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Chapter 14 Reading Work Sheet



1. a. Define the following terms:

- The scientific study of disease
- Concerned with the etiology (cause) of disease and pathogenesis
- Manner in which a disease develops
2. Differentiate between infection and disease:
- Infection: invasion or colonization of the body by pathogenic microorganisms
- May exist in the absence of detectable disease
- Disease: occurs when an infection results in any change from a state of health
- An abnormal state in which part or all of the body is incapable of
performing its normal functions
b. Consider what you know about HIV and its interaction with the human body. An
individual can be infected with HIV and test seropositive for HIV, or they can have
AIDS. Differentiate between HIV infection and HIV disease.
- The body may be infected with the HIV virus that causes AIDS but
experience no symptoms of the disease
2. Differentiate between normal microbiota (normal flora) and transient microbiota:
- Normal microbiota: microorganisms that colonize a host without causing disease
- Normal flora
- Transient microbiota: microorganisms are present in an animal for a short time
without causing a disease
3. Name five body sites that typically have an abundance of normal microbiota:
1) Skin
2) Eyes (Conjunctiva)
3) Nose and Throat (Upper Respiratory System)
4) Mouth
5) Large Intestine
6) Urinary and Reproductive Systems
4. Name 5 body sites that are typically sterile (no normal flora):
1) Brain, CNS
2) Blood, Tissues, Organ Systems
3) Sinuses, Inner and Middle Ear
4) Lower Respiratory Tract: Larynx, Trachea, Bronchioles, Lungs, Alveoli
5) Kidneys, Ureters, Urinary Bladder, Posterior Urethra
6) Uterus, Endometrium, Fallopian Tubes, Cervix, Endocervix
5. Describe microbial antagonism (aka: competitive exclusion), explain how it
benefits the human host, and give several examples:
- Normal microbiota can benefit host by preventing overgrowth of harmful

- Normal microbiota protect host against colonization by potentially pathogenic

microbes by competing for nutrients, producing substances harmful to the invading
microbes, affecting conditions such as pH and available oxygen
- When balance between normal microbiota and pathogenic microbes is upset
disease can result
- Normal bacterial microbiota of adult human vagina maintains local pH of about 4
- Presence of normal microbiota inhibits overgrowth of yeast Candida
albicans can grow when balance between normal microbiota and pathogens is upset
and when pH is altered
- If bacterial population is eliminated by antibiotics, excessive douching,
deodorants pH of the vagina reverts to nearly neutral C. albicans can flourish and
become dominant microorganism
- In large intestine: E. coli cells produce bacteriocins, proteins that inhibit growth of
other bacteria of same or closely related species (pathogenic Salmonella and Shigella)
- Bacterium that makes a particular bacteriocin isnt killed by that bacteriocin
but may be killed by other ones
- Bacteriocins used in medical microbiology to help identify different strains
of bacteria helps determine whether several outbreaks of an infectious disease are
caused by one or more strains of a bacterium
- Clostridium difficile, also in large intestine, inhibited by normal microbiota
possibly by making host receptors unavailable, competing for available nutrients,
producing bacteriocins
- If normal microbiota eliminated (ex. by antibiotics), C. difficile can become
a problem
- Responsible for nearly all gastrointestinal infections that follow
antibiotic therapy
6. Define symbiosis:
- Relationship between normal microbiota and host where at least one organism is
dependent on the other
- Living together of two different organisms or populations
7. There are 3 kinds of symbiotic relationships. Name and differentiate between these.
1) Commensalism: two organisms live in association and one is benefited while the
other is neither benefited nor harmed
2) Mutualism: both organisms or populations are benefited
3) Parasitism: one organism (parasite) exploits another (host) without providing
any benefit in return
8. Explain what is meant by opportunistic microorganisms.
- Microorganism that does not ordinarily cause disease but can become pathogenic
under certain circumstances
- Dont cause disease in their normal habitat in healthy person but may do so in a
different environment
9. Define probiotics:
- Microbes inoculated into a host to occupy a niche and prevent growth of
10. List and describe the significance and application of Kochs Postulates:

