1. Kelas Berrtaraf Internasional SMAK PENABUR Gading Serpong 2012/2013 INFECTIOUS DISEASES CHAPTER 13 Leonardus, S.Si.

2. Kelas Berrtaraf Internasional SMAK PENABUR Gading Serpong 2012/2013 Content Cholera, malaria, tuberculosis (TB) and HIV/AIDS Antibiotics

3. Kelas Berrtaraf Internasional SMAK PENABUR Gading Serpong 2012/2013 Learning Outcomes Candidates should be able to: (a) define the term disease (see page 37) and explain the difference between an infectious disease and non-infectious diseases (limited to sickle cell anemia and lung cancer; see pages 40 and 41); (b) describe the causes of the following diseases: cholera, malaria, TB, HIV/AIDS, smallpox and measles;

4. Kelas Berrtaraf Internasional SMAK PENABUR Gading Serpong 2012/2013 Learning Outcomes (c) explain how cholera, measles, malaria, TB and HIV/AIDS are transmitted; (d) discuss the roles of social, economic and biological factors in the prevention and control of cholera, measles, malaria, TB and HIV/AIDS (a detailed study of the life cycle of the malarial parasite is not required); (e) discuss the global patterns of distribution of malaria, TB and HIV/AIDS and assess the importance of these diseases worldwide;

5. Kelas Berrtaraf Internasional SMAK PENABUR Gading Serpong 2012/2013 Learning Outcomes (f) outline the role of antibiotics in the treatment of infectious diseases; (g) use the knowledge gained in this section in new situations or to solve related problems.

6. Kelas Berrtaraf Internasional SMAK PENABUR Gading Serpong 2012/2013 Infection: the invasion of any living organism by disease-causing microorganisms (pathogens), which proceed to establish themselves, multiply and produce various symptoms in their host Disease: a condition in which the normal function of some part of the body (cells, tissues or organs) is disturbed

7. Kelas Berrtaraf Internasional SMAK PENABUR Gading Serpong 2012/2013 Infectious diseases are transmissible or communicable diseases. The pathogen can spread from infected people to uninfected people The pathogen cannot survive outside the human body, others can survive in water, human food, feces or animals Some people may spread a pathogen even though they do not have a disease themselves, such as people are symptom-less carriers

8. Kelas Berrtaraf Internasional SMAK PENABUR Gading Serpong 2012/2013 The way in which a pathogen passes from one host to another is called the transmission cycle The pathogen also spread up by: – Respiratory droplets/vomits – Direct body contact/sexual intercourse – Arthropod vectors – Air borne transmission – Water borne transmission – The fecal-oral route

9. Kelas Berrtaraf Internasional SMAK PENABUR Gading Serpong 2012/2013 1.It is caused by the bacterium Vibrio cholerae, water borne transmission 2.It occurs where people do not have access to proper sanitation 3.If the bacteria do reach the small intestine they multiply and secrete a toxin, Choleragen, which disrupts the functions of epithelium so that salts and water leave the blood causing severe diarrhea CHOLERA

10. Kelas Berrtaraf Internasional SMAK PENABUR Gading Serpong 2012/2013 PathogenVibrio cholerae Methods of transmissionFood-borne, water-borne Global distributionAsia, Africa, Latin america Incubation* period1 – 5 days Site of action of pathogenWall of small intestine Clinical features Severe diarrhoea, loss of water and salts, dehydration, weakness Method of diagnosisMicroscopical analysis of feces Annual incidence worldwide5,5 million Annual mortality worldwide120.000 *Incubation : the phase in the development of an infectious disease between initial infection and the appearance of the first symptoms. CHOLERA

11. Kelas Berrtaraf Internasional SMAK PENABUR Gading Serpong 2012/2013 1.It is caused by the protist Plasmodium, 2.The vector is Arthropod (insect), female Anopheles mosquitoes 3.Malaria may also transmitted during blood transfusion and when unsterile needles are reuse 4.The sporozoites, merozoites, and tropozoites attack liver and red blood cells 5.If people are continually reinfected they become immune to malaria MALARIA

12. Kelas Berrtaraf Internasional SMAK PENABUR Gading Serpong 2012/2013 Pathogen Plasmodium falciparum, P. vivax, P. ovale, P. malariae Methods of transmissionInsect vector; female Anopheles mosquito Global distributionThroughout the tropics and subtropics Incubation* periodFrom week and to a year Site of action of pathogenLiver, red blood cells, brain Clinical features Fever, anemia, nausea*, headaches, muscle pain, shivering, sweating, enlarge spleen Method of diagnosisMicroscopical examination of blood Annual incidence worldwide300 million (90% in Africa) Annual mortality worldwide 1,5 – 2,7 million; intropical Africa malaria kills 1 million children under the age of 5 *nausea: A feeling of sickness, with loathing of food and inclination to vomit MALARIA

