Chapter 3

COMMUNICABLE DISEASE
EPIDEMIOLOGY
 Brainstorming

What are the components in the chain of disease

transmission?

What are the methods to control communicable

diseases?
Chain of disease transmission
Person-to-person
transmission
Reservoir

Portal of exit Susceptible Host

Portal of entry
Agent

Mode of transmission
3 01/03/2021
 Chain of disease transmission

Is the linkage of factors involved in the

transmission of communicable disease in the form
of chain of successive events

Six links are identifiable in the chain

 InfectiousAgent: bacteria,virus
 Reservoir:Man, animals and non-living things
 Chain of disease transmission ...

 Portal of exit:GIT,RT,Skin/mucous membren

 Mode of transmission:direct,Indirect

 Route of entry: :GIT,RT,Skin/mucous membren

 Susceptiblehost: a host who is highly likely to

acquire infection when exposed to the infectious
agent
Course of infectious disease over time in relation to clinical expression

Implies natural history of infectious disease

Exposure Infection Infectious Disease Disease

Outcome

Stage of Susceptibility sub clinical stageclinical

stageStage of Outcome

Exposure to an infectious agent does not necessarily

lead to infection; and an infection does not
necessarily lead to disease.
 Course of infectious disease over time....

Characteristics of the agent that affect the course

of infectious disease include:
Infectivity: is the ability of the agent to produce
infection in an exposed host

Pathogenicity: the ability of an agent to produce a

clinically manifest disease in susceptible host

Virulence: the ability of an agent to produce severe

disease.
 Course of infectious disease over ...

Antigenicity: refers to the ability of the agent to

induce immune response & thus an immune state
in the host.

Toxigenecity: refers to the capacity of the agent to

produce a toxin, or poison.

Resistance: refers to the ability of the agent to

survive adverse environmental conditions during
transmission.
Course of infectious disease over time in relation
to its communicability

Different periods are encountered in the course of

development infectious disease.  
Prepatent Period: is the time interval between
infection and the point at which the infection can
first be detected
Measured by the first shedding of the infectious
agent by the host.
Sometimes infection cannot be detected when the
agent is first shed, only later when antibodies to
the agent appear, as in HIV.
 Course of infectious disease over time in relation to its
communicability...

Incubation Period: the time interval between

infection and the first clinical manifestation of
disease

 It is the time between biological & clinical onset

 Useful to identify the source of infection and the

infectious agent especially in the investigation of
epidemics
Course of infectious disease over time in relation to its
communicability...

Communicable Period: the period during which an infected

host can transmit the infection to others

Measured
 by the length of the time in which the agent is shed
by the host

The
 degree of transmissibility does not remain constant
throughout the period of communicability, as the amount of
infectious agent that is shed by the infected host is variable at
different points time

 
 Course of infectious disease over time in relation to its
communicability...

Generation time: is the period between the onset

of infection in a host &the maximal
communicability of that host

The
 maximal communicability may be during or
after the incubation period.

Latent Period: the time interval between recovery

and the occurrence of a relapse of infectious
disease
 Spectrum of disease

Literally, the word spectrum means a range of

possible options for something

Spectrum of disease thus implies the range in the

expression of disease, be it in terms of the degree
of severity or clinical manifestation

For infectious disease the spectrum of infectious

disease is referred as the gradient of infection
 Spectrum of disease...

The manifestation of disease ranges from

unapparent infections at one extreme to fatal illness
at the other

No reaction (no infection)

Sub-clinical or unapparent infection (infection with

no disease)
 Spectrum of disease...

Atypical disease

Frank disease

Severe disease

E.g. - Measles: over 90% clinically apparent

-Mumps: about 66% clinically apparent
-Poliomyelitis: over 90% not clinically apparent
General approaches in the prevention and contropl of
communicable diseaser

Measures directed on the reservoir of

infection
1. Measures to be taken when the reservoir is human
being
Detection and treatment of cases
Screening
Isolation
Quarantine
 General approaches in the prevention and contropl of
communicable diseaser

2. Measures to be taken when animals act as reservoirs

E.g. – destroying rats to control plaque; destroying stray dogs


and vaccinating pet dogs to control rabies; treating infected cattle
and immunizing those at risk to control anthrax

3. Measure to be taken when non-living things serve as reservoirs

Sterilization, disinfection and disinfestations, E.g. – chlorination


of water
 
 
 
 General approaches in the prevention and contropl of
communicable diseaser

4. Measures targeting the mode of transmission

Sterilization, disinfection and disinfestations

Control of vectors

Improvement of environmental sanitation

 
General approaches in the prevention and contropl of
communicable diseaser

5. Measures targeting the susceptible host

Immunization, Chemoprophylaxis

proper nutrition and exercise

Limit human beings exposure to the reservoir or

transmitter, :limiting exposure to water bodies
infested with snails, use of bed net and insect
repellents, condom use
Personal hygiene