LINESES, PRINCESS KATE H.

DMD III - MAXILLA

08/31/2023
Activity 2
Chain of Infection Worksheet

1. Outline the chain of infection by identifying the reservoir(s), portal(s) of exit, mode(s) of transmission, portal(s) of entry, and factors in host
susceptibility for the following common diseases
a. Dengue (Information about dengue fever is provided as an example).
b. Covid19
c. Polio
d. Tetanus
e. Hepatitis A
f. Hepatitis B
g. Tuberculosis

Disease Reservoir(s) Portals of exit Mode(s) of transmissiom Portal(s) of entry Factors in host susceptibility
a. Dengue Humans serve as the Usually, the blood is the By the bite of an Aedes mosquito Through the mosquito It is influenced by a combination
virus's main reservoir. dengue virus's portal of that is infected with a dengue bite wound, the virus of genetic, immunological, and
exit from an infected virus enters the victim's environmental factors.
person. bloodstream.
b. Covid19 The SARS-CoV-2 virus Respiratory secretions When a carrier coughs, sneezes, The respiratory system Similar to other infectious
is thought to have bats serve as the COVID-19 talks, or breathes, respiratory is the primary entry diseases, a number of factors
as its main reservoir, virus's main exit point. droplets are released that are point by which the virus affect how susceptible a host is
with a possible This includes respiratory the main way the virus is spread enters the body. The to the COVID-19-causing
pangolin species droplets released when an from person to person. Indirect virus's particles can SARS-CoV-2 virus. Age, immune
serving as an infected person speaks, transmission occurs when a enter the respiratory response, genetics, blood type,
intermediary host and breathes, coughs, sneezes, person contacts a contaminated tract and possibly infect and underlying medical issues are
a possible route for or any other respiratory surface and eventually touches cells if a person inhales a few examples.
human transmission. motion. their face, primarily their mouth, respiratory droplets
Since then, the virus nose, or eyes. These droplets containing the virus.
has spread widely might settle on surfaces and
throughout human objects.
populations.
c. Polio Humans are the The gastrointestinal
primary reservoir of system serves as the
the poliovirus. The poliovirus' main exit point.
virus can be carried When poliovirus infects a
and shed by infected person, it mainly grows in
people through their the intestines, specifically
feces and, in certain in the intestinal epithelial
cases, through cells that line the
respiratory secretions. intestines. As the virus
multiplies, it might be
released into the stool and
end up in the infected
person's feces.
d. Tetanus The environment The portal of exit is not
contains the bacterium the primary concern in the
Clostridium tetani, case of tetanus because
mainly in soil, dust, the focus is on preventing
and manure. It the initial infection.
produces spores that Tetanus toxoid
can persist in the immunization, which
environment for a very offers immunity against
long time. the tetanus toxin, is the
primary means of
prevention.
e. Hepatitis A Infected humans are The feces of an infected
the primary reservoir person serve as the portal
of the hepatitis A virus. of exit of the hepatitis A
Those who have virus. A viral infection that
hepatitis A expel the affects the liver, hepatitis
virus in their feces, A is primarily spread orally
especially when the and fecally. When a
infection is acute. person has hepatitis A, the
virus multiplies in the liver
and excretes a significant
amount of virus particles
into the bile.
The virus is mainly transmitted
through the fecal-oral route,
which involves coming into touch
with contaminated feces. This
can occur either through direct
contact with the feces of an
infected person or by consuming
tainted food or drink.
Clostridium tetani spores can
enter the body through a wound
or a break in the skin. This
commonly happens whenever
the spores come into contact
with a severe burn, incision from
surgery, deep puncture wound,
or any other opening in the skin.
The fecal-oral pathway is the
main route the virus transmits.
Consuming tainted food, drink,
or beverages or coming into
close contact with an infected
person are two ways this might
happen.
The virus enters the
body through the mouth
and initially infects cells
lining the throat and
intestines.
When spores enter the
body through a wound,
they can germinate into
active bacteria in
low-oxygen situations,
such as deep stab
wounds.
Through the mouth, the
virus enters the body.
Once consumed, it can
make it through the
stomach's acidic
environment and into
the small intestine.
Different factors that affect how
an infection develops affect the
host's susceptibility to the
poliovirus, which causes
poliomyelitis (polio). such as age,
GI health, malnutrition,
socioeconomic circumstances,
and so etc.
The likelihood and severity of the
disease are regulated by a
number of factors that affect the
host's susceptibility to tetanus,
Like wound contamination,
severity, immunization history,
wound treatment, environmental
exposure, and so forth.
Hepatitis A is a viral infection that
predominantly affects the liver,
and the probability and severity
of the infection are influenced by
a number of factors. Including
things like age, immune health,
personal hygiene, travel history,
immunity from prior infections,
and many more.
f. Hepatitis B Infected humans are Hepatitis B virus (HBV) The virus is mainly transmitted Through direct contact Hepatitis B is a viral infection that
the primary reservoir primarily exits the body from mother to child after with contaminated predominantly affects the liver,
of the hepatitis B virus. through an infected childbirth, through sexual blood or other bodily and the likelihood and severity of
Hepatitis B patients person's blood and other contact, and through contact fluids, the virus enters the infection are influenced by a
have the virus in their bodily fluids. Through with contaminated blood. the body. It can get number of factors. such as age at
blood as well as other contact with contaminated Additionally, it can spread via through skin breaches transmission, transmission from
bodily fluids such blood or bodily fluids, other bodily fluids. or mucous membranes. mother to child, sexual activity,
saliva, vaginal fluids, hepatitis B is a viral drug use involving injection,
and semen. Even if infection that mostly vertical transmission, etc.
they do not exhibit any affects the liver.
symptoms, chronic
carriers can still spread
the virus.
g. Tuberculosis Infected individuals The primary portal of exit The airborne route is the main The bacteria enter the A number of factors that affect
are the primary for the tuberculosis (TB) way to transmit TB infection. body through the the likelihood and severity of the
reservoir of the TB bacteria, Mycobacterium Tiny infectious droplets respiratory tract, infection have an impact on the
bacteria. Active TB tuberculosis, is through containing the germs can be particularly the lungs. host's susceptibility to
patients, particularly the respiratory tract. released into the air and inhaled tuberculosis (TB), a bacterial
those with pulmonary by bystanders when a person infection brought on by
(lung) TB, can release with active TB coughs or sneezes. Mycobacterium tuberculosis. For
the bacteria into the example, smoking, diabetes,
air by coughing, constricted housing, age, prior TB
sneezing, talking, or infections, concurrent infections,
even singing. genetic variables, and so forth.