- Provides the framework for study of etiology of any infectious disease

- Showed that specific infectious disease is caused by specific microorganism that
can be isolated and cultured on artificial media
1) Same pathogen must be present in every case of the disease
2) Pathogen must be isolated from the diseased host and grown in pure culture
3) Pathogen from pure culture must cause the disease when its inoculated into a
healthy, susceptible laboratory animal
4) Pathogen must be isolated from the inoculated animal and must be shown to be
the original organism
11. Define communicable disease:
- Any disease that can be spread from one host to another
- Infected person transmits an infectious agent, directly or indirectly, to another
person who in turn becomes infected
12. Define contagious disease and provide several examples:
- Disease that is easily spread from one person to another
- Very communicable and capable of spreading easily and rapidly from one person
to another
- Chickenpox and measles
13. Define noncommunicable (infectious) disease and provide several examples:
- Disease that is not transmitted from one person to another
- Caused by microorganisms that normally inhabit the body and only occasionally
produce disease or by microorganisms that reside outside the body and produce disease
only when introduced into the body
- Clostridium tetani
14. For each of the following indicate whether the disease is considered communicable
(C) or noncommunicable (N):
C a. chicken pox
N b. tetanus
C c. tuberculosis
N d. pyelonephritis (caused by E.coli)
C e. bacterial meningitis
N f. appendicitis followed by peritonitis
C g. strep throat
C h. botulism
N i. gangrene


15. Differentiate between the terms sporadic disease, endemic disease, epidemic
disease, and pandemic disease give examples of each.
- Sporadic disease: occurs occasionally in a population
- Typhoid fever
- Endemic disease: constantly present in a certain population
- Common cold
- Epidemic disease: disease acquired by many hosts in a given area in a short time
- Influenza
- Pandemic disease: epidemic disease that occurs worldwide
16. Differentiate between the terms acute disease, chronic disease, and subacute
disease and give an example of each.
- Acute disease: symptoms develop rapidly but last for only a short time
- Influenza
- Chronic disease: disease develops more slowly bodys reactions may be less
severe but the disease is likely to continue or recur for long periods
- Infectious mononucleosis, tuberculosis, hepatitis B
- Subacute disease: disease with symptoms that are intermediate between acute
and chronic
- Subacute sclerosing panensephalitis
17 What is meant by latent disease? Give two examples.
- Disease characterized by a period of no symptoms when the pathogen is inactive
causative agent then becomes active to produce symptoms of the disease
- Shingles varicella virus
- Epstein-Barr virus
18. Differentiate local infection and systemic infection.
- Local infection: pathogens are limited to a small area of the body
- Boils and abscesses
- Systemic infection: microorganisms or their products are spread throughout the
body by the blood or lymph
- Measles
19. What is meant by focal infection?
- Systemic infection that began as an infection in one place
- Can arise from areas such as teeth, tonsils, or sinuses
20. Differentiate the following terms:
- Toxic inflammatory condition arising from the spread of microbes, especially
bacteria or their toxins, from a focus of infection
- Blood poisoning: systemic infection arising from the multiplication of pathogens in
the blood
- Common example of sepsis

- Presence of bacteria in the blood
- Presence of viruses in blood
- Presence of toxins in the blood (tetanus)
21. Differentiate primary and secondary infection.
- Primary infection: acute infection that causes the initial illness
- Secondary infection: caused by an opportunistic pathogen after the primary
infection has weakened the bodys defenses
22. Define subclinical infection.
- Doesnt cause any noticeable illnesses
23. List and compare the 5 stages of disease development.
1) Incubation period
- Interval between initial infection and first appearance of any signs or symptoms
- Time depends on the specific microorganisms involved, its virulence, number of
infecting microorganism, resistance of the host
2) Prodromal period
- Characterized by early, mild symptoms of disease general aches and malaise
- Relatively short period
3) Period of illness
- Disease is most severe
- Person exhibits over signs and symptoms of disease
- Number of white blood cells may increase or decrease
- Generally patients immune response and other defense mechanisms overcome
the pathogen and period of illness ends
- If disease not successfully over come (or successfully treated) patient dies
during this period
4) Period of decline
- Signs and symptoms subside
- During this phase patient is vulnerable to secondary infection
- Phase may last from less than 24 hours to several days
5) Period of convalescence
- Person regains strength and body returns to its prediseased state recovery has
24. Define reservoir (reservoir of infection):
- A continual source of infection
- Required for disease to perpetuate itself
- Can be living organism or inanimate object that provides pathogen with adequate
conditions for survival and multiplication and an opportunity for transmission
- Human, animal, or nonliving
25. Define carrier.

