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Infectious Diseases

School of Science and


Technology

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Topics

Topics to Cover in this Presentation

Definitions of health, disease, pathogen


Classification of diseases
Routes of disease transmission
Stages of infections

Definitions

Health: a condition of physical, mental, and social well-being


and the absence of disease or other abnormal condition

Disease:
Is an interruption, or disorder of a body, system, or organ
structure or function.

Normal Microbiota

Animals, including humans, are usually germ-free in


utero.
Microorganisms begin colonization in and on the
surface of the body soon after birth.
Microorganisms that establish permanent colonies
inside or on the body without producing disease make
up the normal microbiota.
Transient microbiota are microbes that are present
for various periods and then disappear.

Relationships Between the Normal


The normal microbiota can prevent pathogens from causing an infection
Microbiota and the Host
this phenomenon is known as microbial antagonism.
Normal microbiota and the host exist in symbiosis (living together).
There are three types of symbiosis:
Commensalism (one organism benefits and the other is unaffected)
Mutualism (both organisms benefit)
Parasitism (one organism benefits and one is harmed)

Pathology, Infection, and


Pathology is the scientific study of disease.
Disease
Pathology is concerned with the etiology (cause),

pathogenesis (development), and effects of disease.


Infection is the invasion and growth of pathogens in the
body.
Opportunistic Microorganisms- Opportunistic pathogens
do not cause disease under normal conditions but cause
disease under special conditions.
A host is an organism that shelters and supports the growth
of pathogens.
Disease is an abnormal state in which part or all of the body
is not properly adjusted or is incapable of performing normal
functions (loss of homeostasis).

Classifying Infectious
SIGN- Objective manifestations of disease that can be observed or
Diseases
measured by others.

SYMPTOM- Subjective characteristics of disease felt only by the


patient.
SYNDROME- Group of symptoms and signs that characterize a
disease or abnormal condition.

Ex: Middle East respiratory syndrome (MERS), also known as camel


flu, is a viral respiratory infection caused by the MERS-coronavirus.
Symptoms: include fever, cough, diarrhea, and shortness of breath.

Ex: Severe acute respiratory syndrome (SARS) is a viral respiratory


disease of zoonotic origin caused by the SARS coronavirus. The only
symptom common to all patients appears to be a fever above 38C.
SARS may eventually lead to shortness of breath and/or pneumonia.

Classifying Infectious
Diseases
Communicable disease- Disease transmitted from one host to another.

Contagious disease- Communicable disease that is easily spread.

Noncommunicable disease- Noncommunicable diseases (NCDs), also known as


chronic diseases, are not passed from person to person. They are of long duration and
generally slow progression. The 4 main types of noncommunicable diseases are
cardiovascular diseases, cancers, chronic respiratory diseases (such as chronic
obstructive pulmonary disease and asthma) and diabetes.

Predisposing Factors

A predisposing factor is one that makes the body more


susceptible to disease or alters the course of a disease.

Examples include gender, climate, age, fatigue, and


inadequate nutrition.

Entry of Infection
Entry of infection is a "gate where infection can invade in
host-organism and cause disease. Such an entrance can be:
Cutaneous (i.e. for malaria, spotted fever, etc.);
Airway mucousal (for flu, measles, scarlet fever);
Gastrointestinal mucosal (for dysentery, typhoid);
Urogenital mucosal (for gonorrhoea);
Blood or lymph vessel walls during biting by insects/animals or
surgical manipulation.
Entrance

point also can determinate a form of disease. For


example streptococcus invasion at tonsils causes tonsillitis,
through skin dermatitis, and at uterus it can causes
endometritis.

Routes of Transmission

Droplet (Aerogenic) Transmission also known as respiratory route, it is a


typical way of transmission for many infectious agents (such bacteria and
viruses).
Vehicle transmission
Airborne
Fecal-Oral Transmission infections spread commonly by indirect way: by
contaminated water or stuff (i.e. by people not washing their hands before
preparing food, or untreated sewage being released into a drinking water
supply). (not from a sick person to a healthy person).
Foodborne
Transmission by Direct Contact- Sexual Transmission, kisses, hand shake,
embracing. Vector transmission: bites by insects, etc.

