LIVING AGENT – BACTERIA (H.

pylori)
1. Identification procedures
The H. pylori infection can be detected by submitting a stool sample (stool antigen test) or by using a
device to measure breath samples after swallowing a urea pill (urea breath test) (Mayoclinic, 2021)

2. Chemical composition
Helicobacter pylori is a gram-negative bacterium (JG Kusters, 2006)

3. Genetic composition/enzyme
H. pylori contains only five identifiable genes (dnaE, dnaN, dnaQ, dnaX, and holB) that encode core
subunits of DNA polymerase III, which although representing a less complex holoenzyme than E. coli,
is consistent with the complexity observed in many of the sequenced organisms to date (Richard, 2001).

4. Viability
H. pylori survives in acidic conditions by producing urease, which catalyzes hydrolysis of urea to yield
ammonia thus elevating the pH of its environment (Celli, 2009).

5. Reservoir
H. pylori lives in the stomach attached to the cell lining and overlying mucus, where it escapes the
toxic effects of acid in the gastric space (JG Kusters, 2006).

6. Transmission system
It may be passed from person to person through direct contact with saliva, vomit or fecal matter. H.
pylori may also be spread through contaminated food or water (Mayoclinic, 2021).

7. Latency
Delays in Helicobacter pylori eradication therapy after peptic ulcer diagnosis, time-dependently,
increase the risk of recurrent ulcer, even more so for complicated ulcer, starting from delays of 8 to 30
days (Sverdén, 2018).

8. Specific
It is a type of bacteria that causes infection in the stomach. It is the main cause of peptic ulcers, and it
can also cause stomach cancer. H. pylori can also inflame and irritate the stomach lining (gastritis)
(Cleveland Clinic, 2021).

9. Infectivity, pathogenicity, virulence

H. pylori is a common bacterium, and approximately 50 percent of the world's population has been
estimated to be infected (Brown, Unknown Year). Major symptoms such as abdominal pain, heartburn,
and nausea have been observed 3 – 4 days after ingestion of the bacteria (Velocity EHS, 2017).
Infection with H. pylori is the strongest known risk factor for gastric cancer, which is the second
leading cause of cancer-related deaths worldwide (Wroblewski, 2010). The primary colonisation of H.
pylori usually occurs during early childhood and decreases with age, but following an episode of acute
gastritis, the infection can last a lifetime (Abadi, 2015).

10. Selectivity
It has not been necessary for the media used to isolate H. pylori from the stomach to be highly selective
because relatively few contaminants survive in the low-pH environment of the stomach. However,
current research on the transmission and sources of infection requires more selective media. In several
studies workers have tried to determine the prevalence of H. pylori in the oral cavities or feces of
infected patients, but these efforts have been hindered by the large number of contaminants and the
fastidious nature of the bacterium. Therefore, the need for a more selective medium has become
increasingly important (Stevenson, 2000).
NON-LIVING AGENT – CHEMICALS (Arsenic)
1. Identification procedures
Tests are available to diagnose poisoning by measuring arsenic in blood, urine, hair, and fingernails
(CDC, 2010).

2. Effective dose
Exposure to high enough amounts of arsenic can be fatal. Lethal doses of arsenic are difficult to
quantify, and they depend on solubility, valence states, and other factors. The Agency for Toxic
Substances and Disease Registry suggests that the minimal lethal exposure in humans ranges from 1 to
3 ppm. low-level dose is excreted within a few days after ingestion. (Schmidt, 2014).

3. Eco kinetics
Arsenic occurs naturally in soil and minerals and it therefore may enter the air, water, and land from
wind-blown dust and may get into water from runoff and leaching. Volcanic eruptions are another
source of arsenic. Arsenic may enter the environment during the mining and smelting of these ores
(CDC, 2010).

4. Pharmacokinetics
Absorbed arsenic accumulates in the liver, kidneys, heart and lungs, with smaller amounts in the
muscles, nervous system, gastrointestinal tract, spleen, and lungs. Arsenic is deposited in the keratin-
rich tissues: nails, hair, and skin. Mee's lines occur in the fingernails and toenails (Ratnaike, 2018).

5. Toxicity (pathogenicity)
Breathing in high levels of arsenic can cause a sore throat and irritated lungs. Swallowing high levels of
arsenic can cause nausea, vomiting, diarrhea, muscle weakness and cramping, skin rashes, and other
problems. Even death, resulting from cardiovascular collapse and hypovolemic shock (CDC, 2015).

6. Transmission system
Exposure can occur via all three principal routes, that is, through the inhalation of air, through the
ingestion of food and water, and via dermal absorption (Abernathy, 2001).

7. Specific
No specific symptoms.

8. Selectivity
Health surveillance should include medical and work history, smoking history and clinical examination
of the skin, respiratory and peripheral nervous system. Health surveillance including biological
monitoring for new employees is recommended, followed by periodic health surveillance (Government
of Western Australia, Unknown Year).

9. Reservoir
The highest levels of arsenic (in all forms) in foods can be found in seafood, rice, rice cereal (and other
rice products), mushrooms, and poultry, although many other foods, including some fruit juices, can
also contain arsenic. It is also often found in rocks and soil (American Cancer Society, Unknown Year).