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00:07 | wait. Mhm, mm hmm. . Okay. Um let's get |
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00:41 | So uh let's see. So today winding down of course, another couple |
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00:48 | days. So we'll come back uh next day and close out the |
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00:54 | So uh so we're gonna start today finish next monday. Different infectious |
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01:02 | got a little bit to finish up 25 which will do. And then |
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01:06 | mention a little bit about the oh in terms of kind of like deal |
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01:13 | that information, so to speak. um so due dates. So we |
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01:18 | smart work do sunday for those two and then the final one. Uh |
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01:26 | until next next thursday. Okay. the last one, chapter 26. |
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01:33 | then you know quiz because we end Monday um we don't there's no need |
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01:41 | have the quiz. Obviously would make to have it their birthday sunday. |
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01:45 | well it'll start next monday through next . So you'll have that time to |
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01:52 | to finish the unit quiz. Um so I think we're gonna start |
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02:01 | before we go. Um Any questions anything? Okay, we're gonna start |
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02:06 | a clicker question basically summarizing and It really went over last time. |
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02:12 | let's look at that here. So um um so while you're looking |
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02:20 | these over, remember that. so a little bit to finish up on |
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02:25 | , is all about the uh the and how it can overcome different uh |
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02:34 | innate and adaptive immune system defenses that talked about preceding that in chapter 23 |
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02:40 | . So um again it's going to different types of enzymes um can potentially |
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02:47 | different types of toxins. Um other that enable it to either adhere to |
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02:55 | tissues to um overcome that definitely responses . So these are kind of what |
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03:04 | summary of some of the things we've about so far. Okay. Uh |
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03:09 | so today in relation to chapter 25 extra cellular pathogens. That kind of |
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03:16 | what were some of the things they do to overcome your immune system being |
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03:22 | extra cellular pattern? So remember that can be extra cellular that can be |
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03:26 | sailor have different types of strategies and of So uh and then uh so |
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03:37 | we get into diseases shortly uh and we'll bring it all together now in |
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03:45 | of what your body does, what do and specific to different diseases |
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03:50 | Um All right, Sue for this . Okay, so as we go |
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04:09 | these parental route. So that's the definition. So that's the kind of |
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04:18 | natural pathogens into the system which is birthday surgery certainly, you know, |
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04:23 | you don't disinfect properly or antiseptic musicians properly, injection bite are also other |
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04:31 | um invasions. Those are collections of proteins that your faculty active uh types |
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04:37 | intracellular pathogens can have to get them cells. Um respiratory tract is probably |
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04:44 | most frequently. Travelport um of entry airborne transmission. Right. Uh common |
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04:54 | . You know many people catch colds the year and whatnot. So that's |
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04:58 | uh frequent portal of entry uh indo . That's a special gram negatives. |
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05:04 | course stripped Aquinas breaks down blood clots kindness is a different types that they're |
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05:12 | to be a genius specific depending on bacterium for mites that's all about |
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05:19 | And so inanimate objects acting as indirect of transmission, door knob uh contaminated |
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05:28 | , these kinds of things. Okay M protein certainly for adherents they do |
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05:32 | some other functions as well. So all of these are correct. Okay |
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05:39 | um so as we go into Bruno's that we've talked about. So here's |
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05:44 | of a checklist. This summarizing all stuff yourself we've gone through, we'll |
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05:51 | up with this part down here uh close out the section. So remember |
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06:00 | your inter sailor pathogens, they the ones are viruses. We've talked about |
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06:05 | but these are remember that that various of bacteria particularly intestinal patterns as we'll |
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06:11 | are types that can do this as way to hide from the immune system |
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06:16 | i and that has to do with collection of invasion proteins that never become |
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06:22 | and they can get inside the cell get into other cells and deep penetrate |
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06:28 | into the body. Okay so um so we finished on this last |
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06:35 | So this is this is not gonna a question again. We saw that |
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06:38 | was a fearless factor. And so the pathogens are staphylococcus aureus pattern is |
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06:48 | that can do this. It has per team a right here. We'll |
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06:52 | about it here in this slide. these are strategies that extra sailor pageants |
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06:58 | . Okay so these types do not into sales to hide out from the |
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07:03 | system. Okay um so if they're of course they're gonna be potentially more |
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07:09 | . So what well the having a . Right so if you're an extra |
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07:15 | or pathogen, what's gonna be the that you're going to deal with? |
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07:18 | antibodies coming at you um compliment coming you. Okay. Um Are the |
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07:24 | things being fake? Sensitized is another . So these are all dangers of |
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07:28 | an exercise of pathogens. So what you gonna do? Well you can |
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07:31 | compliments, You can uh you can the effect of an antibody. Okay |
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07:38 | so having a capsule, right hide antigens. Right? Hide your surface |
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07:43 | of engines uh either through put a around yourself. Right capsule basically cover |
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07:50 | your gram negative, the outer a gram positive, it'll cover your |
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07:55 | black can't layer. So you can your engine is not so detectable to |
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08:01 | adaptive immune system by doing you can make yourself less able to be fatal |
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08:06 | for the capsule. Okay so there's advantage to that. And so these |
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08:11 | of the major patterns will look at uh had very thick capsules. |
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08:18 | that's one virulence factor. They have others as well. But again hiding |
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08:24 | the immune system this way um the acid capsule in particular capsules in |
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08:32 | Our policy Sacha ride in nature typically they can have some protein parts in |
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08:37 | as well but to have a hyaluronic capsule, okay, is particularly important |
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08:45 | hyaluronic acid are components of your own . Right? That's the molecules that |
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08:51 | of bind your epithelial cells together. , connect them. And if so |
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08:58 | capsule that has this component in it not be as immunogen inc will not |
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09:04 | as detectable by your body body thinks this is a normal molecules that we |
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09:09 | . It may be okay, don't to maybe make a strong immune response |
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09:14 | it because it looks like something that's of your body. Okay, so |
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09:19 | , very sneak for the pattern to that. Okay um the protein a |
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09:26 | we just saw the picture of that . So this is a way to |
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09:30 | the effect of antibody. Right? remember that this these parts here. |