- Organism (usually refers to humans) that harbors pathogens and transmits them to
- Principle living reservoir of human disease is human body itself
26. Define zoonosis. Using Table 14.2, list 5 zoonoses that you have heard of before
and name the reservoirs.
- Disease that occurs primarily in wild and domestic animals but can be transmitted
to humans
1) Influenza
- Swine, birds
2) Rabies
- Bats, skunks, foxes, dogs, raccoons
3) West Nile encephalitis
- Horses, birds
4) Anthrax
- Domestic livestock
5) Plague
- Rodents
6) Lyme disease
- Field mice
7) Malaria
- Monkeys
27. Give two examples of nonliving reservoirs.
- Soil
- Water
28. What are the three principal routes of disease transmission? Name and describe
1) Contact transmission: spread of disease agent by direct contact, indirect contact,
droplet transmission
2) Vehicle transmission: transmission of disease agents by a medium (water, food,
air, blood, body fluids, drugs, and IV fluids)
3) Vectors: animals that carry pathogens from one host to another
- Arthropods are most important group
- Transmit disease by mechanical transmission or biological
29. Describe and give several examples of diseases that are transmitted by direct
- Person-to-person transmission: direct transmission of an agent by physical contact
between its source and a susceptible host no intermediate object is involved
- Most common forms are touching, kissing, sexual intercourse
- Viral respiratory tract disease (common cold and influenza)
- Staphylococcal infections
- Hepatitis A
- Measles
- Scarlet fever
- STDs

- Infectious mononucleosis
30. Define fomite. Give several examples of fomites.
- Nonliving object involved in the spread of an infection indirect contact
- Tissues
- Towels
- Bedding
- Diapers
- Drinking cups
- Eating utensils
- Toys
- Money
- Thermometers
- Contaminated syringes
31. Describe droplet transmission and give several examples.
- Contact transmission in which microbes are spread in droplet nuclei (mucus
droplets) that travel only short distances
- Discharged into the air by coughing, sneezing, laughing, or talking travel less
than 1 meter from reservoir to the host
- Influenza
- Pneumonia
- Pertussis (whooping cough)
32. Define vehicle transmission, list three types of vehicle transmission and give an
example of a disease that is transmitted by each.
1) Waterborne transmission: pathogens usually spread by water contaminated with
untreated or poorly treated sewage
- Cholera, waterborne shigellosis, leptospirosis
2) Foodborne transmission: pathogens generally transmitted in foods that are
incompletely cooked, poorly refrigerated, or prepared under unsanitary conditions
- Food poisoning, tapeworm infestation
3) Airborne transmission: spread of agents of infection by droplet nuclei in dust
that travel more than 1 meter from the reservoir to the host
- Microbes spread by droplets that may be discharged in fine spray from
mouth and nose during coughing and sneezing
- Droplets small enough to remain airborne for prolonged periods
- Measles
- Tuberculosis
33. Define vector.
- Arthropod that carries disease-causing organisms from one host to another
34. List the vectors for each of the following diseases:
Anopheles (mosquito)
West Nile Encephalitis
Culex (mosquito)
Rocky Mountain Spotted Fever
Dermacentor andersoni and other species (tick)
Lyme Disease
Ixodes spp. (tick)
Canine heartworm
Dirofilaria immitis (mosquito)

Bubonic plague
Epidemic typhus

X. cheopis (rat flea)

Pediculus humanus (louse)

