Infectious

Diseases
 DEFINISI
EPIDEMIOLOGY

FREQUENSI & DISTRIBUSI

ILMU YG MEMPELAJARI :
PENYAKIT,
SIFAT, YG MEMPENGARUHI CACAT,
PENYEBAB, KEMATIAN,
PENGENDALIAN
& FAKTOR FAKTOR DI POPULASI MANUSIA
 Disease
Genetic
Biological
Physical
Chemical

Robin Cochran-Dirksen (adapted

from BioEdOnline Baylor Christine
 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.
 Infectious Diseases - Definitions
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.
Types of carriers
 Kochs Postulates
Koch developed four criteria to demon-
strate that a specific disease is caused by
a particular agent.
1. The specific agent must be associated
with every case of the disease.
2. The agent must be isolated from a diseased host
and grown in culture.
3. When the culture-grown agent is introduced into
a healthy susceptible host, the agent must cause
the same disease.
4. The same agent must again be isolated from the
infected experimental host.
 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)
PRION
Robin Cochran-Dirksen (adapted
from BioEdOnline Baylor Christine
 Bacteria
Bacteria are unicellular
prokaryotic
Have no organized internal
(membranous structures such as
nuclei, mitochondria, or
lysosomes).
Genomes are circular,
double-stranded DNA less protein
than eukaryotic genomes'.
Most bacteria reproduce by
growing and
dividing into two cells (binary
fission).
Only bacteria, can be treated
using antibiotics
Viruses
are not organisms themselves
because, apart from a host cell,
no metabolism and cannot
reproduce.
A virus is composed of
a viral genome of nucleic acid
surrounded by a protein coat (
capsid).
many viruses surrounded an outer
lipid envelope, acquire from
the host cell membrane as they
leave the cell.
viral genomes may be :
double-or single-stranded DNA
virus,
or double-or single-stranded RNA
virus
 Fungi

Fungi are eukaryotic,

heterotrophic organisms have rigid
cellulose-or chitin-based cell walls
Reproduce primarily by forming
spores. Most multicellular, yeasts are
unicellular.

Anti-fungals, is very limited drugs

available and suitable for treatment

It is very difficult drugs that kill fungal

cells without damaging human cells.
 Protozoa

Protozoa are unicellular,

heterotrophic eukaryotic
parasites (amoeba and paramecium.
protozoa do not have cell walls,
rapid and flexible movements.
Protozoa can be acquired through
contaminated
food or water or
by the bite of arthropod .
Helminths

Helminthsare simple,
invertebrate animals,
some are infectious parasites.

Multicellular and have differentiated tissues.

Their physiology is similar in human.

This makes parasitic helminth infections
difficult to treat
frequently very toxic to human cells.
 Prions
Degenerative disorders of the central nervous system
to infectious particles that consist only of protein.
("proteinaceousinfectious particles" ) = prions.
Prion diseases include :
1.Creutzfeldt-Jakob disease (in humans),
2.Scrapie(in sheep), and
3.Bovine spongiform encephalopathy ("mad cow
disease" );

Prion diseases frequently in brain .

priondiseases are : inherited, infection by eating
infected tissue or tissue transplants
 Robin Cochran-Dirksen (adapted
from BioEdOnline Baylor Christine
 Infectious Diseases Throughout
History
Infectious agents have probably always caused
disease in humans.
Smallpox in ancient Egyptian and Chinese.
Malaria and poliomyelitis have existed since
ancient times.
Courtesy of CDC
In the 14th Century, the bubonic plague, or Recreated 1918
Black Death, killed about 20 million people in Influenza virions.
Europe alone. The 1918 Spanish
In the 20th Century, the 1918 influenza may flu killed more than
have killed up to 50 million people worldwide 500,000 people in
Close to 20 million people have died of AIDS to the United States
date. and up to 50 million
worldwide.
 How Infectious Agents
Cause Disease
Production of poisons,
such as toxins and
enzymes, that destroy Courtesy of CDC
Human
Immunodeficiency Virus.
cells and tissues. HIV-1 virions can be seen
on surface of
Direct invasion and lymphocytes.

destruction of host cells.

