Infectious Diseases

Dr. Faisa Salah

MBChB@BU, MSc Tropical and Infectious Disease @UoN,
CTM@Nagasaki University, MSc Travel Medicine @ LSHTM,
DTHM&H@NU

18th /Feb/2024
IDs Lecture One
Infectious Diseases - Definitions
• Disease – a pathological condition of body parts or tissues characterized
by an identifiable group of signs and symptoms.
• Infectious disease – disease caused by an infectious agent such as a
bacterium, virus, protozoan, or fungus that can be passed on to others.
• Infection – occurs when an infectious agent enters the body and begins
to reproduce; may or may not lead to disease.
• Pathogen – an infectious agent that causes disease.
• Host – an organism infected by another organism.
• Virulence – the relative ability of an agent to cause rapid and severe
disease in a host.
Introduction to Infectious Diseases
• Infectious diseases remain one of the leading causes of death in both developed
and developing countries
• Infectious diseases account for more than half of all deaths in children under the
age of 5.
• Of the top ten causes of death compiled by the World Health Organization, five
are due to infectious diseases.
• The top single agent killers are HIV/AIDS, malaria and tuberculosis. The other top
killers are lower respiratory infections and diarrheal diseases, which are caused
by a variety of agents.
• An infection may not necessarily produce disease;
• the infectious agent could be defeated quickly or it could hide somewhere in
the body where it cannot be detected.
Cont.
 Infections cause significant morbidity and mortality, especially
in individuals who are most vulnerable to illness:
 the very young
 Elderly
 Immunosuppressed.
 Chronic disease states.
 Constitute six of the top 10 causes of mortality in developing
countries abetted by malnutrition & unsanitary living
conditions.
Tracing the source of the diseases and contacts are essential in
the management of and outbreak and surveillance
Cont.
• The rapidity of onset and severity of the disease caused by an infectious agent
depends on the virulence of the pathogen.
• Can be transmitted to other individuals
• It deals with :
contagious diseases,
the causation theory
pathogenic microorganisms such as bacteria, viruses, parasites or fungi,
their mode of transmission and
how the immune system reacts and deals with different infectious agents as
well as zoonotic diseases.
The fundamental relationships involved in the host–agent–
environment interaction model

• The pathogenesis of infectious

diseases reflects the
relationship among the:
 human host,
 the infectious agent, and
 the external environment.
Cont.
• The infectious disease process begins at the time of infection, when a
pathogen enters a host and starts to reproduce.
• In the host, pathogenetic mechanisms extend from the level of
populations (eg, person-to-person transmission) to the level of
cellular and molecular processes (eg, genetic susceptibility).
• Many infectious agents, though, are killed by the body’s numerous
defenses before they can begin to reproduce.
Transmission of Infectious Diseases
• Agents that cause infectious diseases can be transmitted in many
ways.
• Through the air
• Through contaminated food or water
• Through body fluids
• By direct contact with contaminated objects
• By animal vectors such as insects, birds, bats, etc.
An Epidemiologist’s View
Epidemiological Triad
The Chain of Infection

Infectious Agent

Susceptible Host
Reservoir

Portal of Entry Portal of Exit

Mode of Transmission
Infectious Disease Agents
• Most infectious agents that cause disease are microscopic in size and
thus, are called microbes or microorganisms.
• Different groups of agents that cause disease are:
• Bacteria
• Viruses
• Protozoa (Protists)
• Fungi
• Helminths (Animals)
Three important Epidemiological Properties
1. Infectivity
- The propensity for transmission
- Measured by the secondary attack rate in a household, schools, etc.
2. Pathogenicity
- the propensity for an agent to cause diseases or clinical symptoms
- measured by the apparent: Inapparent infection ratio
3. Virulence
- The propensity for an agent to cause severe diseases
- Measured by the case fatality ratio
Phases of Infectious Disease

