Study Guide
Senior Health
Public Health, Immunity, Ebola, HIV/AIDS
Public Health is an organized community effort to prevent disease and injury and promote
health
• Focuses on prevention
• Saves billions of dollars
• Local health departments, state health departments and federal public health agencies
Federal Public Health Agencies
 Centers for Disease Control and Prevention(CDC)
 Centers for Medicare and Medical Services(CMS) – manages Medicare(older adults & disabled),
Medicaid(low income) and Children’s Health Insurance Program(CHIP)
 Food and Drug Administration (FDA)
 Health Resources and Services Administration (HRSA)
 Indian Health Services (IHS) operates hospitals, health centers, and health stations that assist
Native Americans and Alaska natives.
 National Institute of Health (NIH) – supports research projects
 Substance Abuse and Mental Health Services Administration (SAMHSA) works to improve the
quality and availability of substance abuse prevention, addiction treatment, and mental health
services, provides federal grant money to states to support and maintain substance abuse and
mental health services.
10 Great Public Health Achievements of the 20th Century
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Immunizations
Motor-vehicle safety
Workplace safety
Control of infectious diseases
Declines in deaths from heart disease & stroke
Safer and healthier food
Healthier mothers & babies
Family planning
Fluoridation of drinking water
Tobacco as a health hazard
Public Health Problems
injuries
teen pregnancy
high blood pressure
tobacco use
substance abuse
resurgence of infectious diseases
bioterrorism
increases in violence
new infectious diseases
escalating cost of health care
new problems –travel
older population brings need for long term care and health problems
environmental concerns
Vocabulary
Undernutrition is a deficiency in calories, protein, vitamins, or minerals as a result of
inadequate diet and frequent infection
Public Health is an organized community effort to prevent disease and injury and promote
health
Protein energy malnutrition is the most serious and deadly form of undernutrition that is the
result of inadequate calorie intake to satisfy the body’s nutritional needs
Vitamin a deficiency is the leading cause of preventable blindness in children and raises the risk
of disease and death from severe infection.
Cretinism is a serious and irreversible form of mental disability that is a result of not getting
enough iodine.
Micronutrients are vitamins and minerals that are needed by the body to produce substances
necessary for proper growth and development.
Immunity is your body’s response to pathogens. It can be active (body produces antibodies) or
passive (passed on from mother through breast feeding or placenta or it can be from another
person’s blood).
1st line of defense - skin, mucus, cilia and saliva
2nd line of defense – inflammatory response
3rd line of defense - antibodies
Bioterrorism is the use of infectious agents as weapons.
Goiter is the unnatural enlargement of the thyroid gland.
Iron Deficiency is the most common nutritional disorder in the world. It’s the main cause of
anemia.
Pathogen is an agent that causes disease, especially a living microorganism such as bacteria
(strep throat, tetanus), virus (Ebola, common cold), fungus (athlete’s foot, ringworm), or
protozoa( malaria, dysentery).
Immune System is the body's defense against infectious organisms and other invaders.
Ebola is a rare and deadly disease caused by infection with a strain of Ebola virus. The
symptoms are similar to the flu so it is sometimes hard to diagnose.
Influenza commonly known as "the flu", is an infectious disease caused by an influenza virus.
Communicable diseases are spread from one person to another or from an animal to a person.
The spread often happens via airborne viruses or bacteria, but also through blood or other bodily
fluid. The terms infectious and contagious are also used to describe communicable disease.
Pandemic is when a disease is widespread in several countries around the world.
Epidemic is an outbreak of disease that spreads easily across at least one country.
How the Immune System Fights Pathogens
Immune System
commonly
Lymphocytes
Macrophages
Helper T cells
B cells
Antibodies
Pathogen
Ebola Facts
There are several different strains of Ebola
 Ebola Sudan
 Ebola Zaire
 Ebola Reston (EBOR)
 Ebola hemorrhagic fever (EHF)
 Ebola Cote d'Ivoire (EBO-CI)
Bushmeat (or fruit bats) is believed to be the original source of the infection
Contraction of Ebola
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You can get the virus if you have direct contact with a range of bodily fluids from a sick
person, including blood, saliva, breast milk, stool, sweat, semen, tears, vomit, and urine.
"Direct contact" means these fluids need to get into your broken skin (such as a wound)
or touch your mucous membranes (mouth, nose, eyes, vagina). As well, the sick person
has to be far enough along in the illness — with enough virus in the bloodstream — to
successfully transmit the disease.
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So you can get Ebola by kissing or sharing food with someone who is infectious.
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Mothers with Ebola can give the disease to their babies. Ebola spreads through
breastfeeding — even after recovery from the disease.
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You can get Ebola through sex with an Ebola victim. The virus has been able to live in
semen up to 82 days after a patient became symptomatic, which means sexual
transmission — even with someone who has survived the disease for months — is
possible.
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You can get the virus by eating wild animals infected with Ebola or coming into contact
with their bodily fluids. The fruit bat is believed to be the animal reservoir for Ebola, and
when it's prepared for a meal or eaten raw, people get sick.
