Infection

HEALTH
• WHO definition of health

Health is a state of complete physical,

mental and social well being and not
merely the absence of disease or infirmity.
• Pathogens -are disease causing microorganisms.
• Pathology -is the scientific study of diseases.
• Etiology -is the cause of disease.
• Pathogenesis - the manner in which a disease develops
• Epidemiology -the science that studies when and
where disease occur and how they are transmitted in
populations is called epidemiology
• Infection is the invasion or colonization of the body by
pathogenic microorganisms. (The multiplication of the
parasites in or on the tissues of the host ).
• Disease is considered as any change from the general
state of good health. Disease occurs when an infection
results in any change from a state of health.
Role of microorganisms in causing an infection

• Infection and immunity involves interaction btwn the

host and the infecting m.o. Based on the
relationship to hosts m.o can be classified as
saprophytes and parasites.

• Saprophytes are free living m.o that are seen on

dead and decaying organic matter. They are generally
incapable of multiplying on living tissues. Parasites
are microbes that can establish themselves and
multiply in hosts
• Parasites may be either pathogens and
commensals.

• Commensal microbes live in complete

harmony with the host without causing any
damage to it. The normal bacterial flora of
the body consist largely of commensals.
 Relationship of m.o to the healthy human body

• Normal flora- Normal flora is a population of m.o that

infects the body without causing disease.

• Some organisms establish a permanent relationship, as

E.coli is always found in large intestine of humans. They
are the permanent microbiota.

• Others like Strepococci may be present for several days

,weeks or months and then disappear. They are the
transient microbiota.

• Normal flora exists on skin ,oral cavity, URT, latter

part of small intestine, large intestine and adult vagina.
 INFECTION
Primary infection Nosocomial infection

cross
Initial infection Reinfection infections
with a parasite occurring in
Subsequent Cross infection hospital
in a host
infections
by the same
when in a patient
parasite in Secondary infection
already suffering
the host
from a disease , a
when in a host whose new infection is
resistance is lowered set up from
by preexisting another host
infection ,a new
parasite sets up an
infection ,it is termed
secondary infection
 Sources of infection in man
• Man- the commonest source if infection for man is man itself.
The parasite may originate from a patient or a carrier. A
carrier is a person who harbours the pathogenic m.o without
suffering from any ill effect from it.
• Animals- animals may act as sources of human infection.
Infectious diseases transmitted from animals to man are
called zoonoses.
• Insects- blood sucking insects may transmit pathogens to
man. The diseases so caused are called arthropod-borne
diseases.
• Soil and water- soil serves as source of tetanus, fungal and
parasitic infection. Water may also act as source of infection.
• Food- presence of pathogens in food may be due to external
contamination (food poisoning) or due to persistent infection I
n meat or animal products.
 Methods of transmission of infection

• Contact
• Inhalation
• Ingestion
• Inoculation
• Insects
• Congenital
• Iatrogenic or laboratory infection (Iatrogenic-
physician induce infection).
Bacterial Diseases
 Diarrhoea
• Diarrhoea is caused by a variety of micro-organisms
including viruses, bacteria and protozoans. Diarrhoea
causes a person to lose both water and electrolytes, which
leads to dehydration and, in some cases, to death.

• Excreta is the main cause of childhood diarrhoeal diseases.

