Chain of Infection
Chain of Infection
Chain of Infection
(infectious cycle)
Mode of transmission
The requisites (essentials) for the perpetuation of
communicable diseases: The cycle of infection:
• Human reservoirs
• Two types of human reservoir exist:
• Cases: persons with symptomatic illness
• Carriers
• Carrier
• A person or animal without apparent disease who harbors a
specific infectious agent and is capable of transmitting the
agent to others.
• Carriers are dangerous because:
• They do not show any clinical manifestation so they carry
normal life.
• The carrier and his contacts are not aware of their
condition so, they take no precautions.
• It is difficult to discover them.
• It is not always possible to deal with them.
• Chronic carriers can remain infectious for a long time
leading to repeated introduction of the disease to
contacts.
• Types of Carriers:
• Asymptomatic (In-apparent) carrier:
• The carrier state that may occur in an individual with an infection
that is in-apparent throughout its course
• Examples: Polio virus, meningococcus, hepatitis A virus
• Incubatory, Convalescent, Post-Convalescent carriers:
• The carrier state may occur during the incubation period,
convalescence, and post convalescence of an individual with a
clinically recognizable disease.
• Examples of Incubatory carrier: Measles, chickenpox
• Convalescent carriers:
• Examples: Diphtheria, hepatitis B viruses and Salmonella species.
• According to duration of carriage:
• The carrier state may be (transient carrier or
chronic carrier).
• Chronic carriers:
• They continue to harbour an agent for an
extended time (months or years) following the
initial infection.
• Examples: Hepatitis B virus and Salmonella typhi
• Animal reservoirs
• Zoonoses: Infectious diseases that are transmissible
under normal conditions from vertebrate animals to
humans. (with humans as incidental hosts)
• Zoonotic diseases include:
• Brucellosis (cows and pigs)
• Anthrax (sheep)
• Plague (rodents)
• Rabies (bats, dogs, and other mammals).
• Toxoplasmosis (cats)
• Environmental reservoirs:
• Soil, and water
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Measles?
• Indirect transmission:
• An agent is carried from a reservoir to a
susceptible host by:
• Vehicle borne: inanimate vehicle
• Vector borne: animate vector
• Airborne transmission: suspended air
particles
• Vehicle borne:
• An infectious agent is carried from a reservoir to a
susceptible host by an inanimate intermediary.
• Vehicles include:
• Contaminated food and water, typhoid, food poisoning,
dysentery and cholera.
• Biologic products (blood), viral hepatitis, AIDS, syphilis
and malaria.
• Fomites (inanimate objects such as toys,
handkerchiefs, bedding, or surgical instruments).
• Vectors are arthropods such as (mosquitoes, fleas, and
ticks)
• Mechanical transmission:
• The agent does not multiply or undergo physiologic changes
in the vector.
• For example, flies carry Shigella on appendages.
• Biologic transmission:
• When the agent undergoes changes and/or multiplication
within the vector before it is transmitted.
• (Extrinsic incubation period). Example: Malaria, Filariasis.
• Airborne transmission occurs by particles that are
suspended in air.
• There are two types of these particles:
• Dust and
• Droplet nuclei
• Dust particles:
• Result from re-suspension of particles that have settled
on floor or bedding.
• Infectious particles blown from the soil by the wind.
• Example: Fungal spores.
Airborne Transmission
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Mycobacterium
tuberculosis?
• Droplet nuclei
• They represent the dried residue of droplets that have
been coughed or sneezed into the air.
• They are very tiny particles less than 5 µ (microns) in
size and may remain suspended in the air for long
periods.
• Examples:
• Tuberculosis is transmitted more often indirectly,
through droplet nuclei, than directly, through direct
droplet spread.
• Legionnaires’ disease and histoplasmosis also spread
through airborne transmission.
Portal of entry
• An agent enters a susceptible host through a
portal of entry.