YOBE STATE COLLEGE

OF
AGRICULTURE,GUJBA
PUBLIC HEALTH
DEPARTMENT
DPH 211
EPIDEMIOLOGY OF
COMMUNICABLE
AND
NON COMMUNICABLE
DISEASES
3 UNIT
DENINATION OF TERMS
EPIDEMIOLOGY
This is the study of distribution and determinant of a health related state in a
specified population and the application of this study to control health related
problems.
Or
Is the study of epidemics and its prevention.
Or
Is the study of transmission of disease.
Or
Is a branch of medical science which treat epidemics
EPIDEMICS
This is defined as the unusual occurrence of disease (in excess of the expected)
in a community or region.
OUTBREAK
This is defined as the unusual occurrence of disease in excess of the expected
in a localised or small area.
PANDEMIC
This is an epidemic that spread over several countries or continent affecting
large number of people.
ENDEMIC
This is defined as the constant presence of a disease or infectious agent within
a given geographical area or population group, without importing from
outside.
INFECTIOUS AGENT
This is an organism (virus, bacteria, fungi, protozoan, rickettsia or helminths)
that is capable of producing infection or infectious disease.
INFECTION
This is the entry and development or multiplication of an infectious agent in a
human or an animal with the response of the body to defend itself against the
invader.
INFECTIOUS DISEASE
A disease condition caused by the presence or growth of infectious
microorganisms or parasites.
ACUTE INFECTION
An infection characterised by sudden onset, rapid progression, an is often with
severe symptoms.
CHRONIC INFECTION
An infection characterised by delayed onset and slow progression.
PRIMARY INFECTION
An infection that develop in an otherwise health individual.
SECONDARY INFECTION
An infection that develops in an individual who is already infected with a
different pathogen.
LOCALISED INFECTION
An infection that is restricted to a specific location or region within the body of
the host
SYSTEMIC INFECTION
An infection that has spread to several regions or areas in the body of the host
COMMUNICABLE DISEASE
This is a disease that can be transmitted from one individual to another
CONTAGIOUS DISEAES
This is a communicable disease that is easily spread from one individual to
another
NON COMMUNICABLE DISEASE
This is a disease that is not transmitted from one individual to another
OPPORTUNISTIC INFECTION
Is an infection caused by microorganisms that are commonly found in the host
environment
NOSORCOMIAL INFECTION
An infection originating in a patient while in a hospital or another health care
facility.
RESEEVOIR OF INFECTION
This is the source of an infection
Or
A place in which an infectious agent can survive but may or may not multiply.
FORMITES
Any inanimate object capable of being an intermediate in the indirect
tansmission of an infectious agent.
HOST
A person or animal including birds and arthropod that affords subsistence or
lodgement to an infectious agent under natural condition.
INFECTIVITY
Capacity of an infectious agent to enter and multiply in a susceptible host.
Polio and measles have high infectivity.
PATHOGENICITY
The ability of the microbes to cause disease. Measles has high pathogenicity.

VIRULENCE
The degree of pathogenicity of microorganisms (an infectious agent) i.e the
ability of the agent to invade and damage tissues of the host causing severe
manifestation or death.
INFECTIOUS CYCLE OR CHAIN OF
INFECTION
This is defined as a process that begins
when an agent leaves its reservoir or
host through a portal of exit, and is
transported by some mode of
transmission then enters through an
appropriate portal of entry infect a
susceptible host.
ELEMENTS OF THE CYCLE OF
INFECTION
 Presence of microbiological
agent
 Presence of reservoir
 Portal of exit
 Mode of transmission
 Portal of entry
 Susceptible host
INCUBATION PERIOD
This is a period from exposure to infection to the onset of clinical signs or
symptoms’ of infectious diseases
The length of incubation period depends on the following
 The portal of entry
 The rate of growth of organism in the host
 The dosage of the infectious agent
 The host resistance
THE PERIOD OF COMMUNICABILITY
The time during which an infectious agent may be transmitted directly or
indirectly from an infected person to susceptible person or animal.
AGENT
This is an organism (virus, bacteria, fungi, protozoan, rickettsia or helminths)
that is capable of producing infection or infectious disease.
FACTORS AFFECTING AGENT INFECTIVITY
Natural characteristic of the agent
 Production
 Metabolism
 Motility
 Production of toxin
Characteristic of the agent related to infection in human
 Infectivity
 Pathogenicity
 Virulence
 Antigenicity

