Section 1
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How many types of HPV are there
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Cards (316)
Section 1
(50 cards)
How many types of HPV are there
Over 170
S
Number of susceptible people
% of latent syphilis that leads to tertiary syphilis
28
Chlamydia in the US
Higher in women More concentrated in bible belt Increasing number of cases Chlamydia trachomatis
Viral STIs
Herpes simplex (HSV) HIV HPV
Differential Equations
Express how much a system changes over time. Used to calculate size of a system at different times. Can be used to predict course of an epidemic.
How is HPV transmitted
Sexual contact Non sexual routes
Those most at risk for syphilis
MSM (50%) cases Men who have sex with men and women MSW Women
R
people in the state of recovery
Gamma
Rate of recovery Rate at which recover from infection per day Cure Estimated directly from a cohort of infected people Not dependent on number of infected people
Secondary syphilis
Disseminated rash Generalized lymph
%of latent syphilis that leads to no further complications
72
When does an epidemic peak?
When the proportion of people who are still susceptible is equal to R0
Not sexual routes of STI
Vertical transmission IDU Phomites
What do differential equations represent
rate of change
3 Broad definitions of sexual contact
Vaginal intercourse Anal intercourse Oral intercourse
Primary Syphilis
Chancre at site of infection
Lambda
Force of infection/ effective contact parameter Probability susceptible person gets infected The force of infection Probability a susceptible individual acquires infection per unit time estimated directly from a cohort of susceptible people Dependent on beta, c, and dependency Probability of infection depends on number of people who are infected
Complications with chlamydia
ectopic pregnancy infertility
Which strains of HPV cause the majority of worldwide cervical cancers
HPV 16 (54%) HPV 18 (13%)
R0 using SIR model
lambda at t0 *1/gamma Also known as Rt will always decrease over the course of an epidemic due to depletion of susceptibles
2 Types of Anal intercourse
receptive insertive
How many types of HPV are oncogenic
15 to 20
HSV 2
more common genital herpes
Course of Syphilis Infection
Infection Primary Secondary Latent Tertiary
SIR Model
susceptible, infected, recovered Divide population into compartments, susceptible, infectious, recovered. Reflect rate at which flow between those boxes
Population structure in SIR model
assume homogenous mixing since it is a compartmental model, assume same chance of contact with infected people account for heterogeneity by adding more compartments
The most common STI
Chlamydia
Tertiary syphilis
Cardiovascular syphilis Late neuro complications
HSV 1
more common oral herpes
Syphilis in the US
Trepomena palladium Higher in males, growing number of cases now
Negative lambda
As incident cases occur, people leave susceptibles
Which strains of HPV are most often associated with genital warts
HPV 6 HPV 11
Today, do men or women have higher rates in syphilis?
Men Driven by high risk populations
Why is syphilis less common
less infectious more common in high turnover people High risk groups
Types of STI
Bacterial Viral
Herpes Simplex
Common virus Carrier states that can reactivate Sores arise when transmissible Can be vertically transmitted
HPV structure
non enveloped double stranded DNA virus
Latent Syphilis
Non replicating and non infectious a majority of cases
How many incident cases Chlamydia per year
2 to 3 million BUT 1.6 million diagnosed
# of Americans that have had herpes
1/6 or 40 M Most are asymptomatic carriers
Infection with syphilis
Growth of organism at site of infection Dissemination into tissues including CNS
% of women with asymptomatic chlamydia
50% Often diagnosed more
Which stages of syphilis are more reported because they indicate incident infections
primary and secondary
How many types of HPV are anogenital
30 to 40
% of men with asymptomatic chlamydia
30
STI
Infection transmitted through sexual contact
Bacterial STIs
chlamydia, gonorrhea, syphilis
Why are STI rates high in alaska
Small networks young population
Global distribution of HPV
worldwide 10% high prevalence and cancers in africa and south america
Section 2
(50 cards)
Phase 2 sti epidemics
hyper-endemic mass media campaigns screening and tx services partner notification community level behavioral interventions continued outreach to high risk
Re-emerging infectious disease
infectious agents that have been known for some time, were no longer considered public problems, and are now showing upward trends in incidence and or public health concern ex. new problem gonorrhea resistant to antibiotics
Examples of reemerging infectious diseases
measles dengue antibiotic resistant gonorrhea
Crabs
evolved to grab on thick hair prevention could be shaving Doesnt survive long not on body, can be transmitted on towels and sheets
Trichomoniasis
protozoan causes vaginitis Causes inflammation in women and discharge Common for those with immunosuppression or HIV otherwise asymptomatic
Where do reemerging diseases tend to come from
animals emerge at intersection of animal an human populations
Transitional concurrency
