INFECTION PROCESS AND INFECTIOUS DISEASE CONTROL.

Germs are part of everyday life and are found in air, soil, water, and in and on our bodies. Some germs
are helpful, others are harmful. Many germs live in and on our bodies without causing harm and some
even help us to stay healthy. Only a small portion of germs are known to cause infection.

Sources of infection

An infection occurs when germs/microbes enter the body, increase in number, and cause a reaction in
the body. Three things are necessary for an infection to occur:

-Source

-Susceptible Host

-Mode of Transmission

Source

A Source is an infectious agent,microbes or germ i.e virus, bacteria, or other microorganisms.

In healthcare settings, germs are found in many places. People are one source of germs including:

Patients

Healthcare workers

Visitors and household members

People can be sick with symptoms of an infection or colonized with germs I.e a carrier(not have
symptoms of an infection but able to pass the germs to others).

Germs are also found in the healthcare environment. Examples of environmental sources of germs
include:

Dry surfaces in patient care areas (e.g., bed rails, medical equipment, countertops, and tables)

Wet surfaces, moist environments, and biofilms (e.g., cooling towers, faucets and sinks, and equipment
such as ventilators)

Indwelling medical devices (e.g., catheters and IV lines)

Dust or decaying debris (e.g., construction dust or wet materials from water leaks)

Susceptible Host
A susceptible person is someone who is not vaccinated or otherwise immune, or a person with a
weakened immune system who has a way for the germs to enter the body. For an infection to occur,
germs must enter a susceptible person’s body and invade tissues, multiply, and cause a reaction.

Devices like IV catheters and surgical incisions can provide an entry, whereas a healthy immune system
helps fight infection.

When patients are sick and receive medical treatment in healthcare facilities, the following factors can
increase their susceptibility to infection:

Patients in healthcare who have underlying medical conditions such as diabetes, cancer, and organ
transplantation are at increased risk for infection because often these illnesses decrease the immune
system’s ability to fight infection.

Certain medications used to treat medical conditions, such as antibiotics, steroids, and certain cancer
fighting medications(cytotoxic drugs) increase the risk of some types of infections.

Lifesaving medical treatments and procedures used in healthcare such as urinary catheters,
tubes(nasogastric, endotracheal), and surgery increase the risk of infection by serving as additional ways
by which germs can enter the body.

Recognizing the factors that increase patients’ susceptibility to infection allows providers to recognize
risks and perform basic infection prevention and control measures to prevent infection from occurring.

Mode of Transmission

Mode of transmission refers to the way germs are moved to the susceptible person.

Germs don’t move themselves. Germs depend on people, the environment, and/or medical equipment
to move in healthcare settings.

There are a few general ways that germs travel in healthcare settings – through contact (i.e., touching),
sprays and splashes, inhalation, and sharps injuries (i.e., when someone is accidentally pricked with a
used needle or sharp instrument).

Contact moves germs by touching.For example, healthcare provider's hands become contaminated by
touching germs present on medical equipment or high touch surfaces and then carry the germs on their
hands and spread to a susceptible person when proper hand hygiene is not performed before touching
the susceptible person.

Sprays and splashes occur when an infected person coughs or sneezes,or during sunctioning an
unconscious patient,creating droplets which carry germs of short distances (within approximately 6
feet). These germs can land on a susceptible person’s eyes, nose, or mouth and can cause infection
(example:COVID-19, pertussis or meningitis).
Close range inhalation occurs when a droplet containing germs is small enough to breathe in but not
durable over distance.

Inhalation occurs when germs are aerosolized in tiny particles that survive on air currents over great
distances and time and reach a susceptible person. Airborne transmission can occur when infected
patients cough, talk, or sneeze germs into the air (example: TB,measles,COVID-19), or when germs are
aerosolized by medical equipment or by dust from a construction zone (example: Nontuberculous
mycobacteria or aspergillus).

Sharps injuries can lead to infections (example: HIV, HBV, HCV) when bloodborne pathogens enter a
person's body through a skin puncture by a used needle or sharp instrument.

When patients/clients go into a hospital or other healthcare setting to receive care, they become
vulnerable to catching infections. Unfortunately, in the U.S., nearly 75,000 people (approximately 1 in 31
people) in hospitals die each year with these infections—many of which could have been prevented with
proper infection prevention practices. But the good news is that patients, their families, and other
visitors can take steps to prevent infections by simply knowing infection prevention basics!

There are many different germs and infections inside and outside of the healthcare setting. As a result of
the variety of viruses and bacteria, germs spread from person to person through a common series of
events. Therefore, to prevent germs from infecting more people, we must break the chain of infection.
No matter the germ, there are six points at which the chain can be broken and a germ can be stopped
from infecting another person. The six links include: the infectious agent, reservoir, portal of exit, mode
of transmission, portal of entry, and susceptible host.