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09:36 | that's the androgen binding site. so that's going to bind would bind |
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09:41 | that will enable to cause damage. know the effects of antibody engine |
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09:47 | Right? Could be multiple multiple things occur. So if you can counteract |
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09:51 | well, remember this this side that's the fc portion. Alright. |
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09:56 | if we take that like so basically the antibody around and everybody can't do |
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10:03 | effect on the pathogen. So having coated with these protein AIDS will enable |
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10:10 | to not have the effects of the against it. Um So another strange |
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10:16 | course, is to break it apart again. So pretty excited, pretty |
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10:20 | well will destroy degrade the everybody. So nice. Syria is binding to |
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10:28 | mucous membranes is very important for that . And so by having I. |
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10:33 | I. G. A. Is in new coastal secretions to to buy |
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10:37 | it and prevent it from it So because it's regular park then you |
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10:42 | it to be able to attach to mucous membranes and cause disease potentially phase |
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10:48 | . Right? Apoptosis. So some can cause uh induce that in your |
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10:54 | cells. Something that's that program cell . Um phase variation is another way |
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10:59 | hide bandages. We saw that in 10 I think um altering the they |
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11:07 | will have multiple forms of a particular uh and uh a foot gelon for |
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11:13 | , we looked at before. Uh you can change what that looks like |
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11:17 | then then it's temporarily hidden from the . So remember that this idea of |
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11:22 | time right? Works for us. for them. Okay. We can |
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11:27 | a fever that can buy us time adaptive immune system to respond. There's |
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11:33 | slows down their growth but then our system can catch up to it. |
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11:38 | can buy time by hiding their energon being detected by the immune system. |
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11:42 | then they can then grow during that until they're found out again. So |
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11:48 | kind of idea of buying some time and two can work for both, |
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11:53 | of us at certain times. To our advantage or their advantage in |
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11:57 | cases. So um so this is this great closes out then the microbial |
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12:06 | part. Okay so as you get diseases to kind of look at, |
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12:10 | at this, look at innate immune , defenses of gadget immune system defenses |
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12:16 | virulence factors altogether. Now we look different diseases. Okay. Is there |
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12:22 | there are questions about. Okay so worried about The material. So in |
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12:31 | it's broken down by systems and we'll through it pretty much in this |
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12:36 | Uh We're we're not we're not gonna through the beginnings of this. We |
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12:41 | get all the way into their um finish that up on monday. So |
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12:48 | or less we tracked the general urinary . So basically stds and as |
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12:54 | N. S. Pathogens, we're on monday. So we'll focus on |
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12:59 | and soft tissue infections, respiratory Um a little bit about her community |
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13:07 | not that much because we talked about before But in terms of organizing this |
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13:12 | . 26 is pretty much memorizing Okay, so it's up to you |
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13:19 | you want to do this? You want to organize it in a way |
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13:23 | this table here. This is this posted that it's just it's just an |
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13:28 | . You may have a different way doing this. That's fine. |
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13:32 | you may, if you do use as a template, you will probably |
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13:36 | up getting one or two more columns . But again, just a way |
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13:40 | organize the material. Okay, there's list. Here's what to know. |
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13:46 | , um, the you know, wouldn't really get hung up on. |
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13:51 | I do mention symptoms of different infectious and I wouldn't get focused too much |
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13:56 | that because they overlap. So like and fever and then sent them from |
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14:01 | different infectious diseases. But if there's that's really just like remarkable, like |
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14:08 | tetanus producing the spasmodic muscle contractions and , of course that's a characteristic of |
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14:13 | disease. But I wouldn't worry about always this cause fever or malaise or |
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14:18 | blah. Don't worry so much about . Um, rabies has some very |
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14:24 | symptoms. So really obvious to you what's something that's that's probably gonna be |
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14:30 | because if you only see it in one particular disease. Right? That's |
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14:33 | that you probably want to make Okay. But uh, anyway, |
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14:39 | be able to separate out your which are gonna be pretty simple. |
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14:43 | virus virus. Right? Uh, wins right here here here. |
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14:51 | so point being you can't do those stains aren't applicable to those obviously. |
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14:57 | , so just make note of these of things. So, um, |
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15:03 | , and this table is posted on electric four notes. So, if |
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15:07 | want to take a look at um, Okay. So let's start |
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15:11 | this one. So noncommunicable horses communicable . Okay. So we'll begin with |
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15:20 | little of a repeat of the herd , um, process, but not |
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15:26 | not long since we're going to do before, but it does relate to |
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15:32 | community is only applicable to communicable Uh, not applicable to non communicable |
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15:43 | . Let's see. Okay. that mm hmm. It doesn't. |
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16:11 | . So, so communicable diseases, diseases are What spread person to |
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16:18 | Right. Um, you're not gonna tetanus person to person. Okay, |
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16:24 | is uh acquired to a puncture um, infected with tetanus organisms found |
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16:31 | soil. So that's how you typically tetanus. Um, but you're not |
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16:36 | spread that once you have, you're spreading it person to person. |
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16:39 | So, but certainly influenza. Covid , plague and all are all communicable |
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16:45 | transmitted from person to person. So, um, so of course |
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16:51 | answer here is tetanus. Okay. the non communicable disease. Um, |
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16:56 | so we talked about hurting the engine . Uh, remember that It's all |
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17:01 | on of course a being vaccinated be most of the people vaccinated for a |
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17:08 | infectious disease. Okay so um here this diagram, the red individuals are |
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17:19 | that are sick and contagious. Okay focus on the left side here. |
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17:25 | um this side. Okay so those blue are not vaccinated susceptible uh |
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17:38 | The yellows are vaccinated. Okay so was a uh contagious person. So |
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17:45 | person. Uh there is no uh protection many of the unvaccinated people. |
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17:54 | . Too few vaccinated people to act sinks to absorb this fact. Hence |
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18:01 | is a lot more people get Okay over here, lots of |
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18:07 | right? Lots of vaccinated people that acting as a buffer between the um |
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18:13 | contagious sick person and those that are . Okay, so a greater |
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18:18 | So what's what's that value? Have be? Okay, we saw this |
