Copyright 2006 Pearson Education, Inc., publishing as Benjamin CummingsPowerPoint Lecture Slide Presentation prepared by Christine L. Case I C ! " B I " # " $ %a ni n t r o d u c t i o nninth edition TORTORA FUNKE CASEPrinciples of Disease and EpidemiologyCopyright!""# Pearson Ed$cation% &nc'% p$(lishing as )en*amin C$mmingsDiseaseis a Processis a &tate o' Being (ot In $ood )ealthin*ol*es any +actors,-ge, (utrition, $ender, !ace-n abnormal state or process in .hich part or all o' the body is not properly adjusted or is incapable o' per'orming normal 'unctions o'ten because o' in'ection by pathogens.Copyright!""# Pearson Ed$cation% &nc'% p$(lishing as )en*amin C$mmingsPrinciples of Disease and EpidemiologyPathology+ The scientific study of diseaseEtiology+ The st$dy of the cause or origin of a diseaseEtiological agent+ The scientific name of the organism ca$sing the diseasePathogenesis+ The development of disease% ho, the disease happenedCopyright!""# Pearson Ed$cation% &nc'% p$(lishing as )en*amin C$mmings&nfection and Disease&nfection+ Colonization of the (ody (y pathogensDisease+ An abnormal state in ,hich the (ody is not f$nctioning normallyCopyright!""# Pearson Ed$cation% &nc'% p$(lishing as )en*amin C$mmings Infection- pathogen gro.ing in or on the host Virulence/he degree or intensity o' pathogenicity Invasiveness-bility to spread to other tissues Infectivity-bility to secrete to0ins SepticemiaBlood in'ectionCopyright!""# Pearson Ed$cation% &nc'% p$(lishing as )en*amin C$mmings-ostOrganism that shelters and s$pports the gro,th of pathogens or parasitesCopyright!""# Pearson Ed$cation% &nc'% p$(lishing as )en*amin C$mmingsPathogen !e'ers to Bacteria 1 2irus 1 +ungus -n organism .ith the potential to cause disease.Copyright!""# Pearson Ed$cation% &nc'% p$(lishing as )en*amin C$mmingsParasiteOrganism that li.es in or on another organism of a different species /-ost0 Dependent on the host for n$trients-arms the hostCopyright!""# Pearson Ed$cation% &nc'% p$(lishing as )en*amin C$mmings)umans are usually germ,'ree in utero.icroorganisms begin coloni3ation in and on the sur'ace o' the body during and a'ter birth.4e re5uire these organisms.$erm,'ree organisms are less healthy than organisms .ith normal microbiota.Copyright!""# Pearson Ed$cation% &nc'% p$(lishing as )en*amin C$mmings&nfection and Disease&nfection and disease represents a (alance'A pathogen ca$ses harm'A commensal can (e part of the normal flora'The site in the (ody can determine the classification 1E. coli in $rine2(ad3 E. coli in colon 2 normalCopyright!""# Pearson Ed$cation% &nc'% p$(lishing as )en*amin C$mmings on the s6in in the eyes in the nose in the mouth in the upper throat in the lo.er urethra in the lo.er intestine especially in the large intestine (ote that this list basically includes all o' the body sur'aces e0posed to the e0ternal en*ironment. Copyright!""# Pearson Ed$cation% &nc'% p$(lishing as )en*amin C$mmingsNormal /&ndigeno$s0 4icro(iota or 4icroflora-$mans can ha.e $p to 5"56 cells that are (acterial+These ma7e $p normal and transient flora'Skin 1012Mouth 1010GI Tract 1014Copyright!""# Pearson Ed$cation% &nc'% p$(lishing as )en*amin C$mmingsNormal Microbiota establish permanent colonies inside or on the body .ithout producing disease.Transient Microbiota are members o' the normal 'lora that are not al.ays present or are present 'or only a 'e. days, .ee6s, or months be'ore disappearing. Normal and Transient 4icro(iotaCopyright!""# Pearson Ed$cation% &nc'% p$(lishing as )en*amin C$mmingsSym(iosisSymbiosis is the relationship (et,een normal micro(iota and the host'Three Types:Commensalism 8 one organism is (enefited and the other is $naffected4$t$alism 8 (oth organisms (enefitParasitism 8 one organism is (enefited at the e9pense of the otherCopyright!""