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00:00 Okay. Mhm. Okay. What's ? Alright um let's see here.

00:23 , ok folks, let's get Yes it is me, I just

00:31 severe buzz cut somewhat. My ear lowered as my father would say.

00:38 Anyway um we got tired of the nous so said enough um Alright so

00:47 see, so we're back on so remember we didn't have anything to

00:53 last this week or I guess This monday. So back in the

01:12 of that backboard, Very similar exam in terms of average 68 point something

01:20 forget. Um so the exam will open actually tomorrow, so you'll be

01:27 to see it tomorrow for the next of days so certainly take a look

01:32 you have questions, come to office , either in person or virtually Whatever

01:39 prefer. Um that's fine. And the next exam, that's not the

01:49 , 19th. So that's uh the for that will open. Not this

01:55 , but next Friday. Okay. but I'll We'll have a few emails

02:02 then, so I'll of course mention again more than once. So this

02:08 we're gonna finish uh most of 14 , so I think we just have

02:13 little bit left to do on Thursday then we'll start in with um the

02:20 of 16 and 17 is your immune , talking about your immune system will

02:25 that on thursday and continue that through week and then finish up with 15

02:33 pathogenesis so we look at how your fights disease and then 15 we look

02:37 how pathogens are able to counter act defenses and cause disease. So that's

02:43 15 is about. And that will off unit three. Okay. Um

02:50 again do do look through the exam you have questions um let me know

02:59 we'll certainly go over it. Uh a problem. Let's see. So

03:06 if you are I'm trying to will hope to have it done this week

03:12 not this week. Certainly early next and have like a midterm grade posted

03:17 blackboard. So it'll be everything homework's units one and two. Although whatever

03:23 homework graders seeing on mastering that's what's transferred. So um but they will

03:27 transferred to blackboard. Um So basically two exams. Um The homework's up

03:36 um I guess through units too. and then the blackboard quizzes. So

03:43 those, I'll make a company midterm putting a blackboard should be able to

03:47 that again. It'll probably be earliest this week uh as as late as

03:53 next week. Okay well in advance the drop date if that's what you're

03:58 . So so I'll keep you updated the status of that. So um

04:07 so let's um a couple of uh of summary slides here as we

04:15 So again so we're in this we then we'll continue for the next unit

04:20 the next on aspects really focused on Microbiology, medical microbiology how you want

04:27 refer to it. And so this 14 is really just a I know

04:34 inundated with a lot of terms and and that's a lot of what 14

04:39 for better or worse. But um mean those are terms that you probably

04:44 need to know that you'll use um know some more than others as you

04:50 you go on into Nursing school and . But um so many 14 description

04:56 disease in general infectious disease um and aspects of it. Okay. And

05:02 we looked at it kind of in viewpoint here in terms of pathology,

05:06 study of diseases of course and then it down in terms of causes and

05:11 we looked at the coloured boxes are the various um sub topics if you

05:17 that we looked at so far, all all these most of these.

05:23 And so cokes postulates how to determine the infectious agent causing disease. Of

05:29 , what we've learned in the past plus years and how we can we

05:33 where we need to modify things or based on that knowledge. Um pathogens

05:39 severity of disease extent. A lot these basically terms to know here um

05:45 acute disease for example. Um So 15, 16 and 17 which are

05:52 up host resistance that's really where we in on the body's immune system.

05:58 . Of course the health of that a lot to do with our ability

06:01 fight off disease. Okay. And , you know, there are various

06:06 gender, occupation, maybe geography where live um general health. These all

06:13 into whether you come down with infectious and then probably changes is more kind

06:19 . What are you experiencing? Are are you have a fever? Do

06:22 have a penis? Do you have general tiredness? Are showing a rash

06:30 ? What have you? So, are both can be certainly observable but

06:34 always measurable statistic. Right. You measure a fever of course.

06:38 But you can't really measure somebody's so to speak. Right.