overlap between partnerships 1 partnership starts before another resolves
Ways to frame STI control Strategies
Ro level of intervention sti epidemic phases
Immunity to HPV
type specific can be infected with multiple types, increase risk of cancer
Components
a group of connected nodes in a network
Why are STIs a problem for reproductive numbers
exposure not random determined by sex networks different rates of transmission
Determinants of extent of STI transmission in a network
size, number, and fragility of components
phase 3 and 4 sti epidemics
decline and endemic continued health promotion vaccine primary prevention screening and treatment partner notification continued high risk outreach
Interventions to impact rate of partner acquisition, c, for STD
programs to reduce rates of partner change employment programs for sex workers reduce concurrent partnerships establish prevention in settings of high turnover
Factors contributing to infectious disease emergence
host agent environment
U=U
Undetectable = Untransmittable
Who does CDC recommend should get HPV shot
age 11 or 12 young women thru 26 young men thru 21 MSM and trans thru 26 FDA approved for ages 9 to 45
Scabies
mite that burrows in skin and lays eggs spread thru sex or in close conditions Can survive on fomites
Transmission efficiency
B probability of transmission varies over course of infection and other factors viral load, cofactors, treatment HIV very dependent on viral load
Dendritic sexual networks
many sexual networks form long chains most populations have mostly diads core group not observed, but transmission still likely
Geodesic distance
number of links on the shortest path between two nodes
Co factors required for HPV to lead to cervical cancer
smoking age over 30 infection with multiple strains immune suppression
B for STD
average probability of transmission per sexual partner Per act can differ i.e. HIV
Reproductive number
average number of secondary cases generated by one primary case
Core group concept
postulates all epidemic and endemic transmission of STI sustained by small subset of population high rates concurrent relationships large number or sex links within core subgroups sexual bridges to low risk core groups have R0 greater than 1
Transmission dynamics of STI
Only a fraction of community is at risk Heterogeneity in risk Persistent carrier states affect prevention and control Little to no immunity Variability in transmission over course of infection
partner acquisition rate STI
c many STI have minimum rate or year to sustain STI transmission problem is people are not randomly mixed- need to consider networks
Can HPV cause anal and penile cancer?
Yes More common in MSM
Emerging infectious disease
newly identified and previously unknown infectious agents that cause public health problems either locally or internationally
Sexual transmission of HPV
sexual intercourse higher with anal genital-genital oral-genital manual-genital
C for STD
average number of sexual partnerships formed per unit time
STI Epidemic Phases
phase 1- growth phase 2- hyper endemic phase 3- decline phase 4- endemic
Interventions to impact duration of infectiousness for STI
public health active case finding improve access to care try to shorten delay between infection to care to treatment such as EPT
Is HPV a necessary cause for cervical cancer
Yes
D for STD
average duration of infectiousness of an infectious person
HPV life cycle
long incubation many will clear spontaneously Can take years Initial Continuing/ CIN1 CIN 2/3 Cervical Cancer
Nodes
a person in a network
HPV vaccine
Gardasil nonavalent vaccine for oncogenic strains
CIN
cervical intraepithelial neoplasia Abnormal cells in cervix from HPV Stage refers to size of growth of cells
Connected component
a subgroup in which all nodes have a link to at least 1 other node, and no node is connected to a member of any other component in the network
Links or Edges
a sexual relationship in a network
Parasitic STI
Trichomoniasis Scabies Pediculosis pubis/ crabs
Agent in reemerging disease
natural evolution of pathogenic agents such as adaptation and change developing resistance to drugs from antibiotic use and abuse, or overuse in agriculture
Serial monogamy
No overlap between partners
Interventions to impact transmission efficiency,beta, for STD
increase condom use reduce risk sexual practices and other behaviors reduce cofactors that increase infectivity suppressive chemotherapy
Phase 1 sti epidemics
Growth Focus on high risk populations targeted outreach implement screening and treatment programs
Fragility of a network
determined by the number of links that keep a nodes in a component connected
Embedded concurrency
a partnership entirely embedded in another
STI control
Presence of 1 STI increases risk of getting another Treating 1 can impact outcome of another Opportunity to control more than 1 at once
Non sexual transmission of HPV
Mother to child: rare Fomites : hypothesized
Section 3
(50 cards)
Ebola Viral load
transmission depends on viral load and symptoms initially low load and low transmissibility As viral load increases, people become more infectious and symptomatic Based on host and source fluid
Adverse events zika
microcephaly of babies otherwise mild illness
Clinical management for ebola
