| 00:00 | Okay. Mhm. Okay. What's ? Alright um let's see here. |
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| 00:23 | , ok folks, let's get Yes it is me, I just |
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| 00:31 | severe buzz cut somewhat. My ear lowered as my father would say. |
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| 00:38 | Anyway um we got tired of the nous so said enough um Alright so |
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| 00:47 | see, so we're back on so remember we didn't have anything to |
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| 00:53 | last this week or I guess This monday. So back in the |
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| 01:12 | of that backboard, Very similar exam in terms of average 68 point something |
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| 01:20 | forget. Um so the exam will open actually tomorrow, so you'll be |
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| 01:27 | to see it tomorrow for the next of days so certainly take a look |
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| 01:32 | you have questions, come to office , either in person or virtually Whatever |
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| 01:39 | prefer. Um that's fine. And the next exam, that's not the |
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| 01:49 | , 19th. So that's uh the for that will open. Not this |
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| 01:55 | , but next Friday. Okay. but I'll We'll have a few emails |
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| 02:02 | then, so I'll of course mention again more than once. So this |
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| 02:08 | we're gonna finish uh most of 14 , so I think we just have |
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| 02:13 | little bit left to do on Thursday then we'll start in with um the |
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| 02:20 | of 16 and 17 is your immune , talking about your immune system will |
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| 02:25 | that on thursday and continue that through week and then finish up with 15 |
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| 02:33 | pathogenesis so we look at how your fights disease and then 15 we look |
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| 02:37 | how pathogens are able to counter act defenses and cause disease. So that's |
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| 02:43 | 15 is about. And that will off unit three. Okay. Um |
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| 02:50 | again do do look through the exam you have questions um let me know |
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| 02:59 | we'll certainly go over it. Uh a problem. Let's see. So |
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| 03:06 | if you are I'm trying to will hope to have it done this week |
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| 03:12 | not this week. Certainly early next and have like a midterm grade posted |
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| 03:17 | blackboard. So it'll be everything homework's units one and two. Although whatever |
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| 03:23 | homework graders seeing on mastering that's what's transferred. So um but they will |
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| 03:27 | transferred to blackboard. Um So basically two exams. Um The homework's up |
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| 03:36 | um I guess through units too. and then the blackboard quizzes. So |
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| 03:43 | those, I'll make a company midterm putting a blackboard should be able to |
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| 03:47 | that again. It'll probably be earliest this week uh as as late as |
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| 03:53 | next week. Okay well in advance the drop date if that's what you're |
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| 03:58 | . So so I'll keep you updated the status of that. So um |
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| 04:07 | so let's um a couple of uh of summary slides here as we |
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| 04:15 | So again so we're in this we then we'll continue for the next unit |
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| 04:20 | the next on aspects really focused on Microbiology, medical microbiology how you want |
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| 04:27 | refer to it. And so this 14 is really just a I know |
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| 04:34 | inundated with a lot of terms and and that's a lot of what 14 |
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| 04:39 | for better or worse. But um mean those are terms that you probably |
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| 04:44 | need to know that you'll use um know some more than others as you |
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| 04:50 | you go on into Nursing school and . But um so many 14 description |
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| 04:56 | disease in general infectious disease um and aspects of it. Okay. And |
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| 05:02 | we looked at it kind of in viewpoint here in terms of pathology, |
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| 05:06 | study of diseases of course and then it down in terms of causes and |
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| 05:11 | we looked at the coloured boxes are the various um sub topics if you |
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| 05:17 | that we looked at so far, all all these most of these. |
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| 05:23 | And so cokes postulates how to determine the infectious agent causing disease. Of |
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| 05:29 | , what we've learned in the past plus years and how we can we |
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| 05:33 | where we need to modify things or based on that knowledge. Um pathogens |
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| 05:39 | severity of disease extent. A lot these basically terms to know here um |
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| 05:45 | acute disease for example. Um So 15, 16 and 17 which are |
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| 05:52 | up host resistance that's really where we in on the body's immune system. |
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| 05:58 | . Of course the health of that a lot to do with our ability |
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| 06:01 | fight off disease. Okay. And , you know, there are various |
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| 06:06 | gender, occupation, maybe geography where live um general health. These all |
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| 06:13 | into whether you come down with infectious and then probably changes is more kind |
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| 06:19 | . What are you experiencing? Are are you have a fever? Do |
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| 06:22 | have a penis? Do you have general tiredness? Are showing a rash |
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| 06:30 | ? What have you? So, are both can be certainly observable but |
