Appendix C
Glossary

Animal Husbandry: The science of breeding, feeding, and care of domestic animals; includes housing and nutrition (http://www.ncbi.nlm.nih.gov/sites/entrez?cmd=Retrieve&db=mesh&list_uids=68000822&dopt=Full).

Anophelines: A genus of mosquitoes that includes all mosquitoes that transmit malaria to humans (http://www.merriam-webster.com).

Anthroponotic: Transmission from human to human and potentially from human to animal.

Antibiotic: Class of substances that can kill or inhibit the growth of some groups of microorganisms. Used in this report to refer to chemicals active against bacteria. Originally antibiotics were derived from natural sources (e.g., penicillin from molds), but many currently used antibiotics are semisynthetic and modified with additions of man-made chemical components. See Antimicrobials.

Antibiotic Resistance: Property of bacteria that confers the capacity to inactivate or exclude antibiotics or a mechanism that blocks the inhibitory or killing effects of antibiotics.

Antimicrobials: Class of substances that can destroy or inhibit the growth of pathogenic groups of microorganisms, including bacteria, viruses, parasites, and fungi.

Arboviral Diseases: Shortened form of arthropod-borne virus. Any of a group of viruses that are transmitted to humans and animals by mosquitoes, ticks, and



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Appendix C Glossary Animal Husbandry: The science of breeding, feeding, and care of domestic animals; includes housing and nutrition (http://www.ncbi.nlm.nih.gov/sites/ entrez?cmd=Retrieve&db=mesh&list_uids=68000822&dopt=Full). Anophelines: A genus of mosquitoes that includes all mosquitoes that transmit malaria to humans (http://www.merriam-webster.com). Anthroponotic: Transmission from human to human and potentially from human to animal. Antibiotic: Class of substances that can kill or inhibit the growth of some groups of microorganisms. Used in this report to refer to chemicals active against bacteria. Originally antibiotics were derived from natural sources (e.g., penicillin from molds), but many currently used antibiotics are semisynthetic and modified with additions of man-made chemical components. See Antimicrobials. Antibiotic Resistance: Property of bacteria that confers the capacity to inactivate or exclude antibiotics or a mechanism that blocks the inhibitory or killing effects of antibiotics. Antimicrobials: Class of substances that can destroy or inhibit the growth of patho- genic groups of microorganisms, including bacteria, viruses, parasites, and fungi. Arboviral Diseases: Shortened form of arthropod-borne virus. Any of a group of viruses that are transmitted to humans and animals by mosquitoes, ticks, and 0

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 APPENDIX C sand flies; they include such agents as yellow fever and eastern, western, and Venezuelan equine encephalitis viruses. Arthralgia: (Joint pain) or stiffness without joint swelling (http://wonder.cdc. gov/wonder/help/vaers/reportable.htm). Arthropod: As used in this report, refers to insects and ticks, many of which are medically important as vectors of infectious diseases. Arthropod-borne: Capable of being transmitted by insect and tick (arthropod) vectors. Asymptomatic: Presenting no symptoms of disease. Autopsy: Systematic examination of the body of a deceased person by a quali - fied pathologist. The body is inspected for the presence of disease or injury; specimens of the vital organs and/or body fluids may be taken for microscopic, chemical, or other tests. Bacteria: Microscopic, single-celled organisms that have some biochemical and structural features different from those of animal and plant cells. Biological weapons: A harmful biological agent (such as a pathogenic microorganism or a neurotoxin) used as a weapon to cause death or disease usu- ally on a large scale (http://www.merriam-webster.com). Biota: The animal and plant life of a given region (http://www.epa.gov/ OCEPAterms/bterms.html). Bioterrorism: Terrorism involving use of biological warfare agents (as disease causing viruses or herbicides). Botulism: A rare but serious paralytic illness caused by a nerve toxin. Symptoms of botulism include double vision, blurred vision, drooping eyelids, slurred speech, difficulty swallowing, dry mouth, and muscle weakness. The illness can cause paralysis, respiratory failure, and death (http://www.fsis.usda.gov/Fact_Sheets/ Frozen_Fully_Cooked_Products_&_Botulism/index.asp). Bushmeat: Wildlife species which are hunted in the “bush,” or forests (http://www. wcs-congo.org/01ecosystemthreats/02bushmeat/104whatisbushmeat.html).

