Introduction

According to the World Health Organization (WHO), infection prevention and

control (IPC) is a scientific approach and practical solution designed to
prevent harm caused by infection to patients and health workers. It is a subset
of epidemiology, but also serves an essential function in infectious diseases ,
social sciences and global health [1].

Effective IPC is a public health issue that is fundamental in patient safety and

health system strengthening. The prevention of healthcare-associated
infections (HAI), epidemics (including the 2013-2016 Ebola virus disease
outbreak), and pandemics of international concern (For Example; 2009 flu
pandemic and the coronavirus disease 2019 ) are rooted in effective IPC
measures[2]. A guiding principle on WHO's Core Components of IPC is that
"access to health care services designed and managed to minimise the risks of
avoidable HAI for patients and health care workers is a basic human right" [2].

Strengthening global IPC is essential to combat HAI, antimicrobial resistance,

and to respond to disease outbreaks. A study published in 2021 looked at the
WHO's Core Components of IPC and found that most participating countries
have IPC programmes and guidelines in place, however few have set aside the
necessary resources to support the programmes. There is a need to move from
the planning stage into the implementation and monitoring stages,
particularly in low-income countries [3].
The Spread of Infectious Disease
An infection is defined as the successful transmission of pathogenic
microorganisms, such as bacteria, viruses, parasites or fungi that are spread: [4]
[5] [6] [7]

 Directly:
 From person to person
 Through respiratory droplets (for example, coughing or
sneezing)
  Through body fluids
 Direct exposure to infectious agent in environment
 During childbirth from mother to foetus
(transplacental/perinatal)

 Indirectly:
 Biological - Vector or Intermediate host (for example; Zika
Virus)
 Mechanical - Vector or Vehicle  (for example; Plague -
transmission of Yersinia Pestis by fleas)
 Airborne (for example, Tuberculosis)

Epidemiological Triad

In humans, infections occur when an infectious microorganism enters the

body, multiplies, and leads to a reaction in the body and potential infectious
disease. The spread of infectious disease requires three variables, known as
the epidemiological triad [8]:

 The Agent - The microorganism that causes the infection and can be
in the form of bacteria, viruses, parasites or fungi
 The Host - The target of the disease
 The Environment - The surroundings and conditions (these are
external to the host)

[9]

Infection Spread in Healthcare

Healthcare facilities, whether hospitals or primary care clinics are an area

with an elevated risk of disease transmission due to the presence and relative
ratio of susceptible individuals. One in ten patients get an infection whilst
receiving care [10] yet effective infection prevention and control reduces
healthcare-associated infections by at least 30% [10]. In a healthcare setting, the
three components required for infection spread are the following [11]:
  Source - places where infectious agents survive (e.g. sinks, hospital
equipment, countertops, medical devices).
 Environment - patient care areas, sinks, hospital
equipment, countertops, medical devices.
 People - patients, healthcare workers, or visitors.

 Susceptible Person - Someone (Patient, Healthcare Worker, or

Visitor) who is not vaccinated or immune to a particular infectious
disease, or an individual with a compromised immune system /
immunodeficient [11].
 In addition, susceptibility can be heightened in individuals
due to underlying medical conditions, medications, and
necessary treatments and procedures that increase the risk
of infection (for example, surgery).

 Transmission - The way germs are moved to the susceptible

person
 Touch, including via medical equipment or a susceptible
person (for example, MRSA or VRE)
 Sprays or splashes (for example, Pertussis)
 Inhalation of aerosolised particles (for example, TB  or
Measles)
 Sharps injuries introducing blood-borne pathogens (for
example, HIV, HBV, HCV)

Controlling Infectious Diseases Within Communities

Infection control and prevention is a global issue and there are many
protocols and guidelines that can be followed to minimise the spread
of infection between people, within a population and globally [2]. Identifying at-
risk groups such as children, older people  and those with chronic conditions
can also help guide relevant strategies to protect these vulnerable groups. The
first step when looking at infection control can start at the community level by
changing behaviour, including:

 Regular hand washing
 Appropriate use of Face-masks (protect from and prevent spread of
respiratory infections)
 Using insect repellents
  Ensuring up-to-date routine vaccinations and participating in
immunisation programmes
 Taking prescribed medications, such as antibiotics, as directed by
health professionals
 Social distancing  - avoiding contact with others
 Using condoms when having sex, especially with a new partner

Other steps that can be taken to control the spread within communities
include environmental measures such as:

 Modifying environments
 Surveillance of diseases
 Food safety
 Air quality

Medical Interventions
As well as simple steps to prevent and control infections, there are
biochemical interventions that can be implemented to speed up the recovery
process and in some cases prevent viral infections completely. [12] The
development of antibiotics, antivirals  and vaccinations  have been shown to
speed up recovery, slow down the progression and in some cases eradicate
infectious diseases from entire populations.

Antibiotics

Antibiotics are prescribed for bacterial infections and support the body's
natural defence system to eliminate the disease-causing bacterial agent. They
are designed to either kill bacteria or stop them from reproducing. However,
poor use of antibiotics, over-prescribing and the mutation of bacteria has led
the development of resistant bacteria [13]. In these cases, either stronger doses
are required or the combination of one or more antibiotics.

Vaccinations

Vaccinations are designed to improve immunity to a particular disease.

Vaccines work by introducing small amounts of the disease-causing virus or
bacteria into the host, allowing them to build up natural immunity. The
introduction of regular vaccines have slowed down and in some cases
eradicated certain diseases such as polio, measles, mumps, whooping cough
and rubeola (measles). There are also vaccinations for chickenpox, but this is
not given routinely and is reserved for those at risk of spreading the disease to
those with a weakened immune system [14]. This is due to the fact that it is
prevalent in children under 10 years of age and symptoms are usually mild;
this method allows them to build up natural immunity and contributes to
improving the immunisation of a community [15]. This type of protection is
known as herd immunity [16].

Antivirals

Antibiotics provide no defence for infectious diseases that are caused by viral
agents such as influenza, HIV, herpes, and hepatitis B. In these cases,
antiviral medications are the most effective at slowing down the progression
of the disease and boosting the immune system. Unfortunately, as with
antibiotics, viruses can mutate over time and become resistant to these
antiviral drugs [13].

Infection Control in Healthcare Facilities

Another important factor in controlling and preventing infection is by
improving practices in healthcare facilities. It is the duty of healthcare
professionals worldwide to ensure they develop strategies and implement
policies that protect those who may be immunocompromised in order to keep
susceptible patients safe from healthcare-associated infections (HAIs).
Globally, up to 7% of patients in developed and 10% in developing countries
will acquire at least one HAI [2][17].

HAIs are one of the most common detrimental effects in care delivery and
both the endemic burden and the occurrence of epidemics are a major public
health concern. HAIs have a significant impact on morbidity, mortality [18] and
quality of life and present an economic burden at the societal level. However,
a large proportion of HAI are preventable and there is a growing body of
evidence to help raise awareness of the global burden of harm caused by these
infections, including strategies to reduce their spread [11].

[19]

Steps to Improve Infection Control

There are two tiers of recommended precautions by the Center of Disease
Control and Prevention (CDC) [20] to prevent the spread of infections in
healthcare settings: (1) Standard Precautions and (2) Transmission-
Based Precautions [21][6].