• Diarrhoea is the most important public health problem

directly related to water and sanitation. The simple act of
washing hands with soap and water can cut diarrhoeal
disease by one-third. Next to providing adequate sanitation
facilities, it is the key to preventing waterborne diseases.
Diarrhoea
 Diarrhoea-Causative agents
• Bacterial diarrhea can produce more severe forms of
acute diarrhea. Dysentery is diarrhea associated with
blood (plus or minus mucus) and represents more invasive
infection.
• The most frequently identified organisms causing bacterial
diarrhea are Escherichia coli (most common
worldwide), Shigella, Salmonella, Campylobacter (most
common in children), Yersinia, and Clostridium spp.
• Traveler's diarrhea can be most commonly the result
of Shiga-toxin producing E. coli (STEC), as well as Shigella,
Salmonella, Entamoeba histolytic, Giardia,
Cryptosporidium, Cyclospora, and enteric viruses.
 Diarrhoea
Mode of transmission
• Acute diarrhoeal diseases are usually transmitted by
contaminated hands or ingestion of contaminated
food or drinks, and occasionally by aerosol spread
with contaminated droplets of splashed vomitus.
Outbreaks may occur in settings like institutions and
child care centres.
Incubation period
• The incubation period is usually from a few hours to
5 days after exposure for bacterial diarrhoea and 1 to
3 days for viral diarrhoea.
Management
• Acute diarrhoeal diseases are usually managed by
fluid and electrolyte replacement. The patient should
consult his/her family doctor for proper
management if the diarrhoea is severe. Self-
medication is not advisable.
•Causative organism is Vibrio cholera, which is a Gram negative rod
•Water borne and food borne mode of transmission. The bacteria
must enter the gastrointestinal tract in large no.s since the stomach
acid kills most of the bacteria.
•The bacteria enter the intestine and mover about through the
mucous coating producing powerful toxins.
• The toxin stimulate the production of the enzyme adenyl cyclase.
This enzyme increases the level of AMP which leads to abundant
secretion of fluid by the intestine. The presence of infection also
retards water absorption thru the wall.
• Symptoms include severe dysentery, vomiting
and violent cramps with much loss of fluid
• Blood is thickened and urine production stops.
The sluggish blood flow to the brain stops oxygen
to this vital organ and the person enters into
coma and soon dies
• The critical treatment is to restore the water
balance in the body.
• Immunization with preparation of dead bacteria
provided protection for 6 months.
• Prevention include sanitation personal hygiene
and care in food preparation
Salmonella typhi
• Salmonella typhi, a Gram negative rod is the causative
organism, which is very resistant to envtl conditions .It may
remain alive for long periods in fresh water and food.
• Transmitted through contaminated food and water. Source
of disease is the human carrier. The recovered patient may
continue to harbour bacteria which in shed in faeces for
long periods.
• Contaminated sewage is another source. When it mixes
with drinking water due to broken sewer line or natural
disaster epidemics may follow.
• Flies also transport bacteria from sewage to food or water
• The bacteria is acid resistant ,hence it passes thru
he stomach and enters small intestine, where it
multiplies quickly. There it produces deep ulcers
,constipation and bloody stools are the
indication of bacterial penetration to blood
vessels of intestinal walls. The fever rises
gradually and the skin will be covered with bright
red rose spots.
• Chemically killed bacteria are used in the vaccine
for typhoid fever
 Pulmonary tuberculosis
• If a tuberculosis infection does become active, it
most commonly involves the lungs (in about 90%
of cases). Symptoms may include chest pain and a
prolonged cough producing sputum. About 25%
of people may not have any symptoms (i.e. they
remain "asymptomatic")
• Tuberculosis may become a chronic illness and
cause extensive scarring in the upper lobes of the
lungs. The upper lung lobes are more frequently
affected by tuberculosis than the lower ones
 Extrapulmonary tuberculosis
• In 15–20% of active cases, the infection
spreads outside the lungs, causing other kinds
of TB. These are collectively denoted as
