Page 1

COMMUNICABLE
DISEASES

BY: KISHWAR ANIS

Health
Health is a state of
complete physical, mental
and social wellbeing and not
merely absence of disease or
infirmity .
(WHO) 1948
Page 3
Disease
A condition in which body health is impaired, a
departure from a state of health, an alteration of
the human body interrupting the performance
of vital functions
--Webster
A condition of the body or some part or organ of
the body in which its functions are disrupted or
deranged.
--Oxford English
dictionary
Page 4
Theory of Disease:

Disease agent

Man

Disease
Page 5
Epidemiological Triad

Environment

Agent Host
Page 6
Agent
Biological
Nutrient
Physical
Chemical
Mechanical
Absence or insufficiency or excess of a factor
necessary to health
Social
Page 7
 Host
Demographic

Biological

Social and economic

Lifestyle

Page 8
Environment:

Physical
Biological
Psycho-social

Page 9
Page 10
 NATURAL HISTORY OF THE
DISEASE
an uninterrupted progress of disease from entry of
microorganism until recovery or death called as natural
history of disease..

11
Page 11
PERIOD OF PRE-PATHOGENESIS
AGENT HOST

ENVIRONMENTAL
FACTORS
DURING THIS PERIOD AGENT AND HOST COME
TOGETHER FOR PRODUCING A DISEASE.

Primary
12
prevention Page 12
Page 13
 SPECTRUM OF AN INFECTIOUS
DISEASE

The term spectrum of disease is a graphic

representation of variations in the manifestations
of disease (subclinical and clinical). The sequence
of events beginning with the exposure of a
susceptible individual to a pathogenic agent and
ending with a patients recovery or death.

14
Page 14
Page 15
 Infection
The entry and development or multiplication of
an infectious agent in the body of man or animals.
An infection does not always cause illness
There are several levels of infection
Colonization

Subclinical

Latent

Manifest or clinical Page 16

 Virus Parasite

Infection

Bacteria
Fungi

17
Page 17
Infectious disease
A clinically manifest disease of man or animals
resulting from an infection
Contagious disease
It is defined as a disease that is transmitted through
contact scabies ,trachoma ,STD , leprosy

Page 18
 Communicable Diseases

A disease capable of being directly( through

contact with body secretions)or indirectly (through
contact with intimate objects) transmitted from
person to person

Page 19
 Epidemic
It is unusual occurrence (in a region or a
community ) of a disease , specific health related
behavior or other health related events ,clearly in
excess of expected occurrence
Endemic
It is constant presence of disease or infectious
agent within a given geographical area or
population without importing from outside

Page 20
HYPERENDEMIC
Disease is constantly present at a high
incidence/prevalence rate and affects all age groups
equally example : HPV
Sporadic:
It is the occurrence of cases irregularly, haphazardly
from time to time and generally infrequently
Pandemic
It is an epidemic affecting the population over a
large geographical area, pandemic of SARS in
2003

Page 21
Contamination:
This refers to the presence of organic material or micro
organisms on the body surfaces, articles or inanimate
objects
Pollution
Pollution refers to the presence of both organic and
inorganic matter such as offensive material like trade
effluvia or industrial pollutants

22
Generation time
It is defined as the time interval between
receipt of infection by a host and maximal
infectivity of that host.

Communicable period
It is defined as the time during which an
infectious agent may be transferred directly or
indirectly from an infected person to another
person, from an infected animal to man ,or
from an infected person to an animal
including arthropods .

Page 23
Cross infection or Nosocomial infection
An infection originating in a patient while in a
hospital or other health care facility -
a patient with fracture of femur is admitted in the
hospital and he gets hepatitis B during the
management.
Opportunistic infection
Infection by an organism that takes the
opportunity by a defect in host defense to infect
the host and cause disease

Page 24
Iatrogenic or physician induced infection

Any untoward or adverse consequence of a preventive

,diagnostic or therapeutic regimen or procedure that
causes impairment ,handicap ,disability or death
resulting from professional activity of physician or
from the professional activity of other health
professionals .

Page 25
Surveillance

Is defined as the continuous scrutiny of factors that

determine the occurrence & distribution of disease & other
conditions of ill health .It is essential for effective control &
prevention & includes the collection ,analysis
,interpretation & distribution of relevant data for
action.
Eradication :

It is termination of all transmission of infection by

extermination of an infectious agent through surveillance &
containment .It implies that disease no longer occur in a
population - smallpox .

