LECTURE NOTES
Principles of Disease and Epidemiology
BIO 2246 MICROBIOLOGY LEC
Pathology, Infection, and Disease
• Pathology: The study of disease
• Etiology: The study of the cause of a disease
• Pathogenesis: The development of disease
• Infection: Colonization of the body by pathogens
• Disease: An abnormal state in which the body is not functioning normally
Normal Microbiota and the Host
• Transient microbiota may be present for days, weeks, or months
• Normal microbiota permanently colonize the host
• Symbiosis is the relationship between normal microbiota and the host.
Symbiosis
• In commensalism, one organism benefits, and the other is unaffected
• In mutualism, both organisms benefit
• In parasitism, one organism benefits at the expense of the other
Ø Some normal microbiota are opportunistic pathogens
• Microbial antagonism is a competition between microbes.
• Normal microbiota protect the hosts by
Ø Occupying niches that pathogens might occupy
Ø Producing acids
Ø Producing bacteriocins
ü Probiotics: Live microbes applied to or ingested into the body, intended to exert a beneficial effect
Classifying Infectious Diseases
• Symptom: A change in body function that is felt by a patient as a result of disease
• Sign: A change in a body that can be measured or observed as a result of disease
• Syndrome: A specific group of signs and symptoms that accompany a disease
Occurrence of a Disease
• Incidence: Fraction of a population that contracts a disease during a specific time
• Prevalence: Fraction of a population having a specific disease at a given time
• Sporadic disease: Disease that occurs occasionally in a population
• Endemic disease: Disease constantly present in a population
• Epidemic disease: Disease acquired by many hosts in a given area in a short time
• Pandemic disease: Worldwide epidemic
Ø Herd immunity: Immunity in most of a population
Severity or Duration of a Disease
• Acute disease: Symptoms develop rapidly
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• Chronic disease: Disease develops slowly
• Subacute disease: Symptoms between acute and chronic
• Latent disease: Disease with a period of no symptoms when the causative agent is inactive
Extent of Host Involvement
Local infection: Pathogens are limited to a small area of the body
Systemic infection: An infection throughout the body
Focal infection: Systemic infection that began as a local infection
• Sepsis: Toxic inflammatory condition arising from the spread of microbes, especially
bacteria or their toxins, from a focus of infection
• Bacteremia: Bacteria in the blood
• Septicemia: Growth of bacteria in the blood
• Toxemia: Toxins in the blood
• Viremia: Viruses in the blood
• Primary infection: Acute infection that causes the initial illness
• Secondary infection: Opportunistic infection after a primary (predisposing) infection
• Subclinical disease: No noticeable signs or symptoms (inapparent infection)
Predisposing Factors
• Make the body more susceptible to disease
Ø Short urethra in females, Inherited traits, such as the sickle cell gene, Climate and weather,
Fatigue, Age, Lifestyle, Chemotherapy
The Stages of a Disease
• Incubation period - time interval between the initial
infection and the first appearance of signs and
symptoms.
• Prodromal period - characterized by the appearance
of the first mild signs and symptoms.
• Period of illness - the disease is at its height, and all
disease signs and symptoms are apparent.
Ø Death may occur during the period of illness.
Ø Crisis is the phase of fever characterized by
vasodilation and sweating (the body is trying to
return to normal temperature, the fever is
breaking).
• Period of decline - the signs and symptoms
subside.
• Period of convalescence - the body returns to its
prediseased state, and health is restored.
Reservoirs of Infection
• Continual sources of infection
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Ø Human: AIDS, gonorrhea
ü Carriers may have inapparent infections or latent diseases
Ø Animal: Rabies, Lyme disease
ü Some zoonoses may be transmitted to humans
• Nonliving: Botulism, tetanus
Ø Soil
Transmission of Disease
• Contact
Ø Direct: Requires close association between infected and susceptible host
Ø Indirect: Spread by fomites
Ø Droplet: Transmission via airborne droplets
Ø Vehicle Transmission
ü Transmission by an inanimate reservoir (food, water, air)
Vectors
• Arthropods, especially fleas, ticks, and mosquitoes
• Transmit disease by 2 general methods:
Ø Mechanical transmission: Arthropod carries pathogen on feet
Ø Biological transmission: Pathogen reproduces in vector
Nosocomial Infections
• A nosocomial infection is any infection acquired during a stay in a hospital, nursing home, or other
health care facility.
• About 5-15% or all hospitalized patients acquire nosocomial infections.
• Three factors contribute to nosocomial infections:
Ø Microorganisms in the hospital
Ø A compromised host
Ø The chain of transmission
MRSA
• USA100: 92% of health care strains
• USA300: 89% of community-acquired strains
Emerging Infectious Diseases
• Diseases that are new, increasing in incidence, or showing a potential to increase in the near future
• Contributing factors
Ø Genetic recombination (E. coli O157, avian influenza (H5N1)
• Evolution of new strains
Ø V. cholerae O139
• Inappropriate use of antibiotics and pesticides
Ø Antibiotic-resistant strains
Ø Changes in weather patterns
Ø Hantavirus
• Modern transportation
Ø West Nile virus
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• Ecological disaster, war, and expanding human settlement
Ø Coccidioidomycosis
Ø Animal control measures (Lyme disease)
Ø Public health failure (Diphtheria)
Epidemiology
The study of where and when diseases occur
Centers for Disease Control and Prevention (CDC)
Collects and analyzes epidemiological information in the United States
Publishes Morbidity and Mortality Weekly Report (MMWR)
www.cdc.gov
The CDC
• Morbidity: Incidence of a specific notifiable disease
• Mortality: Deaths from notifiable diseases
• Morbidity rate: Number of people affected in relation to the total population in a given time period
• Mortality rate: Number of deaths from a disease in relation to the population in a given time
