Transcript AIDS: The Globalization of Disease

AIDS:
The Globalization of Disease
Early examples of disease
“Globalization”
• Black Death (bubonic plague)in Medieval
EuropeThe Black Death - YouTube
• Monty Python-Bring out your dead! YouTube
• Epidemics of influenza, smallpox and
measles brought from Europe to Indigenous
peoples of the Americas. Syphilis brought
back by Columbus crew to Spain.
• Recently, avian flu, H1N1, SARS in Toronto
all show the same patternsSARS - YouTube
REGIONAL trends of AIDS
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NORTH AMERICA- In the 1980s it was first reported in males in
California. However, HIV can affect everyone, and, in Canada and the
US, the fastest rising infections over the past 5 years (as of 2011) have
been with young women and not homosexual males or men with
multiple partners.
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EUROPE-INTRAVENOUS DRUG USERS
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ASIA-prevalent in PROSTITUTES of all genders/sexes
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SUB-SAHARAN AFRICA-PANDEMIC…EVERYONE IMPACTED even
children born with it. This is also where it is believed to have started in
the early 20th century in monkey hunters cutting up meat.
History of AIDS
• 1981: PCP and Kaposi’s sarcoma reported by doctors in NY and Los Angeles. CDC reports in MMW
a strange killer pneumonia spreading among gay men. Is was designated as GRID (Gay-Related
Immune Deficiency). Referred to as “Gay Cancer.”
• 1982-1985: Cases of AIDS in 1982 began to be reported by fourteen nations. In 1982 CDC received
its first report of "AIDS in a person with hemophilia (from a blood transfusion), and in
infants born to mothers with AIDS.” N.S.-Janet and Randy Conners
• 1983: Dr. Montagnier announced the
isolation of LAV retrovirus
(lymphadenopathy-associated virus),
which later was identified as the cause
of AIDS. 33 countries reported cases.
• 1984: Dr. Robert Gallo of the NCI
isolated HTLV-III retrovirus ( Human
T-cell lymphotropic virus III). It was later
determined that LAV and HTLV-III were the same virus
• 1985: AIDS awareness was brought to the public's consciousness,
Hollywood leading man Rock Hudson, died of AIDS shortly after making it public thus becoming the
first major public figure to announce that he had AIDS. An HIV blood test was brought to large
companies to make it available in large scale.
PATIENT ZERO
• In the early years of the AIDS epidemic, there was controversy
about a so-called Patient Zero, who was the basis of a complex
transmission scenario compiled by Dr. William Darrow and
colleagues at the U.S. Centers for Disease Control (CDC). This
epidemiological study showed how Patient Zero had infected
multiple partners with HIV, and they, in turn, transmitted it to
others and rapidly spread the virus to locations all over the world
• Journalist Randy Shilts subsequently wrote about Patient Zero,
based on Darrow's findings,in his 1987 book And the Band
Played On, which identified Patient Zero as Gaëtan Dugas.
Dugas was an Air Canada flight attendant based out of
Halifax/Montreal who was sexually promiscuous in several North
American cities, according to Shilts' book. He was vilified for
several years as a "mass spreader" of HIV, and seen as the
original source of the HIV epidemic.
History of AIDS
• 1986: President Reagan makes his first mention of the word “AIDS”
publicly and request the Surgeon General C. Everett Koop to
prepare a report which was released in October 1986. Brochure:
“Understanding AIDS” sent to 107 million households. It warned that
“AIDS is one of the most serious health problems that has ever
faced the American public”. 1987: Famous pianist Liberace dies
• AZT (also known as Retrovir®, zidovudine,
or ZDV) -- GlaxoSmithKline
-- became the first anti-HIV
drug (a Nucleoside
Reverse Transcriptase
inhibitor) approved by
the FDA. Reverse transcriptase is the
enzyme that HIV uses to make a DNA
copy of its RNA. This is necessary for the
production of the viral double-stranded
DNA which is integrated into the genetic
material of the infected cell. AZT is used
in combination with at least two other
anti-HIV drugs.
