Infectious disease epidemiology

………some terminologies

Dr Anindya Mukherjee
 Infection
• The entry and development or multiplication
of infectious agent in man or animal.
• It does not always cause illness.
• It has various levels like---
1. Colonization
2. Sub clinical
3. Latent
4. Clinical
 Contamination
• Presence of infectious agent on---
 Body surface
 Cloth/bedding/toys
 Surgical instruments
 Water/milk/food
• Pollution is presence of offensive material
o May or may not be infectious
 Infestation
• Lodgement, development and reproduction of
arthropod on surface of ----
 Body skin
 Gut
 Clothing
• Like ----lice, itch mite, worms
 Host
• Man, animal including birds and arthropods
affording lodgment of infectious agent under
natural condition.
• May be susceptible or immune
• May be primary (definitive) or secondary
(intermediate)
• May be Obligate (only) host like man in Measles
or Typhoid
• Transport host (organism alive but not
developing or reproducing)
 Infectious and contagious disease
• Infectious disease: Disease due to infectious
agent.
• Contagious disease: Disease that is transmitted
through contact like Scabies, Trachoma, STD,
Leprosy.
• Some infectious diseases are contagious while
others are not.
• All Infectious diseases and infestations are
communicable diseases.
 Communicable disease
• Illness due to---
 Infectious agent or toxic product---
 Through their transmission from----
 Infected person/animal/reservoir to----
Susceptible host ---either Directly or
 Indirectly (plant/animal/vector/objects)
 Epidemic and endemic
• Epi: upon; Demos : people
 Occurrence in a community or region
 Of illness/health related event
 Clearly in excess of normal expectancy
• En: in; Demos : people
 Constant presence of disease without
importation like common cold
 Exotic disease: Diseases imported in country
where they do not otherwise occur (Yellow Fever)
• Hyper endemic: High incidence and prevalence
of disease at all age group like Influenza
• Holo endemic: High level of infection beginning
early in life like Malaria
• An endemic may convert to epidemic under
favorable condition like Hepatitis A, Typhoid
• Sporadic: Occurring scattered, irregularly or
infrequently from time to time like Tetanus,
Herpes Zoster, Zoonotic diseases.
• Pandemic: Epidemic crossing international
boundaries like Influenza and Cholera
 Zoonosis
• Infection or infectious disease transmitted from
vertebrate animal to man or vice versa under
natural condition.
• Anthropozoonoses: (Vertebrate to man) like
Rabies, Plague, Anthrax
• Zooanthroponoses: (Man to vertebrate) like
Human TB in cattle
• Amphixenoses: Infection in either direction like
Tripanosoma cruzi and Schistosoma japonicum.
 Zoonosis…..
• Epizootic: Outbreak of disease in animal
population with implication of human spread
like Anthrax, Brucellosis, Influenza, Japanese
encephalitis.
• Enzootic: Endemic occurring in animal like
Rabies, Bovine TB, Endemic typhus
• Epornithic: Outbreak of disease in bird
population like Avian influenza
Nosocomial/ hospital acquired infection

• New disorder unrelated to patient’s primary

condition and associated with being in hospital.
• Not present/incubating/residual during
admission.
• Also includes infections acquired during stay
but appearing after discharge.
• Also includes infections among staff
• Most common: surgical wound/UTI/Hepatitis B
 Iatrogenic/doctor generated disease

• Adverse effects resulting from Health ---

 Products
 Procedures
 Services
 Interventions
 Policies
• Mostly preventable
• Opportunistic infection: Normally non pathogenic
but can cause disease if immunity compromised
like in AIDS.
• Surveillance: Continuous analysis, interpretation
and feedback of systemically collected data by
rapid, uniform and practical method thereby
anticipate and take appropriate investigation &
control measures.
• Eradication: Termination of all transmission of
infection by extermination of agent by surveillance
like Small pox
• Possible eradication: Measles /Polio /Diphtheria
/Guinea worm disease
 Sources and Reservoir
• Source: Person/animal/object from which infectious
agent passes to the host.
• Reservoir:
Person/animal/arthropod/plant/soil/substance..
Where infectious agent lives and multiplies…
In such manner that can be transmitted to…
Susceptible host.
• Source and reservoir may be same or different
• Reservoir may be homologous or heterologous
• Reservoir may be human/animal/non living
 Human reservoir: cases
• Case: Person in population or study having
particular disease/condition under investigation.
• Spectrum of disease or gradient of infection—
• Sub clinical (no sign or symptoms)--Polio
• Latent (host not shed infection but remain
dormant within host)—Herpes
• Clinical (Primary case; Index case; Secondary
case; Suspect case)
 Human reservoir: carriers
• An infected person or animal that harbors specific
infectious agent in absence of clinical disease and
serves as potential source of infection for others.
• Less infectious than case but epidemiologically more
important.
• Type wise:-- Incubatory (Measles, Mumps);
Convalescent (Typhoid, Cholera); Healthy (Polio,
Salmonella, Diphtheria)
• Duration wise:-- Temporary and Chronic (Typhoid,
Hepatitis B, Malaria, Gonorrhea)
• Portal of exit:-- Urinary /Respiratory /Intestinal
/Others