COMMUNICABLE

DISEASE
MS1 LECTURE
Prepared by: Mary Grace S. Penticostes, RN
Objectives:
Differentiate important terms related to

communicable disease
Describe and give examples on the chain of

infection
Describe the type, etiology, pathophysiology,

signs and symptoms of each disease

Know appropriate nursing and medical

management
Deffinition of Terms
INFECTIOUS DISEASE
-Are those diseases not transmitted by ordinary

contact but require direct inoculation through a

break in the previously intact skin or mucus

membrane.
Deffinition of Terms
INFECTION
-Is the entry and development or multiplication of

an infectious agent in the body of man or animals.

An infection does not always cause illness.

-In an infection, the infecting organism seeks to

utilize the host’s resources to multiply, usually at the

expense of the host. The infecting organism, or

PATHOGEN, interferes with the normal functioning of

the host and can lead to chronic wounds,

gangrene, loss of an infected limb, and even death.

Deffinition of Terms
CONTAMINATION
the presence of an infectious agent on a body

surface, on or in clothes, beddings, toys, surgical

instruments or dressings, or other articles or

substances including water and food.

INFESTATION
- It is the lodgment, development and reproduction

of arthropods on the surface of the body or in the

clothing, e.g. lice, itch mite. This term could be also

used to describe the invasion of the gut by parasitic

worms, e.g. ascariasis.

Deffinition of Terms
CONTAGIOUS DISEASE
-is a subset category of communicable diseases,

which are easily transmitted by physical contact

(hence the name-origin) with the person suffering

the disease, or by their secretions or objects

touched by them.
Deffinition of Terms
INCIDENCE AND PREVALENCE OF INFECTIOUS DISEASES
Incidence of an infectious disease:
number of new cases in a given time period expressed

as percent infected per year (cumulative incidence) or

number per person time of observation (incidence

density).
INFESTATION
In epidemiology, the prevalence of a dse in a
statistical population is defined as the total number of

cases of the disease in the population at a given time,

or the total number of cases in the population, divided

by the number of individuals in the population.

Deffinition of
PREVALENCE VS. INCIDENCE
Terms
Prevalence is a measurement of all individuals affected

by the disease within a particular period of time

Incidence is a measurement of the number of new

individuals who contract a disease during a particular

period of time.

EPIDEMIC
(epi= upon; demos= people)
occurs when new cases of a certain disease, in a given

human population, and during a given period,

substantially exceed what is "expected," based on

recent experience.
Deffinition of Terms
ENDEMIC
(En = in; demos = people)
It refers to the constant presence of a disease or

infectious agent within a given geographic area or

population group. It is the usual or expected

frequency of disease within a population.

In a broad sense, can mean "belonging" or "native

to", "characteristic of", or "prevalent in" a particular

geography, group, field, area, or environment; native

to an area or scope.
Deffinition of Terms
HYPERENDEMIC AND HOLOENDEMIC
the term “hyperendemic” expresses that the disease

is constantly present at high incidence and/or

prevalence rate and affects all age groups equally.

the term “holoendemic” expresses that essentially

every individual in a population is infected. As the

disease is ubiquitous, the young are more likely to

express pathogenic responses, whilst the older hosts

will carry the disease asymptomically, or with reduced

damage, due to adaptive community. Examples of this

holoendemic pattern are seen with malaria in areas

of Africa(where 75% of the deaths are in children

under 5)
Deffinition of Terms
PANDEMIC AND EXOTIC
pandemic is usually affecting a large proportion of

the population, occuring over a wide geographic

area such as a section of a nation, the entire nation,

a continent or the world, e.g. Influenza pandemics.

Exotic diseases are those which are imported into a

country in which they do not otherwise occur as

for example, rabies in the UK.

Deffinition of Terms
SPORADIC
means “scattered about”. The cases occur

irregularly, haphazardly from time to time, and

generally infrequently. The cases are few and

separated widely in time and place that they show

no or little connection with each other, nor a

recognizable common source of infection e.g.

polio, meningococcal meningitis, tetanus….

However, a sporadic disease could be the starting

point of an epidemic when the conditions are

favorable for its spread.

Deffinition of Terms
ZOONOSIS, EPIZOOTIC AND ENZOOTIC
Zoonosis an infection that is transmissible under

natural conditions from vertebrate animals to man,

e.g. rabies, plague, bovine tuberculosis…..

An epizotic is an outbreak (epidemic) of disease

in an animal population.
An Enzotic is an endemic occurring in

animals.
Deffinition of Terms
NOSOCOMIAL INFECTIONS
Nosocomial (hospital acquired) infection is an

infection originating in a patient while in a hospital

or another health care facility. It has to be a new

disorder unrelated to the patient’s primary

condition. Examples include infection of surgical

wounds, hepatitis B and urinary tract infections.