Triggering responses
from the hosts immune
system leading to disease
signs and symptoms.
 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.
 Transmission of Infectious
Diseases
Agents that cause infectious diseases
can be transmitted in many ways.
Through the air
Courtesy of VOA
Through contaminated food or Chinese students
wearing masks during a
water SARS outbreak
Through body fluids
By direct contact with
contaminated objects
By animal vectors such as
Courtesy of CDC
insects, birds, bats, etc. Aedes aegypti mosquito
Known to transmit
Dengue fever
Robin Cochran-Dirksen (adapted
from BioEdOnline Baylor Christine
Mode of transmission

Direct
Airborne
Indirect
 Direct transmission:

By direct or immediate transfer

portal of entry by personal contact,
e.g. touching, biting, kissing, sexual intercourse
a very short distance (1 meter or less)

Airborne transmission-
via air over longer distances (> 1meter)
agents are suspended
droplet nuclei (fluid) or attached to dust particles
Examples of airborne transmission:
Inhalation spora ofAntrax bacillus
 Indirect transmission

less intimate contact with the source

Two major types are:

1.Vehicle-borne
contaminated materials transfer the agent
2.Vector-borne
usually an arthropod
a.Mechanical
The agent does not multiply in the mechanical host: FLY,
b.Biological
agents development in the vector: MALARIA
 Related Terms
Endemic/Enzootic: The constant presence of a
disease or infectious agent within a given
geographic area.
Epidemic/Epizootic: The occurrence in an area
of a disease or illness in excess of what may be
expected on the basis of past experience for a
given population (in the case of a new disease,
such as AIDS, any occurrence may be
considered "epidemic").
Pandemic/Panzootic: A worldwide epidemic
affecting an exceptionally high proportion of the
global population.
 What is
infectious
disease
epidemiology?
 What is infectious disease epidemiology?

Epidemiology Infectious disease epidemiology

Deals with one Two or more populations
population
Risk case A case is a risk factor

Identifies causes The cause often known

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What is infectious disease epidemiology?

Two or more populations

Humans
Infectious agents
Helminths, bacteria, fungi, protozoa, viruses, prions
Vectors
Mosquito (protozoa-malaria), snails (helminths-schistosomiasis)
Blackfly (microfilaria-onchocerciasis) bacteria?
Animals
Dogs and sheep/goats Echinococcus
Mice and ticks Borrelia

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What is infectious disease epidemiology?

A case is a risk factor

Infection in one person can be transmitted to others

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What is infectious disease epidemiology?

The cause often known

An infectious agent is a necessary cause

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 Reducing the Spread of
Infectious Diseases
Vaccines
Antimicrobial drugs
Good personal hygiene
and sanitation
Protection against mosquitoes
Quarantine
What is infectious disease epidemiology used for?

Identification of causes of new, emerging

infections, e.g. HIV, vCJD, SARS
Surveillence of infectious disease
Identification of source of outbreaks
Studies of routes of transmission and natural
history of infections
Identification of new interventions
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Re-emerging and Emerging
Infectious Disease
Definitions
(New) Emerging infectious diseases
newly identified or
previously unknown infections

Re-emerging infectious diseases

re-appearance of, or increase in number of,
infections from a disease previously known

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New Emerging Infectious Diseases:

Definition
Diseases of infectious origin
whose incidence in humans has increased
within the recent past or threatens to increase
in the near future,

including:
previously unknown infectious diseases;
known but appearing in new geographic
areas;
or increase abruptly; 43
 Emerging Infectious Diseases
Diseases can emerge or re-emerge due to:
appearance of a previously unknown agent.

evolution of a new infectious agent.

spread of an infectious agent to a new host.

spread of an infectious agent to new locations.

acquisition of resistance to anti-microbial drugs.

deliberate introduction into a population.

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Infectious Diseases as a Cause
of Death
Infectious diseases are responsible for a quarter to a
third of all deaths worldwide.
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.
Infectious Diseases
50
The human species
Continues
to change and to change its surroundings:
the ways we live, work, relax; the places we go;
the foods we eat ...

The changing nature of our interactions

with each other and with our environment alters
the dynamics of disease epidemiology
and exposes us to new threats.
53
Current estimates-
1,415 microbes
are infectious for human.

Of these, 868 (61%)

considered zoonotic.

70% of newly recognized pathogens

are zoonoses.
 Robin Cochran-Dirksen (adapted
from BioEdOnline Baylor Christine
Current estimates-
1,415 microbes are infectious for human.
Of these, 868 (61%) considered zoonotic.
70% of newly recognized pathogens are zoonoses.

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GEOGRAPHIC DISTRIBUTION OF PROBABLE CASES

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Case fatality rate = ------------ = +/- 80 %
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NIPAH VIRUS

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HENDRA VIRUS

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EMERGENCY DENGUE FEVER/
DENGUE HAEMORRHAGIC FEVER

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 Robin Cochran-Dirksen (adapted
from BioEdOnline Baylor Christine
72
 Barriers to Treatment

Political leadership
Socio-cultural factors
Biological research

EPIDEMIL0GICAL
LABORATORY
ECOLOGICAL
ANTHROPOLOGICAL
 Describe
The occurence of disease

Predict
The occurrence
Epidemiology Control the
Distribution of
Of disease Main job disease

Explain the etiology

Of disease