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00:04 Yeah. Oh okay folks. Let's see. We've got so we're

00:36 per your request, we started starting uh three today so just I'm sure

00:44 is obvious to you if not know none of this today is on exam

00:49 tomorrow. Okay so um so we're starting on three which will take us

00:57 exam three which were not ready to about that yet. Have not haven't

01:02 exam to yet, so but still another more than three weeks away.

01:08 um let's see. There's no other other assignments due monday coming up.

01:16 no mastering, no by poured So um just the exam tomorrow or

01:23 whichever day you signed up for and let's see what else. Yeah,

01:32 today such just kind of set this . So as I said last

01:39 so starting really today to the end the semester, it's all kind of

01:43 toward uh disease is really the focus disease. And so 14 is kind

01:50 intro to that topic, looking at in different different aspects of infectious

01:57 Um And so we then kind of from there. I kind of I

02:02 go in order of 15, 17. I do 16 17 and

02:09 15, 15 is the microbial pathogenesis bacteria and others that cause how that

02:17 these. So I set it up by looking at how your immune system

02:21 first and then we look at kind what they do to manipulate the immune

02:27 . So it makes more sense to it that way really? So so

02:31 the reason for kind of the not an exact number order of your

02:35 Um Then, so yeah, I in the last part of that unit

02:43 focus on focuses on specific diseases and and vaccines. And then we'll talk

02:48 vaccines a couple other things. But , so pretty much all kind of

02:52 toward the medical aspect of things. , so again in 14 we kind

02:57 break it down into parts as you here. So this is gonna be

03:03 . Uh you see here kind of learning objectives has a lot of define

03:07 , categorize that list. This There's gonna be a bunch of

03:12 So I guess you just put all terms here. Okay. I know

03:16 looks like a lot, but I it's just the nature of the beast

03:19 with with with talking about this So uh certainly things, you're gonna

03:26 the last time you see this in course of course, as you go

03:29 to nursing school. So um at will give you a bit of uh

03:35 into in depth in all all these obviously, I kind of mentioned,

03:40 , here is, you know how describe disease in this way, here

03:44 some terms blah blah blah, some it will go into more detail than

03:47 , but, you know, don't again the terms here just kind of

03:53 to help you out and and leave money with these things. Okay so

03:59 so we're gonna start with questions. if this is we're gonna see this

04:03 at the end again and we're gonna this question again at the end.

04:06 I guess kind of you're not sure okay but again the nature of this

04:13 particular chapter is a lot of terminology so than probably what we're used to

04:18 this is kind of meant to kind throw some of that in there at

04:22 and see if you can recognize any these. So so the terms here

04:29 disease, subclinical infection commence cell with term endemic is another term herd immunity

04:38 . Okay so those are basically the and seeing if we can find the

04:45 definitions or definition. Okay but again not I'm just gonna once you answer

04:53 gonna go and then because we're gonna the question again and hopefully the percentages

04:58 100% correct this time. Maybe there be the second time around. Okay

05:40 Okay let's count down five B. . Okay here we go. Alright

05:57 what do we get genius consensus? let's mark that 1 63 G.

06:06 well we'll see if you're right um like it was pretty confident that's definitely

06:13 . So um okay so pathology so of um studying this up talking about

06:21 . So the study of disease and effects and things we call pathology.

06:27 of course in that under that let's say we have ideology pathogenesis and

06:34 changes. So for any disease, our context serious infectious disease,

06:39 We're not talking about all diseases because all diseases are caused by infectious

06:44 So we're talking about infectious agents. obviously it's gonna be some sort of

06:48 cause of a disease. What's the causing it? Viral bacterial, what

06:53 you? Um there'll be some kind disease process that occurs. Okay.

06:58 and certainly some side type of symptoms to the body. Of course.

07:05 of course these can be mild to . So a number of different

07:11 Okay. And so the couple of to mention your so infection versus

07:18 Okay, so infection is basically the of infectious agent. Okay. Then

07:24 becomes okay. Is the person actually a disease state? Right. Are

07:29 exhibiting some type of pathogenesis and body ? Okay. Of course. Um

07:35 you are infected, are you automatically you're gonna be have disease? Is

07:43 a given anybody? No, because have if you know anything from this

07:51 three years, we know the notorious notorious but asymptomatic carriers of covid and

07:58 other diseases. So just because you're , you may not know it,

08:03 know, typically don't you may never it because you might have just generated

08:08 disease altogether. Okay, so infection always equate to manifesting itself and you

08:15 sick, You know, I think all know that. And then violence

08:18 pathogenesis. So this this this is the focus on on the microbe.

08:27 , so and this relates of course some people will talk about a lot

08:34 this section, brilliance factors. so that's what relates to pathogenesis.

08:43 i. E. It's about how the infectious agent cause disease?

08:48 How does it how does it how it transmitted? How is it once

08:51 is in a host um what does do to overcome your host defenses and

08:58 disease? Does it produce toxins? it does it um uh doesn't otherwise

09:04 yourselves to get inside yourselves? There's even types that aren't viruses that

09:09 bacterial that can get inside yourselves, kind of how they hide out from

09:13 system. So whatever they can do they have a capsule?

09:17 so they're all different kinds of Can be various factors, but anyone

09:21 agent will have a collection of those that enables them to cause disease.

