Infectious Disease:

Definition of Terms:

Infectious Disease:
• An illness caused by pathogenic microorganisms, such as
bacteria, viruses, parasites or fungi; ( infectious agent that is
spread from an infected person, animal, or inanimate
reservoir to a susceptible host, either directly or indirectly,)
 Definition of Terms:
• contagious disease (also called a communicable disease) is an
infectious disease that is capable of being transmitted from
one person or species to another.

• Contagious essentially means "extremely communicable."

"Contagious diseases" are most often communicable enough
to warrant quarantine, whereas "communicable diseases"
(such as the flu) are not.
Contagious disease: is a communicable disease that is
transmitted to many individuals quickly and easily; highly
infectious.
 Microbes That Cause
Infectious Diseases
 Bacteria. These one-cell organisms are responsible for illnesses
such as strep throat, urinary tract infections and tuberculosis.
 Viruses. Even smaller than bacteria, viruses cause a multitude of
diseases — ranging from the common cold to AIDS.
 Fungi. Many skin diseases, such as ringworm or athlete's foot, are
caused by fungi. Other types of fungi can infect lungs or nervous
system.
 Parasites. Malaria is caused by a tiny parasite that is transmitted
by a mosquito bite. Other parasites may be transmitted to humans
from animal feces.
 Chain of causation in
infectious disease
• The chain consist of, reservoir, portal of exist, mode of
transmission, agent, portal of entry, and the host
 First link : The chain begins by (reservoir) where causal agent can
live and multiply) for example in plague‫طاعون‬, the reservoir may
be other human, rats, and few other animals. In Malaria, the
reservoirs for the parasitic agent are the infected human.