Deffinition of Terms
OPPORTUNISTIC INFECTION
This is infection by organisms that take the

opportunity provided by a defect in host defense

(e.g. immunity) to infect the host and thus cause

disease. For example, opportunistic infections are

very common in AIDS.

Deffinition of Terms
ERADICATION AND ELIMINATION
Eradication of infectious diseases, is the reduction of

the global prevalence of an infectious disease in its

human or animal host(s) to zero.

Elimination, the destruction of an infectious

disease in one region of the world as opposed

to its eradication from the entire world.

Deffinition of Terms
VIRULENCE, PATHOGENICITY AND CASE FATALITY RATE
Virulence: is the degree of pathogenecity of an

organism: the relative ability/damage of a pathogen

to cause disease
Pathogenicity: is the ability of a pathogen to

produce an infectious disease in an organism

Case fatality rate for infectious diseases: is the

proportion of infected individuals who die of the

infection. This is a function of the severity of the

infection and is heavily influenced by how many mild

cases are not diagnosed.

Deffinition of Terms
SIGNS, SYMPTOMS, SYNDROME
Symptoms: evidence of disease that is experienced

or perceived (subjective) subjective changes in

body function noted by patient but not apparent

to an observer {ie pain}

Signs: objective evidence of a disease the

physician can observe and measure.

Syndrome: a specific group of signs and symptoms

that a ccompany a particular disease.

Deffinition of Terms
CHAIN OF INFECTION
Model used to understand the infection process.
Each link represents step in transmission of infection.
Each link has to be present and in order for an

infection to occur.
Deffinition of Terms
Bacteremia: laboratory-proven presence of bacteria

in the bloodstream.

Carrier: person who carries an organism without

apparent signs and symptoms; one who is able to

transmit an infection to others.

Deffinition of Terms
Centers for Disease Control and Prevention (CDC):

federal agency responsible for monitoring endemic

and epidemic disease, for recommending

strategies to decrease disease incidence,

and for developing guidelines to reduce risk to

patients and health care workers.

Deffinition of Terms
Colonization: microorganisms present in or on a

host, without host interference or interaction and

without eliciting symptoms in the host.

Disease: state in which the infected host displays a

decline in health due to the infection.

Emerging infectious diseases: human infectious

diseases with incidence increased within the past

two decades or potential increase in the near future.

Deffinition of Terms
Fungemia: a bloodstream infection caused by a

fungal organism.

High-level disinfection: removal of all

microorganisms, with the possible exception of

spores. This level of disinfection is appropriate for

instruments that come in contact with mucous

membranes but that cannot be sterilized because of

mechanical issues.
Deffinition of Terms
Host: person who provides living conditions to

support a microorganism.

Immune: person with protection from a previous

infection or immunization who resists reinfection

when re-exposed to the same agent.

Incubation period: time between contact and onset

of signs and symptoms

Deffinition of Terms
Infection: condition in which the host inter[1]acts

physiologically and immunologically with a

microorganism.

Latency: time interval after primary infection when

a microorganism lives within the host without

producing clinical evidence.

Deffinition of Terms
Methicillin-resistant Staphylococcus aureus (MRSA):

Staphylococcus aureus bacterium that is not

susceptible to extended-penicillin antibiotic

formulas, such as methicillin, oxacillin, or nafcillin.

Normal flora: persistent nonpathogenic organisms

colonizing a host.

Nosocomial infection: infection acquired in the

hospital that was not present or incubating at the

time of hospital admission.

Deffinition of Terms
Reservoir: any person, plant, animal, substance, or

location that provides living conditions for

microorganisms and that enables further dispersal

of the organism.

Standard Precautions: strategy of assuming all

patients may carry infectious agents and using

appropriate barrier precautions for all health care

worker–patient interactions .
Deffinition of Terms
Sterilization: complete removal of all

microorganisms.

Susceptible: not possessing immunity to a particular

pathogen.

Transient flora: organisms that have been recently

acquired and are likely to be shed in a relatively

short period.
Deffinition of Terms
Transmission-Based Precautions: precautions used in

addition to Standard Precautions when contagious

or epidemiologically significant organisms are

recognized. The three types of Transmission Based

Precautions are Airborne, Droplet, and Contact

Precautions.
Deffinition of Terms
Vancomycin-resistant Staphylococcus aureus (VRSA):

Staphylococcus aureus bacterium that is not

susceptible to vancomycin.

Vancomycin-resistant Enterococcus (VRE):

Enterococcus bacterium that is resistant to the

antibiotic vancomycin.

Virulence: degree of pathogenicity of an organism.