Standard Precautions for All Patient Care:

 Perform hand hygiene [22][23][24]

 Use personal protective equipment (PPE)  to prevent exposure to
infection
 Follow respiratory hygiene/cough etiquette principles
 Ensure appropriate patient placement and isolation precautions [25]
 Properly handle, clean, and disinfect patient care equipment and
medical instruments
 Handle and sterilise textiles and laundry carefully
 Follow safe injection practices and proper handling of
sharps/needles
 Ensure healthcare worker safety via IPC and post-exposure
prophylaxis
 Prevention of intervention-related infections (catheter-associated
urinary tract infections, intravascular catheter-related infections,
surgical site infections)
 The implementation of the specific isolation precaution when
diagnosing some syndromes [25]
 Improving the communication between health care workers
especially when referring potentially contagious patients [26]
 In paediatric departments or ambulatory settings, there should be
efforts to decrease infection from contaminated toys. Families can be
encouraged to bring their own toys [26]

Transmission-Based Precautions

Transmission-Based Precautions [27] used in addition to Standard Precautions

for patients with infectious disease to prevent transmission:

 Contact precautions
 Droplet precautions
 Airborne precautions
[28]

Further details and guidelines for transmission-based and isolation

precautions are provided by the Centers for Disease Control and Prevention
(CDC):

 Transmission-Based Precautions: Centers for Disease Control and

Prevention

Infection Control Programmes in Acute Care

The CDC[29] suggest that the assessment and management of infection control

programmes and practices in acute care hospital can be divided into 4
sections:

 Section 1: Facility Demographics

 Section 2: Infection Control Programme and Infrastructure
 Section 3: Direct Observation of Facility Practices (optional)
 Section 4: Infection Control Guidelines and Other Resources

They have produced a "Infection Prevention and Control Assessment Tool for
Acute Care Hospitals " that is intended to assist in the assessment of infection
control programmes and practices in acute care hospitals.

Environmental Cleaning and Disinfection

Evidence supports the important role of environmental cleaning in controlling

the transmission of organisms (e.g.Staphylococcus Aureus, Vancomycin-
resistant Enterococci, Norovirus, Clostridium Difficile and Acinetobacter),
especially in hospitals and healthcare settings. [30]

If an individual with a suspected or confirmed case of infectious disease has

attended your clinic, all surfaces that the person has come into contact with
must be cleaned.
  The room where they were placed/isolated should not be cleaned or
used for one hour and the door to the room should remain shut.
 The person assigned to clean the room should wear gloves
(disposable single-use nitrile or household gloves) and a disposable
apron (if one is available) then physically clean the environment and
furniture using a household detergent solution followed by a
disinfectant or combined household detergent and disinfectant, for
example, one that contains a hypochlorite (bleach solution) [31].
Products with these specifications are available in different formats
including wipes.
 No special cleaning of walls or floors is required.
 Pay special attention to frequently touched flat surfaces, backs of
chairs, couches, door handles or any surfaces that the affected
person has touched.
 Discard waste (including used tissues, disposable cleaning cloths)
into a healthcare risk waste bag (yellow).
 Remove the disposable plastic apron (if worn) and gloves and
discard into a healthcare risk waste bag.
 If a healthcare risk waste bag is not available, place the waste in a
small household waste bag and tie securely. Do not overfill. Then
place the bag in a second household waste bag and tie securely. Store
in a safe location. If the case is not confirmed the waste can be
disposed of as per usual. If a case is confirmed public health will
then advise you what to do with the waste.
 Once this process has been completed and all surfaces are dry the
room can be put back into use.

Infection Control Programmes Globally

The WHO Guidelines [2] on the Core Components of IPC Programmes at the
national and facility level aim to enhance the capacity of countries to develop
and implement effective technical and behaviour modifying interventions.
They form a key part of WHO strategies to prevent current and future threats
from infectious diseases such as Ebola, strengthen health service resilience,
help combat antimicrobial resistance (AMR) and improve the overall quality
of health care delivery. They are also intended to support countries in the
development of their own national protocols for IPC and AMR action plans
and to support health care facilities as they develop or strengthen their own
approaches to IPC.

[32]
The "Executive Summary of the Minimum Requirements by Core Component "
provides a good summary to present and promote the minimum requirements
for IPC programmes at the national and health care facility level, identified by
expert consensus according to available evidence and in the context of the
WHO core components.

Infection Control in Disaster and Conflict Settings

The principles of IPC remain of paramount importance in emergency settings
in order to protect yourself and your patients. This is especially important
given the unsanitary conditions post-disaster and conflict in camps, which can
create a perfect storm for infection, both for infectious diseases and wound
infection. With a high incidence of complex, open traumatic injuries requiring
surgery performed in sub-optimal surgical environments, there comes an
increased risk of wound infection, which is further exacerbated by limited
access to resources including clear (potable) water and medical consumables,
creating significant challenges for rehabilitation professionals in many
disaster and conflict settings. [33]

When working in an area where infectious diseases (e.g. cholera,

diphtheria, Ebola , Middle East Respiratory Syndrome (MERS)) are an
identified risk, additional IPC precautions will be in place. Make sure that you
have had specific training and have been provided with additional PPE as
required.[33]

Improving Social Determinants

Another important factor to consider in the control of infectious diseases is to
address and improve social determinants  of health within societies. There is a
direct link between a person's health and their environment. WHO has
identified three "common interventions" for improving health conditions
worldwide[34]:

 Education - There is a strong link between health and education [35].

 Social Protection - Access to affordable healthcare and some form of
social security system can also determine the health and behaviours
in a community[36].
 Urban Development - How our villages, towns and cities are
designed can have a big impact on health and the spread of diseases.
Living in overcrowded environments or in housing that is damp
 and/or that does not have adequate facilities and sanitation can
increase the spread of infectious diseases [37].

Conclusion
There is no one solution to controlling the spread of infectious diseases, and
effective IPC indeed requires government intervention and collaboration
between healthcare agencies, individuals and communities. Until certain risk
factors are addressed and behaviours modified, the war against infectious
diseases will continue to be a predominant and costly health issue around the
world.

Resources
The following resources expand further on the four sections mentioned above:

 Infection Control Assessment Tools (2019) - CDC

 IPAC Checklist for Clinical Office Practice: Core Elements (2019) -
Public Health Ontario
 National infection prevention and control (2022) - NHS
Practical Assessment and Treatment of
Cervicogenic Headaches
An online course by Ari Kaplan