Routes of Transmission

Transmission by Indirect Contact. These


diseases can also be transmitted by sharing a towel
or items of clothing in close contact with the body
or any stuff in public use (such are buttons in
elevator). For this reason, contagious diseases often
break out in schools, offices and other public
places.
Waterborne
Iatrogenic Transmission due to medical
procedures, such asinjections, blood
transfusions,or transplantationof infected material.

Sites
of
Infection
Infection can develop in different directions and take different
forms.

Localized infection local injury of tissue or body part.


Usually occur in sites of pathogen invasion.

- Typical sign is local inflammation. For example tonsillitis,


diphtheria, furunculosis are local infection.
- In some conditions local infection can develop into generalized
form.

Generalized infection involve all body and develop after


invasion of pathogen in blood. After invasion pathogen grow in
entrance site and then enter into blood stream.

- This mechanism of infection are typical for such diseases like


influenza, syphilis, hepatitis, some forms of tuberculosis, etc.

The Extent of Host


Involvement
A local infection affects a small area of the body;
a systemic infection is spread throughout the
body via the circulatory system.

A secondary infection can occur after the host is


weakened from a primary infection.

An inapparent, or subclinical, infection does not


cause any signs of disease in the host.

The Severity or Duration of a


The scope of a disease can be defined as:
Disease
Acute

develops rapidly but lasts a short time


(influenza)
Chronic develops more slowly, reactions to the disease
are less severe, likely to be continual or recurrent for long
periods (TB, hepatitis B)
Subacute intermediate between acute and chronic
(sclerosing panencephalitis)
Latent the causative agent remains inactive for a time
but then becomes active to produce symptoms (shingles)

Patterns of disease

What happens in each the following periods of an


infectious disease:

Prodromal period
Incubation period
Period of illness
Period of decline
Convalescence

Infectious Disease Phases


Like other diseases infectious disease have determined
phases of pathological process:
Incubation

period

Prodrome
Manifestation

(illness)

Decline
Convalescence

Incubation Period

At Latin incubatio, means lie or sleep


[somewhere].
Incubation periodis
thetimeelapsed between exposure
to apathogenicorganism and when
symptomsand signs are first
apparent.

Prodromal Period

Prodrome is a
Greek word
means running
before or
harbinger
(precursor).

In medicine, a prodrome is an early symptom (or set of symptoms) that might


indicate the start of a disease before specific symptoms occur.
Typically the fist symptoms of disease are not shows any pathognomonic sings for
specific disease: there are common symptoms such as sickness, headache, fever or
malaise and lack of appetite frequently occur in the prodrome of many infectious
diseases. (measles, rubella, chicken pox)

Manifestation: Maturation of
In this stage disease present individual patterns of symptoms
Disease
or common for different diseases features such as
inflammatory alterations, bleeding, encephalitic signs, etc.
There are 3 phases of this stage that can be clinically evident:
Stage

I - symptoms increasing stage;


Stage II disease peak stage;
Stage III disease fading (decreasing) stage.

Outcome: convalescence or terminal


illness
Terminal illnessis amedical
termpopularized in the 20th century to
describe adiseasethat cannot be cured
or adequately treated and that is
reasonably expected to result in deathof
the patient within a relatively short period
of time.

In this stage occur gradual recovery ofhealthand strength afterillness. It refers to the later
stage of an infectious disease or illness when the patient recovers and returns to normal,
-but may continue to be a source of infection even if feeling better. In this sense, "recovery" can
be considered a synonymous term.

The Development Of Disease

The incubation period is the time interval between the initial


infection and the first appearance of signs and symptoms.
Prodromal period - characterized by the appearance of the
first mild signs and symptoms.
Period of illness - the disease is at its height, and all disease
signs and symptoms are apparent.
Death may occur during the period of illness.
Crisis is the phase of fever characterized by vasodilation and
sweating (the body is trying to return to normal temperature, the
fever is breaking).
Period of decline - the signs and symptoms subside.
Period of convalescence - the body returns to its prediseased
state, and health is restored.