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 INFECTIOUS DISEASE MOVEMENT IN A BORDERLESS WORLD Chemoprophylaxis: The use of drugs or biologics taken by asymptomatic per- sons to reduce the risk of developing a disease (http://odphp.osophs.dhhs.gov/ pubs/guidecps/text/ii_met~1.txt). Communicable Disease: An infectious disease transmissible (as from person to person) by direct contact with an affected individual or the individual’s discharges or by indirect means (as by a vector). Disease: As used in this report, refers to a situation in which infection has elicited signs and symptoms in the infected individual; the infection has become clini - cally apparent. Emerging infections: Any infectious disease that has come to medical atten- tion within the last two decades or for which there is a threat that its prevalence will increase in the near future (IOM, 1992). Many times, such diseases exist in nature as zoonoses and emerge as human pathogens only when humans come into contact with a formerly isolated animal population, such as monkeys in a rain forest that are no longer isolated because of deforestation. Drug-resistant organisms could also be included as the cause of emerging infections since they exist because of human influence. Some recent examples of agents responsible for emerging infections include human immunodeficiency virus, Ebola virus, and multidrugresistant Mycobacterium tuberculosis, and H1N1 influenza A. Emerging infectious diseases: Infections that are rapidly increasing in incidence or geographic range. Emigration: To leave one’s usual country of residence to settle in another. Encephalitis: An acute inflammatory disease of the brain due to direct viral inva- sion or to hypersensitivity initiated by a virus or other foreign protein. Endemic: Present in a community or common among a group of people; said of a disease prevailing continually in a region. Enteric: Of, relating to, or affecting the intestines. Enzootic: A disease of low morbidity that is constantly present in an animal community. Epidemic: The condition in which a disease spreads rapidly through a commu- : nity in which that disease is normally not present or is present at a low level.

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 APPENDIX C Epidemiology: Study of the distribution and determinants of health-related states or events in specified populations. Epidemiology is the basic quantitative science of public health. Epizootic: A disease of high morbidity that is only occasionally present in an animal community. Eradication: Reduction of the worldwide incidence of a disease to zero as a result of deliberate efforts (http://www.cdc.gov/mmwr/preview/mmwrhtml/su48a7.htm). Etiologic agent: The organism that causes a disease. Etiological: Of or pertaining to causes or origins (www.dictionary.com). Etiology: Science and study of the causes of diseases and their mode of operation. Extensively Drug Resistant Tuberculosis (xDR-TB): A relatively rare type of MDR-TB. XDR-TB is defined an M. tuberculosis isolate that is resistant to isoniazid and rifampin plus any fluoroquinolone and at least one of three inject- able second-line drugs (i.e., amikacin, kanamycin, or capreomycin; for more information see http://www.cdc.gov/tb/pubs/tbfactsheets/mdrtb.htm). Flavivirus: Any of a group of arboviruses that contain a single strand of RNA, are transmitted by ticks and mosquitoes, and include the causative agents of dengue, Japanese B encephalitis, and yellow fever. Food Contamination: Poisonous or deleterious substances, such as chemical contaminants, which may or ordinarily render it harmful to health (http://www. fda.gov/Food/FoodSafety/FoodContaminantsAdulteration/default.htm). Foodborne Diseases: Disease caused by consuming contaminated foods or bever- ages. Many different disease-causing microbes, or pathogens, can contaminate foods, so there are many different foodborne infections. In addition, poisonous chemicals, or other harmful substances can cause foodborne diseases if they are present in food (http://www.cdc.gov/ncidod/dbmd/diseaseinfo/foodborneinfections_g.htm). Genomics: The study of all the genes in a person, as well as interactions of those genes with each other and with that person’s environment (http://www.cdc.gov/ genomics/faq.htm). Globalization: The increased interconnectedness and interdependance of peoples and countries, is generally understood to include two interrelated elements: the

