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M265 Medical Microbiology

Epidemiology and Public Health Ref: Burtons Microbiology for the Health Sciences, 9th Ed Ch.11

Lecture # 13

Dr. Samer Swedan

Chapter 11 Outline
Epidemiology Interactions Among Pathogens, Hosts and the Environment Chain of Infection Reservoirs of Infection Modes of Transmission Public Health Agencies Bioterrorism and Biological Warfare Agents

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Epidemiology

Introduction
Epidemiology can be loosely defined as the study of disease. Epidemiologists study the factors that determine the frequency, distribution, and determinants of diseases in human populations. Epidemiologists also develop ways to prevent, control, or eradicate diseases in populations.

Epidemiologic Terminology
A communicable disease is an infectious disease that can be transmitted from one person to another A contagious disease is a communicable disease that is easily transmitted from person-to-person. Zoonotic diseases are diseases that humans acquire from animal sources. The incidence of a particular disease is the number of new cases of that disease in a defined population during a specific time period. The morbidity rate is same as incidence but is usually expressed per 1,000, 10,000 or 100,000 population.

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Epidemiologic Terminology, cont. Prevalence Period prevalence is the number of cases of a disease existing in a given population during a specific time period (e.g., during the year 2009). Point Prevalence is the number of cases of a disease existing in a given population at a particular moment in time (e.g., right now). Mortality/death rate is the ratio of the number of people who died of a particular disease during a specified time period per a specified population

Epidemiologic Terminology, cont. A sporadic disease is one that occurs only occasionally within the population of a particular geographic area; example, tetanus. An endemic disease is one that is always present within the population of a particular geographic area. An epidemic disease is defined as a greater than usual number of cases of a disease in a particular region, usually within a short period of time; example, the Legionnaires disease epidemic of 1976.

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Epidemiologic Terminology, cont. A pandemic is a disease that is occurring in epidemic proportions in many countries simultaneously. Examples include: Influenza Examples: (1) the Spanish flu pandemic of 1918 during which more than 20 million people were killed worldwide; (2) the H1N1 (swine flu) pandemic of 2009-2010.

HIV/AIDS
Tuberculosis Malaria

Interactions Among Pathogens, Hosts, and the Environment

Whether an infectious disease occurs depends on: Factors relating to the pathogen (e.g., virulence of pathogen, mode of entry, number of organisms) Factors relating to the host (e.g., health status, nutritional status, hygiene, age, travel, lifestyle, etc.) Factors relating to the environment (e.g., physical factors such as climate, season, geographic location; availability of appropriate reservoirs; sanitary and housing conditions; and availability of clean water)

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The Chain of Infection

There are 6 components in the infectious disease process:
a pathogen a source of the pathogen (a reservoir) a portal of exit a mode of transmission a portal of entry a susceptible host

The Chain of Infection, cont.

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Reservoirs of Infection The sources of microorganisms that cause infectious diseases are many and varied; they are known as reservoirs of infection or simply reservoirs. Living reservoirs humans, pets, farm animals, insects, arachnids Human carriers: Passive carriers Incubatory carriers Convalescent carriers Active carriers
[completely recovered from disease but still carry the pathogen for a long time]

Reservoirs of Infection, cont. Animals Infectious diseases that humans acquire from animal sources are called zoonotic diseases or zoonoses. Zoonoses may be acquired by direct contact with an animal, inhalation or ingestion of the pathogen, or injection of the pathogen by an arthropod. Examples: Rabies Lyme disease

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Reservoirs of Infection, cont. Arthropods

Many different types of arthropods serve as reservoirs of infection, including insects (e.g., fleas, mosquitoes, lice) and arachnids (e.g., mites and ticks)
When arthropods are involved in the transmission of infectious diseases they are referred to as vectors. Examples of arthropod-borne diseases: Lyme disease Malaria

Reservoirs of Infection, cont.

Nonliving Reservoirs Air, soil, dust, contaminated water and foods, and fomites Fomites - inanimate objects capable of transmitting pathogens (e.g., bedding, towels, eating and drinking utensils, hospital equipment, telephones, computer keyboards, etc.)

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Inanimate Vectors of Infection (Fomites)

Most Common Modes of Transmission of Infectious Diseases

Direct skin-to-skin contact Direct mucous membrane-to-mucous membrane contact by kissing or sexual intercourse Indirect contact via airborne droplets of respiratory secretions, usually produced by sneezing or coughing Indirect contact via food and water contaminated by fecal matter Indirect contact via arthropod vectors Indirect contact via fomites Indirect contact via transfusion of contaminated blood or blood products or by parenteral injection using nonsterile syringes or needles

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Modes of Disease Transmission

Required Self World Health Organization (WHO) Reading A specialized agency of the United Nations founded in 1948; www.who.org Missions: to promote technical cooperation for health among nations; to carry out programs to control and eradicate diseases; to improve the quality of human life Eradicated smallpox Investigates outbreaks of Ebola virus, etc. Attempting to eradicate polio and guinea worm disease

Public Health Agencies

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Public Health Agencies, cont.

Measures for prevention and control of epidemics: Increase host resistance through the development and administration of vaccines that induce active immunity and maintain it in susceptible persons Ensure that persons exposed to a pathogen are protected against the disease (e.g. passive immunization) Segregate, isolate and treat those who have contracted a contagious infection to prevent the spread of the pathogen to others Identify and control potential reservoirs and vectors of infectious diseases

Bioterrorism and Biological Warfare Agents

Required Self Reading Microbes purposely used to harm others in wartime are called biological warfare agents. Pathogens used to create fear, chaos, illness, and death in situations other than war are called bioterrorism agents. Examples: Bacillus anthracis (the cause of anthrax) Clostridium botulinum (the cause of botulism) Smallpox virus (Variola major)

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