copied J I E, 1964 ?;oteslof Lecture, Harvard, n'sv. 18, 1960 Time Required - 90 minutes The m4 49 21 xx 53 43 xxx Xl 71 following slides were used. .Glass mounted Guarda Aa eradication indices - So Luis and Maranhzo unmounted Vale Canaan, 1932 mounted YF in Southern Brazil color 1940 mounted Aa Paraguay DDT - mounted & in Americas 1957 color unmounted Jungle at Tocumen mounted JYF Cent. Am. 194%57 unmounted Tree Ferns unmounted Colorado Indians unmounted Jungle YF and Plague, Caracas mounted YF in Americas 1946-53 mounted YF in Americas, 1954-56 137 1934- mounted Aa eradication Brazil 1943-52 - influence of DDT Yellow Fever Problem A. Tropical Public Health B. International Health Reality of Problem merica - Kan - Ronkeys Africa - Iv;an - Primates Present Asia Potential - Kan - Monkeys Temperate Zones - Seasonal Man. Most difficult problem for International Quaran- tine Committee Most fearsome disease Most emotional reaction Nest severe restrictions on travel to Asia Yellow Fever Zoonosis - 1~:a.n and Other Primates virus - Acute Infection Death or Immunity No Carrier State Transmission Aa - urban maritime - Haemogogus - Cedes - Sabeites Aedes africanus, Aedes hmpsoni No Trans-Ovarian persistence Continued Exi~stence of Virus Pequires series of acute ma%alian 5nfections - not further spaced then life time of infected mosquito 3 Clinically - short incubation - rapid onset - A. infection R. 1ul.l C. intoxication albuminuria hemorrhage anuria Di.agnosis A. Time schedule albuminuria B. Isolation virus C. Repeated neutralization Pathol-ogy - IAver Immunology - complement fixation neutralization - 28 Viruses haemogglutination Imuni zation - 1. FIatural - maternal antibodies + early ;,, infection 2. Vaccination a. killed virus b. virils plus serum C. cultured virus plus serum d. Fch neurotropic virus e. 17D Duration of immunity! (Comment on Poli.0 Vacci.natinn - Yr" vacci.ne viruses are neutropic - Pch. kills lOO$ mice and 100;: + monkeys - Fch gives 605 viremia 17D gives 5;L vi.remia) Today's lecture on YF is in the course on Ecology and Epidemiology of Infectious Diseases in Department of Nicrobiolog3r and Tropical Publi c Health. Tropical Pub1-i.c Health Tropical P;edi.cine - successes always in pre- ventive medicine - YF in 1900 - VF only after Columbus RF in 1913 - 2ose to Asia 1915 - Gorgas studied a decade and a half of results. l?.F. embarked on Eradication of YF' based on reduction of Aa. in key centers of infection - Spontaneous Disappearance Farly victories Ecuador, Peru, Centra.1 America., Nexi.co Failures Brazil - 1919-20 Federal Commiss% R.F. - 192346 Brazil 1.z.F. - ].$!26-32 Rio outbreak - 1%?.8-29 Reci-fe cases in control area 1929 Colombia - Socorro 1929 lienezuela - Guasapati 1929 Boljvia - Sta. Crux 1432 Personal exper!ence on becom:ing responsible for Y? in Forth Brazil. Belt& to Mac&.0 Reorganization - Kanual - Maps FA 52 - Detailed Pecords Larvicide to all. foc2 Adult captures Threshold of Visibility Viscerot0mt.i YFE Aa - a, unrecognized Aa breeding - Local - eradication in several &ties. 2 slides - Light. b. unrecognized endemic Aa transmitted - F in rural areas of NE Brazil - attack on & ?n rural areas ended endemic in Aug, 19% 2 Slid?SC. unrecogn?zed jungle yf very widespread 1i~~tS in many areas where yf had never been..Fecorded Became clear that Socorrw, Guasapati. and Santa Cruz were secondary to Jungle yf yf virus not eradicable - program changed to eradicate ?a - - give story of expansion to 1960 - DDT helped 3 slides lri.ghts Jungle W - clinjcally identical Depends on animal. I.nfections and on forest most l.Ctoes b (Wave phenomenon S.n Pa ?and Jungle Fever) - I&n is Incidental, often dead-end kfection unless Aa is present in - Ameri.ca domicile - Transmission by day time bitj.ng mosquitoes Xan not so frequently infected in forest - vector is n_ight biting Africa A. afrri.ca,nus - monkey brings virus - to Cedes sjmpsoni which transmits ma3 to man. Protection against 3ungle yf recpires individual vaccjriation - Endemic Aa, yf travels with man along human routes of travel Jungle yf travels through forests. Zecent yf history Under - reporting Africa,, Americas Africa - virus widespread, but few re- cognized cases Panama - Kexico - 2 slides ?acl.fic Coast - Ecuador 2 sl?;des Tri n5.da.d - Caracas 3.954 3. sUde YF' 1.946 - I.?56 3 slides F;radicat!.on of Aa led to eradication of AJ E3razil - l.!&rp t SehabFlitatAon of 'I;:radication Concept Eradi.cak.on rwst expand - Internat.'ona.l cooperation Xssentj.al ';JHO, PAHO, UNICEF, TCA But, complete coverage in individual countries needed - USA r,ot entirely ready. small FOX, t;;berculosis, leprosy, typhoid, yaws, syph5li.s Local general un;t vs Unilateral Ca.mpaigns