TRANS: Unit Title
MIRCOPARA LAB
UNIT 1: BASIC PRINCIPLES OF MICROBIOLOGY AND PARASITOLOGY: EPIDEMIOLOGY AND THE NURSE
UNIT 2: MEASURES OF PREVENTION AND CONTROL OF DISEASE TRANSMISSION
OUTLINE
 BASIC PRINCIPLES of MICROBIOLOGY and
PARASITOLOGY: EPIDEMIOLOGY and the NURSE
 MEASURES of PREVENTION and CONTROL of
DISEASE TRANSMISSION
INFECTIOUS DISEASES
o diseases caused by microbes that spread. The
reason why you may be absent for more than
one day is because you have an infectious
disease which has the capability of infecting
others. Whether or not an infectious disease
occurs depends on many factors, including those
pertaining to the pathogen, those pertaining to
the host, and those pertaining to the
environment.
THE EPIDEMIOLOGIC TRIAID
The Epidemiological Triad or Epidemiological Triangle refers to
the Traditional Model of Disease causation. Since it is a triad or
a triangle, it implies that there are three factors involved when
there is a disease. These three factors are the external agent,
the environment and the susceptible host
 The Triangle has three corners (called vertices):
o Agent, or microbe that causes the disease (the
“what” of the Triangle)
o Host, or organism harboring the disease (the
“who” of the Triangle)
o Environment, or those external factors that cause
or allow disease transmission (the “where” of the
Triangle)
COMPONENTS OF THE EPIDEMIOLOGIC TRIAD
 The AGENT is a harmful microorganism that is present in
the ENVIRONMENT that attacks a SUSCEPTIBLE HOST.
o The AGENT (What) is referred to an infectious
microorganism or a pathogen which maybe a:
virus, bacterium, parasite, or another microbe.
o Generally, the agent must be present for disease
to occur; however, presence of that agent alone
is not always sufficient to cause disease.
o A variety of factors influence whether exposure to
an organism will result in _disease ,including the
organism’s ability to cause disease, and dose or
how many.
ZYLYREE YLYZA MARQUEZ
 Bacteria:
o Bacteria are single-celled organisms that
reproduce by themselves.
o They are larger than viruses (but still much too
small to be seen with the naked eye).
o They are filled with fluid and may have threadlike
structures to move themselves, like a tail.
 Virus:
o A virus may have a spiny outside layer, called the
envelope.
o Viruses have a core of genetic material, but no
way to reproduce it on their own.
o Viruses infect cells and take over their
reproductive machinery to reproduce.
 Fungi:
o Fungi are like plants made up of many cells.
o They are not called plants because they cannot
produce their own food from soil and water.
o Instead, they live off animals, including people,
and plants. Mushrooms and yeast are fungi.
 Protozoa:
o Protozoa are very small.
o Most live in water.
o They are parasites, which means they live off
other organisms, in some cases humans.
HOST AND EVIRONMENT
 The HOST (Who) carries the disease.
o Host refers to the human who can get the
disease.
o A variety of factors intrinsic to the host,
sometimes called risk factors, can influence an
individual’s
 exposure,
 susceptibility, or
 response to a causative agent.
o Opportunities for exposure are often influenced
by behaviors such as
 sexual practices,
 hygiene, and
 other personal choices as well as by age and
sex.
o Susceptibility and response to an agent are
influenced by factors such as
 genetic composition,
 nutritional and immunologic status,
 anatomic structure,
 presence of disease or medications,
 psychological makeup.
 The ENVIRONMENT (Where) brings the agent and host
together.
o Environment refers to extrinsic factors that affect
the agent and the opportunity for exposure.
o Environmental factors include physical factors
such as geology and climate, biologic factors
such as insects that transmit the agent, and
socioeconomic factors such as crowding,
sanitation, and the availability of health services.
Thus, a polluted environment would mean that
there are a lot of harmful microbes that are
present.
1
 TRANS: Unit Title
HOW ABOUT OUR HOME ENVIRONMENT? ARE
MICROBES IN OUR HOMES FRIENDS OR FOE?
o The amount of microbes that share our living
spaces might come as a surprise to many.
o But the key question is, are they bad for our
health?
o Bacteria, viruses, fungi, and parasites all live
around our homes.
o When it comes to microorganisms in our living
environments, we are bombarded with
antibacterial and antiviral soaps, cleaning
products of every description, and a general
notion that we must keep our houses clean to
combat deadly microbial threats.
o On the other hand, we are frequently reminded
that probiotic microbes have significant health
benefits.
o Microorganisms are ever-present in our
environment and in our bodies, and many are
known to be beneficial — or even essential — for
our health.
o However, some are pathogens and can make us
very sick, and they can sometimes even kill us.
o Keen to know what microbes might be inhabiting
the various parts of my home,
o I delved into the scientific literature and found out
why some of our microscopic roommates are
good for us, and why others pose a significant
threat to our health.
WHAT MICROBES LURK AROUND OUR HOMES?
o Scientists from NSF International — _which is
based in Ann Arbor, MI — _tested 22 households
in Southeast Michigan.
o They found that dishwashing sponges contained
the highest number of microorganisms, followed
by toothbrush holders, pet bowls, kitchen sinks,
coffee reservoirs, kitchen countertops, stove
knobs, pet toys, and toilet seats.
o In the study, the authors found yeast and molds,
bacteria in the coliform family (including
Escherichia coli), and Staphylococcus aureus on
many of the surfaces tested.
o To assess the microbial diversity in house dust, a
team of scientists — which was led by Jordan
Peccia, a professor of chemical and
environmental engineering at Yale University in
New Haven, CT — _tested samples from 198
homes in Connecticut and Massachusetts.
o The researchers found that the most common
fungal species were Leptosphaerulina chartarum,
Epicoccum nigrum, and Wallemia sebi.
o The most abundant bacteria were from the
Staphylococcus, Streptococcus, and
Corynebacteria families
o Homes with pets and those located in suburban
areas had more diverse bacterial species, while
those with reported water leaks harbored more
fungi.
o Meanwhile, scientists from Seoul National
University in Korea studied the bacteria that
inhabit our refrigerators and toilet seats.
o They found that the many of the bacteria present
were also resident on human skin, indicating that
we are the source of a lot of the microbes in our
living environment.
ZYLYREE YLYZA MARQUEZ
o “In this study, most bacteria detected were
probably not pathogens or opportunistic
pathogens, and genera belonging to common
pathogens were detected in only a very small
fraction of communities on the surfaces of
refrigerators and toilets,” the authors explain.
o So, our tiny roommates are everywhere: from our
kitchen sinks to our living room floors and
toothbrush holders.
o They key question that remains is what their
impact on our health is.
o The answer depends on our age, the state of our
immune system, and, of course, the individual
microorganism in question.
ALLERGY AND HYGIENE
o According to the “hygiene hypothesis” — which
was originally proposed by Prof. David Strachan
