1. Copyright © 2006 Pearson Education, Inc., publishing as Benjamin Cummings PowerPoint ® Lecture Slide Presentation prepared by Christine L. Case M I C R O B I O L O G Y a n i n t r o d u c t i o n ninth edition TORTORA  FUNKE  CASE 14 Principles of Disease and Epidemiology

2. Copyright © 2006 Pearson Education, Inc., publishing as Benjamin Cummings 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. Copyright © 2006 Pearson Education, Inc., publishing as Benjamin Cummings 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. Copyright © 2006 Pearson Education, Inc., publishing as Benjamin Cummings Normal Microbiota and the Host  Not all microorganisms are pathogenic – most can actually help the body  E. coli is typically found in the intestines of healthy adults, however, if it is found in other parts of the body it can lead to disease.

5. Copyright © 2006 Pearson Education, Inc., publishing as Benjamin Cummings Symbiosis  In commensalism, one organism is benefited and the other is unaffected.  In mutualism, both organisms benefit.  In parasitism, one organism is benefited at the expense of the other.  Some normal microbiota are opportunistic pathogens.

6. Copyright © 2006 Pearson Education, Inc., publishing as Benjamin Cummings Normal Flora  After birth, during eating / breathing other microbiota become permanent on the body….  The one’s that do become permanent on the body become the “normal flora”  Transient microbiota are those that are present on the body for days / weeks / months but are not permanent

7. Copyright © 2006 Pearson Education, Inc., publishing as Benjamin Cummings Normal Flora  Factors that determine presence of microbiota  Available nutrients, physical / chemical factors, defenses of the host  Age, diet, health, nutritional status, climate, hygene, lifestyle, occupation

8. Copyright © 2006 Pearson Education, Inc., publishing as Benjamin Cummings Normal Microbiota and the Host  Locations of normal microbiota on and in the human body. Table 14.1c

9. Copyright © 2006 Pearson Education, Inc., publishing as Benjamin Cummings Normal Microbiota and the Host  Microbial antagonism (competitive exclusion) is a competition between microbes.  Normal microbiota protect the host by:  Occupying niches that pathogens might occupy.

10. Copyright © 2006 Pearson Education, Inc., publishing as Benjamin Cummings  Commensalism (most of our normal flora) is when 1 organism benefits from a relationship and the other is neither hurt nor helped  Mutualism leads to benefits for both organisms  Parasitism is where one organism is benefited and the other is harmed – can often lead to disease  Opportunistic microorganisms do not typically cause disease, however, if the host is in some way compromised, it will colonize / cause disease

11. Copyright © 2006 Pearson Education, Inc., publishing as Benjamin Cummings Robert Koch

12. Copyright © 2006 Pearson Education, Inc., publishing as Benjamin Cummings Koch’s Postulates  Koch's postulates are used to prove the cause of an infectious disease. Figure 14.3 (1 of 2)

13. Copyright © 2006 Pearson Education, Inc., publishing as Benjamin Cummings Koch’s Postulates  Koch's postulates are used to prove the cause of an infectious disease. Figure 14.3 (2 of 2)

14. Copyright © 2006 Pearson Education, Inc., publishing as Benjamin Cummings Koch’ Postulates 1.The same pathogen must be present in every case of the disease. 2.The pathogen must be isolated from the diseased host and grown in pure culture. 3.The pathogen must cause the disease when innoculated into a healthy host. 4.The pathogen must be isolated from the innoculated organism and must be the original microorganism

15. Copyright © 2006 Pearson Education, Inc., publishing as Benjamin Cummings 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.

16. Copyright © 2006 Pearson Education, Inc., publishing as Benjamin Cummings Classifying Infectious Diseases  Communicable disease: A disease that is spread from one host to another.  Contagious disease: A disease that is easily spread from one host to another.  Noncommunicable disease: A disease that is not transmitted from one host to another.

17. Copyright © 2006 Pearson Education, Inc., publishing as Benjamin Cummings 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.  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.  Herd immunity: Immunity in most of a population.

18. Copyright © 2006 Pearson Education, Inc., publishing as Benjamin Cummings Figure 14.4

19. Copyright © 2006 Pearson Education, Inc., publishing as Benjamin Cummings Severity or Duration of a Disease  Acute disease: Symptoms develop rapidly.  Chronic disease: Disease develops slowly.  Subacute disease: Symptoms between acute and chronic.  Latent disease: Disease with a period of no symptoms when the patient is inactive.

20. Copyright © 2006 Pearson Education, Inc., publishing as Benjamin Cummings Extent of Host Involvement  Local infection: Pathogens are limited to a small area of the body.  Systemic infection: An infection throughout the body.  Bacteremia: Bacteria in the blood.  Septicemia: Growth of bacteria in the blood.

