The Unfortunate Nurse by Karen M. Aguirre

Before Class

Students should read the January 2003 article “Texas Lifestyle Limits Transmission of Dengue Virus” by P. Reiter et al., Emerging Infectious Diseases, vol. 9, no.1, pp. 86–89 (http://0-www.cdc.gov.mill1.sjlibrary.org/ncidod/eid/vol9no1/02-0220.htm). Again, as you read, circle terms that you do not understand and look up definitions for them using the On-Line Medical Dictionary (http://www.nlm.nih.gov/medlineplus/mplusdictionary.html) or other sources. Do your best and we will demystify the rest together in class.

In Class

We will start with a discussion of what we have learned about dengue and what challenges the disease presents to our society.

Questions

1. Legal immigrants typically are tested for certain diseases. Obviously, people entering illegally undergo no such screening. What concerns might that cause in light of recent immigration trends in the United States? What would immigration watch-dog groups say about the cost to society of dengue? Can you think of other examples of medical issues that become entangled in political considerations?

2. From what you have read and the information we have presented in class on the incidence and epidemiology of dengue and on dengue surveillance, do you think we are in much danger of a serious dengue epidemic locally?

3. Consider the Reiter article that you read before class. Describe the climatologic argument for considering dengue as a limited danger. Describe the “life-style” argument.

4. Optional, food for thought: Earlier in this case study, we saw dengue transmitted by a needlestick. Outside of hospitals, dengue is transmitted from person to person via mosquito bite. Why is it that HIV, another blood-borne virus, can be transmitted by needlestick, but is not transmitted by mosquito bite?

5. Your instructor will give you a table or figure showing the National Institute of Health’s projected funding budget for various diseases for 2007. Look it over. Do you think each allocation is defensible? Explain how politics can sometimes drive research funding decisions.

Homework Assignment

The following writing assignment is designed to demonstrate student mastery of the goals for this case study:

As a take-home project, design (with artwork and text) three short (no more than two sides of a page each!) educational brochures on dengue—one appropriate for primary care physicians, a second intended to encourage recently graduated researchers to pursue research in this field, and a third that is appropriate for laypeople who maintain homes or plan to travel into areas where dengue is endemic. Begin sketching your plans in class. Some information may be common to all three brochures and some will be quite different. Your instructor is available for consultation.

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