ESST 3103 LAB #2

Activity 1
1. Portal of Entry
Portal of Entry Two examples of diseases
using this
portal of entry
Ringworm- touching
Skin contaminated surfaces, or
contact with the skin of an
infected person or animal.
(Mayo Clinic,n.d)
Scabies- occurs through the
contact of skin with an
infected person (CDC, 2010)
Gonorrhea- enters through
the mouth or through the
Mucous Membranes vagina/penis through sexual
contact. (Cleveland Clinic,
n.d.)
Viral Meningitis- enters the
mouth and nose and travels
HIV – can be transmitted to
the fetus though the placenta
Placenta endothelial tissues. (Al-
husauni, 2008).
Zika-transmitted from mother
to fetus during pregnancy.
Intestinal hookworms and
Cholera (WHO, n.d.)
Gastrointestinal Route
Hepatitis A and Hepatitis B
(Whittier, 2017).
Parenteral Route
Methods to prevent the
spread of these
diseases using this portal of
entry.
Ringworm- wash hands often
and avoid skin contact with
infected persons/animals.
(Mayo Clinic, n.d.)
Scabies - Avoid direct skin
contact and using clothing of
an infected person (CDC,
2018)
Gonorrhea- avoid sexual
contact with infected persons
and use protection.
(Healthline, 2019).
Viral Meningitis- avoiding
close contact of infected
persons, sanitize
contaminated surfaces and
washing hands regularly.
(CDC, 2019)
HIV – treatment and the use
of medicines can prevent the
spread from mother to fetus.
(HIV.gov, 2018)
Zika – avoid going to places
and getting into contact with
persons infected with the
virus. (CDC, 2020)
Avoid ingestion of fecal
contaminated food and water.
(CDC, 2020)
Hepatitis A- keeping good
hygiene and getting
vaccinated. (CDC, 2020)
Hepatitis B- vaccinating,
washing hands after contact
with blood and body fluids.
(CDC, 2017)
 2. Modes of Transmission
Mode of Transmission How does this type of Examples of diseases spread
transmission occur, under via this mode of
what circumstances? transmission.
This occurs when the HIV, Conjunctivitis (Pink
disease is spread from eye)
Direct contact reservoir to host via the
interaction of an infected
organism by touching or
sneezing. (CDC, 2012)
This happens when the Hookworms, tapeworms.
disease is spread by
Indirect contact anything other than the
infected organism. For
example, touching
contaminated surfaces.
(CDC, 2012)
Disease causing agents are Measles, Chickenpox,
suspended into dust and air Tuberculosis (Healthline,
Airborne particles for long periods of 2020)
time and travels for great
distances. (CDC, 2020)
This provides an Cholera, Hepatitis A,
environment for the Cryptosporidiosis
Food and waterborne pathogen to grow and (Department of Health,
multiply and comes into 2020).
contact with the host
through skin contact and/or
ingestion (CDC, 2020)
These are organisms that are Dengue, Lyme, Zika
carriers of diseases such as
Vector mosquitoes, ticks and fleas
that comes into contact with
the host by feeding of their
blood and so transmits the
disease. (CDC, 2020)

Activity 2
Yellow Fever
Reservoirs: Blood of humans and Animals
Portals of exit: Through mosquitoes when feeding on human and/or animal blood. (CDC, 2019)
Modes of transmission: This is a vector borne disease, so the major mode of transmission is
usually though the bites of an infected mosquitoes. There is also possible transmission through
contaminated needles. (DerSarkissian, 2019).
Portals of entry: Entry occurs when an infected mosquito bites the skin. (CDC, 2019)
Factors in host susceptibility: If an individual is not vaccinated for yellow fever, this increases
the susceptibility of them contacting the disease. Factors also include climate, as mosquitoes
favor tropical regions, population density and proximity to mosquito breeding grounds. (Barnett,
2007)
Viral Hepatitis A
Reservoirs: Gastrointestinal tract of humans.
Portals of exit: Fecal matter. (WHO, 2020)
Modes of transmission: Transmission can occur though the consumption of contaminated food
and water containing feces of an infected person as well as sexual contact. (WHO, 2020)
Portals of entry: The disease can enter the mouth and through the digestive tract.
Factors in host susceptibility: Persons who are not vaccinated or live in unsanitary conditions
that is have lack of access to clean water and food, having a sexual partner with the diseases or
living with an infected person increases the susceptibility of being infected. (WHO,2020)

Activity 3
3.1 Calculating the incidence
 Year of Diagnosis Total Serotype Population Number Incidence Rate
1988 31 1204000 2.57
1989 24 1213000 1.98
1990 36 1221000 2.95
1991 65 1229000 5.29
1992 106 1237000 8.57
1993 82 1244000 6.59
1994 99 1250000 7.92
1995 109 1254000 8.69
1996 175 1258000 13.9
1997 109 1260000 8.65