History of AIDS
• 1987: A touch of a Princess: On March
20, 1987 princess Diana changed the public
perception of AIDS at the opening of a special
ward at London’s Middlesex Hospital. She
was seen not wearing gloves and shaking
hands with people with AIDS.
Princess Diana: AIDS activist – YouTube
1990: Death of Ryan White, a nineteen year old, white,
heterosexual, teenager from Indiana died because of
AIDS which he contracted from blood products, as part
of his treatment for hemophilia. Elton John: Ryan White
Saved my life part 2 – YouTube
AIDS Boy Banned From Attending School - 1st August
1985 - YouTube
YouTube - Elton John - The Last Song
CBC News In Depth: Tainted Blood
1991-Freddie Mercury, singer in “Queen” dies
• Magic Johnson combats AIDS
misperceptions - USATODAY.com
• Tainted blood scandal Canada’s Red Cross
late 1980s/early 1990s (Hepatitis and HIV)
• CBC: Life And Times
• CBC News - Nova Scotia - AIDS activist
lauded for perseverance
• (2015)QUILT
• On February 24, 1995, NWA (also featured Dr. Dre and Ice
Cube) rapper Eazy-E was admitted into Cedars Sinai Medical
Center in Los Angeles with what he believed to be asthma.
Instead he was diagnosed with AIDS, and announced his illness
in a public statement on March 16. The disease came about in
Eazy because of his sexual activity, which started when he was
twelve and resulted in not only a fatal disease, but six children to
FIVE different women. He died due to "complications from
AIDS" one month after his diagnosis, on March 26, 1995, at
approximately 6:35 PM (Pacific time). He was 31 years old.
• Celebrities who died of AIDS Pictures CBS News
History of AIDS
1999: Origin of HIV-1 Discovered. A research
team from UAB lead by Dr Beatrice Hahn identified a
subspecies of chimpanzee native to West-Central Africa as the
natural reservoir for HIV-1. Viruses related to HIV-1 had
previously been found in chimpanzees and were given the
designation SIVcpz (for Simian Immunodeficiency Virus).
Both HIV-1 (chimpanzees) and HIV-2 (sooty mangabeys)
originated in Africa.
Why the epidemic arose in the mid-20th century is not
clear.
People in some African
nations contract the virus by
eating 'bushmeat'
Pan troglodytes sub-especies and distribution
1. Pan troglodytes verus
2. P. t. vellerosus
3. P. t. troglodytes
4. P. t. schweinfurthii
December 2, 2011 Jacques Pepin's 'The Origins Of AIDS'
A Canadian professor's groundbreaking look at the genesis of the AIDS
virus is generating global buzz for shedding new light onto the world's most
devastating pandemic.
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As The New York Times is reporting, Dr. Jacques Pepin's "The Origins of
AIDS," published earlier this month by Cambridge University Press, traces
the improbable journey of HIV/AIDS to a single bush hunter (dubbed
"patient zero") in central Africa who "manipulated chimpanzee meat" in
1921:
Dr. Pepin sifts the blizzard of scientific papers written about AIDS, adds his
own training in epidemiology, his own observations from treating patients in
a bush hospital, his studies of the blood of elderly Africans, and years of
digging in the archives of the European colonial powers, and works out the
most likely path the virus took during the years it left almost no tracks.
Working slowly forward from 1900, he explains how Belgian and French
colonial policies led to an incredibly unlikely event: a fragile virus infecting a
small minority of chimpanzees slipped into the blood of a handful of
hunters, one of whom must have sent it down a chain of “amplifiers” —
disease eradication campaigns, red-light districts, a Haitian plasma center
and gay sex tourism. Without those amplifiers, the virus would not be what
it now is: a grim pilgrim atop a mountain of 62 million victims, living and
dead.