"extrapulmonary tuberculosis“
• Extrapulmonary TB occurs more commonly
in immunosuppressed persons and young
children. In those with HIV, this occurs in more
than 50% of cases
 Extrapulmonary tuberculosis
• Extrapulmonary infection sites include
the pleura (in tuberculous pleurisy),
the central nervous system (in
tuberculous meningitis), the lymphatic
system (in scrofula of the neck),
the genitourinary system (in urogenital
tuberculosis), and the bones and joints
(in Pott disease of the spine), among others.
• .
 Miliary tuberculosis
• A potentially more serious, widespread form
of TB is called "disseminated tuberculosis", it
is also known as miliary tuberculosis. Miliary
TB currently makes up about 10% of
extrapulmonary cases.
• Miliary tuberculosis is a form of tuberculosis
that is the result of Mycobacterium
tuberculosis travelling to extrapulmonary
organs, such as the liver, spleen and kidneys.
Acid fast stain
 Tuberculosis
• This is a disease of crowded populations
,especially of lower socioeconomic groups
• Air borne mode of transmission
• Causative organism is a rod shaped bacterium
Mycobacterium tuberculosis
• . It enters the respiratory tract and grows in the
lung tissue
• Symptoms are chronic cough ,chest pains ,high
fever and flow of thick expectorated matter called
sputum
 Tuberculosis
• Incubation period is 2-10 weeks but 6months
may pass before the symptoms become fully
recognized
• In the infected lung ,cells of macrophages,
leucocytes and T- lymphocytes surround the
parasite and due to deposition of calcium salts
and fibrous materials , a hard nodule-tubercle is
formed. This is visible in the patients’ chest X-ray.
• The tubercle may break apart and spread bacteria
to liver , bone and kidneys. This disease is then
called miliary tuberculosis
 Tuberculosis
• The bacteria does not produce toxins ,but due to the
rapid growth it consumes the tissues.
• Due to the presence of fatty waxy material in cell wall,
the bacterium is much resistant to environmental
changes .
• The organism is acid-fast stain with red carbol fuchsin
stain.
• Bovine tuberculosis, caused by M.bovis is equally
dangerous in cows and humans.
• Bacille Calmette Guerin (BCG) is a preparation of an
attenuated strain of M.bovis that is used in
immunization programs throughout the world.
 Plague
• An infectious disease caused by a gram
negative bacillus named Yersinia pestis.
• Plague is a zoonotic disease. The plague
bacillus is naturally parasitic in rodents,
infection transmitted among them by rat fleas.
• Both male and female fleas transmit the
infection. The fleas acquire infection by
feeding on infected rodents.
• In man plague occurs in 3 forms: bubonic,
pneumonic and septicaemic
 Plague
• In the bubonic form there is swelling of the
lymph nodes
• In septicemic form tissues may turn black and
die ( necrosis )
• In pneumonic form shortness of breath ,cough
and chest pain may occur
 Plague
• Bubonic and septicemic plague are generally
spread through flea bites or handling an
infected animal
• The pneumonic from is generally spread
between people through the air via droplets
• Diagnosis is typically by finding the bacterium
in fluid from a lymph node , blood or sputum
PLAGUE
Acute necrosis due to bubonic plague
Ulceration due to flea bite
 Plague
Transmission of Y. pestis to an uninfected individual is possible
by any of the following means.
• droplet contact – coughing or sneezing on another person
• direct physical contact – touching an infected person,
including sexual contact
• indirect contact – usually by touching soil contamination or
a contaminated surface
• airborne transmission – if the microorganism can remain in
the air for long periods
• fecal-oral transmission – usually from contaminated food or
water sources
• vector borne transmission – carried by insects or other
animals.
•
 Pneumonic plague
• Pneumonic plague is spread by droplet
infection. Bacilli spread thru lymphatics
producing hemorrhagic pneumonia. The
bloody mucoid sputum that is coughed out
contains bacilli in enormous no.s.
• Pneumonic plague is highly infectious and
fatal.
• An attack of plague confers lasting immunity.
 Bubonic plague
• When a flea bites a human and contaminates the
wound with regurgitated blood, the plague carrying
bacteria are passed into the tissue.