09:27 , So that's really what we pretty explore in that chapter 15, which

09:31 microbial pathogenesis. How do these things disease? So, um so you'll

09:37 business factors a lot really for the of the semester in that context.

09:43 , so um so I kind of expanding on this same framework here.

09:51 , so, as it goes through 14 Today and next week. So

09:56 look at pathology in terms of, communicable and noncommunicable disease. Right that's

10:01 type of thing the occurrence of This fits into the category of

10:08 Okay so looking at data relating to particular disease infectious disease. How many

10:16 are occurring at the moment? How is the disease? Okay. Um

10:22 then what's the frequency? Is there there is there an outbreak?

10:26 Is there a rapid rise in number cases? Is there's basically a low

10:31 of steady number of cases? So , I'll tell you something in terms

10:34 epidemiology. Okay and so that's why several infectious diseases by law have to

10:46 reported. Okay. Certainly things like S. T. D.

10:50 Uh influenza Covid there's a number of that you must be reported once identified

10:57 the physician. Okay and that's where data comes from. That's where that

11:01 from that. We collect on all of infectious diseases throughout the year.

11:07 . And get a feel for it's a disease that's not particularly relevant that

11:12 anymore. We don't see many It's something that all of a sudden

11:15 haven't seen anything in the data Now all of a sudden boom,

11:18 of cases. So we use that in different ways. Right? And

11:22 collected on a daily basis basically. um I mean as a nurse you

11:28 if you come across somebody with one these diseases you have, it has

11:31 be reported. Okay. And we'll a little bit more about that

11:35 next time about the types of diseases , signed the symptoms. Some bodily

11:40 , of course. Right, signs symptoms of fever. I got a

11:44 , my my my neck hurts or feel tired. Right. There's always

11:50 this group, there's things that are . You can measure a fever,

11:56 . Put an exact number on There's other things that more subjective.

12:00 . Like I feel malaise, you all heard that term malaise feel

12:05 Right? That's not really something you measure is more subjective type, but

12:09 both of those are typically associated with kind of bodily changes. Okay,

12:16 of disease extent. Uh, so relates to uh is it is a

12:21 , is it something that's ongoing for and months or is it something that

12:26 call acute last for maybe 10 14 and you're through with it? And

12:30 things in between as well. the extent of infection relates to.

12:37 it just localized in a certain part the body? Has it spread

12:42 Okay. Uh, certainly uh, you're your own immune system,

12:48 Which is basically referring to here. of course, go a long way

12:52 determining that. Right. You have healthy immune system. Can you just

12:56 the infection right there or are you compromised and not not your muse system

13:03 functioning as well. So that's certainly play a role. Um Maybe you

13:08 certain factors that you could be related gender. Ah Maybe what part of

13:15 world you're living in the geography? your occupation in some cases. So

13:20 of these things can factor into you in particular infection and so transmissibility of

13:29 . Okay, um what where might fit in in terms of these blocks

13:37 ? These colored blocks, where would put transmit transmissibility of disease? What's

13:43 best guess here? Yeah, It'd be it'd be in this

13:48 Right. So this really relates to transmission of disease. Absolutely.

13:55 so there are some diseases that can passed person to person. Okay,

14:00 rapidly and others that don't fit the at all. Okay, so we'll

14:04 about that uh in a little Okay, so we're talking about infectious

14:11 . This is something we emphasize more microbial pathogenesis, I. E.

14:16 it's worth kind of looking at the , how this happens. Right?

14:20 there's going to be uh whatever the is, there's some kind of a

14:26 source. So even if there's no , outbreak of curling or anything,

14:31 just have the interest of, I to know um where would I find

14:36 where do I find the meningitis the one that causes the number one

14:42 of meningitis in young adults and Where would I find it?

14:48 And so there's gonna be a source they naturally reside, even if there's

14:51 an outbreak going on, that's where that's where they live and that's what

14:54 call that reservoir. Okay. And so from that reservoir which can be

15:00 things, an animal can be other think I know what that is.

15:08 got battery backup, yep. So on a sec. Let me turn

15:14 one on briefly. Uh Okay so like I said, animals can be

15:23 reservoir um rabies, certainly various animals reservoirs. Um the many diseases are

15:34 are the reservoir. Other humans are ones that are the source. So

15:37 asymptomatic carriers are the ones that are source. So that's true for the

15:43 organism when meningitis outbreak occurs, which occurred in dorms and whatnot. Um

15:50 due to just another, an asymptomatic that's nearby. And so that's Uh

15:57 somewhere in order 40, of the just carries that meningitis organism in their

16:03 and show no signs or symptoms. so as mentioned. Yeah, so

16:11 number of those the reservoirs are humans it can be, it can be

16:14 can be a reservoir bodies of water what have you. It depends on

16:18 agent. So in terms of transmission course is how is it getting from

16:23 host? I'm sorry, from that to you. Okay. So that

16:29 be also a number of different It can be an insect that mosquito

16:33 something maybe takes it to you. can be a ingesting a contaminated water

16:38 . So a number of different Can you can get it get to

16:43 airborne right through food, what have ? Okay, so once in the

16:49 . So the transmission part um is to the rest of the process.

