Characteristics of Infectious Disease

Disease: Any condition in which the normal structure or functions of the body are damaged or
impaired.

Infection: The successful colonization of a host by a microorganism. Can lead to disease.

Signs of Disease: Objective, measurable, and observable by clinicians. Includes changes to

Vital Signs such as heart rate, body temperature, and breathing, as all affect key functions.
Other observable conditions are also considered signs, such as high antibody count in blood
serum.

Symptoms of Disease: Felt or experienced by a patient, but cannot be clinically confirmed or

objectively measured. Purely subjective. Examples are pain, nausea, and loss of appetite.

Syndrome: A group of signs and symptoms characteristic of a particular disease.

Nomenclature of Symptoms:
● Cyto-: Cell
● Hepat-: Of the liver
● -pathy: Disease
● -emia: Of the blood
● -itis: Inflammation
● -lysis: Destruction
● -oma: Tumor
● -osis: Diseased or abnormal condition
● -derma: Of the skin

Infectious Disease: Any disease caused by the direct effect of a pathogen

● Iatrogenic Diseases: Diseases contracted as result of a medical procedure, usually due
to contaminated surgical sites and wounds.
● Nosocomial Diseases: Diseases acquired in hospital settings.
● Zoonotic Diseases: Diseases transmitted from animals to humans.

Communicable Disease: A disease capable of being spread from person to person through
either direct or indirect mechanisms.

Contagious Diseases: Both infectious AND communicable

Varieties of Noninfectious Diseases:

● Inherited: Genetic diseases.
● Congenital: Present at or before birth.
● Degenerative: Progressive, irreversible loss of function.
● Nutritional Deficiency: Impaired boyd function due to lack of nutrients.
 ● Endocrine: Disease involving malfunction of regulatory hormone producing glands.
● Neoplastic: Abnormal growth (benign or malignant)
● Idiopathic: Disease for which the cause is unknown.

Stages of Acute Infectious Diseases:

1. Incubation Period: Occurs after entry into host. Pathogen begins to multiply, but there
are too few to produce signs or symptoms of disease. Lasts from a day to multiple years.
2. Prodromal Period: Pathogen continues to multiply and the host experiences general
symptoms and observable signs of disease. Disease is unidentifiable at this stage
despite presence of symptoms and signs as they are too nonspecific to indicate a
particular disease.
3. Period of Illness: Symptoms and signs at peak visibility and severity.
4. Period of Decline: Number of pathogen particles decreases along with symptoms and
signs of illness. The host is vulnerable to developing secondary infections during this
stage due to their immune system’s weakened state from tackling the first infection.
5. Period of Convalescence: The body returns to its normal functions, with the exception
of permanent damage if any is dealt.

Acute Diseases: Short term diseases.

Chronic Diseases: Long term diseases.

How Pathogens Cause Disease

Koch’s Postulates: Method for determining whether a articular microorganism is the cause of a
particular disease.
1. The suspected pathogen must be found in every case of disease and not be found in
healthy individuals.
2. The suspected pathogen can be isolated and grown in pure culture.
3. A healthy test subject infected with the suspected pathogen must develop the same
signs and symptoms of disease as seen in postulate 1.
4. The pathogen must be re-isolated from the new host and must be identical to the
pathogen from postulate 2.

Holes in the Postulates:

● Pathogens can also be found in healthy individuals
● Not all subjects are equally susceptible to disease
● Not all pathogens are microorganisms that can be grown in a pure culture.

Molecular Koch’s Postulates:

1. The phenotype (sign or symptom of disease) should be associated only with pathogenic
strains of a species.
 2. Inactivation of the suspected gene(s) associated with pathogenicity should result in a
measurable loss of pathogenicity.
3. Reversion of the inactive gene should restore the disease phenotype.

Pathogenicity: The ability of a microbial agent to cause disease.

Virulence: The degree to which a disease is pathogenic. Virulence of a pathogen is measured

using Median Infectious Dose (ID50) and the Median Lethal Dose (LD50)

Primary Pathogen: Causes disease regardless of host’s microbiota or immune system.

Opportunistic Pathogen: Can only cause disease when the host’s immune system is
compromised.

Adhesion: The capability of pathogenic microbes to attach to the cells of the body.

Invasion: The dissemination of pathogens throughout local tissues.

Virulence of Viral Pathogens

Endotoxin: The lipopolysaccharide on the outer membrane of gram-negative bacteria that

triggers the immune system’s inflammatory response.

Exotoxin: Protein molecules produced by a wide variety of living pathogenic bacteria that target
receptors on specific cells and damage them via molecular mechanisms.

Viral adhesins: One of the first steps in any viral infection is adhesion of the virus to specific
receptors on the surface of cells. This process is mediated by adhesins that are part of the viral
capsid or membrane envelope.

Examples of viral adhesins: Hemagglutinin (attachment site: Sialic acid of respiratory and
intestinal cells).