Chicken pox

Varicella-zoster virus (VZV): Incubation period apporox. 1 month

Air transmission (by coughing and sneezing) and by direct contact with mucus,
saliva (spit), or fluid from the blisters.
Prodromal period- common symptoms- flu (Chickenpox often starts with a fever,
headache, sore throat, or stomachache. These symptoms may last for a few days,
with thefever in the 38- 39C range.
Manifestation, maturation of disease- red, itchy skin rash that usually appears first
on the abdomen or back and face, and then spreads to almost everywhere else on
the body, including the scalp, mouth, arms, legs, and genitals.
Outcome or convalescence- normal body t , all blisters have dried, usually
about 1 week.

Epidemiology

The science of epidemiology is the study of the


transmission, incidence, and frequency of disease.

Modern epidemiology began in the mid-1800s with


the works of Snow, Semmelweis, and Nightingale.

The Occurrence of a Disease

Disease occurrence is reported by incidence and


prevalence.

Incidence Number of people contracting the


disease in a given time period.

Prevalence Number of total cases at a


particular time regardless of when they
developed.

Occurrence
Diseases are classified by frequency of occurrence:
Sporadic

occurs occasionally (typhoid fever in

the U.S.)
Endemic constantly present in a population
(common cold)
Epidemic many cases in a given area in short
period (influenza)
Pandemic a world wide epidemic (influenza
occasionally, AIDS might be considered pandemic)

Epidemiologic Definitions of Infections

Endemic:

a disease that is constantly present to a greater or lesser degree in people of a certain class or in people living in a particular
location.
A characteristic of a particular population, environment, or region.
Examples of endemic diseases include chicken pox that occurs at a predictable rate among young school
children in our country or malaria in some areas of Africa.
The disease is present in a community at all times but in relatively low frequency.

Sporadic:
Sporadic- a disease which occurs in single and scattered cases.
Occurs in the apparent absence of any environmental or inherited cause.
Examples of a sporadic disease are sporadic fatal insomnia and sporadic prion disease.

Epidemic and Pandemic:

Epidemic disease - any infectious disease that develops and


spreads rapidly to many people (Zika virus, Ebola).

Pandemic- Epidemics over a wide geographic area and affecting a


large proportion of the population (Bird flu).

Types of Epidemiological
Descriptive Epidemiology - collects all data that
Investigations:
describes the disease under study. Most studies are
reptrospective.
Relevant information includes information about:
- Affected individuals.
- The place the disease occurred.
- The period in which the disease occurred.
Retrospective studies done after the episode has
ended, backtracks to the cause and source of the disease.
Prospective studies a group of people who are free of
a particular disease are chosen and their subsequent
disease experiences recorded for a given period of time.

Analytical Epidemiology

analyzes a particular disease to determine the probable


cause. Studies tend to be cross-sectional all data is
collected at one time; provides information about prevalence.

Case-control method (retrospective) a group of people


who have the disease is compared with another group of
people who are free of the disease to determine factors that
might have preceded the disease.
Cohort method (prospective) compare a population that
has had contact with the agent causing the disease and
another group that has not.
Experimental Epidemiology controlled experiments are
designed to test hypotheses are performed.

Morbidity and Mortality Rate

Morbidity rate is the number of people affected


by a disease in a given period of time (incidence)
in relation to the total population.

Mortality rate is the number of deaths resulting


from a disease in a population in a given period of
time in relation to the total population.

Case
Reporting
Case reporting
provides data on incidence and

prevalence to local, state, and national health officials.


Establishes the chain of transmission.

The Centers for Disease Control and Prevention (CDC), a


branch of the U.S. Public Health Service, is the main
source of epidemiologic information in the United States.

The CDC publishes the Morbidity and Mortality Weekly


Report to provide information on morbidity (incidence)
and deaths (mortality).

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