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Gresham College: Professor Chris Whitty – Infectious Diseases: The Oldest Enemy – #6/6 – The Changing Impact of Infections as We Go Through Life and Age

29/03/2020

As Professor Whitty is now CMO for England and Wales and in the context of Coronavirus Pandemic i have reposted this series

This episode is very relevant

 

About this series

A series of lectures on infectious diseases, demonstrating how they have dominated medicine and mortality in the UK. Infectious diseases remain a major threat, and the combination of widespread travel, antimicrobial resistance to drugs and a rising proportion of the population in older age groups means that the threat is now increasing again.

Some infections come in repeated epidemic waves, others are new to human populations. A known human threat such as influenza may mutate, or a new infection jumps the species barrier from animals to humans: recent examples include HIV and Ebola, and the historical example of plague. What happens depends on the route of transmission. Our methods for tacking an airborne disease like influenza are different from those for touch (Ebola), insect vector (Zika), water (cholera) or sexual transmission (HIV).

The brain is well protected against most infections, but once they get into or around the brain they can cause fatal or serious long-term consequences. Some infections are well adapted to the brain including meningococcal meningitis. Control measures including vaccination have reduced the risk of some, but not all, of these very serious infections. Professor Whitty looks at how infections get into the brain, their effect and how we can prevent and treat them.

Certain infections have a specific impact on the peripheral nerves. Some are predominately on the motor nerves causing weakness or paralysis (for example polio). Others affect the sensory nerves. Some bacteria produce toxins which damage nerves function including tetanus and diphtheria.

The lung has a large surface area, is open to the outside world and is the site for common serious infections, in particular pneumonia. The heart is less susceptible to infection, but heart infections can be severe. Some lung infections are becoming less common due to vaccination, whilst others are likely to increase globally. Infections via the respiratory route are often the most difficult to combat via public health measures.

Our gut is permanently full of large numbers of bacteria, but serious infections rarely occur due to its extraordinary immune system. Specialised bacteria and parasites can, however, damage the gut or its functions. The liver can be damaged by hepatitis viruses, parasites and other infections. Common gut bacteria which normally cause no serious problems can bypass the gut’s defences and cause serious infections including septicaemia. Public health has reduced but not eliminated transmission of these potentially dangerous infections.

The very young and the very elderly are particularly susceptible to infections. Some infections caught as a child are usually trivial but are likely to be much more severe in adults, or present differently in different age groups. Otherwise minor infections can have major effects in pregnant women or particularly on their unborn babies such as rubella and Zika. The changing pattern of disease as we progress in life has implications for treatment and prevention.

 

 

About this lecture

The very young and very elderly are particularly susceptible to many infections and for many infections, age will predict how likely someone is to die once infected. The immediate and long-term effects of an infection changes throughout our life course. Some infections which if caught as a child are usually relatively trivial are likely to be much more severe in young adults including mumps and chickenpox.

Other infections present in very different ways depending on the age of the sufferer; for example, severe malaria in young children is a completely different disease from severe malaria in adults although the parasite is the same. Otherwise trivial infections can have major effects in pregnant women or particularly on their unborn babies; examples include rubella and Zika. Several vaccines work differently in different age groups. This changing pattern of what makes disease severe as we progress from the first trimester of pregnancy by stages through to becoming very elderly has implications for treatment and prevention of disease.

Professor Chris Whitty

Christopher Whitty CB FRCP FMedSci is Gresham Professor of Physic (the term for medicine when the post was created in 1597) at Gresham College, Professor of Public and International Health at the London School of Hygiene and Tropical Medicine, and Consultant Physician at University College London Hospitals (UCLH) and the Hospital for Tropical Diseases.

Professor Whitty is also Chief Scientific Adviser at the Department of Health and Social Care and head of the National Institute for Medical Research (NIHR). He is involved in many day-to-day public health decisions for the UK, especially for infectious diseases and emergencies.

He is a Fellow of the Academy of Medical Sciences. He was interim Government Chief Scientific Adviser and Head of the Science and Engineering Profession and was previously Chief Scientific Adviser at the UK Department for International Development (DFID).

Professor Whitty has worked as a clinician and in public health research in the UK, Africa and Asia. He undertook his postgraduate training in epidemiology, economics and medical law.

A multidisciplinary research scientist, he is current in many areas of science and has an international reputation. Professor Whitty’s work spans the breadth of medicine, while his research has mainly focused on infectious disease and diseases of poverty in the UK, Africa and Asia. Infectious diseases are the theme for his first series of lectures as Gresham Professor of Physic

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