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| 06:34 | always measurable statistic. Right. You measure a fever of course. |
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| 06:38 | But you can't really measure somebody's so to speak. Right. |
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| 06:42 | so you can have both. Both be parts of any kind of disease |
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| 06:46 | of course occurrence is the epidemiology. what this is centered on here. |
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| 06:52 | so what are the there are diseases diseases that must be by law |
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| 06:59 | notified. And we use that data to see at any given time what |
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| 07:06 | the state of the health of the so to speak. Right. Is |
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| 07:09 | is there a certain surge in a type of infectious disease? Why is |
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| 07:15 | who is it happening to? What of the country etcetera? These kind |
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| 07:19 | things. So we use this information hopefully contain and see what's going |
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| 07:23 | There's something new that we haven't seen . So so we need that of |
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| 07:28 | . And then uh then communicable and diseases transmission of communicable person to person |
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| 07:35 | . These are the diseases we can get vaccinated against write and produce this |
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| 07:40 | immunity. Okay so we touched on of these and so we're kind of |
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| 07:46 | today is kind of more about transmission disease um uh the the health care |
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| 07:55 | and how that can cause disease. something that's certainly applicable to you all |
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| 08:01 | are going to be nurses certainly. then um and then a little bit |
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| 08:07 | the I. D. S. talked about that before um and I |
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| 08:11 | we'll probably leave until next time some the epidemic epidemiological stuff. Okay but |
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| 08:17 | that's kind of where we're at. so let's look at this question |
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| 08:21 | So this has some terms that we um last time but it introduces a |
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| 08:28 | a couple of couple that um we'll about today. Okay. We're going |
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| 08:31 | the false answer here. Okay. So we did talk about herd |
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| 08:39 | Uh Yes that's that's the only The other ones are all we talk |
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| 08:45 | the I. D. S before these other ones are kind of |
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| 09:13 | Mm hmm. Okay counting down from . Okay let's see. See that's |
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| 09:43 | . Um Yeah herd immunity that's definitely . We have to be vaccinated in |
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| 09:49 | to generate herd immunity. Alright. remember it's not just it's not just |
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| 09:57 | getting vaccinated but it's also getting enough vaccinated, right? You know it's |
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| 10:03 | ones that are vaccinated already sinks to the infectious agent right and protect others |
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| 10:09 | us. So certainly you have vaccination a definite part of that. Okay |
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| 10:16 | contact transmission indirect. Uh That's and transmissions are modes of disease transmission. |
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| 10:25 | Both of which are true in direct might we'll talk about those here in |
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| 10:30 | few minutes. H ai that's the acquired infections. Um What you get |
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| 10:37 | perfectly healthy or you have some other you're in the hospital for. But |
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| 10:43 | there you catch an infectious disease um as a result of being in the |
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| 10:49 | . So that's uh that's certainly what is. But we use the term |
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| 10:55 | to be called, you may see term nosocomial. Nosocomial is kind of |
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| 11:01 | older term which specifically meant hospital hospital infection. Nosocomial but now they've broadened |
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| 11:08 | term because health care doesn't just occur the hospital occurs at home occurs in |
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| 11:14 | clinics around town and elsewhere. So of those are potentially uh uh areas |
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| 11:25 | infectious disease can be caught acquired. so we'll talk about that here shortly |
|
| 11:30 | well. So um uh mostly D. S. That is true |
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| 11:35 | most are viruses with animal origins. what zoonotic means. Okay so let's |
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| 11:42 | so we're gonna go through these um get through some of this but we'll |
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| 11:49 | have to save that for thursday. um So um let's kind of just |
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| 11:57 | this through an example here. Kind a this is out of your |
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| 12:01 | Um And so remembering that, you with disease pathology, right? We |
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| 12:04 | a cause we have a disease We have a result of the infection |
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| 12:12 | the body and something happens to the . Right? And so this is |
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| 12:15 | study where you have swimmers using use this community pool coming down with |
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| 12:22 | disease. Okay. And so the was traced to this out of the |
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| 12:30 | here, traced to after water analysis this cryptosporidium protozoa disease talked about those |
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| 12:40 | . Right. And um this is for any infectious disease. There's gonna |
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| 12:45 | some cause, right? It'll have types of features. Remember the term |
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| 12:51 | factors. Right? So you might that these are very tolerant to |
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| 12:56 | So they actually have a a an around them that allows them to |
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| 13:01 | Um So like proto zones, they have these weird life cycles. |
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| 13:07 | And this is no different as you see right here, going through different |