prophylactic antibiotics fluid replacement electrolyte replacement management of pain,nausea,agitation nutrition social support safe burial
Geographic disparities in gonorrhea
high in bible belt and alaska
Surveillance tasks for ebola
screening isolation contact tracing facility based
Active surveillance
following all contacts of cases
Challenges with managing emerging disease
surveillance gaps limited capacity for lab testing, especially novel pathogens delay in reporting insufficient preparedness for control
important strains of ebola
zaire and sudan majority of outbreaks
Transmission of gonorrhea
transmitted through vaginal oral and anal sex in women more common in cervix and urethra 5-10% in pharynx rectum vertical- passing through birth canal
Complications with gonorrhea
PID swelling of testes and epididymis
Incubation period dengue
3-14 days
Political context and ebola
post conflict infrastructure government mistrust health worker shortages weak health systems limited WASH porous borders
Transmission of zika
mosquito Sex Blood
Natural Reservoir of ebola
fruit bats
Reproductive number of zika
Can vary between 1.4 and 6.6
Who is most at risk for ebola
caregivers health workers transport workers morticians
E Coli
Reemerging infectious disease live in intestines of cows killed by cooking. in US can get not well done get sick from toxins from ecoli going into blood stream
Febrile phase dengue
0-6 days high viremia
Ebola testing
very sensitive but not specific doesnt miss people, but get lots of false positives need safe transport of sample
Vector in reemerging disease
Resistance to pesticides
Host in reemerging disease
human demographic change most of the driving force population growth interaction with new environments mass migration by natural or social causes human behavior change human susceptibility to infection poverty and social unrest
Symptoms of gonorrhea
most often none (50% women, 10% men) pain with urination (mostly men) discharge swollen testes lower stomach pain pain in sex rectal soreness,itching,discharge,pain
passive surveillance
hotlines reports by community leaders medical referrals case logs
Solutions to handle emerging disease
GIS to monitor environmental changes that influence emergence improved diagnostics new vaccines internet based information tech to improve reporting, facilitate communication, inform
Clinical course of dengue
Febrile phase Critical phase Recovery phase
Emerging vector borne disease
dengue zika
Contact tracing for ebola
direct- caring indirect- in same home funeral attendance
SARS
corona virus emerged in china spread because of travel
Zika virus
single stranded RNA
Managing emerging diseases
surveillance at national, regional, global level epi, labs, ecologically investigation and early control implement prevention measures
Natural host of zika
monkeys
What has increased likelihood of ebola infections today
deforestation population expansion human to human transmission
Direct transmission of ebola
eating bats or fruit with bat saliva
Critical phase dengue
potential shock, bleeding, organ impairment rising IGG capillary leakage day 4-6
Environment in reemerging disease
economic development and land use (urbanization, deforestation) Humans in closer contact with reservoir and vector Climate change Greater rainfall and drought, increased vector population, change in migration Technology agrobusiness
Dengue symptoms
asymptomatic to mild for 80% Severe in 5% vomiting fever rash headache
Prevalence of Dengue
present in 124 countries annually 70-100k infections 2M severe forms, mostly children approximately 21k deaths
Components of outbreak response framework
alert system testing clinical care health promotion screening
incubation period of ebola
2-21 days
Treatment of dengue
no specific treatment care of symptoms
Speed and ease of travel with reemerging disease
travel of vector and animal human travel
Growth of megacities and emerging disease
large population in equatorial areas with high infection transmission poor infrastructure lack of access
Gonorrhea as a reemerging infectious disease
increasing incidence and public health concern higher rates transmission of antibiotic resistant strains for every diagnosed case, probably 1 or more incident
Indirect transmission of ebola
eating infected animals can survive on fomites for hours can survive on external body fluids for days can survive in dead bodies for months
health promotion and ebola
lacking educate the population
Antibiotics and gonorrhea
now ceftriaxone and azithromicin recommended resistant to many others when prevalence of resistance is greater than 5% in surveillance, recommendations are changed
Recovery phase dengue
rising IGG day 3-10
Transmission of dengue
single bite in a period of high viremia in an infected human pre infectious period in mosquito is 8 to 10 days mosquito infected for life
Ebola pathophysiology
immune system gets deregulated get inflammation and vascular leaking
Vector of zika
aedes aegypti
Section 4
(50 cards)
Inactivated vaccines
whole virus or bacteria killed with heat or chemicals extracted or purified proteins used today. are technically subunit virus capsid proteins or polysaccharides from walls give response conjugate can be used to boost response