• Y.pestis spreads thru the lymphatics of the infected

human until it reaches a lymph node where it
stimulates hemorrhagic inflammation that causes
lymph nodes to expand
• If the lymph nodes is overwhelmed , the infection can
pass into the blood stream causing secondary
septicemic plague and if the lungs` are seeded it can
cause secondary pneumonic plague
 Septicemic plague
• In septicemic plague bacterial endotoxins
cause intravascular coagulation causing tiny
clots through out the body and possible
necrosis from clots
Viral Diseases
• Communicable diseases- diseases that are
transmissible among hosts. These may be
transmitted by direct as well as indirect
methods. Some communicable disease are
further described as contagious, since they
pass with particular ease among hosts. eg.
chicken pox, measles, genital herpes
RABIES
Rabies virus
Rabies virus
 Rabies
• Rabies occurs in most animals in nature from
dogs, cats horses, rats,skunks and bats.
• Rabies is caused by Lyssa viruses including
: rabies virus and Australian bat lyssavirus
• Bullet shaped virus
• Virus enters the tissue during a bite, skin
wound or abrasion from an infected animal.
• Incubation period 6 days to one year.
 Rabies
• Rabies is spread when an infected animal scratches or
bites another animal or human.Saliva from an infected
animal can also transmit rabies if the saliva comes into
contact with the mouth, nose, or eyes.
• Overall dogs are the most common animal involved.
More than 99% of rabies cases in countries where dogs
commonly have the disease are caused by dog bites.
• In Americas, bat bites are the most common source of
rabies infections in humans, and less than 5% of cases
are from dogs.
• Rodents are very rarely infected with rabies.
• The rabies virus travels to the brain by following
the peripheral nerves. The disease can only be
diagnosed after the start of symptoms.
 Rabies
• Animal control and vaccination programs have
decreased the risk of rabies from dogs in a number of
regions of the world. Immunizing people before they
are exposed is recommended for those who are at high
risk.
• The high-risk group includes people who work with
bats or who spend prolonged periods in areas of the
world where rabies is common.
• In people who have been exposed to rabies, the rabies
vaccine and sometimes rabies immunoglobulin are
effective in preventing the disease if the person
receives the treatment before the start of rabies
symptoms.
 Rabies
• Washing bites and scratches for 15 minutes with
soap and water, povidone iodine, or detergent
may reduce the number of viral particles and may
be somewhat effective at preventing
transmission.
• Only a few people have survived a rabies
infection after showing symptoms and this was
with extensive treatment known as
the Milwaukee protocol.
• Merieux human diploid cell vaccine is the new
rabies vaccine available. It produces high amt of
antibodies after three injections in the arm.
 Rabies
• Rabies is a viral disease that causes acute inflammation
of the brain in humans and other warm-
blooded animals.Early symptoms can include fever and
tingling at the site of exposure.These symptoms are
followed by one or more of the following symptoms:
violent movements, uncontrolled excitement, fear of
water, an inability to move parts of the body,
confusion, and loss of consciousness.Once symptoms
appear it nearly always results in death.
• The time period between contracting the disease and
the start of symptoms is usually one to three months;
however, this time period can vary from less than one
week to more than one year. The time is dependent on
the distance the virus must travel to reach the central
nervous system.
Mumps
Mumps virus
 Mumps
• Disease of children’s salivary glands
• Disease transmitted by droplets, contact and
fomites
• The virus is present in urine, blood and
cerebrospinal fluid
• Mumps virus is single stranded RNA virus
Mumps
 Mumps
• Mumps, also known as epidemic parotitis, is a viral
disease caused by the mumps virus.
• Initial signs and symptoms often include fever, muscle
pain, headache, and feeling tired.This is then usually
followed by painful swelling of one or both parotid glands.
• Symptoms typically occur 16 to 18 days after exposure and
resolve after 7 to 10 days.Symptoms in adults are often
more severe than in children.About a third of people have
mild or no symptoms.
• Complications may include infections of the coverings of
the brain (15%), pancreatitis, (4%). permanent deafness,
and painful testicular swelling which uncommonly results
in infertility.Women may develop ovarian swelling but this
does not increase the risk of infertility.
 Mumps
• Mumps is highly contagious and spreads rapidly among people
living in close quarters.
• The virus is transmitted by respiratory droplets or direct contact
with an infected person. Only humans get and spread the
disease.People are infectious to each other from a few days before
the start of symptoms to four days after.
• After an infection a person is typically immune for life.Reinfection
is possible but tends to be mild.
• Diagnosis is usually suspected due to parotid swelling and can be
confirmed by isolating the virus on a swab of the parotid duct.
• Testing for IgM antibodies in the blood is simple and may be
useful; however, can be falsely negative in those who have been
immunized.
 Mumps
• Mumps is preventable by two doses of the mumps vaccine.
• Most of the developed world includes it in their immunization
programs, often in combination with measles and rubella vaccine.
• Countries that have low immunization rates may see an increase
in cases among older age groups and thus worse outcomes. There
is no specific treatment.
• Efforts involve controlling symptoms with pain medication such
as acetaminophen.
• Intravenous immunoglobulin may be useful in certain
complications. Hospitalization may be required if meningitis or
pancreatitis develops. About one per ten thousand people who
are infected die.
Measles
 Measles