Learn more on this topic

Related articles
History of Infection Control Guidelines - Physiopedia Introduction No matter
what practice setting, maintaining good infection control methods are of vital
importance to protect not only the clinician, but also the patients that they treat. Over
the years, infection control practices have taken many different forms. Fundamental to
the idea of infection control is the maintenance of barriers or safeguards between the
clinician and the patient with the infection, disease, or pathogen. United States[edit |
edit source] The United States saw little in the way of organized infection control until
the 1950s, with growing numbers of staphylococcal infections plaguing hospitals.
However, it wasn't until the 1970s that infection control programs became widespread
and even mandated in hospitals. From there the guidelines were refined until they
became what we see today.[1][2] 1850-1900[3] - Physicians in the US, as well as other
countries, began to recognize the benefits of antiseptic techniques for the control of
infections. Physicians conducted first epidemiological studies concerning the
implementation of antiseptic techniques such as handwashing. 1877 - First hospital
manual suggested housing patients with infections in separate facilities from patients
without infections. Gave rise to dedicated infectious disease hospitals. 1910 - Cubic
System of Isolation and Barrier Nursing Patients with infections were placed in separate
wards. Hospital staff washed hands and equipment after contact with those in the ward.
1950s [3]- Staphylococcal epidemics within hospital patients and staff sparked the first
implementation of formal infection control programs Maintaining a clean environment
was a central focus of many of these programs. 1970 - United States Centers for Disease
Control and Prevention (CDC) first introduced a framework for hospital patient
isolation. Framework consisted of color coded disease/infection categories with
generalized precautions used for all diagnoses included in a category. Categories
included wound and skin, discharge, blood, enteric, protective, strict, and respiratory.
1976[3] - Joint Commission on Accreditation of Healthcare Organizations sets mandate
for infection control programs. Mandate required hospitals to maintain an established
infection control program in order to receive Joint Commission accreditation. 1983 -
CDC framework was updated to include disease-specific isolation guidelines. Previously
used categories also updated. Updated categories included Blood and Body Fluid
Precautions, Drainage/Secretion Precautions, Enteric Precautions, Tuberculosis
Isolation, Strict Isolation, Contact Isolation, and Respiratory Isolation. Disease specific
guidelines tailored for a specific infection or disease. Selection of precautions could be
based on the ones suggested by a specific category or for a specific disease or infection.
Clinical judgement was encouraged in the selection of precautions for each individual
patient and not all precautions suggested for a category or infection/disease had to be
used. 1985 - Universal Precautions Introduced in response to HIV epidemic and
increasing reports of clinical staff becoming infected with HIV from accidental needle
sticks and contact with patient’s blood. Blood and Body Fluid Precautions now applied
to all patients regardless of formally assigned precautions. Blood and Body Fluid
precautions expanded from only glove and gown use to the addition of eye protection
and masking for specific procedures and the use of individual ventilation devices for
CPR. Gloves to be worn if potential for contact with blood or specific body fluids and
hands to be washing after removal. 1987 - Body Substance Isolation All moist body
substances including blood, urine, feces, saliva, sputum, wound discharge, and any
other bodily fluids were considered infectious, regardless of the patient’s actual
infection status, and were therefore required to be isolated. Gloves to be worn if there
was a potential for contact with any moist body substance and, after removal, hands
only needed to be washed if visibly soiled. “Stop Sign Alert” posted on door of patients
with airborne transmittable infection/disease, instructing visitors/staff to check with
nurse regarding the need to wear a mask. Staff immunization/immunity required for
entry into rooms of patients with measles, mumps, rubella, or varicella. [4] 1989 -
Occupational Safety and Health Administration (OSHA) Bloodborne Pathogens
Regulations Expansive guideline for the protection of workers from blood borne
pathogens. Has continued to be updated and clarified for specific environments and
situations since creation and is still in place today. 1996 - Guideline for Isolation
Precautions in Hospitals Introduced Standard Precautions, a combination of Universal
Precautions and Body Substance Isolation. Precautions to be utilized with all patients
regardless of disease/infection status and in conjunction with any other implemented
precautions. Replaced category and disease specific precautions with with Airborne
Precautions, Droplet Precautions, and Contact Precautions, based on disease/infection
mode of transmission. Two criteria for assigning these precautions sets to a patient.
Confirmed presence of specific disease, infection, or pathogen. Observation of selected
signs and or symptoms suggestive of possible presence of disease, infection, or
pathogen warranting the need for Airborne, Droplet, or Contact Precautions. Precaution
assignment based on observation alone, meant to be temporary until confirmation of
diagnosis. 2007 - CDC Guideline for Isolation Precautions: Preventing Transmission of
Infectious Agents in Healthcare Settings Current utilized guidelines Emphasizes
application to all healthcare settings. Contents include:[5] Administrative
Responsibilities Education and Training Surveillance Standard Precautions Hand
hygiene Personal protective equipment Respiratory hygiene/cough etiquette Patient
placement Patient-care equipment and instruments/devices Care of the environment
Textiles and laundry Safe injection practices Infection control practices for special
lumbar puncture procedures Worker safety Transmission Based Precautions General
principles Contact Precautions Patient placement Use of personal protective equipment
Patient transport Patient-care equipment and instruments/devices Droplet Precautions
Airborne Precautions Protective Environment Conclusion[edit | edit source] It has
taken a long time to reach the current infection control guidelines that we live by today
and many factors have influenced their evolution. Undoubtedly the currently utilized
guidelines will continue to evolve as contagious diseases and infections change, but it
will always be important to understand how they got to where they are now.
Resources[edit | edit source] CDC Infection Control Resources CDC Guideline for
Isolation Precautions: Preventing Transmission of Infectious Agents in Healthcare
Settings OSHSA Bloodborn Pathogen and Needlestick Prevention Homepage Infection
Control in Older Adults - Physiopedia Introduction Infectious diseases account for
one third of all deaths in people 65 years and older.[1] Active infection is a challenge not
only for older adults with infectious diseases, but also for health care providers[2]. It is
therefore essential for clinicians, such as physiotherapists who manage older adults in
different settings, to identify challenges in the control of infection in older adults and
measures to stop the spread of infection. Elderly and infections, key points Early
detection is more difficult in the elderly because the typical signs and symptoms, eg
fever and leukocytosis, are frequently absent. A change in mental status or decline in
function may be the only presenting problem in an older patient with an infection. An
estimated 90 percent of deaths resulting from pneumonia occur in people 65 years and
older. Pneumonia, flu and other infectious diseases (including COVID-19) have resulted
in high mortality rates among older adults (mortality resulting from influenza also
occurs primarily in the elderly). Urinary tract infections are the most common cause of
bacteremia in older adults. Asymptomatic bacteriuria occurs frequently in the elderly;
however, antibiotic treatment does not appear to be efficacious. There are also
challenges with specific vaccines or anti-viral therapy for some infectious conditions,
including the class of coronaviruses that include SARS, MERS, and COVID-19. 
Antibiotics are useless against viral infections. This is because viruses are so simple that
they use their host cells to perform their activities for them. So antiviral drugs work
differently to antibiotics, by interfering with the viral enzymes instead. It is possible to
vaccinate against many serious viral infections eg measles, mumps, hepatitis A and
hepatitis B. Some viruses eg those that cause the common cold, are capable of mutating
from one person to the next. Vaccination for these kinds of viruses is difficult, because
the viruses have already changed their format by the time vaccines are developed.
Infection Control Challenges in Older Adults[edit | edit source] This section will focus
on issues related to infection control in older adults, taking into account physiological
changes and health care settings. Physiological Changes[edit | edit source] With aging,
physiologic changes occur that affect the immune system as well as various organ
systems. Aging itself is not a disease however, with time, the accumulation of such
changes can sometimes lead to a clinical condition in older adults known as frailty. Age
related immune changes Immunosenescence describes an age-related poor immune
function that predisposes older adults to infectious diseases[3] and is attributed to a
functional decline in the innate and adaptive immune system due to ageing.
Immunosenescence Innate immunity due in the older person is classically causes the