Subunit vaccines types
recombinant vaccines vector vaccines
toxoid
inactivated toxin used in a vaccine
Population vaccine strategies
mass vaccination ring vaccination
long lasting vaccines
gives lifelong protection
Recombinant vaccines
type of subunit vaccine that removes essential genes and inserts into another genome to produce antigen
Measles vaccine
recommend 2 doses: 1st at 12- 15 months 2nd at age 4-6 97% effective LAIV
Vector vaccine
type of subunit vaccine. extract and insert gene coding for antigen in a live vector it is a carrier expressing foreign gene
Vaccine effectiveness
estimate of a vaccines protective effect in the real world includes general population influenced by individual and herd immunity Calculated from observational study compare against unvaccinated calculation depends on study design
Vaccinology
science of developing vaccines to prevent disease
Weakness of inactivated vaccine
response is humoral only several boosters
monovalent
also univalent vaccine designed to immunize against a single antigen or single microorganism
broad immunity vaccines
protects against multiple strains
Better approach to ebola outbreak
rapid response population engagement proactive contact tracing more lab resources vaccine wash MEURI treatment Research PALM
early viral vaccines developed
1930 to 1950 yellow fever and flu
Limitations of live vaccines
tend to be efficatious but safety concern for immunosuppressed and requires cold chain
vaccine efficacy
reduction in the incidence of disease among people who received a vaccine compared to the incidence in unvaccinated people calculated in RCT represents best case controlled scenarios less generalizable made to maximize internal validity
Attenuated
an organism that is non pathogenic but remains immunogenic lab culture bacterial, genetic manipulation
Stable vaccines
does not require special handling
First versions of vaccines
variolation smallpox scabs or fluids scratched into skin produced milder disease than naturally acquired smallpox
Things to consider with building clinics for ebola
flow cross contamination supply access
Mass vaccination
administration of vaccine to large population in shor time
Gardasil 9
nonavalent vaccine against HPV
vaccines developed today
chickenpox HPV shingles
Vaccine
any biologically derived substance that elicits a protective response when administered to a susceptible host contains an agent that resembles an org, usually from weakened or killed forms of the microbe
multivalent
a vaccine designed to immunize against two or more strains of the same organism
Examples of live vaccines
Measles
Ring Vacciation
vaccination of susceptible individuals in a prescribed area around an outbreak contacts of index case make buffer of immune people to prevent spread used to control smallpox
Conjugate
a polysaccharide used to enhance immunogenicity makes molecule bigger to identify antigen
strengths of inactivated vaccines
fewer side effects less stringent handling
Live attenuated vaccines
Live pathogen, but weakened. May cause minor illness in rare cases. must replicate in host to elicit response produces humoral and cell mediated immunity
drawback of mass vaccination
adverse events more noticeable
MEURI
monitored emergency use of unregistered and investigational interventions expanded access treatments that not proven effective, not possible to study rn, data of some support , informed consent, well followed treatment
Can vaccines cross react?
yes administer separately to get best response
When are vaccine effectiveness estimates valid
if groups have comparable susceptibility to infection similar exposure risk equal risk of being diagnosed
benefit of mass vaccination
rapid increase in herd immunity
Who introduced variolation to europe
Lady Mary Wortley Montague 1700s wife of english ambassador of turkey had kids undergo variolation, led trials on prisoners
age and vaccines
live vaccines for children over age 2 years for flu
Hep B, flu vaccines developed
1970 to 1990
polio, MMR vaccine developed
1950 to 1970
Critical vaccine threshold calculation
1- 1/Ro missing imperfect vaccines and non random mixing
Critical vaccine threshold
with increasing reproductive number, necessary effort to contain disease isnt linear need high vaccine coverage high benefit if done have herd immunity
Simple vaccine administration
single dose ideally
Ideal vaccine characteristics
Immunogenic long lasting safe offer broad immunity stable administered simply affordable
Early bacterial vaccines developed
1910 to 1930
Adjuvants
agents added to vaccines to modify and boost the immune response and provide longer lasting protection can prevent clearance of antigen to improve recognition improve delivery of antigen to lymphoid direct immune resposne
immunogenic vaccines
produces good immune response that protects against reinfection
PALM
RCT of ebola trans epidemic
Variolation
an early method of vaccination using infected material from a patient in china, india, middle east
Safe vaccine
minimal adverse effects no or mild disease doesnt increase risk of other diseases
Section 5
(50 cards)
How long does it take lyme to be transmitted
36-48 hours
how is attack rate expressed
percentage
When is lyme most likely the cause of facial palsy?