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| 13:13 | , feeding stages, and reproductive stages common for a protozoan. Okay then |
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| 13:21 | then of course you have a reservoir it resides. Right, Cryptosporidium are |
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| 13:28 | uh contaminants in water. So feces animals. So uh somehow being resistant |
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| 13:36 | chlorine the water, they were able survive in that pool water. |
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| 13:42 | And so the life cycle, They different types of virulence factors. So |
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| 13:48 | virulence factors is any feature or features enable the organism to cause disease. |
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| 13:53 | , so for this thing, its to certain types of chemicals, it |
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| 13:59 | be, maybe they do attach to intestinal wall. So it probably is |
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| 14:03 | mechanism for that. Would certainly be virulence factor. Uh They can form |
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| 14:07 | cyst which is kind of a dormant that makes them somewhat resistant. Uh |
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| 14:13 | that's very typical of protozoa, all that affect your gut because because the |
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| 14:18 | not necessarily a friendly environment because it's acidic as you get into the |
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| 14:23 | Um so it has to be able survive that. Um So again, |
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| 14:28 | kind of thing is this is one , but as we look at different |
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| 14:32 | agents, they're gonna have the same to them. Okay, Reservoir away |
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| 14:38 | be transmitted. Okay. And um uh in this case gastrointestinal disease. |
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| 14:45 | so the fecal oral route is how um intestinal pathogens are acquired through water |
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| 14:55 | through food. Okay. As we'll here in a little bit. |
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| 14:59 | so uh certainly the symptoms right, are aware of, we've all had |
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| 15:05 | some point not necessary Kryptos for radio but we've had some sort of gastrointestinal |
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| 15:11 | food poisoning at one time or another it was san manila or B coli |
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| 15:16 | what have you? And very Of course constant is diarrhea um it |
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| 15:23 | be a severe abdominal pain, depending the infectious agent could even be blood |
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| 15:29 | . So all depends on the severity the violence of the agent. |
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| 15:36 | But that's typical for gastrointestinal upsets. . And so treatment as with most |
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| 15:45 | infections? Okay. There's really no . Okay, why is that thinking |
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| 15:58 | the intestinal system if you eat are you owning that forever? Are |
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| 16:04 | just renting it analogy drink water? you holding on to that water |
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| 16:10 | Are you getting rid of? It through? Right. So in gastrointestinal |
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| 16:17 | unless it's something super severe you just it run its course because it will |
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| 16:24 | pass. Okay and um what you is rehydration therapy give water electrolytes, |
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| 16:33 | what you're doing, you're losing So just do that. Um You |
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| 16:38 | even give antibiotics because most of these are due to viruses, stomach |
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| 16:44 | You all heard that? Right? viral causes are really what caused most |
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| 16:49 | . I. Tract infections now of if it's become severe um you can |
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| 16:55 | very bad abdominal pains and cramps and can appear in the stool. That's |
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| 17:00 | another level. So it may require at that state. Just depends on |
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| 17:05 | severe but for most it's just run course and drink lots of fluid. |
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| 17:11 | And so this uh natasa. Okay those there are specific protocol. |
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| 17:21 | Old drugs. Again you don't need memorize this, this is all |
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| 17:26 | what I'm showing here is strictly just of what is typical for any kind |
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| 17:30 | infectious agent cause symptoms. They produce etcetera. That's kind of what this |
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| 17:37 | about. Okay and so the tension diagnostics we will talk about not in |
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| 17:44 | unit but the next unit we'll talk little bit about detections. So we |
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| 17:48 | to first talk a little bit about adaptive immune system. Right? And |
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| 17:51 | engines. Because that serves the basis uh tests you do to identify different |
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| 17:59 | agents. So of course the big has been for quite some time. |
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| 18:03 | you you've been drilled into okay cokes I'd take a sample isolate the organism |
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| 18:12 | then see what you got identify it forth. Okay That obviously takes |
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| 18:16 | Okay you still do it. But you also want to rapidly especially |
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| 18:22 | something quite virulent. And the patient noticeably not getting well very quickly that |
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| 18:29 | want to rapid I. D. that often involves antibody engine reactions. |
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| 18:34 | so there's a number of tests to many different types of infectious agents and |
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| 18:38 | can do it within a couple hours know what it is and then treat |
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| 18:43 | . But you know you still for infectious diseases. You still do the |
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| 18:48 | that's played it out the classic microbiology isolation. You still do as well |
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| 18:54 | this is often also a important step . Okay But also there's many you |