upregulation of a number of pro-inflammatory cytokines, eg IL-6, C-reactive protein,
and others[3]. Such a chronic pro-inflammatory state can lead to anorexia, nutritional
impairment, muscle weakness, and weight loss, all of which can contribute to infections
in older adults[4].  Immunosenescence and inflammaging are gradual, relentless
processes, with their clinical impact often not fully apparent until progression to frailty.
Coupled with other factors such as multimorbidities and declining functional status,
this frailty results in increased morbidity and mortality (including from infection).[1]  
Age related organ-specific physiologic changes Aging causes physiologic changes that
affect nearly every organ system, independently of existing co-morbidities and disease.
This process is the result of lifelong accumulation of molecular and cellular damage
caused by a number of mechanisms. These changes include structural transformations,
altered anatomy, and decreased function in multiple physiologic systems, as well as loss
of feedforward and feedback mechanisms between interacting systems, resulting in a
constellation of physiologic changes causing progressive homeostatic dysregulation and
contribute to vulnerability to infections[1]. Health Care Settings[edit | edit source] Due
to the unique needs of older adults, there are a variety of settings in which they may
reside or seek care. Common places of residences include: family homes; senior
apartments; older adult day care centers; long-term care facilities; acute care;
rehabilitation centers; home care. Some of these selected settings be discussed with
respect to infection control and challenges in older adults. Acute Care Centres[edit |
edit source] Older adults often reside in acute care centres due to the presence of
comorbidities. Infection control challenges at this centre include Poor assessment of the
infection status of older adults by physician prior to transfer to acute centres Poor
record of comorbidity Drug resistance pathogens Atypical clinical findings of infection
among this population. eg an older adult with pneumonia may be more likely to present
with confusion and functional deterioration than shortness of breath or new cough, and
that may result in delayed diagnosis, resulting in inappropriate intervention and
ultimately a delay in effective interventions[5]. Nursing Homes[edit | edit source]
Residents of nursing homes are susceptible to infectious diseases due to the following
factors: host factors, structural concerns and process factors[5][6]. Host factors that
make older adults susceptible to infectious diseases include immunosensecence, multi-
morbid conditions, impaired mental status, and incontinence. Some older adults may
serve as hosts for antimicrobial-resistant pathogens. Structural control (the ability of
the facility to have sufficient resources to manage the infection in the nursing home).
This involves preparing and implementing programs to monitor infections at nursing
homes. Process factors include a nursing home's ability to deliver effective health care
delivery services. It includes having highly-educated personnel with knowledge of
controlling infections among older adults. Process factors also include good diagnostic
tools and effective infection monitors. In the case of affected older adults, unavailability
of this equipment or problems in any of the above factors may result in delayed
intervention or mismanagement of infection. Home Healthcare and Rehabilitation
Services[edit | edit source] Home health services are becoming increasingly utilized for
older adults, as they require a longer period of medical attention in the home setting.
Atypical clinical presentation that may mask the presence of infection in this population
present challenges to controlling infection in older adults. May further delay
intervention in the affected individual as is deemed necessary. In rehabilitation
services, older adults receiving treatment for hydrotherapy and functional
rehabilitation should be considered for proper screening of infections because they may
be asymptomatic[5]. Recommendations[edit | edit source] Control of infections in older
adults is particularly challenging for clinicians and healthcare systems. Clinicians need
to consider the multi-modal aspects of infection risk factors in older adults when
conducting general assessments in order to prevent and reduce the spread of infection.
During this pandemic of COVID-19, older people need to be familiar with the
prevention of infection in order to prevent the contraction and spread of covid-
19Zoonotic Diseases - Physiopedia Introduction A zoonotic disease is any disease or
infection that is transmissible from vertebrate animals to humans. [1],[2] Recently
emerged zoonotic diseases include globally devastating diseases such as: Coronaviruses
(CoV), a large family of viruses that cause illness ranging from the common cold to
more severe diseases such as Middle East Respiratory Syndrome (MERS-CoV),Severe
Acute Respiratory Syndrome (SARS-CoV) and COVID 19[3] Ebola virus disease Highly
pathogenic avian influenza Bovine spongiform encephalopathy [4] Key Points Nearly
two-thirds of human infectious diseases arise from pathogens shared with wild or
domestic animals Endemic and enzootic zoonoses cause about a billion cases of illness
in people and millions of deaths every year, and emerging zoonoses are a rising threat
to global health, having caused hundreds of billions of US dollars of economic damage
in the past 20 years Ecological and evolutionary perspectives can provide valuable
insights into pathogen ecology and can inform zoonotic disease-control programmes
Anthropogenic practices (ie those caused by humans or their practices) eg. changes in
land use, animal production systems, and widespread antimicrobial applications, affect
zoonotic disease transmission Risks are to all countries; as global trade and travel
expands, zoonoses are increasingly posing health concerns for the global medical
community Multisectoral collaboration, including clinicians, public health scientists,
ecologists and disease ecologists, veterinarians, economists, and others is necessary for
effective management of the causes and prevention of zoonotic diseases[5] How do
Zoonoses spread[edit | edit source] Because of the close connection between people and
animals, it’s important to be aware of the common ways people can get infected with
germs that can cause zoonotic diseases. These can include: Direct contact: Coming into
contact with the saliva, blood, urine, mucous, feces, or other body fluids of an infected
animal. Examples include petting or touching animals, and bites or scratches. Indirect
contact: Coming into contact with areas where animals live and roam, or objects or
surfaces that have been contaminated with germs. Examples include aquarium tank
water, pet habitats, chicken coops, barns, plants, and soil, as well as pet food and water
dishes. Vector-borne: Being bitten by a tick, or an insect like a mosquito or a flea.
Foodborne: Each year, 1 in 6 Americans get sick from eating contaminated food. Eating
or drinking something unsafe, such as unpasteurized (raw) milk, undercooked meat or
eggs, or raw fruits and vegetables that are contaminated with feces from an infected
animal. Contaminated food can cause illness in people and animals, including pets.
Waterborne: Drinking or coming in contact with water that has been contaminated with
feces from an infected animal.[6] Approaches for Zoonotic Disease Control[edit | edit
source] Mitigating the impact of endemic and emerging zoonotic diseases of public
health importance requires multisectoral collaboration and interdisciplinary
partnerships. Collaborations across sectors relevant to zoonotic diseases, particularly
among human and animal (domestic and wildlife) health disciplines, are essential for
quantifying the burden of zoonotic diseases, detecting and responding to endemic and
emerging zoonotic pathogens, prioritizing the diseases of greatest public health
concern, and effectively launching appropriate prevention, detection, and response
strategies. These structures must be in place before an outbreak, epidemic, or pandemic
occurs to have an effective, coordinated public- and animal-health response. Countries
that lack a well-functioning coordination mechanism could fail to rapidly detect and
effectively respond to emerging health threats, which could spread to other countries
and threaten global health security.[4] Prevention[edit | edit source] On a personal
level The best way to protect oneself from many of these zoonotic diseases is to practice
good hygiene after handling animals or their waste. Washing hands thoroughly with
hot, soapy water after any contact will help prevention contraction of zoonotic diseases.
[2]   In addition screening newly received animals, conducting a routine sanitization of
the contaminated environment, equipment, and caging, wearing gloves and protective
clothing will help decrease the possiblity of contracting a zoonotic disease.[7] The four
principal means of preventing spread of zoonoses are[1] 1. parasite recognition and
control 2. vaccination programs 3. sanitation methods 4. behavior training to prevent
bites and scratches On a world wide level Preventing zoonotic diseases requires
coordinated actions by government authorities responsible for human and animal
health. The prevention and control of zoonotic diseases impose a unique, often heavy
burden on public health services, particularly in resource-limited settings. Because
zoonotic diseases can deeply affect animals and humans, for many zoonotic infections,
medical and veterinary health agencies have a large stake in disease surveillance and
control activities. Collaboration between agencies is pivotal but takes time, requiring
dedicated planning and well-exercised coordination of activities. Achieving this level of
