Epidemiology Of Communicable Disease

Disease Agent Source of Mode of Special Diagnosis Prophylaxis Complication Miscellaneous

infection transmission feature/sign
symptoms
Small pox Variola virus Centrifugal, deep Globally eradicated in
seated rash, May 1980
affects palms and
soles
Chicken pox Varicella Zoster Cases Droplet and Droplet Pleomorphic, Clinical Lifelong Most common late Palms and soles are not
(person to nuclei centripetal, diagnosis immunity from complication is affected by the rash.
person vertical transmission superficial rash from rash, clinical infection shingles, threatening if
contact) (congenital varicella) followed by vesicular Live attenuated transmitted in 1st
oropharyn macule, papule, fluid under chicken pox trimester of
geal vesicle and scab. electron vaccine. pregnancy.
secretion Person becomes microscope
lesions of non-infectious
skin and when the lesion
mucosa gets crusted.
Measles RNA Cases only Airborne (droplet Maculo- papular Clinical Live attenuated Overall most common Does not follow the
(Rubeola) paramyxovirus (no and droplet nuclei) retro auricular diagnosis measles vaccine cx: Diarrhoea iceberg theory of disease.
(only one subclinical rash (koplik’s MR (9 and 16 Most common cx in
serotype) or spot in buccal months) young children: Otitis
carriers) mucosa) Media
Rare cx: SSPE (Sub
acute sclerosing pan
encephalitis)
Most common cause
of mortality:
Secondary bacterial
infection and
pneumonia

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Rubella RNA Toga virus Clinical or Droplet and droplet Coryza, sore Clinical Same as measles Classical triad of Blueberry muffin rash
(German subclinical nuclei throat, low grade diagnosis, (MR vaccine) congenital rubella (seen in TORCH) in
measles) cases Vertical transmission fever, post Congenital syndrome: 1.Cataract neonates. Recipients
(congenital rubella auricular and infection: at 2. Sensorineural advised not to become
syndrome) post.cervical birth, virus Hearing Loss 3. Patent pregnant over the next 1
lymphadenopathy is detected Ductus Arteriosus month after receiving the
followed by rash in (PDA) vaccine.
(can be presented pharyngeal
without rash as secretions,
well). CSF,multipl
Forchheimer e organs,
spots on soft urine and
palate. rectal
swabs.
Presence of
IgM and
IgG (6
months)
HaI test
Mumps Myxovirus Clinical Droplet infection, Pain and swelling Clinical Live attenuated Male: orchitis (most
parotiditis and Direct contact of parotid glands diagnosis, vaccine. common extra
subclinical (may involve viral culture salivary gland
cases sublingual and in blood complication in male)
submandibular) Female: ovaritis.
One of the main
infectious causes of
sensorineural
deafness.
Diphtheria Corynebacteriu Case or Droplet infection Greyish or Clinical Combined or
m diphtheriae carrier direct contact from yellowish diagnosis mixed vaccine:
infected cutaneous membrane (false DPT
lesion membrane)
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Epidemiology Of Communicable Disease

transmission by commonly over Single vaccine:

object. the tonsils, FT, APT, PTAP,
pharynx or larynx PTAH, TAF
with well-defined Anti-sera:
edges and the Diphtheria
membrane cannot antitoxin
be wiped away.
Whooping cough Bordetella Cases. Droplet infection Characterized by Clinical Td vaccine in
(pertussis) pertussis Infects and direct contact bursts of rapid, diagnosis EPI schedule.
only man. consecutive
coughs followed
by a deep, high-
pitched
inspiration(whoop
)
Tetanus Clostridium Soil and Bacteria typically Muscle stiffness, Clinical Td vaccine in
tetani dust are enter the body spasm and diagnosis EPI schedule
the through cuts, wound rigidity, stiffness
reservoir. or puncture injuries. of neck muscle,
Typically Non-contagious. difficulty in
present in swallowing.
soil, dust
and
manure.
Influenza Influenza virus Case or Person to person by Sudden onset of Clinical Both live and Reye syndrome (fatty liver
A, B, C, D (All subclinical droplet infection or chills, malaise, diagnosis is killed vaccine with encephalopathy) is a
known epidemic case. A droplet nuclei fever, muscular difficult are present. rare and severe
and pandemic major created by sneezing, pains and cough. except (Pentavalent in complication of influenza
are caused by reservoir coughing or talking. epidemics. EPI schedule) B, particularly in young
A&B) of Highly contagious. Lab children.
influenza diagnosis:
virus Virus
exists in isolation,

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animal Serology,
and birds. ELISA.
Avian influenza Avian H5N1 Primarily
strain affect
birds. Bird
viruses
can infect
other
species,
specially
pigs and
human.
Pandemic H1N1 virus Primarily Droplet infection, Regular flu RT-PCR Inactivated Has pandemic potential.
influenza A affects person to person symptoms in vaccine. Suspected case: person
(swine flu) pig. contact uncomplicated Live attenuated with acute febrile
case. Severe vaccine. respiratory illness with h/o
pneumonia and close contact with an
CNS infected person, travel
complication in history or community
severe case. residence where confirmed
cases are present.
Probable case: Acute
febrile respiratory illness
and tested positive with
influenza A
Confirmed case: Acute
febrile respiratory illness
with laboratory confirmed
influenza A H1N1.