in 1989 —
o allergic diseases are able to be prevented “by
infection in early childhood, transmitted by
unhygienic contact with older siblings, or
acquired prenatally from a mother infected by
contact with her older children.” House dust
exposes us to diverse microbes.
o In an article published in the October edition of
Nature Immunology, Profs. Bart N. Lambrecht
and Hamida Hammad — from the VIB Center for
Inflammation Research at Ghent University in
Belgium —
o explain that studies in animal models have shown
that exposure to some viruses, bacteria, and
parasites is linked to lower rates of allergy.
o Allergic diseases, including eczema, hay fever,
asthma, and food allergies, affect 50 million
individuals in the United States, while hay fever
alone affects 400 million individuals globally.
o Allergies develop when our bodies mistake an
otherwise harmless substance as a threat and
react with an immune response.
o Microbes are known to affect this process in
several ways.
o Certain bacteria, such as Bacterioides,
Bifidobacterium, Faecalibacterium, and
Enterobacteria, produce metabolites that promote
the generation of regulatory T cells.
o These cells play a major role in protecting us
from developing allergies, but children who are
prone to allergy are known to have lower levels of
these types of bacteria in their guts.
o Microbial components also affect another type of
immune cell.
o Dendritic cells patrol epithelial barriers —
_namely, the skin, gut, and lungs — _where they
detect incoming allergens.
o And if this happens in the absence of microbial
components, dendritic cells tend to drive allergic
immune reactions, whereas if microbes are
present, they do not.
o So, where can we find these beneficial
microorganisms that might protect us from
developing allergies?
MICROBES THAT MIGHT GIVE US THE EDGE
2
 TRANS: Unit Title
o Prof. Peccia found that certain beneficial bacteria
were preferentially found in homes that housed
multiple families and those with more than three
children.
o One of these, Faecalibacterium prausnitzii, “is
anti-inflammatory and protective against Crohn’s
disease,” he explains.
o Members of the lactobacillus family were also
found in higher numbers in such households, and
these probiotic bacteria have been implicated in
protection against allergies and asthma.
o In a separate study, Prof. Peccia’s team found
that yeasts in the fungal class Kondoa may have
a protective effect against severe asthma when
present in the home.
o Drinking unpasteurized cow’s milk is linked to a
lower risk of allergy.
o Exposure to microorganisms in raw milk and
those in the dust of homes located on farms has
been strongly implicated in lower allergy rates.
o However, bacteria and fungi aren’t the only
friendly microorganisms.
o Although most people tend not to associate
parasites with Western nations, in the U.S.,
millions of individuals are chronically infected with
these microorganisms.
o But it’s not all bad news: there is evidence that
tiny parasitic worms called helminths protect their
host from allergies.
o Many allergens are similar in structure to
helminth proteins, which is why in cases of
chronic exposure to helminths, these proteins
compete with allergens, leading to non-allergic
immune responses.
o Not all infections are beneficial. For example,
lower respiratory tract infections in children under
3 years of age are a risk factor for wheezing and
asthma.
o The hygiene hypothesis has been criticized in
light of this. Prof. Lambrecht says that new
theories suggest that loss of diversity in the
human microbiome —
o a topic I recently explored in a separate article —
o means that the microbes and parasites that once
provided us with protection from allergies no
longer fulfill this function.
o While microorganisms may play an important role
in preventing allergic disease from developing in
small children, they can pose a serious threat to
the health of others
WHEN ARE MICROBES BAD FOR OUR HEALTH?
o For people who have already developed allergic disease,
microbes in the living environment spell bad news.
o Early life fungal infections, especially those of the airways,
are linked to the worsening of existing allergic asthma.
o Infections of the airways with viruses and bacteria can
have similar effects, while fungal skin infections are known
to trigger eczema.
o Prof. Peccia also found that the homes of severely
asthmatic children tended to harbor similar microbial
allergens.
o In particular, high concentrations of fungi were found in the
homes of these children, with yeasts in fungal class
Volutella standing out.
o Our refrigerators are ideal living environments for harmful
microorganisms.
ZYLYREE YLYZA MARQUEZ
o In addition to the danger that microbes pose to those
already allergic or asthmatic, food-borne household
microorganisms contribute to a significant number of
illnesses each year.
o The Centers for Disease Control and Prevention (CDC)
estimate that every year, 3,000 people die from food
poisoning.
o Here, the culprits include Salmonella, certain types of E.
coli, Listeria, and fungi.
o According to the 2013 NSF International Household Germ
Study, the refrigerator vegetable compartment was a
ready source of Salmonella, Listeria, and fungi, while E.
coli were found in the refrigerator meat compartment, as
well as on rubber spatulas, blender gaskets, can openers,
and pizza cutters.
o So, the bottom line is that among the plethora of
microorganisms that inhabit our homes and living spaces,
some are friends, and some are foes.
o More importantly, how we react to particular microbes
depends on our individual immune systems.
o Does that mean that I should keep my home meticulously
clean?
o Cleaning my kitchen’s hotspots — mostly the dishwashing
sponge, refrigerator, kitchen sink, counter, and cooking
utensils — will certainly go some way toward protecting
my family from contracting food poisoning.
o As for the rest of the microbes, it depends. In homes with
family members who already have allergies, reducing
exposure to any of the culprits that trigger symptoms
makes sense.
o But are we increasingly becoming trapped in a vicious
cycle of cleanliness to prevent allergy symptoms,
depriving the next generation from the much-needed early
exposure to microbes
o There is no clear answer, but scientists are
getting closer to finding out how exposure to
microorganisms might have protected us from
allergies in the past.
o “In the future, we might also see effective and
large-scale preventive strategies based on this
new knowledge that can restore the lost
symbiotic relationships between microorganisms
and humans without causing disease or requiring
a return to an unhygienic lifestyle.”
HOW IS THE EPIDEMIOLOGICAL TRIAD APPLIED?
o The interactions of the host, agent, and
environment correlate with the spread of
infectious diseases
o The epidemiological triad is designed to be
shaped like a teeter totter (see saw) with the
environment being the base, the host being on
one side and the agent being on the other.
o When the teeter totter is balanced it is known as
the equilibrium state, this state signifies that
everything is healthy.
o In a scenario where there is an infectious
disease, the teeter totter would be weighted
towards one side.
o The goal of an epidemiologist is to decipher the
connection between any of these three main
factors
