| 00:06 | I know. Yeah. Yeah. . Mm. Ok. Now, |
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| 00:35 | it. Hm. Testing. Hello. Hello. Hello. |
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| 00:48 | folks, welcome to last week of semester. Um, the, |
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| 00:59 | so what we got, we got , unit quiz starting Friday. So |
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| 01:06 | that's gonna be comprehensive, um, chapter 23 24 25 and 26. |
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| 01:16 | , one more smart work to do then the exam four. So if |
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| 01:20 | didn't get the email yesterday, I've, so we're not doing it |
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| 01:28 | CASA because, um, there was kind of weird scheduling thing and, |
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| 01:37 | , it's like they overbooked or something that. So it gets very crowded |
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| 01:41 | Casa during, uh, during finals because of course many of the courses |
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| 01:46 | this one uses CASA. So they really inundated and they said, |
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| 01:51 | well, we can't do it on dates that you wanted, which were |
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| 01:56 | 7th and 8th. I think. said, well, well, you |
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| 02:00 | do it on a Sunday and I that would, that would go over |
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| 02:03 | a lead balloon. So, so I said, ok, that's |
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| 02:08 | gonna work. So, um, they said, ok, we'll just |
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| 02:13 | it remotely. Ok. So all gotta do very easy. I |
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| 02:18 | you should be doing cartwheels, You're gonna have to, you don't |
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| 02:20 | to drive the CAA, you have sign up for a time slot. |
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| 02:23 | can be in on Mars taking the . All you gotta do is have |
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| 02:28 | things. Anybody know what those three are, a computer, a internet |
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| 02:39 | and a webcam. That's it. can be on Fiji Islands for all |
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| 02:45 | care. Taking the exam. Because all you're gonna do is you're |
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| 02:49 | go, it's just like taking a like taking a unit quiz or taking |
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| 02:54 | quiz. You're going in the Super simple. OK. So, |
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| 02:59 | , but um tomorrow uh I'll have it's, it's just an ungraded practice |
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| 03:06 | . We'll say the sky is true or false, something dumb. |
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| 03:10 | ? The only purpose of it is make sure your system is functional, |
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| 03:13 | ? Your webcam thing is working. can get into the respond this |
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| 03:17 | you've done all that properly and that will be up for a week. |
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| 03:21 | can do 100 times if you want just to make sure that, you |
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| 03:25 | , your stuff is working, So when the time comes to start |
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| 03:28 | exam, you won't have any right? So that's, that's the |
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| 03:33 | thing is to, to give yourself of mind, right? That's so |
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| 03:39 | know that, hey, this is , I've done it 100 times between |
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| 03:42 | and the exam. I'm good. you won't have any technical issues. |
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| 03:46 | . So that will be up Uh, again, you can |
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| 03:49 | you know, do it as many as you want to convince yourself your |
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| 03:53 | is fine. So, um, do, you will, if you |
|
| 03:58 | , this was like, uh during times, right? You had a |
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| 04:02 | of, it was all remote. , um and I actually didn't |
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| 04:06 | respond to use something else. But , so you probably got the |
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| 04:09 | If you haven't downloaded it to your already, you need to do |
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| 04:12 | The response was thingy. Ok. it's, it's, it's the browser |
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| 04:17 | the monitor, they kind of Ok. Um So again, uh |
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| 04:24 | that quiz is up, um uh the, the test my system |
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| 04:30 | , if you will, um you , just start doing it, just |
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| 04:34 | trying it out, making sure it . Everything's fine. Ok? If |
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| 04:38 | not, um that's the, that's one thing I'm doing today is to |
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| 04:43 | out. Ok, because it doesn't you anywhere if somebody is having |
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| 04:46 | What do you, who do you ? Ok. So I'll find that |
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| 04:50 | because you don't contact me. I know how to fix response. |
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| 04:53 | I'm not an it person. So but uh when I uh I'm gonna |
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| 04:57 | and then when I get the information , I'll email you. So if |
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| 04:59 | have issues, you know, who contact? Ok. Um, |
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| 05:05 | uh, so this is gonna be the, I decided on the |
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| 05:09 | Um, I figured most people when sign up for these past exams, |
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| 05:13 | always, there's always a second day gets loaded. Right? Procrastination. |
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| 05:17 | . So I said, ok, was the 7th and 8th. So |
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| 05:20 | just do it on the eighth, ? Um, I think that's |
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| 05:25 | They, is everybody sad that we're it this way. Ok. |
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| 05:29 | I didn't think so. I know it's not, not really because I |
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| 05:33 | a bunch of emails. So I zero emails about this. So I |
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| 05:37 | , ok, I'm, I'm, good to go. Ok. |
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| 05:40 | you know, those I'm sure at time or another you've taken exams |
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| 05:45 | If you were here during the you certainly did. Um, |
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| 05:50 | and I'll, I'll be reiterating this the next week and a half. |
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| 05:54 | , um, you know, the , right? So obviously you're not |
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| 05:59 | a Proctor walking around looking at what doing. So just don't do anything |
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| 06:03 | . Ok. Look at the answer the questions, you know, |
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| 06:06 | have a, the book taped up front of you on the ceiling or |
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| 06:09 | like that. Ok. So you possibly even look through the book |
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| 06:13 | and, and it won't work So they even try it. |
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| 06:16 | just on the way, if you , uh, should I try |
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| 06:20 | Probably not. Ok. So because the videos are reviewable at, after |
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| 06:25 | exam and, uh, so just do it. If you think it's |
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| 06:28 | suspicious, then probably don't try Ok. Um, anyway, upset |
