The shift in pattern of disease from an endemic to an epidemic could be attributed to urbanization and the fact that people went from nomadic lifestyles to more sedentary ones.
People are more in contact with each other, so TB has been spreading more
Sanitation - Cholera spreading in sewage water that runs through the streets
What are some of the leading causes of death worldwide, and why do we see these patterns? Why and where do we see increases or declines in infectious disease? Chronic disease?
leading causes of death include: lower respiratory disease
lung infection
diarrheal disease
heart disease
patterns in poorer countries affected by structural violence
malaria (example) - increases in countries closer to the equator (hospitable for viruses); poor nutrition, poor housing/infrastructure, poor sanitation
disease burden of infectious diseases and chronic diseases: wealthier countries have larger disease burdens of chronic diseases (better living conditions but less activity),
ALL related, back to Paleolithic transition, from countries of improved living conditions to higher burden of chronic disease.
Inequality
More wealthy countries have better nutrition, sanitation, and access to medicine overall so infectious diseases will go down. Use of over antibiotics, urbanization, and deforestation could lead to a rise in infectious disease. however chronic diseases are more likely due to longer life expectancies etc.
access to healthcare
What is malaria, why does it cause disease, how does it spread, and what are the underlying social and ecological issues in the spread, treatment, and control of the disease?
Malaria is an infectious parasite which makes its way into mosquitoes that infect humans when they draw blood. Drug companies can't profit from giving out antimalarials; general education; ecological factors → dam building, deforestation, higher birthrates b/c women expect their children are subject to dying
Mosquitoes are the vectors; malaria is the disease caused by the parasite. Poverty and malaria both impact each other and is in a negative feedback loop
Social factors- increased globalization. Vectors on imported goods.
Sachs and Malaney- Bidirectional relationship. Don't know whether malaria causes poverty or poverty causes malaria. It's kind of both. vicious cycle.People are going to be sicker and so they can't help their families as much. Companies don't want to invest in those countries because their people are likely to get malaria.
What are newly or re-emerging diseases? Are they actually newly emerging? Why or why not? Give examples of diseases that explain your answer.
Ex: Tuberculosis, cholera, malaria, dengue, diphtheria, polio
Paul Farmer argument - all of the diseases have always been there but weren't noticed because it didn't affect the wealthy
What contributes to patterns of HIV worldwide? Would you argue that personal behavior, structural violence and/or poverty is the most important determinant? Support your answer with examples from class and/or the readings.
Economic development and land use (those in rural areas travel to urban areas for work, and while away turn to sex workers for their needs)
Zoonoses: infectious diseases contracted from animals (between species, bushmeat) HIV-1: Pan in east, HIV-2: Sooty Mangabees in west.
Poverty and social inequality
Human demographics and behavior
Technology and industry (medical technology)
Travel and commerce (People travel to more urban areas to find work and that's where the sex workers are)
Breakdown of public health measures (not enough condoms - example from class was that they only got 3 condoms for the whole year; people who need help are in rural areas and would have to travel a long way and be treated for long amounts of time → leaving their families behind, affected person might be the "bread winner" so they can't leave their families)
Lack of Political Will - Companies aren't willing to supply medication that can't be paid for (applies to poorer countries)
95% of people living with HIV live in low- and middle- income countries
viral load is highest in first 1-6 weeks, but doesn't show symptoms
Is it structural violence or personal? A combination of both, condom use or previous std, structural violence, not being able to afford condoms, or not being allowed (sex workers, networks), poverty.
What is TB? Why do we see drug resistance with TB, and why is it such a problem? What are the other main problems concurrent with TB and what complications arise from this?
We see drug resistance with TB because people don't finish their medications properly, killing off the weaker strains and encouraging the growth of MDR strains and passing those on.
DOTS (Direct Observation) helped with this
TB is caused by mycobacterium tuberculosis (bacteria coated with fatty membrane that resides on the lungs)
5% of new cases are resistant, problem in poverty areas.
HIV and TB can be partially due to Structural Violence (farmer!)
Farmer - some people fall through the cracks
stigma of having the disease (a poor ppl disease)
"noncompliance" puts blame on patient, even when not necessary their fault for not completing treatment
What role does poverty play in the ecology of disease?
Creates conditions that can help to propagate disease, such as poor house construction, inadequate nutrition and sanitation, overcrowding, inability to afford treatment.
viewed as "re-emergent disease" since seems to mainly occur in impoverished areas; adds to stigma
Impoverished people tend to lack resources to receive treatment and they tend not to care as much
What does Kuru teach us about the value of an anthropological perspective in global health, and how?
It was originally thought that Kuru was a genetic disorder because the disease pattern was through families. However, the people in this area considered "family" to be more of a social contract (linear scheme of social relationships) than a genetic tree. They adopted other hunter gatherers, protectors etc. as family members. This essentially ruled out the genetic component of the disease. Without anthropologists going into the villages and finding out this information, the disease may still be questioned today. By going into the villages, they also found out about the cannibalism within the tribes that wasn't very publicized either. Transmission was associated with cultural customs as to who is supposed to dispose of past community members (dead). Death and family and honoring the disease. It lives in the brain, disease spreads due to social and cultural factors that contribute to its spread. Helped us understand more about prion diseases such as mad cow disease.
What effects does globalization have on health and disease, both locally and worldwide? Why is this important, particularly in light of the current patterns of disease globally?
Spreads to unexposed populations, example is the virgin soil epidemic- history of conquest- new world wasn't used to new disease (incas and aztecs had higher population drops). population decline can lead to social cultural changes.
Non-communicable diseases - spread of globalization leads to unhealthier lifestyles (high calorie/fat/sugar diets, little exercise) related to industrialization. Present day examples- sars, flu epidemic, HIV.
For health: globalization as spread of preventative techniques- HIV/ AIDS: using condoms (ex. Thailand, large push for condom distribution). Vaccinations for smallpox, polio. Sanitation education for airborne diseases (TB, polio)
Factors causing leading to the probability of increased virulence
· increased Population size

· vectored Mode of transmission

· high Mobility of the humans

· Cultural factors (religion, family structure)

· Globalization

· Technological change

· Social change

· Environmental change (roads being built into rain forests bringing people into closer contact with primates)
HIV2 decreasing virulence
Commonly seen in West Africa
Did not migrate.Cultural factor of religious practices
Monogamy/stable families and stable sexual relationships
Less virulent to start with because of chance
Perhaps it has something different in the virus that allows it to replicate differently helping it to stay where it originate
Why was smallpox so virulent, and why was it (relatively) easy to eradicate?
It was also easy to eradicate because its symptoms were visible, so infected people could be avoided and targeted for treatment. Low mutation rates.So virulent because people were packed together densely so it could kill of hosts without worrying about not having any left. Also, because it was transmitted so easily, it didn't have to keep the host alive long enough to spread.
HIV1 increasing virulence
Migration to cities
sexual contact increased
more people and more chances of infection
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