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| 19:01 | that can't be cultivated. So you is the only only choice you |
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| 19:05 | Um But rapid idea is a very thing. So uh the okay, |
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| 19:13 | there yet. So so again, just an example. Uh you can |
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| 19:19 | any infectious disease and kind of go and see that there's a reservoir where |
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| 19:24 | organisms found. There was a motor . There's uh there's a disease state |
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| 19:30 | causes depending on where it's affecting. there's ways to detect it and treat |
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| 19:35 | . Okay, so um so here's question. Let's look at this. |
|
| 19:41 | one. I actually got um out the book out of your book in |
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| 19:46 | chapter. So it says all members a group of ornithologists which are birdwatchers |
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| 19:54 | barn owls in the wild have had . Okay. Um One murder is |
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| 20:02 | her third infection. What is the likely source of their infections? |
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| 20:10 | The mansion is probably fairly obvious This will take us into transmission of |
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| 21:02 | . Can captain down from 12. . Yeah, that's a slam dunk |
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| 21:24 | , contaminated hands while the walls handing owls and the nest. So this |
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| 21:30 | going to be I'd say it's probably oral route I'm thinking so somebody is |
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| 21:38 | to be a gastrointestinal pathogen um having owls and the nests and abetting certainly |
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| 21:45 | probably come into contact with that. The fact that the drinking water is |
|
| 21:53 | . I don't know that's really relevant because there's nothing about that they're drinking |
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| 21:57 | or anything. Uh the fact that have a carrier on that was really |
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| 22:01 | either. I mean you know in of in terms of these others catching |
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| 22:10 | disease from this person, Okay. using food. No the the implication |
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| 22:16 | is that they're handing these birds So that would seem to be the |
|
| 22:22 | conclusion here. Okay um the um transmission of disease. Right so we |
|
| 22:30 | this graphic last time. Okay um reservoir is gonna be the source where |
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| 22:37 | lives. Okay. And it doesn't it doesn't have to be in the |
|
| 22:43 | of these outbreaks. Right. It just be at any time. This |
|
| 22:48 | where you find it typically. Um and so of course then whether |
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| 22:54 | science it has to be transmitted to and that's what we'll talk about next |
|
| 22:58 | modes of transmission. Uh like I before uh this part over here we'll |
|
| 23:04 | about in the context of Chapter Okay so let's look at modes of |
|
| 23:11 | . Okay so you just mentioned Okay so humans humans of course can |
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| 23:17 | um source from many different diseases. , mumps, um diphtheria uh certainly |
|
| 23:25 | . T. D. S. , so humans are the one that |
|
| 23:30 | the ones that are the reservoir for uh and because there can be asymptomatic |
|
| 23:35 | right? That that don't show any of disease. And there are typically |
|
| 23:40 | ones that already the source for these . Animals. Zoo in Oc. |
|
| 23:47 | those are animal specific the reservoirs and rabies typical example. So Lyme |
|
| 23:55 | a tick. So zoom can of be various types of insects, um |
|
| 24:03 | types of mammals. Um Ebola, was the bat and that seems to |
|
| 24:09 | a a not uncommon reservoir Ebola covid SARS uh These are all uh bats |
|
| 24:18 | thought to be the reservoir for So um non living uh soil and |
|
| 24:26 | . Okay and so certainly uh soil different different types of pathogens. Tetanus |
|
| 24:34 | course uh botulism as well. Um of course contaminated water sources uh cholera |
|
| 24:44 | as we just mentioned. Okay so infection cycle. So this of course |
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| 24:51 | where we go from reservoir to Okay. And that can take many |
|
| 24:57 | and so we look at it in of contact. Um Vehicle think of |
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| 25:03 | vehicle as like a a medium or that is carrying the agent. |
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| 25:10 | And then vectors vectors are very commonly not exclusively but barely commonly insects. |
|
| 25:17 | um so the contact we have three direct indirect droplets. So drop it |
|
| 25:25 | droplet and airborne. Okay. Which get somewhat confusing but there is between |
|
| 25:32 | and airborne distance. Okay so those can travel long distances. Things like |
|
| 25:40 | tuberculosis is one of those um The of the length depends on is the |
|
| 25:47 | on the nature of uh person with is in a cough obviously. Okay |
|
| 25:53 | create airborne particles and I think it on the combination of of the mucus |
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| 25:59 | produced and the thickness and the being on air particles and things like |
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| 26:04 | Uh Some some of them are easily travel that way than others. Okay |
|
| 26:09 | so with droplet that's typically things like flu um are typically droplet covid. |
|
| 26:19 | droplet type infection. Short distances. the direct that's pretty pretty self |
|
| 26:25 | So either uh kissing your partner um or you know S. T. |
|
| 26:32 | . Modes of transfer um hand holding these kinds of things uh indirect. |
|
| 26:37 | the phone might. Right so full is inanimate object, a bench top |
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| 26:43 | wall floor. Um I used Kleenex something. A a needle. Okay |
|
| 26:51 | contaminated needle. These are all phone . Okay um Now the vehicle. |
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| 27:00 | again think of it as a matrix medium through which the agents transported. |
|
| 27:05 | it can be waterborne airborne or food . There can also be other variants |
|
| 27:09 | this and get this out of the . Um The uh blood and drugs |
|
| 27:17 | blood borne diseases. Um So transfusions HIV one of the mechanisms was through |
|
| 27:27 | blood um making a blood borne pathogen well as STD any case. So |
|
| 27:34 | um typically through people contamination of water um or a water treatment system is |
|
| 27:42 | by some other kind of catastrophe. so you know get appropriate uh water |
|
| 27:50 | going on, which can introduce So uh certainly things like cholera, |
|
| 27:57 | , these are kind of waterborne disease airborne. And so again, these |
|
| 28:01 | traveling distances. Okay, very often the particle particle that's carrying the agents |
|
| 28:09 | dust particles, pet hair called dander carry these things. Um food born |
|
| 28:18 | . So that can be several variations . So it can be um food |
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| 28:24 | being contaminated, animal rights, butchered you eating the contaminated meat? It's |