Antigenic variation also occurs in certain types of enveloped viruses, including influenza
viruses, which exhibit two forms of antigenic variation: antigenic drift and antigenic shift

Influenza viruses use both antigenic drift and antigenic shift to avoid being recognized by
the immune system.

Virulence Factors of Eukaryotic Pathogens

Mycotoxins: Fungal toxins

Protozoan pathogens are unicellular eukaryotic parasites that have virulence factors and
pathogenic mechanisms analogous to prokaryotic and viral pathogens, including adhesins,
toxins, antigenic variation, and the ability to survive inside phagocytic vesicles.

Disease and Epidemiology

Language of Epidemiologists

Etiology: Study of a cause of disease.

Prevalence: The number of individuals with a particular illness in a given population at a point
in time.

Incidence: The number of new cases in a period of time.

Sporadic Diseases: Diseases that are seen only occasionally, usually without geographic
concentration.

Endemic Diseases: Diseases that are constantly present in a population within a given
geographic region.

Epidemic Diseases: Diseases for which a larger than expected number of cases occurs in a
short time within a geographic region.

Tracking Infectious Diseases

Morbidity: The state of being diseased.

Mortality: Incidence and prevalence of death.

Modes of Transmission

Reservoir: Living organism or nonliving site containing a pathogen.

Passive Carrier: Contaminated with and capable of spreading the pathogen, but is not infected.

Active Carrier: Infected individual capable of spreading the disease.

 ● Asymptomatic Carrier: Active carrier that does not display symptoms.

Contact Transmission: The pathogen spreads through direct or indirect contact with a carrier
or reservoir.

Vehicle Transmission: The transmission of pathogens through water, food, or air.

Vector Transmission: A contaminated animal spreads the pathogen from one host to another.

Nosocomial Infection: Infections acquired in healthcare facilities.

Immunology Overview

Physical Defences

Barries consist of cells that are tightly joined to prevent invaders from crossing through to
deeper tissue. Physical Barriers -> example: the endothelial cells that line blood vessels
(endothelia) have very tight cell-to-cell junctions, blocking microbes from gaining access to the
bloodstream. Cell junctions are generally composed of cell membrane proteins that may
connect with the extracellular matrix or with complementary proteins from neighboring cells.

The skin is one of the body’s most important physical barriers. Composed of a thin upper layer
(epidermis); a second, thicker layer that contains hair follicles, sweat glands, nerves, and blood
vessels (dermis); an a layer of fatty tissue that has blood and lymph vessels (hypodermis).

The mucous membranes consist of a layer of epithelial cells bound by tight junctions. The
epithelial cells secrete mucus, which covers and protects the more fragile cell layers beneath it
and traps debris and particulate matter.

Mechanical defenses physically remove pathogens from the body, preventing them from taking
up residence.

Examples: shedding of skin cells; expulsion of mucus via mucociliary escalator (sneezing,
coughing, and coming to contact with the stomach); excretion through intestinal peristalsis; and
blinking.

Chemical Defenses

Antimicrobial Peptides: Chemicals that are built to destroy foreign and infected cells. Some
are constantly produced and others are only produced in response to the presence of a certain
pathogen.
● Acute-Phase Proteins: AMPs that are primarily produced in the liver and secreted into
the blood in response to inflammatory molecules from the immune system.
 ○ Ferritin and Transferrin bind and sequester iron, thereby inhibiting the growth of
pathogens.

Cytokines: Soluble proteins that act as signals between cells.

Autocrine Function: The same cell that releases the cytokine is the recipient of the signal/ self
stimulation.

Paracrine Function: Cytokine is used to communicate with OTHER cells.

Endocrine Function: Cytokines are released into the bloodstream to be carried to distant cells.

Cellular Defenses

Component Cells in Blood:

● Erythrocytes: Transports oxygen and carbon dioxide between tissue and lungs.
● Platelets/Thrombocytes: Releases growth factors for repair and healing of tissues.
● Leukocytes: Various defenses
○ Neutrophils: Nonspecific phagocytic antibacterial cells that release cytotoxic
chemical from granules. Accounts for 50-70% of all leukocytes.
○ Eosinophils: Nonspecific phagocytic antiparasitic cells that release toxic
proteins, antihistamines and degradative enzymes. Very effective against
antigen-antibody complexes. Accounts for 1-3% of all leukocytes.
○ Basophils: Nonspecific proinflammatory cells. Accounts for roughly less than
1% of all leukocytes.
○ Lymphocytes: Specific/adaptive immunity cells. T (TERMINATOR) cell directly
attack other cells. B (Base?) cells release antibodies. Natural killer cells are
similar to T cells but are nonspecific. Accounts for 20-40% of all leukocytes.
○ Monocytes: Specific and highly effective phagocytic cells that engulf pathogens
and worn out cells. Can serve as antigen presenting cells (APC) or other
components of the immune system. Accounts for 1-6% of all cells.
Hematopoiesis: The process of differentiation of blood cells.

Pathogen Recognition and Phagocytosis