collaboration can be daunting in many real-world situations where resource disparities,
differences in institutional culture and priorities, disparate legal authorizations, and
many other factors can impede development of the formal structures needed to ensure
effective implementation of disease prevention and control programs. Field
observations and anecdotal reports suggest ongoing risks to human health, to the
preservation of wildlife, and, in many cases, to livestock production—the last of which
can compound human hardships by negatively affecting livelihoods—in the absence of
formal structures that enable intersectoral collaboration.[8] Classes of Zoonoses[edit |
edit source] Including viruses, bacteria, parasites, and fungi. Viral Zoonoses - 6
Common Viral Zoonoses[edit | edit source] Coronaviruses (CoV) are a large family of
viruses that cause illness ranging from the common cold 3 strains of corana virus are
Middle East Respiratory Syndrome (MERS-CoV), Severe Acute Respiratory Syndrome
(SARS-CoV, Covid19 - a new strain that has not been previously identified in humans.
Detailed investigations found that SARS-CoV was transmitted from civet cats to
humans and MERS-CoV from dromedary camels to humans. Several known
coronaviruses are circulating in animals that have not yet infected humans. 2.
Ehrlichiosis - Ehrlichiosis is the general name used to describe diseases caused by the
bacteria Ehrlichia chaffeensis, E. ewingii, or E. muris eauclairensis in the United States.
These bacteria are spread to people primarily through the bite of infected ticks
including the lone star tick (Amblyomma americanum) and the blacklegged tick (Ixodes
scapularis). People with ehrlichiosis will often have fever, chills, headache, muscle
aches, and sometimes upset stomach. Doxycycline is the treatment of choice for adults
and children of all ages with ehrlichiosis.[9] 3. Rocky Mountain Spotted Fever
(Rickettsia ) Rocky Mountain Spotted Fever is a tick borne disease, due to an
intracellular pathogen known as Rickettsia rickettsi 4. Rabies - Rabies is an
infectious, zoonotic disease that destroys brain cells and can lead to death if left
untreated before symptoms appear.  It is caused by a virus that lives in the saliva of a
host or carrier and can be transmitted by being bitten by the carrier or if the
infected saliva enters an open wound or mucous membranes.  Rabies has been reported
as being transmitted to people after breathing in air from caves that contained millions
of bats and through organ transplants from an infected person.  The most common
sources of infections for humans are from wild animals and dogs.[10] 5. West Nile Virus
- West Nile virus (WNV) is the leading cause of mosquito-borne disease in the
continental United States. It is most commonly spread to people by the bite of an
infected mosquito. Cases of WNV occur during mosquito season, which starts in the
summer and continues through fall. There are no vaccines to prevent or medications to
treat WNV in people. Fortunately, most people infected with WNV do not feel sick.
About 1 in 5 people who are infected develop a fever and other symptoms. About 1 out of
150 infected people develop a serious, sometimes fatal, illness. You can reduce your risk
of WNV by using insect repellent and wearing long-sleeved shirts and long pants to
prevent mosquito bites.[11] 6. Equine Encephalitis - A mosquito borne infection
normally maintained in nature by a cycle from an arthropod vector to a vertebrate
reservoir host.[1] Some people experience it only as a mild illness for others it is fatal
(fatal in about one-third of the cases). Symptoms of eastern equine encephalitis usually
appear three to 10 days after a bite by an infected mosquito.[12] No vaccine exists for
humans.[1] Personal protective measures are the primary way to avoid contracting the
virus.[1] Bacterial Zoonoses - 10 Common Bacterial Zoonoses[edit | edit source]
Anthrax Anthrax is an acute infectious disease caused by the spore-forming bacterium
Bacillus anthracis[13], a microbe that lives in the soil.[14] A serious infectious disease
caused by gram-positive, rod-shaped bacteria known as Bacillus anthracis. Anthrax can
be found naturally in soil and commonly affects domestic and wild animals around the
world. Rare in the United States - people can get sick with anthrax if they come in
contact with infected animals or contaminated animal products. Contact with anthrax
can cause severe illness in both humans and animals. Anthrax is not contagious, which
means you can’t catch it like the cold or flu. Anthrax can occur in three forms:
cutaneous, inhalation, and gastrointestinal.[13][14] 2. Bartonella (Cat Scratch Fever) -
bacterial disease caused by Bartonella henselae. Most people with CSD have been bitten
or scratched by a cat and developed a mild infection at the point of injury. Lymph
nodes, especially those around the head, neck, and upper limbs, become swollen.
Person with CSD may experience fever, headache, fatigue, and a poor appetite.[15]  
Bartonella will begin in the human as a pustule that will gradually progress to regional
lymphadenopathy which can last for months (or become a systemic illness in
immunocompromised patients).   Can also be transmitted through the feces of fleas.[1]
3. Lyme Disease Lyme disease or Lyme borreliosis is the most commonly transmitted
tick-borne infection in the United States and among the most frequently diagnosed tick-
borne infections worldwide[16]. 4. Brucellosis Brucellosis is a bacterial infection that
spreads from animals to people. Most commonly, people are infected by eating raw or
unpasteurized dairy products. Sometimes, the bacteria that cause brucellosis can spread
through the air or through direct contact with infected animals. Signs and symptoms of
brucellosis may include fever, joint pain and fatigue. The infection can usually be
treated with antibiotics. However, treatment takes several weeks to months, and the
infection can recur. Brucellosis affects hundreds of thousands of people and animals
worldwide. Avoiding raw dairy products and taking precautions when working with
animals or in a laboratory can help prevent brucellosis.[17] 5. Ehrlichiosis   The general
name used to describe several bacterial diseases that affect animals and humans.
Human ehrlichiosis is a disease caused by at least three different ehrlichial species in
the United States. Ehrlichiae are transmitted to humans by the bite of an infected tick.
Symptoms usually occur within 1-2 weeks following a tick bite[18][19] and include
fever, headache, fatigue, and muscle aches. Ehrlichios is is diagnosed based on
symptoms, clinical presentation, and later confirmed with specialized laboratory tests.
Treatment for adults and children of all ages is doxycycline.[18]  6. Leptospirosis A
bacterial disease that affects humans & animals. Caused by the bacteria genus
Leptospira. Spread through urine of infected animals, which can get into water or soil
and can survive for weeks to months. Most common method of transmission is through
direct contact with infected urine or other bodily fluids such as saliva, or contaminated
water, soil, or food.[20] 7. Plague (Yersinia enterocolitica, Yersinia pestis)   Plague is a
zoonotic infection that has affected humans for thousands of years. In humans, the
primary plague syndromes are bubonic, septicemic, and pneumonic. All of these result
from infection with the gram-negative bacillus Yersinia pestis. The typical life-cycle
of Y. Pestis starts within an insect vector followed by transmission to a mammalian
host, typically rodents or other wild animals. Humans are only affected as incidental
hosts. Despite this, Y. pestis is arguably one of the most important microbes in human
history.  It has caused three documented pandemics, with the “black death” in 14th
century Europe leading to the death of up to 30% of the population. The most recent
pandemic began in the late 19th century in Asia and India, and it continues today in
Africa. Outside of this, the bacterium remains endemic in the Americas and Asia and
also exists as a potential bioterrorism threat, spurring ongoing vaccine development 8.
Rickettsia (Rocky Mountain Spotted Fever) A disease caused by the bacterium
Rickettsia rickettsii, which is carried by ticks. People usually start having fevers and
feeling nauseous about a week after being bitten by a tick. A few days after the fever
begins people will often have a rash, usually on the arms or ankles. They also may have
pain in their joints, stomach pain, and diarrhea.[15] When you remove ticks from any
animal, the crushed tick or its parts can also pass this disease through any cuts or
scrapes on your skin.[15]  9. Methicillin Resistant Staphylococcus Aureus (MRSA)
Methicillin-Resistant Staphylococcus Aureus (MRSA) is defined as a type of bacterial
staph infection that is non-responsive to antibiotics normally prescribed to treat such
infections.[21]  MRSA was first described in 1961-1962 in a patient whose infection was
resistant to the drug Methicillin, which was discovered in 1960. The incidence of MRSA
greatly increased in the United States in the 1980s and was especially emerging in
patients who used intravenous drugs[22]. The bacteria from which MRSA arises,
staphylococcus aureus, is found in the skin and in the nostrils of one third of all people
and do not show any symptoms of having been exposed to the bacteria. These carriers of
the bacteria are then exposing the bacteria to all of the items that they touch as well as
expelling it into the air where it will remain until the item is next cleaned. 10.
Streptococcus suis is a zoonotic pathogen that infects pigs and can occasionally cause
serious infections in humans. S. suis infections occur sporadically in humans
throughout Europe and North America, but a recent major outbreak has been described
in China with high levels of mortality. The mechanisms of S. suis pathogenesis in
humans and pigs are poorly understood.[23] Fungal Zoonoses[edit | edit source] Fungal