SOURCE AND RESERVOIR

SOURCE OF AN INFECTION
This is an immediate person or object from which agent passes to host
 RESERVOIR
This is a natural habitat, in which an agent lives, grows and multiply
TYPES OF RESERVOIR
 Human reservoir
 Animal reservoir
 Non-living reservoir

HUMAN RESERVOIR
This is classified into two
 Case
 Carrier
CASE
Any person in a population group or study group identified as having a
particular disease, health disorders or condition under investigation.
Cases are classified as
 Primary case
 Index case
 Secondary case
 PRIMARY CASE
This is the person who brings disease to a country.
OR
This is an individual who is directly exposed to a source of outbreak

 INDEX CASE

This is the first person identified by health authorities with a disease

which makes the team aware of the possible outbreak.
 SECONDARY CASE
This is an individual who is contracted an infection or illness infection
through exposure to primary case

Classification of case according to spectrum of disease

 Typical > this shows typical manifestation of the diseases and their
level of severity may range from being mild to moderate to severe
 Atypical > this does not show the typical manifestation of diseases
 Subclinical/inapparent> this can pass undiagnosed.
CARRIER
A person or animal without apparent disease who harbours a specific
infectious agent and is capable of transmitting the agent to others.
Carrier is dangerous because;
 He did not show any clinical manifestation of disease, so he carries
normal life.
 The carrier and his contact are unaware of their condition, so they take
no precaution.
 It is difficult to discover him.
 He can remain infectious for a long time leading to repeated
introduction of the disease to contacts.
TYPES OF CARRIER
 Convalescent carrier
 chronic carrier
 Healthy carrier
 Incubatory carrier

CONVALESCENT CARRIER
This is a person who continue to harbour the infectious agent even after
recovery from illness and may excrete the pathogens for a short period e.g
typhoid fever
CHRONIC CARRIER
This is a person who continue to harbour the infectious agent for a longer
period of time e.g month or years e.g hepatitis B
INCUBATORY CARRIER
This is a person who shed the infectious agent during the incubation period of
a disease. E.g HIV/AIDS, measles, influenza
HEALTHY CARRIER
This is the person who remains well throughout the infection e.g diptheric
meningococcosis, salmonella typhi
ANIMAL RESERVOIR
Diseases that can be transmitted under natural conditions from vertebrate
animals to human are called ZOONOSIS e.g rabies, yellow fever , plague,
anthrax, brucellosis
Two types under natural condition
Epizootic
An outbreak of disease in animal’s population implication that it may affect
human population e.g anthrax, rabies
Enzootic
An endemic occurring in animals e.g anthrax, rabies, brucellosis, tuberculosis
Natural condition
 Ingestion ; where humans uses animals for food
 Vector ; where there is a vector transmitting the infection from animal to
man e.g malaria
 Animal bite; where animals bit human being e.g rabie
 Contermination; where animals conterminate human environment in
flooding
Famous animal reservoir are ; cat,dog,horse, cattle, poultry and rodent
RESERVOIR IN NON LIVING
These incudes; water, soil, air, milk, eggs, vegetables that are contaminated
with pathogenic microorganism and serve as source of infection. Man is
indefinite reservoir of cholera or typhoid fever agents bringing the agent out
through faeces, urine, or vomiting and contaminate food, water, or vegetable
and these serve as source of infection to a susceptible person
 Soil can also act as reservoir of infection e.g (soil may
harbour agent that cause tetanus and anthrax).
 Water e.g primary reservoir of legionares bacillus
 Food; meat, milk, vegetables
PORTAL OF EXIT
This is a path by which an agent leaves its human or animal source host
Portal of exits are;
  Respiratory tract e.g influenza virus
 Genitourinary tract e.g sexually transmitted disease
 Alimentary tract e.g hepatitis A virus
 Blood e.g hepatitis B virus
 In-utro transmission e.g rubella, CMV

