CHAINS OF INFECTION

The chain of infection is a model that describes how infections spread.

It has six links:
Agent
Reservoir
Portal of Exit
Mode of Transmission
Portal of Entry
Susceptible Host

Agent- The infectious microorganism, such as a bacterium, virus, or fungus.

Reservoir- The place where the infectious agent lives and reproduces.Reservoirs can
be people, animals, or the environment.
Portal of Exit- The way the infectious agent leaves the reservoir. This could be through
a wound, cough, or sneeze.
Mode of Transmission- The way the infectious agent travels from the reservoir to a new
host. This could be through direct contact, indirect contact, or airborne transmission.
Portal of Entry- The way the infectious agent enters the new host. This could be through
a break in the skin, the mouth, or the nose.
Susceptible Host- A person or animal who is not immune to the infectious agent.

From what I understood, the chain of infection is like a roadmap for understanding how
infections spread from one person to another. It has six important parts: the germ that
causes the infection, the place it lives and multiplies, how it leaves that place, how it
travels to a new person, how it gets inside that person, and finally, the person who can
catch the infection. By studying these parts, we can learn how to stop infections from
spreading and keep people healthy. It's a key tool in healthcare and keeping our
communities safe.

NON-SPECIFIC HOST RESISTANCE

The human body possesses a remarkable arsenal of non-specific host resistance

mechanisms that provide an immediate defense against potential pathogens. These
innate defenses, described as nonspecific because they do not target specific
pathogens, are essential for preventing infections from taking hold in the body. This
synthesis paper delves into the multifaceted nature of nonspecific innate immunity,
emphasizing that it encompasses physical, chemical, and cellular defenses. It explores
how these defenses work in harmony, providing a robust first line of protection against a
wide range of potential threats.

● Physical Defenses:
The body's physical defenses constitute its most fundamental nonspecific
resistance. The skin, composed of three layers, serves as a robust barrier
against external microbes. Dead skin cells, shed regularly, take away surface
microbes. This epidermal layer's composition, filled with keratin, creates a tough
and resilient surface, resistant to degradation by bacterial enzymes.

● Mucous Membranes:
Mucous membranes lining various body parts, such as the respiratory and
digestive tracts, offer another layer of nonspecific defense. These membranes
consist of epithelial cells bound by tight junctions, secreting protective mucus that
traps debris and microorganisms. In many regions, mechanical actions, like the
mucociliary escalator in the respiratory system, aid in moving trapped microbes
out of the body. This combination of physical and mechanical defenses provides
a formidable barrier against infections.

● Endothelia:
The endothelia, the tightly packed cells lining various tissues, serve as frontline
defenses against invaders. For example, the blood-brain barrier's endothelial
cells prevent microbes in the bloodstream from entering the central nervous
system, shielding it from infection. Mechanical defenses in different regions,
including urinary peristalsis, keep microbes from taking residence and causing
infection.

● Microbiome:
Resident microbiota in various body regions act as a first line of defense by
competing with pathogens for resources. In the vagina, for instance, they
outcompete opportunistic pathogens, preventing infections by limiting nutrient
availability. Disruption of the microbiota can lead to increased susceptibility to
infectious diseases, highlighting the importance of these symbiotic
microorganisms.

● Chemical Defenses:
In addition to physical barriers, the innate nonspecific immune system employs
chemical mediators to inhibit microbial invaders. Chemical defenses are essential
in inhibiting colonization and infections. The body's chemical defense arsenal
 includes sebum on the skin's surface, gastric fluids in the stomach, urine's
flushing action in the urinary tract, and saliva in the oral cavity.

● Antimicrobial Peptides (AMPs):

AMPs, a special class of cell-derived mediators, play a pivotal role in
antimicrobial defense. They have broad-spectrum antimicrobial properties and
can induce cell damage in various ways, preventing the establishment of
infections. Some AMPs are produced continually, while others are primarily
triggered in response to invading pathogens.