2. For the following diseases, what are the ways you can control the outcome of infection by modifying the environment? Provide specific examples

Changing the environment can be crucial in regulating how infections spread for a variety of disorders. Controlling mosquito breeding
areas is crucial for the prevention of dengue since Aedes mosquitoes are the main vectors of the disease. This could involve emptying containers of
standing water, maintaining water storage sites, employing mosquito nets, and using insect repellents. By increasing indoor air ventilation, which
helps spread infectious droplets and lowers the quantity of bacteria in the air, TB transmission can be lessened. Living situations that are too
crowded make TB transmission more likely. The disease's spread can be stopped by encouraging better housing and living conditions. In the case of
polio, the poliovirus can spread through contaminated water and food. Providing access to sanitary facilities and clean drinking water aids in
 preventing transmission. This lowers the chance of contracting polio. Wearing masks in crowded and indoor environments can dramatically
minimize the transmission of respiratory viruses, including COVID-19. COVID-19 mostly transmitted by respiratory droplets, therefore encouraging
people to keep physical distance from others helps to reduce the spread of the virus. Hepatitis A and B can be transmitted through contaminated
food, drink, and bodily fluids. Good sanitation practices, such as handwashing with clean water and utilizing sanitary facilities, can help prevent the
spread of hepatitis A and B. Finally, tetanus spores in tetanus can enter the body through open wounds and are present in soil. Spore invasion and
subsequent infection can be avoided by taking care of your wounds properly, keeping them clean, and using the right dressings. It's crucial to
remember that, especially for diseases with numerous routes of transmission, altering the environment may not totally reduce the danger of
infection. Other important factors in limiting the effects of infections include efforts to promote public health, vaccinations, education, and the
state of the healthcare system. These actions can be combined with environmental changes to produce stronger disease preventive and control
methods.