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You can get Ebola through contact with a contaminated surface. Though Ebola is easily
killed with disinfectants like bleach, if it isn't caught, it can live outside the body on, say,
a doorknob or counter top, for several hours. In body fluids, like blood, the virus can
survive for several days. So you'd need to touch an infected surface, and then put your
hands in your mouth and eyes to get Ebola.
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You could also get the virus by working in a biosafety-level-4 lab that studies Ebola,
touching lab specimens, and then putting your contaminated hands in your mouth, eyes or
a cut.
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You can get Ebola by being pricked with a needle or syringe that has been contaminated
with the virus.
Ebola Hemorrhagic Fever
Incubation period: 2-21 days
Stage I (unspecific):
-Extreme body weakness
-diarrhea, nausea and vomiting, anorexia
abdominal pain
- headaches
- pain in joints
- muscular pain or tenderness, back pain
- mucosal redness of the oral cavity, difficulty in swallowing
- swelling or infection of the membrane lining the eyelids
- rash all over body except in face
** If the patients don’t recover gradually at this point, there is a high probability that the
disease will progress to the second phase, resulting in complications which eventually lead to
death
Stage II (Specific):
- Hemorrhage
- neuropsychiatric abnormalities (higher brain function – feelings and emotions, irritability,
anxiety)
- absence of urine formation
- hiccups
- rapid breathing
** Patients who progressed to phase two EHF almost always die
Late Complications:
-Joint pain
- ocular (eye)diseases (ocular pain)
- hearing loss
- inflammation of one or both of the testes
HIV/AIDS
Human Immunodeficiency Virus
Acquired Immune Deficiency Syndrome
What is it?
HIV is a virus spread through body fluids that affects specific cells of the immune system, called
CD4 cells, or T cells. Over time, HIV can destroy so many of these cells that the body can’t fight
off infections and disease. When this happens, HIV infection leads to AIDS.
What about HIV around the World?
HIV disease continues to be a serious health issue for parts of the world. Worldwide, there were
about 2 million new cases of HIV in 2014. About 36.9 million people are living with HIV around
the world, and as of March 2015, around 15 million people living with HIV were receiving
antiretroviral therapy (ART). An estimated 1.2 million people died from AIDS-related illnesses
in 2014, and about 39 million people worldwide have died of AIDS-related causes since the
epidemic began. Seventy percent of all people living with HIV in 2014 were living in SubSaharan Africa, which bears the heaviest burden of HIV/AIDS worldwide. Other regions
significantly affected by HIV/AIDS include Asia and the Pacific, Latin America and the
Caribbean, and Eastern Europe and Central Asia.
How is HIV passed from one person to another?
In the United States, HIV is spread mainly by having sex or sharing injection drug
equipment such as needles with someone who has HIV.
Only certain fluids—blood, semen (cum), pre-seminal fluid (pre-cum), rectal fluids, vaginal
fluids, and breast milk—from an HIV-infected person can transmit HIV. These fluids must come
in contact with a mucous membrane or damaged tissue or be directly injected into the
bloodstream (from a needle or syringe) for transmission to possibly occur. Mucous membranes
can be found inside the rectum, the vagina, the opening of the penis, and the mouth.
In the United States, HIV is spread mainly by
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Having sex with someone who has HIV. In general:
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Anal sex is the highest-risk sexual behavior.
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Vaginal sex is the second highest-risk sexual behavior.
o
Having multiple sex partners or having other sexually transmitted infections can increase
the risk of infection through sex.
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Sharing needles, syringes, rinse water, or other equipment (works) used to prepare injection
drugs with someone who has HIV.
Less commonly, HIV may be spread by
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Being born to an infected mother. HIV can be passed from mother to child during pregnancy,
birth, or breastfeeding.
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Being stuck with an HIV-contaminated needle or other sharp object. This is a risk mainly for
health care workers.
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Receiving blood transfusions, blood products, or organ/tissue transplants that are
contaminated with HIV. This risk is extremely small because of rigorous testing of the US
blood supply and donated organs and tissues.
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Eating food that has been pre-chewed by an HIV-infected person. The contamination occurs
when infected blood from a caregiver’s mouth mixes with food while chewing, and is very
rare.
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Being bitten by a person with HIV. Each of the very small number of documented cases has
involved severe trauma with extensive tissue damage and the presence of blood. There is no
risk of transmission if the skin is not broken.
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Oral sex
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Contact between broken skin, wounds, or mucous membranes and HIV-infected blood or
blood-contaminated body fluids. These reports have also been extremely rare.
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Deep, open-mouth kissing if the person with HIV has sores or bleeding gums and blood is
exchanged. HIV is not spread through saliva. Transmission through kissing alone is
extremely rare.
Where did it come from?
Scientists identified a type of chimpanzee in West Africa as the source of HIV infection in
humans. They believe that the chimpanzee version of the immunodeficiency virus (called simian
immunodeficiency virus, or SIV) most likely was transmitted to humans and mutated into HIV
when humans hunted these chimpanzees for meat and came into contact with their infected
blood. Studies show that HIV may have jumped from apes to humans as far back as the late
1800s. Over decades, the virus slowly spread across Africa and later into other parts of the
world. We know that the virus has existed in the United States since at least the mid- to late
1970s.