3
 TRANS: Unit Title
IMBALANCE TOWARDS THE AGENT
o When looking at the epidemiological teeter totter,
there are moments when there is an imbalance
that causes many different scenarios.
o If the imbalance is towards the agent, it is
considered as the agent having more of an ability
to cause a disease on man.
o This can be shown by the corona virus, as this
disease is increasing in cases every day.
o In this situation, the viruses are the agents
carrying the corona virus and infecting the host,
humans.
o The corona virus has also more control of
passing the disease because of their invisibility
and mode of transmission.
o Also, there is no ability to tell the difference
between a common flu virus with the corona
virus.
o This allows the host to transmit the disease to
other hosts without even knowing.
o Eventually, this expanded the area the disease
infected because of the agent’s ability to transmit
the disease to the host.
IMBALANCE TOWARDS THE HOST
o Another outcome that is shown in the imbalance
 The CHAIN of INFECTION refers to a series of events
of the epidemiological teeter totter is towards the
host.
o This imbalance explains that the amount of ways
a person is susceptible to a disease increased.
o A good example of this can be shown by the
H1N1 flu virus.
o The flu virus is transmitted from person to person
through contact with others who have the flu or
ZYLYREE YLYZA MARQUEZ
possibly through surfaces that people with the flu
have touched in the past.
o Every year, people get infected with the flu virus
even if they have had it in the past or have taken
flu vaccines.
o This is because the H1N1 flu virus is an RNA
virus, which means that it mutates and changes
every so often.
o This forces doctors to change the flu vaccine
every year to try and decrease our susceptibility.
o Unfortunately, there’s a possibility that the
vaccine may not work and can still cause you to
contract the virus.
o This, ultimately, leaves people vulnerable to the
disease whether they are vaccinated or not.
o This shows how a host’s susceptibility to a
disease may increase because of the agent and
environment they’re in.
IMBALANCE TOWARDS THE ENVIRONMENT
o The environment also plays a key role in how the
agent and host are affected by a disease.
o The environment plays a role in where the
disease is most likely to spread and where it is
currently located.
o With the use of previously explained diseases,
the corona virus is only found in most places with
a hot climate such as the United States, Europe,
United Kingdom, Asia Pacific.
o Although the flu is a disease that is common
worldwide, it is typically transmitted in the colder
months of the year.
o This shows epidemiologists that more prevention
should be placed on these areas when the
climate correlates with the rate of susceptibility to
the host.
o In certain times of the year, in specific
environments, the host may not have a high
susceptibility to certain diseases but may be
susceptible to others.
o Just like the host and the agent, the environment
has direct correlation to the other factors when
spreading a disease.
CHAIN OF INFECTION
that has to happen to enable germs that are bacteria, fungi
and viruses) to cause infections in a person.
o As explained, the traditional epidemiologic triad
holds that infectious diseases result from the
interaction of agent, host, and environment.
o More specifically, transmission occurs when the
agent leaves its reservoir or host through a portal
4
 TRANS: Unit Title
of exit, is conveyed by some mode of
transmission, and enters through an appropriate
portal of entry to infect a susceptible host.
o This sequence is sometimes called the chain of
infection.
o The role of the nurse is to break at least one of
the sides of the Triangle, disrupting the
connection between the environment, the host,
and the agent, and stopping the continuation of
disease.
 There are six components in the infectious disease
process (also known as the chain of Infection).
o There must be a pathogen.
 Example: Virus
o There must a source of the pathogen (reservoir).
 Example: Andy (reservoir) has a cold
o There must be a portal of exit (the way for the
pathogen to escape from the reservoir).
 Example: When Andy blows his nose, cold
viruses get into his hands.
o There must be a mode of transmission (the
way for the pathogen to travel from Andy to
another person).
 Example: Andy is shaking hands with Joe;
the cold virus is being transferred to Joe.
From his hand to the mucous membranes of
his nose. (And would therefore, not develop
a cold) if he had previously been infected by
that particular cold virus and had developed
immunity to it.
o There must be a portal of entry (the way for the
pathogen to gain entry into Joe.
 Example: When Joe rubs his nose, the cold
virus is transferred from his hand to the
mucous membranes of his nose.
o There must be a susceptible host. Joe would
not be a susceptible host (and would, therefore,
not develop a cold) if he had previously been
infected by that particular cold virus and had
developed immunity to it
o The figure clearly indicates that for a person to
get infected with a disease or for a person to get
sick, a chain of event happens.
o Germs/disease causing agents are everywhere;
they live and multiply in a reservoir that includes
humans, animals, soil, food, and water.
o These disease-causing agents get out from the
reservoir from a portal of exit like mucus with the
agent comes out from the mouth of a person;
infected blood comes out from an injured wound.
o Once they come out, these infected mucus or
blood are transmitted through droplets when one
speaks, coughs out or through contact with
hands or soil.
o The infection then gets into another person
through a portal of entry such as mouth, wounds,
and eyes of a susceptible person who becomes
another sick person because he/she contracted
the agent
THE RESERVOIR
o By ‘reservoir’, we mean a place where germs can
live and multiply.
o The ‘place’ can be a person – a patient/client or a
member of staff – but it can also be any part of
the surrounding area of a health care setting,
furnishings in the patient’s/client’s room and the
equipment we use in health care.
ZYLYREE YLYZA MARQUEZ
THE PORTAL OF EXIT FROM THE RESERVOIR
o The ‘portal of exit’ is the means by which the
germ can escape from the reservoir.
o For instance, think about some germs (the
infectious agent) sitting on top of a used
commode (the reservoir).
o A health care worker comes along and touches
the commode, and some of the germs move onto
her hands.
o The health care worker’s hands are now the
‘portal of exit’ – the means by which the germs
are able to move from the commode to another
place.
o Other ‘portals’ can be people’s normal excretions
(stools, vomit), body fluids (blood, saliva) and the
air they breathe from their lungs, especially when
they cough.
o The portal can vary from one infection to another
(for example diarrheal infections are usually
passed on via the patient's feces).
o Germs can even be spread around on the tiny
flecks of skin that peel off our bodies throughout
the day and which form part of the dust that
settles on all kinds of surfaces.
o Non-human portals of exit for germs include
items of equipment that haven’t been properly
cleaned, such as commodes, bed mattresses,
pillows and reusable equipment
