Symbiotic Relationships Between Microbes and
Pathogens attach to cellsa process called
Their Hosts (pp. 415418)
1 symbiotic relationships
mutualism, in which both members benefit;
parasitism, in which a parasite benefits while
the host is harmed; and, morerarely,
commensalism, in which one member benefits
while the other is relatively unaffected.
Any parasite that causes disease is called a
pathogen.
2. Organisms called normal microbiota live in
and on the body. Some of these microbes are
resident, whereas others are transient.
3. Opportunistic pathogens cause disease when
the immune system is suppressed, when normal
microbial antagonism (competition)
is affected by certain changes in the body, or
when a member of the normal microbiota is
introduced into an area of the body unusual for
that microbe.
Reservoirs of Infectious Diseases of Humans
1. Living and nonliving continuous sources of
infectious disease are called reservoirs of
infection. Animal reservoirs harbor agents of
zoonoses, which are diseases of animals that
may be spread to
humans via direct contact with the animal or its
waste products or via an arthropod. Humans
may be asymptomatic carriers.
2. Nonliving reservoirs of infection include soil,
water, and inanimate
objects.
The Invasion and Establishment of Microbes in
Hosts: Infection
1. Microbial contamination refers to the mere
presence of microbes in or on the body or
object. Microbial contaminants include
harmless resident and transient members of the
microbiota as well as pathogens, which after a
successful invasion cause an infection.
2. Portals of entry of pathogens into the body
include skin, mucous membranes, and the
placenta. These portals may be bypassed via the
parenteral route, by which microbes are
directly deposited into deeper tissues.
3.
adhesionvia a variety of structures or
attachment proteins called adhesion factors.
Some bacteria and viruses lose the ability to
make adhesion factors called adhesins and
thereby become avirulent.
4. Some bacteria interact to produce a sticky
web of cells and polysaccharides
called a biofilm that adheres to a surface.
The Nature of Infectious Disease
1. Disease, also known as morbidity, is a
condition sufficiently adverse
to interfere with normal functioning of the
body.
2. Symptoms are subjectively felt by a patient,
whereas an outside observer
can observe signs.
A syndrome is a group of symptoms and
signs that collectively characterizes a particular
abnormal condition.
3. Asymptomatic, or subclinical, infections may
go unnoticed
because of the absence of symptoms, even
though clinical tests
might reveal signs of disease.
4. Etiology is the study of the cause of a
disease.
5. Nineteenth-century microbiologists proposed
the germ theory of disease, and Robert Koch
developed a series of essential conditions called
Kochs postulates to prove the cause of
infectious diseases.
Certain circumstances can make the use of
these postulates difficult or even impossible.
6. Pathogenicity is a microorganisms ability to
cause disease;
Virulence is a measure of pathogenicity.
Virulence factors, such as adhesion factors,
extracellular enzymes, toxins, and
antiphagocytic factors, affect
the relative ability of a pathogen to infect and
cause disease.
7. Toxemia is the presence in the blood of
poisons called toxins.
Exotoxins are secreted by pathogens into their
environment.
 Endotoxin, also known as lipid A, is released
from the cell wall of dead and dying Gram-
negative bacteria and can have fatal effects.
8. Antitoxins are antibodies the host forms
against toxins.
9. The disease processthe stages of infectious
diseasestypically consists of the incubation
period, prodromal period, illness, decline,
and convalescence.
The Movement of Pathogens Out of Hosts:
Portals
of Exit
1. Portals of exit, such as the nose, mouth, and
urethra, allow pathogens to leave the body and
are of interest in studying the spread of disease.
Modes of Infectious Disease Transmission
1. Direct contact transmission of infectious
diseases involves person- to-person spread by
body contact. Transmission of pathogens via
inanimate objects (called fomites) is called
indirect contact transmission.
2. Droplet transmission (a third type of contact
transmission) occurs when pathogens travel less
than one meter in droplets of mucus to a new
host as a result of speaking, coughing, or
sneezing.
3. Vehicle transmission
Aerosols are clouds of water droplets that,
travel more than one meter in airborne
transmission.
Fecal-oral infection can result from drinking
sewage-contaminated water or from ingesting
fecal contaminants.
Bodily fluid transmission is the spread of
pathogens via blood, urine, saliva, or other
fluids.
4. Vectors transmit pathogens between hosts.
Biological vectors are animals, usually biting
arthropods, that serve as both host and vector
of pathogens.
Mechanical vectors are not hosts to the
pathogens they carry.
Classification of Infectious Diseases (pp. 433
434)
1. There are various ways in which infectious
disease may be grouped and studied. When
grouped by time course and severity, disease
may be described as acute, subacute, chronic,
or latent.
2. When an infectious disease comes either
directly or indirectly from another host, it is
considered a communicable disease.
If a communicable disease is easily transmitted
from a reservoir or patient, it is called a
contagious disease.
Noncommunicable diseases arise either from
outside of hosts or from normal microbiota.
Epidemiology of Infectious Diseases (pp. 434
442)
1. Epidemiology is the study of where and when
diseases occur and
of how they are transmitted within populations.
2. Epidemiologists track the incidence (number
of new cases)
and prevalence (total number of cases) of a
disease and classify
disease outbreaks as endemic (usually present),
sporadic (occasional),
epidemic (more cases than usual), or pandemic
(epidemic on more than one continent).
3. Descriptive epidemiology is the careful
recording of data concerning a disease; it often
includes detection of the index casethe first
case of the disease in a given area or
population.
Analytical epidemiology seeks to determine the
probable cause of a disease.
Experimental epidemiology involves testing a
hypothesis resulting from analytical studies.
4. Healthcare associated infections (HAIs)
(nosocomial infections) and healthcare
associated diseases (nosocomial diseases) are
acquired by patients or workers in health care
facilities. They may be exogenous (acquired
from the health care environment),
endogenous (derived from normal microbiota
that become opportunistic
while in the hospital setting), or iatrogenic
(induced
by treatment or medical procedures).