What are the stages of HIV?
HIV disease has a well-documented progression. Untreated, HIV is almost universally fatal
because it eventually overwhelms the immune system—resulting in acquired immunodeficiency
syndrome (AIDS). HIV treatment helps people at all stages of the disease, and treatment can
slow or prevent progression from one stage to the next.
Acute infection: Within 2 to 4 weeks after infection with HIV, you may feel sick with flu-like
symptoms. This is called acute retroviral syndrome (ARS) or primary HIV infection, and it’s the
body’s natural response to the HIV infection. (Not everyone develops ARS, however—and some
people may have no symptoms.) During this period of infection, large amounts of HIV are being
produced in your body. The virus uses important immune system cells called CD4 cells to make
copies of itself and destroys these cells in the process. Because of this, the CD4 count can fall
quickly. Your ability to spread HIV is highest during this stage because the amount of virus in
the blood is very high. Eventually, your immune response will begin to bring the amount of
virus in your body back down to a stable level. At this point, your CD4 count will then begin to
increase, but it may not return to pre-infection levels.
Clinical latency (inactivity or dormancy): This period is sometimes called asymptomatic HIV
infection or chronic HIV infection. During this phase, HIV is still active, but reproduces at very
low levels. You may not have any symptoms or get sick during this time. People who are on
antiretroviral therapy (ART) may live with clinical latency for several decades. For people who
are not on ART, this period can last up to a decade, but some may progress through this phase
faster. It is important to remember that you are still able to transmit HIV to others during this
phase even if you are treated with ART, although ART greatly reduces the risk. Toward the
middle and end of this period, your viral load begins to rise and your CD4 cell count begins to
drop. As this happens, you may begin to have symptoms of HIV infection as your immune
system becomes too weak to protect you.
AIDS (acquired immunodeficiency syndrome): This is the stage of infection that occurs when
your immune system is badly damaged and you become vulnerable to infections and infectionrelated cancers called opportunistic illnesses. When the number of your CD4 cells falls below
200 cells per cubic millimeter of blood (200 cells/mm3), you are considered to have progressed
to AIDS. (Normal CD4 counts are between 500 and 1,600 cells/mm3.) You can also be
diagnosed with AIDS if you develop one or more opportunistic illnesses, regardless of your CD4
count. Without treatment, people who are diagnosed with AIDS typically survive about 3 years.
Life expectancy without treatment falls to about 1 year once someone has a dangerous
opportunistic illness. People with AIDS need medical treatment to prevent death.
How can someone tell if they are infected?
The only way to know if you are infected with HIV is to be tested. You cannot rely on symptoms
to know whether you have HIV. Many people who are infected with HIV do not have any
symptoms at all for 10 years or more. Some people who are infected with HIV report having
flu-like symptoms (often described as “the worst flu ever”) 2 to 4 weeks after exposure.
Symptoms can include:
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Fever
Enlarged lymph nodes
Sore throat
Rash
These symptoms can last anywhere from a few days to several weeks. During this time, HIV
infection may not show up on an HIV test, but people who have it are highly infectious and can
spread the infection to others.
However, you should not assume you have HIV if you have any of these symptoms. Each of
these symptoms can be caused by other illnesses. Again, the only way to determine whether you
are infected is to be tested for HIV infection.
Is there a cure for HIV?
For most people, the answer is no. Most reports of a cure involve HIV-infected people who
needed treatment for a cancer that would have killed them otherwise. But these treatments are
very risky, even life-threatening, and are used only when the HIV-infected people would have
died without them. Antiretroviral therapy (ART), however, can dramatically prolong the lives of
many people infected with HIV and lower their chance of infecting others. It is important that
people get tested for HIV and know that they are infected early so that medical care and
treatment have the greatest effect.
What is PReP?
Fast Facts
• Pre-exposure prophylaxis, or PrEP, is a way to help prevent HIV by taking a pill every day.
• People who are at substantial risk for HIV should talk to their doctor about PrEP.
• PrEP must be taken every day to be most effective.
Pre-exposure prophylaxis, or PrEP, is a way for people who do not have HIV to help prevent
HIV infection by taking a pill every day. The pill contains two medicines that are also used, in
combination with other medicines, to treat HIV. When someone is exposed to HIV through sex
or injection drug use, PrEP can help stop the virus from establishing a permanent infection.
When used consistently, PrEP has been shown to greatly reduce the risk of HIV infection in
people who are at substantial risk. PrEP is much less effective when it is not taken consistently.
PrEP is a powerful HIV prevention tool, and can be combined with condoms and other
prevention methods to provide even greater protection than when used alone. People who use
PrEP must commit to taking the drug daily and seeing their health care provider every 3 months
for HIV testing and other follow-up.
*HIV/AIDS information from the CDC.gov
Be prepared to discuss why public health is a global issue. Think of underdeveloped
countries and the issues that health care workers face.