THE MODE OF TRANSMISSION
o This is how the germs move, or spread, from one
place to another.
o This can happen in a number of ways, such as
health care workers’ hands touching dirty
equipment or contaminated medical instruments,
or through the air (coughs, sneezes).
THE PORTAL OF ENTRY INTO THE ‘HOST
o This means that the germs that have been
moved from the reservoir now invade the person
(the ‘host’).
o They can do this by entering wounds and cuts,
being swallowed and being breathed in.
o Patients who are having treatments that involve
cutting the skin or placing medical instruments
inside the body, such as a catheter being placed
into the bladder or a feeding tube being passed
down the throat, are also at risk of infection.
o Another example is people who inject drugs with
used needles.
THE SUSCEPTIBLE HOST
o Healthy people have their own defenses which
help them fight infection.
o This means that even if some harmful germs
enter the body, the person can ‘fight them off’
and stay well.
o The ability of the body to defend itself against
infection is called ‘immunity’.
o Some people, however, can’t fight infection
effectively. These include very young children,
older people, people who are ill or who are
receiving particular medicines that reduce their
immunity, people with long-term health conditions
like diabetes and those who are physically weak
due to, for instance, malnutrition or dehydration.
o People such as these are ‘susceptible hosts’ –
meaning they are vulnerable to developing
5
 TRANS: Unit Title
infection when their bodies are invaded by
germs.
THE INFECTIOUS AGENT
o The infectious agent is simply the germ that
causes the infection.
o Germs are all around us and within us, and
many play very important roles in keeping us
healthy.
o The problem comes when a germ leaves its
normal place to go elsewhere in the body – the
germs that sit on your skin and which usually
cause no harm, for instance, getting into a cut.
o The germ could then cause infection.
o There are also many germs that are not helpful to
health and which cause disease.
o Entry of any of these germs into the body is
likely to cause problems.
THE COVID-19 PANDEMIC
o The coronavirus disease 2019 (COVID-19) is an
infectious disease caused by severe acute
respiratory syndrome coronavirus 2 (SARS-CoV-
2), a new strain of virus first detected in Wuhan,
China in 2019.
o COVID-19 is known to target a person’s
respiratory system. Infected patients may exhibit
symptoms such as fever, cough, shortness of
breath, and in some cases, muscle pain and sore
throat.
o Some patients may also be asymptomatic.
o On March 11, 2020, the World Health
Organization (WHO) has characterized COVID-
19 as a pandemic due to the exponential
increase of the number of cases in more than
100 countries.
EPIDEMIOLOGICAL TRIAD OF COVID-19
o On March 16, 2020. President Rodrigo Roa
Duterte placed the entire Philippines under a
State of Calamity amid the threats posed by
COVID-19.
o The figure above shows that the Agent is the
Corona virus.
o The Host are all ages especially the vulnerable
people like children, elderly, and
immunocompromised individuals (ex: cancer
patients).
o The environment – The virus started in China
specifically Wuhan Market.
ZYLYREE YLYZA MARQUEZ
o If we look into the environment of Wuhan Market,
it is same in Philippines where there are areas of
overcrowding like in churches, jeepneys, market,
airplane, etc.
o What then are the different components of the
Chain of Infection of the Corona virus? What
should be done to break the chain of infection?
CHAIN OF INFECTION OF THE COVID-19 PANDEMIC
o Coronavirus Disease 2019 (COVID-19) is an
infectious disease caused by a new coronavirus
recently introduced to humans for the first time.
o The World Health Organization (WHO) has called
it a pandemic.
o This means that the virus has spread all over the
world. About 80% of those who have COVID-19
have mild symptoms.
o Coronaviruses are a large family of viruses
causing a range of illnesses, from the common
cold to more serious infections such as those
caused by
o Middle East Respiratory Syndrome-related
Coronavirus (MERS-CoV)
o Severe Acute Respiratory Syndrome-related
Coronavirus (SARS-CoV).
SYMPTOMS
 Most common symptoms are:
 • Fever (not necessarily a high fever
 • Dry cough
 • Tiredness or fatigue
 • Shortness of breath or difficulty breathing
 • Some patients experience aches and
pains, nasal congestion, runny nose, sore
throat, or diarrhea
 Severe Symptoms include:
 • Difficulty breathing or shortness of breath
 • Persistent pain or pressure in the chest
 • Mental confusion or changes in alertness
 • Bluish lips or face Symptoms of COVID-19
can range from mild to severe.
o Around 80% of people have mild symptoms.
o It takes at most 14 days for symptoms of COVID-
19 to show.
 If an individual has these and live in a place
under ECQ or have recently traveled to/from
a place under ECQ, call the local Barangay
Health Emergency Response Teams
(BHERT or the Department of Health (DOH)
hotline - (02) 894 COVID (26843) or 1555 for
all network subscribers.
6
 TRANS: Unit Title
 They will assess and advise the need to
seek medical attention and which nearest
health facility you should go to.
PEOPLE OF ALL AGES CAN BE INFECTED WITH
COVID-19.
 Groups that are at higher risk of developing severe illness
include:
o - People 65 years old and older (our lolos and
lolas)
o - Anyone with pre-existing medical conditions
(example: high blood pressure, heart or lung
disease, or diabetes)
o - Those with high-risk pregnancies (example:
women aged 17 and younger, aged 35 and older,
those with pre-existing medical conditions)
o - COVID-19 is transmitted from person to person
through droplets. It is transmitted when one
individual talks, sneezes, or coughs producing
‘droplets’ of saliva containing the COVID-19
virus. These droplets are then inhaled by another
person.
o - COVID-19 transmission usually occurs among
close contacts -- including family members and
healthcare workers. It is therefore important to
maintain a distance of more than 1 meter away
from any person who has respiratory symptoms.
o - A person can also catch COVID-19 by touching
objects or surfaces, then touching their eyes,
nose, or mouth. This is why it is important to
regularly wash your hands.
WHAT ARE THE NEW CLASSIFICATIONS OF
INDIVIDUALS FOR COVID-19?
 1. Suspect.
 2. Probable;
 3. Confirmed
o Persons Under Investigations (PUI) will now be
classified as suspect or probable.
o People who tested positive for COVID-19 will be
classified as confirmed.
o This is to align the Philippines' case classification
with the definitions of the World Health
Organization (WHO) to have a more uniformed
reporting mechanism across countries
AN INDIVIDUAL HAS RESPIRATORY SYMPTOMS.
WILL HE/SHE BE CLASSIFIED AS SUSPECT
 He/she are defined as a person who is suspect with
COVID-19 if:
 Has an influenza-like illness (ILI) that manifests with fever
(38°C), cough or sore throat, and have any of the
following:
 a. Travel history to an area with local
transmission of COVID-19 during the 14
days before symptoms began: or,
 b. History of close contact with person
probable or confirmed with COVID-19 during
the 14 days before symptoms began.
 Has fever, cough, or other respiratory symptoms, and
belong to vulnerable populations:
 a. Those aged 60 years and above;
