1
Q
when will a disease be considered “emerging”
A
- haven’t occurred in humans before
- have occurred before but only in small numbers of people in isolated places
- have occurred throughout human history, but have only recently been recognized as distinct diseases resulting from an infectious agent
2
Q
what is an example of an emerging disease that have occurred throughout human history, but have only recently been recognized as distinct diseases resulting from an infectious agent
A
sleeping sickness
3
Q
what is an example of an emerging disease that haven’t occurred in humans before
A
covid-19
4
Q
what is an example of an emerging disease that have occurred before but only in small numbers of people in isolated places
A
- AIDS
- ebola hemorrhagic fever
5
Q
what are re-emerging diseases
A
- Historically major health problems globally or in a particular country
- declined dramatically
- and are again becoming health problems
6
Q
what are some likely characteristics of emerging pathogens
A
- likely zoonotic
- likely have a broad host range numerous mammal and non-mammal species
- can be any pathogen group but viruses are overrepresented and ~40% are RNA viruses
- many fall within CDC category C
7
Q
what is the most abundant emerging pathogen goup
A
- RNA viruses
- 40%
8
Q
what are the factors influencing re-emergence of human pathogens ranked
A
- changes in land use/ agricultural practices
- changes in human demographics + society
- poor population health
- hospitals and medical procedures
- pathogen evolution like drug resistance/ more virulence
- contamination of food sources/ water supplies
- international travel
- failure of public health programs
- international trade
- climate change
9
Q
what are some re-emerging diseases
A
- cryptosporidiosis
- diphtheria
- malaria
- meningitis, necrotizing fasciitis, TSS, other
- pertussis (whooping cough)
- rabies
- rubeola (measles)
- schistomomiasis
- tuberculosis
- yellow fever
10
Q
the infectious agent Cryptosporidium parvum is what kind of agent, and what disease does it cause
A
- protozoa
- cryptosporidiosis
11
Q
what are the contributing factors leading to the re-emergence of cryptosporidiosis
A
- inadequate control in water supply
- international travel
- increased use of child-care facilities
12
Q
the infectious agent corynebacterium diptherie is what kind of agent, and what disease does it cause
A
- bacterium
- diphtheria
13
Q
what are the contributing factors leading to the re-emergence of diphtheria
A
interruption of immunization program due to political changes
14
Q
the infectious agent Plasmodium species is what kind of agent, and what disease does it cause
A
- protozoon
- malaria
15
Q
what are the contributing factors leading to the re-emergence of malaria
A
- drug resistance
- favourable conditions for mosquito vector
16
Q
the infectious agent group A streptococcus is what kind of agent, and what disease does it cause
A
- bacterium
- meningitis, necrotizing fasciitis, TSS, other
17
Q
what are the contributing factors leading to the re-emergence of meningitis, necrotizing fasciitis, TSS, other
A
- uncertain
- sometimes we just never acc know
18
Q
what are the contributing factors leading to the re-emergence of pertussis (whooping cough)
A
- refusal to vaccinate based on fears its not safe
- or decreased vaccine efficacy
- or waning immunity among vaccinated adults
19
Q
the infectious agent Bordetella pertussis is what kind of agent, and what disease does it cause
A
- bacterium
- pertussis (whooping cough)
20
Q
the infectious agent rhabdovirus group is what kind of agent, and what disease does it cause
A
- virus
- rabies
21
Q
what are the contributing factors leading to the re-emergence of rabies
A
- breakdown in public health measures
- changes in land use
- travel
22
Q
the infectious agent Morbillivirus genus is what kind of agent, and what disease does it cause
A
- virus
- rubeola (measles)
23
Q
what are the contributing factors leading to the re-emergence of rubeola (measles)
A
- failure to vaccinate
- failure to receive 2nd vaccine dose
24
Q
what are the contributing factors leading to the re-emergence of schistosomiasis
A
- dam construction
- ecological changes favouring snail host
24
the infectious agent *schistosoma species* is what kind of agent, and what disease does it cause
- helminth
- schistosomiasis
25
the infectious agent *mycobacterium tuberculosis* is what kind of agent, and what disease does it cause
- bacterium
- tuberculosis
26
what are the contributing factors leading to the re-emergence of tuberculosis
- antibiotic-resistant pathogens
- immunocompromised populations
27