april-october with headache with fever no history of herpetic lesions bilateral nerve 7 involvement in endemic areas
Neuroborreliosis
facial palsy from lyme disease
Mathematical models
explicit mathematical description of the simplified dynamics of a system Not perfect representations of the real world approximate real world but permit thought experiments that are otherwise impossible
Rule of 7 for low risk of lyme meningitis (not lyme)
less than 7 days of headache less than 70% of mononuclear cells in CSF no cranial nerve 7 involvement
were pandemics more common before the 20th century?
no
why do lumbar puncture with lyme?
lyme disease and lyme meningitis both have headache lyme meningitis needs IV antibiotics for at least 2 weeks
how do structured networks influence speed of disease spread
slow down transmission
Treatment of lyme disease
under age 8 amoxicillin over 8 doxy treatment 14-21 days of anx for most cases 28 days for arthritis
Early Disseminated Lyme Disease
weeks to months neuroborreliosis meningitis and cranial neuritis carditis
what are 4 properties of flu that allow it to rapidly evolve and cause pandemics
low proofreading antigenetic shift antigenetic drift non human reservoirs and mixing vessels
When is lyme most common
March to december
Stages of Lyme
Early localized early disseminated late
Aseptic meningitis
due to enterovirus no direct treatment, just symptomatic care
When is meningitis due to lyme?
Prevalence of infections that cause meningitis almost identical at same time Lyme treated with antibiotics aseptic doesnt have treatment
Why doesnt the BASIC reproductive number not apply to an established epidemic
not a fully susceptible pop. Use Rt
Late stage lyme disease
months to years arthritis
Key assumption for compartmental models
population is homogenous in each compartment
Primary compartmental model imputs
parameters governing rules for moving between compartments
Are models useful?
They are all wrong but some are useful Based on assumptions
How fast is headache for bacterial meningitis
immediate, die quickly
Early Localized Lyme Disease
Weeks flu like illness single EM rash
Reservoir of lyme disease
deer tick primarily live on white footed mice
Lyme disease parasite
borrelia burgdorferi
When does an epidemic peak
when the proportion of people who are susceptible is equal to R0 or when di/dt=0 or when R(s/N)=1
Can lambda change
yes, number of people infected changes over time
Diagnosis of lyme disease
Presence of EM rash Two tier serology First is sensitive, second is specific
1st Tier lyme test
ELISA 100% sensitivity Identifies all cases
Where does Lyme mostly occur
north east and upper midwest This is where these ticks live Cases outside this range visited northeast or midwest
How many cases of lyme have erythema migrans rash
27%
what percent of kids with lyme have meningitis?
10%
lyme is responsible for what percent of craniel nerve 7 palsy in endemic areas?
50%
Types of mathematical models
compartmental network agent based
Agent based model
represent individuals in the system
Key SIR model assumptions
population is fixed latency period is zero infectious period = disease duration after recovery, people are immune people homogenous in compartments infection only arises from infected people
Unhelpful predictors of meningitis
history to tick bite EM rash place or residence
Predictors that help determine if lyme meningitis
seasonality duration of symptoms cranial neuropathy % mononuclear cells in CSF
When is it better to calculate IR than CI
Variable time dynamic population
Lyme meningitis onset
over period of time
Components of modeling and policy making
Available data scientific understanding scientific insight data collection policy advice and question Build, adapt, fit
what percent of kids with lyme associated nerve 7 palsy have meningitis?
68%
Modeling and policy making in public health
questions define purpose model design based on data and current understanding Validation shows further adaptation needed
Can Lyme be detected in blood right away?
