Questions NATIONAL CENTER FOR CASE STURY TOACHINGTN SCIENCE Sick on a South Amer

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NATIONAL CENTER FOR CASE STURY TOACHINGTN SCIENCE Sick on a South American Sugarcane Plantation Kevin M. Bonney Department of BiologicajSciencesm borough Community College, Brooklyn, N Part I -At the Plantation; Symptoms of an Unknown Illness Appear João Santos and his son Marco both work at a rural sugarcane plantation in the state of Bahia in northern Brazil. João, who is 48 years old, has worked there for more than thirty years while Marco, who is 21 years old, has worked there for almost five years. During harvest season, the two work up to twelve hours a day in the hot equatorial sun, chopping tall stalks of sugarcane with machetes and loading the stalks into the backs of trucks to be driven to the processing mill t during t The highlight of the Santos' day occurs in the carly afternoon when the plantation owner's young, magnanimous daughter brings our cool, freshly squeezed sugarcane juice for the two men to drink. She usually does not offer the to the other men, only to Joso and Marco (Joáo teases Marco that it is because she has a crush on him) She often stays to talk with them while drinking a glass of the sweet juice herself before retreating into her fathers luxurious, modern house before he notices. with several dozen other workers in a camp on the outskirts of the plantation, near the edge of the forest l thatched-roof hut with two other workers. Each man has a cot to sleep on and a trunk to store his in, but not much else. The camp lacks running water and electricity, but the men do have access d from a well and a suitable outhouse, similar to the conditions they have at home in their village main concern of the Santos's, other than the long working hours, is the constant invasion of their hut by insects and rodents. The plantation owner has promised to pour concrete on the dirt floors in the huts and provide insect netting to cover their cots, but each year that passes is another year he fails to fulfill his promises. Despite the many discomforts They share a small the Santos's must con plantation and try not to complain toom but they have not been able to find any other jobs in the area that would pay them higher wages. tinue working in order to feed their large family who live in a nearby village, so they stay at the uch. João and Marco each earn the equivalent of less than $1,000 USD per year For the past two weeks, João and Marco have been experiencing high fevers, fatigue, myalgia (muscle aches) abdominal pain, nausea, loss of appetite,a of breath) u are common among the workers, presumably contracted through nd diarrhea. João has also experienced headache and dyspnea (shortness pon exertion. At first the men thought that they had come down with one of the diarrheal ailments that contaminated food or water, which would usually resolve within a few days. Another worker reported having similar symptoms several weeks earlier that had eventually waned and resolved, so they thought that perhaps they had contracted a contagion from him. They had been sick like this before and it had passed, but this time was different; their symptoms were not improving after a few days as anticipated. Despite feeing ill the men were compelled o continue working in the fields so they could earn moncy to feed thei family. They finally decided to send a message to Joaquim, one of the elders in their vil age who is known as the unofficial village doctor, asking for medicine to relieve their fever and muscle aches so they could continue working. Joaquim broughr them a homemade medicine derived from the curare vine, which is commonly used to treat fevers and other alments in the Amazon. However, despite taking the curare medicine for seven days, the men's symptorms continued to worsen, especially for João. Sick on a South American Sugarcane Plantation" by Kevin M. Bonncy Page

Explanation / Answer

Ans 1) Some of the common pathogens that are found in South America are American Trypanosomiasis, Trypanosoma cruzi, Trypanosoma brucei gambiense, Trypanosoma brucei rhodesiense, protozoan parasites, Necator Americanus, Trichuris truichiura, etc. These are some of the most commonly occurring ones.

Ans 2) Some of the common questions that will be asked by the doctors are:-

How long it has been that they are suffering from the symptoms?

What did they eat or consume? Where do they drink water from?

Have they suffered from such symptoms before?

Did they take any medicines or consult anyone for the symptoms?

Which area do they do the jobs?

Ans 3) The disease they mostly might be suffering from is Chagas disease. It is highly prevalent in the sugarcane plantations of South America and is caused by Trypanosoma cruzi. it is caused by the biting of the insect. Some of the common symptoms of the disease in its initial stage is loss of appetite, fever, headaches, diarrhea, muscle pain, nausea. The disease is transmitted by insect vector which is called triatomine bug which is infected by Trypanosoma cruzi. It is also known as kissing bugs. It can also be caused by blood transfer from someone suffering from Chagas disease.

Ans 4) The diagnostic test is done to find out the presence of the Trypanosoma cruzi. It can be found out by microscopic examination of blood that is freshly coagulated. It can be done by preparing thick blood smears using Giemsa stain. There are many immunoassays also done to confirm the presence.

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