06:42 so you can have both. Both be parts of any kind of disease

06:46 of course occurrence is the epidemiology. what this is centered on here.

06:52 so what are the there are diseases diseases that must be by law

06:59 notified. And we use that data to see at any given time what

07:06 the state of the health of the so to speak. Right. Is

07:09 is there a certain surge in a type of infectious disease? Why is

07:15 who is it happening to? What of the country etcetera? These kind

07:19 things. So we use this information hopefully contain and see what's going

07:23 There's something new that we haven't seen . So so we need that of

07:28 . And then uh then communicable and diseases transmission of communicable person to person

07:35 . These are the diseases we can get vaccinated against write and produce this

07:40 immunity. Okay so we touched on of these and so we're kind of

07:46 today is kind of more about transmission disease um uh the the health care

07:55 and how that can cause disease. something that's certainly applicable to you all

08:01 are going to be nurses certainly. then um and then a little bit

08:07 the I. D. S. talked about that before um and I

08:11 we'll probably leave until next time some the epidemic epidemiological stuff. Okay but

08:17 that's kind of where we're at. so let's look at this question

08:21 So this has some terms that we um last time but it introduces a

08:28 a couple of couple that um we'll about today. Okay. We're going

08:31 the false answer here. Okay. So we did talk about herd

08:39 Uh Yes that's that's the only The other ones are all we talk

08:45 the I. D. S before these other ones are kind of

09:13 Mm hmm. Okay counting down from . Okay let's see. See that's

09:43 . Um Yeah herd immunity that's definitely . We have to be vaccinated in

09:49 to generate herd immunity. Alright. remember it's not just it's not just

09:57 getting vaccinated but it's also getting enough vaccinated, right? You know it's

10:03 ones that are vaccinated already sinks to the infectious agent right and protect others

10:09 us. So certainly you have vaccination a definite part of that. Okay

10:16 contact transmission indirect. Uh That's and transmissions are modes of disease transmission.

10:25 Both of which are true in direct might we'll talk about those here in

10:30 few minutes. H ai that's the acquired infections. Um What you get

10:37 perfectly healthy or you have some other you're in the hospital for. But

10:43 there you catch an infectious disease um as a result of being in the

10:49 . So that's uh that's certainly what is. But we use the term

10:55 to be called, you may see term nosocomial. Nosocomial is kind of

11:01 older term which specifically meant hospital hospital infection. Nosocomial but now they've broadened

11:08 term because health care doesn't just occur the hospital occurs at home occurs in

11:14 clinics around town and elsewhere. So of those are potentially uh uh areas

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

11:35 most are viruses with animal origins. what zoonotic means. Okay so let's

11:42 so we're gonna go through these um get through some of this but we'll

11:49 have to save that for thursday. um So um let's kind of just

11:57 this through an example here. Kind a this is out of your

12:01 Um And so remembering that, you with disease pathology, right? We

12:04 a cause we have a disease We have a result of the infection

12:12 the body and something happens to the . Right? And so this is

12:15 study where you have swimmers using use this community pool coming down with

12:22 disease. Okay. And so the was traced to this out of the

12:30 here, traced to after water analysis this cryptosporidium protozoa disease talked about those

12:40 . Right. And um this is for any infectious disease. There's gonna

12:45 some cause, right? It'll have types of features. Remember the term

12:51 factors. Right? So you might that these are very tolerant to

12:56 So they actually have a a an around them that allows them to

13:01 Um So like proto zones, they have these weird life cycles.

13:07 And this is no different as you see right here, going through different

13:13 , feeding stages, and reproductive stages common for a protozoan. Okay then

13:21 then of course you have a reservoir it resides. Right, Cryptosporidium are

13:28 uh contaminants in water. So feces animals. So uh somehow being resistant

13:36 chlorine the water, they were able survive in that pool water.

13:42 And so the life cycle, They different types of virulence factors. So

13:48 virulence factors is any feature or features enable the organism to cause disease.