COMMUNICABLE DISEASE
Is an illness due to an infectious agent or as

toxic products which is transmitted directly or

indirectly to person, animal or through an

agency of an intermediate animal, host and

vector of inanimate environment.

INFECTIOUS DISEASE PROCESS
A causative organism
A reservoir of available organisms
A portal or mode of exit from the reservoir
A mode of transmission from reservoir to host
A susceptible host
A mode of entry to host
 1. CAUSATIVE OR PATHOGENIC MICROORGANISM

Must be able to enter the body and invade or

colonize host tissue by attaching to specifific host

cells then cause damage to those cells by

production of toxins or destructive enzymes. The

pathogen may enter the body through any body

orififice or broken skin.

Types
Bacteria, viruses, fungi, parasites (protozoa,

helminths), prions.
CHARACTERSITICS:
1.PATHOGENICITY- ability to produce disease
2. VIRULENCE- disease severity
3. INFECTIOUS DOSE- number of organisms needed

to initiate infection
4. TOXEGENICITY- capacity to produce injurious

substances that damage the host

5. ADAPTABILITY- ability to adjust to changing

condition (ie resistance to antimicrobial agents

2. Reservoir

The environment in which a pathogenic microorganism lives

and
1 survives naturally; can be human, animal, or

environmental.
Examples of each type include:

1. Human—pulmonary tuberculosis.
2. Animal—ticks infected with the bacteria Borrelia

burgdorferi, which causes Lyme disease.

3. Environment—Legionnaire’s disease (Legionella

pneumonphila) through water.

4. Fomite— Methicillin (oxacillin)–resistant Staphylococcus

aureus bacteria on a bedside table.

Portal of Exit from Reservoir/Portal of Entry into the Host

The portal of entry into the host is typically the same as the portal
of exit from the reservoir

1. Respiratory tract
2. GI/GU tract
3. Body fluids (except for sweat) such as blood, urine, semen
4. Skin, mucous membranes
5. Transplacental
Mode of Transmission

How the pathogenic microorganism is spread to a host by an

infectious source.
Horizontal transmission is the spread of a pathogen from one

individual to another individual or vertically from mother to

offspring via transplacental transmission, contact through the

birth canal, or through breastfeeding or close contact after

birth.
There are two main types of transmission: direct and indirect
I. Direct Transmission
1. Direct contact—infected by touching the reservoir (eg,

Clostridium diffificile fecal-to-oral transmission or rubella virus

crossing the placenta to the fetus).

2. Droplet transmission.
a. Droplets of large particles more than 5 microns in size usually

from respiratory secretions.

b. Transmitted through coughing, sneezing, or talking to
an infected person (eg, human metapneumovirus spread
through coughing).
c. Transmitted through aerosolizing procedures (eg, sprays
of infectious agents during a nebulization treatment or a
sputum induction)
3. Airborne transmission

a. Droplet nuclei—less than 5 microns that remains suspended in air

(eg,1tuberculosis and varicella [primary chickenpox]).

b. Dust particles in the air containing the infectious agent
(eg, Aspergillus fungi through dust)

II. Indirect Transmission

Touching an inanimate object or fomite that has had direct contact

with the reservoir (eg, touching a tissue of a child with Influenza virus

or touching a bedside table contaminated with Clostridium difficile).

1. Common vehicle route (through contaminated items).
a. Food (eg, Salmonella and Campylobacter).
b. Water (eg, cholera and Legionellosis).
c. Medications (eg, hepatitis C infection from contaminated
multidose vials).
2. Vectorborne transmission.
a. A living creature acts as an intermediary acquiring a
pathogen from one living host and transmits the disease
agent to another living organism, often an arthropod (fly,
mosquito, tick).
b. Can be mechanical (carried on the surface) or biological
(host is infected with pathogen) vectors
Susceptible Host

1. Determined by a complex interrelationship

between a host and an infectious agent, by factors

that influence infection or disease, such as:

a. Pathogenicity—the ability to produce disease in

a host. The organism invades a host, enters tissue,

colonizes then spreads from host to host while not

necessarily causing death to the host

b. Virulence—the wide range of damage that can occur to
the host because of the toxic capabilities of the pathogen. Given

that the host–pathogen relationship is fluid, the outcome can be

1
dictated by:
i. Number of pathogens to which the host is exposed; route and

duration of exposure.
ii. Invasiveness of the pathogen and its ability to produce
toxins.
iii. Age, genetic constitution of host, and general physical,
mental, and emotional health and nutritional status of
host.
iv. Ability to bypass or overcome host defense mechanisms

(immunologic response)
 References:

Brunner and Suddart's Textbook of Medical-Surgical Nursing

12th Edition
Lippincott Manual of Nursing Practice 10th Edition