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 The concept of epidemic process

 The following three obligatory factors


of an epidemic process

 The epidemic process in period of science-technical progress

 Improvement of material and cultural conditions

 Urbanisation

 Technical discharge into environment

 Severe ecological effects

Increasing the evolution the infection diseases

 Microorganisms parasitize on host

 Microorganisms causing infection disease parasitize on host and due


to continuous reproduction of new generations which chance their
properties in accordance with evolution of the environment
conditions.

 Living inside its host, the pathogenic microorganism persist for a


definite period of time.

 Then the pathogenic microorganism can survive by changing its


residence

 It is moving to another host via a corresponding transmission


mechanism

 This continues chain of successive transmission of infection (patient


carrier)

Manifested by symptomatic or asymptomatic forms of the disease


is called an epidemic process.

 Microorganisms parasitize on host

 The source of infection microorganism is an object which is the site


of natural habitation multiplication of the pathogenic
microorganisms and in which the microorganisms are accumulated.
 Since pathogenic microorganisms are parasitized only a living
microorganism can be such an object

 An epidemic focus is the residence of infection including the


surrounding territory within the boundaries of which the source can,
under given condition, transmit a given disease through the agency
of the pathogenic microorganisms

 The focus of infection remains active until the pathogenic


microorganisms are completely eradicated plus the maximal
incubation period in persons that were in contact with the source of
infection


Some features of epidemic process

 The intensity of an epidemic process can also different. Three stages of


quantities changes are usually distinguished in the epidemic course:

 Sporadic incidence, epidemic and pandemic.

 Sporadic incidence is a normal (minimal morbidity characteristic of a given


infection (Country or region). Many Infection diseases occur as a single cases.

 Some features of epidemic process

 Group incidence of Infection diseases is a community is assessed (опр.разм)


in every day medical practice as an epidemic outburst.

 An epidemic is characterized by morbidity that 30-10 times exceeds given


disease in a given locality – development of multiple epidemic foci.

 Pandemic - widespread epidemic throughout large territories.

 Endemic – an epidemic qualitatively. An epidemic disease constantly occurs


among population of a given area. Long existence of any infection diseases in
a given country can be due to presence of some natural factors.

 Exotic disease – can only be brought from a foreign country.

 The following three obligatory factors


of an epidemic process

1. the source of pathogenic microorganisms

2. The mechanism of their transmission

3. macroorganism susceptible to infection


Infection diseases are classed according to their source as antroponoses
(The source is man), and zoonoses (the source is

animal) and antropozoonoses (both man and animal) can be the source of
infection.

1. the source of pathogenic microorganisms A diseased person is the


primary source from which the infection

spreads. A patient is the most dangerous source of infection because he


or she release a great quantity of the pathogenic microorganisms.

 Spreading of infection

 The danger of infection spreading from the patient depends on the period of
the disease.

 During the incubation period the role of the patient is not great.

 The pathogenic microorganisms are released into environment during the


late incubation period only in measles, cholera, dysentery and some others.

 The greatest quantity of microbes are released during the advanced stage of
the disease which is assoсiated with some clinical manifestation such as
frequent stools, vomiting, sneezing and cough

 In Typhoid fever, paratyphoid A and B the patient is a danger to the surround


people from the moment when the clinical symptoms become apparent.

 If the disease is severe, the patient remains in bed and can only infect his
relatives.

 If the disease has mild course and the patient does not attend for medical aid
and continues performing his routing duties (at the office, school) thus
actively promoting the spread of infection.

 Carriers of infection

 Carriers of infection – is of another source of morbidity

 Carrier state is an infection process that run an asymptomatic course. There


are can healthy persons.

 Carriers of infection release pathogenic microorganisms into environment the


in a smaller quantity before than patient with clinically manifest diseases. But
they are danger to community too since they actively associated with healthy
people and spread the infection
 Carrier state can persistent in person who sustained microbes in patient after
their clinical recovery.

 Acute carrier state can last from several days to several weeks

 Chronic carriers in 3-5% of cases carrier state can persist for years or even
for the rest of the life, which can be explained by defective immune system

Various concurrent diseases can promote persistence of carrier state: the


bile duct diseases, the urinary diseases, the nasopharynx and others/

 Healthy Carrier

 Persons with asymptomatic infection

 Transitory carrier state is characterized by rapid withdrowal of the


pathogenic microorganisms from a subject, foci where these
microorganism might multiply are absent.

 From 30 to 100 carriers can be detected among people surrounding


one patient with meningococcal infection or poliomyelitis.

 Healthy Carrier are less dangerous for surrounding people because


the pathogenic microorganisms are not usually detected in them
during subsequent tests.

 If a carrier of typhoid fever etc. is employed at a food cafering


establishment or a children institution he is specially dangerous for
the surrounding people.

 Infected animal are the source of infection diseases that are


common for man and animal.