21. Copyright © 2006 Pearson Education, Inc., publishing as Benjamin Cummings Extent of Host Involvement  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.

22. Copyright © 2006 Pearson Education, Inc., publishing as Benjamin Cummings 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

23. Copyright © 2006 Pearson Education, Inc., publishing as Benjamin Cummings The Stages of a Disease Figure 14.5

24. Copyright © 2006 Pearson Education, Inc., publishing as Benjamin Cummings Reservoirs of Infection  Reservoirs of infection are continual sources of infection.  Human — AIDS, gonorrhea  Carriers may have inapparent infections or latent diseases.  Animal — Rabies, Lyme disease  Some zoonoses may be transmitted to humans.  Nonliving — Botulism, tetanus  Soil

25. Copyright © 2006 Pearson Education, Inc., publishing as Benjamin Cummings Transmission of Disease  Contact  Direct: Requires close association between infected and susceptible host.  Indirect: Spread by fomites.  Droplet: Transmission via airborne droplets.

26. Copyright © 2006 Pearson Education, Inc., publishing as Benjamin Cummings Transmission of Disease Figure 14.6a, d

27. Copyright © 2006 Pearson Education, Inc., publishing as Benjamin Cummings Transmission of Disease  Vehicle: Transmission by an inanimate reservoir (food, water).  Vectors: Arthropods, especially fleas, ticks, and mosquitoes.  Mechanical: Arthropod carries pathogen on feet.  Biological: Pathogen reproduces in vector.

28. Copyright © 2006 Pearson Education, Inc., publishing as Benjamin Cummings Transmission of Disease Figures 14.7b, 14.8

29. Copyright © 2006 Pearson Education, Inc., publishing as Benjamin Cummings Nosocomial (Hospital-Acquired) Infections  Are acquired as a result of a hospital stay.  5-15% of all hospital patients acquire nosocomial infections. Figures 14.6b, 14.9

30. Copyright © 2006 Pearson Education, Inc., publishing as Benjamin Cummings Relative Frequency of Nosocomial Infections Table 14.5

31. Copyright © 2006 Pearson Education, Inc., publishing as Benjamin Cummings Percentage of Nosocomial Infections Percentage Resistant to Antibiotics Gram + cocci51%29%-89% Gram – rods30%3-32% Clostridium difficile13% Fungi6% Common Causes of Nosocomial Infections

32. Copyright © 2006 Pearson Education, Inc., publishing as Benjamin Cummings Emerging Infectious Diseases  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  Inapproriate use of antibiotics and pesticides  Antibiotic resistant strains

33. Copyright © 2006 Pearson Education, Inc., publishing as Benjamin Cummings Emerging Infectious Diseases  Changes in weather patterns  Hantavirus  Modern Transportation  West Nile virus  Ecological disaster, war, and expanding human settlement  Coccidioidomycosis  Animal control measures  Lyme disease  Public Health failure  Diphtheria

34. Copyright © 2006 Pearson Education, Inc., publishing as Benjamin Cummings Crossing the Species Barrier UN 13.3

35. Copyright © 2006 Pearson Education, Inc., publishing as Benjamin Cummings Epidemiology  The study of where and when diseases occur Figure 14.10

36. Copyright © 2006 Pearson Education, Inc., publishing as Benjamin Cummings John Snow1848-1849Mapped the occurrence of cholera in London Ignaz Semmelweis1846-1848Showed that hand washing decreased the incidence of puerperal fever Florence Nightingale1858Showed that improved sanitation decreased the incidence of epidemic typhus Epidemiology

37. Copyright © 2006 Pearson Education, Inc., publishing as Benjamin Cummings DescriptiveCollection and analysis of data regarding occurrence of disease Snow AnalyticalComparison of a diseased group and a healthy group Nightingale ExperimentalStudy of a disease using controlled experiments Semmelweis Case reportingHealth care workers report specified disease to local, state, and national offices Nationally notifiable diseases Physicians are required to report occurrence PLAY Animation: Epidemiology

38. Copyright © 2006 Pearson Education, Inc., publishing as Benjamin Cummings Table 14.7 (1 of 2) “AIDS” to “Gonorrhea”; “Pertussis” to “Streptococcal Toxic Shock Syndrome”

39. Copyright © 2006 Pearson Education, Inc., publishing as Benjamin Cummings Table 14.7 (2 of 2) “Haemophilus influenzae” to “Mumps”; “Streptococcus pneumonaie” to “Yellow Fever”

40. Copyright © 2006 Pearson Education, Inc., publishing as Benjamin Cummings Centers for Disease Control and Prevention (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.

41. Copyright © 2006 Pearson Education, Inc., publishing as Benjamin Cummings  Collects and analyzes epidemiological information in the United States.  Publishes Morbidity and Mortality Weekly Report (MMWR) www.cdc.gov Centers for Disease Control and Prevention (CDC)