1. Principles of Disease and Epidemiology14
Principles of Disease and Epidemiology

2. Principles of Disease and Epidemiology
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

3. 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.
Figure 14.1c

4. Normal Microbiota and the Host
Locations of normal microbiota on and in the human body.
Table 14.1c

5. Normal Microbiota and the Host
Microbial antagonism is a competition between microbes.
Normal microbiota protect the host by:
Occupying niches that pathogens might occupy
Producing acids
Producing bacteriocins
Probiotics are live microbes applied to or ingested into the body, intended to exert a beneficial effect.

6. Symbiosis Commensalism Mutualism Parasitism
Some normal microbiota are opportunistic pathogens.

7. Koch’s Postulates
Koch's postulates are used to prove the cause of an infectious disease.
Figure 14.3 (1 of 2)

8. Koch’s Postulates
Figure 14.3 (2 of 2)

9. 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.

10. Classifying Infectious Diseases
Communicable disease
Contagious disease
Noncommunicable disease

11. Occurrence of 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.
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.

12. Reported AIDS cases in the United States
Figure 14.4

13. Obesity Epidemic

14. Severity or Duration of a Disease
Acute disease: Symptoms develop rapidly.
Chronic disease: Disease develops slowly.
Latent disease: Disease with a period of no symptoms when the patient is inactive.

15. Extent of Host Involvement
Local infection: Pathogens are limited to a small area of the body.
Systemic infection: An infection throughout the body.
Septicemia: Growth of bacteria in the blood.

16. Predisposing Factors Make the body more susceptible to disease
Short urethra in females
Inherited traits such as the sickle-cell gene
Climate and weather
Fatigue
Age
Lifestyle
Chemotherapy

17. The Stages of a Disease
Figure 14.5

18. Reservoirs of Infection
Reservoirs of infection are continual sources of infection.
Human — AIDS, gonorrhea
Carriers may have inapparent infections or latent diseases.
Other Animals — Rabies, Lyme disease
Some zoonoses may be transmitted to humans.
Nonliving — Botulism, tetanus
Soil and Water

19. Viral and Bacterial Zoonoses
Table (1 of 3)

20. Table (2 of 3)

21. Transmission of Disease
Contact
Direct
Indirect: Spread by fomites.
Droplet

22. Transmission of Disease
Vehicle: Transmission by an inanimate reservoir (food, water).
Vectors: Arthropods, especially fleas, ticks, and mosquitoes.
Mechanical
Biological

23. Transmission of Disease
Figures 14.7b, 14.8

24. Table 14.3

25. Nosocomial (Hospital-Acquired) Infections
Are acquired as a result of a hospital stay.
5-15% of all hospital patients acquire nosocomial infections. ~20,000 die as a result per year
Figures 14.6b, 14.9

26. Relative Frequency of Nosocomial Infections
Table 14.5

27. Common Causes of Nosocomial Infections
Percentage of Nosocomial Infections
Percentage Resistant to Antibiotics
Gram + cocci
51%
29-89%
Gram – rods
30%
3-32%
Clostridium difficile
13%
Fungi 6%

28. Emerging Infectious Diseases (EIDs)
Diseases that are new, increasing in incidence, or showing a potential to increase in the near future.
Contributing factors
Genetic recombination
E. coli 0157, Avian influenza (H5N1)
Evolution of new strains
V. cholerae 0139
Inappropriate use of antibiotics and pesticides

29. Emerging Infectious Diseases
Changes in weather patterns
Malaria
Modern Transportation
West Nile virus
Animal control measures
Lyme disease

30. Epidemiology
The study of where and when diseases occur
Figure 14.10

31. Epidemiology John Snow 1848-1849
Mapped the occurrence of cholera in London
Ignaz Semmelweis
Showed that hand washing decreased the incidence of puerperal fever
Florence Nightingale
1858
Showed that improved sanitation decreased the incidence of epidemic typhus
PLAY
Animation: Epidemiology

32. Centers for Disease Control and Prevention (CDC)
Morbidity: Incidence of a specific notifiable disease.
Mortality: Deaths from notifiable diseases.

33. Centers for Disease Control and Prevention (CDC)
Collects and analyzes epidemiological information in the United States.
Publishes Morbidity and Mortality Weekly Report (MMWR)

34. “AIDS” to “Gonorrhea”; “Pertussis” to “Streptococcal Toxic Shock Syndrome”
Table 14.7 (1 of 2)

35. “Haemophilus influenzae” to “Mumps”; “Streptococcus pneumonaie” to “Yellow Fever”
Table 14.7 (2 of 2)