Introduction to Public Health Diseases Classes of Diseases Vector borne illnesses Water borne illnesses Directly communicable illnesses Occupational and environmental illnesses Chronic illnesses Impact of Diseases Deaths in war World War I was the first war where wounds killed more people than illness Life expectancy Early deaths count more That is why it is hard to raise it once you get to 75 Communicable diseases keep the life expectancy low Diarrheal diseases are the biggest killer of children worldwide Disease agents Living parasites spirochetes amoebas bacteria virus Environmental and Occupational Asbestosis Arsenic Vector Borne Illness Mosquito borne - Examples malaria spirochetes yellow fever virus West Nile, St. Louis Encephalitis, etc. virus Dengue fever - bone break fever virus Why is mosquito borne illness consistent with a miasma? Ticks, Fleas, Bedbugs - Examples Lyme spirochetes deer ticks Typhus Bacteria fleas - rats and other carriers Bubonic plague bacteria fleas, then direct human Ehrlichiosis Bacteria Ticks Other agents Schistosomiasis (Aka: Bilharziasis) Flukes Intermediate host - snail Potentiated by the Aswan Dam Trypanosomiasis African: Sleeping sickness (Tsetse flies American: Chagas Disease (Reduviid bugs) Incidental Transmission Polio virus fecal-oral transmission Flies get the virus on their feet when sitting on shit carry the virus to food How do you control flies? Legal issues? Transmission and Control of Vector Borne Illnesses Usual model is that the mosquito carries the illness from an animal reservoir can you control the animal? can you eradicate the animal? Vector Can you control the vector? Human behavior Can you avoid contact with the vector? Treatment Can you treat the illness? Malaria Control - - #1 debilitating infectious disease The reservoir is human Why is this a special problem? Treatment spirochete develops resistance requires long term treatment Mosquito control drain the swamps spray Avoidance repellant bed nets Legal Issues? Water Borne Illness Cholera bacterium Vibrio cholerae endotoxin - shuts down water reabsorption Typhoid Salmonella Typhi human reservoir Both fecal-oral environmental and direct human spread Controlling Water Borne Illness Waste water management Treatment Disposal to avoid cross contamination Oysters, any one? Drinking water treatment Chlorination Making sure you only get treated water Vaccinations Limited value Legal issues?