HLTC25

Lecture 3- Infectious diseases

Direct contact
● Environment
○ Contact with contaminated reservoirs in the environment (e.g., soil, vegetation)
○ Examples: legionnaires’ disease, tetanus, anthrax
■ Anthrax
● Skin form
● Testicle
● Injectable
● Respiratory
○ Mortality can be 80% or greater
● Spore forming bacteria; is why it can stay in envelopes and survive
for long periods of time and remain infectious
● Environment
○ Notable activity: anthrax
○ Anthrax outbreak in Russia thought to be the result of thawing permafrost
○ Bacterial infection caused by B. anthracis bacteria, four forms
○ >2000 reindeer infected, dozens sick
○ One child died
○ Source? Heatwave thawed reindeer carcass from decades ago
■ Infected with anthrax
■ Impact of climate change

● Animals
○ Spread via petting/touching animals, and broken skin generated from animal bites
or scratches
■ Examples: rabies, salmonellosis, Cat Scratch fever
● Animals
○ Notable activity: salmonellosis
○ An outbreak of salmonellosis among children attending a reptile exhibit at a zoo
○ Foodborne infection, caused by salmonella bacteria
■ Bacteria also live in guts of reptiles
○ 39 confirmed, 26 suspected cases
○ Median age of 7 years
○ Contact with Komodo dragon pen-- a risk factor
○ Proper handwashing was found to reduce the likelihood of illness
● vertical/perinatal
○ Transmission of diseases from mother to unborn child during pregnancy, during
delivery or via breastfeeding
 ○ Examples: hepatitis B, herpes simplex 2, HIV
Indirect contact
● Infectious agents are transmitted from reservoirs to susceptible hosts via suspended air
particles, inanimate objects, and animate intermediaries
● Airborne:
○ Spread via aerosolized droplets. Small, light droplets that remain suspended (and
remain infectious) for long distances and periods of time
● Airborne:
○ Notable activity: measles
○ Airborne transmission of measles in physicians' office
○ Viral illness spreads very effectively via air
■ One of the most contagious viruses known
○ Three children sick, arrived at doctors office >60 min after measles-infected child
departed
○ coughing, air recirculation, low humidity
● Vehicles
○ Indirect spread of infectious agents. The vehicle may provide an environment for
the agent to grow/multiply or produce toxins. Vehicles include food, water, blood,
and fomites.
○ Examples: norovirus, E. coli., botulism
○ Touching a doorknob and then touching face; particles are found on the fingers
due to touching the doorknob
● Vehicles
○ Notable activity: norovirus
○ Large multistate outbreak of norovirus gastroenteritis associated with frozen
strawberries, Germany, 2012
○ Viral illness is highly contagious. Spreads via food & water
○ Nearly 11,000 cases of norovirus were identified in schools
○ Strawberries were identified as the cause
■ Supplied by a catering company in France
■ Imported from China
● Vectors
○ The infectious agent is carried via a mechanical vector. vectors carry agents from
one host to another without getting infected. Vectors include mosquitos, fleas, and
ticks.
○ Do not live, grow or multiply. They just carry
○ Examples: plague, Lyme disease
○ The rat is the reservoir of plague
○ Ticks spread Lyme disease
Notes
● A disease may fit into more than one transmission category
○ This is very likely to be the case
● If a disease fits into more than one transmission category, one type might occur more
frequently than the others
○ E.g., influenza can transmit via direct physical contact, fomites, and aerosolized
particles (mix of droplet + airborne). However, the aerosolized route is the most
common
● Effective reproductive number (R0): “Average number of additional infections caused by
1 infection.”- Ontario COVID-19 science advisory table

Case Study:
● Direct and indirect contact; the mosquito is a vector; physical contact (sexual contact),
vertical/perinatal (breastfeeding)
● Most efficient and common the transmission method is indirect contact because the
mosquito is a vector
● Barriers such as long sleeve clothing and bug spray to kill the mosquito carrying the
virus; avoid traveling, avoid getting pregnant creating measures such as A/C from
mosquitos traveling to the human.
● Yes, they are necessary because they will reduce the risk of others getting and spreading
the virus. stigmatization
● Travel restrictions and quarantine