Principles of Disease

and Epidemiology

Pathology
 Branch of medicine to study disease
 Cause or etiology of disease
 Manner which disease develops
 Structural and functional changes by
disease and effects on host

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 Infection and Disease
 Exposure – left unprotected to contact
with MO
 Infection - invasion or colonization of body
by pathogenic MO
 Disease - any change from normal state of
health or abnormal state, in which body
not properly adjusted or not capable of
carrying on normal function

Infection and Disease

 Infection not necessarily indicate
disease
 Normal flora - may colonize or infect
specific areas of body without
causing disease; may however cause
disease given right circumstances
 Person infected with MO (i.e., HIV)
but show no symptoms of disease

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 Normal Flora:
Opportunist
 E. coli NF in stool, but #1 cause of
urinary tract infection
 Viridans group Streptococcus NF in
oropharyngeal area, but cause subacute
bacterial endocarditis when gains
entrance into bloodstream
 Considered opportunistic pathogen

Normal Flora: Carriers

 In addition to usual NF, some persons
colonized by MO generally considered
pathogenic, but without disease
 These individuals are carriers and transmit
pathogenic MO to others who develop
disease
 Neisseria meningitidis – URT
 Salmonella typhi – GI tract, gall bladder
(reservoir site)

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 Types of Infectious
Disease
 Infectious disease – by disease producing
MO
 Congenital disease – present at birth and
result of condition in utero (maternal
infection, use of drug or alcohol, etc.); may
result in birth defects
 Iatrogenic disease – caused by health care
personnel during delivery of care; could be
due to use of contaminated equipment,
administration of drug, etc.
 Nosocomical disease - hospital acquired
disease
 Idiopathic disease – undetermined cause

Nosocomial Infections
 Hospitals provide perfect
environment for MOs, in
part because patient with
weakened condition and
more susceptible to
infection and disease
 Up to 15% of hospitalized
patients get a nosocomial
infection
 Most nosocomial infections
caused by opportunistic
pathogens typically
considered NF

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 Types of Nosocomial
Infections

Septicemia

Koch’s Postulates:
Etiology of Infectious
Disease
 1 – Pathogen present in every case
of disease
 2 - Pathogen isolated from diseased
host and grown in pure culture
 3 - Pathogen must cause same
disease when inoculated into
healthy, susceptible host
 4 - Pathogen must again be isolated
from inoculated animal, shown to be
same as originally isolated MO
 Not possible to identify etiology of
all infectious diseases following
Koch’s postulates:
 MO not isolated on culture media
 MO not inoculated into healthy human
host to cause disease

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 Epidemiology
 Study of when and where diseases occur and
how transmitted in a population
 Also concerned with methods of controlling
and preventing a disease; drugs, vaccines, and
reservoirs
 State and Federal Public Health Department
 The Centers for Disease Control and
Prevention, (CDC), Atlanta, Georgia
 The World Health Organization (WHO),
within the United Nations

Spread of Disease:
Reservoirs
 For a disease to perpetuate, must be a
source of infection called a reservoir
 Humans – Carriers or sick individuals
during incubation, acute, or convalescent
phases (when transmitted depends on
disease)
 Animals – diseases found in animals called
zoonosis
 Non-living entities - such as soil or water

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 Spread of Disease:
Transmission
 Causative agents transmitted from
the reservoir of infection to a
susceptible host via four main routes:
 1. Contact
 2. Common Vehicle
 3. Airborne
 4. Vector

1. Contact Transmission
 Direct contact – spread from
person to person via touching,
kissing, or sexual intercourse
 Indirect contact – to a
susceptible host by means of
non-living object called fomite
(i.e., contaminated needles)
 Droplet transmission – spread
by droplets in saliva and mucous;
discharged by sneezing,
coughing, laughing, or talking.
The droplets travel only short
distance (< 1 meter) and not
considered airborne

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 2. Common Vehicle
Transmission
 Refers to transmission of disease causing
agents by a common inanimate reservoir to
a large number of individuals
 Food
 Water
 Blood
 Drugs

3. Airborne Transmission
 Refers to spread of agents of
infection by droplet nuclei or dust
 In this instance the particles travel >
1 meter from the reservoir to the
host
 i.e., air condition unit

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 4. Vector
Transmission
 An animal that carries pathogen from one
host to another
 Arthropods are most common type
 Transmit disease either by:
 Mechanical – pathogen on feet or other body
parts to food ingested by humans
 Biological – arthropod bites infected host,
acquires the pathogen, MO reproduce inside
the vector, pathogen transmitted to new host
via salivary glands or feces

Infectious Disease: How

Spread
 Communicable disease – spreads from one host
to another either directly or indirectly
 Noncommunicable disease – doesn’t spread
from host to host but caused by MO:
 Normally inhabits body and occasionally causes disease
 Resides outside the body and produces disease when
introduced into the body
 Contagious disease – a disease that spreads
easily from one person to another

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 Infectious Disease:
Severity/Duration
 Acute disease – develops rapidly, lasts
relatively short time i.e. “cold”
 Chronic disease – develops slowly, body’s
reaction usually less severe, but disease is
continuous or recurrent for long period i.e. TB
 Subacute disease – intermediate between
acute and chronic i.e. “infectious” hepatitis
 Latent disease – MO remains inactive for long
period, then becomes active and produce
symptoms i.e. chickenpox/shingles

Infectious Disease:
Frequency of Occurrence
 Sporadic – occurs occasionally i.e. measles
in USA
 Endemic – constantly present in population
i.e. TB inner city LA
 Epidemic – many people in a given area
acquire disease in short period of time i.e.
pertussis in USA 2010
 Pandemic – worldwide epidemic i.e. Covid-
19

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 Infectious Disease:
Health of Body
 Primary infection – acute infection causes
initial illness
 Secondary infection – by opportunistic
pathogen after primary infection has
weakened the body’s defenses
 Inapparent or subclinical infection –
doesn’t cause any noticeable illness (i.e.,
healthy carriers)

Infectious Disease:
Signals
 Symptoms – subjective changes in body
function such as pain or malaise (not
measurable)
 Signs – objective changes that can be
observed and measured; such as fever,
swelling, or rash
 Syndrome – a group of symptoms and
signs that always accompany a particular
disease

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 Infectious Disease:
Stages
 Period of incubation –
time between acquiring
infection and
appearance of first
symptoms/signs
 Prodromal period –
first signs/symptoms
appear
 Period of illness –
disease most acute,
overt signs/symptoms
occur (increase or
decrease in WBCs may
occur here)

Infectious Disease:
Stages
 Period of decline – where
signs/symptoms subside
 If the decline occurs
quickly, it is said to occur
by crisis
 If the decline occurs over
longer period of time, it is
said to occur by lysis
 Period of convalescence
- where person regains
strength and body
returns to pre-diseased
state

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