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00:07 wait. Mhm, mm hmm. . Okay. Um let's get

00:41 So uh let's see. So today winding down of course, another couple

00:48 days. So we'll come back uh next day and close out the

00:54 So uh so we're gonna start today finish next monday. Different infectious

01:02 got a little bit to finish up 25 which will do. And then

01:06 mention a little bit about the oh in terms of kind of like deal

01:13 that information, so to speak. um so due dates. So we

01:18 smart work do sunday for those two and then the final one. Uh

01:26 until next next thursday. Okay. the last one, chapter 26.

01:33 then you know quiz because we end Monday um we don't there's no need

01:41 have the quiz. Obviously would make to have it their birthday sunday.

01:45 well it'll start next monday through next . So you'll have that time to

01:52 to finish the unit quiz. Um so I think we're gonna start

02:01 before we go. Um Any questions anything? Okay, we're gonna start

02:06 a clicker question basically summarizing and It really went over last time.

02:12 let's look at that here. So um um so while you're looking

02:20 these over, remember that. so a little bit to finish up on

02:25 , is all about the uh the and how it can overcome different uh

02:34 innate and adaptive immune system defenses that talked about preceding that in chapter 23

02:40 . So um again it's going to different types of enzymes um can potentially

02:47 different types of toxins. Um other that enable it to either adhere to

02:55 tissues to um overcome that definitely responses . So these are kind of what

03:04 summary of some of the things we've about so far. Okay. Uh

03:09 so today in relation to chapter 25 extra cellular pathogens. That kind of

03:16 what were some of the things they do to overcome your immune system being

03:22 extra cellular pattern? So remember that can be extra cellular that can be

03:26 sailor have different types of strategies and of So uh and then uh so

03:37 we get into diseases shortly uh and we'll bring it all together now in

03:45 of what your body does, what do and specific to different diseases

03:50 Um All right, Sue for this . Okay, so as we go

04:09 these parental route. So that's the definition. So that's the kind of

04:18 natural pathogens into the system which is birthday surgery certainly, you know,

04:23 you don't disinfect properly or antiseptic musicians properly, injection bite are also other

04:31 um invasions. Those are collections of proteins that your faculty active uh types

04:37 intracellular pathogens can have to get them cells. Um respiratory tract is probably

04:44 most frequently. Travelport um of entry airborne transmission. Right. Uh common

04:54 . You know many people catch colds the year and whatnot. So that's

04:58 uh frequent portal of entry uh indo . That's a special gram negatives.

05:04 course stripped Aquinas breaks down blood clots kindness is a different types that they're

05:12 to be a genius specific depending on bacterium for mites that's all about

05:19 And so inanimate objects acting as indirect of transmission, door knob uh contaminated

05:28 , these kinds of things. Okay M protein certainly for adherents they do

05:32 some other functions as well. So all of these are correct. Okay

05:39 um so as we go into Bruno's that we've talked about. So here's

05:44 of a checklist. This summarizing all stuff yourself we've gone through, we'll

05:51 up with this part down here uh close out the section. So remember

06:00 your inter sailor pathogens, they the ones are viruses. We've talked about

06:05 but these are remember that that various of bacteria particularly intestinal patterns as we'll

06:11 are types that can do this as way to hide from the immune system

06:16 i and that has to do with collection of invasion proteins that never become

06:22 and they can get inside the cell get into other cells and deep penetrate

06:28 into the body. Okay so um so we finished on this last

06:35 So this is this is not gonna a question again. We saw that

06:38 was a fearless factor. And so the pathogens are staphylococcus aureus pattern is

06:48 that can do this. It has per team a right here. We'll

06:52 about it here in this slide. these are strategies that extra sailor pageants

06:58 . Okay so these types do not into sales to hide out from the

07:03 system. Okay um so if they're of course they're gonna be potentially more

07:09 . So what well the having a . Right so if you're an extra

07:15 or pathogen, what's gonna be the that you're going to deal with?

07:18 antibodies coming at you um compliment coming you. Okay. Um Are the

07:24 things being fake? Sensitized is another . So these are all dangers of

07:28 an exercise of pathogens. So what you gonna do? Well you can

07:31 compliments, You can uh you can the effect of an antibody. Okay

07:38 so having a capsule, right hide antigens. Right? Hide your surface

07:43 of engines uh either through put a around yourself. Right capsule basically cover

07:50 your gram negative, the outer a gram positive, it'll cover your

07:55 black can't layer. So you can your engine is not so detectable to

08:01 adaptive immune system by doing you can make yourself less able to be fatal

08:06 for the capsule. Okay so there's advantage to that. And so these

08:11 of the major patterns will look at uh had very thick capsules.

08:18 that's one virulence factor. They have others as well. But again hiding

08:24 the immune system this way um the acid capsule in particular capsules in

08:32 Our policy Sacha ride in nature typically they can have some protein parts in

08:37 as well but to have a hyaluronic capsule, okay, is particularly important

08:45 hyaluronic acid are components of your own . Right? That's the molecules that

08:51 of bind your epithelial cells together. , connect them. And if so

08:58 capsule that has this component in it not be as immunogen inc will not

09:04 as detectable by your body body thinks this is a normal molecules that we

09:09 . It may be okay, don't to maybe make a strong immune response

09:14 it because it looks like something that's of your body. Okay, so

09:19 , very sneak for the pattern to that. Okay um the protein a

09:26 we just saw the picture of that . So this is a way to

09:30 the effect of antibody. Right? remember that this these parts here.