13:53 , so for this thing, its to certain types of chemicals, it

13:59 be, maybe they do attach to intestinal wall. So it probably is

14:03 mechanism for that. Would certainly be virulence factor. Uh They can form

14:07 cyst which is kind of a dormant that makes them somewhat resistant. Uh

14:13 that's very typical of protozoa, all that affect your gut because because the

14:18 not necessarily a friendly environment because it's acidic as you get into the

14:23 Um so it has to be able survive that. Um So again,

14:28 kind of thing is this is one , but as we look at different

14:32 agents, they're gonna have the same to them. Okay, Reservoir away

14:38 be transmitted. Okay. And um uh in this case gastrointestinal disease.

14:45 so the fecal oral route is how um intestinal pathogens are acquired through water

14:55 through food. Okay. As we'll here in a little bit.

14:59 so uh certainly the symptoms right, are aware of, we've all had

15:05 some point not necessary Kryptos for radio but we've had some sort of gastrointestinal

15:11 food poisoning at one time or another it was san manila or B coli

15:16 what have you? And very Of course constant is diarrhea um it

15:23 be a severe abdominal pain, depending the infectious agent could even be blood

15:29 . So all depends on the severity the violence of the agent.

15:36 But that's typical for gastrointestinal upsets. . And so treatment as with most

15:45 infections? Okay. There's really no . Okay, why is that thinking

15:58 the intestinal system if you eat are you owning that forever? Are

16:04 just renting it analogy drink water? you holding on to that water

16:10 Are you getting rid of? It through? Right. So in gastrointestinal

16:17 unless it's something super severe you just it run its course because it will

16:24 pass. Okay and um what you is rehydration therapy give water electrolytes,

16:33 what you're doing, you're losing So just do that. Um You

16:38 even give antibiotics because most of these are due to viruses, stomach

16:44 You all heard that? Right? viral causes are really what caused most

16:49 . I. Tract infections now of if it's become severe um you can

16:55 very bad abdominal pains and cramps and can appear in the stool. That's

17:00 another level. So it may require at that state. Just depends on

17:05 severe but for most it's just run course and drink lots of fluid.

17:11 And so this uh natasa. Okay those there are specific protocol.

17:21 Old drugs. Again you don't need memorize this, this is all

17:26 what I'm showing here is strictly just of what is typical for any kind

17:30 infectious agent cause symptoms. They produce etcetera. That's kind of what this

17:37 about. Okay and so the tension diagnostics we will talk about not in

17:44 unit but the next unit we'll talk little bit about detections. So we

17:48 to first talk a little bit about adaptive immune system. Right? And

17:51 engines. Because that serves the basis uh tests you do to identify different

17:59 agents. So of course the big has been for quite some time.

18:03 you you've been drilled into okay cokes I'd take a sample isolate the organism

18:12 then see what you got identify it forth. Okay That obviously takes

18:16 Okay you still do it. But you also want to rapidly especially

18:22 something quite virulent. And the patient noticeably not getting well very quickly that

18:29 want to rapid I. D. that often involves antibody engine reactions.

18:34 so there's a number of tests to many different types of infectious agents and

18:38 can do it within a couple hours know what it is and then treat

18:43 . But you know you still for infectious diseases. You still do the

18:48 that's played it out the classic microbiology isolation. You still do as well

18:54 this is often also a important step . Okay But also there's many you

19:01 that can't be cultivated. So you is the only only choice you

19:05 Um But rapid idea is a very thing. So uh the okay,

19:13 there yet. So so again, just an example. Uh you can

19:19 any infectious disease and kind of go and see that there's a reservoir where

19:24 organisms found. There was a motor . There's uh there's a disease state

19:30 causes depending on where it's affecting. there's ways to detect it and treat

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

19:46 chapter. So it says all members a group of ornithologists which are birdwatchers

19:54 barn owls in the wild have had . Okay. Um One murder is

20:02 her third infection. What is the likely source of their infections?