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18:23 | we saw this number these data before even at the low end for this |
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18:28 | zero value. Okay. Which is measure of measure really of kind of |
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18:33 | productivity of the infectious agent virus or . So it relates to the number |
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18:38 | people who come down with disease uh on who contracted from a contagious |
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18:45 | So 12 to 18. Right? a high value. Measles. |
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18:50 | mumps. Covid's on the low end well. But even on the low |
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18:54 | you still need to have at least quarters of the population is vaccinated to |
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18:58 | that herd immunity. Okay, so that herd means that those vaccinated people |
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19:04 | the sink to absorb infectious agents protecting people which which can happen for a |
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19:11 | of The reason. You're not gonna 100% compliance on anything. Okay. |
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19:17 | certainly not in the vaccination for a of reasons. And as mentioned |
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19:22 | At least I said a week we're not we're not close to 75% |
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19:27 | terms of vaccination against the so so that's that's what we heard community |
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19:36 | for many diseases we talked about today next week there are vaccines available for |
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19:41 | of course and so but not for . So let's look at uh skin |
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19:49 | soft tissue infections first. Okay, staff, uh staphylococcus, soap, |
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19:57 | aureus, staph epidermal cysts don't need know that one, but epidermis is |
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20:02 | common skin inhabitant. All staff are grape like clusters, gram positive, |
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20:10 | epidermis, that's really the strings of cysts are not really disease causing. |
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20:16 | a occasionally they may cause a mild , but the by and large, |
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20:23 | staph aureus is the one that's the one here. Okay. And so |
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20:28 | has of course a number of virulence . Um they can infect the typically |
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20:34 | a break in the skin abrasion of have you um they can on occasion |
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20:41 | through into the natural openings in the pores or follow hair follicles. There's |
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20:48 | types of skin infections where I think probably all aware of boils. Uh |
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20:55 | , there's another name that's very similar boils, but you can have things |
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20:59 | political itis. Um or hair follicles infected stais which has to do with |
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21:06 | eyelashes around your eyes getting infected. What else is there? Carbons I |
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21:12 | very similar to Doyle's And so this coagulates virulence factors. So there's a |
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21:19 | correlation between staph aureus strains that incorporates that are much more pathogenic or virulent |
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21:27 | our coagulates negative strength. Okay, that that correlates to a positive for |
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21:33 | . That often correlates to it's a a virulent strain. And so with |
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21:38 | basically a puncture wound or other abrasion introduce them into the skin into |
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21:44 | A boiler typically appears. It's like hard not not uncommon that not being |
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21:49 | to this, this actually coagulate creating um uh clot creating a cocoon basically |
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21:57 | the cells protecting it. Uh It fill up, you'll get some uh |
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22:04 | psychosis, innate immune response. And you'll get some proliferation of staff, |
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22:08 | get some bigger psychosis of staff fluid . So of course it swells up |
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22:13 | you get it's not it's very common have the boil has to be punctured |
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22:18 | drained in order to treat the Okay, Um toxic shock syndrome that |
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22:27 | came to prominence. I think in 80s, it's beginning it started with |
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22:33 | a particular feminine product tampon that was absorbent and um but that created an |
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22:42 | that a lot of proliferation of And so the strain produced the superannuation |
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22:49 | remembers one that causes these body wide immune response and can put the body |
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22:54 | shock. Um You still see cases it now and then but but not |
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22:59 | as much. Um. M. . Alright so Mersa uh stands for |
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23:05 | resistant staph aureus. This term here . Okay. Um now now more |
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23:15 | current term is what they call A. I anybody know what nosocomial |
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23:23 | to? Well I guess hospital, hospital acquired infections more current term is |
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23:31 | care required because because health care is just in the hospital anymore. It's |
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23:37 | clinics and home health care etcetera call kind of fall under the umbrella. |
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23:42 | point of it is is that you getting treatment for whatever really it can |
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23:48 | a sore back uh and get your scoped um something like that, you |
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23:55 | to the hospital or a clinic or you and while you're there getting treated |
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24:01 | you acquire an infection has nothing to when you went into in went into |
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24:06 | place with it, you acquired it you were there. Okay. And |
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24:10 | this is a problem especially for many um you know you know They can |
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24:16 | for around 10% of these infections occurring in cases occur in hospitals. And |
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24:22 | one of the bigger ones is staph particularly methicillin resistant types and now there's |
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24:29 | minus and resistance multi drug resistant And so you have to think of |
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24:34 | know particularly the hospital, what's it full of sick people? Right. |
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24:38 | Oftentimes elderly, right susceptible to Um Of course there's lots of disease |
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24:44 | bacteria there. Right? Uh There and the transmission occurs typically through the |
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24:51 | workers they're working on. There's something patient to patient right? Um Not |
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24:57 | black collapsing in the proper sanitary Right? Really the number one way |
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25:05 | to really reduce the levels of this acquired infections. It's a very basic |
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25:12 | what would you think it would be your hands? A constant. So |
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25:19 | workers of course your nurses and and the doctors can vote to um is |
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25:26 | constant reinforcement. Meeting weekly biweekly monthly and saying wash your hands dispose of |
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25:35 | your soiled garments and other things patients in a proper way. Okay um |
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25:43 | goes a long way to minimize this also things like um not properly using |
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25:52 | different types of medical equipment like um tubes, catheters in particular um parts |
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26:01 | put in bodies like a heart valve or a knee replacement. These kinds |
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26:05 | things. These these come as prepackaged sterilized really packed instruments and if you're |
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26:12 | open properly handled properly that can lead staph infection and and other types. |
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26:19 | it's it's really um that that's where weak point can be is in this |
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26:26 | not using sanitary procedures, these other of procedures that need to be done |
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26:30 | . Uh Nonetheless um and the so we go into different skin infection types |
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26:40 | we're gonna it's a matter the difference a matter of of depth. So |
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26:46 | can be as superficial as impetigo scalded syndrome. So you see the baby |
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26:53 | of blistering on his back just kind it can begin with like an abrasion |
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26:57 | the skin that doesn't really get cleaned treated well initially. And then it |
