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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

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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
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Theory of Disease:
Disease agent

Man

Disease
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Epidemiological Triad

Environme
nt

Agen Host
t
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Agent
Biological
Nutrient
Physical
Chemical
Mechanical
Absence or insufficiency or excess of
a factor necessary to health
Social
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 Host
Demographic

Biological

Social and economic

Lifestyle

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Environment:

Physical
Biological
Psycho-social

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

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PERIOD OF PRE-
PATHOGENESIS
AGENT HOST

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

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Primary prevention Page 12
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 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.

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 Infection
The entry and development or multiplication
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

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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

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 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

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 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

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 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
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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

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 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 .

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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
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 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 .

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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 .

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 Dynamics of Disease
Transmission
Basically there are three links in the
chain of transmission :

Source or Reservoir

Mode of transmission

Susceptible host

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 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
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 Reservoirs of infection

Living Non living

Human Animals Birds Arthropods soil substance

beings

Cases carriers

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Human reservoirs

Patients Carriers

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 Human Reservoirs

1. Cases
2. Carriers

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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

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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
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Spread of Communicable disea

Direct

Indirect
Reservoir Susceptible
(Man, animal, Airborne
Host
Inanimate) Vehicl (Man, animal)
e
Vector
Inanimate

Intermediate host Direct:______

Indirect:
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 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
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 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 arthropo
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 infectiv
material. Freshly soiled fomites are likely to
spread the agents of infection
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 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
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 Disease Spread

Source

Contact

Suspect

Reservoir

Fomites

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 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

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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.

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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

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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

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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

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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.

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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

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 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.

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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.

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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
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