• RNA virus
• Disease characterized by the presence of red rash on
the skin
• Highly communicable respiratory disease of children.
• In the beginning there is fever ,coughing and
sneezing, the most communicable part of the disease

•
Measles virus
 Measles
• Measles, also known as morbilli, rubeola, or red measles, is a
highly contagious infection caused by the measles virus. Initial signs
and symptoms typically include fever, often greater than 40 °C ,
cough, runny nose, and red eyes.
• Two or three days after the start of symptoms small white spots
may form inside the mouth, known as Koplik's spots. A red, flat rash
which usually starts on the face and then spreads to the rest of the
body typically begins three to five days after the start of symptoms.
• Symptoms usually develop 10–12 days after exposure to an infected
person and last 7–10 days.
• Complications occur in about 30% and may
include diarrhea, blindness, inflammation of the brain,
and pneumonia among others.
 Measles
• Measles is an airborne disease which spreads easily
through the coughs and sneezes of those infected. It may
also be spread through contact with saliva or nasal
secretions.
• Nine out of ten people who are not immune who share
living space with an infected person will catch it.
• People are infectious to others from four days before to
four days after the start of the rash.People usually only
get the disease at most once.
• Testing for the virus in suspected cases is important for
public health efforts.
 Measles
• The measles vaccine is effective at preventing the disease.
• Vaccination has resulted in a 75% decrease in deaths from
measles between 2000 and 2013 with about 85% of
children globally being currently vaccinated. No specific
treatment is available.
• Supportive care, however, may improve outcomes.This
may include giving oral rehydration solution (slightly
sweet and salty fluids), healthy food, and medications to
help with the fever.
• Antibiotics may be used if a bacterial infection such as
pneumonia occurs. Vitamin A supplementation is also
recommended in the developing world
Chicken pox
Chicken pox
Varicella zoster virus
 Chicken pox
• Caused by DNA virus named Varicella zoster virus (VZV) .
• Virus transmitted chiefly by droplets and skin contact
• In the beginning there is fever, anorexia and headache when
virus multiplies in the respiratory tract
• Then it passes to the blood stream and localises in the
peripheral nerves and skin ,it multiplies rapidly in cutaneous
tissue. Resulting in the development of fluid filled tear drop
shaped skin lesions called vesicles.
• The vesicle contains large amount of virus laded highly
infectious fluid which after 3-4 days break open forming crusts
which become dry.
• The disease become serious when lungs and brain is involved.
 Chicken pox
• Chickenpox, also known as varicella, is a
highly contagious disease caused by the
initial infectionwith varicella zoster virus (VZV).
• The disease results in a characteristic skin rash that
forms small blisters, is itchy, and eventually scabs over.It
usually starts on the face, chest, and back and then
spreads to the rest of the body.
• Other symptoms may include fever,feeling tired,
and headaches.
• Symptoms usually last five to ten days.Complications may
occasionally include pneumonia,inflammation of the
brain, or bacterial infections of the skin among others.
• The disease is often more severe in adults than
children.Symptoms begin ten to twenty one days after
exposure to the virus.
 Chicken pox
• Chickenpox is an airborne disease which spreads easily
through the coughs and sneezes of an infected
person.It may be spread from one to two days before
the rash appears until all lesions have crusted over.It
may also spread through contact with the blisters.[
• Those with shingles (Herpes zoster )may spread
chickenpox to those who are not immune through
contact with the blisters.
• The disease can usually be diagnosed based on the
presenting symptom;however, in unusual cases may be
confirmed by polymerase chain reaction (PCR) testing
of the blister fluid or scabs.
• Testing forantibodies may be done to determine if a
person is or is not immune.People usually only get the
disease once.
 Chicken pox
• The varicella vaccine has resulted in a decrease in the
number of cases and complications from the disease. It
protects about 70 to 90 percent of people from disease
with a greater benefit for severe disease.
• Routine immunization of children is recommended in
many countries.Immunization within three days of
exposure may improve outcomes in children.
• Treatment of those infected may include calamine
lotion to help with itching, keeping the fingernails short
to decrease injury from scratching, and the use
of paracetamol (acetaminophen) to help with fevers.
• For those at increased risk of complications antiviral
medication such as aciclovir are recommended
Dengue fever
Aedes aegyptii
Dengue virus
 DENGUE FEVER
• RNA virus, transmitted by the mosquito Aedes
aegyptii
• Transmitted when diseased mosquito injects its saliva
into the wound during a blood meal.
• Only the female mosquito bites
• The mosquito becomes infectious 9-12 days after it has
consumed blood from dengue fever victim and will die
soon regardless of whether it transmits the virus.
• Dengue fever is accompanied by severe fever and
prostration . There is severe pain in limbs and muscles
and one feels that if bones are breaking-break bone
fever
 DENGUE FEVER
• Dengue fever also known as breakbone fever, is
a mosquito-borne tropical disease caused by
the dengue virus.
• Symptomsinclude fever, headache, muscle and joint
pains, and a characteristic skin rash that is similar to
measles.
• In a small proportion of cases the disease develops into
the life-threatening dengue hemorrhagic fever,
resulting in bleeding, low levels of blood platelets and
blood plasma leakage, or into dengue shock syndrome,
where dangerously low blood pressure occurs.
• There is facial rash severe vomiting and circulatory
failure due to shock
 DENGUE FEVER
• Dengue is transmitted by several species
of mosquito within the genus Aedes,
principally A. aegypti.
• The virus has five different types;infection with
one type usually gives lifelong immunity to that
type, but only short-term immunity to the others