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| 06:34 | that. So I'll be emailing So there's still people that I still |
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| 06:41 | , um, emails bouncing back from handful of people. I wanna, |
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| 06:46 | wanna say maybe there's like six or , I still get emails bounced not |
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| 06:50 | my emails basically. So spread the . Ok. If um um because |
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| 06:57 | sure there's gonna be somebody goes We're having the exam on remotely on |
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| 07:00 | eighth, we're not going to I'm sure I'll get at least a |
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| 07:02 | , a couple of those so spread word. Ok? Um All |
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| 07:08 | Any questions for me? I hope has a semi relaxing uh holiday. |
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| 07:16 | , so today, so what we've to do is finish up diseases. |
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| 07:21 | , so it's like a little bit much left to squeeze it into one |
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| 07:28 | if I, if I talk like , you know, um, so |
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| 07:36 | go for like 45 minutes and then it a day. Ok, I |
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| 07:40 | a little bit left for Thursday. . So where 45 minutes is |
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| 07:46 | I'm not sure. Let's see. 1139. So let's say 1230 somewhere |
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| 07:56 | 1230. Ok. I think everybody cool with that or do you want |
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| 08:00 | to talk a mile a minute and finish all in Monday. I can't |
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| 08:05 | that anyway. So. All So we'll, um, do about |
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| 08:09 | minutes worth and then leave the rest , um, Thursday. Ok. |
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| 08:16 | let's, which is roughly gonna be , I think. Hm, somewhere |
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| 08:24 | either Tetanus botulism, somewhere in that would be kind of the end |
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| 08:30 | Ok. Um, then what we'll left is rabies listeriosis and maybe |
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| 08:40 | I don't know, maybe we'll just . Yeah, we'll see how I |
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| 08:43 | . OK. Maybe we'll stop in minutes and just go. No. |
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| 08:47 | right. Won't do that. All . Let's move on. Let's go |
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| 08:50 | . Let's start with a question. not? OK. Um All |
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| 08:56 | So this kind of goes to, know what to know for this part |
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| 09:02 | the material, right? What's the ? What's the disease it causes? |
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| 09:07 | are some of the interesting features? is an example of that. All |
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| 09:12 | . The pseudo membrane. If you that you should go, it's this |
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| 09:17 | . It can only be this OK. Um I remember that |
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| 09:24 | I I'll show you a slider in second. So let's get through this |
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| 09:35 | . Mm So anybody in her had ? No. OK. Just |
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| 09:43 | Yeah. If you know the answer , now you do. That's out |
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| 09:47 | the bay. Um Yeah. All . 210. Yeah, it is |
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| 10:03 | . So pseudo membrane is diphtheria, ? So um infects the back of |
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| 10:10 | throat begins to get an inflam inflammatory . Then you get, you |
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| 10:16 | uh, uh a scar a lesion and then that's where the kind of |
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| 10:21 | pseudo membrane builds up in the back the throat there. Ok. Characteristic |
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| 10:25 | diphtheria. No, that's the whooping is over. That's different. So |
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| 10:31 | what we're gonna actually start with in of diseases today is whooping cough. |
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| 10:36 | . So, uh so again, is the theory. So remember one |
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| 10:42 | to do this again, I'm not you how to study for this particular |
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| 10:46 | , there's a table and again, would, I don't have, I |
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| 10:50 | add a couple of columns there. But these are the main things, |
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| 10:54 | ? These are things to know uh , gram state morphology or applicable. |
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| 11:02 | Obviously, the disease it caused cau by it v factors, you |
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| 11:08 | um don't need to list every single but kind of the more prominent ones |
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| 11:13 | those um features like I said, most of the diseases we we go |
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| 11:20 | have a kind of unique things to . Most of them uh motor transmission |
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| 11:26 | be good to know maybe reservoir reservoir disease where you find it at. |
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| 11:32 | . So, um anyway, the so we went through skin and soft |
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| 11:39 | . So basically, staph and strep through those diseases and ended with upper |
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| 11:46 | tract infections. So, uh strep falls under a scarlet fever, not |
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| 11:52 | a serious disease in terms of causing , but more like more alarming when |
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| 11:56 | see somebody with this bright red rash them. Um, the body, |
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| 12:02 | immune system person gets over it within few days. But uh diphtheria was |
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| 12:07 | we ended with last time. So is uh uh a um toxin |
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| 12:13 | uh that pseudo membrane formation. Um it was the cause of death among |
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| 12:20 | back in the thirties. But vaccination it out uh for the most |
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| 12:24 | But still you'll see cases of diphtheria up uh here and there um where |
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| 12:30 | isn't where it should be. So anyway, let's uh move |
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| 12:38 | So we've got um uh lower lower respiratory tract infections, G I |
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| 12:46 | infections and this is an STD. . That's uh syphilis and then we'll |
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| 12:57 | meningitis, OK. This guy and probably leave that, that and that |
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| 13:06 | Thursday. OK. So, um covering these guys today. OK. |
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| 13:19 | All right, let's look at the way. Here we go. |
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| 13:24 | whooping calls. OK. So um to tell her and so the, |
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| 13:31 | D tap uh vaccine, uh the is diphtheria T tetanus uh P is |
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| 13:38 | , right? For the, against pertussis toxin. And so the this |
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| 13:44 | negative. So the coxal bacillus, kind of a, it's a |
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| 13:48 | but it's a short rod. That's they call this Toxo bacillus. E |
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| 13:51 | is a kind of a similar Um So this is a multiple multi |
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| 13:57 | producer, um like, you respiratory illness, this we tra travel |