# Pearson Ed$cation% &nc'% p$(lishing as )en*amin C$mmingsCommensalismE9' Staphylococcus epidermidis as a normal s7in microflora Staphylococcus epidermidis 7 bene'its by ha*ing a habitat)umans 7 no apparent bene'it nor harm .ith &taphylococcus as normal 'loraCopyright!""# Pearson Ed$cation% &nc'% p$(lishing as )en*amin C$mmings4$t$alismE9' Lactobacillus acidophilus /:actic acid8prod$cing (acteria0 li.ing on the .aginal epitheli$m Bacteria 7 bene'its 'rom the habitat .ith constant temperature and 'ood supply 8glycogen9+emale 7 bene'its 'rom the production o' lactic acid by the bacteria, protection 'rom yeast and other bacteriaCopyright!""# Pearson Ed$cation% &nc'% p$(lishing as )en*amin C$mmingsParasitismE9' Ascaris lumbricoides in h$mansAscaris lumbricoides 1 (enefits from the ha(itat-$mans 1 s$ffer from maln$trition% poor gro,th% anemia% ,ea7nessCopyright!""# Pearson Ed$cation% &nc'% p$(lishing as )en*amin C$mmingsNormal 4icro(iota and the -ostNormal microbiota protect the host by: Occ$pying niches that pathogens might occ$pyProd$cing acids or to9ins /(acteriocins0Competing ,ith pathogens for n$trientsProbiotics 8 li.e micro(es applied to or ingested into the (ody% intended to e9ert a (eneficial effectMicrobial Antagonism or Colonization Inhibition:pathogenic microorganisms are inhibited by normal 'lora 'rom coloni3ing healthy organisms 8a 'orm o' symbiosis9 Copyright!""# Pearson Ed$cation% &nc'% p$(lishing as )en*amin C$mmingsOpport$nistic 4icro(esSome normal micro(iota are opport$nistic pathogens'A good organism ,hich gains entrance into a ne, site can (e pathogenic'Copyright!""# Pearson Ed$cation% &nc'% p$(lishing as )en*amin C$mmings !obert :och played an important role in determining that speci'ic microbes .ere associated .ith speci'ic diseases. +our PostulatesCopyright!""# Pearson Ed$cation% &nc'% p$(lishing as )en*amin C$mmingsKoch;s Post$latesKochs/he Body ?e'ends >sInnate Immunity , &6in and ucous embranes, &ecretions o' the &6in and ucous embranes, Phagocytic .hite blood cells, -ntimicrobial proteins, In'lammatory response-dapti*e Immunity , /,#ymphocytes :ill Pathogens, B,#ymphocytes Produce -ntibodiesCopyright!""# Pearson Ed$cation% &nc'% p$(lishing as )en*amin C$mmingsPredisposing Factors or Ris7 Factors4a7e the (ody more s$scepti(le to diseaseShort $rethra in females&nherited traits s$ch as the sic7le8cell geneClimate and ,eatherFatig$eAge:ifestyleChemotherapyCopyright!""# Pearson Ed$cation% &nc'% p$(lishing as )en*amin C$mmings/he Compromised )ost 8Immunocompromised9 is /he Compromised )ost 8Immunocompromised9 is ost at !is6ost at !is61' .urns /.roken Skin02' Surgical 1ounds /.roken Skin02' Suppressed Immune Systems /3ue to Ill ealth0Copyright!""# Pearson Ed$cation% &nc'% p$(lishing as )en*amin C$mmings"ther Immunocompromised &tates ,2ery young1old, "*eruse1isuse o' antibiotics 86ills normalmicro'lora9, >se o' illegal drugs,"*eruse1isuse o' steroids, Cancer, Chemotherapy1!adiation, (o *accination,Burns,?iabetes,&tress,Poor (utrition ,Ill healthCopyright!""# Pearson Ed$cation% &nc'% p$(lishing as )en*amin C$mmings(osocomial In'ections(osocomial In'ections-n in'ection that is ac5uired during the course o' stay in a health 'acility.Copyright!""# Pearson Ed$cation% &nc'% p$(lishing as )en*amin C$mmingsNosocomial /-ospital8Ac>$ired0 &nfectionsAre ac>$ired as a res$lt of a hospital stay'C85CI of all hospital patients ac>$ire nosocomial infections'Fig$res 56'#(% 56'@Copyright!""# Pearson Ed$cation% &nc'% p$(lishing as )en*amin C$mmingsChain o' /ransmissionE(osocomial In'ections -re /ransmitted By ?irect Contact Bet.een &ta'' embers and PatientsCopyright!""# Pearson Ed$cation% &nc'% p$(lishing as )en*amin C$mmings(omites such as catheters* syringes* and respiratory de$ices can transmit nosocomial in)ections'Copyright!""# Pearson Ed$cation% &nc'% p$(lishing as )en*amin C$mmingsControl o' (osocomial In'ectionsControl o' (osocomial In'ectionsPre*enti*e or Prophylactic easuresEPre*enti*e or Prophylactic easuresE1' and"ashing 412' 3isin)ect 56uipment2' 7ecessary -nti%iotics 8nly4' In)ection Control TeamCopyright!""