Meningococcal Neisseria Carriers Droplet infection. Sudden onset of Clinical Meningococcal

meningitis meningitidis are the Portal of entry is intense headache, diagnosis, vaccine
most nasopharynx. nausea, vomiting, CSF culture (polysaccharide
important fever and
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source of photophobia, stiff (confirmato polysaccharide-

infection neck ry) protein
(distinguishing conjugate
feature) vaccine)
ARI Numerous Airborne route, No pneumonia: Clinical PPV and PCV
(pneumonia) bacteria and direct person to normal cough and diagnosis, vaccine.
viruses (Park person contact. cold without any blood and
table 2) danger sign. sputum
Pneumonia (not culture,
severe): Fast chest x-ray
breathing but no
chest indrawing
Severe
pneumonia: Nasal
flaring, grunting,
cyanosis.
Very severe
pneumonia: Not
able to drink,
convulsions,
abnormally sleepy
or difficult to
wake up, stridor,
severe
malnutrition.
Severe Acute Corona virus Cases Direct or indirect General flu NO specific Pulmonary
Respiratory (SARS-CoV) contact of mucous symptoms (fever, vaccine against decompensation,
Syndrome membrane of eyes, malaise, SARS. ARDS, non-
(SARS) nose or mouth with headache, cough, cardiogenic
respiratory droplets sore throat, runny pulmonary edema,
or fomites. nose, SOB in tension pneumothorax
severe case) from ventilation.

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Tuberculosis*** Mycobacterium Two Droplet infection Pulmonary TB Clinical BCG live DOTS chemo therapy (
(Details from tuberculosis sources: and Droplet nuclei Extra -pulmonary diagnosis attenuated 6months and 9 months
Park) Human TB: Organ TB, vaccine in EPI duration)
and Lymph node, Chest X-ray schedule.
Bovine Pleura, Intestine, Sputum for First line drugs
GU tract, Joints AFB (bactericidal):
and Bones, MT Rifampicin(RMP), INH
Meninges of brain test(screeni (Isoniazid), Streptomycin,
(TB does not ng) Pyrazinamide,
affect hair and GeneXpert Ethambutol(bacteriostatic)
nails) MTB/RIF Second line drug:
(confirmato Fluroquinolones,
ry) Ethionamide,
capreomycin, Kanamycin
and Amikacin,
Cycloserine,
Thioacetazone,
Macrolides.

DOTS-Plus regimen
Regimen for MDR and
XDR TB.

Poliomyelitis RNA polio virus Man is the Faeco-oral route and a) Inactivated Officially ELIMINATED
only Droplet infection Inapparent(subcli (SALK) polio from Bangladesh (Still
known nical) infection vaccine IPV present in India, Pakistan
reservoir. b) Abortive polio (killed) And Afghanistan)
or minor illness
c) Non-paralytic Oral (Sabin)
polio polio vaccine
d) Paralytic polio (live): Most
(Flaccid temperature
paralysis) sensitive (needs
to be preserved

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in -15 to -25
degree
centigrade)
Viral Hepatitis HAV, HBV, C, HAV: HAV and HEV: Jaundice, fever, Clinical Live and killed High risk population for
D, E and G virus Contamina Feaco-oral route, fatigue, nausea, diagnosis HAV vaccine, Liver cirrhosis in HBV:
ted food close personal vomiting, (history and chronic HBV and High risk sexual
and water, contact, abdominal pain physical Recombinant HCV. behaviour.
direct consumption of etc. examination DNA IV Drug users.
contact contaminate food or ), Imaging, inactivated Recipient of frequent
with water PCR. vaccine for blood or blood products.
infected HBV organ recipients.
person HBV: Contact with Serological (Pentavalent in Occupational risk eg:
infected markers: EPI schedule) health care workers,
HBV: blood(parenteral), HAV – IgM travelling from endemic
Blood, unprotected sexual anti-HAV NO vaccine for HBV zone.
semen, contact, sharing of antibodies HCV.
vaginal needles or other
fluid and drugs, vertical HBV-
other body transmission from HBsAg
fluid of mother to surface
infected child(perinatal), antigen,
person. child to child anti-HBs
Carriers transmission antibodies
are seen.
HCV: Sharing HCV- Anti-
HCV: needles or other HCV
Blood of drugs, receiving antibodies,
an contaminate blood HCV RNA
infected products, organ test
person transplants
HDV- HDV
HDV: HDV: Typically RNA, anti-
Blood and occurs in individuals HDV
body fluid, antibodies

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Epidemiology Of Communicable Disease

Requires already infected with

HBV to HBV HEV- Anti-
replicate. HEV
antibodies,
HEV: HEV RNA
Contamina
ted water
and
undercook
ed or raw
shellfish.