09:36 that's the androgen binding site. so that's going to bind would bind

09:41 that will enable to cause damage. know the effects of antibody engine

09:47 Right? Could be multiple multiple things occur. So if you can counteract

09:51 well, remember this this side that's the fc portion. Alright.

09:56 if we take that like so basically the antibody around and everybody can't do

10:03 effect on the pathogen. So having coated with these protein AIDS will enable

10:10 to not have the effects of the against it. Um So another strange

10:16 course, is to break it apart again. So pretty excited, pretty

10:20 well will destroy degrade the everybody. So nice. Syria is binding to

10:28 mucous membranes is very important for that . And so by having I.

10:33 I. G. A. Is in new coastal secretions to to buy

10:37 it and prevent it from it So because it's regular park then you

10:42 it to be able to attach to mucous membranes and cause disease potentially phase

10:48 . Right? Apoptosis. So some can cause uh induce that in your

10:54 cells. Something that's that program cell . Um phase variation is another way

10:59 hide bandages. We saw that in 10 I think um altering the they

11:07 will have multiple forms of a particular uh and uh a foot gelon for

11:13 , we looked at before. Uh you can change what that looks like

11:17 then then it's temporarily hidden from the . So remember that this idea of

11:22 time right? Works for us. for them. Okay. We can

11:27 a fever that can buy us time adaptive immune system to respond. There's

11:33 slows down their growth but then our system can catch up to it.

11:38 can buy time by hiding their energon being detected by the immune system.

11:42 then they can then grow during that until they're found out again. So

11:48 kind of idea of buying some time and two can work for both,

11:53 of us at certain times. To our advantage or their advantage in

11:57 cases. So um so this is this great closes out then the microbial

12:06 part. Okay so as you get diseases to kind of look at,

12:10 at this, look at innate immune , defenses of gadget immune system defenses

12:16 virulence factors altogether. Now we look different diseases. Okay. Is there

12:22 there are questions about. Okay so worried about The material. So in

12:31 it's broken down by systems and we'll through it pretty much in this

12:36 Uh We're we're not we're not gonna through the beginnings of this. We

12:41 get all the way into their um finish that up on monday. So

12:48 or less we tracked the general urinary . So basically stds and as

12:54 N. S. Pathogens, we're on monday. So we'll focus on

12:59 and soft tissue infections, respiratory Um a little bit about her community

13:07 not that much because we talked about before But in terms of organizing this

13:12 . 26 is pretty much memorizing Okay, so it's up to you

13:19 you want to do this? You want to organize it in a way

13:23 this table here. This is this posted that it's just it's just an

13:28 . You may have a different way doing this. That's fine.

13:32 you may, if you do use as a template, you will probably

13:36 up getting one or two more columns . But again, just a way

13:40 organize the material. Okay, there's list. Here's what to know.

13:46 , um, the you know, wouldn't really get hung up on.

13:51 I do mention symptoms of different infectious and I wouldn't get focused too much

13:56 that because they overlap. So like and fever and then sent them from

14:01 different infectious diseases. But if there's that's really just like remarkable, like

14:08 tetanus producing the spasmodic muscle contractions and , of course that's a characteristic of

14:13 disease. But I wouldn't worry about always this cause fever or malaise or

14:18 blah. Don't worry so much about . Um, rabies has some very

14:24 symptoms. So really obvious to you what's something that's that's probably gonna be

14:30 because if you only see it in one particular disease. Right? That's

14:33 that you probably want to make Okay. But uh, anyway,

14:39 be able to separate out your which are gonna be pretty simple.

14:43 virus virus. Right? Uh, wins right here here here.

14:51 so point being you can't do those stains aren't applicable to those obviously.

14:57 , so just make note of these of things. So, um,

15:03 , and this table is posted on electric four notes. So, if

15:07 want to take a look at um, Okay. So let's start

15:11 this one. So noncommunicable horses communicable . Okay. So we'll begin with

15:20 little of a repeat of the herd , um, process, but not

15:26 not long since we're going to do before, but it does relate to

15:32 community is only applicable to communicable Uh, not applicable to non communicable

15:43 . Let's see. Okay. that mm hmm. It doesn't.

16:11 . So, so communicable diseases, diseases are What spread person to

16:18 Right. Um, you're not gonna tetanus person to person. Okay,

16:24 is uh acquired to a puncture um, infected with tetanus organisms found

16:31 soil. So that's how you typically tetanus. Um, but you're not

16:36 spread that once you have, you're spreading it person to person.

16:39 So, but certainly influenza. Covid , plague and all are all communicable

16:45 transmitted from person to person. So, um, so of course

16:51 answer here is tetanus. Okay. the non communicable disease. Um,

16:56 so we talked about hurting the engine . Uh, remember that It's all

17:01 on of course a being vaccinated be most of the people vaccinated for a

17:08 infectious disease. Okay so um here this diagram, the red individuals are

17:19 that are sick and contagious. Okay focus on the left side here.

17:25 um this side. Okay so those blue are not vaccinated susceptible uh

17:38 The yellows are vaccinated. Okay so was a uh contagious person. So

17:45 person. Uh there is no uh protection many of the unvaccinated people.

17:54 . Too few vaccinated people to act sinks to absorb this fact. Hence

18:01 is a lot more people get Okay over here, lots of

18:07 right? Lots of vaccinated people that acting as a buffer between the um

18:13 contagious sick person and those that are . Okay, so a greater

18:18 So what's what's that value? Have be? Okay, we saw this

18:23 we saw this number these data before even at the low end for this

18:28 zero value. Okay. Which is measure of measure really of kind of

18:33 productivity of the infectious agent virus or . So it relates to the number

18:38 people who come down with disease uh on who contracted from a contagious

18:45 So 12 to 18. Right? a high value. Measles.