• Incubation period – time between infection and the appearance of

signs and symptoms.
• Prodromal phase – mild, nonspecific symptoms that signal onset of
some diseases.
• Clinical phase – a person experiences typical signs and symptoms of
disease.
• Decline phase - subsidence of symptoms.
• Recovery phase – symptoms have disappeared, tissues heal, and the
body regains strength.
Classification of Infectious Disease
• By duration
• Acute – develops and runs its course quickly.
• Chronic – develops more slowly and is usually less severe, but may persist for a long,
indefinite period of time.
• Latent – characterized by periods of no symptoms between outbreaks of illness.
• By location
• Local – confined to a specific area of the body.
• Systemic – a generalized illness that infects most of the body with pathogens distributed
widely in tissues.
• By timing
• Primary – initial infection in a previously healthy person.
• Secondary – infection that occurs in a person weakened by a primary infection.
How Infectious Agents Cause Disease
I. Production of poisons, such as toxins and enzymes, that destroy
cells and tissues.
II. Direct invasion and destruction of host cells.
III. Triggering responses from the host’s immune system leading to
disease signs and symptoms.
Some Infectious Disease Spread by Contact

1. Sexually transmitted disease : Syphilis, Gonorrhea, chlamydia,

AIDS
2. Staphylococcal and streptococcal infections
3. Many nosocomial infections
4. Rhinovirus cold
5. Brucellosis (Slaughter house contact)
6. Hepatitis B virus infection
Water and Food-borne Infections

1. Salmonellosis
2. Campylobacter
3. Clostridium perfringen food poisoning
4. Staphylococcal enterotoxin food poisoning
5. Cholera
6. Giardiasis
7. Listeriosis
Important Airborne Infections

Tuberculosis
Influenza
Childhood infections: Measles, mumps. Rubella, pertussis
Parainfluenza
RSV
Legionella
 Important Vector borne Infections

1. Malaria 5. Dengue fever

2. Viral encephalitis: 6. Yellow fever
SLE,WEE,EE 7. Rocky mountain fever
3. Schistosomiasis 8. Leishmaniosis
4. Tularemia 9. Trypanosomiasis
Reservoirs of Infectious Diseases

1. Human
2. Animal
3. Soil
4. Water
 Human Reservoir Infections

1. HIV/AIDS infections
2. Syphilis
3. Gonorrhea
4. Shigellosis
5. Typhoid fever
6. Hepatitis B virus
7. Herpes simplex virus
 An Animal reservoir (Zoonosis)

1. Nontyphoidal salmonellosis
2. Brucellosis
3. Anthrax
4. Listeriosis
5. Viral encephalitis
6. Rabies
7. Plague
Important Diseases with a Soil Reservoir

1. Histoplasmosis
2. Coccidoidomycosis
3. Blastomycosis
4. Botulism
 Water Reservoir Infections

1. Pseudomonas Infections: Sepsis, UTI, Hot tub

folliculitis
2. Legionnaires’ diseases
3. Melloidosis
Example of an Infectious Disease - Flu
• Acute contagious disease caused by the influenza virus.
• Respiratory tract infection, but symptoms felt throughout entire body.
• Epidemics occur seasonally with low fatality; more deadly pandemics
occur several times each century.
• Highly changeable virus that can infect multiple species, including
humans, pigs, and birds.
• Concern exists that current avian flu will lead to a new pandemic.
Example of an Infectious Disease - AIDS
• AIDS (Acquired Immune Deficiency Syndrome) is the disease caused
by the virus called HIV (human immunodeficiency virus).
• HIV attacks cells of the immune system and destroys their ability to
fight infection by other agents.
• HIV is spread through the direct exchange of body fluids.
• There is a long period of time from HIV infection to the onset of AIDS.
• Anti-HIV drugs prolong the length and quality of life, but there is no
vaccine or cure for AIDS.
Reducing the Spread of Infectious Diseases
• Vaccines:
• The most effective method of stemming the spread of infectious disease
• Antimicrobial drugs
• Good personal hygiene and sanitation
• Protection against mosquitoes
• Quarantine
Emerging Infectious Diseases
• Emerging diseases are those that have recently appeared within a population, or
whose incidence or geographic range is increasing rapidly.
• Diseases can emerge or re-emerge due to:
I. appearance of a previously unknown agent.
II. evolution of a new infectious agent.
III. spread of an infectious agent to a new host.
IV. spread of an infectious agent to new locations.
V. acquisition of resistance to anti-microbial drugs.
VI. deliberate introduction into a population.
Questions????