Й • МЕД

ЬНЫ ИЦ
АЛ И
KHARKIV NATIONAL
О Н

MEDICAL UNIVERSITY
Н •

•У
ЬКОВСКИЙ

НИВ
DEPARTMENT OF

ЕРСИТЕТ
INFECTIOUS DISEASES
ХАР

INTRODUCTORY LECTURE

Associate professor D.V. Katsapov

 INFECTOLOGY
science about infection
Parts:
MICROBIOLOGY, VIROLOGY - is science
about the pathogens.
EPIDEMIOLOGY - is science about reasons of
origin and routs of transmission of infectious agents

INFECTIOUS DISEASES
clinical symptoms,
diagnostics,
diff. diagnostics,
treatment
 PANDEMICS FACTSHEET

•1st recorded pandemic of plague : in A.D. 542 in Egypt and

Ethiopia;. killed 100 million people.
•2nd great plague pandemic 14th century in Europe, Central
Asia, the North East, India, and China. 25 million people in
Europe alone died.
•3rd plague pandemic began in Burma in 1894; spread to China
and North America.
•MODERN ERA
•AIDS pandemic. HIV has infected more than 60 million men,
women and children and AIDS has cost the lives of nearly 20
million adults and children. Despite the intense international
response to the HIV/AIDS pandemic, HIV continues to spread,
causing more than 14,000 new infections every day, 95% of
these are in the developing world. (WHO review 2011)
•Influenza (H1N1) pandemic 2009
 Present days

 The 2014 Ebola outbreak is one of the

largest Ebola outbreaks in history and the
first in West Africa. It is affecting four
countries in West Africa: Guinea, Liberia,
Nigeria, and Sierra Leone;
 It is reported 3069 suspect and confirmed
cases of EVD, including 1752 laboratory-
confirmed cases, and 1552 deaths.
 NEGLECTED TROPICAL DISEASES
(NTDS)
 The neglected tropical diseases (NTDs)
represent a group of more than a dozen
major chronic infectious diseases, most of
them parasitic infections, with high
endemicity in the developing countries of
Africa, Asia, and the Americas.
 The conceptual framework of the NTDs
was formulated in the years following the
2000 launch of the Millennium Declaration
 Ranking of NTDs by Disease Burden (DALYs) and
Comparison with HIV/AIDS, Tuberculosis, and Malaria.

Hotez PJ, Bottazzi ME, Franco-Paredes C, Ault SK, et al. (2008) The Neglected Tropical Diseases of Latin America and the Caribbean: A
Review of Disease Burden and Distribution and a Roadmap for Control and Elimination. PLoS Negl Trop Dis 2(9): e300.
doi:10.1371/journal.pntd.0000300
http://www.plosntd.org/article/info:doi/10.1371/journal.pntd.0000300
 The Major NTDs in India and South Asia Ranked by
Prevalence.

Lobo DA, Velayudhan R, Chatterjee P, Kohli H, et al. (2011) The Neglected Tropical Diseases of India and South Asia: Review of Their
Prevalence, Distribution, and Control or Elimination. PLoS Negl Trop Dis 5(10): e1222. doi:10.1371/journal.pntd.0001222
http://www.plosntd.org/article/info:doi/10.1371/journal.pntd.0001222
 MENA countries with the highest prevalence of NTDs.

Hotez PJ, Savioli L, Fenwick A (2012) Neglected Tropical Diseases of the Middle East and North Africa: Review of Their Prevalence,
Distribution, and Opportunities for Control. PLoS Negl Trop Dis 6(2): e1475. doi:10.1371/journal.pntd.0001475
http://www.plosntd.org/article/info:doi/10.1371/journal.pntd.0001475
 History of department of
infectious diseases of KHNMU
- founded in 1923 on the base of infectious department of the Kharkov
military hospital (Sq. of Rudnev, 14), 55 beds
.

Professor Professor Professor Professor

Z. Nesmelova I. R. Braude Т. Т. Chorna V. N. Kozko
Headed Headed Headed 1992 г.
1923-1931 1932-1958 1969-1991
 FORMS OF INFECTIOUS PROCESS
CARRIAGE CLINICAL INFECTION
-TRANSITORY -TYPICAL - ATHYPICAL
-CONVALESCENT - ACUTE - LATENT
- CHRONIC
-ACUTE
-COMBINED
-CHRONIC - Slow infection INFECTION

Inapparent form– absence of clinical symptoms

•Reinfection – repeated infection
•Superinfection– infection with new agent on current of infectious
disease
•Endogenous infection
Exacerbation– repeated deterioration
Relapse – recurrence of symptoms after apparent recovery
Complication – (specific, nonspecific)
 SPECIFIC PROPERTIES OF
PATHOGENIC MICROORGANISMS
INFECTIVITY- is ability to entry to the human organism,
survive and multiply, causing morphological and
functional damage.
VIRULENCE- qualitative manifestation of pathogenicity
INFECTING DOSE
INFECTIVITY, BACTERIAL
- ASSOCIATION;
- ADHESION;
- INVASION;
- PRODUCTION OF TOXINS;
• ENDOCELLULAR
• EXTRACELLULAR
 SPECIFIC PROPERTIES OF
PATHOGENIC MICROORGANISMS