infections associated with zoonotic transmission are an important public health
problem worldwide . A number of these infections are among the group of the most
common fungal diseases, such as: dermatophytosis, sporotrichosis , and histoplasmosis.
[24]     1.Dermatomycoses - infections of the skin, hair and nails, which are caused in
most cases by dermatophytes, and in rarer cases by yeasts and moulds. Fungal
infections of the skin are the most frequently occurring infectious diseases, with a
worldwide prevalence of 20% to 25% and high and growing relapse rates. Clinical image
of dermatomycoses very heterogeneous and cannot always be differentiated from other
dermatoses. Further, a simultaneous bacterial infection of the damaged skin,
pretreatment with corticosteroid-containing preparations or secondary contact allergy
hinder identification of dermatomycoses. Dermatomycoses must always be treated. The
choice of antimycotic therapy (therapeutic, duration, dose) depends on the pathogen
and on the severity and type of infection, and treatment is either local and/or systemic.
A fast diagnosis and pathogen typing are for successful therapy of fungal diseases[25] 2.
Histoplasmosis is a fungal disease associated with bat guano (stool).[15] and is a type of
lung infection. It is caused by inhaling Histoplasma capsulatum fungal spores. These
spores are found in soil and in the droppings of bats and birds. This fungus mainly
grows in the central, southeastern, and mid-Atlantic states. Most cases of
histoplasmosis don’t require treatment. People with weaker immune systems may
experience serious problems. The disease may progress and spread to other areas of the
body. Skin lesions have been reported in 10 to 15 percent of cases of histoplasmosis that
has spread throughout the body.[26] 3. Coccidioidomycosis ( is an infection usually
caused by inhaling the spores (“seeds”) of either Coccidioides immitis or Coccidioides
posadasii fungi). These spores are found in the soil in certain geographic areas (called
endemic), and get into the air when the soil is disturbed. This can happen with
construction, gardening, farming, windy weather, dirt biking or driving all-terrain
vehicles (ATV’s) in these areas. Coccidioidomycosis cannot be passed from person-to-
person. The most common states for people to be infected with coccidioidomycosis are
Arizona and California, followed by Nevada, New Mexico, Texas, and Utah [27]     
Parasitic Zoonoses[edit | edit source] 3 Common Parasitic Zoonoses[edit | edit source]
1, Toxocara Canis (Roundworm) A parasitic disease associated with cats, dogs and their
environment.[15]  Toxocara canis is an infection transmitted from animals to humans
caused by the parasitic roundworms commonly found in the intestine of dogs (Toxocara
canis) and cats (T. cati).   The most common Toxocara parasite of concern to humans is
T. canis, which puppies usually contract from the mother before birth or from her milk.
The larvae mature rapidly in the puppy’s intestine; when the pup is 3 or 4 weeks old,
they begin to produce large numbers of eggs that contaminate the environment through
the animal’s stool. The eggs soon develop into infective larvae.   Humans can become
infected after accidentally ingesting infective Toxocara eggs in soil or other
contaminated surfaces. In most cases, Toxocara infections are not serious. The most
severe cases are rare, but are more likely to occur in young children, who often play in
dirt, or eat dirt (pica) contaminated by dog or cat stool.[28] 2. Hookworm: Ancylostoma
caninum is a parasitic disease associated with dogs and their environment.[15] Animals
can indirectly pass hookworm to humans. Animals that are infected pass hookworm
eggs in their stools. The eggs can hatch into larvae, and both eggs and larvae may be
found in dirt where animals have been and can get into the human body through direct
contact with the dirt.eg if a child is walking barefoot or playing in an area where dogs or
cats have been. If a person contracts animal hookworm eggs, the larvae that hatch out
of the eggs reaching the intestine and cause bleeding, inflammation (swelling), and
abdominal pain. People can get painful and itchy skin infections when animal
hookworm larvae move through their skin.[29] 3. Echinococcosis (tapeworm)
Tapeworms are flat, segmented worms that live in the intestines of some animals.
Animals can become infected with these parasites when grazing in pastures or drinking
contaminated water. Eating undercooked meat from infected animals is the main cause
of tapeworm infection in people. Although tapeworms in humans usually cause few
symptoms and are easily treated, they can sometimes cause serious, life-threatening
problems[30] Healthcare-Associated Infections - Physiopedia Introduction
Healthcare-associated infections (HAI), also referred to as hospital-acquired infections,
are infections that are acquired in the course of treatment that did not exist prior to
admission[1]. HAI can affect healthcare staff, patients, visitors, and can occur in
hospitals, nursing homes, or any other health care facility with regular patient contact.
Such an infection can also appear after discharge or in the home setting[1]. HAI
represents a significant burden and risk to healthcare systems globally, with hundreds
of millions of patients affected each year. It results in unnecessary illness and death,
increased antibiotic resistance of microorganisms, prolonged length of care, and a
resulting increase in cost to hospitals, facilities, patients and families, as well as
healthcare systems globally[1]. HAI occurs in all countries regardless of Human
Development Index, but appears to affect patients in low-income and middle-income
countries two- to three-fold higher than high-income countries[2]. Additionally, the
WHO reports that the true impact of HAI is not well-understood due to limited data
reliability and lack of surveillance systems for detecting HAI in developing regions[1]
[3]. It is a global priority to address HAI, and effective infection prevention and control
(IPC) instituted at the level of governments and healthcare systems is one potential
solution. Global Burden and Incidence[edit | edit source] Overall, HAI occurs more
frequently in developing regions than in developed countries. According to a 2011 WHO
report[4], HAI occurs at a rate of 7.6 per 100 individuals in high-income countries and
a rate of 15.5 per 100 patients in developing countries. In Europe, with an HAI
prevalence of 7.1 per 100 patients, that equates to 4.13 million patients every year
impacted by an HAI, based on a 2011 Lancet meta-analysis[4]. Hospital-wide
prevalence in developing countries ranges from 5.7% to 19.1% (pooled, 10.1%). Urinary
tract infections are the most common type of HAI in Europe and the U.S., whereas
surgical site infections are the most frequent HAI hospital-wide in developing
countries[4]. HAI incidence rates, based on the 2011 WHO report and Lancet meta-
analysis, are shown below: Overall HAI Incidence[3][4] Region Category Cases per 100
patients Developing* countries 15.5 Europe 7.1 USA* 4.5 *Developing: low- and middle-
income according to World Bank classification 2009[4] **2002 data[3] ICU-Acquired
Infection (Adult)[4] Region Category Cases per 1000 patient-days Developing countries
42.7 Developed countries 17.0 USA 13.6[3] *Developed: high-income country, defined
according to World Bank classification 2009[4] Surgical Site Infection[3] Region
Category Cases per 100 surgical procedures Developing countries 1.2 to 23.6 (pooled =
11.8)[4] Europe 2.9 USA 2.6 Paediatric and Neonatal Infection[3] Type of Setting Cases
per 1000 patient-days Paediatric ICU (Developing countries) 1.6 to 46.1 Neonatal ICU
(Developing countries) 15.2 to 62 Neonatal ICU (USA) 6.9 HAI in the ICU Setting[edit |
edit source] In particular, HAIs occur most frequently in the ICU setting[2], where
various factors including use of invasive medical devices and lines, prolonged bed rest,
multiple comorbidities, and high exposure risk predispose patients to transmission.
Additionally, data suggest that 30% of patients in the ICU are affected by at least one
episode of HAI[2][4]. The mean cumulative incidence of infection in adult critically-ill
patients is 17.0 episodes per 1000 patient-days. The most common type of HAI among
these patients is ventilator-associated pneumonia[3]. High frequencies of infection also
occur in association with use of central lines and urinary catheters[2]. Physiotherapy
and HAI[edit | edit source] Due to the broad role of physiotherapists and involvement
in the continuum of patient care, including hospitals, ambulatory clinics, nursing
homes, rehabilitation hospitals, and homes, HAIs are a growing area of concern in
physiotherapy[5]. Physiotherapists routinely work in close proximity among patients
presenting with a range of illnesses, interact with a variety of healthcare staff, and
frequently provide hands-on and physical assist to patients. Physiotherapists often work
with older adult patients, who are more prone to infection. Additionally, the
comparatively long length of treatment sessions (30 to 60 minutes) and course of care
among settings make both patients and physiotherapists particularly susceptible to
HAIs. Due to these factors, it is especially important for physiotherapists to practice
effective IPC and hand hygiene, regardless of clinical setting. According to the World
Health Organization's "My 5 Moments of Hand Hygiene" approach, healthcare workers
including physiotherapists should clean their hands before touching a patient, before
clean/ aseptic procedures, after body fluid exposure/risk, after touching a patient, and
after touching patient surroundings[5]. Global Impact of HAIs[edit | edit source]
Although the full picture of the impact of HAIs is yet to be elucidated, there is strong
evidence from existing published studies that hundreds of millions of patients are
effected globally each year, with the highest impact occurring in low- and middle-
