Hi, students. In our module this week, we're going to be looking at some of the major issues in global health. We're going to begin by looking at infectious or communicable diseases. After that, we're going to talk about non-communicable disease. Then we're going to look at injury, violence, and disaster, and we're going to end this module by looking at one of the most important cross-cutting themes in global health: maternal, child, and reproductive health. But since we're going to start this module with infectious disease, I thought you might enjoy taking a little trip with me to Asia, where I'm going to talk to you about the story of SARS. [MUSIC] Since we are about to discuss infectious or communicable diseases, I thought it might be useful to tell you a little story. Hi class, I am in Hong Kong and I'm actually standing outside the entrance to what used to be the Metropal hotel. In 2003, a doctor from Guangdong Province in China came to stay in this hotel for a wedding. He wasn't feeling good. He was a respiratory disease specialist. Went to the wedding. Went out shopping with his brother. Did everything. Started feeling sick. Went to a local hospital. Soon, he was dead. But not only did he die on the ninth floor, in what used to be room 911, he had an infectious disease that was so pathogenic, that was so virulent, that within a few months time, 8,000 people around the world had become infected. Almost 10% of those people died. Well how did this come about? And what lessons does this teach us for global health? Well that is going to be our topic of discussion very soon. That doctor that I told you about. Over in the hotel. Once he got sick, he came to this hospital. He became inpatient. After several days, unfortunately, he died. But he did not die before he infected many of the workers here at the hospital who then spread disease to others. Now if you're beginning to think like a global health person, you've probably started asking yourself a couple of questions. One, this doctor who came to the hotel. What disease did he have? You're probably asking yourself, how did he get it? How did it spread so quickly? Where did it come from? Well I'm going to answer those questions, but to do that, I think we're going to hop on a train, right here in Hong Kong. And we're going to go into the mainland, we're going to go to a city called Guanjo. [NOISE] The story of how this doctor got sick and brought what we now call SARS or Sudden Acute Respiratory Syndrome to Hong Kong, has to do with one thing. Something that I mentioned earlier in Botswana, and that is interdependence. SARS, a coronavirus, actually jumped from animals to human beings. Yet, another zoonosis. It came from bats. In Guangdong, parts of the Guangdong region of China, bats were eaten as food by some folks. Bats carry the virus. Eventually the virus jumped to human beings. The virus, shifted a bit in its genetic structure and became easily transmissible from human being to human being. There are many important lessons from this transmission that we need to think about. One of course is this idea of interdependence. The second is that because we are interdependent, we have to think carefully about our relationship with nature and with the world around us, because there are many implications for everything that we do, especially related to health. Good morning, [FOREIGN]. Yes, for everything that we do. You know, I think another lesson we could say is that the importance of surveillance and reporting. Since SARS there has been a major increase in rules, regulations, and structures for reporting outbreaks of infectious disease. So please keep in mind that the story of infectious disease is not just the story of human beings getting sick. It is the story of our relationship with animals, with the world, and a story about how we live and we choose to live in this one large, but very small world that we call home. I think it's time for me to take you on another little trip. This time we're going to Vietnam. [NOISE] He came here and while I'm sure hoping that he would be diagnosed, treated and feel better, ultimately he died. The virus did not die however, because he already transmitted it to several doctors who were attending at this hospital, who subsequently began to spread the pathogen to other members of the Vietnamese population. Now it wasn't simply the doctors here that got infected, but also an official from the WHO, whose specialty was emerging and re-emerging infectious diseases. He ultimately died as well. Now, I wish I could say that the story of SARS stopped here. It did not. Ultimately SARS spread, just as it spread to Vietnam from Hong Kong to many other countries. Thousands of people were infected; many, many people died. Fortunately, and ultimately, the virus burned itself out, as happens with many more virulent pathogens. But nonetheless, SARS remains an important lesson. Just as I have traveled through many countries telling you this story, and I am soon to head back home, so too do viruses travel with us. Viruses and many infectious diseases, you must always remember, do not recognize borders. They do not need passports. All they need is a host that can carry them along. Now as we talk more about infectious disease in this unit, I want you to be aware of something. I've told you about a highly virulent pathogen, but remember most pathogens are not as high-profile as SARS. In fact, what kills many people or sickens many people around the world, are much more commonplace pathogens that we don't think about very much. Those that cause more mundane conditions, such as lower respiratory infections to children and the elderly, and one of the top killers of children, diarrhea.