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Interestingly, Pepin, an infectious disease specialist at the University of
Sherbrooke in Quebec who spent many years living and working in
Africa, also believes that he (along with well-meaning doctors and
nurses) may have inadvertently helped to pass along the AIDS virus
himself while working at a Canadian-funded program in Zaire (Congo).
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"The chances that this hunter alone could launch an epidemic are very
low," Pepin tells Canada's The Globe and Mail. "But there are all the
chances in the world that he went to be treated for a tropical disease
and a little HIV stayed in the syringe. Then the next patient was injected
with it intravenously.“
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Pepin also believes the rapid expansion through sex alone is
mathematically impossible -- instead, he names a Port-au-Prince-based
plasma center called Hemo-Caribbean as being one "amplifier" in the
spread of the AIDS virus. The center, which operated only from 1971 to
1972, was known to have low hygiene standards.
Global summary of the AIDS epidemic,
December 2008
Number of people living
with HIV in 2008
Total
Adults
Women
Children under 15 years
34.4 million [31.1 – 35.8 million]
31.3 million [29.2 – 33.7 million]
15.7 million [14.2 – 17.2 million]
2.1 million [1.2 – 2.49 million]
People newly infected
with HIV in 2008
Total
Adults
Children under 15 years
2.7 million [2.4 – 3.0 million]
2.3 million [2.0 – 2.5 million]
430 000 [240 000 – 610 000]
AIDS deaths
in 2008
Total
Adults
Children under 15 years
2.0 million [1.7 – 2.4 million]
1.7 million [1.4 – 2.1 million]
280 000 [150 000 – 410 000]
At the end of 2007, the CDC estimates that there were 571,378 people living with HIV/AIDS in the 39 states
and dependent areas that have a history of confidential name-based HIV reporting, based on reported
diagnoses and deaths.
However, the total number of people living in the USA with HIV/AIDS is thought to be around 1.1 million.
What are the symptoms of AIDS?
Early symptoms
Some people have flu like illness within a month or two
after exposure to the virus
They may have fever, headache, malaise and enlarged
lymph nodes
These symptoms usually disappear within a week
More persistent and severe symptoms may not surface
for a decade or more after HIV first enters the body in
adults:
Diarrhea for more than one month
Dry mouth and skin rushes
Severe headache
Dry cough
AIDS: this term applies to the most advanced stages of HIV infection.
All HIV-infected people who have fewer than 200 CD4+ T cells
Opportunistic Infections
Most AIDS-defining conditions are opportunistic infections, which
rarely cause harm in healthy individuals. In people with AIDS, these
infections are often severe
Bacteria:
• Mycobacterium Avium Complex
• Mycobacterium Tuberculosis
Viruses:
• Varicella-Zoster Virus
• Herpes Simplex Virus
• Cytomegalovirus
Protozoa:
• Coccidiosis (Cryptosporidiosis,
Cyclosporiasis, and Isosporiasis)
• Toxoplasmosis
• Leishmaniasis (not in the U.S.,
but in Southern Europe and in
many other parts of the world)
• Chagas
• Malaria
Fungi:
• Pneumocystis carinii
Pneumonia
• Candidiasis
• Aspergillosis
• Cryptococcosis
• Histoplasmosis
• Coccidioidomycosis
• Microsporidiosis
Kaposi’s Sarcoma, or KS, is a type of cancer. It causes patches of
cancerous tissue to grow under the skin and in the lining of the mouth,
nose, throat, or other organs and tissue, including cartilage, bone, fat,
blood vessels, tendons, ligaments, or other fibrous tissues. These
patches are red, purple or brown and are comprised of cancerous cells
and blood cells. These lesions often appear as raised blotches or lumps.
In many cases, there are no symptoms besides the red or purple patches,
though the patches themselves can be quite painful. KS can spread to the
digestive tract or to the lungs, which can make breathing hard or cause
internal bleeding, which can render it life-threatening. It can also cause
painful swelling, especially in the legs, groin, or around the eyes.