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27:01 | of grows and toxin here called exfoliated . Kind of creates a party upper |
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27:07 | most hilarious of skin. So it's a deep infection but certainly noticeable impetigo |
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27:13 | often associated with uh kids and daycare were all little kids aren't the most |
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27:20 | individuals. So scratching themselves. That of thing can cause rashes on their |
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27:26 | typical of impetigo. And they were superficial layers and as we get into |
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27:33 | quickly start to caucus infections of the . Now you can get deeper and |
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27:37 | and deeper. Okay so things like syphilis and um necrotizing fasciitis. And |
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27:44 | we're having more and more deeper penetration the skin layers and of course the |
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27:50 | to to to penetrate into the skin depends on the bureau since factors |
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27:55 | The high ironic days coagulates is your in aces. These are all things |
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28:00 | I'm able to penetrate deeper and Okay, so of course, or |
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28:05 | that we've seen before has an arsenal growth factors. And you know, |
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28:12 | , no one staph aureus pageant will necessarily have all of these, but |
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28:18 | have a collection of them and the they do have will determine how rarely |
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28:23 | will be entirely. Um but certainly has a uh an arsenal of |
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28:31 | factors. Okay, we saw that already. So streptococcus species, there's |
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28:36 | be some overlap. So there's there's similarity in terms of the types of |
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28:40 | factors, particularly with these hyaluronic basescu , that kind of stuff. But |
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28:45 | historically strip is classified through these um reactions on blood dog. Okay. |
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28:53 | they of course are also grand positive they're in chains. So hence the |
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28:57 | strep toe, but there are variations um streptococcus pneumonia is primarily in |
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29:04 | Okay. Uh but nonetheless, so mollison's or what break apart red blood |
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29:10 | . Okay. And so um complete Asus Shut up here somebody. It's |
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29:18 | of cute. And did the cotton dipped into strep and drew a |
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29:24 | you see clearing his own green alpha icis that's partial Hamal icis. Okay |
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29:32 | so it turns green because of oxidation the hemoglobin. Okay, here is |
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29:39 | color. I have a whitish color blood sugar. That's the gamma |
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29:44 | But all three groups have pathogens in . So just because they don't show |
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29:50 | doesn't mean they're not pathogenic. Um And so G. A. |
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29:55 | . Stands for group A strip. another historical term papaya chinese is a |
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30:03 | virulent strain that many of these can multiple diseases, multiple types of skin |
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30:09 | , strep throat as well familiar Um And so if you look at |
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30:15 | groups together here, Okay and kind the major ones. So streptococcus you |
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30:22 | is one that causes um uh it's oral it's part of your oral microbiome |
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30:29 | it can cause cavities. Um You form biofilms. The plaque you feel |
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30:34 | your teeth is from typically from this . Um oral dental procedures like getting |
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30:41 | tooth pulled or losing people, things that, a root canal. Uh |
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30:46 | connections because of potential exposure of them the rest of your body and get |
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30:50 | um into the bloodstream. Endocarditis occurs they attached to like heart valves. |
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31:00 | they will grow from a biofilm and interfere obviously with the function of the |
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31:05 | , causing inflammation of the lining of heart. Okay um the other the |
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31:12 | pneumonia will talk about that in the of respiratory infections um of course cause |
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31:19 | . It's the second leading cause of right behind my syria meningitis. Uh |
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31:26 | attorneys will talk about it shortly. diseases it causes uh and enterococcus um |
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31:33 | is different from the others and that causes actually A G. I. |
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31:38 | infection. So it's an intestinal Okay so um the various factors we |
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31:48 | about in protein and these others So looking at um is again in |
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31:56 | context of respiratory infections because we classify throat as an upper respiratory infection. |
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32:02 | so we'll talk about it there But here is focused on rheumatic |
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32:07 | This is a this is a cross effect. So um antibodies we saw |
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32:15 | before way back in talking about Jenner smallpox vaccine. Okay so he created |
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32:23 | smallpox vaccine notice made from cowpox. so cowpox a benign doesn't cause disease |
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32:28 | humans. Safe choice for a vaccine it still produces an immune response toward |
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32:35 | antibodies that will attack smallpox. Okay it's a cross reaction. So similarly |
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32:42 | um rheumatic fever is uh you may had a strep throat in your in |
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32:47 | body produce antibodies to the organism specifically the M. Protein. Okay. |
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32:54 | those antibodies, the M protein engine chemically very similar to um your heart |
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33:03 | proteins and also to um uh connective proteins that are in your joints. |
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33:10 | so you get you get somewhat of autoimmune response here. So the antibodies |
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33:15 | produced the M protein due to this will then also cross react potentially with |
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33:22 | muscle and or connective tissue and joints pain obviously. So uh so that |
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33:29 | that is uh potentially an issue. so we called the name for this |
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33:34 | what's called so a secondary immune The primary one is antibodies to the |
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33:42 | . The m protein. Secondary Oh some of those anybody's not cross |
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33:46 | to some of your tissues. Okay so or sequel. Right um the |
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33:56 | precipitous and advertising fast. So here depths of infection. Okay so you're |
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34:03 | so whereas impetigo um uh scalded skin and various superficial layers. Now we're |
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34:12 | below that. So dermal layers is syphilis, necrotizing fasciitis. So you |
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34:17 | see here so this is the recipients top. Okay um down here now |
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34:23 | penetrating down into the bone, that right there um And again the the |
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34:29 | of infection based based on what are virulence factors it possesses? What type |
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34:35 | and both knees can start with abrasions That left untreated can become something that's |
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34:43 | . Okay it's all about what what the types of toxins and toxins out |
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34:48 | tissue. Um These other enzymes are to penetrate deeper into the tissue. |
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34:54 | it's really a types of various factors possessed. Okay that will determine you |
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35:01 | how bad this infection can get. um Okay um any questions this point |
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35:10 | uh what does it mean when it uh emperor facilitated adherence protein. Oh |
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35:20 | . Okay yeah so m protein has dual functions that can act as a |
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35:26 | to bind two cells. Um Plus has also has the effect of being |
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35:32 | to inactivate compliment too. So it kind of do both things. So |
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35:37 | is the truth enabling it to? for streptococcus pneumonia is important for it |
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35:43 | um adhere to your respiratory tract So that's the m protein helps helps |