● Plasma Protein Mediators: Plasma contains various proteins that maintain

homeostasis and contribute to the nonspecific innate immune response.
Acute-phase proteins are produced in response to inflammation, while the
complement system, cytokines, and interleukins play essential roles in immune
signaling and microbial defense.

● Inflammation-Eliciting Mediators: Many chemical mediators discussed in this

paper contribute to inflammation and fever, essential nonspecific immune
responses. Cytokines, histamine, prostaglandins, and other mediators stimulate
inflammation, fever, and edema, supporting the activities of white blood cells and
inhibiting pathogen growth.

The human body's nonspecific innate defenses, encompassing physical, chemical, and
cellular mechanisms, form a complex and integrated network of protection against
potential pathogens. These defenses work harmoniously to provide a rapid response
against infections, creating a formidable barrier that is crucial for maintaining health and
well-being. Understanding the multifaceted nature of non-specific host resistance is
essential for appreciating the body's remarkable ability to fend off a wide range of
potential threats.

● Formed Elements of Blood:

Blood consists of plasma and formed elements, the latter originating from hematopoietic
stem cells. The three major categories of formed elements are red blood cells (RBCs),
platelets, and white blood cells (WBCs).

● Red Blood Cells (RBCs):

RBCs are primarily responsible for transporting oxygen to tissues and play a crucial role
in maintaining overall health.

● Platelets:
Platelets, or thrombocytes, are essential for blood clot formation and tissue repair.

● White Blood Cells (WBCs):

WBCs, also known as leukocytes, serve as vital components of both innate and
adaptive immunity.

● Granulocytes:
Granulocytes are a subgroup of WBCs characterized by the presence of granules in
their cytoplasm. This category includes neutrophils, eosinophils, and basophils.

● Neutrophils:
Neutrophils are instrumental in combating extracellular bacteria through mechanisms
like phagocytosis and degranulation, leading to pus formation.

● Eosinophils:
Eosinophils play a role in protecting against parasites, helminths, and participating in
allergic reactions through their granules' contents.

● Basophils:
Basophils, important in allergic responses and inflammation, release histamine and
other chemical factors when activated.

● Mast Cells:
Mast cells, resembling basophils, are involved in allergic responses and reside in
tissues, playing a role in inflammatory reactions.

● Agranulocytes:
Agranulocytes lack visible granules and consist of lymphocytes and monocytes. They
contribute to both innate and adaptive immunity.

● Natural Killer Cells:

Natural killer cells are a type of lymphocyte involved in nonspecific immune responses,
targeting abnormal cells such as infected or cancerous cells.

● Monocytes:
Monocytes differentiate into macrophages and dendritic cells upon entering tissues,
serving as essential phagocytic cells and linking innate and adaptive immune
responses.

● Pathogen Recognition:
Phagocytes recognize pathogens through pattern recognition receptors (PRRs) like
toll-like receptors (TLRs) that bind to pathogen-associated molecular patterns (PAMPs).

● Phagocytosis:
Phagocytes engulf pathogens in vesicles, forming phagosomes, which fuse with
lysosomes to create phagolysosomes. This process leads to the destruction of
pathogens.

● Inflammatory Response:
Inflammation is an essential part of the immune response. It results from increased
vascular permeability, vasodilation, and the release of proinflammatory chemicals,
leading to erythema, edema, heat, pain, and altered function at the site of injury or
infection.

● Acute Inflammation:
Acute inflammation is a short-lived and localized response to injury or infection, aiding in
the elimination of pathogens and the repair of damaged tissues.

● Chronic Inflammation:
Chronic inflammation occurs when acute inflammation is insufficient to clear pathogens,
leading to prolonged low-level battles and possible tissue damage. Granulomas can
form in response to chronic inflammation.

● Fever:
Fever is a systemic response to infection, regulated by the hypothalamus. It enhances
immune defenses, inhibits pathogen growth, and promotes immune activation.
However, excessively high fevers can be detrimental.