Dengue Fact Sheet (taken from the CDC website)

What is dengue?
Dengue is an acute infectious disease that comes in two forms: dengue and dengue hemorrhagic fever. The principal symptoms of dengue are high fever, severe
headache, backache, joint pains, nausea and vomiting, eye pain, and rash. Generally, younger children have a milder illness than older children and adults.

Dengue hemorrhagic fever is a more severe form of dengue. It is characterized by a fever that lasts from 2 to 7 days, with general signs and symptoms that
could occur with many other illnesses (e.g., nausea, vomiting, abdominal pain, and headache). This stage is followed by hemorrhagic manifestations, tendency
to bruise easily or other types of skin hemorrhages, bleeding nose or gums, and possibly internal bleeding. The smallest blood vessels (capillaries) become
excessively permeable (“leaky”), allowing the fluid component to escape from the blood vessels. This may lead to failure of the circulatory system and shock,
followed by death, if circulatory failure is not corrected. Although the average case-fatality rate is about 5%, with good medical management, mortality can be
less than 1%.

What causes dengue?

Dengue and dengue hemorrhagic fever are caused by any one of four closely related flaviviruses, designated DEN-1, DEN–2, DEN-3, or DEN-4.

How is dengue diagnosed?

Diagnosis of dengue infection requires laboratory confirmation, either by isolating the virus from serum within 5 days after onset of symptoms, or by detecting
convalescent-phase specific antibodies obtained at least 6 days after onset of symptoms.

What is the treatment for dengue or dengue hemorrhagic fever?

There is no specific medication for treatment of a dengue infection. Persons who think they have dengue should use analgesics (pain relievers) with
acetaminophen and avoid those containing aspirin. They should also rest, drink plenty of fluids, and consult a physician. Persons with dengue hemorrhagic fever
can be effectively treated by fluid replacement therapy if an early clinical diagnosis is made, but hospitalization is often required.
How common is dengue and where is it found?
Dengue is endemic in many tropical countries in Asia and Latin America, most countries in Africa, and much of the Caribbean, including Puerto Rico. Cases have
occurred sporadically in Texas. Epidemics occur periodically. Globally, an estimated 50 to 100 million cases of dengue and several hundred thousand cases of
dengue hemorrhagic fever occur each year, depending on epidemic activity. Between 100 and 200 suspected cases are introduced into the United States each
year by travelers.

How is dengue transmitted?

Dengue is transmitted to people by the bite of an Aedes mosquito that is infected with a dengue virus. The mosquito becomes infected with dengue virus when
it bites a person who has dengue or DHF and after about a week can transmit the virus while biting a healthy person. Monkeys may serve as a reservoir in some
parts of Asia and Africa. Dengue cannot be spread directly from person to person.

Who has an increased risk of being exposed to dengue?

Susceptibility to dengue is universal. Residents of or visitors to tropical urban areas and other areas where dengue is endemic are at highest risk of becoming
infected. While a person who survives a bout of dengue caused by one serotype develops lifelong immunity to that serotype, there is no cross-protection
against the three other serotypes.

What can be done to reduce the risk of acquiring dengue?

There is no vaccine for preventing dengue. The best preventive measure for residents living in areas infested with Aedes aegypti is to eliminate the places where
the mosquito lays her eggs, primarily artificial containers that hold water.

Items that collect rainwater or are used to store water (for example, plastic containers, 55-gallon drums, buckets, or used automobile tires) should be covered
or properly discarded. Pet and animal watering containers and vases with fresh flowers should be emptied and scoured at least once a week. This will eliminate
the mosquito eggs and larvae and reduce the number of mosquitoes present in these areas.

For travelers to areas with dengue, as well as people living in areas with dengue, the risk of being bitten by mosquitoes indoors is reduced by utilization of air
conditioning or windows and doors that are screened. Proper application of mosquito repellents containing 20% to 30% DEET as the active ingredient on
exposed skin and clothing decreases the risk of being bitten by mosquitoes. The risk of dengue infection for international travelers appears to be small, unless
an epidemic is in progress.

Can epidemics of dengue hemorrhagic fever be prevented?

The emphasis for dengue prevention is on sustainable, community-based, integrated mosquito control, with limited reliance on insecticides (chemical larvicides
and adulticides). Preventing epidemic disease requires a coordinated community effort to increase awareness about dengue/DHF, how to recognize it, and how
to control the mosquito that transmits it. Residents are responsible for keeping their yards and patios free of sites where mosquitoes can be produced.