No Symptoms have to be present for at least 2 weeks
Compartmental models
divide population into compartments based on infectious states and other variables state of system is defined by number of people in compartments
2nd tier lyme test
Western blot Confirmatory positive with 2 of 3 IGM bands or 5 of 10 IGG bands Highly specific with few false positives
is TB solely caused by m tuberculosis bacteria?
No
Is lyme EM rash diagnostic?
Yes
When are mathematical models helpful
determine plausibility of epi explanations of disease transmission and prevention improve understanding of dynamics in a population predict impact of changes
Will a reproductive number in a fully susceptible population be higher or lower to that with some immunity?
Higher
Section 6
(50 cards)
Is western blot highly sensitive
no
vaccine effectiveness applies to what validity
external
vaccine efficacy applies to what validity
internal
3 sets of parameters for agent based modeling
traits behaviors/interactions environment
Should ebola rapid test be sensitive or specific
Sensitive so that it can detect all cases
Do adjuvants prevent clearing of antigen by immune system
Yes
Common network types
random lattice small world spatial scale free
sociometric network studies
recruit multiple people and try to match partners and form connections
Reproductive number calculation
risk of transmission per contact * number of susceptible contacts per time * duration of infectiousness BCD
Why do assumptions required for calculating R0 for STI differ from other diseases
Not all completely susceptible Not homogenous population STI exposure is not random
Lattice networks
everyone has 4 neighbors node degree is 4 structure reduces severity and extends epidemic
prevalence
number of cases divided by number in total population
What measure of association is ideal for STI
incidence
L
total number of links in a network
Why do vaccinated and unvaccinated groups need to have comparable susceptibility and risk of exposure for vaccine effectiveness to be valid
RR is unadjusted and may be susceptible to confounding
Which physical symptom indicates primary syphilis infections
chancre sore
Cumulative incidence
number of new cases divided by number initially at risk
Odds ratio
ad/bc
Challenges with network studies
missing data missing relationships between people may not capture all missing people infections not picked up
Spatial network
people distributed in space and connected based on geography
Relative risk
[a/(a+b)]/[c/(c+d)]
Agent based models
similar to network based models but allow for more heterogeneity agents are people but interact to influence disease states can also impact behavior
Two obstacles preventing elimination of TB
MXR No vaccine
Does STI transmission occur more rapidly over fragile sexual networks
No
Random networks
random mixing give rise to most severe and fast epidemics, highest peaks
Is the primary input of SIR the number of people who immigrate into the population
No
Is dengue fever only active during outbreaks?
No, it is endemic in several places
Reproductive number calculation for STI
av probability of transmission per sex partner * Av number of partners per time * Av duration of infectiousness of an infected person
Small world network
see a lot of people have close neighbors then a handful have long distance connections generally small, uncertain epidemics cut off from pop represent long range connections which impact severity of epidemic
In SIR is infectious period same length as latent period
Nope
Attack rate
number of new cases divided by number susceptible
Adjacency matrices
use to describe connections within a population in most ID are symmetric and undirected
Egocentric network studies
recruit and ask who connected to and network based on nodes recruited- dont expand upon partners easy but miss data
How did host factors contribute to emergence of ebola in west africs in 2014
porous borders mobility health work shortages mistrust of government poor santiation
Degree
the number of connection each note has
Scale free network
more severe outbrekas number of connections are exponential. A handful have large number of connections
What are two host traits that contribute to the development of emerging disease
human demographic changes speed and ease of travel
Node degree distribution
average number of connections per individual per time step also called average node degree distribution higher distribution has more transmission
a
number of elements in the full adjacency matrix
Agent based model limitations
requires large amount of info about disease process and human behavior assumptions make inference and sensitivity analysis hard structural assumptions hard to communicate and replicate hard to generalize
Can someone get HPV without having sex
Yup
Degree distribution for circle
1 line
Network and agent based models
explicity represent individuals in a population state of system represented by people behavior and status and their contacts
Degree distribution
distribution of all of the individual node degrees tend to be highly positively skewed in sex networks
I
the infected people to contact
What are two characteristics of gonorrhea that contribute to its classification as reemerging
widespread antibiotic resistance spread thru most sexually active individuals
Are STIS usually symptomatic?
Nah
Why does infection with HPV not guarantee development of cervical cancer
Not all strains are oncogenic Many people naturally clear infection Some people dont have other associated factors
Can STI be transmitted via fomite?
yes, HPV
Model inputs of network and agent based models
natural disease history per contact infection probability contact distribution movement
Section 7
(16 cards)