Cellular defense plays a vital role in protecting the body against infections and
maintaining overall health. Understanding the components and mechanisms involved in
cellular defense, including blood elements and immune cells, is crucial for effective
disease prevention and treatment. Acute inflammation and fever are essential parts of
the immune response, but they must be carefully regulated to prevent harm to the body.
Infection and Host Resistance: Lesson III
 VACCINES IN THE ELIMINATION OF DISEASE

1 CONCEPT OF VACCINATION

Key Terms related to Vaccination

1. IMMUNITY: When your body learns how to fight a disease, it becomes immune
to it, which means you are less likely to get sick from that disease.
2. HERD IMMUNITY: Happens when people in a community are protected from a
disease, either because they got vaccinated or they already had the disease and
got better.
3. DISEASE ERADICATION: Means completely getting rid of a disease from
everywhere in the world.

● BASIC MECHANISM ON HOW VACCINE WORKS

As a vaccine is given as a shot or injected:
1. RECOGNITION BY IMMUNE SYSTEM: Acts like body's defense force,
recognizes these pieces of the germ as invaders.
2. IMMUNE RESPONSE: It produces special proteins called antibodies that are
designed to fight that particular germ.
3. LEARNING AND MEMORY: If you're exposed to the real, strong germ, it can
quickly recognize it and fight it off effectively.
4. LONG-TERM PROTECTION: It prevents you from getting sick or reduces the
severity of the illness when in contact with the actual disease-causing germ.

● 2 COMMON TYPES OF VACCINES TO PREVENT INFECTIOUS DISEASES

Live Attenuated
Inactivated Vaccine

Live Attenuated Vaccine

Composition: Live attenuated vaccines are made from weakened, live forms of the
disease-causing microorganisms (usually viruses or bacteria). These organisms are
modified in a laboratory to make them less harmful.

Immune Response: When a live attenuated vaccine is administered, the weakened

microorganisms can replicate in the body, causing a mild infection. This mild infection
triggers a strong and long-lasting immune response.

Effectiveness: They closely mimic a natural infection, so the immune system

remembers how to fight the real disease.
Examples: Measles, mumps, and rubella (MMR) vaccine, the oral polio vaccine (OPV),
and the yellow fever vaccine.

Inactivated Vaccine
Composition: Inactivated vaccines, also known as killed vaccines, are made from
microorganisms that have been completely killed or inactivated. These microorganisms
cannot replicate or cause disease.

Immune Response: When an inactivated vaccine is administered, it contains pieces of

the killed microorganisms or proteins from them. These pieces stimulate the immune
system to produce an immune response.

Effectiveness: Inactivated vaccines may require multiple doses or booster shots to

achieve and maintain immunity. The immune response they induce may not be as
strong or long-lasting as that of live attenuated vaccines.

Examples: Common examples of inactivated vaccines include the polio vaccine

(injected, also known as IPV), the hepatitis A vaccine, and the influenza vaccine (flu
shot).

2 IMPORTANCE OF VACCINE IN PREVENTING DISEASES

● Herd Immunity
Herd immunity, also known as community immunity. It is a crucial concept in public
health and vaccination. It occurs when a high percentage of individuals within a
community or population become immune to a particular infectious disease, either
through vaccination or previous infection. This collective immunity helps protect
vulnerable populations who are unable to receive vaccines due to medical reasons or
are at a higher risk of severe complications.

● How Herd Immunity works?

1. High Vaccination Rates: When a significant portion of the population is
vaccinated against a disease, it becomes challenging for the disease to spread
within that community because there are fewer susceptible individuals for the
virus or bacteria to infect.
2. Breaking the Chain of Transmission: Vaccinated individuals act as barriers or
shields, interrupting the chain of transmission. When a vaccinated person is
exposed to the disease, their immune system quickly recognizes and fights it off,
preventing further spread.
3. Protecting Vulnerable Groups: Vulnerable populations, such as infants who are
too young to be vaccinated, individuals with certain medical conditions that
 contraindicate vaccination, and the elderly, are at higher risk of severe illness or
complications from infectious diseases. Herd immunity helps protect them
because the disease is less likely to be present in the community.

Importance in Protecting Vulnerable Groups

1. Infants: Babies are often too young to receive some vaccines, like those for
measles or whooping cough. Herd immunity reduces the risk of these diseases
reaching infants.

