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infectious diseases (Prophylaxis (Isolation (Obligatory hospitalization…
infectious diseases
Prophylaxis
Therapy, Protection of porta of entry, Vaccinations, Immunoglobulines, Chemoprophylaxis
Isolation
Obligatory hospitalization and therapy of the patient with infectious disease
Isolation in the separate room of the hospital ward
Leave from work/school – is also isolation
Quarantine
Obligatory hospitalization and observation of healthy person suspected to develop infectious disease, due to the contact with infected case / being in incubation period
Quarantine lasts as long as the maximal incubation period of given disease
Sanitary cordon
All legal and administrative actions directed to total isolation of given administrative or geographical area and to discontinuation of any forms of communication to and from the area.
Nowadays – extremely rare…
Isolation, quarantine and sanitary cordon will be rejected by individuals and communities…
Forms of spread of infectious diseases
Sporadic cases
Epidemic/outbreak
Increased number of cases of given disease limited in time and observed in given area.
Has beginning, termination and is limited to well defined region/area.
Endemic
Increased number of cases of given disease unlimited in time and limited to given area.
Pandemic
Epidemic covering continents or even global.
New etiological agent appears
Not limited to any area, may last for many years…
Bacterial toxins
Exotoxins
Proteins – sensitive to temperature
Excreted by alivie microorganisms
Have extremely specific point of attack
Extremely strong toxins
Stimulate production of antibodies
Botulism, Tetanus, Staphylococcal alfa-toxin
Scarlet fever/ erythrogenic toxin, Gaseous gangrene
Endotoxins
Complex substances (i.e. glycoproteins)
Usually released from destructed microbes
Unspecific, multidirectional activity
Limited activity
Do not induce antibody production
Gram-negative bacteria
Group A streptococci
Staphylococci
Anthrax
Chlamydia
symptoms
Related to microorganism
Relatively rare: Labial Herpes, Shingles, Tetanic convulsions
Related to inflammatory responce:
Frequent, nonspecific: Fever, Rashes, Tachycardia, Lymphadenopathy, Petechiae, Meningeal symptoms, Hepatomegaly, Pus/exudates, Pain
Fever may result from
Infection, Malignancy, Autoimmune/allergic diseases, Tissue necrosis, Hyperthyroidism
Carrier
Clinical definition
Infected person in which the microorganism replicates,
The person may become a source of infection,
The person do not have any symptoms:
Clinical symptoms
Laboratory abnormalities
Pathological abnormalities
Epidemiological definition
Any infected person, that may become a source of infection,
Ill or healthy
Classifications
according to
Causative agent: Bacteria, Viruses, Fungi, Parasites, Prions
Clinical syndromes/anatomical location (ie. sepsis, meningitis, pneumonia, hepatitis)
Route of spread (i.e. airborne, oral-fecal, contact with blood)
Type of subjects at risk: (i.e. immunocompromised patients, travelers, inpatient)
Clinical course (i.e. acute, chronic, subacute etc.)
Microorganisms
factors of virulence
Toxins, Adhesins, Enzymes, Capsules, Fimbria
Specific receptors, Rapid replication, Phenotypic/genotypic variability
Elements of immunity
Skin and mucosal membranes
pH of the skin, gastric juices, urine etc.
Nonspecific factors
(Lyzozyme, interferons, complement, siRNA, APOBEC, etc.)
Specific, active immunity: Humoral, Cellular
laboratory tests
Confirming presence of the microorganism in human body: Cultures (bacterial, viral), PCR, Serology (HBsAg)
Confirming immune interaction with the microorganism:
ELISA (anti-HBc, anti-HCV, anti-SARS, anti-borrelia) – many mistakes
Confirming inflammatory reaction:
Leucocytosis / bands, CRP, procalcytonine, Inflammatory abnormalities in cerebro-spinal fluid
Show abnormalities related to organ/system destruction:
Aminotransferases
Thrombocytopenia, d-dimer levels
Epidemiologic chain
Describes consecutive steps in spread of microbes and infectious diseases
Describes mechanisms of outbreaks
Provides base for any prophylactic activities
Routes of spread
Indirect: Droplet/airborne, Fecal-oral/water, Insects, Soil etc.
Direct: Placental, Blood, Sexual
Vector
Arthropod or vertebrate
Transfers microorganisms between a source of infection and a susceptible person:
Passive
Active (given microorganism replicates in them)
Interactions between microorganisms and human body
Harmful: Parasitism, pathogenicity, Need therapy
Neutral: Colonization, commensalisms (ie. carrier of MRSA)
Rarely need therapy only for epidemiologic or prophylactic reasons
Mutually beneficial:
Symbiosis (i.e. physiological flora of the skin, vagina, bowels)
Antibiotics are harmful to that flora…
a disease caused by, or related to, direct or indirect interaction between human body and microorganisms.
Infectious disease (related to infection)
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contagious disease (easily disseminating)