INFECTIOUS DISEASES.

(w10 21/22/23)
Disease: an abnormal condition affecting an organism, which reduces the
effectiveness of the functions of the organism.
Infectious disease: a disease caused by a pathogen that can be
transmitted from one host organism to another.
Non-infectious disease: a disease with a cause other than a pathogen,
including genetic disorders (such as sickle cell anaemia) and lung cancer
(linked to smoking and other environmental factors).

Disease
Cholera
Malaria

Type of causative
organism
Bacterium
Protoctist-Plasmodium

Tuberculosis (TB)

Bacteria

AIDS (Acquired
Immune Deficiency
Syndrome)
Smallpox
Measles
Borne-carried by_____

Virus

Virus
Virus

Name of causative
organism
Vibrio cholerae
Plasmodium
falciparum, P. vivax, P.
ovale, P.malariae
Mycobacterium
tuberculosis, M. bovis
Human
immunodeficiency
virus(HIV)
Variola
Morbillivirus

How is cholera transmitted?

Water-borne & food-borne disease

Infected people pass out large number of bacteria in their faeces
Contaminate water supply, infected people handle food or cooking
utensils without washing their hands
Bacteria transmitted to uninfected people

How is measles transmitted?

Virus spread by airborne droplets

Major disease in places which have insanitary conditions and high
birth rate
Measles virus is easily transmitted in these conditions
Infects mainly malnourished infants suffering from vitamin A
deficiency

How is malaria transmitted?

1. Female Anopheles mosquito (insect vector) bite infected person with

Plasmodium
2. Takes up some of the pathogens gametes with the blood meal
3. Gametes fuse and develop in the mosquitos gut to form infective
stages which move to the mosquitos salivary glands.
4. Mosquito feeds again
5. Injects an anticoagulant that prevents blood meal from clotting so
that it flows out of host into the mosquito
6. Infective stages pass out into blood together with the anticoagulant
in the saliva
7. Parasites enter red blood cells and multiply (plasmodium multiplies
both in human and mosquito-huge increase in number of parasite
increases chances of infecting another person or mosquito)
Blood transfusion
Unsterile needles are reused
How is TB transmitted?
1. Infected people with the active form of this disease cough or sneeze
2. Bacteria carried in the air in tiny droplets of liquid
3. Uninfected people inhale the droplets
(Spreads most rapidly in overcrowded conditions and among people
who sleep close together in large numbers, are homeless, people
who live in poor, substandard housing, have low immunity due to
malnutrition or being HIV positive)
Form of TB caused by M. bovis also occurs in cattle and is spread to
humans in meat and milk. (unpasteurised milk)
How is HIV/AIDS transmitted?
(virus spread only by intimate human contact, no vector and unable to
survive outside the human body)

Transmitted in semen and vaginal fluids during sexual intercourse

Infected blood or blood products(blood donation)
The sharing of intravenous needles (contaminated hypodermic
syringes)
Mother to foetus across placenta
Mother to infant in breast milk

Factors of prevention and control

Cholera

Cholera is best controlled by treating sewage effectively, providing a

clean water supply

Provision of clean piped water, which is chlorinated

Maintaining good hygiene in food preparation.
Giving a solution of salts and glucose intravenously to rehydrate the
body. If they can drink, they are given oral rehydration therapy.

Malaria
Reduce the number of mosquitoes

Spread oil on surface of water to make it impossible for mosquito

larvae and pupae to breathe
Drain marshes and clear vegetation
Biological control: stock ponds, irrigation and drainage ditches and
other permanent bodies of water with fish that feed on mosquito
larvae
Spray preparation containing bacterium Bacillus thuringienis which
kills mosquito larvae but not toxic to other life forms

Avoid being bitten by mosquitoes

Sleep beneath mosquito nets

Use insect repellents
Soaking mosquito nets in insecticides every six months
Sleep with animals
Do not expose skin when mosquitoes are active at dusk (wear longsleeved clothing)

Use drugs to prevent the parasite infecting people

Prophylactic drugs like quinine and chloroquine inhibits protein

synthesis and prevents parasite from spreading within the body (for
infected people)
Proguanil inhibits the sexual reproduction of plasmodium inside the
biting mosquito

Introduction of simple dipstick-type tests for diagnosing malaria (quicker

without the need for labs)
The whole genome of plasmodium has been sequenced and this may lead
to the development of effective vaccines
TB

Increasing standards of living and treating HIV infection can

therefore help to reduce the incidence of TB.

