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Introduction To Infectious Diseases Final
Introduction To Infectious Diseases Final
Nino Badridze
MD, MPH, PhD
What is infection and Infectious disease
Definition
Infection:
is the invasion of an organism's body tissues by disease-
causing agents, their multiplication, and the reaction
of host tissues to the infectious agents and the toxins they
produce.
Infectious disease:
also known as transmissible disease or communicable
disease, is illness resulting from an infection.
Infectious Diseases as a Cause of Death
• Infectious diseases are responsible for a quarter to a third of all
deaths worldwide.
Definition of infection
Complex process of interaction between pathogen
and human body
Three factors are involved in the infection:
pathogen, host and environment
Factors Influencing Disease Transmission
Agent Environment
• Infectivity • Weather
• Pathogenicity • Housing
• Virulence • Geography
• Immunogenicity • Occupational setting
• Antigenic stability • Air quality
• Survival • Food
• Age
• Sex
Host •Behaviour
• Nutritional status
•Health status
Basic factors of infectious Disease
• Pathogenic,
• Conditionally-pathogenic
• non-pathogenic microbes
Pathogenic Microbes specificity
- Pathomorphological,
- Pathophysiological and
- Clinical changes,
• Pathogenic,
• Conditionally-pathogenic
• non-pathogenic microbes
Conditionally-pathogenic microorganisms
• Conditional pathogens can cause disease in people by direct
implementation to the tissue or in individuals with reduced
resistance to infection such as those who have an increased
use of antibiotics, the elderly, and newborn infants.
Conditional pathogens include Escherichia coli and
Streptococcus agalactiae.
Viruses, rickettsia, fungi, protozoa
and Helminths also are
characterized by Toxicity and other
virulence factors
Infectivity and it’s related factors
• Factors affect the pathogenicity of a microorganism are very
diverse.
• The infectious process is the result of a complex interaction of
these factors.
• In addition, the course and outcome of the infectivity are
influenced by the route of transmission of the pathogen, the
number of pathogens (dose, concentration) at the time of
infection, the gateway to the infection, and more.
A) Humoral immunity
B) Cellular immunity
Two types of Immune Response
• Humoral immunity is also called antibody-mediated immunity.
With assistance from helper T cells, B cells will differentiate into
plasma B cells that can produce antibodies against a specific
antigen.
• Weather
• Housing
• Geography
• Occupational setting
• Air quality
• Food
Factors Influencing Disease Transmission
Agent Environment
• Infectivity • Weather
• Pathogenicity • Housing
• Virulence • Geography
• Immunogenicity • Occupational setting
• Antigenic stability • Air quality
• Survival • Food
• Age
• Sex
Host •Behaviour
• Nutritional status
•Health status
The Chain of Infection
• The Chain of infection is the way all infectious diseases spread.
• Each link has a unique role in the chain, and each can be
interrupted, or broken, through various means.
• The goal of infection prevention and control practice is to break
a link in the chain to prevent the transfer of microorganisms
Infectious Agent
• An infectious agent is a microorganism that is capable
infiltrating another living thing and producing infection.
Examples include bacteria, viruses, fungi and parasites.
Tuberculosis
Scarlet Fever
Tetanus
Gonorrhea
Diptheria
Streptococcal Infections
Pneumonia (can also be viral or fungal)
Pertussis
Bubonic Plague
Viral Diseases
*Common Cold
*Influenza
*HIV/AIDS
*Herpes (Simplex and Zoster)
*Hepatitis A,B,C, D, E, F and G.
*Measles, Mumps and Rubella.
*Poliomyelitis.
*Infectious mononucleosis.
Taxonomy Size Site of Propagation Examples
Disease
Prions 30–50 kD Intracellular Prion protein Creutzfeld-Jacob
disease
Viruses 20–300 nm Obligate intracellular Poliovirus Poliomyelitis
• Vertical transmission:
from mother to embryo, fetus or baby during
pregnancy or labour. Ex: HIV/AIDS, Hepatitis B, Herpes
simplex and etc
Ways of Transmission of Infectious Diseases
• Iatrogenic transmission:
due to medical procedures: injection or
transplantation infected material.
• Vector-borne transmission:
transmitted by a vectors (which include mosquitoes,
ticks, and fleas). Vector is an organism that
does not cause disease itself but transmits infection from
one host to another. (Dengue fever, West
Nile Virus, Lyme disease, malaria).
Airborne
Droplet
Portal of Entry – “The Way In”
• The ‘Portal of Entry’ represents the ‘way in’- it is the way in
which an infectious agent gets in to the next host. The portal
of entry could include:
– Communicable Diseases:
– Spread from one host to another, directly or indirectly.
Example: Tuberculosis, herpes, flu, AIDS, chickenpox,
mumps, polio, hepatitis and others.
– Contagious Diseases:
– Spread easily from one person to another.
Example: Chickenpox, measles, Varicella and etc .