16:54 transmission part is probably the least Where it becomes an issue for the

16:59 is once it's in the host now got a whole bunch of barriers if

17:05 will, it's got to get around and over and what have you

17:09 your innate, your innate and adaptive system. It's got to get through

17:13 that. Right. So um so the hosts uh overcoming these barriers,

17:21 Multiplying, maybe causing damage. These are typically a part of the

17:26 . And again, you know, damage may be minimal or it could

17:30 severe. Right? Are you infected Ebola that could be severe damage?

17:35 are you infected with covid virus? going to be fairly minimal.

17:39 So it all depends. And of this all relates to the factors.

17:45 , and so the factors for part part of the infection sometimes for for

17:51 in establishing itself in the body than causing damage. Maybe toxins doing this

17:58 of the process and maybe a allows to attach. Right, that's another

18:04 an earlier part of the process. of the infection. So, you

18:07 , it kind of depends. And some pattern types will have a lot

18:11 in factors. Some very few. , but it does relate to the

18:17 , right? So the violence a organism is very there's lots of these

18:23 factors and it can be very Okay, So of course this all

18:27 to sum up all these effects will lead to some sort of pathology in

18:32 body disease state. And so we'll focus and we'll focus on this

18:39 chapter 15 but it's kinda gonna give brief kind of this is how this

18:44 starts and is initiated. Okay. so uh okay, so this is

18:52 we'll see this again because this is in the context of your innate immune

18:56 . So your microbiota is part of innate immune system, Like your skin

19:03 a physical barrier, your mucous membranes your body cavity, your throat,

19:09 your intestine and so forth. These all innate immune system defenses. Um

19:15 so to are the microbes uh your microbes that are occupying these areas?

19:24 . And so of course we call normal microbiota. Okay, and so

19:29 does this initially come from? Because where do you acquire this from?

19:36 back when longer for me than for ? But when would I have acquired

19:40 microbiome? That's part of it. really it would have been um during

19:51 . And so as you head into birth canal you will pick up a

19:56 portion of your microbiota during that Okay so hey thank your mother for

20:01 microbiota. Okay. Um but of it's probably likely changed over time as

20:08 gotten older. Um but the uh once you come out of the birth

20:15 now you're of course you're exposed to air and here come the microbes begin

20:19 eat and breathe. Right? So are gonna contribute to adding more microbes

20:23 your system. But they are you they've done studies with called uh you

20:31 to know this term. I'm just write it for your own do with

20:35 what you will what's called Noto biotic . That's an animal completely raised birth

20:45 death, completely devoid. Never had microbes on it. Basically think of

20:50 as a sterile animal that's not Sterile terms of there's no microbes on it

20:55 at all. That's how they grew and cultivated it and the animal frankly

21:02 very sickly compared to its counterparts that know we're grown quote normally right handed

21:09 and all this. So that in tells you microbiome must be doing something

21:14 of course we have 20 plus years seemingly information coming out every day on

21:21 benefits of your microbiome. Okay. of which tend to be more in

21:27 area of digestion because of the vast of bacteria in our gut.

21:32 Aiding us providing us different types of acids and vitamins and things and a

21:39 to consume different types of foods calories us where we otherwise wouldn't but of

21:45 affecting the immune system is also definitely a thing. And so um in

21:52 of their just their mere presence Um keeps other things out right?

22:00 your skin and your skin is occupied your own microbiome, well that space

22:05 can be occupied by a potential Right so just occupying space in your

22:10 and on your body. That's a help. Okay because your microbiome is

22:16 to you in a way. Okay so um certainly there's micro environments that

22:23 created throughout your body by by their . Okay um they'll have a certain

22:31 that have a certain part of the because they're adapted to it. So

22:36 tends to be kind of salty and acidic to a degree. And so

22:42 types like staph staphylococcus like that kind environment. So that's why they tend

22:47 be more present there. Um Other uh and happy to get that are

22:52 anaerobic and that's because that's their Okay so you know you have these

22:57 micro environments around your body that are by certain types. Okay now having

23:04 that they're everywhere in your body. mean they're not every every single space

23:09 ? They if there's something is wrong you're seeing microbes in your brain.

23:15 , They shouldn't be there. you shouldn't see them in your

23:19 right? Or your other vital But you know, aside from

23:23 they typically are in most other Um the uh and so of course

23:30 can vary because, you know, health varies throughout your life. Um

23:36 geography may change. So geography didn't the microbiome if you're living here or

23:42 living across the world somewhere else that influence your microbiome, your diet.

23:48 your diet changes over time. That influence the microbiome your age,

23:53 If you're older, maybe the system work as well, or those kind

23:57 changes. So, you know, have you'll have kind of a core

24:02 members of your microbiome that pretty much constant, but you will have types

24:07 may come and go, you here and there. Okay. But

24:12 , obviously they are an important Okay. Um and so we look

24:17 this obviously these microbes on your body in your body. Um so

24:24 like we humans are have been evolving six million years or so, we've

24:31 microbes the whole time. Right? they there there along with the ride

24:36 for the ride with us. so they've certainly have evolved with us

24:39 well. Okay. And obviously means a relationship between us and them.

24:45 . And for most of it it's uh what we call commence elastic.

24:51 these are we can explain relationships in context. So we typically used.