20:10 The mansion is probably fairly obvious This will take us into transmission of

21:02 . Can captain down from 12. . Yeah, that's a slam dunk

21:24 , contaminated hands while the walls handing owls and the nest. So this

21:30 going to be I'd say it's probably oral route I'm thinking so somebody is

21:38 to be a gastrointestinal pathogen um having owls and the nests and abetting certainly

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

21:57 or anything. Uh the fact that have a carrier on that was really

22:01 either. I mean you know in of in terms of these others catching

22:10 disease from this person, Okay. using food. No the the implication

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

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

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

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

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

25:03 vehicle as like a a medium or that is carrying the agent.

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

25:59 produced and the thickness and the being on air particles and things like

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

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.

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

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

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

36:15 your primary innate immune system defenses, and they're certainly compromised in terms of

36:21 . Um and then, you uh going in for surgery. So

36:26 have, you know, you've exposed body, you have, oops,

36:31 , you have you may have a wound that's been sewn up. And

36:35 that's the potential for infection. If careful. And then of course various

36:40 of um of AIDS or mechanical devices are used right there breathing to a

36:49 , a cat, you know, types of Catholics, right. I

36:53 uh a you know, a we the external bladder for people that can't

37:03 , they have the bag. So that's your catheter. Um different

37:07 of devices put in the body, replacement, the replacement. These are

37:11 potential points of acquiring infections. And so then of course, chain

37:18 transmission. Right, so you have , okay, you have this and

37:28 have this compromised host microorganism, the environment then getting those together,

37:36 transmitting transmission of disease. Right causing . So um the the routes of

37:47 . So of course to go between patients that are ill and maybe patients

37:54 are not so ill like you or who's going in between healthcare people.

38:00 , nurses aides, doctors, what you write are going between you know

38:08 various sources and so um not to you know think of the the bedding

38:15 patients are on there has to be um the uh railing the surfaces they

38:22 and things like that and so these all potential points of transmission.

38:27 And so um types of infections you ? Okay Very often our staff.

38:37 . Staff number one I think currently this one See the fi style shows

38:49 tends to show up most often than right now there's been a it used

38:53 be staff okay what's called uh It's kind of the name methicillin resistant

39:02 aureus. I think that's been overtaken clostridium difficile but there's others intro intro

39:09 . Uh so um e coli urinary infection. So that's the most common

39:15 terms of U. T. So um certainly these are things to

39:22 with but can can be hospitals of have half, well if they're accredited

39:28 they'll have a a committee that committee a panel or a group whose job

39:36 to keep on track of this of rate of hospital acquired infections and and

39:44 and these kind of things to see they following everybody complying with what you're

39:49 to do here in terms of not disease and so I just kinda wanna

39:55 don't need to memorize this or I'm kind of show you an example of

40:00 . And H. Ai and this the most common one these days is

40:04 difficile. So it's a it's a positive. Um Remember those, this

40:09 one of the endospore former. Remember group? This group is one of

40:13 endospore forming types. This produces So again virulence factors, right?

40:19 it actually is in the guts of um healthy people, okay in the

40:29 intestine but it's held it's held at by your normal microbiota. Okay.

40:37 in some individuals um if you get um then you can you're gonna you're

40:43 affect your gut microbiome and so it change the balance of what's in

40:48 And that's when the clustering freestyle can hold, okay they can begin to

40:55 and that's when issues can occur. so what happens is they produce

41:01 Uh This can cause inflammation. So is healthy intestinal tissue. The cells

41:07 here's the track going through and then the cells begin to die. As

41:13 result you can certainly see the difference these these two panels here on the

41:18 B. And C. Compared to . Which is healthy. And so

41:22 this can of course kind of severe tract inflammation, diarrhea especially among the

41:30 this is really a is an issue uh can can can be fatal.