18:50 mumps. Covid's on the low end well. But even on the low

18:54 you still need to have at least quarters of the population is vaccinated to

18:58 that herd immunity. Okay, so that herd means that those vaccinated people

19:04 the sink to absorb infectious agents protecting people which which can happen for a

19:11 of The reason. You're not gonna 100% compliance on anything. Okay.

19:17 certainly not in the vaccination for a of reasons. And as mentioned

19:22 At least I said a week we're not we're not close to 75%

19:27 terms of vaccination against the so so that's that's what we heard community

19:36 for many diseases we talked about today next week there are vaccines available for

19:41 of course and so but not for . So let's look at uh skin

19:49 soft tissue infections first. Okay, staff, uh staphylococcus, soap,

19:57 aureus, staph epidermal cysts don't need know that one, but epidermis is

20:02 common skin inhabitant. All staff are grape like clusters, gram positive,

20:10 epidermis, that's really the strings of cysts are not really disease causing.

20:16 a occasionally they may cause a mild , but the by and large,

20:23 staph aureus is the one that's the one here. Okay. And so

20:28 has of course a number of virulence . Um they can infect the typically

20:34 a break in the skin abrasion of have you um they can on occasion

20:41 through into the natural openings in the pores or follow hair follicles. There's

20:48 types of skin infections where I think probably all aware of boils. Uh

20:55 , there's another name that's very similar boils, but you can have things

20:59 political itis. Um or hair follicles infected stais which has to do with

21:06 eyelashes around your eyes getting infected. What else is there? Carbons I

21:12 very similar to Doyle's And so this coagulates virulence factors. So there's a

21:19 correlation between staph aureus strains that incorporates that are much more pathogenic or virulent

21:27 our coagulates negative strength. Okay, that that correlates to a positive for

21:33 . That often correlates to it's a a virulent strain. And so with

21:38 basically a puncture wound or other abrasion introduce them into the skin into

21:44 A boiler typically appears. It's like hard not not uncommon that not being

21:49 to this, this actually coagulate creating um uh clot creating a cocoon basically

21:57 the cells protecting it. Uh It fill up, you'll get some uh

22:04 psychosis, innate immune response. And you'll get some proliferation of staff,

22:08 get some bigger psychosis of staff fluid . So of course it swells up

22:13 you get it's not it's very common have the boil has to be punctured

22:18 drained in order to treat the Okay, Um toxic shock syndrome that

22:27 came to prominence. I think in 80s, it's beginning it started with

22:33 a particular feminine product tampon that was absorbent and um but that created an

22:42 that a lot of proliferation of And so the strain produced the superannuation

22:49 remembers one that causes these body wide immune response and can put the body

22:54 shock. Um You still see cases it now and then but but not

22:59 as much. Um. M. . Alright so Mersa uh stands for

23:05 resistant staph aureus. This term here . Okay. Um now now more

23:15 current term is what they call A. I anybody know what nosocomial

23:23 to? Well I guess hospital, hospital acquired infections more current term is

23:31 care required because because health care is just in the hospital anymore. It's

23:37 clinics and home health care etcetera call kind of fall under the umbrella.

23:42 point of it is is that you getting treatment for whatever really it can

23:48 a sore back uh and get your scoped um something like that, you

23:55 to the hospital or a clinic or you and while you're there getting treated

24:01 you acquire an infection has nothing to when you went into in went into

24:06 place with it, you acquired it you were there. Okay. And

24:10 this is a problem especially for many um you know you know They can

24:16 for around 10% of these infections occurring in cases occur in hospitals. And

24:22 one of the bigger ones is staph particularly methicillin resistant types and now there's

24:29 minus and resistance multi drug resistant And so you have to think of

24:34 know particularly the hospital, what's it full of sick people? Right.

24:38 Oftentimes elderly, right susceptible to Um Of course there's lots of disease

24:44 bacteria there. Right? Uh There and the transmission occurs typically through the

24:51 workers they're working on. There's something patient to patient right? Um Not

24:57 black collapsing in the proper sanitary Right? Really the number one way

25:05 to really reduce the levels of this acquired infections. It's a very basic

25:12 what would you think it would be your hands? A constant. So

25:19 workers of course your nurses and and the doctors can vote to um is

25:26 constant reinforcement. Meeting weekly biweekly monthly and saying wash your hands dispose of

25:35 your soiled garments and other things patients in a proper way. Okay um

25:43 goes a long way to minimize this also things like um not properly using

25:52 different types of medical equipment like um tubes, catheters in particular um parts

26:01 put in bodies like a heart valve or a knee replacement. These kinds

26:05 things. These these come as prepackaged sterilized really packed instruments and if you're

26:12 open properly handled properly that can lead staph infection and and other types.