|
| 28:28 | it's not cooked properly. Perhaps, maybe the food is sitting out at |
|
| 28:34 | temp for quite a long time and begins to grow in there and then |
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| 28:38 | ingest it. Okay, um undercooked has mentioned uh handling right the sanitary |
|
| 28:46 | of the food preparation. Right. Are you, are the servers wearing |
|
| 28:54 | , hairnet, um are they cleaning floor, uh cleaning the countertop? |
|
| 29:00 | how, how sanitary is the process on? Any anything that's compromised? |
|
| 29:06 | can be a point where you can foodborne illness, washing hands, |
|
| 29:12 | workers washing their hands when they go the bathroom before returning to the rest |
|
| 29:17 | cook area. So anyway, so are all examples of foodborne illness. |
|
| 29:22 | so with waterborne and airborne, this be linked to this. These can |
|
| 29:31 | hand in hand, fecal oral transmission be a result of waterborne or |
|
| 29:36 | Those can kind of be linked Okay. And so um the I'm |
|
| 29:43 | , not airborne doesn't make any Not that one. Foodborne. |
|
| 29:49 | Foodborne and waterborne can be linked with oral route. Right servers not washing |
|
| 29:55 | hands after having been in the bathroom example. Um Waterborne contaminated water, |
|
| 30:02 | oral route. Ok. Congenital Mother. The child. Very common |
|
| 30:10 | of this are the female has some of STD that's transmitted to the baby |
|
| 30:16 | birth. Okay. Syphilis for Okay. That would be congenital |
|
| 30:22 | Um The vector typically insects. Um uh really trying hard to think of |
|
| 30:34 | of the factory that's not an Um I gotta think about that uh |
|
| 30:41 | and biological transmission. So distinction there think of a fly that is hovering |
|
| 30:48 | garbage, a garbage can or right? It lands on garbage on |
|
| 30:53 | of the plane and then it lands you. So whatever is on its |
|
| 30:59 | parts typically legs, and it gets you, then you ingest whatever you |
|
| 31:04 | infected as a result. Pretty much of a random process. But that's |
|
| 31:09 | called mechanical transmission. Okay um and theoretically buy that you catch a number |
|
| 31:16 | different infectious diseases, right? It's of a very random kind of process |
|
| 31:22 | with biological transmission. Okay. Which a specific parasitic life cycle. So |
|
| 31:29 | for example, okay where humans are of that life cycle. Okay. |
|
| 31:36 | so so biological transmission and contrast isn't random kind of thing where you can |
|
| 31:42 | you know many different types of infectious . It's a specific one. So |
|
| 31:47 | I said like malaria for example. . Um Now. Okay any questions |
|
| 31:55 | . Okay so let's look at this this is an introduction into H. |
|
| 32:00 | . S. Okay so the number this should also be a slam |
|
| 32:05 | The number one um uh preventative to your nation. H Eyes is |
|
| 32:50 | count down eight. Alright. wash hands. Um I can be |
|
| 33:04 | out of it if somebody's very strong feel very strong about something else. |
|
| 33:09 | yeah watch hands is definite definitely the you might have thought the loves |
|
| 33:16 | Um Not necessarily. So because the of the globes aren't necessarily disinfected. |
|
| 33:24 | . Um but the the and you handle them property right? Maybe you |
|
| 33:31 | the wrong with the unwashed hand or like that so that their hands number |
|
| 33:38 | practice um to rent prevent. So associated infections as mentioned, this used |
|
| 33:45 | be called hospital acquired nosocomial because health obviously is expanded will be in the |
|
| 33:51 | . Nowadays these are all of uh where infectious disease can be acquired. |
|
| 33:59 | the main thing here is um you you know whether you're at a clinic |
|
| 34:05 | you're at a hospital or a home worker, you okay you acquire an |
|
| 34:12 | disease as the result of those interactions the hospital. You're in there for |
|
| 34:17 | else Maybe just in order to get on your needs or something. And |
|
| 34:21 | , you know, somehow the person transmits this disease to you And now |
|
| 34:27 | have this, that's that's what that's this is. This health care, |
|
| 34:31 | infections. And so um the, know, this can be gives you |
|
| 34:38 | value of 4-5%. It can be little bit higher than that depending on |
|
| 34:44 | facility. Um, But there is a a level of of these infections |
|
| 34:51 | on in the hospital at any given . Okay. So you're never it's |
|
| 34:55 | at 0%. Okay, there are difference here and there, and |
|
| 35:00 | you know, it's you know, you're dealing with humans, there's gonna |
|
| 35:03 | error, all the procedures and that's there's a breach in the process. |
|
| 35:11 | anyway, so there's kind of three that come together himself. Microorganisms in |
|
| 35:16 | hospital environment. So once the hospital take the hospital scenario, what's the |
|
| 35:22 | full of lots of not well people , Maybe there with different types of |
|
| 35:29 | , you know, carrying pathogens that normal healthy types don't cause problems. |
|
| 35:35 | in these compromised people, you you have people that maybe are burn |
|
| 35:39 | that some of our cancer patients and and that compromised immune systems. So |
|
| 35:44 | that sets the table for opportunistic pathogens do their thing. Right? And |
|
| 35:51 | particularly what you acquire and these are opportunistic pathogens. And so, um |
|
| 35:57 | so the the other purple one that host. I just a whole variety |
|
| 36:04 | different types, right? Cancer patients drugs that suppress the immune system. |
|
| 36:10 | if there's burn victims, they're they're susceptible because their skin skin is one |
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| 36:15 | your primary innate immune system defenses, and they're certainly compromised in terms of |
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| 36:21 | . Um and then, you uh going in for surgery. So |
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| 36:26 | have, you know, you've exposed body, you have, oops, |
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| 36:31 | , you have you may have a wound that's been sewn up. And |
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| 36:35 | that's the potential for infection. If careful. And then of course various |
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| 36:40 | of um of AIDS or mechanical devices are used right there breathing to a |
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| 36:49 | , a cat, you know, types of Catholics, right. I |
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| 36:53 | uh a you know, a we the external bladder for people that can't |
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| 37:03 | , they have the bag. So that's your catheter. Um different |
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| 37:07 | of devices put in the body, replacement, the replacement. These are |
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| 37:11 | potential points of acquiring infections. And so then of course, chain |
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| 37:18 | transmission. Right, so you have , okay, you have this and |
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| 37:28 | have this compromised host microorganism, the environment then getting those together, |
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| 37:36 | transmitting transmission of disease. Right causing . So um the the routes of |
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| 37:47 | . So of course to go between patients that are ill and maybe patients |