MODES OF TRANSMISSION
Many different ways
Direct transmission
(a) DIRECT CONTACT
There is essential immediate transfer of the agent from a reservoir to a
susceptible host by direct contact or droplet spread.
 Direct contact occurs through; skin to skin contact, kissing and
sexual intercourse.
 Direct contact refers also to contact with soil or vegetation
harbouring the infectious agent or organism.
Examples of diseases by this contact includes; sexually transmitted
diseases, acquired immunodeficiency syndrome, leprosy, skin and
eye infection
(b) DROPLET INFECTION
 Here there is direct projection of the spray of droplet of
saliva and pharyngeal secretions produced by sneezing,
coughing, even talking.
Examples of diseases by this includes; common cold,
tuberculosis, meningococcal meningitis, whooping cough
and measles
(C) CONTACT WITH SOIL
 Direct exposure of the susceptible tissues to the diseases
agent with soil.
Examples incudes; tetanus, hookworms

Trans placental
Diseases includes German measles, malaria, Syphilis, varicella, hepatitis
B, AIDS
 Indirect transmission
This is a form of transmission that involves the transfer of infections
from a reservoir to a susceptible host by
 Vehicle borne inanimate vehicle
 Vector borne; animate vehicle
 Air borne; suspended air particles

VEHICLE BORNE
An infectious agent is carried from a reservoir to a susceptible host by an
inanimate intermediary.
Vehicle incudes;
 Contaminated food and water;
Examples of diseases includes;
Typhoid, paratyphoid, food poisoning, dysentery, cholera
 Biological product (blood)
Examples includes; Hepatitis B, AIDS, Syphilis
 Fomites (inanimate object) such as door knobs, toys,
handkerchief, bleeding and surgical instrument, beddings
VECTOR BORNE TRANSMISSION
This is an arthropod or any living carrier (e.g. snail) that transport an
infectious agent to a susceptible host.
Arthropods includes; flies and mosquito, fleas, cockroaches, ticks, mites,
sucking lice.
Two types of transmission are under this
 Mechanical transmission
Here the agent does not multiply or undergo physiologic changes
in the vector. For example, flies carry Shigella on appendages
 Biological transmission
Here when the agent undergoes changes and or multiplication
within the vector before its transmitted.

AIR BORNE TRANSMISSION

Airborne transmission occurs by particles that are suspended in the air.
There are two types of these particles
 Dust particles
 Droplet nuclei
 Dust particles
 This result from re-suspension of particles that have settled on floor or
beddings or infectious particles blown from wind
Examples fungal spore
 Droplet nuclei
This represent the dry residue of droplets that have been coughed or
sneezed into the air, they are very tiny particles less than 5microns in
size and they remain suspended for a long period.
Examples; tuberculosis is transmitted indirectly more often through droplet
nuclei than directly through direct droplet spread, legionnaires diseases and
histoplasmosis also spread through airborne.
PORTAL OF ENTRY
This is the route through which an agent uses to get into the host. In general ,
portal of entry is similar to portal of exit
 Respiratory tract
 Ingestion
 Dermal
 Blood borne
 Mucus membrane
HOST FACTORS
These are intrinsic factors that influence an individual ‘s exposure ,
susceptibility, or response to a causative agent
These factors includes
 Host immunity
 Virulence of organism

Factors affecting host immunity

 Age
 Sex
 Pregnancy
 Nutrition
 Trauma, stress, fatigue
 Occupation
 Environment
 Education and culture
 Socioeconomic standard
 Vaccination
Herd immunity