26:19 it's it's really um that that's where weak point can be is in this

26:26 not using sanitary procedures, these other of procedures that need to be done

26:30 . Uh Nonetheless um and the so we go into different skin infection types

26:40 we're gonna it's a matter the difference a matter of of depth. So

26:46 can be as superficial as impetigo scalded syndrome. So you see the baby

26:53 of blistering on his back just kind it can begin with like an abrasion

26:57 the skin that doesn't really get cleaned treated well initially. And then it

27:01 of grows and toxin here called exfoliated . Kind of creates a party upper

27:07 most hilarious of skin. So it's a deep infection but certainly noticeable impetigo

27:13 often associated with uh kids and daycare were all little kids aren't the most

27:20 individuals. So scratching themselves. That of thing can cause rashes on their

27:26 typical of impetigo. And they were superficial layers and as we get into

27:33 quickly start to caucus infections of the . Now you can get deeper and

27:37 and deeper. Okay so things like syphilis and um necrotizing fasciitis. And

27:44 we're having more and more deeper penetration the skin layers and of course the

27:50 to to to penetrate into the skin depends on the bureau since factors

27:55 The high ironic days coagulates is your in aces. These are all things

28:00 I'm able to penetrate deeper and Okay, so of course, or

28:05 that we've seen before has an arsenal growth factors. And you know,

28:12 , no one staph aureus pageant will necessarily have all of these, but

28:18 have a collection of them and the they do have will determine how rarely

28:23 will be entirely. Um but certainly has a uh an arsenal of

28:31 factors. Okay, we saw that already. So streptococcus species, there's

28:36 be some overlap. So there's there's similarity in terms of the types of

28:40 factors, particularly with these hyaluronic basescu , that kind of stuff. But

28:45 historically strip is classified through these um reactions on blood dog. Okay.

28:53 they of course are also grand positive they're in chains. So hence the

28:57 strep toe, but there are variations um streptococcus pneumonia is primarily in

29:04 Okay. Uh but nonetheless, so mollison's or what break apart red blood

29:10 . Okay. And so um complete Asus Shut up here somebody. It's

29:18 of cute. And did the cotton dipped into strep and drew a

29:24 you see clearing his own green alpha icis that's partial Hamal icis. Okay

29:32 so it turns green because of oxidation the hemoglobin. Okay, here is

29:39 color. I have a whitish color blood sugar. That's the gamma

29:44 But all three groups have pathogens in . So just because they don't show

29:50 doesn't mean they're not pathogenic. Um And so G. A.

29:55 . Stands for group A strip. another historical term papaya chinese is a

30:03 virulent strain that many of these can multiple diseases, multiple types of skin

30:09 , strep throat as well familiar Um And so if you look at

30:15 groups together here, Okay and kind the major ones. So streptococcus you

30:22 is one that causes um uh it's oral it's part of your oral microbiome

30:29 it can cause cavities. Um You form biofilms. The plaque you feel

30:34 your teeth is from typically from this . Um oral dental procedures like getting

30:41 tooth pulled or losing people, things that, a root canal. Uh

30:46 connections because of potential exposure of them the rest of your body and get

30:50 um into the bloodstream. Endocarditis occurs they attached to like heart valves.

31:00 they will grow from a biofilm and interfere obviously with the function of the

31:05 , causing inflammation of the lining of heart. Okay um the other the

31:12 pneumonia will talk about that in the of respiratory infections um of course cause

31:19 . It's the second leading cause of right behind my syria meningitis. Uh

31:26 attorneys will talk about it shortly. diseases it causes uh and enterococcus um

31:33 is different from the others and that causes actually A G. I.

31:38 infection. So it's an intestinal Okay so um the various factors we

31:48 about in protein and these others So looking at um is again in

31:56 context of respiratory infections because we classify throat as an upper respiratory infection.

32:02 so we'll talk about it there But here is focused on rheumatic

32:07 This is a this is a cross effect. So um antibodies we saw

32:15 before way back in talking about Jenner smallpox vaccine. Okay so he created

32:23 smallpox vaccine notice made from cowpox. so cowpox a benign doesn't cause disease

32:28 humans. Safe choice for a vaccine it still produces an immune response toward

32:35 antibodies that will attack smallpox. Okay it's a cross reaction. So similarly

32:42 um rheumatic fever is uh you may had a strep throat in your in

32:47 body produce antibodies to the organism specifically the M. Protein. Okay.

32:54 those antibodies, the M protein engine chemically very similar to um your heart

33:03 proteins and also to um uh connective proteins that are in your joints.

33:10 so you get you get somewhat of autoimmune response here. So the antibodies

33:15 produced the M protein due to this will then also cross react potentially with

33:22 muscle and or connective tissue and joints pain obviously. So uh so that

33:29 that is uh potentially an issue. so we called the name for this

33:34 what's called so a secondary immune The primary one is antibodies to the

33:42 . The m protein. Secondary Oh some of those anybody's not cross

33:46 to some of your tissues. Okay so or sequel. Right um the

33:56 precipitous and advertising fast. So here depths of infection. Okay so you're

34:03 so whereas impetigo um uh scalded skin and various superficial layers. Now we're

34:12 below that. So dermal layers is syphilis, necrotizing fasciitis. So you

34:17 see here so this is the recipients top. Okay um down here now

34:23 penetrating down into the bone, that right there um And again the the

34:29 of infection based based on what are virulence factors it possesses? What type

34:35 and both knees can start with abrasions That left untreated can become something that's

34:43 . Okay it's all about what what the types of toxins and toxins out

34:48 tissue. Um These other enzymes are to penetrate deeper into the tissue.