 b. Those with pre-existing health conditions;
 c. Those with high-risk pregnancies; and,
 d. Health workers
 e. You developed severe and acute
respiratory illness with no explainable
etiology that requires overnight
hospitalization
ZYLYREE YLYZA MARQUEZ
WHO CAN BE CONSIDERED PEOPLE PROBABLE
WITH COVID-19?
o A person is classified as probable with COVID-19
if the person was originally suspected with
COVID-19 and their:
a. Test turned out inconclusive.
b. Test was done in a non-official RT-PCR laboratory
WHO CAN BE CONSIDERED PEOPLE CONFIRMED
WITH COVID-19?
o A person is confirmed with COVID-19 if their
samples sent for testing to official laboratories
returned positive using the RT-PCR method.
WHO WILL BE TESTED FOR COVID-19?
o You will be tested for COVID-19 if you are either
suspect or probable with COVID-19.
o However, priority will be given to those with
severe illness, as well as people suspect with
COVID-19, and with history of contact with
people probable or confirmed with COVID-19 14
days before the onset of symptoms
WILL THERE BE CHANGES IN THE MANAGEMENT
AND TREATMENT OF COVID-19?
 Protocols for management and treatment will remain and
are based on the severity of symptoms.
AN INDIVIDUAL IS A PERSON UNDER MONITORING
(PUM)
 14-day self-quarantine at home must still be practiced if
he/she has a history of exposure to a person probable or
confirmed with COVID-19, or travel history to a place or
community with confirmed COVID-19 cases.
AN INDIVIDUAL IS A PUI WITH MILD SYMPTOMS
 Previously classified PUIs with mild symptoms will be
classified as suspect with COVID-19 and shall finish their
14-day self-quarantine in their homes or in their local
Temporary Treatment and Monitoring Facility.
AN INDIVIDUAL IS A PUI WITH SEVERE SYMPTOMS
 Previously classified PUIs with severe symptoms will need
testing.
 He/she needs to be admitted to a Level 2 or Level 3
hospital.
IS TESTING FREE?
 Yes, testing is free. However, testing is only required for
suspect cases.
HOW DOES AN INDIVIDUAL GET TESTED IF I
HE/SHE IS A SUSPECT CASE?
 He/she will be referred to a Level 2 or Level 3 hospital to
have the following samples taken:
o a. Nasopharyngeal swab (sample is taken from
the back of the nose and throat);
o b. Oropharyngeal swab (sample is taken from
the throat).
WHO SHOULD BE SENT HOME?
 People who are suspect or probable with COVID-19
should be referred to a Temporary Treatment and
Monitoring Facility or be sent home for strict 14-day home
quarantine. Non-COVID-19 patients are also advised to go
home.
WILL AN INDIVIDUAL BE ALLOWED TO GO HOME
WHILE WAITING FOR HIS/HER TEST RESULTS?
 If he/she has only has a mild symptom, he/she will be
instructed to undergo a strict 14-day home quarantine.
Patients manifesting severe symptoms will require
hospitalization.
7
 TRANS: Unit Title
IS HOSPITALIZATION NEEDED FOR SUSPECT
PATIENTS?
 People suspect with COVID-19 with mild illness need not
be hospitalized.
 They may be sent home after being tested but are advised
to return when symptoms worsen.
SUMMARY
 So, in covid-19, we can say that there is an imbalance
towards the host, agent and the environment.
 The disease follows the chain of infection.
 So, there must be measures to be done to break the chain
of infection.
 WE MUST STOP THE DISEASE FROM FURTHER
SPREADING.
 This shall be our focus in the next module
UNIT 2: MEASURES OF PREVENTION AND
CONTROL OF DISEASE TRANSMISSION
ASEPSIS
 Measures that are used to prevent infection from entering
a wound.
o Examples: Bathing, wearing gloves, wearing
gown.
MEDICAL ASEPSIS
o or clean procedure. It is the state of being free
from disease causing microorganisms.
o It is concerned with eliminating the spread of
microorganisms through facility practices.
o The three levels of asepsis are sterilizing,
disinfecting, and cleaning.
 Sterilization –
o The process of making something free from
bacteria or other living microorganisms.
o It refers to any process that removes, kills, or
deactivates all forms of life (in particular referring
to microorganisms such as fungi, bacteria,
viruses, spores.
o After sterilization, an object is referred to as being
sterile or aseptic.
 Example: Autoclaving of used surgical
instruments
 Disinfection
o The process of cleaning something, especially
with a chemical, in order to destroy bacteria.
o It is the process of eliminating or reducing
harmful microorganisms from inanimate objects
and surfaces.
 Using Lysol solutions to soak used surgical
instruments like scissors.
 Using chlorine bleach (typically a >10%
solution of sodium hypochlorite), which is
effective against most common pathogens,
including disinfectant-resistant organisms
such as tuberculosis (mycobacterium
tuberculosis), hepatitis B and C, fungi.
 Cleaning –
o is the process of removing unwanted substances,
such as dirt, infectious agents, and other
impurities, from an object or environment.
o Cleaning occurs in many different contexts and
uses many different methods.
 Examples: - Commercial cleaning: Bus
terminal cleaning
ZYLYREE YLYZA MARQUEZ
 - Environmental remediation, the removal of
pollution or contaminants from the natural
environment
 - Housekeeping, including spring cleaning
 - Hygiene including personal grooming
SURGICAL ASEPSIS
 sterile, asepsis.
 This makes use of a set of specific practices and
procedures performed to make equipment and areas free
from all microorganisms and to maintain that sterility
 Note: One principle in asepsis, is that some
treatments and procedures require surgical
asepsis and others only require medical
asepsis
ANTISEPSIS
 Measures that exclude or destroy harmful
microorganisms.
 Examples: Gargling with oral betadine
solution, flushing wound with Chlorhexidine
PROTECTIVE
o Provision of personal protection.
 Examples: Face shields, shoe cover, head
turban
GOOD HYGIENE
o the primary way to prevent infections.
o The first line of defense is to keep germs at bay
by following good personal hygiene habits.
o Prevent infection before it begins and avoid
spreading it to others with these easy measures.
WASH YOUR HANDS WELL.
o You probably wash your hands after using the
bathroom, before preparing or eating food, and
after gardening or other dirty tasks.
o You should also wash up after blowing your
nose, coughing, or sneezing; feeding or stroking
your pet; or visiting or caring for a sick person.
o Wet your hands thoroughly.
o Lather up with soap or cleanser and rub it into
the palms and backs of your hands and your
wrists.
o Be sure to clean your fingertips, under your nails
and between your fingers.
o Rinse under running water.
o Dry your hands and wrists thoroughly.
COVER A COUGH.
o Cover your mouth and nose with a tissue when
you sneeze or cough, then dispose of it.
o If no tissue is handy, cough or sneeze into your
elbow rather than into your hands.
WASH AND BANDAGE ALL CUTS.
o Any serious cut or animal or human bite should
be examined by a doctor.
o Do not pick at healing wounds or blemishes, or
squeeze pimples.
o Don't share dishes, glasses, or eating utensils.
o Avoid direct contact with napkins, tissues,
handkerchiefs, or similar items used by others.
PRACTICE GOOD FOOD-SAFETY TECHNIQUES TO
AVOID GETTING SICK
o Although most cases of food-borne infection are
not dangerous, some can lead to serious medical
conditions, including kidney failure and
meningitis.
8
 TRANS: Unit Title