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35:49 | to do that attachment attachment to you're to your mucous membrane really for the |
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35:57 | part. But these guys any Yeah so let's look at this |
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36:07 | It's kind of a general question Um Keep this over. Okay so |
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36:17 | hmm. Back this way. Alright we go. So respiratory infections, |
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36:22 | respiratory infections and G. I. infections are what in nature? Mm |
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37:01 | . Mhm. Alright let's see. they are in fact viral in |
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37:14 | Most most respiratory tract infections most gi infections tend to be viral and tend |
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37:21 | be less severe than the bacterial Okay um uh The worst effects of |
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37:30 | . I tract infections are typically due certain bacterial types. Um The also |
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37:37 | respiratory infections, the worst affected typically pneumonia is caused by bacteria. Okay |
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37:43 | so let's uh here so we're gonna this down into upper and lower respiratory |
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37:52 | infections. Okay. Very common is a initial viral infections. They |
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37:58 | Okay. To then be preceded by more than to be followed by uh |
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38:05 | infection. Secondary infection that's much So pneumonia uh is much worse than |
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38:12 | they have flu typically. And so there are some reasons for that that |
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38:17 | get into. So here we go with streptococcus diogenes and strep throat. |
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38:24 | ? So consider that an upper respiratory infection, the fancy name is fair |
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38:28 | itis for that bright red throat. It uh strep throat can actually lead |
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38:36 | some of these other conditions like scarlet or rheumatic fever. Um The scarlet |
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38:44 | itself is rarely fatal. It's a If you see it, it's gonna |
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38:52 | typically being Children less than 10 years . Um it's not common at all |
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38:57 | see it in Children older than Um What's it's more frightening looking at |
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39:03 | else, it's preserved. It's really red color in the individual. The |
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39:11 | occurs through this toxin that x on capillaries to dilate them, right? |
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39:17 | when you dilate blood vessels, they're gonna get closer to the skin |
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39:21 | it's gonna get this red splotchy kind color. And so with scarlet |
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39:26 | it's a really bright red type of . And so uh those that get |
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39:30 | and people can be alarmed when they it, but like I said |
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39:34 | you could just get over it and doesn't amount to anything more serious than |
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39:40 | . Um the diphtheria though. Uh so much a danger now that we |
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39:46 | see up kicks here and there across country again, that's depending on vaccination |
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39:53 | , but certainly just accept 80 80 ago, 90 years ago. it |
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40:01 | deadly among Children for sure. And it was one of the probably one |
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40:06 | the first cases of showing the value vaccination because literally probably within a very |
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40:14 | time frame of introducing the vaccine for theory that the cases dramatically dropped. |
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40:21 | . Um The bacterium bacterium is one these we called opium or fix, |
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40:27 | no really kind of uniform shape to . It has like branching forms with |
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40:32 | club shaped forms. Uh it happens it's the way it divides crazies on |
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40:40 | . It is aerobic and uh picture and shows kind of the oddball shapes |
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40:48 | thing has in fact um So immunization course where I used to be a |
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40:55 | killer of Children. Mathletes rocked and still is fairly low for the most |
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41:00 | through the vaccination. So this vaccine a 33 effects. So these were |
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41:07 | theory of T. Is for tetanus Okay. Um and it's against the |
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41:14 | . All three of these produced Okay. Um so the theory of |
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41:21 | starts as like like many respiratory tract , they started kind of like with |
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41:25 | like symptoms that are relatively not so . Uh They can get to fever |
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41:31 | and progress downhill from there. Um characteristic of diptheria is a pseudo |
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41:38 | Okay, So what happens is so theory is it's kind of in the |
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41:43 | of the throat and when it begins it affects it will then begin to |
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41:49 | toxins. Okay. And the toxin one that inhibits protein synthesis. So |
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41:55 | will kill the cells. You then get that action combined with your body's |
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42:02 | inflammatory response will produce a lesion in back of the throat. And that |
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42:08 | will fill up then with clotting factors kind of heal it. So you |
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42:12 | a company from clotting factors that begin form the fiber network and that traps |
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42:18 | those diphtheria bacteria that are alive and right? So it becomes this network |
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42:24 | that's what it looks like when it big enough, is a pseudo membrane |
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42:27 | the back of the throat. And can enlarge enough to where it can |
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42:33 | breathing. Okay, people have died they couldn't breathe with the size of |
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42:38 | pseudo membrane. Um I don't know it's that easy just to cut it |
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42:43 | . Okay. But nonetheless it is characteristic of this of this disease, |
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42:50 | um it is treatable with antibiotics if does acquire it if they have not |
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42:55 | vaccinated. Um But you want to rather quick about it because toxin can |
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43:03 | know, get into your blood and throughout your system and that's when serious |
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43:08 | can occur organ failure and things like because um we'll talk about this vaccine |
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43:15 | here in a second in the context of p because this vaccine like other |
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43:23 | change over time as we as we to make them better. Uh And |
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43:29 | was one of them that that Uh We changed this not too long |
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43:34 | . Um So with cutaneous diphtheria not anything you know about that. It's |
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43:39 | it's a relatively very mild cousin to diphtheria. Um does not cause any |
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43:46 | of serious disease that the respiratory form . But you can on occasion see |
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43:53 | infection form of this disease. Um Tonight the lower respiratory tract infection |
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43:59 | pertussis called whooping cough because the characteristic makes when they have the full blown |
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44:09 | . Very characteristic sound um supported tele a cocktail bacillus is used that for |
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44:18 | that are kind of really short Not not spherical but almost kind of |
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44:24 | just short rods. And uh so gram negative. It's the thing that |
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44:29 | with is this mucus Salieri escalator. so that's one of your primary innate |
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44:36 | system defenses for your respiratory tract. and so remember Celia. So you |
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44:43 | see if you look down in the you'll see Celia and they they emanate |
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44:49 | these cells that produce them and this movement in conjunction with mucus that's produced |
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44:58 | keep out particulates and microbes and things getting into your lungs. Okay so |
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45:03 | very important defense function. So you this working, You want it needs |
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45:09 | be moving you want the mucus And mucus needs to be at the right |
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45:14 | say viscosity thickness, right? To optimally. Um And so they're meant |
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45:19 | work, work together. Okay? with whooping cough, it's again multiple |