34:54 it's really a types of various factors possessed. Okay that will determine you

35:01 how bad this infection can get. um Okay um any questions this point

35:10 uh what does it mean when it uh emperor facilitated adherence protein. Oh

35:20 . Okay yeah so m protein has dual functions that can act as a

35:26 to bind two cells. Um Plus has also has the effect of being

35:32 to inactivate compliment too. So it kind of do both things. So

35:37 is the truth enabling it to? for streptococcus pneumonia is important for it

35:43 um adhere to your respiratory tract So that's the m protein helps helps

35:49 to do that attachment attachment to you're to your mucous membrane really for the

35:57 part. But these guys any Yeah so let's look at this

36:07 It's kind of a general question Um Keep this over. Okay so

36:17 hmm. Back this way. Alright we go. So respiratory infections,

36:22 respiratory infections and G. I. infections are what in nature? Mm

37:01 . Mhm. Alright let's see. they are in fact viral in

37:14 Most most respiratory tract infections most gi infections tend to be viral and tend

37:21 be less severe than the bacterial Okay um uh The worst effects of

37:30 . I tract infections are typically due certain bacterial types. Um The also

37:37 respiratory infections, the worst affected typically pneumonia is caused by bacteria. Okay

37:43 so let's uh here so we're gonna this down into upper and lower respiratory

37:52 infections. Okay. Very common is a initial viral infections. They

37:58 Okay. To then be preceded by more than to be followed by uh

38:05 infection. Secondary infection that's much So pneumonia uh is much worse than

38:12 they have flu typically. And so there are some reasons for that that

38:17 get into. So here we go with streptococcus diogenes and strep throat.

38:24 ? So consider that an upper respiratory infection, the fancy name is fair

38:28 itis for that bright red throat. It uh strep throat can actually lead

38:36 some of these other conditions like scarlet or rheumatic fever. Um The scarlet

38:44 itself is rarely fatal. It's a If you see it, it's gonna

38:52 typically being Children less than 10 years . Um it's not common at all

38:57 see it in Children older than Um What's it's more frightening looking at

39:03 else, it's preserved. It's really red color in the individual. The

39:11 occurs through this toxin that x on capillaries to dilate them, right?

39:17 when you dilate blood vessels, they're gonna get closer to the skin

39:21 it's gonna get this red splotchy kind color. And so with scarlet

39:26 it's a really bright red type of . And so uh those that get

39:30 and people can be alarmed when they it, but like I said

39:34 you could just get over it and doesn't amount to anything more serious than

39:40 . Um the diphtheria though. Uh so much a danger now that we

39:46 see up kicks here and there across country again, that's depending on vaccination

39:53 , but certainly just accept 80 80 ago, 90 years ago. it

40:01 deadly among Children for sure. And it was one of the probably one

40:06 the first cases of showing the value vaccination because literally probably within a very

40:14 time frame of introducing the vaccine for theory that the cases dramatically dropped.

40:21 . Um The bacterium bacterium is one these we called opium or fix,

40:27 no really kind of uniform shape to . It has like branching forms with

40:32 club shaped forms. Uh it happens it's the way it divides crazies on

40:40 . It is aerobic and uh picture and shows kind of the oddball shapes

40:48 thing has in fact um So immunization course where I used to be a

40:55 killer of Children. Mathletes rocked and still is fairly low for the most

41:00 through the vaccination. So this vaccine a 33 effects. So these were

41:07 theory of T. Is for tetanus Okay. Um and it's against the

41:14 . All three of these produced Okay. Um so the theory of

41:21 starts as like like many respiratory tract , they started kind of like with

41:25 like symptoms that are relatively not so . Uh They can get to fever

41:31 and progress downhill from there. Um characteristic of diptheria is a pseudo

41:38 Okay, So what happens is so theory is it's kind of in the

41:43 of the throat and when it begins it affects it will then begin to

41:49 toxins. Okay. And the toxin one that inhibits protein synthesis. So

41:55 will kill the cells. You then get that action combined with your body's

42:02 inflammatory response will produce a lesion in back of the throat. And that

42:08 will fill up then with clotting factors kind of heal it. So you

42:12 a company from clotting factors that begin form the fiber network and that traps

42:18 those diphtheria bacteria that are alive and right? So it becomes this network

42:24 that's what it looks like when it big enough, is a pseudo membrane

42:27 the back of the throat. And can enlarge enough to where it can

42:33 breathing. Okay, people have died they couldn't breathe with the size of

42:38 pseudo membrane. Um I don't know it's that easy just to cut it

42:43 . Okay. But nonetheless it is characteristic of this of this disease,

42:50 um it is treatable with antibiotics if does acquire it if they have not

42:55 vaccinated. Um But you want to rather quick about it because toxin can

43:03 know, get into your blood and throughout your system and that's when serious

43:08 can occur organ failure and things like because um we'll talk about this vaccine

43:15 here in a second in the context of p because this vaccine like other

43:23 change over time as we as we to make them better. Uh And

43:29 was one of them that that Uh We changed this not too long

43:34 . Um So with cutaneous diphtheria not anything you know about that. It's

43:39 it's a relatively very mild cousin to diphtheria. Um does not cause any

43:46 of serious disease that the respiratory form . But you can on occasion see

43:53 infection form of this disease. Um Tonight the lower respiratory tract infection

43:59 pertussis called whooping cough because the characteristic makes when they have the full blown

44:09 . Very characteristic sound um supported tele a cocktail bacillus is used that for

44:18 that are kind of really short Not not spherical but almost kind of

44:24 just short rods. And uh so gram negative. It's the thing that

44:29 with is this mucus Salieri escalator. so that's one of your primary innate

44:36 system defenses for your respiratory tract. and so remember Celia. So you

44:43 see if you look down in the you'll see Celia and they they emanate

44:49 these cells that produce them and this movement in conjunction with mucus that's produced

44:58 keep out particulates and microbes and things getting into your lungs. Okay so