the infectious agent *flavivirus group* is what kind of agent, and what disease does it cause
- virus
- yellow fever
28
what are the contributing factors leading to the re-emergence of yellow fever
- insecticide resistance
- urbanization
- civil strife
29
which emerging pathogens were noted by the CDC in 2015 that need immediate research and development
1. Crimean-Congo haemorrhagic fever
2. Filovirus diseases (EVD and Marburg)
3. Highly pathogenic emerging Coronaviruses relevant to humans (MERS Co-V and SARS)
4. Lassa Fever
5. Nipah
6. Rift Valley Fever
7. Other serious diseases: chikungunya, severe fever with thrombocytopenia syndrome, and zika virus
30
when the CDC made their list of prioritizing emerging pathogens, what elements were considered
1. Human transmissibility
2. Severity or case fatality rate
3. Spillover potential *(i.e., alternate hosts/reservoirs)*
4. Evolutionary potential *(i.e., does it change)*
5. Countermeasures *(e.g., antibiotics or vaccines)?*
6. Difficulty of detection or control
7. Public health context of the affected area(s)
8. Potential outbreak scope *(i.e., risk of INTL spread)*
9. Potential societal impacts
31
what other pathogens did the CDC look at when coming up w their priority list *and why werent they added*
- HIV
- influenza
- tuberculosis
- malaria
- dengue
- smallpox/ monkeypox
- *disease control initiatives already established, R&D, and funding established*
32
what tools did the CDC develop to evaluate diseases for accelerated R&D
- improve diagnostics
- vaccines/ other med counter measures
- therapeutics
33
SARS-CoV-2 is the _____ coronavirus known to infect humans
7th
34
what does SARS stand for
severe acute respiratory syndome
35
which coronaviruses cause severe disease
- SARS-CoV
- MERS-CoV
- SARS-CoV-2
36
which coronaviruses cause mild disease
- HKU1
- NL63
- OC43
- 229E
37
describe the structure of SARS-CoV-2
- enveloped beta-coronavirus
- viral envelope is coated by spike glycoproteins, envelope, and membrane proteins
- ssRNA genome
38
what other coronaviruses is SARS-CoV-2 similar to
- SARS-CoV-1 (80%)
- bat coronavirus RaTG13 (96.2%)
- *suggests animal origin*
39
how large is the SARS-CoV-2 genome
about 30k nucleotides
40
what is the first step in SARS-CoV-2 infection
virus binding to a host cell through its target receptor
41
how is host cell binding + entry mediated w SARS-CoV-2
- **by the S protein**
- S1 subunit of S protein contains the receptor binding domain that binds to the peptidase domain of ACE2
42
what does ACE2 stand for
angiotensin-converting enzyme 2
43
how does SARS-CoV-2 work
- virus binds to ACE2 and TMPRS2 on the cell surface
- will be expressed in the airway epithelial cells + vascular endothelial cells
44
why does SARS-CoV-2 have pandemic potential
- higher transmission relative to SARS-CoV-1
- tropism is potentially enhanced for nasal epithelial cells
- recognizes ACE2 from a diversity of animal species (including humans)
- has an intermediate affinity for human ACE2
- highest infectious potential is before/ within first 5 days of symptom onset
45
what is a big reason why we believe SARS-CoV-2 wasn't manipulated for humans
cause its only intermediately affinity for human ACE2, they wouldve made it have a *high* affinity
46
how many americans think SARS-CoV-2 leaked from a Wuhan lab
2/3
47
who is Alina Chan
- molecular biologist
- wrote a ny times op-ed about why SARS-CoV-2 prob started in a lab
48
who is Paul Offit
- prof of pediatrics
- co-inventor of rotavirus vaccine
- author of over 160 papers on vaccine safety
- wrote a blog post arguing against Chan's nytimes op-ed
49
what were Chan's arguments in the nytimes op-ed
1. SARS-like virus that caused the pandemic emerged in Wuhan, a city where the world's foremost SARS-like virus research lab is located
2. a year before the outbreak, Wuhan had proposed creating viruses w SARS-CoV-2'd defining features
3. Wuhan was doing this work under biosafety level 2 conditions, which couldnt have prevented SARS-CoV-2 from escaping
4. the hypothesis that it came from an *animal* at a market in Wuhan isn't supported by strong evidence
5. key evidence that would be expected if it did come from wildlife trade is missing
50
what were Offit's arguments *against* chan's points
1. bat coronavirus spillover events into humans is common *(~70% of human viruses and bacteria have animal origins, and 1 in 40 people in china have antibodies to it)*
2. Wuhan lab studied a strain called WIV1, which didnt cause disease in people. also no evidence of the researchers sick w COVID prior to the outbreak
3. they weren't woring w SARS-CoV-2. but if they were, level 2 containment wouldve been enough.
