Infectious

Diseases
 Infectious Diseases
Study Objectives: to know
1. What is an infectious disease??
2. What is an infection??
3. Causes of re-emerging of the problem of the infectious diseases
4. Microbiological Classification of Infectious Diseases.
5. Means of Transmission of Infectious Diseases.
6. The action of pathogen in infectious process (pathogenicity)
7. What is infectivity ,virulence, Immunogenicity and incubation period .
8. Manifestations of infectious process (Infection spectrum).
9. The immune reaction of host in infectious process.
10.Common symptoms and signs.
 Infectious Diseases
What is an infectious diseases??

Infectious disease is:

① A group of common diseases
② Caused by different pathogens
③ Possessing infectivity.
④ To form epidemic.
⑤ Infectious disease is a threat to the health of people.
 Infectious Diseases
What is an infectious disease??

A case is a risk factor …

 Infection in one person can be transmitted to others
 Infectious Diseases
What is an infection??

Definition of infection
① Complex process of interaction between pathogen
and human body
② Infection is composed of three factors: pathogen,
host and environment
③ There are commensalisms and opportunistic
infection
 Infectious Diseases
Causes of re-emerging of the problem of the infectious diseases:
1. Loss of Antibiotic Effectiveness.

2. Increased Population Density: Transmission from person to person

is more likely.
3. Travel: Travelers may bring back pathogens.
4. Global Warming: May affect rainfall or other factors that currently
affect diseases or their carriers.
5. Biological Warfare or Terrorist Attacks: There have recently been
a number of threats of such attacks involving anthrax.
6. New Routes of transmission: Organ Transplants.
7. Complacency and Ignorance: Many, possibly most, people do not
wash their hands after using the toilet.
Microbiological Classification of Infectious
Diseases

Bacterial Gram-negative
Gram-positive
Viral DNA virus
RNA virus
Enveloped vs non-enveloped
Fungal Disseminated
Localized
Parasitic Protozoa
Helminths
 Means of Transmission of Infectious
Diseases
Contact Requires direct or indirect contact (fomite,
blood, or body fluid)
Food or Ingestion of contaminated food or water
Water
Airborne Inhalation of contaminated air

Vector-borne Dependent on biology of vector as well as

infectivity of organism
Perinatal Similar to contact infection, however, the
contact may occur in utero or during
delivery.
Sexual
transmission by sexual intercourse.
Factors Influencing Disease Transmission

Agent Environment
• Infectivity • Weather
• Pathogenicity • Housing
• Virulence • Geography
• Immunogenicity • Occupational setting
• Antigenic stability • Air quality
• Survival • Food

• Age

Host • Sex
• Genotype
• Behaviour
• Nutritional status
•Health status
 Infectious Diseases
Factors Influencing Disease Transmission( Agent)

Pathogenicity
What does pathogenicity mean???
It means the ability of a microbiological agent to
induce disease
The pathogenicity of pathogen is related to :
1. Invasiveness
2. virulent
3. Number of pathogen
4. Mutation (variability)
 Infectious Diseases
Factors Influencing Disease Transmission( Agent)
Infectivity:
 Ability of agent to cause infection
 Number of infectious particles required
 In person-to-person transmission, secondary attack rate is
a measure of infectivity

Virulence :
Severity of the disease after infection occurs.

Measured by case fatality rate or proportion of clinical cases that

develop severe disease.

 Infectious Diseases
Factors Influencing Disease Transmission( Agent)

Immunogenicity
 Ability of an organism to produce an immune response that

provides protection against reinfection with the same or similar

agent

 Can be life long or for limited periods

 Important information for development of vaccines

 Infectious Diseases
The immune reaction of host Infection
in infectious process will be : and Immunity

Non specific Specific

immunity immunity

Humoral
Immunity
Barrier Action
Immunoglobulin:
IgG, IgM, IgE, IgA, IgD

Ext. barriers:
Int. barriers: Cell mediated
skin , mucosa &
Placenta or BBB immunity
their Secretion

Phagocytosis

Humoral Action
Complement, Lysozyme,
Fibronectin, Cytokines
 Infectious Diseases
Barriers for Defense Against Infection:
1. Skin:
 Prevents entry of infectious organisms, unless injured.
 Severe burn patients who die are usually killed by infections. So much skin is
damaged they are very vulnerable to infections.
2. Mucus membrane:
 Mucous is usually rich in enzymes that will kill many pathogens
3. Cilia:
 These are hair-like structures lining the respiratory tract. They work to sweep
foreign particles out of the respiratory tract.
 Damaged by smoking, leaving smokers more vulnerable to infections.