Infectious agent is the pathogen (germ) that causes diseases

Reservoir includes places in the environment where the pathogen lives (this includes people, animals
and insects, medical equipment, soil and water)

Portal of exit is the way the infectious agent leaves the reservoir (through open wounds, aerosols, and
splatter of body fluids including coughing, sneezing, and saliva)

Mode of transmission is the way the infectious agent can be passed on (through direct or indirect
contact, ingestion, or inhalation)

Portal of entry is the way the infectious agent can enter a new host (through broken skin, the respiratory
tract, mucous membranes, catheters and tubes)

Susceptible host can be any person (the most vulnerable of whom are receiving healthcare, are
immunocompromised, or have invasive medical devices including lines, devices, and airways)

The way to stop germs from spreading is by interrupting this chain at any link.The chain can be broken
by cleaning hands frequently, staying up to date on vaccines (including the flu shot), covering coughs
and sneezes, staying home when sick, following the rules for standard and contact isolation, using
personal protective equipment the right way, cleaning and disinfecting the environment, sterilizing
medical instruments and equipment, following safe injection practices, and using antibiotics wisely to
prevent antibiotic resistance.

10 ways Nurses can recommend to patients and families in order to prevent infection:

1. Speak up for your care.

2. Clean your hands often.

3. Ask about safe injection practices.

4. Ask to have your room cleaned.

5. Ask questions about your medications.

6. Ask if you should shower before having surgery.

7. Ask each day if you still need a catheter.

8. Ask about vaccinations so you stay healthy.

9. Recognize an infection preventionist(Nurses).

10. Learn about healthcare-associated infections.

Leisons produced by infective agents in the body

Pathogens can be found in various compartments of the body, where they must be combated by
different host defense mechanisms. Virtually all pathogens have an extracellular phase where they are
vulnerable to antibody-mediated effector mechanisms. However, intracellular phases are not accessible
to antibody, and these are attacked by T cells.

The mammalian body is susceptible to infection by many pathogens, which must first make contact with
the host and then establish a focus of infection in order to cause infectious disease. To establish an
infection, the pathogen must first colonize the skin or the internal mucosal surfaces of the respiratory,
gastrointestinal, or urogenital tracts and then overcome or bypass the innate immune defenses
associated with the epithelia and underlying tissues. If it succeeds in doing this, it will provoke an
adaptive immune response that will take effect after several days and will usually clear the infection.
Pathogens differ greatly in their lifestyles and means of pathogenesis, requiring an equally diverse set of
defensive responses from the host immune system.

General signs and symptoms of infectious process

Signs and symptoms vary depending on the organism causing the infection, but often include fever and
fatigue. Mild infections may respond to rest and home remedies, while some life-threatening infections
may need hospitalization.
Many infectious diseases, such as measles and chickenpox, can be prevented by vaccines. Frequent and
thorough hand-washing also helps protect you from most infectious diseases.

Each infectious disease has its own specific signs and symptoms. General signs and symptoms common
to a number of infectious diseases include:

Fever

Diarrhea

Fatigue

Muscle aches

Coughing

Principles of infectious disease control

The primary concern of infectious disease control in public health, whether in developing or
industrialized countries, is the reduction, elimination, or even eradication of infectious disease. This is
accomplished by directing control measures to the agent, the routes of transmission, or the host. Such
control measures include:

(1) identifying and then reducing or eliminating infectious agents at their sources and reservoirs, (2)
breaking or interfering with the routes of transmission of infectious agents

(3) identifying susceptible populations and then reducing or eliminating their susceptibility.

-Control measures applied to the host: active immunization, passive immunization, chemoprophylaxis,
behavioural change, reverse isolation, barriers, and improving host resistance.

- Control measures applied to vectors: chemical, environmental, and biological.

- Control measures applied to infected humans: chemotherapy, isolation, quarantine, restriction of

activities, and behavioural change.

-Control measures applied to animals: active immunization, isolation, quarantine, restriction or

reduction, chemoprophylaxis, and chemotherapy.

-Control measures applied to the environment: provision of safe water, proper disposal of faeces, food
and milk sanitation, and design of facilities and equipment.

- Control measures applied to infectious agents: cleaning, cooling, pasteurization, disinfection, and
sterilization.

Achieving maximum impact on control of a specific infectious disease may involve more than one of
these interventions. For example, the control of hepatitis A infection can be achieved through
interventions that may include: active immunization, passive immunization, food preparation and hand-
washing behaviours, provision of safe water, food sanitation, and proper disposal of faeces.

All the above measures go along way in preventing and controlling infectious disease.