# Pearson Ed$cation% &nc'% p$(lishing as )en*amin C$mmingsRelati.e Fre>$ency of Nosocomial &nfectionsTa(le 56'CCopyright!""# Pearson Ed$cation% &nc'% p$(lishing as )en*amin C$mmingsNosocomial &nfectionsCopyright!""# Pearson Ed$cation% &nc'% p$(lishing as )en*amin C$mmingsEmerging &nfectio$s DiseasesDiseases that are ne,% increasing in incidence% or sho,ing a potential to increase in the near f$t$re'New diseases with increasing incidence(;.&-!&2. Ebola=. 4est (ile 2irus$ired to report occ$rrenceCopyright!""# Pearson Ed$cation% &nc'% p$(lishing as )en*amin C$mmingsTa(le 56'L /5 of !0MA&DSN to MHonorrheaN3 MPert$ssisN to MStreptococcal To9ic Shoc7 SyndromeNCopyright!""# Pearson Ed$cation% &nc'% p$(lishing as )en*amin C$mmingsTa(le 56'L /! of !0MHaemophilus influenzaeN to M4$mpsN3 MStreptococcus pneumonaieN to MOello, Fe.erNCopyright!""# Pearson Ed$cation% &nc'% p$(lishing as )en*amin C$mmingsEpidemiologyEpidemiologyThe study of the distribution and determinants of health4related states or events %including disease&) and the application of this study to the control of disease and other health problems( 4*5.The study of the transmission) incidence) and fre6uency of disease;.?escripti*e Epidemiology2.-nalytical Epidemiology=.E0perimental EpidemiologyCopyright!""# Pearson Ed$cation% &nc'% p$(lishing as )en*amin C$mmings-escriptive #pidemiology-escriptive #pidemiology?ata about in'ected people are collected and analy3ed in descripti*e epidemiology.4ho, 4hat, 4hen, 4here, )o., etc.Copyright!""# Pearson Ed$cation% &nc'% p$(lishing as )en*amin C$mmingsAnalytical #pidemiologyAnalytical #pidemiology- group o' in'ected people is compared .ith an unin'ected group. -nalytical epidemiology aims to research and study ris6 and protector 'actors o' diseases. Copyright!""# Pearson Ed$cation% &nc'% p$(lishing as )en*amin C$mmingsCopyright!""# Pearson Ed$cation% &nc'% p$(lishing as )en*amin C$mmingsCopyright!""# Pearson Ed$cation% &nc'% p$(lishing as )en*amin C$mmingsCopyright!""# Pearson Ed$cation% &nc'% p$(lishing as )en*amin C$mmingsCopyright!""# Pearson Ed$cation% &nc'% p$(lishing as )en*amin C$mmings#$perimental #pidemiology#$perimental #pidemiology>se o' controlled e0periments designed to test hypotheses are per'ormed in e0perimental epidemiology. E0ampleE2 groups o' mice .ith in'ection)ypothesesE ne. drug can treat disease$roup - 7 treated .ith normal saline 8Control group9$roup B 7 treated .ith normal saline 8E0perimentalor in*estigational group9Copyright!""# Pearson Ed$cation% &nc'% p$(lishing as )en*amin C$mmingsClinical TrialClinical TrialCopyright!""# Pearson Ed$cation% &nc'% p$(lishing as )en*amin C$mmings4or(idity+ &ncidence of a specific notifia(le disease'4ortality+ Deaths from notifia(le diseases'4or(idity rate+ N$m(er of people affected in relation to the total pop$lation in a gi.en time period'4ortality rate+ N$m(er of deaths from a disease in relation to the pop$lation in a gi.en time'Copyright!""# Pearson Ed$cation% &nc'% p$(lishing as )en*amin C$mmings/he C?C is the ain &ource o' /he C?C is the ain &ource o' Epidemiological In'ormation in the Epidemiological In'ormation in the >nited &tates>nited &tatesCopyright!""# Pearson Ed$cation% &nc'% p$(lishing as )en*amin C$mmingsCollects and analy?es epidemiological information in the United States'P$(lishes Morbidity and Mortality Weekly Report /MMWR0 ,,,'cdc'go.Centers for Disease Control and Pre.ention /CDC0Copyright!""# Pearson Ed$cation% &nc'% p$(lishing as )en*amin C$mmingsortality, number o' deaths orbidity 7 number or incidence o' disease or illness in a populationCopyright!""# Pearson Ed$cation% &nc'% p$(lishing as )en*amin C$mmings#S.7C#S:8nline exams9)lashcards:http:996ui:let'com914;and>principles>o)>disease>)lash>cards9http:996ui:let'com92;disease>principles>o)>disease>)lash>cards9