o You can prevent infections by food-borne o However, studies show that on average,
pathogens in your household by preparing and healthcare providers clean their hands less than
storing foods safely. half of the times they should.
o The following precautions will help kill microbes o This contributes to the spread of healthcare-
that are present in the food you buy and help you associated infections that affect 1 in 31 hospital
avoid introducing new microbes into your food at patients on any given day.
home:
o • Rinse all meat, poultry, fish, fruits, and
vegetables under running water before cooking
or serving them.
o • Wash your hands with soap and water before
and after you handle raw meat.
o • Separate raw foods and cooked foods. Don't
use the same utensils or cutting boards with
cooked meat that were used to prepare the raw
meat without washing between uses.
o • Cook foods thoroughly, using a meat
thermometer to ensure that whole poultry is
cooked to 180° F, roasts and steaks to 145° F,
and ground meats to 160° F. Cook fish until it is
opaque.
o • Defrost foods only in the refrigerator or in the
microwave.
o Whether you are young or young at heart, getting
vaccinated is an essential part of staying healthy.
Many serious infections can be prevented by
immunization. While vaccines may cause some
common side effects, such as a temporarily sore
arm or low fever, they are generally safe and
effective
STANDARD PRECAUTIONS
o refer to the minimum infection prevention
practices that apply to all patient care, regardless
of suspected or confirmed infection status of the
patient, in any setting where health care is
delivered.
UNIVERSAL PRECAUTIONS
o is an approach to infection control to treat all
human blood and certain human body fluids as if USE OF PERSONAL PROTECTIVE EQUIPMENT
they were known to be infectious for HIV, HBV (PPE): HOW TO WEAR AND HOW TO REMOVE
and other blood borne pathogens. o Personal protective equipment is special
TRANSMISSION BASED PREVENTION equipment you wear to create a barrier between
o Precautions are the second tier of basic infection you and germs.
control and are to be used in addition to Standard o This barrier reduces the chance of touching,
Precautions for patients who may be infected or being exposed to, and spreading germs.
colonized with certain infectious agents for which Personal protective equipment (PPE) helps
additional precautions are needed to prevent prevent the spread of germs in the hospital.
infection transmission.
HANDWASHING.
o All people do handwashing.
o It is a health practice that we do to clean our
hands.
o As we all know, our hands touch anything and
can harbor harmful;
o microbes that can be transferred to other person
or patients, so we wash our hands properly.
o HANDWASHING with soap removes germs from
hands.
o This helps prevent infections because:
o People frequently touch their eyes, nose, and
mouth without even realizing it.
o Germs can get into the body through the eyes,
nose and mouth and make us sick.
o HANDWASHING/HAND HYGIENE is a great
way to prevent infections.