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 INFECTIOUS DISEASE MOVEMENT IN A BORDERLESS WORLD opening of borders to increasingly fast flows of goods, services, finance, people and ideas across international borders; and the changes in institutional and policy regimes at the international and national levels that facilitate or promote such flows (http://www.who.int/trade/glossary/story043/en/index.html). Hantavirus: A group of viruses that cause hemorrhagic fever and pneumonia. Hantaviruses are transmitted to humans by contact direct or indirectly with the saliva and excreta of rodents such as deer mice, field mice, and ground voles. Heparin: A b lood-thinning drug (http://www.fda.gov/Drugs/DrugSafety/ PostmarketDrugSafetyInformationforPatientsandProviders/UCM112597). Herd immunity: A reduction in the probability of infection that is held to apply to susceptible members of a population in which a significant proportion of the individuals are immune because the chance of coming in contact with an infected individual is less. Host: Animal or plant that harbors or nourishes another organism. Immigration: To arrive and take up permanent residence in a country other than one’s usual county of residence. Immune-Competence: The ability of the immune system to respond appro- priately to an antigenic stimulation (http://medical-dictionary.thefreedictionary. com/immune+competence). Immunologically Compromised: A condition (caused, for example, by the administration of immunosuppressive drugs or irradiation, malnutrition, aging, or a condition such as cancer or HIV disease) in which an individual’s immune system is unable to respond adequately to a foreign substance. Incubation Period: The time from the moment of inoculation (exposure to the infecting organism) to the appearance of clinical manifestations of a particular infectious disease (http://agclass.nal.usda.gov/agt/mtwdk.exe?k=default&l=60& w=47104&n=1&s=5&t=2). Infection: The invasion of the body or a part of the body by a pathogenic agent, such as a microoganism or virus. Under favorable conditions the agent develops or multiplies, the results of which may produce injurious effects. Infection should not be confused with disease. Inoculum: Collective term for microorganisms or their parts (spores, mycelial fragments, etc.) which are capable of infection or symbiosis when transferred to

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 APPENDIX C a host (http://agclass.nal.usda.gov/agt/mtwdk.exe?k=default&l=60&w=837&n= 1&s=5&t=2). Insectivorous Mammals (insectivores): Small mammals (shrews and moles) with short, dense fur, five clawed toes on each foot, and small eyes and ears. As the name implies, insectivores eat many insects and their larvae, however, they also eat many other invertebrates. They are land-dwellers, burrowers, and some spend much of their life in water (http://www.dcnr.alabama.gov/watchable-wildlife/ what/Mammals/Insectivores/). Intellectual Property: Property (as an idea, invention, or process) that derives from the work of the mind or intellect; also an application, right, or registration relating to this (http://www.merriam-webster.com/dictionary/Intellectual%20Property). Intermediate Host: A host which is normally used by a parasite in the course of its life cycle and in which it may multiply asexually but not sexually (http://www. merriam-webster.com/dictionary/intermediate%20host). International Health Regulations (IHR): An international legal instrument that is binding on 194 countries across the globe, including all the member states of WHO. Their aim is to help the international community prevent and respond to acute public health risks that have the potential to cross borders and threaten people worldwide. The IHR, which entered into force on June 15, 2007, require countries to report certain disease outbreaks and public health events to WHO. Building on the unique experience of WHO in global disease surveil- lance, alert and response, the IHR define the rights and obligations of countries to report public health events, and establish a number of procedures that WHO must follow in its work to uphold global public health security (http://www.who. int/topics/international_health_regulations/en/). Iron Curtain: The political, military, and ideological barrier erected by the Soviet Union after World War II to seal off itself and its dependent eastern European allies from open contact with the West and other noncommunist areas (http://www.britannica.com/EBchecked/topic/294419/Iron-Curtain). Latency: Delay between exposure to a disease-causing agent and manifestation of the disease (onset of infectiousness) (http://www.cdc.gov/niosh/docs/2000-127/ chartbk9.htm). Microbe: A microorganism or biologic agent that can replicate in humans (including bacteria, viruses, protozoa, fungi, and prions). Microbial Threat: Microbes that lead to disease in humans.

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 INFECTIOUS DISEASE MOVEMENT IN A BORDERLESS WORLD Microbiology: A branch of biology dealing especially with microscopic forms of life. Migration: The regular, usually seasonal, movement of all or part of an animal population to and from a given area (http://www.britannica.com/EBchecked/ topic/381854/migration). Mitigation: Initiatives that reduce the risk from natural and man-made hazards. Melamine: An industrial chemical that can cause health problems such as kidney disease (http://wwwn.cdc.gov/travel/content/in-the-news/melamine-china.aspx). http://wwwn.cdc.gov/travel/content/in-the-news/melamine-china.aspx). Morbidity: Diseased condition or state. Mortality: The quality or state of being mortal; the number of deaths in a given time or place; the proportion of deaths to population. Multiple Resistance or Multi-Drug Resistance Tuberculosis (MDR-TB): Property of bacteria that are resistant to more than one antibiotic. In this report, MDR refers to Tuberculosis that is resistant to at least two of the best anti- tuberculosis drugs, isoniazid and rifampin. These drugs are considered first-line drugs and are used to treat all individuals with tuberculosis (for more information, see http://www.cdc.gov/tb/pubs/tbfactsheets/mdrtb.htm). Mutation: Genetic change that can occur either randomly or at an accelerated rate through exposure to radiation or certain chemicals (mutagens) and may lead to change in structure of the protein coded by the mutated gene. Myalgia: Muscle pain. Necropsy: An autopsy performed on an animal. Notifiable Disease: Disease physicians are required to report to state health departments. Oviposit: To lay eggs, especially by means of an ovipositor (a tube in many female insects that extends from the end of the abdomen and is used to lay eggs) (http://www.thefreedictionary.com/ovipositor). Paleolithic Period: Ancient cultural stage, or level, of human development, char- acterized by the use of rudimentary chipped stone tools (http://www.britannica. com/EBchecked/topic/439507/Paleolithic-Period).