2. Individuals with Medical Conditions: Some people, due to medical conditions

or allergies, cannot receive vaccines safely. Herd immunity offers protection to
them.
3. Elderly: Older individuals often have weaker immune systems and may not
respond as well to vaccines. Herd immunity helps shield them from diseases like
the flu.

● VACCINE HESITANCY
So here are some common reasons on why people are hesitant to be vaccinated:

SAFETY CONCERNS
● Worries about vaccine side effects.
● Misunderstandings about vaccine ingredients, such as preservatives or
adjuvants.
● Fears of long-term health consequences.
MISINFORMATION
● Spread of false information on social media and websites.
● Lack of trust in government or healthcare authorities.
● Misleading anecdotes and narratives about vaccine risks.
RELIGIOUS BELIEFS
● Some religious groups have objections to vaccines due to moral or ethical
concerns.
● Conflicts between faith and vaccination can be a barrier.

3 CURRENT VACCINATION PROGRAMS

Here are some of the current vaccination programs:

● COVID-19 VACCINATION
COVID-19 vaccination programs have been implemented worldwide to combat the
coronavirus pandemic. These programs involve the distribution and administration of
vaccines developed to protect against the SARS-CoV-2 virus. Efforts include mass
vaccination campaigns, prioritizing healthcare workers, the elderly, and high-risk
populations.
 ● INFLUENZA VACCINATION
Seasonal influenza vaccination campaigns are conducted annually to reduce the spread
and impact of seasonal flu viruses. These programs often target vulnerable populations,
including the elderly and individuals with certain medical conditions.
● CHILDHOOD VACCINATION
Routine childhood vaccination programs continue to protect children from a range of
vaccine-preventable diseases, such as measles, mumps, rubella, polio, and more.
These programs are essential to maintain herd immunity.
● Human Papillomavirus (HPV) VACCINATION
HPV vaccination programs aim to prevent cervical and other cancers caused by the
human papillomavirus. Typically, these programs target preadolescent and adolescent
populations.
● Tetanus, Diphtheria, and Pertussis (Tdap) VACCINATION
Booster shots for tetanus, diphtheria, and pertussis are important to maintain immunity
against these diseases, particularly for adults and pregnant women.

COVID 19-VACCINATION PROGRAM

This program aims to achieve the following goals:

Vaccine Development and Approval: It involves the development of safe and

effective vaccines against COVID-19. Multiple vaccine candidates were
researched, developed, and tested in clinical trials to ensure their safety and
efficacy. Regulatory agencies like the FDA (U.S.), EMA (Europe), and WHO
played a vital role in reviewing and approving these vaccines for emergency use
or full authorization.
​
Global Distribution and Allocation: Vaccines are distributed and allocated to
countries based on purchase agreements with manufacturers, contracts with
pharmaceutical companies, and participation in initiatives like COVAX. The
objective is to ensure equitable access to vaccines for all countries, regardless of
their income levels.

Vaccine Rollout and Administration: Vaccination centers and clinics are set up
to administer the vaccines. Countries implement mass vaccination campaigns to
ensure efficient distribution and coverage. High-priority groups, such as
healthcare workers and the elderly, are usually among the first to receive
vaccines.

Challenges and Considerations: Challenges in the program include

addressing vaccine hesitancy, combating misinformation, and overcoming
logistical hurdles to ensure that vaccines reach even the most remote areas.
Adapting to new variants of the virus also remains a concern.

Achievements: As of September 2021, millions of people worldwide had received at

least one dose of a COVID-19 vaccine. Many countries reported a decline in COVID-19
cases and hospitalizations as vaccination coverage increased, demonstrating the
program's effectiveness.

COVID-19 vaccines offer critical benefits, including highly effective prevention of severe
illness, hospitalization, and death, contributing to herd immunity, aiding economic
recovery, and bolstering global public health efforts. However, they may come with mild
side effects for some individuals and have faced challenges like vaccine hesitancy and
misinformation.