Host pathogen interactions
- 2. Terms "infection" and "disease" are not synonymous Infection results when a pathogen invades and begins growing within a host. Disease results when, as a consequence of invasion and growth of a pathogen, tissue function is impaired. •Our bodies have defense mechanisms to prevent infection and, should those mechanisms fail, to prevent disease after infection occurs.
- 4. Host Infection and Pathogens Occurrence and Spread of Infection: • Infection occurs when micro-organismsm (pathogen) invade sterile body tissues • infectious disease occurs when infection is associated with clinically manifested tissue damage • Colonization- presence of organisms on a body surface or in a lumen, but not producing disease • All persons have bacteria (and some fungi) on skin surfaces or in the oral cavity • Invasion of tissues (avoids immune system) organisms have moved into tissues to cause disease • Toxin production (endotoxin or exotoxin) toxins can be produced in body or ingested
- 5. Host • A person (or animal) who permits lodgment of an infectious disease agent under natural conditions. • Once an agent infects the host, the degree & severity of the infection will depend on the host’s ability to fight off the infectious agent.
- 6. Defense mechanisms present in host: • Resistance: ability of the host to prevent infection from occurring & infectious disease from developing • Resistance is normally aided by: • Barriers to infection: intact, functional epithelial surfaces (respiratory tract, gastric acid, antibacterial action of bladder secretions and saliva of oral cavity) • Immune system • Nonspecific • Examples: skin, mucosal surfaces, tears, saliva, gastric juices, & the immune system. • Nonspecific defense mechanisms such as immunity may decrease as we age. • Disease-specific • Immunity (resistance) against a particular agent.
- 7. 7 Resistance • Resistance diminished by: • Debilitation from malnutrition (poor diet, alcoholism) • Cancer • Poorly functioning immune system (congenital or acquired) • Drug therapy – corticosteroids, antibiotics • Previously damaged or abnormal anatomical structure Black (2008)
- 8. Environment: Source & Reservoir • Source: immediate site from which pathogen transferred to host. Can be human, animal, inanimate (water, soil, food) • Reservoir: where infectious organisms live & multiply; • humans often reservoir and host. • Common ones: feces, food, water Source and Reservoir: example: Yellow fever in jungle areas: • reservoir = monkeys • source = mosquitoes (vector) carrying virus from infected individuals
- 9. Why do pathogens cause disease and some don't? • Virulence! the ability of an organism to cause infectious disease • Some infectious agents are easily transmitted (very contagious), but they are not very likely to cause disease (not very virulent). • Ex: polio virus : probably infects most people who contact it, but only about 5 - 10 % of those infected actually develop clinical disease. • Other infectious agents are very virulent, but not terribly contagious. • Ex; Ebola hemorrhagic fever virus virulence very high (50 - 90 % fatality rate among those infected); however, virus not transmitted easily by casual contact.
- 10. 10 Most worrisome infectious agents are those that are both very contagious and very virulent. Black (2008)
- 11. The Movement of Pathogens Out of Hosts: Portals of Exit to Portals of Entry • Pathogens leave host through portals of exit • Many portals of exit are the same as portals of entry • Pathogens often leave hosts in materials the body secretes or excretes
- 12. 12 Sites of Entry / Cause / S/S • Ingestion into gastrointestinal tract; • microorganisms contaminating food or water • Salmonella, Vibrio cholera • S/S abdominal pain, nausea, vomiting, diarrhea • Inhalation into respiratory tract; • microorganisms in air • S/S cough, chest pain, shortness of breath, coughing blood • Ascension into urinary tract; • microorganisms that enter bladder through urethra or catheter • S/S painful urination, blood in urine, pelvic pain, flank pain • Ascension into biliary tree Black • microorganisms entering common bile duct from GI tract (2008) • S/S abdominal pain, jaundice
- 13. 13 Sites of Entry / Cause / S/S • Crossing of mucosal surfaces • microorganisms that penetrate oral, anal, genital, or conjunctival linings • S/S Human papillomavirus, HIV, herpes simplex virus, Neisseria gonorrhea • Experience local irritation, ulceration, pain, redness • Entrance through wound sites • Direct inoculation of micro-organisms leads to direct spread Black (2008)
- 14. Three groups of transmission • Contact transmission • Vehicle/ fomite transmission • Vector transmission • Biological or mechanical Fomites: inanimate objects that transmit disease Vector: insect or small animal carrier of disease
- 15. Contact transmission • Direct: (person-to-person): through direct physical contact (skin-to-skin or body fluids) eg.., STDs, cold sores • Indirect: pathogens or agents transferred via intermediate item, organism etc. to susceptible hosts.