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 APPENDIX C Pandemic: Occurring over a wide geographic area and affecting an exceptionally high proportion of the population. Paracetamol (acetaminophen): A drug used in the treatment of mild pain, such as headache and pain in joints and muscles, and to reduce fever. The drug inhibits prostaglandin synthesis in the central nervous system. Overdoses can cause fatal liver damage (http://www.britannica.com/EBchecked/topic/3205/acetaminophen). Paramyxoviridae: Important pathogens of humans and a common cause of respiratory disease in children (http://virus.stanford.edu/paramyxo/paramyxo. html). In this report, Paramyxoviridae is used to refer to the Nipah virus, a newly emerging zoonosis that causes severe disease in both animals and humans. The natural host of the virus are fruit bats of the Pteropodidae Family, Pteropus genus (http://www.who.int/csr/disease/nipah/en/index.html). Parasite: An organism that lives in or on and takes its nourishment from another organism. A parasite cannot live independently. Parasitic diseases include infec- tions by protozoa, helminths, and arthropods (http://www.medterms.com/script/ main/art.asp?articlekey=4769). Patency: In this report patency refers to the patent period—the period between acquisition of the parasite and the time when eggs, larvae, or microfilariae are shed (http://books.google.com/books?id=oKSEhVMVrJ4C&pg=PA3&lpg= PA3&dq=patency+and+parasites&source=bl&ots=Wh45JBXqGB&sig= oYApNDLeVhJ3mQZCGCqi2hNNlZE&hl=en&ei=ac1gSoqdItqBtgfEv5XRDA &sa=X&oi=book_result&ct=result&resnum=4). Pathogen: Organism capable of causing disease. Pathogenic: Capable of causing disease. Pathology: The branch of medicine concerned with disease, especially its structure and its functional effects on the body (http://www.biology-online. org/dictionary/Pathology). Phylogeny: The connections between all groups of organisms as understood by ancestor/descendant relationships (http://www.ucmp.berkeley.edu/exhibit/ introphylo.html). Physiochemical: Of or relating to physiological chemistry. Prevalence: Total number of cases (new as well as previous cases) of a disease in a given population at a point in time.

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 INFECTIOUS DISEASE MOVEMENT IN A BORDERLESS WORLD Prions: A newly discovered type of disease-causing agent, neither bacterial nor fungal nor viral, and containing no genetic material. A prion is a protein that occurs normally in a harmless form. By folding into an aberrant shape, the nor- mal prion turns into a rogue agent. It then co-opts other normal prions to become rogue prions. They have been held responsible for a number of degenerative brain diseases, including Mad Cow disease, Creutzfeldt-Jakob disease, and possibly some cases of Alzheimer’s disease. Prophylaxis: Measures designed to preserve health (as of an individual or of society) and prevent the spread of disease (http://www.merriam-webster.com/ dictionary/prophylaxis). Public Health: The art and science of dealing with the protection and improve- ment of community health by organized community effort and including preven- tive medicine and sanitary and social health. . Quarantine: The enforced isolation or restriction of free movement imposed to prevent the spread of a contagious disease. Quinolones: Class of purely synthetic antibiotics that inhibit the replication of bacterial DNA; includes ciprofloxacin and fluoroquinolone. Radiological Agents: Materials that emit radiation that can harm living organ- adiological isms (http://books.google.com/books?id=XdXpn6NH2GcC&pg=PA363&lpg= PA363&dq=radiological+agents&source=bl&ots=5CneVzp3-e&sig=Z6Y8qF9p rbJx7hdI510dNRGBj_Q&hl=en&ei=edFgSpq8MaCwtgeM16zWDA&sa=X&oi =book_result&ct=result&resnum=2). Recombine: The process by which the combination of genes in an organism’s offspring becomes different from the combination of genes in that organism (http://www.bio-medicine.org/biology-definition/Genetic_recombination/). Reservoir: Any person, animal, arthropod, plant, soil, or substance (or combina- tion of these) in which an infectious agent normally lives and multiplies, on which it depends primarily for survival, and in which it reproduces itself in such manner that it can be transmitted to a susceptible vector. Resistance: See Antibiotic Resistance. Rickettsial Disease: Caused by organisms within the genus of rickettsiae. Rickettsiae comprise a group of microorganisms that phylogenetically occupy a position between bacteria and viruses (http://emedicine.medscape.com/article/968385-overview).