13. Kelas Berrtaraf Internasional SMAK PENABUR Gading Serpong 2012/2013 Plasmodium malariae Quarterner Malaria Plasmodium vivax Tertiana Malaria Plasmodium falciparum Tropical Malaria MALARIA

14. Kelas Berrtaraf Internasional SMAK PENABUR Gading Serpong 2012/2013 1.It is caused by the HIV (Human Immunodeficiency Syndrome) or Retro Virus 2.The virus infects and destroys cells of the body’s immune system  T helper Lymphocyte 3.AIDS is not disease, no vector, and cannot survive outside the living things. 4.Spread up by intimate human contact, sexual intercourse, blood donation, sharing of intravenous needles and across the placenta from mother to fetus. 5.Homosexuals has high risk of AIDS  Why ??? 6.HIV is slow virus and after infection there may not be any symptoms until years later. At this stage a person is HIV positive but does not have AIDS. Acquired Immuno Deficiency Syndrome (AIDS)

15. Kelas Berrtaraf Internasional SMAK PENABUR Gading Serpong 2012/2013 Structure of HIV and HIV infection Acquired Immundeficiency Syndrome (AIDS)

16. Kelas Berrtaraf Internasional SMAK PENABUR Gading Serpong 2012/2013 PathogenHuman Immunodefeciency Virus (HIV) Methods of transmission In semen and vaginal fluids during sexual intercourse, infected blood or blood products, contaminated hypodermic syringes, mother to fetus across placenta, mother to infant in breast milk Global distributionWorldwide, especially in sub-saharan africa and south-east asia Incubation* period Initial incubation a few weeks, but up to ten years or more before symptoms of AIDS may develop Site of action of pathogenT helper lymphocytes, macrophages, brain cells Clinical features HIV infection – flu-like symptoms and then symptomless AIDS – opportunistic infections including pneumonia, TB, and cancer; weight loss, diarrhoea, fever, sweating, dementia Method of diagnosisBlood test from antibodies to HIV Estimated total number of people infected with HIV world wide in 2002 42 million Estimated number of few cases of HIV infection worldwide in 2002 5 million Estimated number of deaths from AIDS-related diseases worldwide in 2002 3,1 million (one third due to TB) Acquired Immundeficiency Syndrome (AIDS)

17. Kelas Berrtaraf Internasional SMAK PENABUR Gading Serpong 2012/2013 Acquired Immundeficiency Syndrome (AIDS) HIV Life Cycle

18. Kelas Berrtaraf Internasional SMAK PENABUR Gading Serpong 2012/2013 HIV Infection Graphic Acquired Immundeficiency Syndrome (AIDS)

19. Kelas Berrtaraf Internasional SMAK PENABUR Gading Serpong 2012/2013 There is as yet no cure for AIDS and no vaccine for HIV. How we stop the spread of HIV ? Acquired Immundeficiency Syndrome (AIDS) AIDS Victims

20. Kelas Berrtaraf Internasional SMAK PENABUR Gading Serpong 2012/2013 1.It is caused by two bacteria, Mycobacterium tuberculosis and M. bovis 2.These bacteria particularly attack the lungs, but it can spread throughout the whole body and even infect the bone tissue 3.Some people become infected and develop TB quite quickly, whilst in other the bacteria remain inactive for many years 4.30% of the world’s population is infected whit TB without showing any symptoms of the infection 5.TB is spread when infected people with the active form of the illness cough or sneeze and the bacteria are carried in tiny droplets of liquid TUBERCULOSIS (TB)

21. Kelas Berrtaraf Internasional SMAK PENABUR Gading Serpong 2012/2013 PathogenMycobacterium tuberculosis and M. bovis Methods of transmissionAirborne droplets; via unpasteurised milk Global distributionworldwide Incubation* periodFew weeks or months Site of action of pathogen Primary infection in lungs; secondary infection in limph nodes, bones and gut Clinical features Racking cough, coughing blood, chest pain, shortness of breath, fever, sweating, weight loss Method of diagnosis Microscopical examination of sputum for bacteria, chest-X ray Annual incidence worldwide (1998) 8 million (more than 6000 cases in UK) Annual mortality worldwide (1998) 2 million TUBERCULOSIS (TB)

22. Kelas Berrtaraf Internasional SMAK PENABUR Gading Serpong 2012/2013 TUBERCULOSIS (TB) Global Distribution of TB