Infection and disease

Infection and disease

• Infection: Entry of “infectious” organisms inside the body,
their multiplication

• Disease: Cell / tissue damage, signs and symptoms

All infections may not necessarily cause disease

Microbes come in different shapes and sizes

Bacteria Protozoa

Viruses

Fungi
Parasites
Historical perspective
 Evidence from mummies

Unknown child from Naples

Egyptian pharaoh Ramses V

Source: http://plaza.ufl.edu/
Egyptian art tells us about polio

Source: The Art Archive at Art Resource, NY

Supernatural explanations for
infectious diseases

Climate, soil, air, bad omen etc believed to

make one sick

Source: Infectious Disease Epidemiology, Nelson and Williams

 Hippocrates
• Dismissed supernatural
explanations

• Seasonal changes in
disease patterns

• Fever and swelling –

immune response
Hippocrates (460-377 BC)
 Fracastoro
• First to propose that
infectious diseases were
caused by invisible, minute,
self-replicating seeds

• Proposed transmission by
direct contact, air and
through objects

• Described several infectious

diseases
(1478-1553)
Renaissance era in medicine
(14-17 century)
 Foundations of modern medicine
• Anatomy

• Physiology

• Circulation

• Brain

• Surgical instruments

• hygiene
Hospitals and hygiene
 First microscope (1600s)

Focus
Sample
Lens

Antonie Leeuwenhoek

FOUNDER of MICROBIOLOGY
First vaccine

• Edward Jenner (1749-1823)

• World’s first vaccine –

against small pox

• Father of immunology
Ignaz Semmelweis (1818-1865)
• saviour of mothers

• Hand washing in
chlorinated lime

• Reduced maternal deaths

by 5-fold

• No acceptance; died at 47
Louis Pastuer (1822-1895)

• Fermentation

• Pasteurization

• Vaccine development
Robert Koch (1843-1910)
• Koch’s postulates

• Gold standard in
microbiology

• Fathers of Microbiology
- Robert Koch
- Louis Pasteur
 Koch’s postulates

First set of rules on how to link a disease to an infectious agent. Still used
Several bacterial agents were
discovered in the 1800s

Year Disease/organism
1874 Leprosy
1882 Cholera streptococcus
1884 Diptheria
1884 Typhoid
1884 Tetanus
1892 Gas gangrene
1894 Plague
Self-experimentation to prove Koch’s
postulates
• Inoculate organism into one’s own body to prove
disease etiology / pathogenesis

• Yellow fever / hookworms / Hepatitis E virus

Dr. Michael Balayan

 Reservoirs and vectors
• Transmission of plague from rats to humans

• Transmission of yellow fever through Aedes aegypti

 First established viral disease with obligate cycle in insect

 no human to human transmission

• Transmission of malarial parasite (Plasmodium falciparum

through Aedes aegypti)
 Disarming the microbe

• Alexander Fleming
discovered penicillin in
September 1928.

• World’s first antibiotic

“That’s funny”
Penicillin: Miracle cure
 Terminology…
• Incidence Fraction of a population that
newly contracts a disease during a
specific time. (Eg. Influenza virus)

• Prevalence Fraction of a population having

a specific disease at a given time. (eg. HIV)

• Endemic disease Disease constantly present in a

population. (eg. Malaria)

• Epidemic disease Disease acquired by many

hosts in a given area in a short
time. (Eg. Dengue epidemic in Delhi)

• Pandemic disease Worldwide epidemic (eg. Influenza

pandemic).
 Major pandemics
• Bubonic plague (1347-1351): ~ 200 million dead

• Influenza (1918-1919): ~ 100 million dead

 Discovery of antimicrobial drugs
• 1928 – penicillin

• 1928 to 1962: 15 classes of antibiotics

How does the future look?

BLEAK ; increase in drug-resistance /void in drug discovery

 Normal microbiota and the host:

• Locations of normal
microbiota on and in the
human body
 Normal microbiota and the host:

• Transient microbiota may be present for days, weeks, or

months

• Normal microbiota permanently colonize the host

• Symbiosis is the relationship between normal microbiota and

the host
 Normal microbiota: how the host
benefits ?
• Microbial antagonism is competition between microbes.

• Normal microbiota protect the host by:

– occupying niches that pathogens might occupy
– producing bacteriocins

• Probiotics are live microbes applied to or ingested into the

body, intended to exert a beneficial effect.
 Microbes
• Are invisible to the naked eye

• Are everywhere around us, inside us, on us, in our food, in our
homes, in the air we breathe and the water we wash in.

• Are mostly useful, but some are harmful

• Have been around for 3.8 bn years.

 Microbes exist in huge numbers
 In one single teaspoon of garden soil, there are over 100,000
microbes.

 In 1 litre of seawater, there are over 1bn microbes.

 On your skin there are more microbes than there are people in the
world.

 There are so many microbes, that scientists have only named <1%
of them.

 Microbes outnumber all other species and make up most of the

living matter on the planet