EPIDEMIOLOGY OF THE

DISEASES
INFECTIOUS

Autonomous University Corporation of Cauca

Adriana María Muñoz
 Disease Epidemiology
Infectious
• EI considered as a global phenomenon that
affects large masses of populations.

• Epidemiology > Uses > to study the evolution

of the morbidity and mortality that they entail,
the affected groups, the geographical changes,
cycles and allows the design of strategies for
their control, elimination and eradication.
Investigate the etiology, mechanisms of
transmission, factors involved, allows
define programs and actions for your
surveillance, prevention and control.
 Current Situation of Diseases
Infectious

-> 13.3 million deaths per year

Second cause of death (25%), first
cardiovascular diseases (31%).
• First cause in children and young people (43%)
• More than 1,500 individuals die every hour from
these diseases (half under 5 years of age).
• Lower respiratory tract infections
• AIDS
• Diarrheal diseases
• Tuberculosis
• Malaria
• Measles
• Tetanus
• whooping cough
• Sexually transmitted diseases
• meningitis
 Thought ) Antibiotics and Vaccination
The chapter on infectious diseases could be
closed

Why does the problem continue ?

• Continued emergence of New Agents (legionella,
 hantavirus, prions)
• Re-emergence of some infections (tuberculosis,
malaria, diphtheria), which were considered
controlled.
• Establishment of new forms of transmission
(intravenous route, refrigeration systems).
• The emergence of microbial resistance to
antibiotics.
• Factors with notable impact on the environment.
EI They will continue to be a very prominent chapter in the
century
XXI
Successes achieved in recent decades :
• Smallpox eradication
• Control of poliomyelitis, leprosy, neonatal
tetanus.
• Reduction in mortality and morbidity due to E.
YO.
• Introduction of new medications and vaccines
that are increasingly more efficient against
infections
 General concepts
• Colonization : proliferation of an infectious
agent in the skin, cavity or viscera of a host or
animal.
• Infection : invasion and multiplication of
microorganism in host tissues
• Infectious Disease : set of
clinical manifestations produced by the
infection.
• Epidemiological Chain : Series of links involved
in the transmission of an agent (from a
 reservoir or an infected source) to a susceptible
host.
1.Transmissibility: ability of the agent to spread
from one host to others.
Depending on frequency of contacts, time
during which pathogens are eliminated.
2.Pathogenicity: ability to cause disease
(virulence). It ranges from inapparent infection
to cases with complete clinical expression.
• A minimum number of Microorganisms or
Infectious Dose is needed to overcome the host
defenses and cause disease.
• The number of organisms present in the
inoculum plays a prominent role in
transmissibility and pathogenicity .
• Example : The sputum or oral secretions of an
infected adult contains 10 6 to 10 7
Inhalation viral per milliliter and the
particles of 5 particles are enough to
infection. cause
3. Immunogenicity : ability to induce a specific
and long-lasting immune response in the host.
Figure 1 Natural history of the infectious disease (Modified from Halloran ME)

Dynamics of transmissibility

Start Time of the Completion of the

exposure transmissibility transmissibility
Individual Latency Transmissibility Non-infectious individual
Susceptible period period - improvement
- cured/deceased

Time

Dynamics of the
pathogenicity

Exhibition Onset of Infection

time symptoms resolution
Individual Period of Period of Non-sick individual
Susceptible incubation demonstrations - cured/deceased
Clinics - immune
- bearer

Time
• Reservoir : natural host or habitat in which the agent
finds the conditions essential for its survival, and from
there it passes to the susceptible host through
transmission mechanisms.
• Human being, animal, plant, soil, inanimate object.
• Source of Infection : it is an occasional habitat
 in which the agent temporarily maintains the
ability to reproduce:
• Secretions, feces, blood, water, food or an
object.
• Example: Hepatitis A; the man is the
contaminated reservoir, water or food source.
• Zoonoses: group of more than 400 infections,
whose reservoir is a vertebrate animal and can
spread to humans. (brucellosis, anthrax)
 KIND OF PLACE WHERE MOST COMMON Form FOODS MORE
MICRO ORGANISM THEY ARE USUALLY OF TRANSMISSION APPETIZING BY
FOUND THESE
MICROORGANISMS
staphylococcus In the nose, Through our Creams, creams,
throat, skin hands, sneezing or sauces, fresh cheeses,
(especially talking over food and etc.
pimples, wounds work utensils.
and nails). Through the
SALMONELLAS In the intestine of The sauces
People and (especially
animals. hands or utensils or mayonnaise), meats,
raw materials when etc.
they are contaminated.
CLOSTRIDIUM On earth Through the tools Preserves and
BOTULINUM of work or raw homemade sausages.
material, if they have
been in contact with
the ground.
CLOSTRIDIUM Pre-cooked foods that
PERFRINGENS In the dirt, dust and are allowed to cool
hands of the slowly.
handler.
 • Carrier : person who without presenting
clinical evidence of disease disseminates
microorganisms.
• It may be in the incubation or convalescent
phase.
• It may be a healthy person with colonization or
inapparent infection.
Transmission Mechanisms, Host
Susceptible and Environment
• Transmission Mechanisms : routes and means
 used by the infective agent to move from the
reservoir or infected source to a susceptible host:
1. Direct Contact:
Sexual contact (HIV, gonorrhea)
Mucosal contact (conjunctivitis, mononucleosis)
Transplacental route (rubella)
Hand contact (respiratory tract, skin) Animal bite
(rabies)
2. Through the air:

- Aerosol of large and medium-sized goths

produced when coughing, sneezing or talking
 that contain viable organisms.
Short distance direct transmission (maximum
distance 1m)
Close contact between individuals
Overcrowded situations
Closed spaces.
- Breathable gothic spray : cores
droplets with microorganisms move a few
meters.
Favorable Environmental Conditions: draft, wind,
dust.
It can reach several kilometers
Tuberculosis, flu
3. Common Vehicle : agent is transported through an
inanimate vehicle carried by the receiving subject.
- Water (cholera, typhoid),
- Food (consumption of milk, vegetables, meats,
contaminated products)
- Objects, blood, dirt.
4. By Vector : Arthropod transports the agent
 from one host to another.
malaria
• Host Susceptibility: depends on genetic basis, age,
sex, profession, travel, socio-economic conditions
and lifestyle habits.
It is greater in infants and schoolchildren (new
daycare and school environments.
Elderly (due to declining immune function)
• Environment : It exerts an extensive but tenuous
influence on the elements of the epidemiological chain.
Physical:
• Temperature and humidity (condition the life cycle and
survival of infectious agents in the external
environment.
• Global warming has been associated with the re-
emergence and expansion of dengue and malaria in
many geographic areas.
Biological :
Human and animal population density
Food availability by vertebrate and vector reservoirs.
Socio-Economic:
Education, hygiene and personal habits, health care,
economic availability.
Increasing urbanization, deforestation, change of
land uses, use of pesticides,
intensive livestock jan PSOG•
farming. HYGIENE HABITS
http://maestraespecialpt.blogspot.com/
The Fight Against Diseases
Infectious.

• Vaccines: They contain the antigens

attenuated so that they cannot trigger the
disease.
• But they do have the capacity to provoke a
specific immune response, leaving the body
protected by the acquisition of immunological
memory.
• It is a type of active immunity, since it is the body
itself that synthesizes the antibodies.
• It requires time for antigen recognition and
antibody synthesis, but is long-lasting, sometimes
for life.

• Serums: These are preparations that contain

 specific antibodies obtained from the blood of
another organism and, therefore, provide
passive, immediate and short-lasting immunity,
since it disappears when the inoculated
antibodies disappear.
• The antibodies were obtained from animals. This
type of sera is used to immunize against tetanus,
diphtheria, hepatitis (A and B), etc.
• Medications : It consists of the treatment
with drugs, among which antibiotics deserve
special attention, which inhibit or prevent
bacterial development.

Quantitative Aspects
1. Attack Rate: Measurement of the frequency of
 new cases of the disease in a given population
subjected to infectious risk over a period of
time. (proportion of people who have become ill
among those exposed).
Short period (minutes to months)
Allows you to estimate the intensity of the risk
• It is calculated by : Dividing the number of
detected cases of the disease by the total number
of exposed people and multiplying by 100 to
express it in %.
• Example : food poisoning
126 attended the banquet
 42 got sick
Attack Rate : (42/126)x 100= 33.3%
One third of people were affected
2. Basic Case Reproduction Number R o Average
number of disease cases produced by an infectious
case during its period of transmissibility when it
penetrates a totally susceptible population.
They are calculated using mathematical models
based on observed data.
Example:
Measles had R o = 15 and 17
On average, each case produced 15 to 17
 secondary cases before the infection resolved.
According to Anderson, 1991.
• Parotitis: 10-12
• Rubella: 7-8
• Whooping cough: 16-17
• Diphtheria and poliomyelitis: 5-6
R o : When it is greater than 1 it means that an epidemic
can occur at any time, because each case of infection
generates another.
When it is less than 1: the agent is practically blocked and
the infection has a tendency to disappear. Each case
does not produce another.
 Epidemiological Forms of
presentation of the EI
• Endemic : usual presence or expected level of
prevalence of an infectious disease in a
population.
• Epidemic : community phenomenon in which the
observed incidence of cases clearly exceeds that
expected. If it is localized (town, city...) Epidemic
Outbreak .
• Epidemics occur due to the presence of
factors that alter the Epidemiological Chain
• Example: Emergence of resistant MO,
unknown MOs.
Increased pathogenicity.
• Pandemic : when an epidemic affects several
countries or continents (AIDS, tuberculosis,
malaria, cholera, flu
• Three main Types of Epidemics :
1. Common Source : Disease occurs as a result
of exposure to a common vehicle containing
 the pathogen.
2. Propagative : the agent is transmitted from
one person to another consecutively.
3. Mixed : mixture of the two previous types
 Epidemiological surveillance
• What it is: Permanent and systematic
collection of information to understand the
distribution and trends of diseases.
• Goals:
1. Identify problems
2. Guide interventions
3. Suggest hypotheses for research
• Systems :
1. Mandatory declaration of diseases
2. Notification made by laboratories
3. Disease registries and sentinel systems.
Each country, according to its epidemiological
situation, determines the list of diseases to
notify the health administration.