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 APPENDIX C Salmonella: A group of bacteria that cause typhoid fever, food poisoning, and enteric fever from contaminated food products. Salmonellosis: An infection with bacteria called Salmonella. Most persons infected with Salmonella develop diarrhea, fever, and abdominal cramps 12 to 72 hours after infection. The illness usually lasts 4 to 7 days, and most persons recover without treatment (http://www.cdc.gov/nczved/dfbmd/disease_listing/ salmonellosis_gi.html). Serotype: The characterization of a microorganism based on the kinds and combinations of constituent antigens present in that organism; a taxonomic sub- division of bacteria based on the above. Species Barrier: Difficulty or impossibility for an infectious agent to pass from one species to another (due to differences between species) (http://www. cite-sciences.fr/lexique/definition1.php?lang=an&id_expo=15&id_habillage= 28&iddef=406&idmot=179). Stem Cell: A cell that has the potential to develop into many different cell types in the body during early life and growth (http://stemcells.nih.gov/info/basics/ basics1.asp). Surge Capacity: A measurable representation of a health care system’s ability to manage a sudden or rapidly progressive influx of patients within the cur- rently available resources at a given point in time (http://www.acep.org/practres. aspx?id=29506). Surveillance: Used in this workshop summary to refer to data collection and recordkeeping to track the emergence and spread of disease-causing organisms such as antibiotic-resistant bacteria. Syndrome: A group or recognizable pattern of symptoms or abnormalities that indicate a particular trait or disease (http://www.genome.gov/glossary. cfm?key=syndrome). Temporal Barrier: A barrier which blocks the movement of the entire population of an organism some of the time (http://wdfw.wa.gov/hab/ahg/shrg/11-shrg_fish_ passage_restoration.pdf). Transmission: Process by which a pathogen passes from a source of infection to a new host.

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0 INFECTIOUS DISEASE MOVEMENT IN A BORDERLESS WORLD Universal Precautions: The use of gloves, protective garments, and masks, when handling potentially infectious or contaminated materials (http://www.who.int/ http://www.who.int/ csr/disease/hepatitis/whocdscsrlyo20022/en/index5.html#guidelines). Vaccine: A preparation of living, attenuated, or killed bacteria or viruses, frac - tions thereof, or synthesized or recombinant antigens identical or similar to those found in the disease-causing organisms, that is administered to raise immunity to a particular microorganism. Vector: A carrier, especially an arthropod, that transfers an infective agent from ector: one host (which can include itself) to another. Vector-borne: Transmitted from one host to another by a vector. Viral Sovereignty: Deadly viruses are the sovereign property of individual nations even though they cross borders and could pose a pandemic threat to all the world’s peoples. Coined by Indonesia’s minister of health, Siti Fadilah Supari (http://www.whothailand.org/LinkFiles/Media_AI25Sep08.pdf). Viremia: The presence of virus in the blood of a host. Virulence: The ability of any infectious agent to produce disease. The virulence of a microoganism (such as a bacterium or virus) is a measure of the severity of the disease it is capable of causing. Wheat Gluten: The mixture of proteins, including gliadins and glutelins, found in wheat grains, which are not soluble in water and which give wheat dough its elastic texture (http://www.thefreedictionary.com/gluten). xenotransplantation: Any procedure that involves the transplantation, implan- tation, or infusion into a human recipient of either (a) live cells, tissues, or organs from a nonhuman animal source, or (b) human body fluids, cells, tissues or organs that have had ex vivo contact with live nonhuman animal cells, tissues or organs (synonym: xenogeneic transplantation) (http://www.fda.gov/ BiologicsBloodVaccines/Xenotransplantation/default.htm). Zoonotic Infection: Infection that causes disease in human populations but can be perpetuated solely in nonhuman host animals (e.g., bubonic plague); may be enzootic or epizootic.