传染病学总论
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27
㈤ Latent infection: After infection, pathogens remain latent
inside the body. Develop clinical manifestations when the
host immunity has been impaired. Pathogens usually will not
14
COMMUNICABLE DISEASES
PROFILE
INFECTION AND IMMUNITY
PATHOGENESIS EPIDEMIOLOGY
DIAGLOSIS TREATMENT PROVENTION
15
CONCEPT OF COMMUNICABLE DISEASES • Caused by pathogens: virus、chlamydia、richettsia、
The outcomes will be: A. Recovery. Shigella B. Chronic carrier.
Salmonella typhi
26
㈣ Carrier state:
Definition of different types of carriers: . incubation carrier . acute carrier . convalescent carrier . chronic carrier
• In developing country，a half of death by infectious diseases；
• About 15 million of death by infectious diseases per hour in the worldwide，most occurred in developing country。
prion、bacteria、spirochete、fungus and parasite（ helminth、protozoa）or medical insect • Infectious disease: involve any organ or system of the body and thus embraces all medical disciplines. • Communicability which differentiates infections from noninfectious diseases. Transmission of pathogenic organisms to other people, directly or indirectly, may lead to an epidemic.
malaria, schistosomiasis, ancylostomiasis • Mixed infection: rare • Superinfection: HBV overlap HEV • Secondary infection: HBV following bacilli
22
Infections status（infection ） spectrum
6
Pattern of Infection in Developed Countries
In 20th century, fall in the incidence of communicable diseases in developed countries
due to factors such as : Immunization antimicrobial chemotherapy improved nutrition and better sanitation and housing.
11
Emerging infectious diseases
• SARS （SARS—CoV） • From 2002.11.16 to 2003.7，SARS spreaded 6
continent, 32 countries，cases of 8437， death of 916 • In china, cases of 5327，death of 349 • SARS: most serious emerging infectious diseases in 21 century
2ns were excluded out by host nonspecific or specific immunity.
Such as: Candida albicans Hepatitis A virus
24
㈡ inapparent/sub-clinical infection:
WHO information
near 30 years, about 30 kinds of infectious diseases discovered in the worldwide “Emerging infectious diseases”
10
Emerging infectious diseases
⑶ Infection dose: minimal dose
most frequently occurs in healthy individuals. The outcomes will be: A. Immunity acquired. HAV B. Carrier state: healthy carriers. HBV
25
㈢ apparent/clinical infection :
GENERAL PRICIPLES OF INFECTIOUS DISEASES
1
SINGNIFECANCE AND IMPORTANCE
2
History review
• In 14th century, Plague in European ,20 million people death；
• In 17~18th century, smallbox in European ， 150 million people death；
16
Infection and immunity
17
• 一. Concept of infection The course of struggle between pathogens
and human or animal bodies (host). • Absolutely necessary condition
frequency/ratio
29
三、 Role of Pathogens in Infection Process: ⑴ Invasiveness: adhesion,
penetration ability. Shigella
⑵ Virulence: toxins, enzymes, and histolytic ability. E. histolytica
19
• Commensalism Pathogens live in the host but don’t induce pathologic changes. Escherichia coli in the colon Epstein-Barr virus
20
• Opportunistic infection: Pathogens within the host can
be excreted by the host during period of latency. Herpes simplex
28
• The infection status may change each other in
some conditions. Latent infection Apparent Carrier status Inapparent eliminate
7
Re-emergence of old infectious disease
◆(Tuberculosis) ◆(Viral hepatitis) ◆(Sexually transmitted diseases) ◆others: cholera、charcoal
8
Re-emergence of old infectious disease
• 40 million of HIV/AIDS cases worldwide • HIV infection rates:
11 cases/minute 16000persons/per day 6 million persons/annually。 • 95% in developing country • Maximal nation :Africa, infection rate about 10% • Dec.1 for World AIDS Day
infections • Only several years , drug-resistant emerged.
pathogenic staphylococci were found to have the ability to produce enzymes (penicillinases) that destroyed penicillin, thus rendering the drug useless against these strains • Overuse and misuse make them useless.
• 2 million death of TB in the worldwide annually
• 7～8 million infected by TB in the worldwide annually
• March 24,for World TB Day
9
Emerging infectious diseases
Entrance and colonization of pathogens will lead to the following results
• Eliminate pathogen • inapparent/sub-clinical infection • apparent/clinical infection • Carrier status • Latent infection
12
Emerging infectious diseases
Avian influenza H5N1 virus H1N1 VIRUS
13
Antibiotics
• Antibiotics, within the last 60 years, • Resulted in the cure of many previously lethal
induce pathologic changes if host immunity is suppressed by some factors.