When it develops on its own, KS develops slowly. However, in people
whose autoimmune system is compromised, especially those with
HIV/AIDS, KS can move very quickly. Treating the AIDS itself can help to
limit the spread of the lesions and even to shrink them, but for AIDS
patients, KS contributes to the overall deterioration of health that
eventually leads to death.
AIDS treatment
Antiretroviral treatment: more than 20 drugs
approved. HAART: highly active
antiretroviral
Therapy combines three or more anti-HIV medications daily.
Anti-HIV medications do not cure HIV infection.
Four classes of Anti-HIV drugs approved by the U.S.
Food and Drug Administration (FDA):
1. Non-nucleoside Reverse Transcriptase Inhibitors
(NNRTIs):Efavirenz (Sustiva) binds to and block the
action of reverse transcriptase.
2. Nucleoside Reverse Transcriptase Inhibitors
(NRTIs): zidovudine (Retrovir), tenofovir DF (Viread),
and stavudine (Zerit), are nucleotide analogues.
They inhibit reproduction of the virus.
3. Protease Inhibitors (PIs): lopinavir/ritonavir
(Kaletra)
4. Fusion Inhibitors: enfuvirtide (Fuzeon), are
newer treatments that work by blocking HIV entry
into cells
Core proteins of HIV-1 are produced as part of
long polypeptides that are cut into smaller
pieces by protease to create functional and
mature proteins. Protease inhibitors bind to the
active site, where protein cleavage occurs. With
the inhibition of protease, new viral particles
cannot mature and do not become infectious.
This figure is Fig. 3 from Nature Medicine,
2003, 9:867
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Sub-Saharan Africa remains the region most heavily affected by HIV, with
southern Africa remaining the area most heavily affected by the epidemic. In
2009, sub-Saharan Africa accounted for approximately 70% of people living with
HIV worldwide and new infections among adults and children. The region also
accounted for 72 per cent of the world’s AIDS-related deaths in 2009. Most
transmission in this region occurs in heterosexual relationships, both in the
context of transactional and commercial sex and in longer-term relationships,
including marriage.
As a contrast, in most other regions, HIV disproportionately affects injecting drug
users, men who have sex with men, and sex workers. The epidemic is evolving,
however, and national epidemics throughout the world are experiencing
important transitions. In Eastern Europe and Central Asia, epidemics that were
once distinguished largely by transmission among injecting drug users are now
increasingly characterized by significant sexual transmission. In parts of Asia,
epidemics are more and more characterized by significant transmission among
heterosexual couples. The epidemic in Asia, which has long been
concentrated in injecting drug users, sex workers and their clients, and men who
have sex with men, is steadily expanding into lower-risk populations through
transmission to the sexual partners of those most at risk.
Click on the link to download regional HIV and AIDS statistics, 2009
Young people aged 15–24 years account for an estimated 41 per cent of
new adult HIV infections worldwide. Globally, young women aged 15–24
years account for 64 per cent of all HIV infections among young people. In
sub-Saharan Africa young women aged 15–24 are more than two times more
likely to be infected than their male counterparts. In only three regions – South
Asia, East Asia and the Pacific and Latin America and the Caribbean – are there
more young men who are HIV positive than young women. This reflects the
differences in risk behaviours, which requires that interventions be tailored to fit
the nature and dynamic of the epidemic.
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For the First Time Ever: Bono! - YouTube
Bono's call to action for Africa | Video on TED.com
Bono's Special Message on "No Child Born with HIV" - YouTube
(RED): 2 Pills A Day - The Lazarus Effect - YouTube
YouTube - 'The Lazarus Effect' Film from (RED) & HBO
K'NAAN Speaks on Bill C-393 - Sign the Petition to Save Lives!
– YouTube
• Let Democracy Win! Let the Senate pass Bill C-393. – YouTube
• Frank Valeriote speaks in favour of Bill C-393.mp4 – YouTube
(first 2 minutes)
• GRANDMOTHERS TO GRANDMOTHERS - GET DRUGS TO
AFRICA! - YouTube