24:56 is this is from ecology really. this this concept but the plus minus

25:02 is kind of the is a good or no harm. No foul

25:07 Not beneficial or harmful. Zero. . And so commence commence, commence

25:13 and neutral state types are are what microbiome pretty much is one of those

25:19 types. And so they're benefiting of whether they're one or the other,

25:25 you whether you benefit or you just no effect. Okay so that's but

25:30 where they typically fit in. Now course pathogen pathogen can come in and

25:35 course that will be a negative to , a positive for it. Um

25:41 true parasite would be something probably like viral infection. Um You can have

25:47 saw previously different types of worms. protozoa can have these relationships with you

25:53 well. So obviously they're benefiting while harming you. Okay so um the

26:02 of course if you're on antibiotics that upset your microbiome and that can lead

26:08 some cases to certain diseases developing, wouldn't otherwise happen. So um it's

26:14 good to I sustained my microbiome with lots of uh bloody yogurt and stuff

26:22 that but others eat probiotics you So I think that if you do

26:29 probiotics, my suggestion is get the with the most number of bacteria in

26:34 . Okay because a lot of them along the way as you ingested

26:38 So um the exhibit a profound benefit you think? Okay. Yeah I

26:50 other than do yogurt and things like but my wife does she says thumbs

26:55 anybody else thumbs up. No You find it helps uh Already.

27:10 I mean it would have to be a bacillus. That would be that

27:13 . I don't uh from the The ones I I don't I never

27:19 I could be wrong I don't ever a bacillus that's part of the

27:23 It's typically something like with a little and lack of lack of bacillus but

27:29 not in those performing so yeah it's but I'm not sure if bacillus is

27:34 that's considered a one of those types are good, they're okay, they're

27:39 but I mean um I wouldn't take one that's full of anthrax spores that

27:46 that one. But uh but uh not sure. I know there's a

27:51 core set that fit that group and are our intestinal ones that are there

27:55 they grow, grow and then produce pills with. But so opportunistic pathogens

28:03 I think we talked about those before those arise from members of your microbiome

28:11 ? So um typically your microbes don't any harm unless they're allowed to kind

28:20 leave the area they live in so speak. So if you have like

28:24 puncture wound where they can gain entry your body that that might cause

28:29 then they didn't they turn into an pathogen. Um So yeah, typically

28:34 something is not right, they may certain types may then begin to cause

28:40 . Uh but if if you're everything is imbalanced then normally don't see

28:45 things. Okay. Um Now of asymptomatic carriers, right? We talked

28:52 those before, so you you you're the a pattern for example, but

28:58 not you're not harmed by it. have um I'm not sure what all

29:03 into that. I mean we're all right genetically as our immune system.

29:09 there must be a balance of factors kind of just they don't they don't

29:13 us any issues. So um the okay, Coates, pasha before

29:21 go on any other questions or Okay, so we mentioned this in

29:26 one, but we didn't spend a of time on it because I knew

29:28 gonna we're gonna delve into this in 14. So, so recall this

29:35 his method for linking a infectious agent a disease, right? The chain

29:43 infection he called it. Um And it's a step by step process um

29:51 do that to identify a potential infectious . And it has some kind of

29:57 um He calls them postulates basic tenets of the process okay. Uh that

30:04 follow. But of course we know there are some exceptions to this

30:09 But anyway, the the core core is still used. It is the

30:16 used by CDC. Okay, so for disease control and but we know

30:23 there are there can be adjustments to because we have of course 100 plus

30:30 of knowledge now that we've gained since time. But again the basic framework

30:36 used but we can adjust as So the basic framework is number

30:42 that the microbe infectious agent is only in diseased animals. Okay. And

30:49 able to isolate. So that's the part of this is to be able

30:52 isolate it and to actually do it , which is even better. The

30:56 times you can reproduce stuff in the more confidence you have that you're

31:02 . Okay. And so so the isolation from samples of the animal,

31:09 it be blood or some sort of fluid, what have you. And

31:14 able to isolate and identify the determine its morphology, gram stain of

31:21 etcetera. Okay. And then you're to take that pure culture of course

31:26 where the pure culture when he was this, where the pure culture techniques

31:31 into play and aseptic technique and all . So uh injecting a healthy

31:36 So the healthy animal according to According to the prophets only disease animals

31:43 the pathogen, healthy animals. Do . Okay, so take a healthy

31:47 , inject it with pure culture pathogen the animals should produce the same disease

31:54 . Right? Um and then a time be able to recover that very

32:03 infectious agents. So of course he's to be identical. Right? And

32:09 obviously gives you confidence that yeah, is this is the right thing

32:13 Okay. And so um so I you're gonna get I think it's gonna

32:19 a slam dunk. So those that's basic framework, right? But I

32:24 said there may be some changes that occurred since this time. Okay,

32:28 look at this list. Let me that and see there's something that um

32:34 here. Okay. Oops. All , counting down from six. It

33:58 come. Yeah. If I think said about three times before this

34:04 Alright, so so certainly a is . Okay, um that's your asymptomatic

34:13 are what make that false statement. So um novel pathogen types are

34:19 that is correct, simplest organism still be cultured in the lab, among

34:26 . Um The sea are those uh disease, right. We talked about

34:33 and persistent, which is basically chronic . Um certainly um HIV is one

34:41 those that can linger in the body don't know any effects for several months

34:44 years. Multiple patterns can cause the disease. That's true too.

