10.

1 INFECTIOUS DISEASES:

Infectious diseases are diseases caused by pathogens which are passed from
infected people to uninfected people called disease transmission.
Disease is often an illness or disease of mind or body that leads to poor
health.Some pathogens are transferred from human to human but some
that can survive in food, water, feces etc are transferred indirectly.
Some diseases such as cold or influenza last for a short period but some other
diseases like HIV/AIDS have no permanent cure and treatment is carried out the
entire lifetime.

Some people who are symptomless are called disease carriers.

The way a pathogen transfers from one host to another is known as transmission
cycle. To break this transmission cycle we require control methods which include
vaccines that make us immune to specific pathogens.
Smallpox and rinderpest have been eradicated completely.
Diseases that are always in a population are known as endemic e.g malaria in
tropical reigns.
1. Incidence: no. of people diagnosed over a specific time.
2. Prevalence: no. of people who have a disease at one time.
3. Epidemic: sudden increase in no. of people with a disease.
4. Pandemic: increase in number of cases in the world.
5. Mortality rate: no. of deaths over a specific time.

CHOLERA

TRANSMISSION:
Pathogen that causes cholera is vibrio cholerae which is a bacterium.
A water borne disease so spreads in areas with unhygienic water and food.
Cholera enters the small intestine via the stomach so if the stomach has ph of 4.5
the cholera doesn't survive but if it does enter the small intestine it disrupts the
epithelium lining the small intestine and causes the salt and water to leave the
blood causing severe diarrhea which if not treated within 24 hours can be fatal.
TREATING:
Recovery from cholera is pretty easy and death can be avoided by either oral
rehydration or intravenously.
The disease can be treated pretty cheaply by glucose and salts.
It is important to ensure that the person's fluid intake is equal to the fluid loss.
PREVENTING CHOLERA:
Cholera spreads from untreated feces in underdeveloped cities or countries that
cannot provide a developed sewage system or use human feces as fertilizers.
A vaccine approved by the USA in 2016 provided short term protection against
cholera.
MALARIA

TRANSMISSION OF MALARIA
Most cases of malaria are caused by plasmodium.
The female anopheles mosquito is the disease vector of malaria; it transfers the
diseases from an infected person to an uninfected person.
Malaria can also transfer from reused needles through blood or from mother to
fetus.
● Feed on human blood takes up proteins needed for growing egg and
pathogen gametes in the blood meal.
● Male and female gametes fuse in the mosquito's gut to form ineffective
stages.
● These move to the mosquito's salivary glands.
● The mosquito injects an anticoagulant from its salivary gland that ensures
the blood doesn't clot.
● The ineffective stages enter with the anticoagulant into the host's body into
the blood where they multiply.
P.falciparum is a species that causes severe or fatal malaria.
Temperature conditions such as humidity or rain can increase the probability of
malaria spreading.
Malaria is also found in areas where people of low or no immunity are.
If people are continuously infected with different strains of malaria they become
immune.
You are immune to malaria for the same amount of days you had it.

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TREATING MALARIA
Anti malarial drugs such as quinine and chloroquine are used to treat infected
people.
Chloroquine also acts as a preventative that can be taken before, after or during
an infected insect bite.This inhibits protein synthesis and prevents the parasite
from spreading.
Proguanil has the ability to prohibit sexual reproduction of plasmodium.
Many countries' populations have developed resistance to chloroquine so
mefloquine is an alternative though it has side effects e.g dizziness, vomiting etc.
The best available treatment for P.falciparum is (ATC) artemisinin based
combination therapy which contains drugs from artemisia annua and mefloquine.
PREVENTING MALARIA
1. Reduce the number of mosquitoes.
2. Avoid being bitten by mosquitoes.
3. Use prophylactic drugs to prevent plasmodium from infecting people.
Mosquitoes lay their eggs in water larvae hatch and develop in water but the
pupae breathe above water so oil can be spread on the surface of the water.
● Stock ponds and drainage ditches with fishes that feed on mosquito
larvae.
● Spraying the bacterium bacillus thuringiensis.
● Avoid being bitten by not going out when the mosquito is most active.
● Mosquito nets and insect repellents should be used while sleeping.
● Insecticides can be sprayed inside houses.
● Avoid leaving the house after dusk.
● Malaria is most common in pregnant women and children.
Mosquirix is a vaccine that provides partial protection in kids.
Use of modern gene sequencing and drug design targeting vaccines towards
different stages of mosquito and targeted vaccines against different stages of
parasites life cycle will lead to improvement in control of malaria.