Cryptococcus neoformans Cytomegalovirus Candida albicans
21
• Primary infection: measles, chicken box • Repeated infection:
In 1918, flu in the worldwide，40 million people death。
3
WHO reports：
• Among 52 million of death in the worldwide annually, 17 million(32%) of death from infectious diseases and parasite
18
Kinds of infections
• Commensals • opportunistic infection • Primary infection • Repeated infection • Mixed infection • Superinfection • Secondary infection
㈤ Latent infection: After infection, pathogens remain latent
inside the body. Develop clinical manifestations when the
host immunity has been impaired. Pathogens usually will not
14
COMMUNICABLE DISEASES
PROFILE
INFECTION AND IMMUNITY
PATHOGENESIS EPIDEMIOLOGY
DIAGLOSIS TREATMENT PROVENTION
15
CONCEPT OF COMMUNICABLE DISEASES • Caused by pathogens: virus、chlamydia、richettsia、
The outcomes will be: A. Recovery. Shigella B. Chronic carrier.
Salmonella typhi
26
㈣ Carrier state:
Definition of different types of carriers: . incubation carrier . acute carrier . convalescent carrier . chronic carrier
• In developing country，a half of death by infectious diseases；
• About 15 million of death by infectious diseases per hour in the worldwide，most occurred in developing country。
prion、bacteria、spirochete、fungus and parasite（ helminth、protozoa）or medical insect • Infectious disease: involve any organ or system of the body and thus embraces all medical disciplines. • Communicability which differentiates infections from noninfectious diseases. Transmission of pathogenic organisms to other people, directly or indirectly, may lead to an epidemic.
malaria, schistosomiasis, ancylostomiasis • Mixed infection: rare • Superinfection: HBV overlap HEV • Secondary infection: HBV following bacilli
22
Infections status（infection ） spectrum
6
Pattern of Infection in Developed Countries
In 20th century, fall in the incidence of communicable diseases in developed countries
due to factors such as : Immunization antimicrobial chemotherapy improved nutrition and better sanitation and housing.
11
Emerging infectious diseases
• SARS （SARS—CoV） • From 2002.11.16 to 2003.7，SARS spreaded 6
continent, 32 countries，cases of 8437， death of 916 • In china, cases of 5327，death of 349 • SARS: most serious emerging infectious diseases in 21 century
2ns were excluded out by host nonspecific or specific immunity.
Such as: Candida albicans Hepatitis A virus
24
㈡ inapparent/sub-clinical infection:
WHO information
near 30 years, about 30 kinds of infectious diseases discovered in the worldwide “Emerging infectious diseases”
10
Emerging infectious diseases
⑶ Infection dose: minimal dose
most frequently occurs in healthy individuals. The outcomes will be: A. Immunity acquired. HAV B. Carrier state: healthy carriers. HBV
25
㈢ apparent/clinical infection :
GENERAL PRICIPLES OF INFECTIOUS DISEASES
1
SINGNIFECANCE AND IMPORTANCE
2
History review
• In 14th century, Plague in European ,20 million people death；
• In 17~18th century, smallbox in European ， 150 million people death；
16
Infection and immunity
17
• 一. Concept of infection The course of struggle between pathogens
and human or animal bodies (host). • Absolutely necessary condition
frequency/ratio
29
三、 Role of Pathogens in Infection Process: ⑴ Invasiveness: adhesion,
penetration ability. Shigella
⑵ Virulence: toxins, enzymes, and histolytic ability. E. histolytica
19
• Commensalism Pathogens live in the host but don’t induce pathologic changes. Escherichia coli in the colon Epstein-Barr virus
20
• Opportunistic infection: Pathogens within the host can
be excreted by the host during period of latency. Herpes simplex
28
• The infection status may change each other in
some conditions. Latent infection Apparent Carrier status Inapparent eliminate
7
Re-emergence of old infectious disease
◆(Tuberculosis) ◆(Viral hepatitis) ◆(Sexually transmitted diseases) ◆others: cholera、charcoal
8
Re-emergence of old infectious disease
• 40 million of HIV/AIDS cases worldwide • HIV infection rates:
11 cases/minute 16000persons/per day 6 million persons/annually。 • 95% in developing country • Maximal nation :Africa, infection rate about 10% • Dec.1 for World AIDS Day
infections • Only several years , drug-resistant emerged.
pathogenic staphylococci were found to have the ability to produce enzymes (penicillinases) that destroyed penicillin, thus rendering the drug useless against these strains • Overuse and misuse make them useless.
• 2 million death of TB in the worldwide annually
• 7～8 million infected by TB in the worldwide annually
• March 24,for World TB Day
9
Emerging infectious diseases
Entrance and colonization of pathogens will lead to the following results
• Eliminate pathogen • inapparent/sub-clinical infection • apparent/clinical infection • Carrier status • Latent infection
12
Emerging infectious diseases
Avian influenza H5N1 virus H1N1 VIRUS
13
Antibiotics
• Antibiotics, within the last 60 years, • Resulted in the cure of many previously lethal
induce pathologic changes if host immunity is suppressed by some factors.
Cryptococcus neoformans Cytomegalovirus Candida albicans
21
• Primary infection: measles, chicken box • Repeated infection:
In 1918, flu in the worldwide，40 million people death。
3
WHO reports：
• Among 52 million of death in the worldwide annually, 17 million(32%) of death from infectious diseases and parasite
18
Kinds of infections
• Commensals • opportunistic infection • Primary infection • Repeated infection • Mixed infection • Superinfection • Secondary infection