Vaccination with the BCG vaccine confers immunity to TB in many

people. New vaccines are being developed that it is hoped will be
more effective.
Treatment of HIV drug therapy reduces the risk that an HIV
positive person will get TB.
Contract tracing and subsequent testing for bacterium
Pasteurise milk and infected cattle are routinely tested and any
found to be infected are

HIV/AIDS

All blood to be used in transfusion should be screened to ensure it

does not contain HIV and heat-treated to kill any viruses.
All hypodermic needles should be sterile and used only once, and
disposed of carefully.
A person should avoid sexual activity with anyone whose HIV status
they do not know. If everyone had only one partner, HIV could not
be transmitted. Condom and femidoms, if properly used, can
prevent the virus passing from one person to another during
intercourse. If a person is diagnosed with HIV, all their sexual
contacts should be traced and informed that they may have the
virus. (contact tracing)
The chances of HIV passing from an HIV positive mother to her
foetus are greatly reduced if the mother is treated with appropriate
drugs. These drugs can also greatly increase the length of time
between a person becoming infected with HIV and developing
symptoms of AIDS, and can significantly prolong life.
Injecting drug users are advised to give up their habit, stop sharing
needles or take their drug in some other way
HIV positive women in developed countries are advised not to
breast feed their children

Measles

Measles is a serious disease, which can cause death, especially in

adults and in people who are not in good health, for example
because they do not have access to a good diet.
Vaccination is the best defence against measles. The vaccine is
highly effective, especially if two doses are given. The people most
likely to suffer from measles are therefore those who are
malnourished and who live in areas where no vaccination
programme is in place

Distribution & factors that need to be considered

Cholera
Distribution- no need

Transmission is most likely to occur in the crowded and

impoverished conditions, such as refugee camps.
Large cities with no sewage treatment or clean water. Increasing
quantities of untreated faeces from a growing population favour
choleras survival.( do not have the financial resources to provide
drainage and clean water supply to large areas for substandard
housing)
Raw human sewage is used to irrigate vegetables
Inadequate washing or cooking in contaminated water
Why the vaccines only provide short-term protection?
Vibrio cholera remains in the intestine where it is beyond the reach
of many antibodies
Cholera vaccine is injected rather than taken orally and so it is
unable to stimulate antibody production in the intestine, nor can it
stimulate the production of an antitoxin against choleragen
Many different strains of V.cholerae
Seafood(filter feeders) like oysters and mussels become contaminated
because they concentrate cholera bacteria when sewage is pumped
into the sea.
Symptomless carriers make it difficult to identify infected people

Malaria
1 Anopheles mosquito (vector) breeds / lives, within the tropics in hot and
humid areas ; ora
2 Plasmodium (pathogen) needs to reproduce within the mosquito (at
temperatures above 20C) ;
3 eradicated in some countries outside the tropics ;
4 ref. to LEDCs(less economically developed countries) and, poor / non-existent,
mosquito control programmes ; (this programme was hugely expensive and
unpopular)
5 mosquitoes resistant to, DDT / insecticides / pesticides such as dieldrin ;
6 An increase in Plasmodium that are resistant to drugs / chloroquine / other
named drug ;

7 newer drugs such as mefloquine are expensive and sometimes cause

unpleasant side effects such as restlessness, dizziness, vomiting and disturbed
sleep.
8 doctors in developed countries misdiagonise it as influenza because the initial
symptoms are similar
9 in non-malarial countries, many of the cases are settled immigrants who visit
their relatives in Africa or India and do not take prophylactic drugs because they
do not realise that they have lost their immunity(migration of people as a result
of civil unrest and war)
10 an increase in the proportion cases caused by P.falciparum the form that
causes severe, often fatal malaria
11 difficulties in developing vaccine
12 increase in number of epidemics because of climatic and environmental
changes that favour the spread of mosquitoes.