- 16. Vehicle/ fomite transmission Airborne: pathogen suspended in droplets or dust; can remain in air for hours to days e.g., cold virus travels in droplets when person sneezes, talks Vehicle-borne: pathogen transmitted from source to susceptible individual via intermediate object (fomite) e.g., contaminated medical equipment
- 17. Vehicle/ fomite transmission Food or Waterborne: Pathogen transmitted to susceptible individual via or food water. • intoxication: Chemical or toxin causes body malfunction. • e.g., lead, botulism • infection: Ingestion of pathogenic organism that grows in GI tract. • e.g., V. cholera transmitted in water sources; E. coli in hamburger
- 18. Vector borne transmission Pathogen transmitted to susceptible individual via animal or insect. • mechanical transmission (external): use a host for transport; • e.g., fly landing on food at picnic after it picked up some e.coli • biologic transmission (internal) carried inside vector; use vector for part of life cycle • e.g. malaria parasite Plasmodium in blood ingested by Anopheles mosquito after bite
- 19. 19 Spread of Infectious Agents In Body via the bloodstream • Travel – Septicemia • Travel via the lymphatic system – Enlarged tender lymph nodes suggest possible infection at site • Travel via the body cavity – Can spread in cerebrospinal fluid, peritoneal fluid, joint space • Crossing of the placenta to fetus – Basis for congenital infection Black (2008)
- 20. The Natural Course of Disease sequence of events in infectious disease ncubation interval between exposure & 1st appearance of disease s/s Prodromal 1st disease s/s Fastigium Defervescence Convalescence disease at its peak . disease s/s decline recovery period Defection pathogen killed off or brought into remission
- 21. Number of microorganisms or intensity of signs or symptoms FIGURE 14.10 THE STAGES OF INFECTIOUS DISEASES Incubation Prodromal period period (no signs or (vague, symptoms) general symptoms) Illness (most severe signs and symptoms) Time Decline Convalescence (declining signs (no signs or and symptoms) symptoms)
- 22. Barriers to Decreasing Disease Transmission • Increases in host susceptibility due to changes in • • • • • demographics and behavior Microbial adaptation and change (eg. drug resistance) Emergence of new diseases Breakdown of public health measures International travel and commerce Changes in the environment, technology, and industry Cohen, M. L. (2000). Changing patterns of infectious disease. Nature, 406(6797), 762-767. doi:10.1038/35021206) 22
- 23. Human Microbiome Project (HMP) aims to characterize the microbial communities found at several different sites on the human body, including nasal passages, oral cavities, skin, gastrointestinal tract, and urogenital tract, and to analyze the role of these microbes in human health and disease. Human Microbiome Project: Analyzing microbes that play a role in health and disease http://www.youtube.com/watch?v=axB_8O4WHYg 3 min
Editor's Notes
- #5: In order to cause disease, pathogens must be able to enter the host body, adhere to specific host cells, invade and colonize host tissues, and inflict damage on those tissues. Entrance to the host typically occurs through natural orifices such as the mouth, eyes, or genital openings, or through wounds that breach the skin barrier to pathogens. Although some pathogens can grow at the initial entry site, most must invade areas of the body where they are not typically found. They do this by attaching to specific host cells. Some pathogens then multiply between host cells or within body fluids, while others such as viruses and some bacterial species enter the host cells and grow there. Although the growth of pathogens may be enough to cause tissue damage in some cases, damage is usually due to the production of toxins or destructive enzymes by the pathogen. For example, Corynebacterium diphtheriae, the bacteria that causes diphtheria, grows only on nasal and throat surfaces. However, the toxin it produces is distributed to other tissues by the circulatory system, damaging heart, liver, and nerve tissues. Streptococcus pyogenes, the infectious agent associated with several diseases including strepthroat and "flesh-eating disease," produces several enzymes that break down barriers between epithelial cells and remove fibrin clots, helping the bacteria invade tissues. In order to cause disease, pathogens must be able to enter the host body, adhere to specific host cells, invade and colonize host tissues, and inflict damage on those tissues. Entrance to the host typically occurs through natural orifices such as the mouth, eyes, or genital openings, or through wounds that breach the skin barrier to pathogens. Although some pathogens can grow at the initial entry site, most must invade areas of the body where they are not typically found. They do this by attaching to specific host cells. Some pathogens then multiply between host cells or within body fluids, while others such as viruses and some bacterial species enter the host cells and grow there. Although the growth of pathogens may be enough to cause tissue damage in some cases, damage is usually due to the production of toxins or destructive enzymes by the pathogen. For example, Corynebacterium diphtheriae, the bacteria that causes diphtheria, grows only on nasal and throat surfaces. However, the toxin it produces is distributed to other tissues by the circulatory system, damaging heart, liver, and nerve tissues. Streptococcus pyogenes, the infectious agent associated with several diseases including strepthroat and "flesh-eating disease," produces several enzymes that break down barriers between epithelial cells and remove fibrin clots, helping the bacteria invade tissues.