Human is
the only
reservoir
for HAV,
HBV,
HCV,
HDV.
HEV has
human
and
animals in
some
cases
(zoonotic
transmissi
on)

Acute diarrhoeal Children with Man is the Faeco-oral route NO dehydration: Human rotavirus Components of Diarrhoeal
disease acute diarrhoea: principal Child is playful vaccine Disease Control
reservoir and active, no (Rotarix) Programme:

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Epidemiology Of Communicable Disease

Viral: Rotavirus signs of

dehydration Short term: appropriate
Bacterial: E. coli clinical management
(Enterotoxigenic SOME (ORS)
and dehydration(mild) Long term:
enteropathogeni Pt is thirsty, alert, Better MCH care practice.
c) restless. Preventive strategies.
Shigella Pulse and BP Preventing diarrhoeal
Campylobacter normal. epidemic.
jejuni Skin pinch
Vibrio cholerae retracts
Salmonella(non- immediately.
typhoid) Urine flow
normal.
Protozoa: Moist tongue.
Cryptosporidiu Ant. Fontanelle
m normal.

SEVERE
dehydration:
Pt is drowsy,
limp, cold,
sweaty (may be
comatose).
Rapid, feeble
pulse, sometimes
impalpable.
BP less than 80
mmHg sometimes
unrecordable.
Skin pinch retract
very slowly (more
than 2 seconds).
Very dry tongue.

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Epidemiology Of Communicable Disease

Sunken
fontanelle.
Little or no urine
flow.

Cholera Vibrio cholerae Human is Faecally contaminate Stage of Oral Cholera

the only water. evacuation: “Rice vaccine:
known water” stool Dukoral and
reservoir, Contaminated food Stage of collapse: Sanchol
may be a and drinks. Severe
case or dehydration and
carrier. Direct contact. acidosis
Stage of recovery:
Pt shows sign of
improvement if
death does not
occur.

Typhoid Salmonella Man is the Faeco-oral or urine- Fever (step-ladder Clinical The Vi “Typhoid Mary” is the
(Enteric fever) typhi only oral route pattern), malaise, diagnosis, polysaccharide classic carrier.
known headache, cough WIDAL test vaccine.
reservoir, and sore throat
via case often followed by
and abdominal pain
carrier. and constipation
Soil transmitted Intestinal
Helminthiasis roundworm
(Ascariasis)
Hookworms
(Necator
americanus,

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Ancylostoma
duodenale)
Whipworm
(Trichuris
trichiura)

Dengue (DENV- Vector borne The Aedes mosquito Undifferentiated Clinical High risk patient:
1, DENV-2, disease. becomes infected by fever evaluation
DENV-3, DENV- Aedes aegypti feeding on a patient Classical dengue ELISA, Infants and elderly
4) Aedes from the day before fever (fever, IgM and Obesity
albopictus onset to the 5th day headache, retro- IgG Pregnancy
(viremia stage) of auricular pain) antibodies, PUD
illness. Dengue NS1 antigen Menstruating women
hemorrhagic fever test, PCR. Hemolytic disease such as
(petechiae, G-6PD, Thalassemia
internal bleeding) CHD
Dengue shock Pt on steroids and NSAID
syndrome (signs Chronic dz such as DM,
of shock, organ HTN, Asthma, IHD, CRF,
failure) liver cirrhosis.
Malaria Plasmodium (P. Vector borne Cold stage Blood Anti-malarial drugs:
vivax, P. disease. Transmits Hot stage smear Chloroquine
falciparum, P. through infected Sweat stage microscopy Proguanil
malaria, female Anopheles (thick and Mefloquine
P.ovale) mosquito. thin). Doxycycline
Direct transmission Rapid
Congenial malaria diagnostic
test (RDT).
PCR.
Lymphatic Wuchereria Culex Drug: Diethylcarbamazine
filariasis bancrofti mosquito
Brugia malayi
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Brugia timori (W.bancro

fti)
Mansonia
mosquito
(B.malayi)
Anopheles
mosquito
(B. timori)
Rabies Lyssavirus type Rabid Man is infected by a Characteristic Clinical Post exposure Does not follow iceberg
(Hydrophobia) 1 dogs and deep bite or scratch. symptom of diagnosis prophylaxis theory of disease
cats hydrophobia. NO (Rabies vaccine
cure, mortality immunoglobulin
rate 100% )
Pre-exposure
prophylaxis
(Rabies vaccine
to high risk
group)
Post exposure
treatment of
persons who
have been
vaccinated
previously

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