41:39 and so it's it's a kind of sequel all around transmission patients uh acquire

41:48 . Oftentimes the betting has not changed or it's not changed very frequently and

41:53 what leads to the plus they're on for something else. And so that

42:00 them in this state that this can can occur. And so uh and

42:06 that have it. So memory forms those boards, so it can be

42:11 from one healthcare worker can be the between between patients and transmit this to

42:17 . So um so it's it is issue. Um And so what you

42:24 is to stop antibiotics, whatever the is on, right, so that

42:30 system kind of microbiome recover and then what's called, which is specific gram

42:38 and probiotics. Right? So get microbiome back to normal as soon as

42:45 can because that's what's keeping this thing bay. Right. I forgot to

42:51 up uh back. So my sin the fecal transplants interesting. Okay,

42:57 what would a fecal transplant due for person? Yeah. Yeah, it's

43:04 like taking probiotics. It's just a a it's a natural way to take

43:10 I guess. Um But you would forget how to administer it. Uh

43:16 , so but that's what the that's source of kind of like the we

43:20 talk about that in here, The treatment plant. Um But if you

43:26 a wastewater treatment plant which treats your bacteria basically in the water that are

43:31 breaking down the bad stuff in the ? And if it weren't for treatment

43:36 goes down and not working properly you go to a nearby one and take

43:40 of their bacteria and put it in and they'll get it going again.

43:44 this is kind of what this If you can do a fecal

43:46 get your microbiome back much more Okay because that security mechanism that keeps

43:53 things at bay. Okay so um so in terms of different uh processes

44:02 , parts of the body. Okay these can all be traced to again

44:10 medical devices. So urinary tract mishandling of urinary catheters. Alright so

44:16 are all pre packaged sterile um implements you have to treat. Use open

44:24 and use them and put your hands it or whatnot. Then that introducing

44:29 . Okay surgical site infections and certainly the cleaning wounds properly. Uh can

44:35 to that lower respiratory tract infections. , reading tubes, devices like that

44:40 contaminated um G. I. Tract um often due to just see the

44:48 through immuno compromised patients. So um so again the different devices here here's

44:58 bag for a patient that would be generate tracked catheter assistant urination gloves etcetera

45:08 is uh some kind of I. . Device here. I think here's

45:13 breathing tube I think here. So it is. So any of these

45:17 get contaminated introduced these infectious agents. so what's done? Well what's done

45:24 course is we call universal precautions which of is a encompasses two areas Okay

45:30 is called basic minimal precautions. Okay I call trans transmission specific precautions.

45:37 so collectively this is meant to break chain of transmission. Okay and to

45:45 things in a way that minimize those of infection. Okay so the standard

45:52 that's where handwashing comes in right? techniques you know you have these that

45:58 devices that are used catheters et cetera know open them and use them

46:03 Aseptic lee right? Um having potentially . So betting betting from patients right

46:10 them in the proper receptacles, leave sitting around on the floor. Um

46:16 know dispose of them as you're supposed wash them frequently. These kind of

46:20 . Right? Um Use of isolation and wards um if you have a

46:28 victim right you know it's going to very susceptible to infection then isolate

46:33 put them in a specific area. may need to have areas that are

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

46:50 very important also is education right to monthly if not uh biweekly or monthly

47:01 to go over this and um beyond about maintaining these procedures. Okay the

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

47:24 come in con direct contact with and transmission. Right? So whether it's

47:30 waste, whether urine or feces or patients with skin infections or maybe the

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

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

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

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

48:36 to really break that chain of transmission um do things too, so that

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

48:54 top of what they already have. . So you certainly want to do

48:57 . And also of course not anywhere here though but implied I guess is

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

49:16 this in um First day or at in Chapter one. So um again

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

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

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

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

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

53:34 eat them, the animals get into if you track wastewater, there's a

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

59:45 see you all on thursday and look for the exam will be up

59:48 So take a look at

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