HIV/AIDS
Human immunodeficiency virus (HIV) can lead to acquired immunodeficiency
syndrome (AIDS).
HIV is a retrovirus which means that its genetic material is RNA not DNA.Once
inside the host cell viral RNA is converted back to DNA.

The virus infects and destroys cells of the

body's immune system so that their
numbers decrease.These cells are known
as T-helper lymphocytes.A decrease in the
number of the cells makes the body unable
to defend itself from various infections that
take advantage of the weakened immune
system.
TRANSMISSION OF HIV
HIV is a virus that is spread by intimate human contact,there is no vector.The
virus is unable to survive outside the human body.Transmission is only possible
by the direct exchange of body fluids this means HIV is spread most easily
through intercourse,blood donation and sharing of needles.It can also be
transmitted via the mother to child from the placenta.
The mucous lining of the rectum is not very thick as that of a vagina as a result
the rectal lining is easily damaged during intercourse and the virus can pass from
semen to blood. Having multiple partners both homosexual and hetrosexual all
viruses spread more widely.
HIV is a slow virus and after infection there may not be any symptoms until years
later.Some people do not develop any initial symptoms although there are often
flu-like symptoms for weeks after getting the virus.
Kaposi sarcoma is caused by a herpes like virus that is associated with
AIDS.Kaposi sarcoma and cancers of all internal organs are now most likely
causes of death of people with AIDS along with degenerative diseases of the
brain such as dementia.
TREATING HIV/AIDS
There is no cure of AIDS and no vaccine for HIV.There has been success in
treating people with drugs.Drug therapy can slow down the onset of AIDS quite
dramatically.
Drugs are expensive and have a variety of side effects ranging from mild and
temporary (rashes,headaches,diarrhea) to the severe and permanent (nerve
damage,abnormal fat distribution).
If used in combination, two or more drugs prevent replication of virus inside the
host cell and can prolong life.Drugs are similar to DNA nucleotide e.g
zidovudine.Zidovudine binds to viral enzyme reverse transcriptase and blocks it’s
action.Stops the replication of the viral genetic material and leads to increase in
some of the body,s lymphocytes.The pattern and timing of medication through the
day must be strictly followed.
PREVENTING HIV/AIDS
The spread of HIV/AIDS is difficult to control.It can be transmitted by people who
are HIV+ and have no symptoms and don't know they are infected.The virus
changes surface proteins which make it hard for the immune system to recognize
it.
People can be educated about the spread of the infection and encouraged to
change their behavior and protect themselves and others.Condoms,femidoms etc.
should be used to prevent spread of infection via intercourse.
Injecting drug users are advised to give up their habit and stop sharing needles to
take their drug in some other way.Exchange used needles for sterile one’s.Blood
collected from blood donors is screened for HIV and heat treated to kill any virus.

TUBERCULOSIS(TB)
TB is caused by either of two bacteria Mycobacterium tuberculosis and
mycobacterium bovis.These pathogens live inside the human cells particularly the
lungs.
People with inactive TB infection don't spread it to others but the bacteria can
later become active and this is most likely when people are weakened by other
diseases.Or they suffer from malnutrition, diabetes, consume large amounts of
alcohol etc.
Active forms of TB can cause persistent cough as a defense mechanism, cells
release a hormone that causes a fever and suppresses the appetite.TB is often
the first infection to strike HIV+ people.TB is the leading cause of death among
people with HIV.
TRANSMISSION OF TB
TB is spread when infected people with active form of illness cough or sneeze the
bacteria is carried in the air as tiny droplets of liquids.TB spreads most rapidly
among people living in overcrowded conditions.People who sleep together in
large numbers are also particularly at risk, this disease attacks mostly people who
are poor malnutritioned or HIV+.
Forms of TB caused by M.bovis also occurs in cattle and is spread to humans in
meat and milk.The antibiotic streptomycin was introduced in the 1940s and this
decreased the bacteria of TB.
The incidence of TB is much higher in areas like london because:
● Some strands of TB bacteria are resistant to drugs.
● The HIV/AIDS pandemic.
● Poor housing in inner cities and homelessness.
 ● The breakdown of TB control programs.
TREATING TB
Firstly the doctor takes the samples of sputum (mucus and pus) from their lungs
to test for TB.If TB is confirmed then the patient is isolated.If they are infected with
the drug resistant strain of the bacterium the treatment involves using several
drugs to ensure that all the bacteria is killed.If not killed drug resistant forces
remain to continue the infection.The treatment is a long one 6-8 months or longer.
DOTS(direct observation treatment short course)involves health workers or
responsible family members making sure that patients take their medicine
regularly for 6-8 months.Drugs widely used are isoniazid and rifampicin.Drug
therapy cures 95% of all patients.