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| 14:03 | the droplet transmission, airborne. And this one in particular has a toxin |
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| 14:10 | affects that mucociliary escalator. It's a important defense. You've got innate immune |
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| 14:17 | defense. Um The cop plastic mucus traps organisms, microbes, articulates and |
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| 14:25 | them out of your system. Uh they don't enter your lungs. |
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| 14:28 | but this one has a toxin that affects those ciliated cells. Ok. |
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| 14:36 | if you're killing those, which is that toxin does, it will obviously |
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| 14:41 | that mechanism. Ok. And uh they damage those cells, then that's |
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| 14:48 | of a point of entry in a for the pertussis toxin to kind of |
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| 14:53 | in there. So the pertussis toxin different. It's a, it's a |
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| 14:57 | , protein synthesis. Um, inhibitor affects, it kills cells. |
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| 15:03 | when that begins to travel through the , that's when you're gonna get the |
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| 15:08 | effects of this disease. Ok. kind of a couple of stages. |
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| 15:13 | , it's really just kind of flu like cold, like uh stuffy nose |
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| 15:19 | a little bit, uh, maybe little bit of a fever but you |
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| 15:23 | or less kind of, you don't feel worse beyond that. |
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| 15:28 | But that's where those toxins now are to accumulate and then take their effect |
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| 15:35 | you get to the paroxysmal stage. . So in that stage, now |
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| 15:39 | sedated cells have been damaged, And so you don't have that mechanism |
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| 15:44 | for you. And so what happens you have this accumulation of fluid mucus |
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| 15:49 | up that can't get out. So defense, the mechanism is to cough |
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| 15:56 | . Ok? And um almost like choking on this material and this violent |
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| 16:02 | . And so think of, think an infant that has this, |
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| 16:05 | And they're doing this violent coughing fits their head. So the head is |
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| 16:10 | biggest part of the baby's body, or less, right? So that |
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| 16:13 | is shaken. So that can, can cause those coughing fits, can |
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| 16:16 | neurological damage as a result. So, um but the uh and |
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| 16:24 | where this whooping cough name comes from that stage, you, you like |
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| 16:30 | for air and it creates this characteristic sound. Ok? And um very |
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| 16:37 | of that disease. But uh so can imagine after weeks of this kind |
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| 16:42 | violent coughing and fits and stuff, you finally overcome the disease either |
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| 16:49 | you know, antibiotics, cetera. You, you, you, you |
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| 16:54 | have, your body is taking a . So it's gonna take a while |
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| 16:57 | recover from that from that. And can be uh weeks if not months |
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| 17:02 | you're feeling back to normal. Uh Again, vaccination can prevent |
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| 17:08 | Ok. Vaccines effective. Um uh there's still parts of the world people |
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| 17:15 | get vaccinated for this and you you see cases in other parts of |
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| 17:19 | world in the States. Not so except pockets here and there where vaccination |
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| 17:26 | being kept up and you do see little spikes here and there. |
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| 17:31 | both in whooping cough, um, , et cetera. Ok. |
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| 17:40 | the, this, here, this , so the change in vaccination, |
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| 17:46 | . Or the vaccine type was due , uh, there was maybe like |
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| 17:51 | years ago they saw a, a in diphtheria. I'm sorry, the |
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| 17:59 | cough cases among uh adolescents like 1012 old. Ok. And they attributed |
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| 18:07 | to kind of a weaker form of vaccine vaccine kind of waned. Um |
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| 18:13 | those kids had gotten their booster shot then around turned 12, they didn't |
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| 18:17 | very good immunity toward it. And when they kind of went back and |
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| 18:20 | the vaccine, they then that worked better. And so those kids got |
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| 18:25 | vaccinated. Um and now the standard this newer vaccine form. And so |
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| 18:31 | is more immunogenic? Ok. Um that's the whole reason. So we |
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| 18:36 | talk about it here, but there what we call and you don't need |
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| 18:41 | write this down but nationally notifiable Ok. And so there is like |
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| 18:53 | number of these which if, if a physician clinic diagnoses a person with |
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| 19:00 | specific disease, infectious disease and confirms then that automatically by law has to |
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| 19:05 | reported. Ok. So that's how handle this whole database of the infectious |
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| 19:13 | . Uh on a weekly basis, a, there's, it's tabulated in |
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| 19:16 | report called um more uh MWMR. Morbidity and Mortality report is basically, |
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| 19:27 | what it's called, put out by CDC. So each week it comes |
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| 19:31 | and it tells you, ok, the new, the, the, |
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| 19:34 | , here, here are the new that have come up with diseases, |
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| 19:37 | infectious diseases. So it's how we keep track of all these things. |
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| 19:42 | if we do see a surge, know, and it's all we |
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| 19:46 | we can track it through geography. part of the country are we seeing |
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| 19:50 | cases, uh who's being affected? it mostly Children? Is it mostly |
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| 19:54 | ? Is it mostly this demographic, demographic? So, you know, |
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| 19:58 | having this data continually being poured in a weekly basis, we can keep |
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| 20:03 | of these things and know what's going . Is there an outbreak this and |
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| 20:08 | uh or things like this? You , you know, these kids are |
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| 20:13 | , you know, is, is now not able to fight off disease |
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| 20:17 | well. So you can tell you of information, right? And |
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| 20:19 | and it occurs because you have to these things by law. Ok. |
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| 20:24 | And certainly all the, all the we're talking about are fit in that |
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| 20:29 | or, or you have to um these. Um. Ok. The |