4. Coughing:
 Helps remove foreign material from respiratory tract.

5. Personal Hygiene
 Helps reduce the number of pathogenic organisms on the skin and other
surfaces of the body.
 Infectious Diseases
Infection and Immunity
Manifestations of infectious process (Infection spectrum):
1) Clearance of pathogen (no infection)
2) Covert infection (subclinical infection)
3) Overt infection (Clinical infection or apparent infection)
4) Carrier states
 Health carrier after covert infection.
 Convalescent carrier after overt infection.
 Incubatory carrier before onset of disease.
According to carrier time : #acute (transient) carrier
#chronic carrier
5) Latent infection.
 Infectious Diseases

Pathogenetic Mechanisms:
 Direct tissue invasion: like smallpox

 Production of a toxin: anthrax produce toxins that

invade and destroy tissue

 Immunologic enhancement or allergic reaction

 Persistent or latent infection

 Enhancement of host susceptibility to drugs

 Immune suppression
 Infectious Diseases

Transmission
Cases
 Index – the first case identified
 Primary – the case that brings the infection into a population
 Secondary – infected by a primary case
 Tertiary – infected by a secondary case
T
S
Susceptible P
S
Immune
S
T
Sub-clinical

Clinical
 Infectious Diseases

Incubation
period
 Time between exposure and onset of symptoms or signs of

infection.

 Each disease has typical incubation period but varies widely.

 Requires replication of the organism to some threshold level

for producing symptoms

 Bacterial Diseases

 Tuberculosis
 Scarlet Fever
 tetanus
 Gonorrhea
 Diptheria
 Streptococcal Infections
 Pneumonia (can also be viral or fungal)
 Pertussis
 Bubonic Plague
 There are many others.
 Viral Diseases
*Common Cold
*Influenza
*AIDS/HIV
*Herpes (Simplex and Zoster)
*Hepatitis A,B,C, D, E, F and G.
*Measles, Mumps and Rubella.
*Poliomyelitis.
*Infectious mononucleosis.
 Fungi
*Organisms, but without chlorophyll

*Generally life off of dead organisms or dead material within a living

organism.
*Some are single cell organisms (yeast)

*Some are multi-cell organisms (mushrooms)

*Many are extremely valuable:

-yeasts give us bread and alcohol
-mushrooms.
*Can cause disease by releasing enzymes that damage cells or by
producing toxins. Some mushrooms produce VERY deadly toxins.
 Fungal Diseases
-Candidiasis.
-Athlete’s foot - Tinea pedis
-Jock itch - Tinea cruris
-Nail fungus - Tineu unguis
-Ringworm
-Histoplasmosis
-Over-the-counter medications are usually
effective for mild infections, except of the
nails.
-Systemic treatments can be prescribed for
serious infections, including the nails, and
for histoplasmosis.
 Infectious Diseases
Common symptoms and signs
Fever:
 Three stages : effervescence
fastigium
deffervescence
 Five kinds of fever:
*Sustained fever.
*Remittent fever: one that shows significant variations in 24 hours but
without return to normal temperature. ,
*Intermittent fever: an attack of malaria or other fever, with recurring
fever episodes separated by times of normal temperature ,
*Relapsing fever: alternating periods of fever and apyrexia, each
lasting from five to seven days.
*Saddle type fever.
*Irregular fever.
 Mechanism of Fever
 Temperature is ultimately regulated in the
hypothalamus. A trigger of the fever, called a
pyrogen, causes a release of prostaglandin E2 (
PGE2). PGE2 then in turn acts on the hypothalamus,
which generates a systemic response back to the
rest of the body, causing heat-creating effects to
match a new temperature level.
 Mechanism of Fever
 A pyrogen is a substance that induces fever. These can
be either internal (endogenous) or external (exogenous)
to the body.
 The bacterial substance lipopolysaccharide (LPS),
present in the cell wall of some bacteria, is an example
of an exogenous pyrogen.
 Cytokines (especially interleukin 1) are a part of the
innate immune system, are produced by
phagocytic cells, and cause the increase in the
thermoregulatory set-point in the hypothalamus. Other
examples of endogenous pyrogens are interleukin 6 (IL-
6), and tumor necrosis factor-alpha.
 Mechanism of Fever
 PGE2 acts on neurons in the preoptic area (POA)
through the prostaglandin E receptor 3 (EP3). EP3-
expressing neurons in the POA innervate the
dorsomedial hypothalamus (DMH), the rostral
raphe pallidus nucleus in the medulla oblongata
(rRPa) and the paraventricular nucleus (PVN) of
the hypothalamus .
 Mechanism of Fever
 Fever signals sent to the DMH and rRPa lead
to stimulation of the sympathetic output
system, which evokes non-shivering
thermogenesis to produce body heat and skin
vasoconstriction to decrease heat loss from
the body surface.
 It is presumed that the innervation from the
POA to the PVN mediates the neuroendocrine
effects of fever through the pathway involving
pituitary gland and various endocrine organs
 Infectious Diseases
Common symptoms and signs
Rash eruption
Date of eruption
1st: chickenpox 2nd: scarlet fever
3rd: smallpox 4th: measles
5th: typhus 6th: typhoid fever
Location of eruption
Form of rash
Exanthema :
*maculo-papular rash: A maculopapular rash is a flat, red area
on the skin that is covered with small confluent bumps e.g.
measles.
*Petechia:
*Vesiculo-pustular rash
*Urtecaria.
Enanthema
 Infectious Diseases
Common symptoms and signs
 Toxemic symptoms
 Mononuclear phagocyte system reactions
Hepato- splenomegaly
Lymph nodes enlargement
 Clinical types
acute, sub acute, mild, common, severe,
fulminant, typical, atypical, abortive,
ambulatory