EPIDEMIOLOGY OF COMMUNICABLE DISEASES  When death is the only criterion of severity, this

is the case fatality rate

SERIAL INTERVAL
 Gap in time between the onset of the primary
and the secondary cases
GENERATION TIME
 Interval between receipt of infection and
maximal infectivity of the host
INFECTIOUS (COMMUNICABLE) PERIOD
 Length of time an infectious agent can be
transmitted directly or indirectly from an infected
person to another person, from an infected
anima to man or from an infected person to
animal
INCUBATION PERIOD
 Time from exposure to development of disease
 The time interval between invasion by an
infectious agent and the appearance of the first
sign or symptom of the disease in question
CASE FATALITY RATE
 Proportion of infected individuals who die of the
infection
 Function of the severity of the infection
HERD IMMUNITY
 The level of resistance of a community or group
of people to a particular disease
 Provides an immunological barrier to spread of
disease in the human herd
 If herd immunity is sufficiently high, the
occurrence of epidemic is unlikely
 If high level of immunity is achieved and
maintained to a point where the susceptible
persons are reduced to a small proportion, it
may even lead to elimination of a disease, e.g.
polio
 Herd immunity does not protect against tetanus
EXPOSURE TO INFECTIOUS AGENTS

LATENT PERIOD  No infection

 Clinical
 The period between exposure and the onset of  Subclinical
infectiousness  Carrier
 This may be shorter or longer than the
incubation period Clinical

HOST DEFENCES  Death

 Carrier
 Local or systemic  Immunity
 Specific or non-specific  No immunity
Specific Subclinical
 Active immunity  Carrier
- Humoral  Immunity
- Cellular
 No immunity
- Combination
 Passive immunity MODES OF TRANSMISSION
- Normal human Ig
- Specific human Ig  Direct
- Animal antibodies or antisera - Direct contact
- Contact with soil
VIRULENCE - Droplet infection
- Inoculation into skin or mucosa
 Degree of pathogenicity; the disease evoking
- Transplacental (vertical)
power of a microorganism in a given host
 Indirect
 Numerically expressed as the ratio of the
- Vehicle borne
number of cases of overt infection to the total - Vector borne
number infected
- Air borne
  Mechanical HUMAN RESERVOIR
 Biological
- Fomite borne  CASES
- Unclean hands and fingers - primary case
- index case
SUSCEPTIBLE HOST - secondary case

 An infectious agent seeks a susceptible host according to spectrum of disease

aiming “successful parasitism”  clinical cases – mild or severe,
 Four stages required for successful parasitism typical or atypical
1. Portal of entry  subclinical cases
2. Site of election inside the body  latent infection cases
3. Portal of exit  CARRIERS
4. Survival in external environment - type
 incubatory
ANIMAL RESERVOIRS
 convalescent
 Zoonosis is an infection that is transmissible  healthy
under natural conditions from vertebrate animals - duration
to man, e.g. rabies, plague, bovine tuberculosis  temporary
 There are over 100 zoonotic diseases that can  chronic
be conveyed from animal to man - portal of exit
 urinary
ERADICATION  intestinal
 respiratory
 Termination of all transmission of infection by  others
the extermination of the infectious agent through
surveillance and containment ANIMAL RESERVOIR
 An absolute process, an “all or none”
1. Nontyphoidal salmonellosis
phenomenon, restricted to termination of
2. Brucellosis
infection from the whole world
3. Anthrax
DYNAMICS OF DISEASE TRANSMISSION (CHAIN OF 4. Listeriosis
INFECTION) 5. Viral encephalitis (SLE, WEE, CEE)
6. Rabies
 Source of reservoir 7. Plague
 Modes of transmission
ELIMINATION
 Susceptible host

WATER RESERVOIR  Sometimes used to describe eradication of a

disease from a large geographic region
 Pseudomonas infections  Diseases which are amenable to elimination in
- Sepsis the meantime are polio, measles, leprosy and
- UTI diphtheria
- “hot tub” folliculitis
 Legionnaire’s disease SOIL RESERVOIR
 Melioidosis 1. Histoplasmosis
2. Coccidioidomycosis
TYPES OF RESERVOIRS
3. Blastomycosis
 human reservoir 4. Tetanus
 animal reservoir 5. Botulism
 non-living reservoir
ENDEMIC
 It refers to the constant presence of a disease
or infectious agent within a given geographic
area or population group
 It is the usual or expected frequency of disease
within a population
 “En” = in; “demos” = people
EPIDEMIC
 The unusual occurrence in a community of
disease, specific health related behavior, or
other health related events clearly in excess of
expected occurrence
 “epi” = upon; “demos” = people
 Epidemics can occur upon endemic states too
CONTAGIOUS DISEASE
 Transmitted through contact
 Scabies, trachoma, STD
OPPORTUNISTIC INFECTION
 This is infection by organism that take the
opportunity provided by a defect in host defense
 (e.g. immunity) to infect the host and thus cause
disease
 Example: opportunistic infections are very
common in AIDS
 Organisms include Herpes simplex,
Cytomegalovirus, M. tuberculosis, etc.
IATROGENIC (PHYSICIAN INDUCED) DISEASE
 Any untoward or adverse consequence of a
preventive, diagnostic or therapeutic regimen or
procedure that causes impairment, handicap,
disability or death resulting from a physician’s
professional activity or from professional activity
of other health professionals
 Example: reaction to penicillin, hepatitis B
infection following blood transfusion
ZOONOSIS
 An infection that is transmissible under natural
conditions from vertebrate animals to man, e.g.
rabies, plague, bovine tuberculosis
- Anthropozoonoses, e.g. rabies
- Zooanthropozoonoses, e.g. human TB in
cattle
- Amphixenosis, e.g. T cruzi
EPIZOOTIC
 Is an outbreak (epidemic) of disease in an
animal population, e.g. Rift valley fever, anthrax
ENZOOTIC
 Is an endemic occurring in animals, e.g. bovine
TB
HYPERENDEMIC
 Expresses that the disease is constantly present
at high incidence and/or prevalence rate and
affects all age groups equally
HOLOENDEMIC
 Expresses a high level of infection beginning
early in life and affecting most of the child
population, leading to a state of equilibrium such
that the adult population shows evidence of the
disease much less commonly than do the
children, e.g. malaria
PANDEMIC
 An epidemic usually affecting a large proportion
of the population, occurring over a wide
geographic area such as a section of a nation,
the entire nation, a continent or the world, e.g.
influenza pandemics (1918, 1957, 2009)
EXOTIC
 Disease which are imported into a country in
which they do not otherwise occur
 E.g. rabies in the UK, yellow fever in India and
CCHF
HOST
 A person or an animal that affords subsistence
or lodgment to an infectious agent under natural
conditions
 Types
 Obligate host – the only host
 Definitive (primary) host – attains
maturity or passes sexual stage
 Intermediate host – passes asexual
stage
 Transport host – does not undergo
development
INFECTION

 Infection is the entry and development or

multiplication of an infectious agent in the body
of man or animals
 An infection does not always cause illness
 Levels of infection (gradients of infection)
- Colonization (S. aureus in skin and normal
nasopharynx)
- Subclinical or inapparent infection (polio)
- Latent infection (herpes simplex virus)
- Manifest or clinical infection

CONTAMINATION

 The presence of an infectious agent on a body

surface, or on clothes, beddings, toys, surgical
instruments or dressings, or other articles or
substances including water and food

INFESTATION

 It is the lodgment, development and

reproduction of arthropods on the surface of the
body or in the clothing, e.g. lice, itch mite
 This term could be use to describe invasion of
the gut by parasitic worms, e.g. ascariasis