34:49 so let's kind of just go through of these exceptions. May be exceptions

34:55 not the right word I'd say, amendments to the pasta if you

35:00 Okay, so as I mentioned, aware of carriers. Okay, so

35:06 individuals can carry the pathogen and show disease. Um so that's counter to

35:12 first postulate uh culture ability, the . So the fact that be able

35:18 culture that we can't do that for . Okay. Especially coach didn't have

35:23 deal with viruses. That's a whole level of culturing because it involves having

35:27 culture uh animal cells for the virus grow in. So he would not

35:34 been aware of that certainly. Uh you know, bacteria types are still

35:38 able to be grown in the uh legionella trepany, that's the simplest

35:44 . The so he also had the did that Each infectious disease was caused

35:53 only one type, one agent. . And he thought that only one

35:59 type because only one type of disease not multiple. Okay, so kind

36:03 a one for one in these And so that of course isn't

36:07 So pneumonia is a perfect example of having a collection of symptoms.

36:16 that can be caused by multiple infectious , Not just symptoms, but

36:22 So, pneumonia can be caused by oh my gosh, several microbes from

36:29 bacterial viral um, fungal and I there's an instance of a couple of

36:36 all types can cause pneumonia. So , pneumonia is kind of a more

36:42 a collection of symptoms that produced this illness but has a number of different

36:49 that can cause it. Okay, these meningitis can be caused by really

36:55 environment INGE itis there's four or five types that can cause meningitis.

37:01 you know, it's it doesn't always that. It's a one for one

37:05 . And so streptococcus by a chinese a good one in terms of uh

37:12 microbe that can cause multiple diseases. so strep throat. And actually for

37:16 a number of these strep throat can the initial infection that in the same

37:23 with strep throat, it can lead sometimes scarlet fever or to uh what's

37:29 flesh eating disease, which is kind a catch all for a number of

37:34 infections, severe skin infections, that to really peeling of skin layers.

37:39 it can be, it can penetrate layers of skin um when it gets

37:44 to near the bone, that's when gets, that's when that's what they

37:48 refer to the flesh eating disease. but there can be more superficial and

37:52 more a little bit underneath that, it's not uncommon for those skin infections

37:59 have been preceded by strep throat. , anyway, the point is that

38:04 thing can cause multiple diseases uh we viral agents. Right, so uh

38:11 would he would have been scratching his to cope with if he was dealing

38:14 a viral disease. A didn't know viruses in his time and be if

38:19 had they would have to come up a way to culture it. So

38:24 , of course nowadays it's it's not issue for us. We know all

38:27 viruses and how to culture them and forth. Uh model animal models.

38:33 all of these are typically studied in of disease processes and what's the pathogenesis

38:40 animals, typically mice or rats. there are some infectious diseases that there

38:46 no suitable animal model for and that be posed, posed some problems.

38:52 , so, but nevertheless it doesn't there are these adjustments if you will

38:57 coach pops it doesn't mean we throw he did out. Obviously not.

39:01 still forms the framework for establishing disease agent, but we know we know

39:10 what we have now. We we fall into a hole where we don't

39:14 what's going on. We have we have a pretty good idea because we

39:18 of these all these different variations. , so so we can be aware

39:22 that as well as as you proceed with these kind of studies.

39:27 Um, so classifying infectious diseases. we know that um I mentioned earlier

39:38 any kind of disease state will create sort of will manifest itself in you

39:46 certain symptoms. Right? A headache, sore neck, a what

39:52 you, watery eyes, whatever. . And so subjective, subjective versus

39:58 objective measurable fever is measurable for Um you can see a rash

40:05 you can see swelling, you can a small area is red to be

40:10 to the touch. So these are things, right? But there are

40:13 types that aren't um now a syndrome a disease a syndrome. And I'm

40:20 say that they're these generally are not to infectious diseases. The term

40:31 These are typically non infectious diseases. it's like you see the down

40:36 Okay and so any kind of a is a collection of science and

40:42 No one individual may necessarily have all them. But they're typically are a

40:49 set of of parameters that identifies it a disease but can have variation.

40:57 in terms of the other types of futures associated with that disease. Okay

41:02 example we pretty much know if someone Down syndrome, we can tell that

41:07 a form of autism. So there's what syndromes are okay but you don't

41:15 don't really see that associated with an disease. But you're certainly gonna hear

41:18 term syndrome. Okay um so so communicable and non communicable diseases.

41:27 uh so transportation of via personal person airborne means or direct contact, sexual

41:38 . Right? So certainly all your . T. D. S.

41:40 airborne transmitted respiratory illnesses are typically communicable . E. Covid pneumonia um mumps

41:50 measles for sure so these are ones can um you can um you can

42:01 on trying to say here compared to contrast to noncommunicable that's what I'm trying

42:08 say. So noncommunicable diseases like tetanus a typical example. Okay so you

42:15 acquire tetanus right? You always hear on a rusty nail guy. Get

42:19 tetanus shot. Right? So presumably tetanus organisms in soil um and now

42:28 contaminated with soil particles puncture wound occurs into you causes tetanus but you're not

42:35 to pass it on to somebody Right? Unless the weird coincidence occurs

42:40 somebody goes into your puncture wound and some of that material and puts it

42:46 their own under their own skin or totally implausible. Okay so tetanus is

42:52 going to be a personal person Okay But certainly these other ones

42:57 And so the ease of spread. right in terms of something being very

43:02 . Okay uh like um plague common . The airborne it's very common for

43:11 that are very contagious to be airborne because it travels very quickly through the

43:15 . Okay um Ebola is not one actually that contagious on this level because

43:22 actually have to touch the bodily fluids someone or in contact with the bedding

43:27 such an infected individual um not as as easily spread or something like through

43:33 air? Okay so that that can of indicate contagiousness if you will.