45:03 very important defense function. So you this working, You want it needs

45:09 be moving you want the mucus And mucus needs to be at the right

45:14 say viscosity thickness, right? To optimally. Um And so they're meant

45:19 work, work together. Okay? with whooping cough, it's again multiple

45:26 producer. Uh There's a couple of to it 11 of the stages produces

45:31 trachea toxin which will basically kill the itself. Okay, see then you're

45:37 lack that function later on. Pertussis becomes systemic. So it will I

45:43 it also interferes with protein synthesis causing death. Um It's occurs in

45:51 So again cold like symptoms in the uh what we call the Kotaro

45:58 which may be the last for about week, a week to two

46:01 Um but during that time bacterial proliferation toxin is accumulating and you're beginning to

46:10 off. Well you don't really see full blown effects yet in this stage

46:15 to accumulate toxins and to kill these cells off. Okay, now we're

46:21 paroxysmal stage which can last for month and a half, two

46:26 Um Now you're you're seeing the football of the toxin having done the

46:32 Okay, so you can imagine you know, your cilia and there

46:37 moving. So you're trying to accumulate accumulates and you're trying to breathe

46:45 And so you have these violent coughing . Okay, so the danger is

46:50 um in in infants very young Children infants. So as they're coughing,

46:58 ? Of course, the biggest part the baby infant is his head.

47:02 ? And so when it's confident buying this, you can't really control,

47:05 know, the head movements can cause cause damage to the brain. You

47:10 have neurological impairment as a result of violent shaking we're doing as a baby's

47:17 . So um so it can be with antibiotics, okay? And um

47:25 it takes a while to recover. can imagine if you're having to,

47:29 know, basically cross you can that's going to take a toll on

47:36 body. Of course it's gonna take while to recover from that. Not

47:40 for it to take four or five six months to completely recover from the

47:46 . So um so of course I can't prevent all this. And

47:53 the newer the name is actually now T. Damn. Okay. That's

48:02 current version. So back in 2012 was a peak significant people In the

48:10 the instances of whooping cough in Children age 12 or 13. Okay.

48:17 I looked into this and they so these kids would have been about

48:22 or six years post vaccination. Or at least post booster shot.

48:30 . And so they looked closer at and found that the community from the

48:34 was kind of waning, You after about five or six years

48:37 E. The age of 12 or . And uh those kids became susceptible

48:44 the top. And so um so forced them to to really take a

48:48 at the vaccine and reprove the vaccine to make it more amina genic.

48:56 so uh to activate more of the system from many of those memory cells

49:01 . And so um when they did that that proved to be much more

49:07 . And so we haven't seen this almost 10 years ago now. We've

49:11 now that it's dropped and it's kind maintained that low number. So that

49:17 happen with any vaccine. You can why you constantly that's why you

49:20 one of the things as we go these infectious diseases uh by law these

49:27 to be reported. Okay. Which that we have a huge you know

49:32 bank up of of the number of of all infectious diseases. So we

49:36 see these kinds of trends and see going on and geographically is there something

49:41 on geographically? Why what's what's so ? It's kind of all the realm

49:46 epidemiology. Right. For those that interested. There's a weekly report that

49:52 out. I called him mm. . R. That stands for morbidity

50:01 mortality. Weekly report. And that collates all the cases and and numbers

50:07 types of infectious diseases particularly the End issue gives you a whole summary

50:12 the previous year instances of disease and infectious diseases. A number of cases

50:17 cetera. Um You may find it but mm mm wr so and it

50:25 breaks it down not just across the . S. But also by state

50:29 well. I think they kind of feel for the geography of different where

50:32 see more infectious diseases in one spot another that kind of thing. So

50:38 now okay so continue on with lower tract infections pneumonia. So pneumonia is

50:48 uh not particularly a specific it's a of course but it's not attributable to

50:57 certain pathogens. Many things can cause million. Just like many things can

51:01 gi tract infection. Okay um viral uh I think there's certainly some protozoa

51:10 in there. There may even be fungi in there that could cause the

51:13 . Okay so but number one in list of course is streptococcus pneumonia.

51:21 um you can have violent among us well. It is not as

51:26 Now, pneumonia is very common to as a secondary infection. Okay.

51:35 that let's say let's say you have flu. Okay and the fluid forces

51:42 . You can't really take any you get you can't taking the drugs that

51:50 help you other than to treat So you kind of write it

51:54 Okay get over it. Um What is the one thing you're told or

52:02 do? Why you if you had food. What what should you what

52:05 you take in on a regular basis you have the flip one thing.

52:13 , fluids. Yeah. Alright, fluids. They say hydrate yourself.

52:16 yourself well hydrated. So I can't for you all. But most of

52:22 don't I don't typically drink enough So especially when if I would have

52:28 flu, I probably wouldn't drink And that can affect have effects on

52:32 mucous. I talked earlier about the viscosity. Right? So that can

52:37 an effect. You get dehydrated that have an effect on that. And

52:40 your mucus, the mucus and the will work together. But if the

52:44 is too thick, right? Because dehydrated, well then that consistency doesn't

52:49 very well with the syria. Uh so that's when a motive can

52:57 in as a secondary infection. And uh streptococcus pneumonia is found in healthy

53:04 . Right? Remember the reservoir, ? For this is humans. And

53:09 um uh so you can become susceptible you have this condition where you had

53:15 flu when you get dehydrated and you quick enough and then your immune system

53:19 function is not as good as it be. And so pneumonia. So

53:25 call this because in the next disease what we call it a typical

53:31 Think of it. This is what would call typical typical pneumonia.

53:36 Typical pneumonia is much more severe. is not uncommon to require hospitalization.