also all the early cases happened on the other side of this big river where animal-human spillover is likely, rather than near the Wuhan institute
4. 2 lineages were detected early, why would there be 2 diff viruses created in a lab and then brought to the market
also they killed at the animals at the market, so there wasn't evidence to test *cause she argued that the evidence was missing*
5. there was evidence of SARS-CoV-2 in places that process animals thatve been slaughtered , and also in other animals that were likely intermediate hosts between bats and humans (like racoons and rats)
51
describe the paper looking at genetic tracing of market wildlife and viruses at the epicenter of the covid-19 pandemic
- early sequences belonged to 2 lineages, A and B
- A was detected in environmental samples from the market
- B was detected from patients w direct market contact
- this is consistent w 2 zoonotic spillover events into humans
- start of the pandemic was traced epidemiologically to the market
- analyzed environmental qPCR and sequencing data collected from the market
52
what is one of the main reasons we'll likely never know if covid was a lab construct
cause they killed all the animals at the scene, w/o taking samples
53
what were the conclusions of the paper looking at genetic tracing of market wildlife and viruses at the epicenter of the covid-19 pandemic
1. Common ancestor of SARS-CoV-2 linked to Huanan market matches the global common ancestor
2. Wildlife mtDNA found in samples from stalls positive for SARS-CoV-2 (including raccoon dogs, civets, and bamboo rats – previously identified as possible intermediate hosts)
3. Found additional animal viruses, so live mammals shedding viruses
4. Data consistent with a spillover event from a bat reservoir south of Wuhan and viral transmission chain via animal trade (raccoon dogs)
54
what did Fauci say regarding promoting lab leak hypothesis without evidence
- that all scientists need to be open to the possibility
- if evidence becomes available
55
what is the danger of misinformation regarding scientists
- **casts unsupported blame on scientists**
- Those who studied coronaviruses or led the response – they must have engineered it or allowed it to escape!
- Scientists are part of an international cover-up and accused of taking bribes from the NIH!
- Scientists collecting data or communicating that evidence to support a zoonosis origin to the media, are under attack – harassment, intimidation, threats, and violence!
56
what are the long-term consequences of misinformation
* Withdraw from social media platforms
* Reject opportunities to speak in public
* Divert work to less controversial/timely topics
* Fewer experts available to help in future pandemics
* Fewer experts willing to communicate findings that are important to global health.