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| 20:39 | . So pneumonia has a number of causes. Ok. Uh fungus |
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| 20:48 | uh bacterial viral. Ok. And , so it's by far the more |
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| 20:56 | versions of this are bacterial, specifically pneumonia. I think it may be |
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| 21:02 | quarter uh of cases due to this organism. Um, it has a |
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| 21:09 | thick capsule. Ok. Um Most scenario is most, most respiratory illnesses |
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| 21:19 | viral in nature. Ok. And viral versions where there's the flu cold |
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| 21:27 | the, by comparison to bacterial respiratory , the viral viral ones are less |
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| 21:37 | . Um, you get over Um, yes, you'll have symptoms |
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| 21:43 | fever, uh, cough congestion, kind of thing, but it |
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| 21:47 | it doesn't progress worse than that. typically don't have to get hot |
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| 21:51 | But, and I'm talking about somebody has a healthy immune system. |
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| 21:57 | It's when the bacterial one comes in gives you the worst effects. And |
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| 22:02 | a common scenario is, um, have a, you have a cold |
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| 22:07 | flu. Ok. And uh what's one thing because you can't take antibiotics |
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| 22:14 | actively to treat the flu? So kinda have to ride it out. |
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| 22:18 | so what, what are you Right, when you have a have |
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| 22:23 | flu is to do what? Get and yeah, hydrate, drink, |
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| 22:29 | lots of fluids, right? And I doubt that most of us do |
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| 22:33 | part, drinking lots of fluids. ? And So that actually changes the |
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| 22:38 | of the mucus, right? Remember mucociliary escalator, right? So the |
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| 22:43 | part gets a little bit too, , thick because it's not, you're |
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| 22:47 | drinking enough fluids. And so that kind of impair that mechanism. |
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| 22:51 | So you make it over the, , you get over the flu or |
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| 22:54 | . Ok. But you're kind you know, your immune system is |
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| 22:58 | , you know, you, you that right? Your immune system is |
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| 23:00 | a little bit compromised. And then couple that with dehydrated, right? |
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| 23:05 | that's where a, a secondary bacterial can occur. And that's where this |
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| 23:11 | streptococcus pneumonia can cause even worse effects that flu or cold. Ok. |
|
| 23:18 | so it, it, it gets your lungs. Ok? And so |
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| 23:26 | , um, so remember the um, little balls, right? |
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| 23:33 | your, where your arteries uh in lungs and gas exchange occurs, |
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| 23:37 | The alveoli, right? And so those alveolar cells, the streptococcus |
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| 23:43 | I can't get in there, cause inflammation, ok. And that's |
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| 23:48 | causes a lot of fluid build up your lungs is that inflammatory response |
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| 23:53 | And so of course, you have of blood vessels there, right? |
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| 23:55 | your lungs, uh, that's where gas exchange occurs. And so those |
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| 24:00 | kind of begin to leak fluid. so you get a lot of congestion |
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| 24:03 | your lungs and that's where typically you to, you have to be hos |
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| 24:07 | , maybe have in the worst assistance breathing because you're having, if |
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| 24:12 | have fluid in your lungs, it it very difficult to try to |
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| 24:15 | Ok. And so you've kind of to uh be on antibiotics, obviously |
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| 24:21 | uh clear the lungs of, of infectious agent and then eventually recover. |
|
| 24:26 | so antibiotics are effective. Um but really that fluid build up. And |
|
| 24:32 | you can see here in this diagram is the PM NS. Those are |
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| 24:36 | neutrophils. OK. And you see , and so what's happening is remember |
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| 24:42 | the neutrophils come out of the right? It's part of inflammatory |
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| 24:45 | And so that's why they're filling up in the lungs and then fluid as |
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| 24:49 | comes with it. And then of , they're fighting the bacteria and even |
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| 24:53 | um even though they're, they're fois the, the, the streptococcus, |
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| 25:00 | the streptococcus pneumonia has this, has material in their, in their um |
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| 25:05 | walls called um Pneumo Lyin don't even it, but it, it, |
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| 25:10 | further creates an inflammatory response, makes even worse. So it, |
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| 25:15 | it's quite an ordeal to go through . And so you have to |
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| 25:17 | which is why people get hospitalized in cases. And so monitoring patient uh |
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| 25:23 | antibiotics um uh there is a vaccine the vaccine is more for people my |
|
| 25:30 | . So they recommend it when you're your fifties typically. Um because certainly |
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| 25:35 | you get older, where you can underlying conditions, heart disease, whatever |
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| 25:41 | can make it worse. If you have pneumonia, that you, you |
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| 25:46 | , it becomes a worse ordeal for with these underlying conditions. So they |
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| 25:50 | for, you know, people that more advanced years get, get the |
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| 25:54 | to kind of hopefully prevent that. Now the other thing is this is |
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| 26:01 | the number two cause of meningitis. the first one is the one you |
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| 26:06 | vaccinated for, which was nice That's number one. This is number |
|
| 26:12 | . And so this, you can that, um, you know, |
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| 26:16 | have pneumonia that, that the bacterium get into your blood and then get |
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| 26:20 | the, get into your uh brain that's where meningitis is caused. |
|
| 26:24 | um, so it's not uncommon that pneumonia progresses into potentially meningitis. |
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| 26:33 | very important to get that under Um, while it's in that pneumonia |
|
| 26:39 | . Um, and so the X here shows, well, it's blocked |
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| 26:44 | that. Uh, you can kind see a cloudy area here in the |
|
| 26:48 | that represents that fluid build up. , it's what you call a low |
|
| 26:54 | pneumonia. And so typically it's I know how rare, but I'm |
|
| 27:00 | it's very unusual to have both lobes at once. It's usually one or |
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| 27:04 | other, right. So they call low bar pneumonia, one lobe is |
|
| 27:10 | . Um, all right, let's reading that question. Any questions about |