ZYLYREE YLYZA MARQUEZ 9

 TRANS: Unit Title

EYE AND FACE PROTECTION

o Eye protection is achieved by wearing eyewear
specifically designed to reduce the risk of
exposure to chemical splashes, laser radiation
and/or flying debris.
o There are four primary types of eye protection of
which each has its own limitations

IMPACT GOGGLES.
o offer protection from flying debris only.
o Often have ventilation holes on the sides that
render the user susceptible to chemical splashes
and dust or small debris.
GENERAL SAFETY GLASSES
o Must have side shields, or a one-piece lens that
wraps around the temple.
o Are the minimum level of eye protection that
must be worn in the laboratory.
o Are not effective in protecting the eyes from
splashes and are only recommended for use with
solutions that are not likely to damage the eye,
such as some buffers and salts.
FULL FACE
o protection is achieved by wearing face shields
o offer protection from flying debris only.
o Often have ventilation holes on the sides that
render the user susceptible to chemical splashes
and dust or small debris.

LASER SAFETY GLASSES,

o Selection is based on the laser wavelength and
power.
o Protective properties can be found printed on the
eyewear.
o Are not as effective as laser safety goggles at
filtering all light entering the eyes.

HAND PROTECTION
o Appropriate selection of gloves is essential to
protecting hands.
o Chemically protective gloves are one of the most
important tools to minimize dermal exposures to
CHEMICAL SPLASH GOGGLES AND chemicals in research laboratories.
o Selection is based on the laser wavelength and o Gloves should only be used under the specific
power. conditions for which they are designed, as no
o Protective properties can be found printed on the glove is impervious to all chemicals.
eyewear. o It is also important to note that gloves degrade
o Are not as effective as laser safety goggles at over time, so they should be replaced as
filtering all light entering the eyes. necessary to ensure adequate protection.
o Laboratory personnel should use the information
below, and manufacturer compatibility charts
(found under useful resources in the above right
menu), to choose the type and style of glove.
LIGHT LATEX, VINYL OR NITRILE GLOVES
 Disposable latex (powdered or unpowdered) –