* **Research that could prepare for future pandemics has been deferred, diverted, or abandoned!** *"this is a big one"*
57
what are the threats of manipulating SARS-CoV-2
- was isolated in the lab, and available for research by scientific/ med community
- 2008 study used synthetic bio to create a chimeric SARS virus
- 2020 study determined a single mutation would significantly enhance coronavirus to human ACE2 binding
- all emerging data on SARS-CoV-2 provided in open access
58
what are some research areas in SARS-CoV-2 according to the CDC
- **antiviral research** ability of antiviral meds to treat/prevent infection
- **vaccine development** many now available
- **pathogenesis research** how viruses can be transmitted to a host, severity of illness, how much is produced, and what organs are affected
- **virus stability research** how long it can survive under diff conditions
59
describe the structure of Zika virus
- icosahedral symmetry
- enveloped
- spherical in shape
- +ssRNA genome
60
describe the zikavirus genome
- small (11kb total)
- +ssRNA
- one ORF sequence translated into a single polyprotein
- ORF is flanked by 2 non-coding regions
- first full genome sequence in 2007
61
how many clusters of the zikavirus are there
- 3 main clusters
- originating from a common ancestor
62
what virus family is the zikavirus part of
Flaviviridae
63
how is Zika transmitted
- *arbovirus*- transmitted by arthropods
- mosquitoes are dominant vector
- non-human primates could be a reservoir
- mosquito bites
- sexual
- perinatal
- blood transfusion
64
where is zika present in
- lympth + blood
- semen + vaginal fluids
- saliva
65
where is zika distributed
- USA
- south america
- and some pacific islands
66
how many people w Zika show symptoms
less than 20%
67
what are the symptoms like for Zika
- mild symptoms lasting up to a week
- rarely death
- sometimes misdiagnosed as flu-like symptoms
- fever, join pain, rash
68
what is Guillain-Barré Syndrome
- affects the nervous system
- linked w zika virus
69
how is Zika detected/ diagnosed
- take urine, blood, or saliva from patient
- detect viral RNA using RT-PCR
- can also use ELISA, neutralization assay
70
describe how youd use ELISA to diagnose zika
- detecting or neutralizing IgG and/or IgM ZIKV antibodies
- should be done within first 2 weeks of symptom onset
71
what are the current challenges in zika detection and diagnosis
* Lack of standardized and sensitive tests
* No commercial kits available for the detection of ZIKV
* Some Ab cross-reactivity with dengue virus and yellow-fever virus
72
how can zika be prevented
- avoiding mosquito bites *(insect repellant, long sleeves)*
- prevention of sexual transmission by using condoms
- pregnant individuals shouldnt travel to infected areas cause birth defects are linked to having zika
73
what is the treatment for zika
- no vaccine
- no antiviral
- just treat the symptoms
74
what makes zika a potential bioterrorism threat
- **can purchase online**
- theres a whole ethics argument for the availability for vaccine research vs facilitating bioterrorism
75
what does NiV stand for
Nipah: the virus
76
describe the structure of Nipah virus
- enveloped
- filamentous capside
- pleomorphic (variable shape)
- -ssRNA, non-segmented genome
77
what virus family and genus is Nipah virus in
- Paramyxoviridae virus family
- Henipavirus genus
78
describe the genome of Nipah virus
- -ssRNA
- non segmented
- 18.2kb total
- 6 genes corresponding to 6 structural proteins
79
what are the 6 structural proteins in Nipah virus
- nucleocapsid
- phosphoprotein
- matrix protein
- fusion protein
- glycoprotein
- large RNA polymerase
80
how is Nipah virus transmitted
- fruit bats (flying foxes)
- pigs
- humans
- *less often:* cattle, horses, goats
- direct exposure or exposure to contaminated products/fruits could result in infection
81
where is Nipah virus found
- bangledesh
- india
- malaysia
- singapore
82
describe the symptoms of Nipah virus
- **symptoms like influenza**
- fever
- severe headaches
- muscle pain
- dizziness
- vomiting
- **more severe ones affect the CNS** lie coma, seizures, and inability to breathe
- altered mental state
- may progress to encephalitis (inflammation of the brain) or meningitis
83
what is the incubation period for Nipah virus
5-14 days
84
when does illness present with Nipah virus
3-14 days
85
what is the mortality rate of Nipah virus
40-70%