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| 27:21 | whooping from? Ok. So, , so this is one of the |
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| 27:25 | I think about that's why it's probably to have a column for reservoir. |
|
| 27:30 | . And if you're making the um, so everything we talked about |
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| 27:34 | far, which have been, staff strip, uh, diphtheria |
|
| 27:44 | Uh, I think that's everything, a list. Yeah. There we |
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| 27:57 | in 50. That's what we've gone so far. Ok. So stab |
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| 28:04 | uh Corin bacterium mor to tell. , yeah. Ok. It's coming |
|
| 28:17 | from 10, six. Mhm. . Of course. Humans. |
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| 28:33 | So other humans. So if you whooping cough or you get pneumonia, |
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| 28:37 | get diphtheria or any of these, blame other humans for that. I |
|
| 28:42 | or maybe yourself. Ok. uh legionella. So again, this |
|
| 28:50 | the, I think the last respiratory pathogen will talk about. So |
|
| 28:57 | um, let me just show you side real quick. I'll come |
|
| 29:02 | So you, there's about each about 6000 cases in the States of |
|
| 29:08 | . Ok. And if you look and here is, this is actually |
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| 29:12 | 2019. I have an updated Uh, the point here though is |
|
| 29:16 | I've underlined. All right, they have something to do outbreak at the |
|
| 29:21 | State Fair. Led to a hot display. Ok. Um, |
|
| 29:27 | retirement community, blah, blah, , uh, water system. |
|
| 29:33 | Uh, communications in London. A tower, right? Hotel in |
|
| 29:39 | blah, blah, blah pool, tub. Ok. You look |
|
| 29:42 | um, I pulled this up Um This is 2023. So most |
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| 29:49 | in Seattle, uh they don't get specifics, but you look at legionella |
|
| 29:54 | a spa right here with Richmond Uh right here spa apartment complex. |
|
| 30:05 | , let's see down here. swimming pool facilities, uh sinks, |
|
| 30:13 | , hotel room, uh a Um most recently this big outbreak here |
|
| 30:18 | Poland, 166 people, 23 Um That's why it took a |
|
| 30:25 | a water line uh break. And uh 00 I didn't know that it |
|
| 30:30 | fuller. Mm OK. Each other clubhouse soon. Yeah. Wow. |
|
| 30:37 | . Uh One death. So um this guy legionella is a uh found |
|
| 30:45 | the environment many places uh but mostly aquatic environments associated with amoeba. It |
|
| 30:52 | inside of an amoeba. OK. um so very lots of freshwater |
|
| 30:59 | OK. And it is as a . It's one of those invasive |
|
| 31:05 | OK. So it's a facultative uh pathogen, right? So it goes |
|
| 31:12 | a cell when it infects you, goes inside your cells to kind of |
|
| 31:16 | out from the immune system. So it has those invasions, |
|
| 31:20 | Uh that enable it to be OK. And so uh so as |
|
| 31:26 | mentioned, you know, uh spa hot tubs, uh swimming pools. |
|
| 31:32 | you know water sources, right? so very common is ventilation systems. |
|
| 31:37 | so I'm not gonna go into the workings of how an H VAC system |
|
| 31:41 | . Ok. But it relies on uh water evaporating or evaporate, evaporative |
|
| 31:48 | and heat exchange right to provide cool . Ok? And so in that |
|
| 31:54 | coming to the ventilation system will be you know, tiny, tiny water |
|
| 32:00 | , ok. So you have a tower source for those water that you |
|
| 32:06 | , to bring mechanics creates cool ok? But it depends on this |
|
| 32:12 | source. And so if that cooling , right, or other water source |
|
| 32:18 | , hot tub, et cetera, a water. So if the container |
|
| 32:22 | not clean, disinfected, rarely, when this legionella organism can appear and |
|
| 32:30 | potentially as a respiratory patent, you , you're in a hotel room in |
|
| 32:36 | coming, you can inhale that, ? Because aerosolized in the air, |
|
| 32:41 | ? And so, um you don't massive outbreaks, although, you |
|
| 32:46 | 166 is pretty high, but commonly is in a kind of like the |
|
| 32:51 | 5 to 10 or 12, But regardless, you know, it's |
|
| 32:55 | even one, it it it's this is all 2023 and only half |
|
| 33:00 | 2023. So, um it's, accounts for a number of cases every |
|
| 33:06 | in, in these kinds of ok? Um Probably more commonly in |
|
| 33:11 | and things where especially if the H system isn't maintained very well or cleaned |
|
| 33:15 | lot, you can get cases Um And so this came about really |
|
| 33:23 | to the forefront uh 1976 and um since 1976 very famous year. |
|
| 33:34 | Then you were born, of I was OK. I remember 1976 |
|
| 33:39 | the why is 1976 such a big bicentennial? OK. 2/100 anniversary of |
|
| 33:48 | a declaration of independence, right? that summer was all kinds of stuff |
|
| 33:50 | on. New York City had, going all out, uh, |
|
| 33:54 | of course, write Liberty Bell, ? So, um, lots of |
|
| 33:58 | going on, especially that summer around 4th. Also very, one of |
|
| 34:04 | favorite movies of all time came out 76. Anybody know that one? |
|
| 34:10 | you remember Apollo Creed, Rocky, first Rocky came out in 1976 Sylvester |
|
| 34:17 | . Um, if you haven't seen , that's the best one. Rocky |
|
| 34:21 | . Ok. Have you seen You liked it? Da da |
|
| 34:26 | da, da, da, da da, right. Anyway, |
|
| 34:30 | , um, so he was kind a perfect storm. Ok. You |
|
| 34:36 | a bunch of old people in a , um, where the HMX system |
|
| 34:43 | not maintained. Ok. And this a lot of fatalities occurred as a |
|
| 34:50 | of this, right? So the Legion. So if you know American |
|
| 34:55 | , those are war veterans, So they're gonna be old Right. |
|
| 34:58 | many of them with underlying conditions of sort. Ok. And so, |
|
| 35:03 | , 800 182 and they were all of that one hotel, right? |
|
| 35:08 | Belford Bellevue Stratford Hotel. Ok. so, um, uh, 100 |
|
| 35:14 | 82 cases occurred, right. All that one hotel, almost 30 |
|
| 35:19 | And so even made the cover of magazine that year back when they used |
|
| 35:24 | have paper magazines, right? It's digital now, right? So, |
|
| 35:29 | , and so it, uh, turned out, you know, |
|
| 35:33 | that it was in the ventilation system the cooling time. And so you |
|
| 35:36 | imagine, you know, that being right throughout the hotel's ventilation system, |
|
| 35:42 | ? Um No wonder you had so people uh infected because again, it's |
|
| 35:47 | , you know, these are older and underlying conditions of compromised immune systems |
|
| 35:51 | many of them. So, like I said, like a perfect |
|
| 35:55 | almost. And so, uh this thing I needed to mention here, |
|
| 36:00 | back up for a second. Is atypical pneumonia? Ok. So, |
|
| 36:07 | , typical pneumonia is what you see streptococcus pneumonia. Ok. Uh, |
|
| 36:12 | be a very, uh serious infection be hospitalized, very debilitating while you're |
|
| 36:19 | . Uh, but atypical, you have heard of uh, walking pneumonia |
|
| 36:24 | kind of the atypical fits in that . So for most that, that |
|
| 36:30 | legionella, you know, if you're , healthy immune system, you, |
|
| 36:36 | kind of don't get the worst Ok. And so you can, |
|
| 36:39 | can still be viable, you can be kind of go to work or |
|
| 36:42 | . Right. Even though you have symptoms and that's why they call it |
|
| 36:47 | pneumonia. Ok. But again, on the host, the host is |
|
| 36:52 | , you're gonna get the worst effects those, in those individuals. And |
|
| 36:56 | , um, so there's other types pneumonia that they call atypical or walking |
|
| 37:01 | gene is one of them. other kind of non streptococcus pneumonia. |
|
| 37:08 | is kind of fit in that Ok. Um, so anyway, |
|
| 37:13 | it does account for, it's, think it's uh number four in terms |
|
| 37:18 | pneumonia, I believe in terms of . Um, again, the, |
|
| 37:24 | , those that get the worst effects typically elderly or can be very |
|
| 37:27 | right? Those, those two right are generally the most susceptible. |
|
| 37:33 | , and, uh, but you , it's very treatable with antibiotics. |
|
| 37:37 | , but certainly the way to prevent is through regular maintenance, right? |
|
| 37:41 | , clean, the hot tub, the cooling tower, et cetera, |
|
| 37:46 | receptacles that are holding the water, sure they're clean. Ok. |
|
| 37:52 | ok, the G I tract So like respiratory tract infections, viruses |
|
| 38:01 | the cause of most G I if all heard of stomach flu, |
|
| 38:05 | And so, um, the, of us, I'm sure at one |
|
| 38:11 | or another have experienced G I tract , whether through food or what have |
|
| 38:16 | . Right. And drinking, drinking water, um, main symptoms, |
|
| 38:23 | of water, diarrhea, right. so of course, they can get |
|
| 38:29 | from that. Um, it's Coronavirus very common uh cause you often see |
|
| 38:36 | in uh daycare settings, kind of impetigo, you know, little kids |
|
| 38:42 | , get tigo. Um roto virus also are, are cause of G |
|
| 38:48 | tract upsets in this, in this setting. The norovirus is very |
|