43:40 um okay, any questions? So , epidemiological data. Okay, so

43:52 is an example and this is just show you what what you can do

43:57 this data. Okay. And so is a incidence of kryptos or radio

44:06 . Okay. And that is a type and it is often required to

44:15 water sources. Um and so in particular uh state it measured at 7.5

44:24 per 100,000. That's typically how to it is per 100,000 individuals.

44:30 And so late December and you see increase, you've seen 65 cases in

44:35 county of 430,000. Okay, So calculating the the incidents, okay,

44:45 cases that have popped up. so we have 65 in the county

44:51 430,000. So there's the math times because you report these, this is

44:56 a standard report per 100,000. To kind of normalize when you're comparing

45:01 the country or counties or whatever. and so that comes out to be

45:07 cases per 100,000. Okay, particularly the rate you had before with

45:15 400,000. So when you compare it to that it's double right? It's

45:22 . And so the other thing to is that not all cases are reported

45:29 kind of number you see coming from authority figure is going to be underestimated

45:36 because not everybody that is affected goes doctor and then gets reported.

45:42 Um people may not know even what have or say well I don't have

45:47 insurance. Okay. So for that a reported value will typically underestimate.

45:56 you can always be sure there's probably than that. And this here says

46:00 only one in 10 are reported, then that's basically 10 times more than

46:03 actually out there. Okay. So so that's, you know, that's

46:08 to be aware of. Right? any kind of numbers coming out,

46:11 probably the low end, not not reality. So, but having this

46:17 the a to have to report infectious diseases. There are lists that

46:24 have to report by law and that you to get this data.

46:28 And then you can track and see going on at any given time.

46:35 . And so this allows you to it says form the basis for disease

46:40 and prevention. Right. So is are these cases that are happening?

46:45 there a certain demographic that is happening ? Is it happening in a certain

46:51 area? Is it in the urban or is it in rural areas?

46:55 it um is it connected to a this was first studied, you know

47:00 the 1850s and in England there was outbreaks of cholera and they did this

47:07 of basic epidemiological studies and found it related to most cases came out of

47:13 area of London where it was a water pump or contaminated water pump.

47:18 was and people that's how you get back then you through the local.

47:23 pump, pump your buckets full of and take it home with you.

47:26 that one apparently was contaminated and that's of the cases of color in in

47:30 around the vicinity of that water So they would have known that if

47:33 hadn't collected this kind of data. , so very important. Okay,

47:39 and getting all these all these different in, they can tell you well

47:44 if we do this is these, we have X, Y and

47:48 You're more predisposed to getting this particular or what have you. So this

47:52 the kind of information you can And so uh there is actually a

47:58 of uh at the medical center, is a school of Public Health,

48:04 ? That's where you can study this and get a degree in it if

48:08 so desire. Okay, um so of disease. Okay, so here

48:18 actually using that epidemiological data. And so um so the terms incidence

48:26 prevalence. Okay, so prevalence is really a measure of how long

48:30 been lingering around. Right? So a it's a it represents basically cases

48:37 have carried over old cases and those are new. Right, so the

48:42 though are within the given time. , how many new cases are

48:47 Okay, so for example, you see here and uh uh oops

48:58 Here we go. So in All right, so the prevalence of

49:04 way over here. Okay, so of more recent data, so to

49:09 . So in prevalence at that point at 1.1 million. So 1.1 million

49:13 cases in the US at that point 2014. Okay. So the incidents

49:20 that particular period of time in 2014 37,000. Okay. And so um

49:29 know, is that high or low you have to compare to data before

49:33 data. So here is like H I. V. Aids cases.

49:37 in the 12 years here, right to the epidemic that occurred here in

49:42 states nine from 91 to 78 or rather um you know, relatively low

49:49 then begins to creep up. And so here in three years.

49:55 . You have you already equaled the of cases 250,000? It took you

50:00 years to get right. So certainly indicates, wow, there's there's there's

50:05 huge burst of of cases high incidence and um of course I put into

50:14 , Right. Because you can categorize on what is the numbers, are

50:18 rapidly occurring in a short time period is it kind of steady at a

50:24 rate throughout. Right. So these kind of tell you or is it

50:28 popped up once and then goes away occasionally pops up here and there.

50:32 these all kind of tell you the of these. This is where your

50:37 epidemic, endemic. Sporadic. That's where these terms come in.

50:44 So, um, again, you combine this data with demographic data,

50:50 data, etcetera to kind of get picture of what's going on.

50:55 And so here is kind of a here of data is a percent position

51:02 for flu like symptoms in a particular month period. And you see him

51:08 up as we get into the winter , fall to winter increasing. And

51:14 the red line represents kind of the steady rate that there is. This

51:19 be what's called the endemic value So, you know, quote,

51:24 cold is endemic here in the United . There's always cases of it year

51:29 , right? But not at high . Okay. Whereas we have a

51:34 sudden burst. Right? Then we reach, you know, epidemic levels

51:39 as that. Okay, that's kind how do you fit in here?