 Second link: Portal of exist: from the reservoir, the bites of an

Anopheles mosquito provide a portal of exist for the parasite,
which spend part of its life cycle in the mosquito body.
 Modes of Transmission
 Third link :Mode of transmission: The method of transmission is
the means by which the agent goes from the source to the host.
For example (The mosquitoes are the mode of transmission)
• Direct Transmission: occurs by immediate transfer of infectious
agents from a reservoir to a new host. It requires direct contact
with the source, through touching, biting, kissing, or sexual
intercourse, or by the direct projection of droplet spray onto the
conjunctiva or onto the mucous membranes of the eye, nose, or
mouth during sneezing, coughing, spitting, laughing, singing, or
talking. Direct transmission is limited to a distance of 1 meter or
less.
Modes of Transmission
• Indirect Transmission: occurs when the infectious agent is
transported within contaminated inanimate materials such as
air, water, or food. It is also commonly referred to as vehicle
borne transmission.
 People may be affected by certain communicable diseases
merely through carrying on the normal activities of eating
food and drinking beverages.
Modes of Transmission
 Food borne illnesses frequently reported in the last few years
include salmonellosis;a bacterial agent, hepatitis A; a viral agent,
and shigellosis, a bacterial agent.
 waterborne illness The most commonly reported waterborne
illness is infection by Giardia lamblia, a protozoan.
 Most of the disease-causing agents typically found in foods also
survive in water to cause disease, although water may provide a
less nutritive environment and result in lower concentrations of
the agent.
 Most commonly, exposure to infectious food or water results in
symptoms related to gastrointestinal function, including diarrhea,
nausea, vomiting, stomach cramps, and jaundice. .
Modes of Transmission
 incubation period: This time interval between exposure and
onset of symptoms
 vector-borne transmission: When transmission occurs
through a vector, which is a nonhuman carrier such as an
animal or insect. Common vectors include bats‫الخفافيش‬,
fleas‫البراغيث‬, lice, mosquitoes, rats, and ticks. During vector-
borne transmission, the infectious agent may be transported
mechanically without multiplication or change, or the
infectious agent may develop biologically before passage to a
susceptible host.
Modes of Transmission
 Airborne Transmission
 Airborne transmission occurs through droplet nuclei—the small
residues that result from evaporation of fluid from droplets
emitted by an infected host.
 Because of their small size and weight, they can remain
suspended in the air for long periods before they are inhaled into
the respiratory system of a host.
 Airborne transmission can also occur in dust.
 To be truly airborne, the particles should travel more than 3 feet
through the air from the source to the host. Tuberculosis is
primarily an airborne disease
 Fourth link: Agent The next link in chain is the agent itself, in
Malaria; the agent is the protozoa that multiply in mosquito
 Fifth link: Then the portal of entry, the bite by mosquito
provides the portal of entry into the human host. The
organism may enter the host through the skin, mucous
membranes, lungs, gastrointestinal tract, or genitourinary
tract, and it may enter fetuses through the placenta
 Sixth link: Host: The last link in the chain
 Development of disease in a host is influenced by host defense
mechanisms in addition to other factors as sex, age…etc.
 Environment have a profound influence at any point along the chain for
example:
 Temperature can assist or inhibit multiplication of organisms at their reservoir;
 air velocity can assist the airborne movement of droplet nuclei;
 low humidity can damage mucous membranes;
 ultraviolet radiation can kill the microorganisms. In any investigation of
disease, it is important to evaluate the effect of environmental factors.
Prevention of infectious
diseases
1. Causative Agent
Strategies for breaking this link.
• Remove or reduce the number of microbes through hand
washing.
• Eliminate and destroy microbes using sterilization
techniques.
• Use antibiotics and antimicrobials prudently.
• Conduct surveillance for infectious pathogens at all levels.
 Prevention of infectious
diseases
2. Reservoir
Strategies for breaking this link:
 Eliminate contaminated equipment through thorough sterilization
or the use of disposable supplies.
 Isolate infectious patients when appropriate.
 Relieve infected healthcare workers from duty until non contagious.
Prevention of infectious
diseases
3. Portal of Exit
Strategies for breaking this link —
 Contain infectious microbes, for example, cover the mouth
and nose when coughing or sneezing.
 Use gloves when in contact with any body fluids.
Prevention of infectious
diseases
4. Mode of Transmission
Strategies for breaking this link
 Disrupt direct contact transmission by washing hands after
patient contact.
 Interrupt indirect contact by using bags/covered containers for
isolating contaminated material.
 Prevent contamination of common vehicles, such as adequately
refrigerating food in hospitals.
 Eliminate vectors through public health measures, such as water
drainage in mosquito-ridden areas to prevent malaria and West
Nile Fever where outbreaks have occurred.
Prevention of infectious
diseases
5. Portal of Entry:
Strategies for breaking this link —
 Keep the door closed in respiratory-isolation patient rooms.
 Use masks when caring for patients with -TB.
Prevention of infectious
diseases
6. Susceptible Host:
Strategies for breaking this link —
 Use vaccines, such as the hepatitis B vaccine, for healthcare
workers.
 Employ vaccines for high-risk population, such as influenza
inoculation for the elderly and those with respiratory
conditions.
 Screen healthcare workers
 Support public health interventions that address such areas as
nutrition, potable water, and vector control.
Public Health Measures to
Prevent Infectious Diseases
• Safe water
• Sewage treatment and disposal
• Food safety programs
• Animal control programs
• Vaccination programs
• Public health organization
Role of the community health
nurse
• Information gathering
• Assessment includes full family history, recurrent pattern of
disease , presence of risk factors in individual's environment is
essential part of counseling .
• Record keeping and notification
• Accurate recording.
Role of the community
health nurse
 Policy maker
 Ethical policy decision regarding services
 Maintain detailed specialist knowledge and keeping in research.
 Recognizing disease patterns within the family and community
illustrating a particular mode of transmission.
 Calculating risks of spreading and transmission and outbreak
 Allocating sufficient time to consider all implications of a disease
 Storing and analyzing all information , allows all individuals on a
register to be contacted if new tests or treatment become
available
Role of the community
health nurse
• Care provider
• Nurses are among the many care providers who make up the
interdisciplinary team .
• The nursing profession sets the standard for providing care in
the community .
• Counseling
Role of the community
health nurse
 Educator
 Community health nurse educate client , other nurses and the
public about the health related problems they discover and
the roles of the nurses who work to resolve these problems ,
therapy improving health .
 Teaching about nature of the disease.
 Mechanics of transmission .
 The nurse provide information and giving reassurance and