| 38:54 | Uh You've all heard of the uh ships when people come down and get |
|
| 38:58 | , you know, from G I infections is norovirus is often the one |
|
| 39:02 | the involved in there. Um in terms of bacterial types, so |
|
| 39:08 | , the viral versions of these diseases , don't, don't generally give you |
|
| 39:13 | worst effects. It's again, the types that do OK. And so |
|
| 39:18 | can kind of group them into two uh categories. Uh So think of |
|
| 39:24 | that um interest sailor. So your to inter sailor types, they get |
|
| 39:30 | sales to hide out or to penetrate in the body. OK. That's |
|
| 39:36 | group here. OK. So Shigella E Coli and E Coli has there's |
|
| 39:41 | varieties. Some pipes are like some pipes are completely extra cellular |
|
| 39:46 | So you have a lot of different of E Coli. And so, |
|
| 39:50 | in fact, I think your book um so they all end in ec |
|
| 39:56 | E coli but you have like this is EIEC, you can have, |
|
| 40:03 | , eh, uh ec uh you have U pe C for urinary tract |
|
| 40:12 | uh infection. So there's like several coli that can affect your gut or |
|
| 40:18 | tract. Um, in different some have toxins. Some don't, |
|
| 40:22 | all of them can cause disease. . Um, so the eiec uh |
|
| 40:30 | know, invasive, right? It's be a type that will get into |
|
| 40:33 | intestinal cells, hide out, um use it as a springboard to get |
|
| 40:39 | other tissues. And so some are producers, some aren't. Ok. |
|
| 40:45 | when you typically do involve uh a , that's what can give you the |
|
| 40:49 | effects of the disease. So you , you can have your dehydration and |
|
| 40:55 | . But then you know, cells typically many of these stick to your |
|
| 41:00 | wall, right? Adhesions that can inflammation, then they can produce toxins |
|
| 41:06 | that will kill cells, kill your . It can uh in fact, |
|
| 41:10 | your intestines are highly vascularized, Lots of capillaries, right? And |
|
| 41:15 | toxins can damage those capillaries. So where you get blood to be a |
|
| 41:19 | of the issue. Uh cramping, abdominal spasms and things can result from |
|
| 41:24 | inflammation as well. Those those are worst effects, especially if you see |
|
| 41:28 | dy dysentery, right? Um That's pains and and blood and so it's |
|
| 41:36 | really, really bad. Um now noninvasive type. So this, we've |
|
| 41:42 | this uh here, this diagram here the, on the right before |
|
| 41:47 | it's, it's how these invasive pipes of do their thing, right? |
|
| 41:51 | can infect your cells uh as shown and then they travel through, it |
|
| 41:58 | go into lymph, lymphatic vessels, vessels and spread. Ok. That's |
|
| 42:03 | invasive types. And so remember though these are all gram negatives, |
|
| 42:09 | So you also have that double potentially of the endotoxin effect, |
|
| 42:15 | Um especially, you know, if think it's, if it gets septic |
|
| 42:19 | your blood, right, potentially that happen. So, um but those |
|
| 42:24 | , are the worst effects, For most of us, right? |
|
| 42:27 | immune system, whether we, whether ingest it through bad food, contaminated |
|
| 42:34 | , we'll get the usual symptoms, ? Going to the bathroom a |
|
| 42:38 | right? But then after a few you kind of two or three |
|
| 42:42 | you kind of settles out and you what goes in, what comes |
|
| 42:45 | right? So, um then you of, you're over it, |
|
| 42:50 | Um So, but for others, , it has to do with, |
|
| 42:54 | know how compromised immune system are you as, not as healthy, then |
|
| 42:59 | can get more of the worst Ok. Now, with the, |
|
| 43:03 | noninvasive type, we're looking at the Coli 0157. All right. The |
|
| 43:08 | Chipotle E Coli. Ok. um the uh so the eh, |
|
| 43:15 | intro hemorrhagic? Ok. So it a toxin, the shiga toxin uh |
|
| 43:21 | one that kind of is, is of spread around between, you see |
|
| 43:25 | in shigella, you see e I think even salmonella sometimes they have |
|
| 43:29 | . So it's kind of passed it's through uh via a page. |
|
| 43:35 | we can uh and these are all . Shuga, they're all very closely |
|
| 43:40 | . Ok. And kind of coexist so they can kind of spread this |
|
| 43:45 | around. Um And so, you , 0157. So the the outbreaks |
|
| 43:51 | with Chipotle have been with contaminated right? Lettuce typically. Ok. |
|
| 43:58 | , I think maybe in one But um you go, ok. |
|
| 44:02 | , this 0157, its reservoir is cow. Ok. Cows don't get |
|
| 44:09 | from it. They're doesn't cause any of disease in the cow. That's |
|
| 44:13 | you find it. Ok. So can see how, you know it |
|
| 44:17 | in hamburger meat or there have been of that. So, you |
|
| 44:22 | the carcass is not the uh handle and you know, because 0157 will |
|
| 44:30 | found in contaminated meat. Ok. then, ok, well, |
|
| 44:33 | how does, how does it get produce? How does that, how |
|
| 44:36 | that happen? Well, cows live the land, we grow crops in |
|
| 44:39 | land, right? So they can in proximity to each other, |
|
| 44:42 | Because cows do that, right? on the ground, right? Uh |
|
| 44:48 | you may have nearby field growing um irrigation like run off. |
|
| 44:56 | And so uh if you don't, so you can imagine from the time |
|
| 44:59 | pulled out of the ground and it onto your hamburger or burrito bowl, |
|
| 45:04 | you're eating, right. How many it's passed through right through distributors and |
|
| 45:09 | picking out of the ground and distributors blah, blah, blah. Uh |
|
| 45:12 | know, if you're not using proper , right? Washing the uh the |
|
| 45:18 | uh material, washing the vegetables and . So I should always wash |
|
| 45:22 | you bring them into your house and you eat them, um even though |
|
| 45:26 | says in the bag has been washed times, you know, do a |
|
| 45:31 | more just to be safe. So, um but that's how this |
|
| 45:36 | things happen. OK. And um remember the oddball here, right? |
|
| 45:43 | all these, we talked about salmonella coli these guys are built to, |
|
| 45:50 | um withstand your intestinal system, So they you ingest it to a |
|
| 45:55 | or water, right? They gotta past your stomach into your gut, |
|
| 45:59 | ? So that's not the most hospitable , right? It can be very |
|
| 46:03 | in your gut, in your right? Um So, but they're |
|
| 46:07 | for that. They, they're very tolerant. OK. So the Staph |
|
| 46:13 | , which we mentioned briefly before uh this context, OK? Is a |
|
| 46:20 | is not built to be ingested and its thing. It's the toxin that |
|
| 46:26 | behind. Right. So, unprepared is where it grows and then the |
|
| 46:31 | is left behind and then you ingest . Right. So you don't, |
|
| 46:33 | don't get uh, food poisoning from aureus by ingesting the cells. |
|
| 46:40 | You get it from eating your food which they've dumped their toxin. |
|
| 46:45 | Um, now protozoans, uh, amoeba, amoebic dysentery. That's a |
|
| 46:54 | horrific version of G I tract severe abdominal cramping, uh blood the |
|
| 47:02 | . Ok. Cryptosporidium is also fairly . It's uh many of these protozoal |
|
| 47:07 | of these complex life cycles there in cell types. Uh you get these |
|
| 47:14 | through contaminated water resources. Ok. Both of these can have like what |
|
| 47:19 | called cyst forms, which are kind like a spore. And so |
|
| 47:23 | they, they're in an animal and , uh in the feces and they |
|
| 47:26 | some contaminated water and then you can of ingest it that way. Giardia |
|
| 47:32 | probably the most common of these protozoal . Uh, worldwide. There's hundreds |
|
| 47:38 | thousands of cases of Giardia worldwide every . Ok. And uh contaminated |
|
| 47:45 | Uh, also beware if um, have a dog and you go to |
|
| 47:48 | dog park. Ok. And everybody up after themselves and this is one |
|
| 47:54 | you can catch your dog. you can catch this. Ok. |
|
| 47:59 | , because they step in it, lick the paw then boom. |
|
| 48:03 | And they happened to me once with dog and who room is? |
|
| 48:09 | Ok. Uh That weekend was, gotta stay outside. Sorry. It |
|
| 48:14 | horrific. But I was amazed at fast the, um, the medication |
|
| 48:19 | . So they give you Metro I think it is. And it |
|
| 48:23 | like, bam, like a few was like, he was like, |
|
| 48:26 | cured. I go. Holy That's crazy. But, uh uh |
|
| 48:29 | , it, so they that Metrodin think it was they give for a |
|
| 48:33 | of these protozoal type uh infections. So the OK. Patri giat |
|
| 48:41 | So number one, you don't supply , right? Because it's gonna pass |
|
| 48:51 | ? And so what you gotta do of course, you're losing lots of |
|
| 48:54 | . So hydrate. So what they electro uh rehydration therapy, right? |
|
| 49:00 | and water, you obviously losing a of that, right? Because |
|
| 49:04 | these upset your, your the um it kind of reverses itself, |
|
| 49:10 | So your, your large intestine is about absorbing reabsorbing water, right? |
|
| 49:16 | so this infection kind of reverses So you'll lose water. OK. |
|
| 49:22 | , you know, salts are are , water comes out, right? |
|
| 49:27 | effect. So, um so you to restore that, right? |
|