• Subsequent infection with a different type

increases the risk of severe complications. As
there is no commercially available vaccine,
prevention is sought by reducing the habitat and
the number of mosquitoes and limiting exposure
to bites.
 DENGUE FEVER
• Treatment of acute dengue is supportive,
using either oral or
intravenous rehydration for mild or moderate
disease, and intravenous fluids and blood
transfusion for more severe cases
AIDS
Scanning electron micrograph of HIV-1, colored green, budding from a

cultured lymphocyte .
AIDS VIRUS
 AIDS-Mode of transmission
• The virus responsible for AIDS is known as human
immunodeficiency virus (HIV)
• HIV is a retrovirus and an RNA virus
• HIV exists as several strains in diff parts of the world
• AIDS spread thru blood in
i) homosexuals
ii)intravenous drug users
iii) female sex partners
iv)through open wound
v) transfusion of whole blood
vi)use of unsterile syringes
vii)infants get from their infected mothers
 AIDS -pathogenicity
• HIV has been isolated from the infected
patient’s blood, lymph glands ,brain tissue,
cerebrospinal fluid, tears, bone marrow cells,
cell free plasma, saliva and semen .
• The AIDS virus has a liking for T-lymphocytes
.It multiplies in them causing their
disintegration and decline in the no. of these
cells. Thus the immune system collapses and
passes into defenseless stage
 AIDS-pathogencity
• The period from which the patient is exposed
to infection to the development of the full
fledged clinical picture is generally btwn 9-300
months.
• Persons having AIDS` infection can be
classified into 3 categories:
a) healthy carriers
b) prodromal phase ( severe stage )
c)the end stage
 AIDS-pathogencity
• The end phase comprises symptoms of
respiratory system(lung infection as dry cough,
breathlessness, vague chest pain and unexplained
fever)
• , digestive system(diarrhoea, loss of weight,
,abdominal pain and discomfort)
• neurological system(head ache, personality
changes, loss of memory, convulsions)
• malignancy (Kaposi’s sarcoma-a skin malignancy,
malignancy of lymph glands and carcinoma of
mouth and skin)
 Polio virus
• Poliomyelitis is caused by infection with a member of
the genus Enterovirus known as poliovirus (PV). This
group of RNA viruses colonize the gastrointestinal
tract– specifically the oropharynx and the intestine.
The incubation time (form the first signs and
symptoms) ranges from three to 35 days, with a more
common span of six to 20 days.
 Poliomyelitis,
• Poliomyelitis, commonly shortened to polio, is
an infectious disease caused by the poliovirus.
Approximately 70% of cases are asymptomatic;
mild symptoms which can occur include sore throat
and fever; in a proportion of cases more severe
symptoms develop such as headache, neck
stiffness, and paresthesia
• These symptoms usually pass within one or two
weeks. A less common symptom is
permanent paralysis, and possible death in extreme
cases.
 Pathogenecity
Outcomes of poliovirus infection in children

