Disease causation-Epidemiological triad

A traditional model of infectious disease causation, known as the Epidemiologic Triad is

depicted in Figure 2.

The triad consists of an external agent, a host and an environment in which host and agent
are brought together, causing the disease to occur in the host.

A vector, an organism which transmits infection by conveying the pathogen from one host to
another without causing disease itself, may be part of the infectious process.

A classic example of a vector is the Anopheles mosquito. As the mosquito ingests blood from
an infected host, it picks up the parasite plasmodium. The plasmodium are harmless to the
mosquito. However, after being stored in the salivary glands and then injected into the next
human upon which the mosquito feeds, the plasmodium can cause malaria in the infected
human. Thus, the Anopheles mosquito serves as a vector for malaria.

In the traditional epidemiologic triad model, transmission occurs when the agent leaves
its reservoir or host through a portal of exit, is conveyed by a mode of transmission to
enter through an appropriate portal of entry to infect a susceptible host. Transmission may
be direct (direct contact host-to-host, droplet spread from one host to another)
or indirect (the transfer of an infectious agent from a reservoir to a susceptible host by
suspended air particles, inanimate objects (vehicles or fomites), or animate intermediaries
(vectors)).

Figure 2: Epidemiologic Triad of Disease Causation

AGENT: The first link in the chain of disease transmission is a disease agent.
• The disease agent is defined as a substance, living or non -living or a force, tangible or
intangible, the excessive presence or relative lack of which may initiate or perpetuate a
disease process.

• A disease may have a single agent, but more factors are responsible for disease
transmission.

Agents such as,

1. BIOLOGICAL AGENTS: VIRUS • BACTERIA • PROTOZOVA • FUNGUS

CHARACTERISTICS: - Infectivity - Pathogenicity - virulence

2. PHYSICAL AGENTS: Exposure to excessive heat, cold, humidity, pressure, radiation,

electricity, sound etc..

3. CHEMICAL AGENTS: ENDOGENOUS • EXOGENOUS

4. MECHANICAL AGENTS

5. NUTRITIONAL AGENTS

6. SOCIAL AGENTS

7. OTHERS: Hormones • Lack of part or structure • Chromosomal factors • Immunological

factors

HOST: Human being is referred to as “soil” and the disease agent as “seed”

Host can be,

1. DEMOGRAPHIC FACTORS

2. BIOLOGICAL FACTORS

3. SOCIO ECONOMIC FACTORS

4. LIFE STYLE FACTORS

ENVIRONMENTAL FACTORS:

1. PHYSICAL ENVIRONMENT

2. BIOLOGICAL ENVIRONMENT

3. PSYCHO SOCIAL ENVIRONMENT