 Domestic animals and rodents are dangerous in the epidemiologic


aspect.

 The degree of their danger as source of infection depends on the


relations between people and animals, on the socioeconomic and
living conditions.

 People can get infection during management of diseased animals,


cooking and eating their meat (antrax, brucelosis, Q-fever)

 2. The mechanism of infection transmission

 The causative agent can survive only if its transmitted from one of host to
another, because any given microorganisms destroys the pathogenic
microorganisms by specific antibodies than are formed in it response to the
ingress of these microorganisms.

 Death of an individual host terminates the life of the parasitizing


microorganisms.

 The only exception are sporeforming microbes (Antrax, Tetanus, Botulism)

 4 mechanisms of infection transmission are distinguished according to


the primary localization of pathogenic microorganisms in macroorganisms:

1. 1. Faecal-oral ( food and water-born - intestinal localization)

2. 2. Air-born (dust-born - airways localization)

3. 3. Transmission (by arthropods - localization in the blood circulation system)

4. 4. Contact (transmission infection through direct contact with another person


(through the placenta, by through skin manipulations) or environment objects

 Three phases are distinguished in the transmission

 Three phases are distinguished in the transmission of infection from one


microorganisms to another:

1. Excretion from an infected macroorganism

2. Presence in the environment

3. Ingress into a healthy macroorganism

The methods of excretion from an infected macroorganism (depends on


the locus of infection):

1. Residence – respiratory mucosa – influenza, measles, pertussis –they


can be released with expired air or with droples of nasopharyngeal
mucus.

2. If the infection is localized in the intestine - pathogenic


microorganisms can be excreted with faeces

3. The pathogenic organisms in the blood infect blood sucking


arthropodos


Main factors are involved in transmission of infection:

 Air, water, foods, utensils, arthropods (living agents)


 Dust infection is feacable only with those microorganisms that persist in the
environment and can survive in the absence of water. Tuberculosis can
survive in dust for weeks, agent causing Smallpox, Q-fever , Antrax,
Tularemia can be transmitted with dust

 Water is another important medium by which infection can be transmitted

 Spontaneous purification of water depends on ambient temperature,


chemical composition, aeration degree, exposure to sun rise, the property of
microorganisms and other factors.

1. By Drinking contaminated Water

2. Using Water for domestic purposes, bathing

3. If potable water gets contaminated with feaces can became


epidemic with rapid spreading. Sewage water-born infection may
develop.

 The pathogenic organisms excreted from intestine get on soil, linen,


household objects and water, while those liberated from the always are born
in air.

 Transmission factors – the environment objects that transmit the pathogenic


agents

 Transplacental transmission of infection

 Transmission of infection with food

 The pathogenic organisms can multiply in food staffs

 Food can be infected by contact with infected person or a carrier, by insects


of rodents.

 Food can be infected during transportation, storage and cooking.

 Epidemically important: uncooked natural food, thermally processed food, hot


or cold foods.

 Intestinal diseases are often transmitted through vegetables, fruits

 Soil is contaminated by excrements of human or animals. Various wastes,


dead human and animals.

 Contaminated of soil is an important epidemical factor because soil is the


habitate and site of multiplication of flies, rodents, etc..
 Eggs of some helmints are incubated in soil (ascarides)

 The pathogenic organisms of soil can pass into water, vegetable are grown.
Tetanus, gangrene and anthrax are transmitted through soil.

 It is especially dangerous to use faecal sewage to fertilize soil where


cucumbers, tomatoes and other vegetables are grown.

 Transmissin of infection

 Living objects transmitted infection can be divided in two groups

 Specific and non-specific (mechanical)

 Specific Carriers are lice, body louse (вши), flears (блохи), mosquitoes, ticks
transmit infection by sucking blood (inoculation) of contaminating human
skin with their excrements.

 Inside specific transmitters of infection the pathogenic organisms multiply,


accumulate to the surrounding environment

 A louse sucks blood of a typhoid fever patient and excretes the pathogenic
organisms with faeces only in 4-5 days.

 Non-specific carrier transmit the pathogenic organisms by purely


mechanical method.

 The form of realization of the transmission mechanism, Including the


combination of factors involved in spreading of a corresponding diseases are
known as the transmission routes of the infective agent. Flies carry microbes
of dysentery, typhoid fever, Viral hepatitis. Gadflies transmit microbes of
anthrax and tularemia by their stinging apparatus.

 3. macroorganism susceptible to infection

 Susceptibility an immunity

 Susceptibility of an individual b of a community are distinguished

1. Susceptibility to a disease is a biological property of tissues of a human or an


animal, characterized by optimum condition for multiplication of pathogenic
microorganisms

 Susceptibility is a specific property, that is transmitted by hereditary trait.

 Many infections can affect only a certain species of animals.

 Animals are protected by hereditary (species) immunity to


 human infections