income countries[4]. Viral Infections - Physiopedia Introduction Viral infections are
among the most common afflictions of man. It has been estimated that children
experience two to seven respiratory infections each year; adults are afflicted with one to
three such episodes[1]. Image shows cell with relative size of virus (14) Viruses cause
familiar infectious diseases such as the common cold, flu and warts. They also cause
severe illnesses such as HIV/AIDS, Ebola, influenza and COVID-19. Viral infections
occur due to infection with a virus. Millions of different viruses may exist, but
researchers have only identified about 5,000 types to date. Viruses contain a small piece
of genetic code, and a coat of protein and lipid (fat) molecules protects them. Viruses
invade a host and attach themselves to a cell. As they enter the cell, they release their
genetic material. This material forces the cell to replicate the virus, and the virus
multiplies. The cell may then: Die and it releases replicates of the virus, which infect
new cells. Change the function of the host cell. eg. Some viruses like the human
papillomavirus (HPV) and Epstein-Barr virus (EBV), can lead to cancer by forcing cells
to replicate in an uncontrolled way. For most viral infections, treatments can only help
with symptoms while you wait for your immune system to fight off the virus. There are
antiviral medicines to treat some viral infections. Currently dramatic progress in
antiviral therapeutics is occurring[2]. Vaccines can help in prevention of many viral
diseases.[3] Viruses may remain dormant for a period before multiplying again. The
person with the virus can appear to have fully recovered, but they may get sick again
when the virus reactivates[4]. Viral Infections[edit | edit source] A few notable
examples that have garnered the attention of the public health community and the
population at large include: COVID 19, Ebola, SARS, Influenza, Zika, Yellow fever,
Human immunodeficiency virus (HIV / AIDS), Human papillomavirus (HPV), Viral
gastroenteritis, Varicella, and Viral hepatitis[5]. Image at R: A simplified diagram of the
Hepatitis C virus replication cycle. Respiratory Infections[edit | edit source] A variety of
viruses cause different types of respiratory infections. Rhinovirus, coronavirus and
adenovirus are the leading causes of the common cold. Influenza viruses infect the
upper respiratory system and sometimes spreads to the lungs causing pneumonia.
Influenza has been and continues to be one of the great scourges of man. Influenza
viruses produce epidemic disease annually. Irregularly, but with all-too-great
frequency, widespread epidemics of influenza occur, occasionally producing a pandemic
that involves virtually the whole world. Epidemics attributed to the influenza viruses
have occurred throughout recorded history. In the past century, major epidemics
occurred in 1890, 1900, 1918, 19S7, 1968 and 2019. The great pandemic of influenza in
1918-1919 is estimated to have killed 20--40 million people and accounted for 80% of
the deaths in the U.S. Army during World War I.[1] Another virus called the respiratory
syncytial virus (RSV) causes a respiratory infection called bronchiolitis in infants and
toddlers[6]. Central Nervous System Infections[edit | edit source] Several viruses can
infect the central nervous system (brain and spinal cord). Viral CNS infections have an
annual incidence ranging from 0.26 to 17 cases per 100,000 depending on the age and
vaccination status of the population.  Enteroviruses (a genus of positive-sense single-
stranded RNA viruses, so named by their transmission-route through the intestine) are
the most common cause of viral CNS infection (nearly 60%), followed
by arbovirus and herpes virus, such as herpes simplex virus (HSV) and varicella zoster
virus (VZV)[7]. Viral Meningitis: Enteroviruses are responsible for 80 to 90% and
mumps for 10 to 20% of diagnosed cases of viral meningitis, with many other viruses
sometimes incriminated with considerable geographical and seasonal variation. Viral
Encephalitis Japanese encephalitis is the commonest cause of encephalitis in Asia:
other causes—with considerable geographical and seasonal variation—include dengue
viruses, Enteroviruses (EV71) rabies, Nipah virus, herpes simplex, West Nile virus, and
mumps. Viral Myelitis Viral ‘paralytic’ myelitis is classically caused by poliovirus, which
has now been virtually eliminated from the Americas: other causes—with considerable
geographical and seasonal variation—include Japanese encephalitis and various
coxsackieviruses, echoviruses, enteroviruses and flaviruses.[8] Skin Infections[edit |
edit source] Viruses cause a wide array of skin infections. eg. Herpes simplex viruses
(HSV) cause some of the most common skin infections. HSV type 1 tends to cause
vesicles in the mouth and on the lips, commonly known as cold sores or fever blisters.
HSV type-2 tends to cause genital herpes. The varicella virus causes chickenpox, an
illness characterized by itchy fluid-filled bumps on the skin that eventually rupture and
scab over. The varicella virus also causes shingles, which is a reactivation of the virus
years after the initial bout of chickenpox. Human papillomaviruses (HPV), cause
warts[6]. Digestive System Infections[edit | edit source] Several types of viruses cause
viral gastroenteritis, commonly called the stomach flu. This common illness,
characterized by diarrhea, nausea and vomiting, is caused by many different viruses,
but not the influenza virus According to a June 2012 "American Family Physician"
article, viruses cause 75 to 90 percent of acute gastrointestinal disease in children[9]
Diagnosis[edit | edit source] Viral infections are causing serious problems in human
population worldwide - take the recent outbreak of coronavirus disease 2019. The first
step in combating viral pathogens is to get a timely and accurate diagnosis. Early and
accurate detection of the viral presence is crucial for appropriate treatment, control,
and prevention of epidemics[10]. Diagnostic virology has now entered the mainstream
of medical practice as a result of several independent developments. The dramatic
progress in antiviral therapeutics has increased the need for specific viral diagnoses.
Technological developments, particularly in the area of nucleic acid chemistry, have
provided important new tools for viral diagnosis. The number of patients at risk for
opportunistic viral infections has expanded greatly as a result of the HIV/AIDS
epidemic. Modern management of HIV infection and hepatitis C is providing a new
paradigm for the integration of molecular techniques into management of chronic viral
infections. These developments are not only increasing the use of diagnostic virology
but are reshaping the field. Multiple methods are used for the laboratory diagnosis of
viral infections, including viral culture, antigen detection, nucleic acid detection, and
serology. The role of culture is diminishing as new immunologic and molecular tests are
developed that provide more rapid results and are able to detect a larger number of
viruses[2] Emergence of Viral Diseases[edit | edit source] In order for a new viral
disease to emerge, the causative virus must infect and successfully invade its host,
bypassing the complex and sophisticated antiviral defenses that have evolved in all
animals. It is to be stressed that necessary host, virological, and environmental factors
must, typically, coincide for a disease to emerge[11]. Many of the scariest viruses that
have caused past or current epidemics originated in other animals and then jumped to
people: HIV from other primates, influenza from birds and pigs, and Ebola probably
from bats. So, too, for coronaviruses: The ones behind SARS (severe acute respiratory
syndrome), MERS (Middle East respiratory syndrome) and Covid-19 all probably
originated in bats and arrived in people via another, stepping-stone species, likely palm
civets, camels and possibly pangolins, respectively. Making the jump from one species
to another isn’t easy Successful viruses have to be tightly adapted to their hosts. To get
into a host cell, a molecule on the virus’s surface has to match a receptor on the outside
of the cell, like a key fitting into a lock. Once inside the cell, the virus has to evade the
cell’s immune defenses and then commandeer the appropriate parts of the host’s
biochemistry to churn out new viruses. Any or all of these factors are likely to differ
from one host species to another, so viruses will need to change genetically — that is,
evolve — in order to set up shop in a new animal. Host switching actually involves two
steps The virus has to be able to invade the new host’s cells: That’s a minimum
requirement for making the host sick. To become capable of causing epidemics, the
virus also has to become infectious — that is, transmissible between individuals — in its
new host. That’s what elevates a virus from an occasional nuisance to one capable of
causing widespread harm[12]. Resources[edit | edit source] "Why the world needs
viruses to function" -you may wish to read this interesting article Some exerts below
Viruses seem to exist solely to wreak havoc on society and bring suffering to humanity.
They have cost untold lives over the millennia, often knocking out significant chunks of
the global population – from the 1918 influenza epidemic which killed 50 to 100 million
people to the estimated 200 million who died from smallpox in the 20th Century alone.
The current Covid-19 pandemic is just one in a series of ongoing and never-ending
deadly viral assaults. Most people are not aware of the role viruses play in supporting
much of life on Earth, because we tend to focus only on the ones that cause humanity
trouble. Nearly all virologists solely study pathogens; only recently have a few intrepid
researchers begun investigating the viruses that keep us and the planet alive, rather
than kill us[13].