DRUG RESISTANT TB
Antibiotics act as selective agents killing drug sensitive strains and leaving behind
the resistive ones.Drug resistance occurs as a result of mutation in the bacterial
DNA.Three drugs are used, chance of resistance arising in all three of them is
one in a thousand million.If four drugs are used the chance is reduced to one in a
billion.
If TB is not treated, or the person stops the treatment before the bacteria are
completely eliminated,the bacteria spread throughout the body,increasing the
likelihood that mutations will arise,as the bacteria survive for a long time and
multiply.
MDR-TB strains of TB are resistant to at least the two main drugs used to treat TB
isoniazid and rifampicin.Extremely drug resistant TB (XDR-TB) emerged as a very
serious threat to health.These strains of TB can take two years or more to treat
with drugs.New drug called bedaquiline is now available to treat MDR-TB.

PREVENTING TB
The only vaccine currently available for TB is the BCG which is derived from the
M.bovis and protects 70-80% of people who receive it.No vaccine can be
administered to protect adults.TB can be transmitted between human and
cattle.TB bacteria is killed when milk is pasteurized.

10.2.ANTIBIOTICS
Antibiotics is a substance that kills or stops the growth of bacteria without harming
the infected persons cells.Derived from living organisms and made more effective
by chemical processes.

HOW ANTIBIOTICS WORK

Antibiotics interfere with some aspect of growth or metabolism of the target
bacterium by synthesis of cell walls, activity of proteins in cell surface
membranes, enzyme action, DNA synthesis and protein synthesis.
Bacterial cell wall is made up of peptidoglycan.In bacterial cell wall, peptidoglycan
are held together by cross links.Penicillin prevents synthesis of the cross links by
inhibiting the enzymes that build these cross links.Penicillin is only active against
bacteria while they are growing.

When a newly formed bacterial cell is growing it secretes enzyme called

autolysins which make holes in the cell wall These holes allow the peptidoglycan
chains to link together but penicillin prevents the peptidoglycan chains from linking
together.Autolysins continue to make more holes weakening the cell wall and
eventually bursting because of turgor pressure.
ANTIBIOTIC RESISTANCE
The ability of bacteria or fungi to grow in the presence of an antibiotic that would
normally slow their growth or kill them, antibiotic resistance arises by mutation
and becomes widespread when antibiotics are overused.
Penicillin has no effect on M.Tuberculosis because the thick cell wall of this
bacterium is not very permeable and the bacterium has a gene that codes for a
enzyme that catalyzes the breakdown of penicillin.In some cases antibiotics
cannot bind to the intended site of action.
Bacteria is sensitive to an antibiotic means it is susceptible to that antibiotic.It may
become resistant if they gain a gene coding for a protein that protects them from
the antibiotic.
Penicillin has a structure that can be broken down by B-lactamase (penicillinase)
enzymes.Pathogenic bacteria have become resistant to penicillin because they
have acquired the genes t5hat code for these enzymes.
During conjugation plasmids are transferred from a donor bacterium to a
recipient.Transfer a part of the DNA from circular DNA the same way.Thus It is
possible for resistance to a particular antibiotic to arise in one species of
bacterium and be passed on to another.

CONSEQUENCES OF ANTIBIOTIC RESISTANCE

Resistance may first appear in a non pathogenic bacterium but then be passed to
pathogenic species.Bacteria living where there is excessive use of antibiotics can
cause them to have plasmids carrying resistance genes for several antibiotics.
Methicillin resistant staphylococcus aureus (MRSA) has become a problem in
hospitals around the world and in prisons in the USA.MRSA causes dangerous
infections mostly controlled by vancomycin, an antibiotic often used as a last
resort.Another bacterium common in hospitals enterococcus faecalis developed
resistance to vancomycin and this resistance passed onto S.aureus.
REDUCING THE IMPACT OF ANTIBIOTIC RESISTANCE
Bacterium resistance to a particular antibiotic may not be resistant to that
antibiotic with a slightly altered chemical structure.We should try to reduce the
number of circumstances in which bacteria develop resistance to antibiotics by:
● Using antibiotics only when appropriate.
● Reducing the number of countries in which antibiotics are sold without
doctor prescription.
● Avoiding use of wide spectrum antibiotics and using one specific to
infection.
● Making sure that patients complete their cpurse od medication.
● Making sure that patients dont keep unused antibiotics for self medication
later.
● Changing the type of antibiotic used for certain diseases.
● Avoiding using antibiotics in farming to prevent rather than cure the
infection.