Sample Calculation
Incidence Rate = (number of new cases occurring during a given time period / population at risk
during the same time period) x 10n
Where n = 2
For 1988
Incidence rate = (31 / 1204000) x 105
Incidence rate = (31 / 1204000) x 100000
Incidence rate = 2.57
2.57 new cases per 100,000 of population
From the incidence rates calculated per 100,000 persons, the general trend shows that as the
population increases with the year, the incidence rate also increases. For the year 1989, is seen
that the incidence rate decreased to 1.98 cases per 100,000 persons and then increased for each
year till 1992. In 1993 the incidence rate dropped slightly, to 6.59 cases per 100,000 persons.
The number of cases then increased with increasing population, with the highest incidence rate
being recorded in 1996 with 13.9 cases per 100,000 persons.

3.2
Graph showing the number of Salmonella isolates by serotype
 Number of Salmonella isolates diagnosed for the period 1988-1997
200
180
Number of confirmed cases

160
140
120
100
80
60
40
20
0
1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998
Year

Enteritidis Tryphimurium Other Total

Interpretation: From the line graph shown above, it is seen that the total number of Salmonella
isolates increased over the years from 1988 to 1997. For the Enteritidis serotype, the number of
cases remained at zero until the year 1994 when cases increased to 18 and continued to increase
until 1996 when cases reached at its highest of 107. For the Typhimurium serotype there was
slow increases in cases from 1988 to 1991 and then a dramatic increase in 1992 with the highest
recorded number of cases of 84. After that year the cases slowly decreased to 1997. For the other
serotypes, showed an increase for the year 1989 to 1991 and then decreased in 1992. There was a
slow increase up till 1996 which had its highest recorded cases of 57 and then decreased in 1997.
Out of the three serotypes, the highest recorded cases were for Enteritidis in 1996 with 107 cases.
It was also seen that that the total number of cases were highest in 1996 with a record of 175
cases.

Activity 4
4.1 From the table we see that the exposures that appear to be risk factors are those from eating
eggs, foods containing raw undercooked eggs, eating ground beef, powdered milk and coming
into contact with live chickens since the odds ratio were greater than 1.0.
It was seen that the odds of consuming eggs were 8.8 times larger compared to the odds of
exposure among controls and the relationship between the exposure and S. Enteritidis is casual.
The probability of this was less than one in a thousand is considered statistically significant. The
odds of consuming dishes consisting of raw and/or undercooked eggs were 19 times greater than
the odds of exposure among controls. The probability of finding this was one in a thousand and
is statistically significant. The odds of consuming grounded beef were similar to the odds of
exposure among control and is not associated with S. Enteritidis. The odds of consuming
powdered milk and contact with live chickens are the same to the odds of exposure among
control and is not associated with S. Enteritidis. The consumption of eggshells and dishes
containing raw or undercooked eggs had the most significant risk of infection.
4.2
Control measures that can be considered for Salmonella is to avoid the consumption of
undercooked eggs, ensure that they are thoroughly cooked before eating. Always consume eggs
immediately after cooking and do not leave it at room temperature for long periods of time. Do
not buy eggs that are left open or that is not chilled, and after purchase always keep them clean
and refrigerated. When handling raw eggs, always wash hands after use as well as any other
object that comes into contact with raw eggs and discard of any cracked or unsanitary eggs.
(DerSarkissan, 2018)
4.3
Ensuring proper sanitation, as often as possible of the farm is done to prevent excessive bacterial
growth, as well as monitoring the farm for any rodents or insect infestations. Monitoring the egg
handling process is also important such as the temperature at which the eggs are kept, the
condition at which they are kept, that is if they are well sanitized or not as well as assessing any
factors in the farm, that may introduce salmonella. (Trampel et al, 2014).
4.4
In order to reduce the risk of Salmonellosis farmers must always monitor the birds for any sign
of infection and should act immediately to prevent spread. Testing should also be done on a
regular basis on birds and eggs to monitor the movement of the disease. Frequent sanitation must
be done at the farm to ensure there is always a clean supply of food, water and litter. Proper
control and elimination of any rodents can also help to reduce the spread of Salmonella to eggs
and chickens. Proper egg handling practices should be maintained such as ensuring there are no
faces present on the eggs, nesting boxes should be clean, and eggs should always be refrigerated.
(Safe-poultry, n.d.)

4.5
To monitor the impact of Salmonella, the number of cases in humans should be investigated and
monitored and determining the sources at which the infection took place. Monitoring and testing
egg farms for the disease should also be done overtime to monitor the progression of the disease
in both the farm and in humans. (CDC, n.d.)
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