Outcome Proportion of cases[1]

No symptoms 72%

Minor illness 24%

Nonparalytic aseptic
1–5%
meningitis

Paralytic poliomyelitis 0.1–0.5%

— Spinal polio 79% of paralytic cases

— Bulbospinal polio 19% of paralytic cases

— Bulbar polio 2% of paralytic cases

 Mode of transmission & symptoms
• Polio occurs naturally only in humans. It is highly
infectious, and is spread from person to person either
through fecal-oral transmission (e.g. poor hygiene, or by
ingestion of food or water contaminated by human
feces), or via the oral-oral route.
• Two basic patterns of polio infection are described: a
minor illness which does not involve the central nervous
system (CNS), sometimes called abortive poliomyelitis,
and a major illness involving the CNS, which may be
paralytic or nonparalytic. Adults are more likely to
develop symptoms, including severe symptoms, than
children.t\
 Prevention and control

• Once infected, there is no specific treatment. The

disease can be prevented by the polio vaccine, with
multiple doses required for lifelong protection.
There are two broad types of polio vaccine; an
injected vaccine using inactivated poliovirus and an
oral vaccine containing attenuated (weakened) live
virus..
Protozoal Diseases
 MALARIA
• Malaria is transmitted through he bite of an
infected female Anopheles mosquito.
• Infected mosquito carries the protozoal parasite
Plasmodium . When the mosquito bites you , the
parasite is released into your blood stream
• Once the parasites are inside the body , they
travel to liver , where they mature. After that
they enter the blood stream and begin to infect
RBC
MALARIA
Plasmodium vivax
Symptoms of malaria
 MALARIA
• There are 4 major forms of malaria. Causative
organisms are Plasmodium vivax, P.ovale,
P.malariae and P.falciparaum
• The vector is female anopheles mosquito
• The disease is characterized by chills and fever
and often by vomiting and severe head ache.
• The fever reaches 400 C and a sweating stage
begins as the fever subsides. Between paroxysm
the patient feels normal .RBC ‘s are destroyed
during infection and the patient feels anaemic.
 MALARIA
• Derivatives of quinine are effective in the
treatment of malaria. No vaccines are available
for malaria
• Application of residual insecticide on inside walls
and places where anopheles rests. Community
spraying until malaria is no longer endemic. use
screen rooms and bed nets in endemic areas.
Apply repellents to skin and clothing. Eliminate
breeding places by drainage and filling ,use
larvicides –oil and Paris green. suppressive drugs
,treatment and health education
• Limited acquired immunity. this relative immunity
disappears if the person leaves an endemic area
with its periodic reinfections
 KALA AZAR
• Kala azar is a slow progressing indigenous
disease caused by a protozoan parasite of the
genus Leishmania.
• The disease is endemic in West Bengal and
African countries
• The parasite primarily affects the reticulo
endothelial system and may be found in
abundance in bone marrow, spleen and liver.
 KALA AZAR
• Leishmaniasis is caused by a protozoa parasite
from over 20 Leishmania species. There are 3
main forms of the disease:
• Visceral leishmaniasis (VL)-also known as
kala-azar is fatal if left untreated in over 95%
of cases. It is characterized by irregular bouts
of fever, weight loss, enlargement of the
spleen and liver, and anaemia.
• Cutaneous leishmaniasis (CL) -is the most
common form of leishmaniasis and causes
skin lesions, mainly ulcers, on exposed parts of
the body, leaving life-long scars and serious
disability or stigma.
• Mucocutaneous leishmaniasis- leads to
partial or total destruction of mucous
