COMMUNICABLE DISEASES

EPIDEMIOLOGY SURVEILLANCE AND RESPONSE

Part 1

Learning objectives
To

define contagious and communicable

diseases
To give examples of endemic and epidemic
diseases
To describe the most important disease
causes morbidity and mortality in few
areas

What is a communicable disease ?

one caused by transmission of
a specific pathogenic agent to a susceptible host

directly

(from infected humans/animals)

or
indirectly

(vectors, airborne
particles/vehicles)

Vectors

insects or other animals

that carry the infectious agent from person to person

Biological (arthropods: mosquitoes, ticks, lice,

flea,

Mechanical

bloodsucking flies, bugs, and

mites)

Vehicles
contaminated objects or elements of the
environment (clothes, cutlery, water, milk, food,
blood, plasma,
parenteral solutions or surgical instruments)

Contagious diseases
those that can be spread between humans
without an intervening vector or vehicle
communicable
malaria
measles
syphilis
tuberculosis
typhoid
leprosy
HIV/AIDS
chikungunya

contagious

Main causes of death

Indonesia
(Health Minister Endang Rahayu Sedyaningsih)
the number of deaths from NCDs is increased
from 41.7 percent (1995) to 49.9 percent (2001)
and 59.5 percent (2007)
the number of deaths from CDs
.. ??

Six causes of premature deaths

almost 80% of all deaths from infectious diseases are:
acute respiratory infections
HIV/AIDS
diarrhoeal diseases
tuberculosis
malaria
measles

challenge for health profession:

to investigate and control communicable diseases
investigation must be done quickly, often with limited resources

Epidemic diseases
the occurrence of cases
in excess of what is normally expected in a community or
region
time period, geographical region and
particulars of the population must be specified

The dynamic of an epidemic

is determined by

characteristics of its agent, pattern of transmission,

susceptibility of its human hosts

agents
bacteria, virus, parasites

three main groups of pathogenic

Epidemic diseases

The dynamic of an epidemic

is determined by

pattern of transmission

Direct transmission

Indirect transmission

Touching
Kissing

Vehicle-borne (contaminated
food, water, towels, farm tools)

Sexual intercourse

Vector-borne (insects, animals)

Other contact (childbirth,

Airborne, long-distance (dust,
medical procedures, injection of droplets)
drugs, breastfeeding)
Parenteral (injections with
contaminated syringes)
Airborne, short distance (via
droplets, coughing, sneezing)
Transfusion (blood)
Transplacental

Epidemic diseases

The dynamic of an epidemic

is determined by

susceptibility of its human hosts and environment

host

environment

point of entry

general sanitation

resistance

temperature

immunization/vaccinat air pollution

ion
water quality
socio-economic: population
density, overcrowding and
poverty

Endemic diseases
when the diseases have a relatively stable pattern of
occurrence
in a given geographical area or population group
at relatively high prevalence and incidence

Malaria
major health problems in lowincome tropical countries

endemic

epidemic

if the conditions change

(host, agent or environment)

Example: HIV has become endemic in many areas

Case of smallpox control

country

Population
(millions)

Finland

Number of reported
1990-4

1995-9

2000-04

death
2005-09

295

155

182

1 605

Germany

65

165

231

136

1 323

Italy

34

18 590

2 149

8 773

17 453

134

218 000

221 000

200 000

535 000

Russia