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| 37:54 | are not so ill like you or who's going in between healthcare people. |
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| 38:00 | , nurses aides, doctors, what you write are going between you know |
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| 38:08 | various sources and so um not to you know think of the the bedding |
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| 38:15 | patients are on there has to be um the uh railing the surfaces they |
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| 38:22 | and things like that and so these all potential points of transmission. |
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| 38:27 | And so um types of infections you ? Okay Very often our staff. |
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| 38:37 | . Staff number one I think currently this one See the fi style shows |
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| 38:49 | tends to show up most often than right now there's been a it used |
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| 38:53 | be staff okay what's called uh It's kind of the name methicillin resistant |
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| 39:02 | aureus. I think that's been overtaken clostridium difficile but there's others intro intro |
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| 39:09 | . Uh so um e coli urinary infection. So that's the most common |
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| 39:15 | terms of U. T. So um certainly these are things to |
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| 39:22 | with but can can be hospitals of have half, well if they're accredited |
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| 39:28 | they'll have a a committee that committee a panel or a group whose job |
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| 39:36 | to keep on track of this of rate of hospital acquired infections and and |
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| 39:44 | and these kind of things to see they following everybody complying with what you're |
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| 39:49 | to do here in terms of not disease and so I just kinda wanna |
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| 39:55 | don't need to memorize this or I'm kind of show you an example of |
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| 40:00 | . And H. Ai and this the most common one these days is |
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| 40:04 | difficile. So it's a it's a positive. Um Remember those, this |
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| 40:09 | one of the endospore former. Remember group? This group is one of |
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| 40:13 | endospore forming types. This produces So again virulence factors, right? |
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| 40:19 | it actually is in the guts of um healthy people, okay in the |
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| 40:29 | intestine but it's held it's held at by your normal microbiota. Okay. |
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| 40:37 | in some individuals um if you get um then you can you're gonna you're |
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| 40:43 | affect your gut microbiome and so it change the balance of what's in |
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| 40:48 | And that's when the clustering freestyle can hold, okay they can begin to |
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| 40:55 | and that's when issues can occur. so what happens is they produce |
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| 41:01 | Uh This can cause inflammation. So is healthy intestinal tissue. The cells |
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| 41:07 | here's the track going through and then the cells begin to die. As |
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| 41:13 | result you can certainly see the difference these these two panels here on the |
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| 41:18 | B. And C. Compared to . Which is healthy. And so |
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| 41:22 | this can of course kind of severe tract inflammation, diarrhea especially among the |
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| 41:30 | this is really a is an issue uh can can can be fatal. |
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| 41:39 | and so it's it's a kind of sequel all around transmission patients uh acquire |
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| 41:48 | . Oftentimes the betting has not changed or it's not changed very frequently and |
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| 41:53 | what leads to the plus they're on for something else. And so that |
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| 42:00 | them in this state that this can can occur. And so uh and |
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| 42:06 | that have it. So memory forms those boards, so it can be |
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| 42:11 | from one healthcare worker can be the between between patients and transmit this to |
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| 42:17 | . So um so it's it is issue. Um And so what you |
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| 42:24 | is to stop antibiotics, whatever the is on, right, so that |
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| 42:30 | system kind of microbiome recover and then what's called, which is specific gram |
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| 42:38 | and probiotics. Right? So get microbiome back to normal as soon as |
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| 42:45 | can because that's what's keeping this thing bay. Right. I forgot to |
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| 42:51 | up uh back. So my sin the fecal transplants interesting. Okay, |
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| 42:57 | what would a fecal transplant due for person? Yeah. Yeah, it's |
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| 43:04 | like taking probiotics. It's just a a it's a natural way to take |
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| 43:10 | I guess. Um But you would forget how to administer it. Uh |
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| 43:16 | , so but that's what the that's source of kind of like the we |
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| 43:20 | talk about that in here, The treatment plant. Um But if you |
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| 43:26 | a wastewater treatment plant which treats your bacteria basically in the water that are |
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| 43:31 | breaking down the bad stuff in the ? And if it weren't for treatment |
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| 43:36 | goes down and not working properly you go to a nearby one and take |
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| 43:40 | of their bacteria and put it in and they'll get it going again. |
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| 43:44 | this is kind of what this If you can do a fecal |
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| 43:46 | get your microbiome back much more Okay because that security mechanism that keeps |
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| 43:53 | things at bay. Okay so um so in terms of different uh processes |
