THE CHAIN

OF
INFECTION
The chain of infection describes how a pathogen
gets from where it is to where it's going. It starts
with the infectious agent, which lives in a
reservoir, finds a portal of exit, and uses a mode
of transmission to find a portal of entry into a
susceptible host.
HEXAGON RADIAL
INFECTIOUS
AGENT

SUSCEPTIBLE
RESERVIOR
HOST

THE CHAIN
OF
INFECTION

PORTAL OF PORTAL OF
ENTRY EXIT

MODE OF
TRANSMISSION
INFECTIOUS AGENT

First in the chain of infection is the infectious agent,

which is an organism capable of causing infection or
disease. Examples of infectious agents include bacteria,
viruses, fungi, and parasites.

For example, COVID-19 is an infectious agent.

 TYPES OF INFECTIOUS AGENTS
Infectious agents come
in many shapes and
sizes. Bacteria and
protozoans are
microscopic one-celled
organisms. Viruses are
even smaller. Fungi
grow like plants.
Helminths resemble
worms.
RESERVOIR

The reservoir is where the

infectious agent lives and
multiplies. A reservoir could be a
body of water, human, or animal.
In the case of COVID-19, a
person could be a reservoir for the
virus.
 PORTAL OF EXIT

The reservoir is where the

infectious agent lives and
multiplies. A reservoir could be a
body of water, human, or animal.
In the case of COVID-19, a person
could be a reservoir for the virus.
MODE OF TRANSMISSION
The mode of transmission explains how the infectious agent gets from the
reservoir to the new host. The portal of exit is just how the pathogen exited, but
the mode of transmission explains how it travels from there. This can include
direct contact, respiratory droplets, airborne, vehicles like water or food, or vectors
like mosquitoes, ticks, or fleas.
In the case of COVID-19, its mode of transmission is respiratory droplets. This is
why social distancing and limited gatherings are essential to stop the spread; fewer
people around each other, fewer respiratory droplets flowing through the air. If
you have COVID and you and your respiratory droplets are alone in your home,
they can't reach the next item on the list—a portal of entry to a susceptible host.
Transmission may occur through:

DIRECT CONTACT AIR

INSECTS
PORTAL OF ENTRY
The portal of entry is how the infectious agent enters into the
new host. This could be through the nose and mouth, through
the eyes, or through the bloodstream (e.g., into an open
wound). The portal of entry may be the same as the portal of
exit.
For example, COVID-19's respiratory droplet portal of entry
is the nose and mouth, which is again why masks are worn to
protect against the virus.
SUSCEPTIBLE HOST
A susceptible host is the recipient of the infection. The host must be
susceptible; and not all hosts are susceptible. Hosts might not be
susceptible because they have had the disease previously and
developed antibodies against it. Some hosts have stronger immune
systems than others, e.g., someone who is immunocompromised is a
more susceptible host.
In the case of COVID-19, getting vaccinated makes you a less
susceptible host.