DISEASE CONTROL

Basic Principles of Communicable Diseases

POPULATION
age
Genetic susceptibility
Nutritional status
Previous exposure
Immunization status
General physical condition

ENVIRONMENT
AGENT Shelter
Virulence Attitude
Infectious dose Humidity sanitation
Susceptibility of drugs Food supply
mode of transmission Water supply
Ability to adapt to changes Overcrowding
Essential service
Classification Of Diseases

Grouping of diseases based on certain characteristics.

Easier to understand and remember
Characterized by having same mode of transmission .
 Classification Into 10 Group
1. Water-washed diseases
2. Fecal-oral diseases
3. Food-Borne diseases
4. Diseases of soil contact
5. Disease of water contact
6. Skins infection
7. Respiratory disease and other airborne-transmitted infection
8. Disease transmitted via body fluids
9. Insect-borne disease
10. Zoonoses
i. Ectoparasites zoonoses
ii. Domestic and synanthropic zoonoses
1. Water Washed Diseases

Simplest transmission person to person

Relate to poor hygiene arise from direct contact of the
skin, conjunctiva or mucous membrane
Alternatively, organisms from skin or in conjunctival
secretions can be transported by intermediate vehicle.
Two group under this category:
Skin disease
Eye disease
 Skin disease
Include infection of scabies , lice and superficial fungal.
Tropical ulcer also included here

Eye disease
Include trachoma, epidemic hemorrhagic conjunctivitis,
etc.

Main control method for water washed disease is to

increase water quality.
This include providing an adeuqate volume of water for
washing to encourage personal hygiene.
2. Fecal-oral Disease
Transmitted by person-person contact, through water or food of directly
into the mouth.
Main reason of occurrence were due to absence of a proper water supply,
with rubbish and dirty surrounding,
Associate with abundance number of flies (typically occurred when
disease strive)
Breaking the fecal oral cycle is the basis of control.
This are achieve by :
Personal hygiene
Increase water quality
Food hygiene
Provision of sanitation
Many of the disease in this group cause diarrhea
 Example of disease under this group:
Gastroenteritis
Cholera
Typhoid
Bacillary Dysentry ( Shigellosis)
Giardia
Paratyhoid
Hepatitis A & E
Poliomyelitis
Enterobius
3. Food Borne Disease

Related to disease which only transferred by food.

Can infect food in general food poisoning or sometimes
be very specific in the particular food helminth.
Method of control focused on:
Food hygiene
Proper cooking of food ( right temperature, etc)
Sanitary methods to prevent cross contamination
 Example of disease ;
Food poisoning due to bacteria; Staphylococcus spp,
Bacillus cereus, salmonella spp.
Food poisoning due to fish poisoning; Ciguatera,
Scromboid, etc
Food poisoning due to plant poison (organic or inorganic)
Campylobacter enteritis
Fluke ( intestinal, fish, liver, lung)
Tapeworm ( Fish, swine, Bovine)
Trichinosis
4. Disease Of Soil Contact

Soil can be source of infection.

Particularly due to nematodes and bacterial infection.
Transmission can be direct from:
Soil contamination
Swallowing nematodes eggs,
Larvae penetrate skins in contact with
Developmental stages often take place in the soil
human soil.
 Control of infection via:
Promotion of personal hygiene
preventing contamination of soil
Vaccination (tetanus)
 In the case of nematode infection (trichuris, Ascaris,
hookworm), these always come in together.
This indicates that if she/he is infected with one, likely
to have all three.
Most common in developing country e.g Africa and
South America, Asia
 Example of disease:
Trichuris
Ascaris
Tetanus
5. Disease Of Water Contact

Important medium for disease transmission

Normally through;
Water polluted by fecal matter
Polluted water being used to wash food or food medium
Also serve as medium for fish carry parasitic stage that is
transmitted when being consume.
Minimize contact with water is the best method of
control.
 Example of disease:
Schistosomiasis
Guinea worm
Buruli Ulcer
6. Skins Infection