51:43 . And so, uh, sporadic one of those that occurs very

51:50 So you may have a few cases month and see nothing for three or

51:53 months or maybe the next year? , that's what sporadic would be

51:59 I think we all know what epidemic and, but pandemic is for

52:03 Right. We don't we don't know . We know that. Right?

52:06 epidemic epidemic of course is developing a of cases occurring in a relatively short

52:11 of time. Okay. And then . Right. So disease is always

52:16 here. Common cold is always present other parts of the world, cholera

52:22 always present as endemic. Okay. a, you know, pretty much

52:27 number of cases. Not necessarily doesn't to be high, but a steady

52:34 of cases all the time of a disease. Okay. Um,

52:41 um, oh, severity. so this is where we get into

52:46 of length of time, if you here in terms of disease. So

52:50 versus chronic, uh, probably most infectious diseases. You typically overcome those

52:58 days, two weeks once you acquire agent, chronic disease. So,

53:03 is certainly an example of that um treatment takes several weeks or months,

53:12 , disease manifests itself in your That's hard to get rid of.

53:17 and you always have like lingering symptoms are prolonged for quite some time.

53:24 it's sub acute, uh that's that's strange one. There's not, there's

53:29 few examples of that, to be . Um I think your book mentions

53:33 type of a infectious agent that causes heart disease, uh, that and

53:40 , it's all temporal time. So between acute and chronic and that's

53:45 be something that may be last on order of a few months, Not

53:49 than a year maybe. Okay. going beyond that. Then you get

53:53 the chronic more long term acute is short. So it's kind of a

53:58 thing uh late and of course talk that in the context of viruses.

54:03 . So latent um they you see symptoms and these are common for viruses

54:10 integrate into the host chromosome uh which do shingles is one that kind of

54:17 integrate but hides in your nerve cells then appears um years later. So

54:23 are latent diseases. Um Okay, let's look at this question here.

54:31 look this one up today. So was curious this will take us in

54:34 next topic which is herd immunity. . So what is the percent of

54:43 in the US fully fully vaccinated? . Against covid. Okay. There

54:54 questions. Okay. All right, again, fully vaccinated, So vaccinated

55:21 boosted of course you got your I can google it. Everybody's doing

55:43 now. Okay. Three counting app 32 one. Oh, interesting.

55:56 . Between that was oops. So wait let me see that

56:04 Be with the consensus. Okay, not Right, okay. It's e

56:16 . Um I uh he said oh . Um um Yeah 68%,

56:32 Okay. Um in texas Is it than 60 or more than 60

56:40 It's actually 61 texas us. Okay but it's been uh so we're not

56:51 her community by at all we're not immunity. So um The I think

56:59 highest levels were like 85%. When was 85-1 was 78. Low end

57:06 think was even on a low end was maybe 51% I think I think

57:11 was Louisiana. But yes so vaccination course relates to uh herd immunity.

57:22 and herd immunity relates to those infectious that can be passed that are communicable

57:28 from person to person. This is your herd immunity can factor in and

57:33 . Okay so um the uh the can see that with this um little

57:46 here. Uh so the key So blue is healthy? Non vaccinated

57:56 . Okay uh and you know any , you're gonna have unvaccinated people um

58:04 a variety of reasons. The both and irrational. Uh you know whether

58:10 cultural differences, religious differences or have health care, right? There's always

58:16 be unvaccinated people. So so in example there in the blue ones,

58:20 ? The and they're healthy, So the red are unvaccinated um sick

58:28 people. Okay And yellows are the vaccinated people. Okay so if you

58:35 uh you know lower number of the is vaccinated then you have a scenario

58:41 this, right? So the red there is is transmitting infectious agent you

58:49 very few unvaccinated people. So just them. So these here, here

58:57 here. Right are vaccinated. So don't so the vaccinated people act act

59:03 sinks. Think of it. Act sinks to absorb infectious agent. Take

59:08 of it. Right. Well you have enough sinks. You don't have

59:12 protection between this person and the unvaccinated to absorb the agent And help out

59:19 unvaccinated people. Okay. Because then happens is this easily spreads throughout the

59:25 . So you see all the people red are now sick as well.

59:29 . So you want to get to threshold. That's something like this.

59:33 threshold is 75 typically are higher. so now you have a bunch of

59:40 people surrounding this acting like a buffer the sick person and these unvaccinated healthy

59:48 . Okay, so um as a they have less likelihood of getting

59:53 Right? So you help them in way, but it only helps if

59:57 get to a certain threshold. Okay so you don't need to know our

60:02 value. But I figured I just it in just two, let you

60:07 at that. It's it's how you of think of it as a measure

60:11 of reproduction of the infectious agent. it represents is um if one is

60:19 about a measure of contagiousness to a . Okay, so uh it represents

60:25 number of people who can contract the from one that's sick. So for

60:31 and this is kind of this, need to update that. I think

60:34 actually lower than that. But for let's say six. Rounding up to

60:39 a personal Covid, it can infect other people. Okay. And so

60:44 you look at the scope of this other diseases, so measles is on

60:49 upper end, right? Pertussis, whooping cough. Okay, so they're

60:55 RL value is 10 to 17, , 12 to 18. That means

60:59 an individual can infect those many other . Okay. Which told you which

61:06 most contagious measles or mumps measles of . Okay. It's more contagious uh

61:15 of infecting many more people per each person. Okay. And so of

61:20 as a result, okay, being contagious means the threshold value to reach

61:25 immunity also goes up. Okay, with covid is actually somewhere around down

61:31 , low end, You know, minimum threshold, we're not there.