membranes of the nose, mouth and throat
 Cutaneous leishmaniasis ( oriental
sore, tropical sore or Delhi boil )
• It is a milder disease caused by another
protozoan of the Leishmania genus which
causes skin lesions
 Kala Azar
• Causative agent is a protozoal parasite known as
Leishmania donovani
• Visceral leishmaniasis (VL), also known as kala-
azar, black fever, and Dumdum fever, is the most
severe form of leishmaniasis
• L.donovani causes visceral leishmaniasis( kala
azar) in which the parasite invades the internal
organs
• The blackening of the skin that gave the disease
its common name in India
• Transmitted by the bite of female sand fly and
about 30 species of which are found in tropical
regions and Mediterranean. The infective form is
the saliva of the fly
 KALA AZAR
• Proliferating parasite
SAND FLY ( Phlebotomus argentipes )
 KALA AZAR
• Sand flies are small insects about one fourth
the size of a mosquito.
• They breed in high relative humidity , warm
temp and abundance of vegetation.
• Breed in places with high organic matter
 KALA AZAR
• Early symptoms include chills and sweating,
followed by enlargement of liver and spleen in
which the parasite proliferates. Eventually kidney
function is also lost.
• Loss of appetite, anaemia and greyish
discolouration of the skin of hands, feet
,abdomen and feet which gives the Indian name
Kala Azar meaning black fever .This disease if
untreated will lead to death in a year or two.
• Primary treatment with drugs that contain toxic
metal antimony.
 Kala Azar-Control measures
• Control by elimination of insect vector,
destruction of dogs or other animals known to
harbor the parasites, isolation of patients and
Treatment of all human cases with
pentavalent antimony compounds
• Recovered patients have life long immunity
 Gambia fever
• Trypanosoma gambiense is the causative
protozoan parasite of Gambia fever (African
sleeping sickness).
• Human population is the major reservoir of
Gambian fever.
• Transmitted by tsetse fly vectors.
• When a human being is bitten by the fly,
trypanosomes in the salivary gland are inoculated
into the skin where they multiply, eventually
reaching the blood stream and aggregating in the
small blood vessels of brain and heart.
 Gambia fever

• The disease is endemic in some regions of

sub Saharan Africa, covering areas in 36
countries containing more than 60 million
people.
• A recent study estimates that the total African
population at risk of contracting sleeping sickness
is 69.3 million, with one third of this population
being at a 'very high' to 'moderate' risk and the
remaining two thirds at a 'low' to 'very low' risk.
 Gambia fever-symptoms
• The first stage known as haemolymphatic
phase , is characterized by fever , headaches ,
joint pains, itching and swelling of lymph
nodes.
• The second phase , the neurological phase ,
begins when the parasite invades the central
nervous system by passing through the blood
brain barrier
• The initial symptoms are for weeks or
months. But the starting of fever ,headaches
and a variety of other symptoms indicate the
involvement and development of central
nervous system. Coma and death are
inevitable without effective treatment.
 Gambia fever-symptoms
• Disruption of the sleep cycle is a leading
symptom of this stage and is the one that gave
the disease the name 'sleeping sickness.'
Infected individuals experience a disorganized
and fragmented 24-hour rhythm of the sleep-
wake cycle, resulting in daytime sleep
episodes and night time periods of
wakefulness.
Gambia fever(African sleeping sickness)
Trypanosoma gambiense
 Gambia fever
• Control of vectors and prompt treatment of
human cases with drugs
• No immunization