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45:26 | producer. Uh There's a couple of to it 11 of the stages produces |
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45:31 | trachea toxin which will basically kill the itself. Okay, see then you're |
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45:37 | lack that function later on. Pertussis becomes systemic. So it will I |
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45:43 | it also interferes with protein synthesis causing death. Um It's occurs in |
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45:51 | So again cold like symptoms in the uh what we call the Kotaro |
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45:58 | which may be the last for about week, a week to two |
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46:01 | Um but during that time bacterial proliferation toxin is accumulating and you're beginning to |
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46:10 | off. Well you don't really see full blown effects yet in this stage |
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46:15 | to accumulate toxins and to kill these cells off. Okay, now we're |
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46:21 | paroxysmal stage which can last for month and a half, two |
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46:26 | Um Now you're you're seeing the football of the toxin having done the |
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46:32 | Okay, so you can imagine you know, your cilia and there |
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46:37 | moving. So you're trying to accumulate accumulates and you're trying to breathe |
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46:45 | And so you have these violent coughing . Okay, so the danger is |
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46:50 | um in in infants very young Children infants. So as they're coughing, |
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46:58 | ? Of course, the biggest part the baby infant is his head. |
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47:02 | ? And so when it's confident buying this, you can't really control, |
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47:05 | know, the head movements can cause cause damage to the brain. You |
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47:10 | have neurological impairment as a result of violent shaking we're doing as a baby's |
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47:17 | . So um so it can be with antibiotics, okay? And um |
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47:25 | it takes a while to recover. can imagine if you're having to, |
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47:29 | know, basically cross you can that's going to take a toll on |
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47:36 | body. Of course it's gonna take while to recover from that. Not |
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47:40 | for it to take four or five six months to completely recover from the |
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47:46 | . So um so of course I can't prevent all this. And |
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47:53 | the newer the name is actually now T. Damn. Okay. That's |
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48:02 | current version. So back in 2012 was a peak significant people In the |
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48:10 | the instances of whooping cough in Children age 12 or 13. Okay. |
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48:17 | I looked into this and they so these kids would have been about |
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48:22 | or six years post vaccination. Or at least post booster shot. |
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48:30 | . And so they looked closer at and found that the community from the |
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48:34 | was kind of waning, You after about five or six years |
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48:37 | E. The age of 12 or . And uh those kids became susceptible |
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48:44 | the top. And so um so forced them to to really take a |
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48:48 | at the vaccine and reprove the vaccine to make it more amina genic. |
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48:56 | so uh to activate more of the system from many of those memory cells |
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49:01 | . And so um when they did that that proved to be much more |
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49:07 | . And so we haven't seen this almost 10 years ago now. We've |
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49:11 | now that it's dropped and it's kind maintained that low number. So that |
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49:17 | happen with any vaccine. You can why you constantly that's why you |
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49:20 | one of the things as we go these infectious diseases uh by law these |
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49:27 | to be reported. Okay. Which that we have a huge you know |
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49:32 | bank up of of the number of of all infectious diseases. So we |
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49:36 | see these kinds of trends and see going on and geographically is there something |
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49:41 | on geographically? Why what's what's so ? It's kind of all the realm |
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49:46 | epidemiology. Right. For those that interested. There's a weekly report that |
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49:52 | out. I called him mm. . R. That stands for morbidity |
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50:01 | mortality. Weekly report. And that collates all the cases and and numbers |
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50:07 | types of infectious diseases particularly the End issue gives you a whole summary |
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50:12 | the previous year instances of disease and infectious diseases. A number of cases |
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50:17 | cetera. Um You may find it but mm mm wr so and it |
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50:25 | breaks it down not just across the . S. But also by state |
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50:29 | well. I think they kind of feel for the geography of different where |
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50:32 | see more infectious diseases in one spot another that kind of thing. So |
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50:38 | now okay so continue on with lower tract infections pneumonia. So pneumonia is |
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50:48 | uh not particularly a specific it's a of course but it's not attributable to |
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50:57 | certain pathogens. Many things can cause million. Just like many things can |
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51:01 | gi tract infection. Okay um viral uh I think there's certainly some protozoa |
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51:10 | in there. There may even be fungi in there that could cause the |
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51:13 | . Okay so but number one in list of course is streptococcus pneumonia. |
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51:21 | um you can have violent among us well. It is not as |
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51:26 | Now, pneumonia is very common to as a secondary infection. Okay. |
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51:35 | that let's say let's say you have flu. Okay and the fluid forces |
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51:42 | . You can't really take any you get you can't taking the drugs that |
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51:50 | help you other than to treat So you kind of write it |
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51:54 | Okay get over it. Um What is the one thing you're told or |
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52:02 | do? Why you if you had food. What what should you what |
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52:05 | you take in on a regular basis you have the flip one thing. |
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52:13 | , fluids. Yeah. Alright, fluids. They say hydrate yourself. |
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52:16 | yourself well hydrated. So I can't for you all. But most of |
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52:22 | don't I don't typically drink enough So especially when if I would have |
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52:28 | flu, I probably wouldn't drink And that can affect have effects on |
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52:32 | mucous. I talked earlier about the viscosity. Right? So that can |
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52:37 | an effect. You get dehydrated that have an effect on that. And |
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52:40 | your mucus, the mucus and the will work together. But if the |
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52:44 | is too thick, right? Because dehydrated, well then that consistency doesn't |
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52:49 | very well with the syria. Uh so that's when a motive can |
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52:57 | in as a secondary infection. And uh streptococcus pneumonia is found in healthy |
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53:04 | . Right? Remember the reservoir, ? For this is humans. And |
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53:09 | um uh so you can become susceptible you have this condition where you had |
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53:15 | flu when you get dehydrated and you quick enough and then your immune system |
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53:19 | function is not as good as it be. And so pneumonia. So |
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53:25 | call this because in the next disease what we call it a typical |
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53:31 | Think of it. This is what would call typical typical pneumonia. |
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53:36 | Typical pneumonia is much more severe. is not uncommon to require hospitalization. |