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| 44:02 | , parts of the body. Okay these can all be traced to again |
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| 44:10 | medical devices. So urinary tract mishandling of urinary catheters. Alright so |
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| 44:16 | are all pre packaged sterile um implements you have to treat. Use open |
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| 44:24 | and use them and put your hands it or whatnot. Then that introducing |
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| 44:29 | . Okay surgical site infections and certainly the cleaning wounds properly. Uh can |
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| 44:35 | to that lower respiratory tract infections. , reading tubes, devices like that |
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| 44:40 | contaminated um G. I. Tract um often due to just see the |
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| 44:48 | through immuno compromised patients. So um so again the different devices here here's |
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| 44:58 | bag for a patient that would be generate tracked catheter assistant urination gloves etcetera |
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| 45:08 | is uh some kind of I. . Device here. I think here's |
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| 45:13 | breathing tube I think here. So it is. So any of these |
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| 45:17 | get contaminated introduced these infectious agents. so what's done? Well what's done |
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| 45:24 | course is we call universal precautions which of is a encompasses two areas Okay |
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| 45:30 | is called basic minimal precautions. Okay I call trans transmission specific precautions. |
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| 45:37 | so collectively this is meant to break chain of transmission. Okay and to |
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| 45:45 | things in a way that minimize those of infection. Okay so the standard |
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| 45:52 | that's where handwashing comes in right? techniques you know you have these that |
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| 45:58 | devices that are used catheters et cetera know open them and use them |
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| 46:03 | Aseptic lee right? Um having potentially . So betting betting from patients right |
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| 46:10 | them in the proper receptacles, leave sitting around on the floor. Um |
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| 46:16 | know dispose of them as you're supposed wash them frequently. These kind of |
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| 46:20 | . Right? Um Use of isolation and wards um if you have a |
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| 46:28 | victim right you know it's going to very susceptible to infection then isolate |
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| 46:33 | put them in a specific area. may need to have areas that are |
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| 46:37 | to the to the to the room contained in a certain way. Okay |
|
| 46:41 | again to minimize transmission PPE right your , masks etcetera. Uh And of |
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| 46:50 | very important also is education right to monthly if not uh biweekly or monthly |
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| 47:01 | to go over this and um beyond about maintaining these procedures. Okay the |
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| 47:11 | based precautions. Okay. Again, minimize transmission. So with contact precautions |
|
| 47:21 | , I have to write some of down. These are things that you |
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| 47:24 | come in con direct contact with and transmission. Right? So whether it's |
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| 47:30 | waste, whether urine or feces or patients with skin infections or maybe the |
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| 47:37 | or or things that patients would touch make sure that you clean these areas |
|
| 47:44 | you are being cautious. Droplet So uh this is typically for those |
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| 47:50 | have like obviously respiratory illnesses, but like pneumonia, flu um that are |
|
| 47:58 | are transmitted through droplet transmission. So may need to certainly wear a |
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| 48:04 | but also maybe have to put them a in a kind of a tint |
|
| 48:09 | the surrounding their bed. Right? minimize spread of these materials. So |
|
| 48:15 | precautions certainly can involve that. maybe a specialized ventilation system um even |
|
| 48:22 | a isolating them in a in their ward. So, tuberculosis would fit |
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| 48:27 | that category. So, it's not for TB patients to be in their |
|
| 48:32 | isolated area as well for this Okay, again, all in the |
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| 48:36 | to really break that chain of transmission um do things too, so that |
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| 48:44 | people coming into the hospital don't get with something else. Right? Or |
|
| 48:49 | , you know, people that are , but don't acquire these infectious diseases |
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| 48:54 | top of what they already have. . So you certainly want to do |
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| 48:57 | . And also of course not anywhere here though but implied I guess is |
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| 49:04 | you have saN you have the sanitizer everywhere in the hospital almost. Um |
|
| 49:12 | so with the I. D. . Okay we talked a little bit |
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| 49:16 | this in um First day or at in Chapter one. So um again |
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| 49:25 | are these may have been could have diseases that had been known about for |
|
| 49:32 | some time but but only occurred like and there maybe once and then kind |
|
| 49:38 | went away and much wasn't made of . Okay or it could just be |
|
| 49:43 | something that completely just blew up all a sudden. Okay and like as |
|
| 49:49 | they really more often than not tend be viral in nature. Okay. |
|
| 49:56 | it says here three quarters of the . D. S. Are of |
|
| 50:01 | type and and uh zoonotic and so know as mentioned the covid which has |
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| 50:09 | ancestry in the SARS virus and and MERS virus which is the Middle Eastern |
|
| 50:16 | . Um uh so all three of are our bat origins as is |
|
| 50:24 | Um So it's a definitely something to watch on. Okay and so the |
|
| 50:35 | do we identify these things? Well I mentioned if it's something that was |
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| 50:38 | really common and all of a sudden it is okay um maybe there were |
|
| 50:43 | few cases previously and all of a you see a burst of cases. |
|
| 50:49 | the, maybe it was a disease had, you know, maybe a |
|
| 50:54 | fever and headache and now that agent um, you know severe, it's |
|
| 51:00 | really high fever, abdominal pains or , right? In other words, |
|
| 51:05 | severe. And that's also a So um the, or maybe it's |