Page 26
 Dynamics of Disease Transmission

Basically there are three links in the chain of

transmission :

Source or Reservoir

Mode of transmission

Susceptible host
Page 27
 Reservoir

Any person, animal, arthropod, plant, soil or

substance (or combination of these) in which an
infectious agent normally lives and multiplies, on
which it depends primarily for a prolonged survival
and where it reproduces itself in such a manner that it
can be transmitted to a susceptible host

28
 Reservoirs of infection

Living Non living

Human Animals Birds Arthropods soil substances

beings

Cases carriers

29
Page 29
Human reservoirs

Patients Carriers

30
Page 30
 Human Reservoirs

1. Cases
2. Carriers

Page 31
Cases:
A person in population or a study group
identified as having the particular disease under
investigation.
Presence of infection in host may be:
1) Clinical
2) Subclinical
3) Latent

Page 32
 Carriers :
It is an infected person or animal that harbors
infective agent in the absence of discernible clinical
disease but is capable of transmitting the agent to other
persons

Types of Carriers
Incubatory carrier
Convalescent carrier
Healthy carrier
These three types may be temporary or chronic carrier

Page 33
Page 34
Page 35
Page 36
Page 37
Page 38
Page 39
Spread of Communicable disease

Direct

Indirect
Reservoir Susceptible
(Man, animal, Airborne
Host
Inanimate) Vehicle (Man, animal)
Vector
Inanimate
Intermediate host Direct:______
Indirect:
40
Page 40
Direct Mode of transmission:
Close physical contact e.g. sexually
transmitted disease (AIDS) ,skin to
skin contact (leprosy)
Droplet infections
Contact with the soil
Vertical transmission
41
Page 41
 Indirect Mode of transmission:
Vehicle-borne
These infections are transmitted through the agency
of water, food, ice, blood, serum, plasma and other
biological products e.g. tissues, organs
Vector borne
These infections are transmitted by an arthropod or a
living invertebrate carrier- snails or Cyclops
Air borne
(Droplet Nuclei & Dust )
Fomite borne:
Fomites refer to inanimate objects such as
handkerchiefs, bed linen, towels, books, spoons,
forks, etc., which have been soiled with infective
material. Freshly soiled fomites are likely to spread
the agents of infection
Page 42
 Fomites
Are inanimate articles or substances other than

water or food contaminated by the infectious

discharges from a patient & capable of harboring

and transferring the infectious agent to a healthy

person Fomites include soiled clothes , towels ,

linens, handkerchiefs , cups , spoons ,surgical

dressings
Page 43
 Disease Spread

Source

Contact

Suspect

Reservoir

Fomites

44
Page 44
 Incubation Period
It is the period from the entry of the agent in the body till
the appearance of the signs / symptoms
Uses of incubation period
investigate the source of infection
use the knowledge of incubation period for the
purpose of quarantine
use its knowledge for vaccination or immunization
against disease
can comment on prognosis of disease
screening test if incubation period is long Page 45
Incubation period includes:
1- Median incubation period:
The time require to 50% cases of to occur
following exposure called as Median incubation
period.
2- Latent Period:
The period from disease initiation to disease
detection called as latent period.

Page 46
Control of infection
Infection is controlled by two means
Disinfection
Sterilization

Disinfection
It is the process of killing all microbes
(excluding spores ) by using disinfectant .
Disinfectant
It is a substance which destroys harmful
microbes (not spores ).It is used on inanimate
objects e.g., phenol, cresol, formalin ,bleaching
powder .Disinfectant commonly used in
Pakistan is phenyl
Page 47
Sterilization
It is the process of killing of all the microbes including
spores . Best method of sterilization is autoclaving

Autoclave:
It is widely used in hospital & laboratory practices
Steam under pressure attains a high temperature (122
degree Celsius under 15 lbs/sq inch pressure ) It acts
by giving off its latent heat

Page 48
1. Primordial Prevention

Actions and measures that inhibit the

emergence of risk factors in the form of
environment , social , economical ,
behavioral conditions and cultural pattern of
living.
Curbing the habit of cigarette smoking

49
Page 49
2. Primary Prevention

Actions taken prior to the onset of disease , which

removes the possibility that the disease will ever
occur

1. General Health promotion.

2. Specific protection.

50
Page 50
3. Secondary Prevention

Actions which halts the progression of the

disease at its incipient stage stage and prevents
complications.

Example: Early diagnosis and treatment of

tuberculosis , STD and other disease

51
Page 51
 4. Tertiary Prevention

This is applied in the period of pathogenesis and

extends in the period of recovery. It aims at reducing
impairments/disabilities and helping patients to
utilize the residual capacities maximally.

52
Page 52
Example:
Shortly after the occurrence
of hemiplegia secondary to
stroke, bed care and
physiotherapy are employed
to prevent the development
of decubitus ulcers and
flexion contractures.

Page 53
Page 54
TYPES OF DISABILITY
Impairment
Any loss or abnormality of psychological,
physiological or anatomical structure or function.
Disability
Any restriction or lack (resulting from an
impairment) of ability to perform an activity in the
manner or with in the range considered normal for a
human being;
Handicap
A disadvantage for a given individuals, resulting
from an impairment or a disability, that limits or
prevents the fulfillment of a role that is normal
(depending on age, sex, and social and cultural
factors) for that
55 individual.
Page 55
Page 56