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53:43 | . To give you fluids and treatment and things. Okay. What happens |
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|
53:49 | so um number one pneumonia has a thick capsule. Okay um it will |
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53:57 | into your lungs. Your lungs actually some nutrient rich fluid that coats to |
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54:05 | um Your physiology right? The trachea gets have more and more branches |
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54:12 | And at the end they have these tiny air sacs right now B. |
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54:15 | . I. And so it's fluid bathes those would be a lie. |
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54:19 | can be somewhat nutrient rich and so gets in there and begin to |
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54:24 | Okay you have macrophages that are kind wandering around in there. Okay actually |
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54:29 | fixed macrophages that are kind of patrolling lungs. Uh They'll take as the |
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54:35 | that will trigger the whole tl our and cytokines and inflammatory response. Of |
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54:40 | . Right so now uh you'll get into the site. Okay? They're |
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54:46 | squeeze out through the blood, And what happens is your lung fills |
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54:51 | with fluid. Now okay so you um uh this this this jumble of |
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54:58 | pneumonia i cells of neutrophils. fluid building up in there and that's |
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55:06 | critical imperative ability to breathe right shortness breath etcetera. Um It's it's it's |
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55:13 | uncommon to have the infection in Low to the law. So they |
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55:17 | this low bar pneumonia. It's either or right side. Typically not |
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55:23 | Um But the uh so this reaction your body information that fluid lungs can |
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55:29 | to uh difficulty breathing. Okay. that's that's when it typically requires getting |
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55:36 | hospitalization to get your fluids to get likely on the breathing, getting oxygen |
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55:42 | , antibiotics to clear it up and that hospitalization can last for a few |
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55:48 | in some cases. So um um of course the the if you don't |
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55:54 | it then even if you do, the potential is there that it could |
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55:57 | travel to your brain and cause Because it is it's it's it's number |
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56:04 | and not that far behind Neisseria. is the cause of most cases of |
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56:10 | . Um It was a vaccine Um The vaccine though is really just |
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56:16 | people my age 50' over. I think they really recommended for those younger |
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56:24 | usually with a healthy interest and you bite this off. But again, |
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56:29 | will work as well. Kind of is still the one of choice, |
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56:34 | there are resistant types of course. uh so this is this is typical |
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56:41 | a typical pneumonia. Okay, uh . The next one up is what |
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56:47 | call atypical pneumonia. Check. Um questions about this? Yeah. So |
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56:54 | this is a secondary infection, what people usually precaution against being in the |
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57:02 | ? Why do they usually what? the general precaution like for being |
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57:12 | I don't know, I totally disagree that. That being on the cold |
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57:17 | not mean you're gonna get pneumonia. are you waiting? No, it |
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57:21 | matter. That's a myth. That an absolute myth. Absolutely. |
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57:26 | And my mother told me that for I believe there until I got a |
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57:29 | in microbiology. Yeah. Yeah. . Get being on a cold wet |
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57:38 | . It does not matter at It doesn't matter at all. |
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57:42 | So I guess the way I guess weight from Brent pneumonia is just, |
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57:50 | . Yeah. Yeah exactly. Yeah you have if you have a cold |
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57:54 | back hold of flu then yeah do best to kind of drink lots of |
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57:58 | and that kind of thing. Ah exactly. Yeah. Yeah. Question |
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58:06 | stuff. Um Yeah so being a pathogen uh and and you know proximity |
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58:15 | somewhat to the central nervous system. upper respiratory tract infection more so but |
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58:19 | so um if it progresses um from uh they can you know be in |
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58:27 | proximity to the lbl I. And the calculators that are there that they |
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58:32 | potentially enter the blood there and they to your C. N. |
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|
58:35 | Okay. And so that's the key something that causes meningitis is to get |
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|
58:39 | your C. N. S. some route. And so blood is |
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58:44 | common way. Um But it depends the balance factors they have. We'll |
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58:50 | into that on monday when we talk meningococcal meningitis but yeah it's it's getting |
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58:59 | for it. It likely gets into blood and then gets into the |
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59:05 | Um the Okay, So regarding the presented thus far, what would be |
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59:13 | reservoir of those diseases? And they been, let's see. So skin |
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59:21 | , streptococcus, staphylococcus. Let me that. Sorry. Um, what |
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59:31 | ? We have diptheria? We've had , pneumonia. So the whole lot |
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59:40 | last year. Um, I think everything so far so reservoir for |
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|
59:55 | And uh, can I give you hint? It's it's not animals. |
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60:03 | . Yeah, technically two answers. huh. Mm hmm. Let's answer |
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60:16 | . You can convince me. Okay. So I assume you put |
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60:40 | , what's your other choice? the droplets from drop, it prefers |
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60:46 | drop it. It spread is from coughing sneezing when individual colleges or sneezes |
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60:52 | approximately to somebody else. That's the transmission because it's technically correct and not |
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60:58 | to see uh it's not water at . It's, yeah, you wouldn't |
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61:04 | you're saying that the water from a is what primarily makes up the droplet |
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61:08 | reclaim that. Yeah. Yeah. , it's more like an aerosol. |
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61:14 | Yeah. Yeah. Um, so is humans, humans uh, for |
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61:21 | we looked at so far, the one is um but each note is |
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61:29 | in across the environment. Water, water more more more mostly. Um |
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61:36 | again atypical type of pneumonia. So is um so atypical pneumonias aren't typically |
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61:43 | aren't as serious, don't require You might have heard the term um |
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61:49 | pneumonia that's usually associated with atypical Okay and this is one of those |
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|
61:56 | there was a severe outbreak of this really brought this disease to prominence. |
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62:03 | kills like around 29 people. But was kind of like a perfect storm |
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62:08 | I'll get to here in a But um so legionnaire's disease, legionella |
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62:18 | , sorry is a is found as interest cellular organism inside amoebas typically. |
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62:26 | so amoebas are for the most part water uh inhabitants. Okay and so |
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62:33 | find some freshwater sources all across the . Okay. And uh so as |
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62:40 | as the faculty active interest sailor Okay so it's one of those that |
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62:44 | also induce the same thing in Okay so we can you have the |
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62:51 | and then promote getting engulfed by one yourselves and taking it. Okay So |
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62:56 | is um uh is this motel has single flagellum um gram negative rods. |
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63:06 | uh so you're yourself types, it's they typically get into um Now how |
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63:13 | do you acquire this? Okay most almost every instance I see when I |
