Introduction To Infection Med 2010

Front 1

flora

Back 1

organisms which routinely colonize appropriate surfaces WITHOUT causing disease

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pathogen

Back 2

an organism able to cause in host

Front 3

pathogen + host DOES NOT EQUAL

Back 3

clinically apparent disease

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Why would a organism cause symptomatic disease?

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1. damaged host cells release substances used by pathogen (side effect of bug)
2. Directly assists in spread of pathogen progeny (cough/sneeze)
3. coincidence

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Iceberg concept of infection

Back 5

usually only see disease/affect from microorg. when host is dying

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cell:
exposure of cell without attachment and/or cell entry

Back 6

host:
exposure without infection

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cell:
viral multiplication without visible change or incomplete maturation

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host:
infection without clinical illness (asymptomatic infection)

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cell:
inclusion body formation
or
cell transformation
or
cell dysfunction

Back 8

host:
classical and severe disease
moderate severity/mild illness

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cell:
lysis of cell

Back 9

host:
death of organism

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What determines whether an encounter with a pathogen causes clinical disease

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1. age/immune status of the host
2. genetic make up of the host
3. route/site of exposure
4. Microbial load
5. genetic makeup of the microorganism

Front 11

age/immune status of host

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determines disease
every immune system is different;
young vs. old immune system
taxoplasmosis as example

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taxoplasmosis

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a lot of people have but they show no symptoms unless immune system is compromised

Front 13

genetic make up of host

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determines disease
both a individual and population levels;
for example people in N. Europe can't get HIV because all that could were wiped out by the bubonic plague. CCR5 gene

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mutations can happen without induction?

Back 14

true

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induction equals causation

Back 15

true; induce is to cause

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Route/site of exposure

Back 16

determines disease
where/how you get disease matters for the response

ie. needle vs. coffee cup vs. in eyes

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Microbial load (size of exposure)

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determines disease
depends on the size and on the type of microorg. exposed to;

ie. need lots of samonella
need little shigella to infect

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Genetic make up of microorganism

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determines disease
some bugs are more virulent than others;

ie. each E.coli is not the same

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Various courses of infection

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1. acute
2. chronic/persistant
3. latent
4. persistent slow infection (following acute)
5. persistent slow 'infection' (no acute)

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acute infection

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microorg infects, immune system takes over, recovery and the microbe is eliminated

*sometimes bug wins

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chronic/persistent infection

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you have to have the bug, get the disease; recover, but the bug stays in the infectious form with continuous or intermediate shedding (still contagious)

*thyphoid mary

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latent infection

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bug infects, get the disease, recovery, microbe persists in the latent NONINFECTIOUS form, then reactivation with bug growth and shedding (lytic) causing disease again (stress, immune syst. comprised)

ie. Herpes

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Persistent slow infection (followed by acute infection)

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you get the bug, recovery, but bug persists, growing over time then you have acute infection (final disease) and die.

ie. HIV

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persistent slow infection (no acute infection following)

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exposed to and get bug, but it grows slowly leading up to final disease (death)

ie. prions in mad cow disease

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Various methods of transmission

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1. direct transmission (contact)
2. vertical transmission
3. zoonotic transmission
4. vector borne disease
5. fomite

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direct transmission (contact)

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way to transmit disease
have to touch;

STD, fecal-oral, respiratory/saliva, blood/transplant

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vertical transmission

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way to transmit disease
mother to child

placenta (syphillus), breast milk, birth canal (gonnorhea, herpes, strep)

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zoonotic transmission

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way to transmit disease
from contact with animal
(or vice versa human to animal)

ie. H1N1, rabies, SARS, HIV-primates

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fomite transmission

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way to transmit disease
bug spread by inanimate object; cup

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vector borne disease transmission

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way to transmit disease
disease remain in person, where arthropod is just carried OR its maintained in the arthropod (carrier)

ie. Malaria, tick

arthropod can also get disease from animal and give to human (lyme disease)

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Endemic

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characteristics of a disease that exists continually at some level in an area

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Outbreak

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a sudden increase in the number of cases of a disease in a SMALL, defined area

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Epidemic

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a sudden increase in the number of cases of a disease, typically in a LARGER area

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Pandemic

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a disease outbreak affecting a high percentage of people over most the globe (ie. Avian flu)

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Endogenous source

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disease from source from inside the body (ie person is infected from their own catheter or IV or microorgs)

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exogenous source

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disease from a source OUTSIDE the body

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Nosocomial infection

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infection obtained while visiting the hospital

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Iatrogenic infection

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an infection induced by medical treatment

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Opportunistic pathogen

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a normally non-pathogenic microorg. which causes disease typically in an immuno-compromised patient

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Various ways to organize infections

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1. respiratory
2. central nervous system
3. skin
4. gastrointestinal system
5. vector-borne
6. Nosocomial
7. urogential

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Outside the box mechanism for physicians to think about for 'infections'

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1.microbe A + microbe B = disease
2. microbe A + host genotype = disease (including cancer)
3. Non microbe based 'infections'
4. non-infectious conditions with an epidemiological relationship to infection
5. consider detrimental conditions that survive in a population (ie. sickle cell anemia)