Unit 4 Infectious Disease - Modes of Transmission

UNIT 4: Infectious disease
Transmission of disease
Factors influencing disease transmission
Mode of transmission
WHY IS THIS IMPORTANT?
• Understanding the mode of transmission for a

given disease and susceptibility of the host are
vital for developing methods to prevent the spread
of disease.
TRANSMISSION OF INFECTION
• The transmission (spread) of infection is the

final requirement for a successful infection.
• Two factors affect the spread of infection:
– Reservoirs of infectious organisms – places where
pathogens can grow and accumulate
– Mechanisms of transmission – the various ways in
which pathogens move from place to place.
PATHOGEN RESERVOIRS
• There are three potential reservoirs of

pathogens:
– Humans
– Other animals
– Nonliving reservoirs
HUMAN RESERVOIRS
• There are two types of human reservoir:

– Sick people – Symptomatic individuals are easily
identified.
– May be difficult to identify when symptoms have
yet to develop or have ceased.
– Carriers of infections – individuals who will never
show symptoms but are still infectious.
ANIMAL RESERVOIRS
• Diseases transferred from animals to humans

are called zoonotic diseases.
• Zoonotic diseases can be transmitted through:
Direct contact with humans (bites, scratches, etc.)

Indirect contact (waste material of a litter box, fur,
feathers, or infected meats).
Indirectly transmitted by vectors.
ANIMAL RESERVOIRS
NONLIVING RESERVOIRS
• Nonliving reservoirs of infection include

water, food, and soil.
– Water is the most dangerous.
• Infections of this kind are often seen in
countries with poor sanitation and low levels
of personal hygiene.
NONLIVING RESERVOIRS
• We cannot live without water and as a result,
regions with poor sanitation practices can have
high levels of fecal contamination in the water.
– This leads infection to spread via the fecal-oral
route of infection.
• Food contamination is often a product of
natural spoilage.
• Pathogens found in soil generally require the
skin to be broken for entry into the body.
MECHANISMS OF TRANSMISSION
• There are three modes of pathogen

transmission:
– Contact transmission
– Vehicle transmission
– Vector transmission
CONTACT TRANSMISSION
• A host is exposed to infectious agents by making contact
with the agent or items contaminated with the pathogen
so it can reach a portal of entry into the host.
There are three types of

contact transmission:
•Direct contact
•Indirect contact
•Droplet
DIRECT CONTACT TRANSMISSION
• Microbes directly transferred from an infected person

to another person
• Examples
– Contact with blood or other body fluids
– Ungloved contact with a scabies-infested patient
– Ungloved contact with wounds or mucous membranes
• Diseases transmitted through direct contact include:
– Hepatitis A
– Smallpox
– Staphylococcal infections
– Mononucleosis
– Sexually transmitted diseases.
INDIRECT CONTACT TRANSMISSION
Microbes transferred through contaminated intermediate object
• Examples
–Healthcare personnel not performing adequate hand hygiene
between patients
–Sharing medical equipment without cleaning or disinfection
between patients
–Defective medical equipment allowing for inadequate
disinfection or sterilization
• Nonliving intermediates that act as the agents of transmission by
indirect contact are referred to as fomites, vehicles for transmission.
DROPLET TRANSMISSION
• Droplet transmission is seen in the

transfer of respiratory diseases such
as influenza and whooping cough.
• It can occur through sneezing,
coughing, and even laughing.
VEHICLE TRANSMISSION
• Vehicle transmission involves pathogens riding along
on supposedly clean components.
• Examples of vehicles include:
– Air
– Food
– Water
– Blood
– Bodily fluids
– Drugs
– Intravenous fluids
VEHICLE TRANSMISSION
• Air is a difficult vehicle to control.

– Dust uses air as a vehicle and can contain huge
numbers of pathogens.
– Microbial spores and fungal spores can also use air
to travel from host to host.
VECTOR TRANSMISSION
• Pathogens are transmitted by carriers, usually

arthropods:
– Fleas
– Ticks
– Flies
– Lice
– Mosquitoes
VECTOR TRANSMISSION
There are two types of vector

transmission:
• Mechanical vector– pathogens are on
vector’s body parts and are passively
brushed off and onto the host
• Biological vector – pathogens are
within the vector and transmission to
the host is through a bite.
FACTORS AFFECTING DISEASE
TRANSMISSION
• The overall health of the host has a clear influence
on the disease process.
• For all people, the disease process is affected by:

Immune Competence / Health Status
– Age – disease levels tend to increase as we age
– Gender – some diseases are more prevalent in one
gender or another
• Urinary tract infections (UTIs) are seen more in women
• Pneumonia is seen more in men.
– Lifestyle: drug use, sexual orientation / sexual practices
FACTORS AFFECTING DISEASE
TRANSMISSION
• Occupation – more infections are seen in health care workers.
• Medication: Immunosuppresants, chemotherapy, radiation
• Emotional state – a vulnerable emotional state can decrease
immunocompetence in the host. War / Stress
• Climate – it appears that there is a greater incidence of
respiratory infections in colder climates.
• Diet – Malnutrition, alcoholism, parasites
• Environment: Location, sunlight, pollution, etc.
• Genetic Predisposition
HERD IMMUNITY
• Herd immunity arises when a majority of a population
(herd) is immune to an infection
• there are very few potential hosts and the disease
essentially disappears.
•It is conferred through

vaccination or natural immunity
arising from previous exposure.
•Current examples of herd
immunity include polio and
measles.
•Herd immunity used to
eradicate Smallpox.
Herd Immunity
Herd Immunity
Depends on 3 factors
Duration Infectivity Number of susceptibles

(D) (I) (s)
length of infectious period
Measure of transmissability in the population
Triple product = sID

A threshold sID exists for each potential epidemic situation,
below which an
PORTALS OF EXIT
• Many portals of exit are identical to

the portals of entry.
• Pathogens use these to exit from a
host.
• Exiting is usually achieved
through:
Secretions: saliva, sputum, and

respiratory droplets.
Excretions: Urine / feces
Bodily fluids: blood, CSF, vaginal
secretions, semen, etc.
THE COMPROMISED HOST
• The host’s ability to mount a defense is referred to as
its immunocompetence.
• Immunocompromised individuals have greater
susceptibility to infection and greater risk for severe
infections.
•AIDS
•Genetic immunodeficiency diseases
•Undergoing chemotherapy, or
utilizing immunosuppressant drugs
•Surgical, transplant, and burn
patients
•Premature and newborn infants
•Health care workers
•The elderly

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UNIT 4: Infectious disease

• Understanding the mode of transmission for a

• The transmission (spread) of infection is the

• There are three potential reservoirs of

• There are two types of human reservoir:

• Diseases transferred from animals to humans

Direct contact with humans (bites, scratches, etc.)

• Nonliving reservoirs of infection include

• There are three modes of pathogen

There are three types of

• Microbes directly transferred from an infected person

• Droplet transmission is seen in the

• Air is a difficult vehicle to control.

• Pathogens are transmitted by carriers, usually

There are two types of vector

• For all people, the disease process is affected by:

•It is conferred through

Duration Infectivity Number of susceptibles

Triple product = sID

• Many portals of exit are identical to

Secretions: saliva, sputum, and

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