Communicable disease
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Communicable Disease Life & Health Course # 001278 Naresuan University Thailand
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Communicable disease
- 1. Jabu Munalula M.D. Life Science Course Narasuan University
- 2. ο What is a communicable disease ο Burden of communicable disease ο Causes of communicable disease ο Prevention and control of communicable disease
- 3. ο Can be transmitted from ο Also called, infectious, transmittable ο Spread by infectious agent (pathogens) ο bacteria, viruses, parasites
- 4. ο Not causes by infectious agents ο Not transmissable from person to person ο They may be inheritable genetically ο Examples ο Hypertension, diabetes, heart disease
- 5. ο Infection: invasion of a host by a (micro)organism ο Endemic: stable number of cases over time , stable disease population ο Ex: Dengue fever is endemic to Thailand ο Epidemic: sudden transient rise in disease population ο Ex: AIDS is an epidemic in Thailand ο Pandemic: worldwide epidemic affecting human populations across large regions ο Reemerging diseases: ο Ex: TB, malaria, cholera
- 6. ο The Black Death (plague): started in 14th century, killed 75 million people ο Cholera: killed tens of millions during the 19th century, remains a public health concern ο Influenza ο Measles ο Smallpox ο Malaria ο AIDS
- 7. ο Diarrheal diseases ο Symptoms: diarrhea, abdominal pain ο Ex: cholera ο Respiratory diseases ο Symptoms: shortness of breath, cough ο Ex: pneumonia ο Febrile illness ο Symptom: fever ο Ex: Malaria
- 8. ο Waterborne: contaminated water ο Ex: cholera ο Foodborne: contaminated food ο Ex: salmonella ο Airborne: transmitted through air ο Ex: TB ο Vector-borne: vectors like mosquitos or rats ο Ex: malaria
- 13. Direct Indirect ο Physial contact ο Air bourne ο Sexual contact ο Vector-borne ο Biting ο Vehicle-borne ο Direct projection of droplets ο Across placenta
- 14. ο Human/animal reservoirs = infected host ο Examples ο Animals: dogs / rabies vrus ο Improperly handled food: raw fish/ Opisthorchis viverrini ο Enviornmental reservoirs
- 15. ο Respiratory tract: breathed in through lungs ο Ex: Mycobacterium Tuberculosis ο Gastrointestinal tract: enter through the mouth ο Ex: diarrheal diseases ο Skin: breaks in skin integrity ο Ex: malaria parasite after mosquito bite
- 16. ο Not every exposure results in disease ο Susceptible hosts develop the disease after exposure ο Factors that increase susceptibility: Risk factors ο Poor or no immunity ο Lack of vaccination ο Poor nutrition ο Coexistent disease
- 17. β’ Events that occur from time of exposure to final outcome without intervention β’ Exposure: β’ Infection β’ Disease β’ Outcome β’ Can apply specific targeted interventions to prevent/control
- 18. ο Susceptible host contacts infectious agent ο Agent has not yet entered the body ο Ex, ο Hand shake ο Drinking contaninated water
- 19. ο Infectious agent enters the body ο Starts to multiply ο Clinical manifestations of the disease appear ο Signs ο symptoms
- 20. ο Clinical manifestations are present ο Incubation period from infection to onset of clinical manifestations ο Not all infected hosts develop disease ο Carriers: infected but no clinical manifestations ο Active cases: have clinical manifestations ο Acute infection: rapid onset, short duration of illness ο Chronic infection: prolonged duration of illness
- 21. ο Recovery ο Ex: Common cold ο Chronic illness ο Ex: Syphillis ο Disability ο Ex: elephantitis, polymyelitis ο Death
- 22. ο Single celled free living prokaryote ο Can be found anywhere and everywhere ο Produce chemical toxins that cause disease ο Divide rapidly under the right conditions ο Aerobic: require oxygen ο Anaerobic: do not require oxygen ο Move by air and water ο Can live on many surfaces ο Skin, clothes, hair, furniture
- 23. ο Non-living microscopic particles ο Consist of fragments of DNA or RNA ο No cells ο Do not need to feed ο Attack health living cells ο Take over host cell functions to make more virus particles
- 24. ο Usually enter the body through mouth or skin ο Include protozoa (single celled) and helminths (worms) ο Tape worm, liver flukes, loa loa ο Can lead to liver disease, blindness, heart disease
- 25. ο Rapid growth worldwide population ο Globalization ο By 2015, 90 % of population growth will be in developing countries ο Lack resources to support rapid growth ο Feeding more people requires changes in food production and distribution ο Unsanitary conditions
- 26. ο Shift from rural to urban area ο More people live in urban are than rural area ο Concentrated populations ο Overcrowding ο Close proximity ο Poor sanitation ο Poverty ο Poor education
- 27. ο Cross-border migration ο Political and economic refugees ο Thailand: 2 million immigrants, 150 000 refugees from neighbor countries ο Poor access to health facilities ο No preventive or primary care services ο Unsanitary living conditions
- 28. ο Water and sanitations systems ο Improving in urban area ο Improve management of diarrheal diseases ο Due to rapid population growth, + 20 million people in urban SEAR still with unsanitary water supply