Classifying Infectious Diseases
• Subclinical Infection :
without significant sign and symptoms
•Opportunistic Infections :
caused by non-pathogenic low virulence microorganisms in
immunocompromised individuals (in people with weakened
immune systems, including people with HIV).
Opportunistic Pathogens
By duration
Acute − develops and runs its course quickly.
Chronic − develops more slowly and is usually less severe, but
may persist for a long, indefinite period of time.
Latent − A latent infection is hidden, inactive, or dormant.
characterized by periods of no symptoms between outbreaks of
illness.
Classification of infectious diseases
By location
Local − limited to a specific area of the body.
Systemic − a generalized illness that infects most of the body
with pathogens distributed widely in tissues.
By timing
Primary − initial infection in a previously healthy person.
Secondary − infection that occurs in a person weakened by a
primary infection.
Emerging and re-emerging Infectious Diseases
• Emerging infections
are those that have recently appeared within a
population, increasing rapidly. (ex: HIV, SARS, Ebola,
COVID 19 and etc.).
• Re-emerging Infectious
Diseases whose incidence had significantly declined
in the past, but have again reappeared. (ex: tuberculosis
and etc.).
Relationships Between the Microbiota and the Host
Bacteremia
Presence of small number of low virulence bacteria in the
bloodstream which do not multiply significantly e.g S. typhi,
E.coli
Septicemia
Presence of rapidly multiplying highly pathogenic
bacteria in the bloodstream. Septicemia can lead to;
• Sepsis
• Pyaemia
• Toxemia
Other Definitions
Sepsis;
A whole-body inflammatory state leading to multiple organ
failure and death resulting from sepsis-induced hypotension and
diffuse intravascular coagulation (DIC)
Pyaemia;
A diseased state in which pyogenic bacteria are circulating in the
blood, by development of abscesses in various organs.
Toxemia;
Blood poisoning by toxins from a local bacterial infection
Other Definitions
Viremia
Circulating viruses in the blood stream
Latent virus infection
Reactivation of infection from virus in latent phase
e.g. Herpes zoster: reactivation of Varicella Zoster Virus after
recovery from varicella
An epidemic
(from Greek ἐπί epi "upon or above" and δῆμος demos "people") is
the rapid spread of infectious disease to a large number of people in
a given population within a short period of time. An attack rate in
excess of 15 cases per 100,000 people for two consecutive weeks is
considered an epidemic.
A pandemic
(from Greek πᾶν pan "all" and δῆμος demos "people") is an epidemic
of disease that has spread across a large region; for instance multiple
continents, or even worldwide
Infections can be classified:
By anatomic location:
• Urinary tract infection
• Skin infection
• Respiratory tract infection
• GI system infections
• CNS infections: (encephalitis, meningitis, encephalomyelitis and
etc).
• Odontogenic infection (an infection that originates within
a tooth or in the closely surrounding tissues)
• Vaginal infections
• Intra-amniotic infection
• others
Periods (phases)
of Infectious Disease
Periods ( phases) of Infectious Disease
The incubation period: after the entry of the pathogen into the
host (patient). After entering the pathogen begins replication in the
host. However, there are insufficient numbers of pathogen to cause
signs and symptoms of disease.
Period of decline
• Palpation,
• Percussion,
• Auscultation
Diagnosis
of Infectious Diseases
An important role in the diagnosis of infectious diseases plays
Immunofluorescent stains
General Rule
• Live-attenuated vaccines
• Inactivated vaccines (killed)
• Subunit, recombinant, polysaccharide, and
conjugate vaccines
• Toxoid vaccines
Live-attenuated vaccines
Live vaccines use a weakened (or attenuated) form of the pathogen
(germ).
Inactivated vaccines:
• Hepatitis A
• Flu
• Polio
• Rabies
Subunit, recombinant, polysaccharide, conjugate vaccines
Subunit, recombinant, polysaccharide, and conjugate vaccines use
specific pieces of the germ — like its protein(antigen) or capsid.
One limitation of these vaccines is that you may need booster shots
These vaccines are used to protect against:
• Diphtheria
• Tetanus
Passive immunity
• Passive immunity is the transfer of active humoral
immunity of ready-made antibodies.
Hepatitis B (HBV)
Hepatitis C (HCV)
Examples:
Prevention
Hepatitis B (HBV)
HBV vaccine and HBIG
Hepatitis C (HCV)
No prophylaxis exists
Treatment of Infectious
diseases
Antimicrobial therapy
Treatment of Infectious
diseases
Antibacterial therapy
Antiviral therapy
Antiprotozoal therapy
Antifungal therapy
Treatment of Bacterial Infections
• Antibacterial agents (antibiotics), like all antimicrobial
drugs, are directed against unique targets of the bacteria
cell
• Bactericidal antibiotics kill the bacteria that are within
their spectrum of activity;
• Bacteriostatic drugs only inhibit bacterial growth.
• Interferons
• DAA
• Other
Antiviral therapy
• Interferons
Conventional
Pegylated
Antiviral therapy
(DAA)