| 49:30 | electrolytes and water is the way to that. Uh only in the worst |
|
| 49:36 | , right? Uh If you have and you've got severe abdominal cramp the |
|
| 49:41 | to a fever, then then, , you gotta, then you probably |
|
| 49:44 | to give antibiotics. Right. But only in those really worst case scenarios |
|
| 49:49 | most of us, you know, , we have some little bit of |
|
| 49:53 | but we get over it by just fluids and just letting it pass. |
|
| 49:58 | . Um, ok. Many questions far. Yeah. Oh, |
|
| 50:06 | Dumb. Yeah, Troy is, there's like three or four different stages |
|
| 50:11 | these life cycles and the Troy is the feeding stage, there's one stage |
|
| 50:15 | a feeding, they called Troy. is like a reproductive stage. So |
|
| 50:19 | worry so much about that, but , it's, this is these pro |
|
| 50:22 | have a lot of weird cycles they through. Um OK. So let's |
|
| 50:27 | at this question. Seven. I know if Hitler was a phi beta |
|
| 50:44 | or not. I don't think The city you mean by it? |
|
| 51:25 | . Counting down. Yes. Let's see what we got. |
|
| 51:36 | They all believe they've had syphilis. . Um In a super advanced stages |
|
| 51:45 | syphilis, I think you can um scarring in certain bones or something like |
|
| 51:51 | . And that's how they can, suggests this person may have died from |
|
| 51:55 | . Um advanced, super advanced affects your brain. So I can |
|
| 52:02 | Hitler. Yeah, I can see . Ok. Ok. But um |
|
| 52:07 | been a terrible, well, that makes sense if you probably was neurologically |
|
| 52:10 | at some point. Julius Caesar. . Uh the old Tolstoy was another |
|
| 52:16 | . War and peace. Yeah. Any who, so uh this is |
|
| 52:23 | only really STV we're mentioning. So with most, if not all STV |
|
| 52:31 | they are very susceptible to um desiccation out. OK. Um So um |
|
| 52:41 | is due to the spirochete. Um Chema Palat. OK. So |
|
| 52:47 | spirochete has that corpse screw shape. they have that flagellum just kind of |
|
| 52:53 | around their body and tied at both . And so it's, it's like |
|
| 52:58 | , it, it, it, , it functions the same way as |
|
| 53:02 | flagellum do, right? Most for bacteria, it's out here rotating right |
|
| 53:07 | this guy, it's attached at both , right? And wrapped around the |
|
| 53:11 | . So when it moves, it gives you that really characteristic corkscrew |
|
| 53:17 | . OK? And actually that corkscrew um is what enables it to really |
|
| 53:22 | tissues easier. OK. So as goes through cell layers, it's really |
|
| 53:27 | uses that motion to help facilitate OK. And that's what they |
|
| 53:31 | So once you contract syphilis, they begin to penetrate into your tissues. |
|
| 53:38 | ? They call this disease um the great imitator. OK. |
|
| 53:45 | because of what happens in secondary OK. Which we'll get into here |
|
| 53:49 | a second. So initially you have you contract it and sores appear, |
|
| 53:57 | ? So it's like in the first of months or so, um you |
|
| 54:01 | what's called primary syphilis and these sores shakers are visible um within that |
|
| 54:11 | OK? There are many infectious agents there. Uh The fire keys in |
|
| 54:17 | , OK? You can take a of that, put it on the |
|
| 54:21 | and put on the microscope and you see what you see up there in |
|
| 54:27 | upper right. Watch these spirals course shape moving around. OK? Diagnostic |
|
| 54:34 | disease. OK. So, um , and obviously completely treatable But um |
|
| 54:42 | you let it go and say, , I don't wanna go to the |
|
| 54:47 | . I'm embarrassed. Ok. I have these shanks and blah, |
|
| 54:51 | , blah. Uh it'll go away it does, it goes away after |
|
| 54:55 | six to a weeks time. Uh it kind of becomes what we call |
|
| 54:59 | primary late stage. So you don't anything happen, right? Maybe in |
|
| 55:06 | couple of years, it reappears like see on the right. OK. |
|
| 55:11 | you have a rash. And so the rash can appear in different ways |
|
| 55:16 | different have in different appearance. Um remember rashes are a product of lots |
|
| 55:22 | things, right? You might Oh, ok. It's just maybe |
|
| 55:26 | dermatitis or something or it's some kind allergy or it's, or some kind |
|
| 55:30 | , you know, something that's not , right? Because ra rashes come |
|
| 55:34 | various shapes and forms and caused by different things, right? So probably |
|
| 55:39 | that time you go, you've completely about this. Ok. And because |
|
| 55:45 | happens maybe a couple of years secondary. Ok. And so, |
|
| 55:51 | and still even the sores here. right, you see those are full |
|
| 55:57 | infectious Spiros. Ok. So you are infectious in primary secondary syphilis. |
|
| 56:05 | . Again, pretty treatable. But if you let it go, |
|
| 56:09 | rash does eventually go away. And then you may enter, |
|
| 56:15 | I think I read something, maybe of untreated cases enter into tertiary |
|
| 56:23 | And so by then the bacterium spikes penetrated way into your body. And |
|
| 56:29 | we're in your central nervous system. ? And that's where you can |
|
| 56:33 | you know, these effects of neurological . Uh heart can be affected. |
|
| 56:39 | . Um But uh but again, know, primary secondary syphilis, |
|
| 56:44 | it's treatable um with antibiotics. So, um there is congenital syphilis |
|
| 56:53 | a mother who's infected passes on the during childbirth. Um It can result |
|
| 56:59 | things like a cleft po I think I think its teeth and whatnot. |
|
| 57:06 | But uh and so yeah, the appearance of the rash and secondary |
|
| 57:11 | is why they call it the great because of this, it can mimic |
|
| 57:14 | of different things. Ok. Um right. Let's look at this |
|
| 57:22 | Yeah, while you're reading that any on syphilis? Ok. All |
|
| 57:28 | So causes of meningitis. Ok. kind of like pneumonia, maybe not |
|
| 57:37 | the same variety, but a lot things can cause meningitis too. |
|
| 57:42 | V, no, not all viruses some rabies. Ok. Ok. |
|
| 58:14 | down. So, um, there an exception. So if you put |
|
| 58:25 | change your answer. Ok. no. Oh, no. |
|
| 58:33 | Ok. All right. All 43. Yeah. So rabies, |
|
| 58:43 | it does cause, you know, affects your central nervous system but it |
|
| 58:47 | , it doesn't cause meningitis. Meningitis a very specific condition. Ok. |
|
| 58:53 | , um, the meninges. So with pneumonia and gastrointestinal, there's viral |
|
| 59:01 | , the viral form again is kind the more benign version here. You |
|
| 59:05 | , you maybe get a headache, a little bit, maybe stiff neck |
|
| 59:09 | that's kind of it right, then over it. Uh The worst effects |
|
| 59:13 | from the bacterial versions again. Um The, and the term meningococcal |
|
| 59:20 | , that's, that's the one Niia . That's the one you got vaccinated |
|
| 59:25 | . Ok. And um so with kind of pathogen that infects your central |
|
| 59:33 | system, they've got to have pretty set of virulence factors to cross over |
|
| 59:40 | that blood brain barrier, we call OK? Because rightly, so your |
|
| 59:45 | nervous system, right, your right? Um spinal cord, you |
|
| 59:50 | protect that, right. So you're have multiple protections in terms of |
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| 59:56 | uh cell types that help out. so it's, it's um it's not |
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| 60:02 | , but it's, but it's, , it's not easy to get in |
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| 60:05 | . Ok? If you're a Ok. And so the brain, |
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| 60:09 | course, the skull obvious the obvious , primary uh protection. But then |
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| 60:16 | that, it's a number of different . OK? And collectively three of |
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| 60:23 | , they refer to as the cranial , OK? And so the uh |
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| 60:30 | here, innermost layer, you see of capillaries, right? But |
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| 60:35 | feed the tissues, right? So other thing is though it's cramped |
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| 60:40 | a lot of space in there. . So if there is inflammation of |
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| 60:45 | meninges, ok, that will, know, you, you're gonna have |
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| 60:50 | vessels pressing up against the skull, . And that's where the worst effects |
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| 60:54 | meningitis come in because those blood vessels to tear, right? Bleeding |
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| 61:01 | Ok? Um But you, but , it's a it these tissues aren't |
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| 61:07 | , right? So you have a fluid cerebrospinal fluid that bathes your, |
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| 61:12 | brain and spinal cord. Ok. um obviously, one of the diagnoses |
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| 61:20 | some kind of a central nervous system is to test that that fluid, |