TB distribution

Why tb is found everywhere? (unlike malaria)

TB is transmitted, by, droplets / coughing / sneezing ; A in the air

no vector / no mosquito / no requirement for hot or humid conditions ;
ref. to, HIV infection / lower immunity / immunocompromised
Improvements in public health were reducing tuberculosis even before the arrival of antibiotics
Due to improvements in housing conditions and diet

TB is most prevalent amongst people leaving in poor

accommodation and rising homelessness, or whose immune
systems are not functioning well, perhaps because of malnutrition or
infection with HIV.
Treatment of TB with antibiotics can often completely cure the
disease. However, that is not always the case because:
There are now many strains of thee M. tuberculosis bacterium
that have evolved resistance to most of the antibiotics that are
used;
The bacteria reproduce inside body cell, where it is difficult to
drugs to reach them;
The drugs need to be taken over a long time period, which often
requires a health worker checking that a person takes their drugs
every day (many people do not complete their course as they think
they are cured but they may harbour drug-resistant bacteria and
may spread these to others if they become active)
Resurgence is due to- AIDS pandemic

-breakdown of TB control programmes; partial treatment for TB increases

the chance of drug resistance in Mycobacterium
-migration from Eastern Europe and developing counties to large cities
such as London and New York

HIV/AIDS
Virus cannot survive outside the human body
People with multiple partners are put at risk
Haemophiliacs who were treated with a clotting substance (factor VIII)isolated
from blood pooled from many donors
Virus has a long latent stage- transmitted by people who are HIV positive but who
show no symptoms of AIDS and do not know that they are infected

 Virus changes its surface proteins which make its hard for the bodys immune
system to recognise it. Difficult to develop a vaccine.

HIV infection rates are especially high in sub- Saharan Africa. Many of
these people are not able to receive treatment with effective drugs,
generally for economic reasons.

People in Britain tend to have an HIV test far later stage than any other
Europeans
In Africa and South-East Asia, the epidemic is not restricted to such easily
identifiable groups and widespread testing is not feasible due to expense
of reaching the majority of population and the difficulty of organising it.

70% of all HIV infected adults and children are found in sub-Saharan Africa
Heterosexual sexual transmission is predominant and sub-Saharan Africa is the only
region where more women than men are infected.
The inaccessibility of antiretroviral treatment in this region means that the vast
majority of HIV infected people die around 810 years after infection, with
tuberculosis being the most common AIDS-related illness.
Climbing elsewhere such as in eastern Europe and central Asia. Male-male sex, injection drug use,
and sex work are the predominant risk factors in most other regions. Infection rates are declining in
some regions, including some of the most heavily affected countries in Africa, but Recent HIV
epidemiologic research findings include new insights into the role of HIV viral load, co-infection with
sexually transmitted infections, male circumcision, antiretroviral treatment, serosorting, and
superinfection in HIV transmission and prevention.

Measles

Distribution not needed

Rare condition in developed countries because most children are
vaccinated
Major disease in developing countries, cities where people live in
overcrowded, insanitary conditions and where there is a high birth
rate
Poor response to vaccine shown by some children who need several
boosters to develop full immunity
It can be difficult to give boosters, follow up cases of measles and
trace contacts in large cities with high birth rates and shifting
populations
Migrants and reservoirs can form reservoir of infections

ANTIBIOTICS

Effective antibiotics show selective toxicity, killing or disabling pathogen

but have no effect on host cells.
Antibiotics interfere with some aspect of growth or metabolism of the
target organism such as:
Synthesis of bacterial walls, protein synthesis (transcription and
translation), plasma membrane function, enzyme action, interfere with
metabolic reactions
Broad spectrum antibiotics are effective against a wide range of bacteria
Narrow spectrum antibiotics are active only against a few.

Antibiotic
sensitivity test
Bacteria collected from food, water or faeces and are grown on an agar
medium.
Various antibiotics are absorbed onto discs of filter paper and placed on
the agar plate.
The plate is incubated and the diameters of the incubation zones where
no bacteria are growing are measured.
The diameters are compared with a standard table and the most effective
antibiotics are chosen to treat infected people.