References
1. ↑ Infection prevention and control [Internet]. World Health
Organization. 2020 [cited 27 March 2020]. Available from:
https://www.who.int/infection-prevention/about/ipc/en/
2. ↑ Jump up to:2.0 2.1 2.2 2.3 2.4 World Health Organization. Guidelines on core
components of infection prevention and control programmes at
the national and acute health care facility level . World Health
Organization; 2016.
3. ↑ Tartari E, Tomczyk S, Pires D, Zayed B, Rehse AC, Kariyo P,
Stempliuk V, Zingg W, Pittet D, Allegranzi B. Implementation of
the infection prevention and control core components at the
national level: a global situational analysis . Journal of Hospital
Infection. 2021 Feb 1;108:94-103.
4. ↑ Mayhall CG. Hospital epidemiology and infection control.
Lippincott Williams & Wilkins; 2012 Feb 20.
5. ↑ Control and Prevent the Spread of Germs [Internet]. Centers for
Disease Control and Prevention. 2020 [cited 27 March 2020].
Available from:
https://www.cdc.gov/infectioncontrol/index.html
6. ↑ Jump up to:6.0 6.1 Wilson J. Infection control in clinical practice.
Elsevier Health Sciences; 2006 Jun 21.
7. ↑ van Seventer JM, Hochberg NS. Principles of Infectious
Diseases: Transmission, Diagnosis, Prevention, and Control.
International Encyclopedia of Public Health. 2017:22.
8. ↑ US Department of Health and Human Services. Principles of
Epidemiology in Public Health Practice Third Edition An
 Introduction to Applied Epidemiology and Biostatistics. Chapter
8, Lesson 1. Atlanta, Georgia, USA Accessed 15 March 2020
9. ↑ Let's Learn Public Health.Infectious Diseases - How do we
control them? Published on 26 February 2017. Available
from https://www.youtube.com/watch?
v=2JWku3Kjpq0&feature=emb_logo . [last accessed 17 March
2020]
10.↑ Jump up to:10.0 10.1 Infection prevention and control [Internet]. World
Health Organization. 2020 [cited 27 March 2020]. Available
from: https://www.who.int/infection-prevention/en/
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