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63:21 | it up of legionella or legionnaire's disease associated with being in a hotel being |
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63:29 | hot tub or pool. Okay so often in the hotel and it has |
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63:37 | do with the H. Vac The system that handles the ventilation the |
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63:43 | A C. Okay so in a a unit uh for for providing cool |
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63:53 | is different from what you know they you have in your house. Okay |
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63:59 | they involve a water tower. So all about really it's all about heat |
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64:03 | . Okay? And so you have water tower, you have evaporation of |
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64:06 | in the tower and you have a air that's also some area that's through |
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64:12 | . And so you have the water and then uh forms aerosols providing cool |
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64:19 | and then travels through the hotel or the structure is. And the issue |
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64:25 | when the water in the cooling tower become contaminated. Okay? Uh Typically |
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64:32 | water towers are not cleaned well enough disinfected regularly and so you get this |
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64:39 | accumulating that can have that can carry amoeba carry legionella. Okay. So |
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64:46 | so here's just a snippet of some the things that is from 2019 But |
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64:52 | looked at it in 2020 and 2021 you can see here and there across |
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64:55 | country outbreaks like this. Not necessarily of people in all cases, But |
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65:02 | some cases yes, but you can underlying read the common thing, your |
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65:06 | tub, water system, cooling tower and hot tub. Okay so um |
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65:13 | the uh and so in 1976. that was you weren't I presume you |
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65:22 | born then. Okay. But I 1976. That was humongous year and |
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65:27 | was a humongous year because it was 200th anniversary of The signing of the |
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65:36 | of independence. Right so July 1976 was humongous. Everything was leading |
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65:41 | to that. Okay? Um Ask parents or grandparents. And so um |
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65:49 | summer I think this is part of july. Um There was a |
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65:55 | there's lots of conventions going on So american legion convention. So american |
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66:01 | is these are veterans, former former . Right? So in terms of |
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66:08 | , what are we talking about In terms of american legion conference? |
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66:11 | all oh right so then you have population and all the things that go |
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66:20 | that right, likely underlying diseases uh these kinds of things. Okay so |
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66:27 | what I mentioned earlier was kind of a perfect storm. Um Even though |
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66:30 | was an atypical pneumonia, it kind became a typical one in this |
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66:36 | Okay so again famous enough and made Time magazine cover. Uh so that |
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66:43 | to this there really was not much about this but this operate really marauded |
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66:48 | . And so happened at this hotel where people have died all stayed at |
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66:53 | hotel. And so they traced it the again the the cooling tower that |
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66:59 | the A. C After 29 people . Okay. Again I believe all |
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67:06 | uh men mostly but and again many underlying conditions and smokers and whatnot. |
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67:15 | um so again like with many of respiratory conditions cold flu like symptoms progressing |
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67:20 | headaches and fever. Um you know accounts for as it says here 9% |
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67:28 | 10% of those cases each year of . Um You you can of course |
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67:33 | can be fatal in some cases it is treatable through antibiotics. You can |
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67:39 | detect it through engine tests. And another thing the engine tests. So |
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67:45 | many of these uh many infectious diseases all about rapid I. D. |
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67:53 | find it, what is it? it quickly and then and then see |
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67:59 | how you can treat it with different . And so this is all these |
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68:04 | or geological tests. So we have whole we have antibodies to the various |
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68:10 | agents. So all we have to is get a sample locations and then |
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68:14 | the antibodies to it to see if a reaction. So of course it's |
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68:17 | specific And we can nail down exactly the pathogen is and do it relatively |
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68:24 | . Okay and again we have this lots of different infectious diseases. And |
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68:30 | um because it's not because obviously coach and culturing is a it takes |
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68:36 | And so sometimes you don't have that and you need to identify rapidly. |
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68:41 | ideological tests of all sorts are involved that that are very quick and |
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68:45 | I mean the covid test essentially isn't test is simply an engine test and |
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68:50 | antibody test. Um So any questions so let's look at, we're not |
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69:00 | get a full blown into G. . Tract infections today but I just |
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69:03 | to go to this question just as example of something that's a little bit |
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69:08 | from your typical G. I. infection. Okay so um I might |
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69:15 | looking at this one. So with like with respiratory infections um most gi |
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69:23 | infections are due to viruses as Uh You probably heard you've all heard |
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69:27 | term stomach flu. Right so viral viral G. I. Tract diseases |
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69:33 | relatively usually not as harsh as the versions. Um But the worst effects |
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69:45 | come from your bacterial types and protas type infections. So so for this |
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69:54 | so let's see what we get Okay okay so um so salmonella |
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70:05 | This e coli shigella are all types will cause food poisoning. Ah And |
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70:15 | get it from them because you ingest water food um and they get into |
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70:22 | system. So e coli salmonella and will you ingest those again they're they're |
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70:28 | for withstanding your that environment because they to your stomach and withstand acid. |
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70:34 | generally are acid target and they can that so they get in there. |
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70:38 | colonize your intestinal track and cause disease priority doesn't cause any kind of |
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70:46 | I. Tract infection but the winner is staphylococcus aureus. What? Okay |
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70:54 | this guy um produces an intro Okay so the example of this guy |
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71:02 | the potato salad at the picnic that everybody sick. Okay So when you |
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71:10 | potato salad right or whatever. So you use your hands to peel potatoes |
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71:15 | blah blah right? Staff do this ? Maybe while you're preparing food gets |
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71:21 | there uh basically it's it's at room , right, bacteria grow produce toxin |
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71:28 | behind toxin in the food you eat , you get sick. All right |
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71:32 | staff is not built to get into gut and proliferate cos it's not built |
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71:38 | that but the toxin is right so so it's not you get food poisoning |
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71:43 | staff potentially not because you congested staff your gut. The toxin they left |
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71:49 | is how you got it and it due to the preparation of food. |
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71:54 | And getting staff on the food in first place. Try. Um That's |
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72:01 | how we're going to today. So finish up monday with most of the |
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72:06 | nervous system pathogens. So we'll finish gi track push it questions for I |
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72:20 | able |
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