CHAIN OF INFECTION

Content:
1. chain of infection.
2. roles and functions of the nurse in the chain of infection.
3. different ways on how to break the chain of infection
Chain of Infection:
 is a process that begins when an infectious agent leaves its reservoir or host through a portal of
exit, and is conveyed by some mode of transmission, then enters through an appropriate portal of
entry to infect a susceptible host.
-it explains how a pathogen infects one person to another.
-the chain of infection has 6 links or steps for the infection to be transmitted.
 infectious agent
 reservoir
 Portal of exit
 Mode of transmission
 ortal of entry
 Susceptible host
-each link has an unique role in the chain and each can be interrupted.

Infectious Agent
 is the microorganism that causes the disease
-it is the pathogen itself
 Example: Bacteria, Virus, Protest, Parasite, Fungi
 the virulence or the ability of these pathogen to cause disease depends many condition such as
their potency, their ability to enter and survive in the body, and the susceptibility of the host.
-There are cases na kahit kinakapitan tayo ng pathogen di tayo nagkakasakit we are not susceptible,
hindi madaling mahawaan. For instance, the tuberculosis bacillus infects only a small number of
people, usually people with weakened immune function, or those who are undernourished and living in
crowded conditions, they are more susceptible.
-Another example, during this pandemic. SARS CoV -2 which is the infectious agent of COVID 19, it’s
virulence depends on the immune system of a person. If a person is infected but has a strong immune
system he/she could appear asymptomatic meaning he/she is just a carrier of the virus pero hindi niya
ramdan yung disease. But if he has a weak immune system he could appear symptomatic, ito yung
mga patient na nararamdaman yung symptoms ng virus.

Reservoir
 is the habitat in which the agent normally lives, grows, and multiplies .It could be person, animal,
arthropod, plant, soil or substance.
-The infectious agent primarily depends on the reservoir for its survival. Dito siya titira at
magpaparami, and reservoir is the way para maipasa yung infectious agent sa isang susceptible host
-there are two types of reservoir

1. Animate reservoirs include people, insects, birds, and other animals.

 Human reservoirs
-the carrier of the disease is a person
Example: sexually transmitted diseases, measles, respiratory pathogens
-and very timely yung COVID. You can get the same infection from another person
 Animal and insect reservoir
-the animal or insect is the carrier.
-For example: Lyme disease.
-It can be transmitted thru ticks
2. Inanimate reservoirs include soil, water, food, feces, intravenous fluid, and equipment.
  Environmental reservoirs
-for some infectious agent, the carrier can be plants, soil, and water in the environment
For example: Legionnaires’ disease
-Legionnaires’ disease is a severe form of pneumonia caused by a bacteria Legionella
pneumophila. They can naturally be found in freshwater environments like lakes. However,
pag napunta at nag grow siya sa mga human-build water system like faucets and cooling
water system, dun na nag start yung infection sa tao. They can be transmitted thru inhalation
of water droplet containing the bacteria.

Portal of exit
 is the path by which a pathogen leaves its reservoir
-in human, the key portal of exist are:
 Alimentary
-via vomiting, urine and feces
 Genitourinary
-it can be transferred through sexual intercourse like aids
 Respiratory
-through coughing, sneezing, and talking
 Trans-placental
-where transmission is from mother to fetus

-For example, coronavirus’ portal of exit is through sneezing and coughing. Kaya tayo nagmamask,
not just to protect ourselves but also to protect the people around us, in case man na carrier tayo.

Mode of Transmission
 How pathogens are carried from one place to another
-Ano ba yung way niya para makalipat?
-Now, a pathogen can be transmitted directly or indirectly

 Direct - an infectious agent is transferred from a reservoir to a susceptible host by direct contact
or droplet spread.
-for example, sexually transmitted disease like aids, pag nakipag intercourse ka sa taong infected
pwede kang mahawa.
-Another is corona virus, it can spread through respiratory droplets produced by an infected person
when he/she coughs, sneezes, or talks. Pag napunta sayo yung droplets, pag na inhale mo mahahawa
ka. Kaya nga there’s a protocol na social distancing kasi SARS COV-2, about 3 feet ang kaya niyang
itravel.
 Indirect - The transfer of an infectious agent from a reservoir to a host by suspended air
particles, inanimate objects or animate intermediaries.
Under indirect we have:
1. Airborne - infectious agents are carried by dust or droplet nuclei suspended in air
-now, airborne is the trickiest and most contagious kasi the infectious agent is carried in the air
which is nalalanghap natin freely and it can travel farther distance than droplets. For example,
measles and tuberculosis.

2. Vehicle - may indirectly transmit an infectious agent include food, water, biologic products
(blood), and fomites ( inanimate objects)
-For example, hepatitis. It refers to an inflammatory condition of the liver commonly caused by viral
infection. And it can be transmitted by contaminated food and water and body fluids like blood, vaginal
secretions, or semen.
3. Vector (mechanical or biologic) -such as mosquitoes, fleas, and ticks may carry an infectious
agent through purely mechanical means or may support growth or changes in the agent
-flies carrying Shigella on their appendages and fleas carrying Yersinia pestis, the causative agent
of plague, in their gut
Portals of Entry
-it is how the pathogen enters the body
-Pathogens often enter the body of the host through the same route they exited the reservoir.
Example: mucous membranes, non-intact skin, respiratory tract, gastrointestinal and
genitourinary tracts
-For example, SARS COV-2 exited the reservoir thru respiratory tract, and it will enter the body of the
host thru inhalation.

Susceptible Host
-someone at risk of infection or someone who cannot defend from pathogen.
-It depends on many factors such as age, people with immunodeficiency, people with other illnesses.
-pag sinabing susceptible, ibig sabihin madaling mahawa. As I’ve mentioned earlier, pag malakas
immune system mo you can defend yourself from the pathogen kaya mas susceptible yung mga taong
mahina immune system.
-For example, during this pandemic, may age limit mga pwedeng lumabas, dito sa Cauayan 15 years
old below and 65 and above, pati mga pregnant woman, kasi mas madali silang mahawaan.