35. Define nosocomial infection. What term now replaces this term?
- Healthcare-associated infections (HAIs): develops during a stay at a health care
facility and was not present at the time the patient was admitted
36. What three factors play a role in the development of healthcare-associated
infections? (see Fig. 14.9)
1) Microorganisms in healthcare-associated environment
2) Compromised host
3) Chain of transmission
37. How many deaths result annually in the U.S. due to nosocomial infections?
- 20,000
38. Give examples of three most prevalent groups of microorganisms that cause
nosocomial infections. (see Table 14.4- be sure to look at the percentages)
1) Staphylococcus aureus: surgical wound
2) Clostridium difficile: diarrhea after abdominal surgery
3) Enterococcus spp.: bloodstream
39. Name the 3 most common sites (body sites) of nosocomial infections. (table 14.5)
1) Surgical site infections
2) Lower respiratory infections
3) Gastrointestinal infections
40. Define emerging infectious disease, and list 5 factors that contribute to the
emergence of these diseases.
- Diseases that are new or changing, showing an increase in incidence in recent
past, or a potential to increase in the near future
1) New strains may result from genetic recombination between organisms
2) New serovar (distinct variations within species of bacteria or virus) may result
from changes in or evolution of existing microorganisms
3) Widespread, sometimes unwarranted, use of antibiotics and pesticides
encourages growth of more resistant populations of microbes and the insects and
ticks that carry them
4) Global warming and changes in weather patterns may increase the distribution
and survival of reservoirs and vectors resulting in introduction and dissemination
of diseases such as malaria and Hantavirus pulmonary syndrome
5) Known diseases (chikungunya/dengue and West Nile virus) may spread to new
geographic areas by modern transportation
6) Previously unrecognized infections may appear in individuals living or working in
regions undergoing ecological changes brought about by natural disaster,
construction, wars, expanding human settlement
7) Animal control measures may affect incidence of disease
- Increase in Lyme disease in recent years could be due to rising deer
populations resulting from killing of deer predators
8) Failures in public health measures may be contributing factor to emergence of
previously controlled infections

41. Describe the science of epidemiology.

- The science that studies when and where diseases occur and how they are
42. Briefly state the contributions made by Snow, Semmelweis, and Nightingale to the
science of epidemiology.
a. John Snow
- Series of investigations related to outbreaks of cholera in London during 18481849
- Made map from information compiled showing most individuals who died of
cholera drank or brought water from the Broad Street pump
- Those who used other pumps did not get cholera
- Concluded that contaminated water from Broad Street pump was source of
b. Ignaz Semmelweis
- Between 1846-1848, meticulously recorded number of births and maternal
deaths at Vienna General Hospital because death rate of puerperal sepsis ranged
from 13-18% 4x that of the Second Maternity Clinic
- Nosocomial infection beginning in uterus as result of childbirth or abortion,
frequently caused by Streptococcus pyogenes
- After looking at data, identified a common factor among wealthy women and poor
women who had given birth prior to entering the clinic: they were not examined by
the medical students who had spent their mornings dissecting cadavers
- After ordering all medical students to wash their hands with chloride of lime
before entering deliver room mortality rate dropped to under 2%
c. Florence Nightingale
- Recorded statistics on epidemic typhus in English civilian and military populations
- 1858: published report using statistical comparisons to demonstrate that
diseases, poor food, and unsanitary conditions were killing the soldiers
- All three careful analyses of where/when disease occurred and how it was
transmitted within population constituted new approach to medical research and
demonstrated the importance of epidemiology
- Lowered incidence of infectious disease
Use the Mastering Microbiology Study Area and the Chapter 14 Dynamic Study module to
test yourself on chapter 14 content.
See back for practice items. These are all diseases we will be covering in the latter part
of the semester.


43. For each of the following diseases, name the reservoir and indicate the most
frequent mode of transmission (direct contact, indirect contact [fomite], droplet,
food borne, waterborne, airborne, or vector). If vector-borne, name the vector. In
the box naming the disease, list the name of the etiologic agent (genus and
species). Indicate which of these diseases would be considered zoonoses.




Typhoid Fever



Lyme Disease
* Zoonosis

Animal: Field Mice

Vector: Tick Bites

Ixodes Ticks



Vector: Anopheles mosquito bite

Shigella species


Direct contact (waterborne or vector:


Strep throat



West NileEncephalitis




Vector: Aedes and Culex mosquito bite

Vibrio cholerae




Indirect Contact - formite