|
| 51:11 | completely new set of symptoms. And so it's a, it is |
|
| 51:19 | to be vigilant on in particular those are out there, kind of looking |
|
| 51:23 | the next one. They're really looking animal populations and seeing, are we |
|
| 51:29 | changes in, you know, are seeing now animals coming down with something |
|
| 51:33 | haven't seen before, that's a cue , you know, with zoonotic |
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| 51:37 | which seemed to be like more often not, that's what you wanna look |
|
| 51:41 | our annual populations out there. And , um the and seeing how we've |
|
| 51:46 | different behaviors. Are we seeing maybe outbreaks among different animals that could be |
|
| 51:51 | cause for alarm that maybe we need be aware of and look at this |
|
| 51:55 | closely. Okay, of course, because it's a, you have to |
|
| 52:01 | the human connection there somewhere, Because that's what's going to enable the |
|
| 52:06 | , whether viral or whatever to evolve in fact the human right, ultimately |
|
| 52:10 | to be contact. And so that's as we get human population is |
|
| 52:16 | right, that more and more this going to become an issue because we're |
|
| 52:20 | be just the fact that more humans just gonna be in contact more readily |
|
| 52:25 | these animals. Okay. Um certainly change because that has affected uh migration |
|
| 52:35 | of certain types like insect vectors now have but it used to be contained |
|
| 52:41 | a certain environment because the temperature now warmer, they can expand their range |
|
| 52:47 | so that can affect more people. other types of animals the same way |
|
| 52:52 | migratory patterns can be affected due to change and that can affect humans that |
|
| 52:57 | become infected. Um And so certainly of antibiotics, pesticides um just using |
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| 53:06 | antibiotics to treat the disease and without really um isolating the organism or finding |
|
| 53:12 | what it is and being more specific it. But nowadays use antibiotics for |
|
| 53:17 | , not just treating disease in humans give it to animals. Um Animals |
|
| 53:23 | we farm to make them less resistant they're incredible conditions more susceptible to |
|
| 53:28 | So let's give antibiotics to prevent And of course that gets we eat |
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| 53:34 | eat them, the animals get into if you track wastewater, there's a |
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| 53:41 | of stuff in there picking many different of antibiotics. People flush them down |
|
| 53:44 | toilet as well. So these are opportunities because what does the bacteria need |
|
| 53:49 | become resistant exposure right to these antibiotics they get that exposure through the misuse |
|
| 53:56 | the using them in everything nowadays. um you have to do is have |
|
| 54:01 | population of those of the bacterium that the the combination of genes that make |
|
| 54:07 | resistant and that's they'll proliferate in the of these antibiotics. So that's that's |
|
| 54:13 | problem. Okay so certainly genetic recombination um all the things evolve but when |
|
| 54:22 | have bacteria that can grow as fast we know how they grow right? |
|
| 54:28 | you get a mutation in there well quickly they can blow up in numbers |
|
| 54:33 | simply with viruses viruses mutate rather And so um the number their numbers |
|
| 54:41 | grow rapidly and so it's not it's it happens. They evolve at a |
|
| 54:47 | rate because of that because they're fast rate. So um so it's all |
|
| 54:53 | that constantly have to keep on Okay. Um because there are we |
|
| 54:58 | multiple we have multi drug resistant variants different bacterial types viruses can mutate and |
|
| 55:07 | uh you know get around our host and things like that. So it's |
|
| 55:11 | it's it's an issue obviously. So unfortunately I wish I could say that |
|
| 55:19 | Covid was the last time you see pandemic but would you bet on |
|
| 55:24 | I don't know. So um I not the well I don't think I |
|
| 55:33 | that. Right. I hope there another pandemic. Okay that's what I |
|
| 55:37 | to say. So with epidemiology I'm gonna touch on just the start of |
|
| 55:41 | , I'm not going to go into the we'll save the thursday the different |
|
| 55:46 | but epidemiology of course. Right. look at data obviously and so data |
|
| 55:54 | the incidence and prevalence of diseases and this can help us in different |
|
| 56:00 | Uh we can break it down in of uh there was an all of |
|
| 56:05 | sudden surge in cases. It's Where is it happening? Um who's |
|
| 56:11 | happening to? Is there a pattern terms of is it this certain ethnic |
|
| 56:17 | ? Is it this certain mostly in certain gender and not not one not |
|
| 56:22 | other. Is there a geographical Is that happening in this kind of |
|
| 56:27 | and not this climate? What time year are these? Are these cases |
|
| 56:32 | ? So all of that can be to kind of figure out what's going |
|
| 56:36 | . Okay. And maybe even to the disease. So um controlling controlling |
|
| 56:43 | . Right. So very common in for sure is um so down |
|
| 56:50 | of course West Nile virus is endemic this area um carried by mosquito. |
|
| 56:56 | so what's what's one thing we do terms of controlling reservoirs is to not |
|
| 57:03 | standing water laying around to dump out water to because that's a reservoir for |
|
| 57:08 | mosquito larva growing the standing water and can transmit disease. So that's one |
|
| 57:15 | , certainly food inspection. Uh that's we do that. Right, to |
|
| 57:20 | foodborne disease, the sewage disposal, using hygienic practices to minimize um transmission |
|
| 57:28 | disease. Um and then of course at um graph data, right, |
|
| 57:36 | at instance of disease, you can at effectiveness, is effective effectiveness of |
|
| 57:41 | mechanisms like vaccination, Okay, vaccination decline in um uh in disease. |
|
| 57:50 | is Lyme disease is caused by a . Well, a tick transmits the |
|
| 57:55 | due to a bacterium but is transmitted a tick. And so this is |
|
| 57:59 | looking at numbers of cases of Lyme over 16 years and um seeing peaks |
|
| 58:07 | valleys. And then looking at what what is this all about my |
|
| 58:20 | ? Is this about? Okay, are these peaks about why is it |
|
| 58:24 | up? Okay, so we can at um at least here right corresponding |
|
| 58:31 | that big peak is in the summer . So um that may correlate to |
|
| 58:39 | specifics, but maybe uh summer uh rainfall amounts. Uh this is |
|
| 58:46 | tick is um carried on like deers other types of animals. So there |
|
| 58:51 | be a correlation between summer months and ability of food for those sources. |
|
| 58:57 | or rainfall amounts, Things like that affect tick populations. And so uh |
|
| 59:04 | some correlation there. So uh you , this is kind of what you |
|
| 59:07 | as data for? Maybe you can some kind of a pattern and then |
|
| 59:12 | on that, make assumptions and and see what's going on. okay. |
|
| 59:19 | control it becomes serious. Okay. um uh so there's different ways to |
|
| 59:25 | epidemiological data um to kind of figure what's causing disease and how can we |
|
| 59:32 | it then and so forth? And we look at those, there's like |
|
| 59:35 | different types of that that we'll look next time. Okay. Any |
|
| 59:40 | Yeah, that's all I was gonna today, folks, So let's let's |
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| 59:45 | see you all on thursday and look for the exam will be up |
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| 59:48 | So take a look at |
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