clarify issues that troubling the patient .
 Help the patient in design making .
Role of the community
health nurse
 Advocator : The role of advocate is filled when a person acts
foe another person in a way that is reasonable and prudent .
Acting for another is necessary when the person can not get
his or her own health care needs met independently .
 Planner : Community health nurse are involved in health
planning in an effort to meet the needs of community .Health
planning should include the client whenever possible so that
health care services are relevant or client needs .
• Coordinator of care : Community health nurses coordinate
the care of clients to resources as well as to provide
appropriate services . Care must be coordinate to avoid the
duplication of services
Emerging and Re-emerging
Infectious Diseases
 Globally, infectious diseases remain the leading cause of
death, and they are the third leading cause of death in the
United States
 At least a dozen "new" diseases have been identified (such as
AIDS, Legionnaire disease, and hantavirus pulmonary
syndrome, covid 19), and traditional diseases that appeared to
be "on their way out" (such as malaria and tuberculosis) are
resurging.
 Emerging diseases are diseases that:
(1) have not occurred in humans before (this type of emergence
is difficult to establish and is probably rare);
(2) have occurred previously but affected only small numbers of
people in isolated places (AIDS examples)
Emerging and Re-emerging
Infectious Diseases
• Re-emerging infectious diseases are diseases that once were
major health problems globally or in a particular country, and
then declined dramatically, but are again becoming health
problems for a significant proportion of the population
(malaria and tuberculosis are examples).
• Many specialists in infectious diseases include re-emerging
diseases as a subcategory of emerging diseases.
some explanations for the re-
emergence of infectious
diseases
 some explanations for the re-emergence of infectious diseases.
Tuberculosis has re-emerged due to evolution of the causative
bacteria.
 The pathogen has acquired resistance to the antibiotics used to
treat tuberculosis (either through mutation or genetic exchange)
and the long-term use of antibiotics (both within one individual and
across the population) has selected for the pathogen's proliferation.
Malaria has also become drug resistant, and the vector mosquito
has acquired resistance to pesticides as well.
 The re-emergence of diseases such as diphtheria and whooping
cough (pertussis) is related to inadequate vaccination of the
population.
 When the proportion of immune individuals in a population drops
below a particular threshold, introduction of the pathogen into the
population leads to an outbreak of the disease.
some explanations for the re-
emergence of infectious diseases
 Changes in Land Use
 Dams to store water for irrigation and electric power
introduce water born disease
 The risk of many infectious diseases is influenced by human
alteration of local, regional or global ecosystems. In the
tropics and subtropics, dams created to store water for
irrigation and hydroelectric power have introduced water-
borne diseases, such as schistosomiasis ( ‫بلهارسيا‬, to
communities where they previously did not exist.
• Deforestation : Human activities, such as deforestation,
irrigation, extensive agriculture or building settlements, affect
the ecological conditions in which disease-causing
 Urbanization - Megacities
 Population density is increasing in countries that are not able
to provide adequate sewage systems, safe drinking water,
housing and medical facilities. People are living in
overcrowded "megacities" often million or more, many of
which are in tropical or subtropical regions where infectious
diseases thrive. Today there are over 24 megacities, mostly
in developing countries. It is estimated that by 2010, 50% of
the world's population will be living in urban areas.
• Globalization of World Commerce
• Potential disease-carrying insects and contaminated foods,
plants, and other products cross U.S. borders every day. Since
the 1980's, food imports to the U.S. have doubled.
• Increases in food imports strain the nation's food safety
system.
 Population Movement
 In 1990 it was estimated that there were 20 million refugees
and 30 million displaced persons worldwide. Human
population movements due to political, economic or climatic
events such as flooding, earthquakes and drought, are
important factors in disease emergence. Such crises lead to
interim living arrangements, such as refugee camps and
temporary shelters, that provide ideal conditions for the
spread of infections. Temporary living quarters often share
similarities with urban slums - crowding, inadequate
sanitation, limited access to medical care, lack of clean water
and food, dislocation, and inadequate barriers for disease-
carrying agents.
 Increased Air Travel
 Modern air travel makes it possible to spread infectious
diseases to different parts of the world. People are traveling
to areas where they can get infected and bring new diseases
home with them. How many more victims could a lethal strain
of influenza, similar to the 1918 epidemic, claim today with
half a billion passengers traveling via jet planes? The speed of
travel enables a person carrying a disease such as Ebola to
travel 12,000 miles, pass unnoticed through customs and
immigration before developing symptoms several days later,
thus infecting many other people before getting ill.
 Microbial Adaptation: Tuberculosis
 Tuberculosis is an acute or chronic infection caused by
Mycobacterium tuberculosis, which usually involves the lungs
but may involve any organ or tissue of the body. A worldwide
health problem that reached a peak in the l9th century, it was
thought to have been brought under control by the l960s due
to active public health measures and the use of modern drug
therapies. However, this complacency led to reduced funding
for the diagnosis and treatment of TB at the same time that
the bacterium was developing resistance to the drugs used to
treat it. The problem has been compounded since the 1980s
by the emergence of a new population of vulnerable
 Living In A World With HIV/Aids
 Sharing needles for drug injection is a well-known route of HIV
transmission as well as many blood-borne infections. Injection
drug use contributes to the spread of infectious diseases far
beyond the circle of those who inject. People who have sex
with an injection drug user (IDU) are also at risk for infection
through sexual HIV transmission.
 Antibiotic Abuse
 Just as any organism adapts to changes in its environment, so
the use of antibiotics has become a feature of the
environment in which bacteria breed. Because bacteria
multiply rapidly, there are many opportunities for mutations
to occur under the selective pressure of antibiotics. As such,
many strains of bacteria have now developed resistance to
many common antibiotics. The routine use of antibiotics in
breeding cattle, for example, is one probable source of
resistant bacteria.
 Many infectious diseases, once curable by antibiotics, are
reappearing in forms that are difficult and sometimes
impossible to treat with conventional drugs. Scientists warn
that measures are not taken now to slow their spread, the day
of untreatable common infections may return.
 New antibiotics are constantly being developed to combat the
problem of antibiotic resistance. Research on the genetics of
bacteria using advanced molecular genetic technologies may
provide new opportunities to develop specific antibiotics for
certain bacteria