INFECTIVITY, VIRAL
- ATTACHMENT;
- ENTRY;
- TRANSCRIPTION;
- TRANSLATION;
•INCLUSIONS;
•REDUSED HOST CELL FUNCTION;
•CELL INJURY, LYSIS, DEATH
•LATENCY
•NEOPLASM
 NON-SPECIFIC PROTECTIVE MECHANISMS
Undamaged skin and mucosal layer
Secretion of fatty and sweat glands
lysozyme
Secretory Ig A
Phagocytes
Normal microflora
Acid gastric medium
cilia of respiratory mucosa
hematoencephalic barrier
Enzymes (hydrolase)
interferon
lymphoquin
prostaglandin
System of compliment
Non-specific inflammation
Excretory system
SCHEME OF PHAGOCYTOSIS
 CYTOKINE

 Family of polypeptide hormone-like macromolecules

with short life period, synthesized and by excreted by
cells, with messenger functions and providing cellular
integration and differentiation, regulation of growth,
apoptosis and other functions.

 IL – interleukin;
 INF – interferon;
 TNF – tumor necrosis factor;
 CSF – colony stimulating factor;
 CHC – chemokine.
 For today it is identified more than 100 cytokines
HUMAN IMMUNE RESPONSE SYSTEM

I. NATURAL FACTORS (nonspecific) 4-5 hrs

Cellular: macrophages, neutrophils, NK-cells;
Humoral: IgG (natural), compliment etc.

II. EARLY INDUCTABLE ANSWER, 96 hrs

Cellular: NK-cells, macrophages, neutrophils;
Humoral: IL, CSF, TNF.

III. SPECIFIC ADAPTIVE ANSWER

Cellular: lymphocytes, macrophages;
Humoral: specific antibodies IgМ, IgG, cytokines.

Major histocompatibility complex – HLA;

Th1 – cellular: γ-INF, NK, CD8;
Th2 – humoral: IL- 4, 5, 6, 10.
 CLASSIFICATION OF INFECTIOUS DISEASES
Mechanism, Groups of Human Animals Environment
factors infections
Alimentary Intestinal Typhoid, Paratyphoid B, Botulism,
-water paratyphoid A, iersiniosis,
salmonellosis, clostrydiosis, etc.
-food shigellosis, brutcellosis,
cholera, polio
other
Air-droplet Respiratory Diphtheria, Ornithosis, etc. Aspergillosis,
tract influenza, measles, muromycosis, etc.
etc.
Transmissive Blood Louse-borne Plague, Hospital
(flies, fleas, lice, typhus, malaria, tularemia, tick- infections
etc.) viral hepatitis B,C borne
encephalitis, etc.
Contact Cutaneous Gonorrhea, Anthrax, Tetanus,
trachoma, etc. hydrophobia dermatomicosis
-direct; covering
-indirect

Vertical Innate measles, syphilis, Toxoplasmosis,

other lysteriosis
PECULIARITIES OF INFECTIOUS DISEASES

 Connection with specific pathogen,

 Contagiousness,
 Epidemic spread
 Exacerbations, relapses, chronic course
 Immune reactions, formation of specific
immunity
 Carriage of infection
 Cyclic clinical course
I. Incubation period
II. Prodromal period
III. Climax
IV. Convalescence
 CLINICAL PECULIARITIES OF
INFECTIOUS DISEASES
 General intoxication,
 Fever(duration, character)
 Febris continua
 Febris remittens
 Febris intermittens
 Febris reccurens
 Febris hectica
 Febris undulans
 Febris irregularis
 CNS affection, meningeal syndrome,
 Affection of skin and mucous membranes (exanthema, enanthema),
 Joints affection,
 Lymphadenopathy,
 Catarrhal and respiratory syndrome,
 CVS affection,
 Dyspeptic syndrome,
 Hepatolienal syndrome.
LABORATORY INVESTIGATION
ANAMNESIS OF DESEASE (A. morby)

EPIDEMIOLOGICAL ANAMNESIS (A. epidemica)

PHISICAL EXAMINATION

LABORATORY INVESTIGATION
•Mycroscopy
•Culturing
•Immunological (serological)
•Biochemical
•Imaging
•Molecular genetic (PCR)
 TREATMENT

ANTIBIOTICS
Sensitivity
Dosage, concentration
Method of administration,
Side effects
Scheme and duration
Stable concentration

ANTIVIRAL DRUGS

ANTI PROTOZOAL DRUGS

 TREATMENT

SPECIFIC IMMUNOTHERAPY
immunoglobulin
Gamma - globulin
Blood serum
Immune serum (antitoxic, antimicrobial)

NONSPECIFIC IMMUNOTHERAPY
Immunostimulant
Immunosupressor
Interferon, inductors
Human immunoglobulin
 TREATMENT
DEZINTOXICATION (PO, IV)
Colloid solutions
Sorbents

REHYDRATION (PO, IV)

Polyionic crystalloid solutions

 DESENSIBILIZATION
 DYSBIOSIS CORRECTION
 ENZYMES
 VITAMINS
 SYMPTOMATIC TREATMENT
 PROPHYLAXIS

SPECIFIC IMMUNOPROFILAXIS
Vaccines (active)
Primary (toxoids, pertussis, polio, hepatitis B, haemophilus influenzae type B, MMR)
With special indications (influenza, meningococcal)
Specific antisera (passive)
normal human immunoglobulin
hyperimmune serum
animal sera
NONSPECIFIC IMMUNOPROFILAXIS
Immunostimulant
Interferon, inductors
THANK YOU FOR ATTENTION!