ZYLYREE YLYZA MARQUEZ 10

 TRANS: Unit Title
o Used when working with biological hazards
(human blood, body fluids, tissues, bloodborne
pathogens, specimens)
 Disposable nitrile (puncture and abrasion resistant,
protection from splash hazards)
o - Used when working with biological hazards and
chemical splash hazards
 Disposable vinyl (economical, durable, similar to latex)
o - Used when working with biological hazards.
LIGHT CHEMICAL RESISTANT GLOVES
 Natural rubber latex (chemical resistant, liquid-proof)
o - Used when working with small volumes of
corrosive liquids, organic solvents, flammable
compounds
ZYLYREE YLYZA MARQUEZ
LIGHT TO HEAVY CHEMICAL RESISTANT GLOVES
 Nitrile (chemical resistant, good puncture, cut and
abrasion resistance)
o - Worn when using apparatus under pressure, air
or water reactive chemicals
HEAVY CHEMICAL RESISTANT GLOVES
 Butyl (high permeation resistance to most chemicals)
o - Used when working with large volumes of
organic solvents, small to large volumes of
dangerous solvents, acutely toxic or hazardous
materials
INSULATED GLOVES
 Terrycloth autoclave (heat resistant)
o - Used when working with hot liquids and
equipment, open flames, water bath, oil bath
 Cryogen (water resistant or waterproof, protection against
ultra-cold temperatures)
o - Used when handling cryogenic liquid
WIRE MESH GLOVES
 Wire mesh (cut resistant)
o - Used when working with live animals and
exposed to potential cuts
BODY PROTECTION
o Lab coats are required for all wet labs.
o Cotton or cotton/poly blends are sufficient for labs
without risk of fire.
11
 TRANS: Unit Title
o Nomex coats are required for work with
pyrophoric, flammable liquids in quantities of
more than 4 liters or when work involves
flammable liquids and an ignition source such as
a burner.
o Barrier coats must be worn when working with
infectious materials.
o Barrier coats can be autoclaved by placing the
coats in a pan and placing an additional pan of
water in the autoclave.
TRADITIONAL(COTTON/COTTON-POLYESTER
BLEND
o protects skin and clothing from dirt, inks, non-
hazardous chemicals)
 General use; chemical, biological, radiation
and physical hazards
FLAME RESISTANT
o Working with water or air reactive chemicals,
large volumes of organic solvents, and potentially
explosive chemicals
 (e.g., Nomex or other flame-resistant cotton
— resists ignition
BARRIER (PREDOMINANTLY POLYESTER)
o offers splash protection, not flame resistant
 Working with infectious material
RESPIRATORY PROTECTION
o Respiratory protective equipment is only used as
a "last line of defense," and as a result, requires
individual assessment and training.
o Proper fitting and use are key to respirator
efficacy
ZYLYREE YLYZA MARQUEZ
SURGICAL MASK
o Protect against large droplets and splashes
(does not require fit testing)
o Working with live animals; working with infectious
material in BSL-2+ level labs but only protects
your sample from you, not the other way around.
N-95 RESPIRATOR
o Protects against dusts, fumes, mists,
microorganisms (requires fit testing)
o Working with live animals or infectious materials
in BSL-2 level labs with known airborne
transmissible disease
o (e.g., tuberculosis, also required for influenza
(flu); dusty environments.
HALF-MASK RESPIRATOR
o Purifies air, protects against variety of
particulates, vapors, dust, mists, fumes; depends
on filter cartridge used (requires fit testing)
o Working with live animals or infectious materials
with known airborne transmissible disease; dusty
environments; chemical vapors; particulates
FULL FACE RESPIRATORS
o Same as half-mask, with greater protection
factor; eye, mucus membranes and face
protection; depends on filter cartridge used
(requires fit testing)
o Working with live animals or infectious materials
with known airborne transmissible disease; dusty
environments; chemical vapors; particulates
o Note: Respirator cartridges For use in half-mask
respirators and full-face respirators
12
 TRANS: Unit Title

o • P-100: for dust only

o • Organic Vapor (OV): for fumes of organic
solvents only
o • Acid Gas: vapors of hydrochloric acid, sulfuric
acid,

 PPE, or Personal Protective Equipment,

helps prevent staff emergencies on the job
due to inhalation, absorption, irritants, or
other prolonged contact with a cleaning
chemical.
 This actively reduces accidents, improves
the health of your employees, and makes for
a safer, secure work environment
ISOLATION PRECAUTIONS
o barriers between people and microbes that help
prevent the spread of pathogens in the hospital.
o Visitors of a patient who has an isolation sign
outside their door should stop at the nurses'
station before entering the patient's room.
o They must be instructed to:
 - Wash hands before entering and upon
exiting the patient’s room.
 - Wear N-95 mask or surgical mask
(depending on the microbe of the infectious
disease)
 - Wear gown
 - Wear gloves
 - Leave fresh flowers as this may serve as
reservoir inside the patient’s room.

o Protective or reverse isolation is for patients with

very low immune system like cancer patients.
o Door of the room must always be closed, no
fresh flowers or fresh plants inside the room, and
patient wears mask.
o Visitors are limited to at least 1 to 2 inside the
room.
o Visitors need to wear mask, gown, and gloves if
with direct contact to the patient.
o And wash hands before entering and before
going out the patient’s room.

ZYLYREE YLYZA MARQUEZ 13

 TRANS: Unit Title

o Portal of Exit
o Mode of Transmission
o Portal of Entry
o Susceptible Host
o The measures done to break the chain of
transmission of covid-19 are:
 Disinfection of the streets, crowded places
 Quarantine- stay at home
 Isolation of PUIs, PUMs
 Cleaning of surroundings
 Wearing of masks,
 face shield,
 Protective personal equipment (PPE)
 Boosting immune system
 Personal hygiene
 Handwashing
 Hospitalization of covid-19 positive patients
 Contract tracing
 Lockdown
 Swab test
o These measures were done by individuals,
families, and the government to flatten the curve
by stopping the transmission of the agent to
susceptible hosts.
STEPS IN DONNING PERSONAL PROTECTIVE
EQUIPMENT (PPE)
o Will vary based on the level of protection needed.
o Use safe work practices to protect you and limit
the spread of infection
o Keep hands away from face and PPE being
worn.
o Change gloves when torn or heavily
contaminated.
o Limit surfaces touched in the patient
environment.
o Regularly perform hand hygiene.
o Always clean hands after removing gloves.
o The type of PPE used will vary based on the type
of exposure anticipated, and not all items of PPE
will be required.
o NB Masks and goggles are not routinely
recommended for contact precautions.
o Consider the use of these under standard
infection control precautions or if there are other
routes of transmission.
PUTTING ON PERSONAL PROTECTIVE EQUIPMENT
(PPE)
o Perform hand hygiene before putting on PPE.
o The order for putting on PPE is
o Apron or Gown,
o Surgical Mask,
o Eye Protection (where required)
o Gloves.

BREAKING THE CHAIN OF COVID-19

TRANSMISSION
o Agent
o Reservoir

ZYLYREE YLYZA MARQUEZ 14

 TRANS: Unit Title

o Perform hand hygiene immediately on removal.

o All PPE should be removed before leaving the
area and disposed of as healthcare waste.

REMOVING PERSONAL PROTECTIVE EQUIPMENT

(PPE)
o The order for removing PPE is
o Gloves,
o Apron or Gown,
o Eye Protection,
o Surgical Mask

REFERENCES

Notes from the discussion by MICROPARA LAB MODULES

ZYLYREE YLYZA MARQUEZ 15

 TRANS: Unit Title

ZYLYREE YLYZA MARQUEZ 16