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| 61:26 | what's going on over here is uh a spinal um uh tap, they |
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| 61:33 | it where they're taking some of the , inserting a needle, taking some |
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| 61:37 | that cerebrospinal fluid and then look under microscope. Obviously, it should be |
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| 61:42 | of any kind of bacteria, If there, if there's bacteria in |
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| 61:45 | , then obviously that signals something's right. OK. And they do |
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| 61:50 | coupled with um uh antibody engine they have antibodies to the various certainly |
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| 61:58 | isa and hemma is another one that meningitis, uh uh antibodies to these |
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| 62:04 | pathogens. And they can see a quick reaction, uh clumping reaction antibody |
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| 62:09 | engine. And that's indicative of this is this strain of this meningitis |
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| 62:16 | . Ok. Um Very rapid And so uh in terms of |
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| 62:21 | if it is nice serial meningitis looking like these gram negative diplo, I |
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| 62:27 | of almost being shaped cells together. . Uh That's kind of what they |
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| 62:32 | like. OK. Uh But here just shows this blood brain barrier |
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| 62:38 | the protection, right? So here your uh your neurons shown here and |
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| 62:43 | you have like uh astrocytes, leal , Schwan subs are all kind of |
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| 62:48 | cells. Here's a capillary that will of course nutrients, but even those |
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| 62:55 | regulated. But what gets to your is tightly controlled, OK, by |
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| 63:00 | various support cells. OK. Uh , and obviously you want it that |
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| 63:04 | you wanna protect those cells, your , right? So um so what |
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| 63:09 | means is a pathogen has a hard getting in there. But so too |
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| 63:13 | be treatment that you're trying to give somebody who's infected, right? |
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| 63:17 | So, of course, you can help that by choosing the right antibiotic |
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| 63:23 | terms of chemical structure types to make easier. But uh but this is |
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| 63:27 | a pathogen has to face in order to get in there. OK. |
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| 63:31 | so recall with steria meningitis is we've this op A proteins, right? |
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| 63:38 | so that brings about, excuse brings about that tight uh connection with |
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| 63:46 | . And so this will be like that nasal pharyngeal area. So remember |
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| 63:52 | , the the reservoir are humans for . And so um they can penetrate |
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| 63:57 | layer of cells through this kind of mechanism. OK? And then come |
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| 64:01 | the other side from the transito, ? So we can come out and |
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| 64:06 | could be a blood vessel, And in fact, uh the blood |
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| 64:12 | maybe hit your ride in a OK? Uh or monocyte, |
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| 64:19 | And that's how we can then get that blood brain barrier, OK? |
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| 64:25 | of course, cause infection. So VF factors that we see here also |
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| 64:31 | a very thick capsule as well. ? And you see here, these |
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| 64:36 | , these are neutrophils, right? here are the nice bacteria, there's |
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| 64:42 | neutrophil, right? So uh the L and the phase variation, |
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| 64:48 | , changing the engines on the right? Hide from the immune |
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| 64:51 | So here you see a a section the brain and all these little red |
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| 64:56 | , right? This is where inflammations , brain presses up against the skull |
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| 65:02 | those capillaries begin to burst, And so um all throughout the brain |
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| 65:08 | , you see that here. So with um meningitis became infected. Number |
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| 65:17 | , you're on a clock. So we can begin with, you |
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| 65:21 | , typical flu like symptoms, You have a, may have a |
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| 65:26 | for sure, sore neck. and maybe a little bit of a |
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| 65:31 | . Ok. And, um, , but then when you get to |
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| 65:37 | effects, symptoms of like, higher fever, uh, particularly things |
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| 65:44 | , um, convulsions and vomiting, that's you, you, you need |
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| 65:51 | go to the doctor. Ok. , because I had only one experience |
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| 65:55 | this just as not directly but, , a friend when I was like |
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| 66:01 | junior high, I guess, maybe grade or something. Um, he |
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| 66:05 | contracted meningitis on a Friday and he on a Sunday. Ok. So |
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| 66:12 | rested very rapidly. Ok. So , you get to like convulsions and |
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| 66:17 | , that's, that's when you really to obviously before then, but you |
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| 66:21 | to have care. So it's, curable with antibiotics. Um, but |
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| 66:26 | can progress, go downhill very Ok. So that's why, of |
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| 66:30 | , you know, when there are of this, like in a |
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| 66:33 | right? That's why y'all get There's other, other, other humans |
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| 66:37 | the reservoirs. So, in a cores, right? It can spread |
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| 66:41 | quickly. But, um, when get these kind of worser symptoms, |
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| 66:46 | know, it can become fatal very . So, uh, so a |
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| 66:50 | vaccinated, but b uh, if feel these symptoms coming on, obviously |
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| 66:56 | , get help as soon as you . And so uh the capsule is |
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| 67:01 | , is what the vaccine is constructed . OK. Um And these are |
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| 67:07 | more common, uh you don't need memorize a particular serotypes, of |
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| 67:13 | but it's the ac yw variants that ones that the vaccines against these |
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| 67:19 | I guess the more common strains that out there that cause these infections. |
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| 67:24 | , um and let's see. Any , any questions? OK. Um |
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| 67:36 | I went a little bit further than or two. Ok. It was |
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| 67:39 | quite a little bit more than 45 . So let's stop it there and |
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| 67:43 | , we'll wrap it up next Folks with tetanus botulism and rabies. |
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| 67:59 | . |
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