Skin is common site for several communicable disease

Present with rashes of various kind
Infection often transmitted from person-to-person via
skin contact or airborne route
Control done by:
Avoidance of contact with infected individual
Vaccination (if available)
 Example of disease:
Scabies, fleas, lice
Chickenpox/shingles
Measles
Rubella
Mumps
Streptococcal skins infection
Leprosy
7. Respiratory Disease And
Other Airborne-
transmitted Infection
Our vulnerable respiratory apparatus is easily invaded
by microorganism
This due to our continuously breathing activity
The common site of entry is nasopharynx
Our ciliated lining and mucus secreting cells of
respiratory tract can act as non-specific host defense
mechanism, entrapping microorganisms and passing
them to exterior.
 In attempting to expel this secretions by coughing or
spitting, organisms may be transferred to another host.
Respiratory infection are usually transmitted by direct
contact between individuals
Very effective if closer to contact.
Control is mostly non-specific since human contact is
difficult to be avoid due to daily activity.
 *respiratory is enigma, yet only some
individuals manifest disease.
This is due to the factor infective dose
and host response which determine the
infection.
Environmental factor can:
Increase the infective (overcrowding)
Reduce host resistance (malnutrition)
 Examples of disease;
Tuberculosis
Acute Respiratory Infection (ARI)
Influenza
Whooping cough
Diphteria
Meningococcal meningitis
Pneumonia
Otitis
Acute Rheumatic Fever
8. Disease Transmitted Via
Body

Fluids
Includes infections transmitted from one human to another by
physiological fluids of the body blood, saliva, seminal fluid
Transmission normally direct via sexually or non sexually contact
The main cause:
Close personal contact
Intimate/sexual intercourse
Considered as social disease, determine by habit and peoples attitude
 Example of disease:
Human Immunodeficiency Virus
Hepatitis B & C
Yaws
Endemic syphilis
Venereal syphilis
Gonorrhea
Chlamydia
Ebola Hemorrhagic Fever
Trichomonas
Genital herpes
Human Papilloma
9. Insect-borne Disease

Vector transmission is one of the commonest methods of

spreading disease.
Divided into two chapter:
Flight insect
ectoparasites
 Mosquito-borne disease:
Most important due to its abundant, close proximity to
human and blood meal.
Some parasites are specific for certain type of mosquito
e.g malaria & anophelines.
Others e.g arboviruses are less selective and utilize many
different species.
Parasite development within mosquito are:
Morphological without multiplication
Asexual reproduction (arbovirus)
Sexual reproduction (malaria)
Arboviruses
Grouped into three symptom-complexes:
1. Those producing mainly fever and/or Arthritis e.g
chikungunya, Onyong-nyong, west nile.
2. Those presenting as fever and encephilitis japanese
encephilitis, Murray Valley etc.
3. Hemorrhagic fevers Yellow fever, dengue, rift valley,
etc
 Example of disease
Japanese encephalitis
Dengue
Yellow fever
Malaria
Lymphatic filariasis
African Trypanosomiaosis (Sleeping sickness)
10. Zoonoses

Infection that is naturally transmitted between

vertebrae animals and humans
10.1.1 Ectoparasite Zoonoses

Disease caused by non-flying vectors e.g fleas, lice

Responsible for important group of infections that are
often associated with animal (reservoir)
Human are often the accidental victims of these
zoonotic infections
 Example of disease:
Plague
Typhus
Louse borne relapsing fever
Tick borne relapsing fever
Lyme disease
10.1.2 Domestic
And
Synanthropic Zoonoses
Zoonoses disease which does not involve vector (direct
from animal to human)
Most of infection are due to close association between
human and domestic animals (domestic)
Zoonoses from unwelcome animal e.g rats are called
synantrophic.
Link to animals which depend on human for food and
companions e.g cat, dogs, cow and other.
Control depends upon an understanding of the contact
with the animal
 Example of disease
Rabies
Leptospirosis
Hydatid disease
Toxocariasis
Toxoplasmosis
Brucellosis
Anthrax
Lassa fever
Transmission
cycle
1. Direct infection

Human A Human B
2. Intermediate host
Human Reservoir

Human

Mollucs Mollucs

Human
3. Intermediate host
Human reservoir

Huma
n

Mollu
Fish
cs

Mollu
Fish
cs

Huma
n
4. Animal-human reservoir

Human

Animal Animal

Human
5. Vector human reservoir

Human

Antropod Antropod

Human
6. Animal reservoir

Human

Animal Animal
7. Vector-Human Reservoir

Human
Animal

Antropod Antropod

Animal
8. Vector-animal reservoir
to vector-human reservoir

Insect Animal Insect Human

Animal Insect Human Insect

References

Roger W. Communicable disease epidemiology and

control; 3rd edition.2009. Cambridge University Press,
Cambridge. United Kingdom

David L. H.,. Control of Communicable Disease Manual.

18th edition.2004. America Public Health Association.
United Book Press Inc. Baltimore. USa