61:37 like at 68%. Okay, um here in Texas. So anyway,

61:45 how you read that. Right? um so as we look at classes

61:51 infection. So again, I know getting inundated with more terms here.

61:57 but this refers to uh this is a single individual that's infected.

62:04 what can be the nature of the . Okay, well local infection.

62:09 of a oh I don't know, splinter or something that's infected finger gets

62:15 . And the infection basically stays right . Their body has ways of kind

62:19 containing it that we'll talk about But that's a local infection. But

62:23 local infection can spread to a uh spread so systematic infection to the

62:31 Very not uncommon for um any kind dental procedure where you got the wisdom

62:37 pulled, things like that root That's opportunity for bacteria in your mouth

62:43 potentially gain entrance into the rest of body. And so that can become

62:47 systemic infection. Sepsis is really an condition due to spread of toxin

62:56 or bacteria in the blood. Okay the the endo toxin effect. Okay

63:03 the gram negative talk about that way , that can be a type of

63:07 . Um septicemia is of course that well the focal infection uh that's more

63:15 of the example of of the uh infected and it goes to another part

63:23 the body systemic is more widespread. so focal kind of goes from one

63:30 to another specific area, systemic is potentially the entire body okay circulated through

63:38 through blood but it can be through lymphatic fluid. We'll talk about what

63:41 is later. Um And so uh of post resistance. Right so primary

63:50 . Okay um and secondary infection. not uncommon say for something like uh

63:57 get the flu can I Which is primary infection. And then as a

64:03 of the flu, your body is is is not 100% yet. The

64:11 system has fought out the flu virus now it's kind of depressed a little

64:16 and and then that can set the for a second of infection which can

64:21 times be the more serious one. for example, not uncommon for flu

64:28 be followed by pneumonia. Okay. so pneumonia being a secondary infection.

64:34 , But only occurring really because the primary infection kind of wore you down

64:41 bit that you weren't able to effectively off the secondary infection. Okay.

64:47 and of course then your your what you call carriers? Right. Asymptomatic

64:53 are what fit in that last Subclinical or in apparent that's your you're

65:01 carriers are in that group. No no signs or symptoms of disease

65:06 the passenger but no signs or Okay. Um Alright so predisposing factors

65:15 development of disease. Okay. Um I mentioned earlier things like gender,

65:24 age occupation, even uh many other can determine your susceptibility to disease.

65:33 ? Um Females are more predisposed to tract infections. Males more predisposed to

65:42 respiratory type conditions of different types. The uh climate and weather. You

65:50 to have more respiratory illnesses occurring in months. People tend to huddle together

65:55 often uh spread those diseases. Um . So age and particularly to depressed

66:05 systems typically and that can make you susceptible. Um your chemotherapy obviously you're

66:12 chemotherapy that's certainly affecting your immune your ability to fight off disease

66:20 Um If one is a taxidermist, , stuffed animals, right, well

66:25 you're handling animal hides, animal animal , uh those can have particular types

66:30 bacteria that cause infectious disease and they more predisposed to those types. Um

66:38 in any case uh a disease will a particular pattern. So keep that

66:46 in mind. So we have uh Uh five stages. Right? So

66:52 acquire the infectious agent, there will a period of time where you don't

66:58 anything. You don't feel any Nothing. Okay. Of course that's

67:02 the agent is. Um it's at point, you know, maybe you're

67:07 some conquers it and it's gone and further happens. But if not then

67:12 kind of a period where it may multiplying. Um And then enough enough

67:19 agents are present now that you begin see feel symptoms. Okay, so

67:25 pro drama period is kind of the symptoms. So maybe tired feeling a

67:34 not necessarily a fever yet, but may feel kind of may.

67:39 that kind of classifies programmable. But of course the worst effects of disease

67:45 of course during the period of Okay, so whether it's fever,

67:52 have you? Okay. And then then of course you hopefully your immune

67:59 overcomes the illness and you're a period decline. Okay, so the numbers

68:07 infectious agents are dropping and your immune is taking over and your body is

68:14 . Okay. And so the period convalescence is really just that repairing itself

68:22 getting back to normal, so to . Okay? So you know the

68:27 each of these stages right? Can in terms of length, of course

68:32 severity depending on the disease. So the question asked during which period

68:40 would a person spread the disease? . A. B. C.

68:46 . E. F. F. all the above which periods could the

68:55 spreading diseases? Someone else is just of these periods or no?

69:03 I gotta turn this thing on. , counting down from six.

69:58 Oops. So what happened here? , and see the results we

70:04 There we go. Okay. Is correct. So you can you

70:12 you can uh if you're around the you can it's likelihood greater in

70:20 Or D. But certainly that person uh is continue infectious agent. So

70:27 possible to still catch it whether it's . B. C. D.

70:30 E. Okay, so but again likelihood it's more so C.

70:37 D. But it is possible. , so let's Revisit This 1,

70:46 last time. Okay. And I'm go ahead and put the clock on

70:57 . Oops. Yeah. Mhm. , counting down from five two.

71:44 right, 210. It is Okay. So it's when are the

71:57 that are correct C and D, . Yeah. See C and

72:08 Okay folks, that's it. So two next

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