86
what is the mortality rate of zika virus
basically 0
87
how is Nipah virus detected and diagnosed
- identification of symptoms
- viral isolation, followed by RT-PCR
- detecting anti-Nipah antibodies using ELISA
88
how can you prevent Nipah virus
- no vaccine
- no anti-viral
- *supportive care only*
89
describe using ribavirin to treat Nipah virus
- effective against the virus in vitro
- but human investigations are inconclusive
90
what is a potential way to target Nipah virus post-exposure
an antibody targeting Nipah G glycoprotein
91
why might Nipah virus be a bioterrorism threat
- has attributes that make it good
- very damaging symptoms + high mortality rate
- easily spread from human to human
- transmissible to a number of common mammals *(dogs, cats, pigs, cattle)*
- previous natural outbreaks caused fear, disease, disabilities, death, social disruption, severe economic loss
- no good vaccines, no antiviral
- genetic manipulation is possible *(viral genome published)*
- possible dispersal via deliberate infection of pigs
92
describe the structure of ebola virus
- enveloped
- cylindical/ tubular in shape
- -ssRNA genome
93
ebola virus is part of what virus family and what genus
- **family** Filoviridae
- **genus** Ebolavirus
94
what are the diff species of ebola virus
- **ebola virus** (EBOV, Zaire)
- **sudan virus** SUDV
- **Reston virus** RESTV
- **Tai Forest virus** TAFV
- **Bundibugyo virus** BDBV
95
how many species of ebola are there
5
96
describe the genome of ebola virus
- -ssRNA
- 19 b total
- 7 genes encoding 11 proteins
97
what is the natural reservoir for ebola virus
- **unknown**
- suspected to be fruit bats
98
who can be infected w ebola virus
- humans
- bats
- monkeys
- apes (primates)
99
how does ebola virus spread
- direct contact of mucous membranes *(eyes, nose, mouth)*
- wounds or abrasions on skin w infected bodily fluids *(saliva, urine, semen etc)*
- ebola virus-contaminated objects
100
**true/false** ebola virus is spread through food, water, or air
FALSE
101
**true/false** ebola virus is transmissible through arthopods
FALSE
102
where is ebola virus found
- west africa
- nigeria
- south africa
- some central, like sudan, congos, uganda
103
which virus has caused the majority of human deaths from EVD
zaire ebola virus
104
what caused the 2014-2016 ebola virus epidemics in west africa
saire ebola virus
105
how many cases and deaths of zaire ebola virus were there in the epidemic in west africa
- 28,000 suspected cases
- 11,000 deaths
106
what are the symptoms of ebola virus
- fever/ chills
- severe headache
- muscle pain
- weakness
- fatigue
- diarrhea
- vomiting
- abdominal pain
- **peak is unexplained hemorrhage (bleeding/ bruising)**
- **death from shock + multiorgan failure**
107
what is the incubation period for ebola virus
2-21 days
108
how soon after infection w ebola virus can death occur
within 3 weeks
109
**true/false** the diagnostic tests available for ebola virus differ based on timeline of infection
true
110
what diagnostic tests are available for ebola virus within a few days after symptoms begin
- antigen-capture ELISA
- IgM ELISA
- PCR
- virus isolation
111
what diagnostic tests are available for ebola virus later in disease course or after recovery
IgM and IgG antibodies
112
what diagnostic tests are available for ebola virus retrospectively in deceased patients
- PCR
- virus isolation
113
how can ebola be prevented
vaccine!!
114
describe the ebola vaccine
- rVSV-ZEBOV (called Ervebo, 2019)
- protective against species Zaire
- a live, attenuated recombinant vesicular stomatitis virus
- manufactured by Merck
- contains the EBOV glycoprotein
115
who gets pre-exposure ebola vaccines
- EVD responders
- lab and support staff
- healthcare personnel
116
what is the treatment for ebola
- provide fluids
- maintain O2 levels
- treat secondary infections
117
Microbial
flashcards
Decks in class (15)
# Cards
-
Intro45
-
Pandemics and Epidemics23
-
Risk Assessment and Societal Infrastructure99
-
Disease and Microbial Forensics Investigations116
-
4: Organisms- Viruses183
-
5: Organisms: Fungi161
-
6: Organisms: Bacteria121
-
9: Food Security & Agricultural Attack109
-
10: Microbiome Analysis103
-
11: Toxin Analysis & Nucleic Acid Analysis153
-
Sequencing from Lab DNA21
-
12: DNA sequencing, genome assembly, DNA diagnostics84
-
13: Emerging Pathogens118
-
Maybe long answers3
-
Important i think149