- 29. ο Unregulated cross border livestock trade ο Unhealthy livestock rearing practices ο Current production methods ο Increase risk of H1N1 ο Small scale vs industrialized poultry farming ο Biosecurity investment ο Increased poultry density ο Single species cultivation
- 30. ο HIV/AIDS ο Tuberculosis ο Malaria ο Respiratory diseases ο SARS ο Influenza ο Malaria ο Diarrheal diseases SEAR: South East Asia Region
- 31. ο Viral infection ο Affects mammals and birds ο Common symptoms ο Chills, fever, body pain, soar throat, weakness ο Transmitted through air ο Cough or sneeze ο Also direct contact with bird dropping/secretions ο Can be killed by sunlight, detergent, disinfectant
- 33. ο Global seasonal epidemics ο 250,000-500,000 deaths annually ο Major influenza pandemics in 20th century ο H5N1 (2009): avian flu (Asia) ο Influenza A H1N1 (2009): swine/avian flu (N. America) ο Vaccination available for specific strains ο Not widely available ο Usually in developed countries ο Usually to high risk populations
- 34. ο Bird flu: primarily a bird illness ο few reports of direct human to human transmission ο Main risk factor: handling infected poultry ο Quite lethal: 60% of known infection die ο Currently the most concerning pandemic threat ο High reservoir population ο Highly virulent ο Significant mutation rate ο High mortality
- 36. ο Most common cause of influenza in 2009 ο Endemic in some human populations ο Caused 17000 deaths by 2010 ο Less virulent than H5N1 ο Combination of avian, pig, human genes
- 39. ο Viral respiratory disease in humans ο Hong Kong, 2009 epidemic ο 8422 cases, 900 deaths ο 10% fatality ο Spread to 37 countries in a few weeks ο Did not reach pandemic proportions
- 41. ο Most deadly infectious disease ο Soon will be overtaken by AIDS ο Caused by bacteria, Mycobacterium tuberculosis ο Spread through the air from infected cough/sneeze ο Classic symptoms: ο Chronic cough, blood tinged sputum, fever, night sweats, weight loss ο One third of global population infected with TB bacteria ο 1 new infection every second
- 43. ο Globally : 33 million people living with HIV ο 0.8% of adult population ο 2.6 million newly infected in 2009 ο Most new infecting in developing countries ο New cases decreased 16% from 2001-2009 ο Women account for 51% of people living with HIV ο SEAR: 3.5 million people living with HIV ο India, Indonesia, Myanmar, Nepal, Thailand
- 44. ο Retrovirus ο Attacks immune system ο Acquired immunodefiencey syndrome AIDS ο Opportunistic diseases ο Pnemocystis carinii ο Cryptosporidium ο Cervical dyspasia/cervical cancer ο Kaposis sarcoma
- 45. ο Transmission ο Sexual intercouse ο MSM ο Prostitution ο Unprotected sex ο Intravenous drug use ο Placenta (mother child transmission) ο Medical procedure (rare)
- 46. HIV: How fast can it spread? β’ San Francisco gay men 0-50% in +/- 5 years β’ Edinburgh IVDU 0-50% in 3 years β’ Nairobi prostitutes 0-85% in 6 years β’ Chiangmai (Thailand) prostitutes-- incidence 10% per month β’ Harare (Zimbabwe) young adults--.2%β 20% in 5 years
- 47. ο Treatment ο No cure yet ο Anti-retroviral therapy ο ART (anti retroviral therapy) ο HIV is becoming a chronic disease ο Less people dying of opportunistic diseases
- 48. ο Impact: ο > 2 billion people at risk ο +/- 300 million cases/yr ο +/- 2 million deaths/yr., mainly African kids ο Biology: ο Vector-borne (Anopheles mosquito) ο Gradually acquired, incomplete immunity
- 50. ο Bednets, especially when insecticide-treated ο Early diagnosis & treatment requires access to functioning lab, effective drugs ο Domiciliary spraying ο Control of larval breeding ο Environmental, chemical, biological ο Chemoprophylaxis of selected groups ο Vaccine: not yet
- 51. ο # 2 cause of death in under 5βs in LICβs (cholera and others can cause epidemic diarrhea in adults) ο Multiple organisms ο Rotavirus and other viruses, various types of E. coli, Salmonella, Shigella, Campylobacter, giardia, cr yptosporidia, ? helminths etc. ο Different types/patterns of diarrhea: ο acute watery, dysentery, chronic ο Main mechanism of death, esp. in acute watery dd ο Dehydration ο Risks: ο unsafe drinking water, poor sanitation, unavailable washing water, malnutrition, not breast feeding, probably HIV, traditional treatment practices, and misuse of medication
- 52. ο Prevention: ο Better drinking water, better sanitation, more washing water, food safety, hygiene, breast feeding & food safety, immunization ο ??rotavirus vaccine ο Management ο Oral rehydration with appropriate fluid (cereal- based ORS probably better) ο Continued breast (or other feeding if weaned) ο Avoid dangerous traditional practices (withholding oral intake, purges etc.) ο Train health workers that ORS, not medicines, is the treatment (except for dysentery).
- 53. ο TB ο Malaria ο STD ο Syphilis ο gonorrhea
- 54. ο Interventions applied before disease occurrence ο Protect individual and community ο Vaccination: vaccine preventable diseases ο Influenza ο Tentanus ο Measles ο Strep pnuemonia ο mennigitis
- 55. ο Applied to reduce severity of disease after it has occurred ο Include public health and education measures ο Improves health care ο Transmission control