53:43 . To give you fluids and treatment and things. Okay. What happens

53:49 so um number one pneumonia has a thick capsule. Okay um it will

53:57 into your lungs. Your lungs actually some nutrient rich fluid that coats to

54:05 um Your physiology right? The trachea gets have more and more branches

54:12 And at the end they have these tiny air sacs right now B.

54:15 . I. And so it's fluid bathes those would be a lie.

54:19 can be somewhat nutrient rich and so gets in there and begin to

54:24 Okay you have macrophages that are kind wandering around in there. Okay actually

54:29 fixed macrophages that are kind of patrolling lungs. Uh They'll take as the

54:35 that will trigger the whole tl our and cytokines and inflammatory response. Of

54:40 . Right so now uh you'll get into the site. Okay? They're

54:46 squeeze out through the blood, And what happens is your lung fills

54:51 with fluid. Now okay so you um uh this this this jumble of

54:58 pneumonia i cells of neutrophils. fluid building up in there and that's

55:06 critical imperative ability to breathe right shortness breath etcetera. Um It's it's it's

55:13 uncommon to have the infection in Low to the law. So they

55:17 this low bar pneumonia. It's either or right side. Typically not

55:23 Um But the uh so this reaction your body information that fluid lungs can

55:29 to uh difficulty breathing. Okay. that's that's when it typically requires getting

55:36 hospitalization to get your fluids to get likely on the breathing, getting oxygen

55:42 , antibiotics to clear it up and that hospitalization can last for a few

55:48 in some cases. So um um of course the the if you don't

55:54 it then even if you do, the potential is there that it could

55:57 travel to your brain and cause Because it is it's it's it's number

56:04 and not that far behind Neisseria. is the cause of most cases of

56:10 . Um It was a vaccine Um The vaccine though is really just

56:16 people my age 50' over. I think they really recommended for those younger

56:24 usually with a healthy interest and you bite this off. But again,

56:29 will work as well. Kind of is still the one of choice,

56:34 there are resistant types of course. uh so this is this is typical

56:41 a typical pneumonia. Okay, uh . The next one up is what

56:47 call atypical pneumonia. Check. Um questions about this? Yeah. So

56:54 this is a secondary infection, what people usually precaution against being in the

57:02 ? Why do they usually what? the general precaution like for being

57:12 I don't know, I totally disagree that. That being on the cold

57:17 not mean you're gonna get pneumonia. are you waiting? No, it

57:21 matter. That's a myth. That an absolute myth. Absolutely.

57:26 And my mother told me that for I believe there until I got a

57:29 in microbiology. Yeah. Yeah. . Get being on a cold wet

57:38 . It does not matter at It doesn't matter at all.

57:42 So I guess the way I guess weight from Brent pneumonia is just,

57:50 . Yeah. Yeah exactly. Yeah you have if you have a cold

57:54 back hold of flu then yeah do best to kind of drink lots of

57:58 and that kind of thing. Ah exactly. Yeah. Yeah. Question

58:06 stuff. Um Yeah so being a pathogen uh and and you know proximity

58:15 somewhat to the central nervous system. upper respiratory tract infection more so but

58:19 so um if it progresses um from uh they can you know be in

58:27 proximity to the lbl I. And the calculators that are there that they

58:32 potentially enter the blood there and they to your C. N.

58:35 Okay. And so that's the key something that causes meningitis is to get

58:39 your C. N. S. some route. And so blood is

58:44 common way. Um But it depends the balance factors they have. We'll

58:50 into that on monday when we talk meningococcal meningitis but yeah it's it's getting

58:59 for it. It likely gets into blood and then gets into the

59:05 Um the Okay, So regarding the presented thus far, what would be

59:13 reservoir of those diseases? And they been, let's see. So skin

59:21 , streptococcus, staphylococcus. Let me that. Sorry. Um, what

59:31 ? We have diptheria? We've had , pneumonia. So the whole lot

59:40 last year. Um, I think everything so far so reservoir for

59:55 And uh, can I give you hint? It's it's not animals.

60:03 . Yeah, technically two answers. huh. Mm hmm. Let's answer

60:16 . You can convince me. Okay. So I assume you put

60:40 , what's your other choice? the droplets from drop, it prefers

60:46 drop it. It spread is from coughing sneezing when individual colleges or sneezes

60:52 approximately to somebody else. That's the transmission because it's technically correct and not

60:58 to see uh it's not water at . It's, yeah, you wouldn't

61:04 you're saying that the water from a is what primarily makes up the droplet

61:08 reclaim that. Yeah. Yeah. , it's more like an aerosol.

61:14 Yeah. Yeah. Um, so is humans, humans uh, for

61:21 we looked at so far, the one is um but each note is

61:29 in across the environment. Water, water more more more mostly. Um

61:36 again atypical type of pneumonia. So is um so atypical pneumonias aren't typically

61:43 aren't as serious, don't require You might have heard the term um

61:49 pneumonia that's usually associated with atypical Okay and this is one of those

61:56 there was a severe outbreak of this really brought this disease to prominence.

62:03 kills like around 29 people. But was kind of like a perfect storm

62:08 I'll get to here in a But um so legionnaire's disease, legionella

62:18 , sorry is a is found as interest cellular organism inside amoebas typically.

62:26 so amoebas are for the most part water uh inhabitants. Okay and so

62:33 find some freshwater sources all across the . Okay. And uh so as

62:40 as the faculty active interest sailor Okay so it's one of those that

62:44 also induce the same thing in Okay so we can you have the

62:51 and then promote getting engulfed by one yourselves and taking it. Okay So

62:56 is um uh is this motel has single flagellum um gram negative rods.

