Warm-up Questions

● What is a Pathogen?

● List the 5 Pathogens.

● Mononucleosis, Common Cold, and Ebola are examples of what?

● Athlete’s Foot, Ringworm, and Jock Itch are example of what?

● Ticks are linked to what type of Pathogen?

Communicable Disease Basics

Objectives

● Describe three ways infectious agents can be transmitted

● Describe at least three ways to decrease risk of infections in public settings

● List three examples of common infectious diseases and how to reduce risk of infection

Chain of Infection

Chain of Infection

● Model used to understand the infection process

● Each link represents step in transmission of infection

● Each link has to be present and in order for an infection to occur

1 - The Infectious Agent-any disease causing microorganism (pathogen)

Infectious agents are:

● Bacterial ● Viral● Fungal ● Parasitic

2 - The Reservoir

-Where a microorganism normally lives and reproduces

Examples of reservoirs:

● Humans● Animals● Water● Food

3 - The Portal of Exit

-route of escape of the pathogen from the reservoir.

Examples of portals of exit:

● Flu or cold - mucous secretions● West Nile Virus - when the

mosquito bites and feeds on the bird’s blood

● Hepatitis A - stool● SARS - droplet, contact

4 - The Route of Transmission (Spread)

-the way the pathogen gets from the reservoir to the new host

Transmission:Respiratory Droplets

● From respiratory tract (i.e., nose, mouth) secretions of infected person– E.g. cough, sneeze

● Do not circulate in air for long time or travel far (mostly < 3 feet)

● Many diseases spread by respiratory droplets; e.g. flu, cold, pertussis, SARS

● Can spread germs directly or indirectly

Droplet Transmission

Agent is coughed or sneezed out into the air and floats on droplets

Direct Spread by Droplets

● Close contact with infected person (<3 ft)● Infected person coughs, sneezes, talks, sings● Droplets land directly on mucous membranes

(eyes, nose, mouth) of susceptible person

Indirect Spread by Droplets

Droplets with the infectious agent land on a table, doorknob etc.

Indirect Spread by Droplets

Someone touches contaminated object

Indirect Spread by Droplets

Touch nose, mouth, eyes with contaminated hand

Airborne Transmission

● Germs stay suspended in air on small particles

● Uncommon method of transmission● Only occurs for certain germs, such as

tuberculosis– Less commonly for flu, SARS

Airborne - This Needs to be Breathed in to be Infectious

Other Methods of Transmission

● Food/water/hands contaminated with stool from infected person; e.g., norovirus

● Blood exposures, sexual contact– a.k.a. blood-borne; e.g. HIV, hepatitis B and C

● Vector-borne – E.g. Mosquitoes and West Nile virus, malaria

● Unlikely methods of spread in courtroom

5 - The Portal of Entry

-route through which the pathogen enters its new host

Respiratory System

● Inhale germs

Other Portals of Entry

Sexual contact

Breaks in Protective Skin Barrier

Ingestion

6 - The Susceptible Host

-A person who can get sick when they are exposed to a disease causing pathogen. . I love wesley he penis is huge

How to Break the Chain of Infection

What Is the Purpose of Respiratory Hygiene?

● To reduce the transmission of airborne diseases

Hand Hygiene

● Wash hands frequently with soap and warm water for at least 20 seconds

● Alcohol hand gels

Use gloves where contact with body secretions and excretions is taking place

Cover Your Cough!

Cough Etiquette

● Limit close contact (<3 feet) with coughing clients

● Cover cough/sneeze with tissue

● Offer mask to coughing clients

Keep a clean environment

● Clean contaminated surfaces with commercial germicidal cleanser or wipes

Maintain vaccinations for employees

● Flu shot- every year for age >50 and high-risk groups

● Tetanus shot every 10 years● Hepatitis B for persons who

may contact objects contaminated with blood

● Pneumovax (“pneumonia” vaccine) for age ≥65

● Hepatitis A

What Are Some of the Airborne Diseases of Concern?

● Pertussis● Tuberculosis● Influenza● Common colds

Pertussis (Whooping Cough)● Droplet and contact

transmission● Runny nose and

prolonged severe cough● A bacterial infection ● Most dangerous for

babies● Vaccine preventable for

children aged 7 and under

Tuberculosis

Agent● Caused by bacterium, Mycobacterium

tuberculosis

Reservoir● Humans

TB in King County

Latent TB Infectionvs.

Active TB Disease

Latent TB Infection

● Person infected with TB bacteria● Bacteria kept dormant by person’s

immune system● Not sick or contagious● 10% develop TB disease over life time● Infection detected by TB skin test

TB Skin Test (PPD)

Active TBDisease

● Usually involves lung infection● Cough >3 weeks, fevers, weight loss,

night sweats● Can cause serious illness but is

treatable with antibiotics● Contagious until appropriately treated

Preventing Spread of TB

● Patients with TB disease should delay court appearance until appropriate duration of therapy

● Patients with active TB are no longer contagious after 2-3 weeks of appropriate therapy– should be cleared by doctor

Influenza(Flu)

Agent● Virus

Reservoir● Humans● Animals (e.g. birds, pigs)

– Generally different strains

Flu Transmission:Respiratory Droplets

● Direct: Close contact (<3 feet)– Droplets from cough/sneeze enter mouth,

nose, eyes of susceptible person● Indirect: Contaminated surfaces● Cases peak each winter in U.S.

How Do I Protect Myself From the Flu?

● Flu VaccineRecommended for:➢Persons >50 years old➢Anyone with a chronic illness, such as asthma or

diabetes➢Children age 6-23 months➢Women who will be pregnant during flu season

Habits for Good Health

● Avoid close contact with people who are sick

● Stay home when sick● Cover mouth/nose with tissue when

coughing/sneezing● Avoid touching nose, mouth, eyes● Wash hands often with soap/water or

alcohol rub

What Can You Do to Reduce Your Chances of Getting Sick?

● Encourage coughing clients to wash their hands (or use alcohol hand rub)

● Wash your own hands frequently● Wipe down counters, pens, phones,

computer keyboards, etc. with disinfectant cleaner as needed

● Cough etiquette- cover with tissue● Offer mask to coughing clients

Recommendations

● Staff and clients should have access to:– Hand washing facilities– Tissues – Trash cans for disposing of tissues

● Consider having alcohol

hand rub available

QUESTIONS???