63:06 uh so you're yourself types, it's they typically get into um Now how

63:13 do you acquire this? Okay most almost every instance I see when I

63:21 it up of legionella or legionnaire's disease associated with being in a hotel being

63:29 hot tub or pool. Okay so often in the hotel and it has

63:37 do with the H. Vac The system that handles the ventilation the

63:43 A C. Okay so in a a unit uh for for providing cool

63:53 is different from what you know they you have in your house. Okay

63:59 they involve a water tower. So all about really it's all about heat

64:03 . Okay? And so you have water tower, you have evaporation of

64:06 in the tower and you have a air that's also some area that's through

64:12 . And so you have the water and then uh forms aerosols providing cool

64:19 and then travels through the hotel or the structure is. And the issue

64:25 when the water in the cooling tower become contaminated. Okay? Uh Typically

64:32 water towers are not cleaned well enough disinfected regularly and so you get this

64:39 accumulating that can have that can carry amoeba carry legionella. Okay. So

64:46 so here's just a snippet of some the things that is from 2019 But

64:52 looked at it in 2020 and 2021 you can see here and there across

64:55 country outbreaks like this. Not necessarily of people in all cases, But

65:02 some cases yes, but you can underlying read the common thing, your

65:06 tub, water system, cooling tower and hot tub. Okay so um

65:13 the uh and so in 1976. that was you weren't I presume you

65:22 born then. Okay. But I 1976. That was humongous year and

65:27 was a humongous year because it was 200th anniversary of The signing of the

65:36 of independence. Right so July 1976 was humongous. Everything was leading

65:41 to that. Okay? Um Ask parents or grandparents. And so um

65:49 summer I think this is part of july. Um There was a

65:55 there's lots of conventions going on So american legion convention. So american

66:01 is these are veterans, former former . Right? So in terms of

66:08 , what are we talking about In terms of american legion conference?

66:11 all oh right so then you have population and all the things that go

66:20 that right, likely underlying diseases uh these kinds of things. Okay so

66:27 what I mentioned earlier was kind of a perfect storm. Um Even though

66:30 was an atypical pneumonia, it kind became a typical one in this

66:36 Okay so again famous enough and made Time magazine cover. Uh so that

66:43 to this there really was not much about this but this operate really marauded

66:48 . And so happened at this hotel where people have died all stayed at

66:53 hotel. And so they traced it the again the the cooling tower that

66:59 the A. C After 29 people . Okay. Again I believe all

67:06 uh men mostly but and again many underlying conditions and smokers and whatnot.

67:15 um so again like with many of respiratory conditions cold flu like symptoms progressing

67:20 headaches and fever. Um you know accounts for as it says here 9%

67:28 10% of those cases each year of . Um You you can of course

67:33 can be fatal in some cases it is treatable through antibiotics. You can

67:39 detect it through engine tests. And another thing the engine tests. So

67:45 many of these uh many infectious diseases all about rapid I. D.

67:53 find it, what is it? it quickly and then and then see

67:59 how you can treat it with different . And so this is all these

68:04 or geological tests. So we have whole we have antibodies to the various

68:10 agents. So all we have to is get a sample locations and then

68:14 the antibodies to it to see if a reaction. So of course it's

68:17 specific And we can nail down exactly the pathogen is and do it relatively

68:24 . Okay and again we have this lots of different infectious diseases. And

68:30 um because it's not because obviously coach and culturing is a it takes

68:36 And so sometimes you don't have that and you need to identify rapidly.

68:41 ideological tests of all sorts are involved that that are very quick and

68:45 I mean the covid test essentially isn't test is simply an engine test and

68:50 antibody test. Um So any questions so let's look at, we're not

69:00 get a full blown into G. . Tract infections today but I just

69:03 to go to this question just as example of something that's a little bit

69:08 from your typical G. I. infection. Okay so um I might

69:15 looking at this one. So with like with respiratory infections um most gi

69:23 infections are due to viruses as Uh You probably heard you've all heard

69:27 term stomach flu. Right so viral viral G. I. Tract diseases

69:33 relatively usually not as harsh as the versions. Um But the worst effects

69:45 come from your bacterial types and protas type infections. So so for this

69:54 so let's see what we get Okay okay so um so salmonella

70:05 This e coli shigella are all types will cause food poisoning. Ah And

70:15 get it from them because you ingest water food um and they get into

70:22 system. So e coli salmonella and will you ingest those again they're they're

70:28 for withstanding your that environment because they to your stomach and withstand acid.

70:34 generally are acid target and they can that so they get in there.

70:38 colonize your intestinal track and cause disease priority doesn't cause any kind of

70:46 I. Tract infection but the winner is staphylococcus aureus. What? Okay

70:54 this guy um produces an intro Okay so the example of this guy

71:02 the potato salad at the picnic that everybody sick. Okay So when you

71:10 potato salad right or whatever. So you use your hands to peel potatoes

71:15 blah blah right? Staff do this ? Maybe while you're preparing food gets

71:21 there uh basically it's it's at room , right, bacteria grow produce toxin

71:28 behind toxin in the food you eat , you get sick. All right

71:32 staff is not built to get into gut and proliferate cos it's not built

71:38 that but the toxin is right so so it's not you get food poisoning

71:43 staff potentially not because you congested staff your gut. The toxin they left

71:49 is how you got it and it due to the preparation of food.

71:54 And getting staff on the food in first place. Try. Um That's

72:01 how we're going to today. So finish up monday with most of the

72:06 nervous system pathogens. So we'll finish gi track push it questions for I

72:20 able

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