Report: The infectious process, levels of infectious process.

Features of
infectious diseases, their characterization.
Sajid Mehmood Adnan Akram Aftab Ahmed

Accident & Emergency Department. Department of Infectious Diseases. Department of Infectious Diseases.
Royal Infirmary Liverpool. University Hospital Riga. Kaunas Medical University Hospital.
United Kingdom Latvia Kaunas. Lithuania

sajid@infekcijas.eu adnan@infekcijas.eu aftab@infekcijas.eu

The infectious process is a unity of physiological defensive reactions and pathological reactions
that develop in definite conditions of outer world (environment) as a response to the impact of
the initiator.
In other words -: Infectious process is the interaction between micro and macro – organisms in
the conditions of the outer world.

Infectious disease – terminal stage of infectious process who’s manifestations are different. +/-
physiological, clinical, etc.
Infectology – science of infectious process. Infectious disease are that which are initiated by
pathogenic or conditioned pathogenic microorganisms.

Characteristics:
1. contagiousness
2. incubation
3. cycle of clinical symptoms development
4. development of specific immunity

Classification of infectious diseases:

In the international classification infectious and parasitic diseases are included in the 1 st class.
The 1st class can be subdivided into:
- Intestinal infections
- Tuberculosis - Other viral infections- Bacterial zoonosis - Syphilis and other venereal
- Other bacterial infections diseases
- Poliomyelitis and other enteroviral diseases of the CNS - Other diseases caused by
- Viral infections with rash spirochetes
- Viral infections carried by arthropods - Mycoses
- Helminthiases
- Other infectious and parasitic diseases
-Rickettsiosis and other diseases carried by arthropods

Classification according to carrying mechanism of causative agent

- Intestinal infections : the intestines are the main localization of the disease,
e.g. shigellosis, cholera, poliomyelitis

- Respiratory infections : causative agent is localized in the respiratory tract, in the

mucous membrane of the oral cavity, trachea, bronchi, and teeth ridge (gums and jaw)
e.g. influenza, diphtheria, meningococcal, TB

- Transmissive infections (blood borne) : the causative agent is localized mainly in the blood and
lymph, e.g. typhus, hemorrhagic fever, rabbit fever

- Integument infections : the causative agent uses to localize in the integuments, e.g. erysipelas,
rabies, tetanus, listeriosis

General Clinical Characteristics

A cyclic course interchanging in periodically defined succession.

1. Incubation – from entrance/ingression of disease initiator into the organism till occurrence of
symptoms prior to disease. It lasts from some minutes till many months.
2. Prodromal or precursory period – occurrence of the first, usually general symptoms.
Commonly it lasts for several days.
3. Meridian of peak period of disease – non-specific symptoms manifest to the utmost, specific
symptoms appear.
4. Period of convalescence or recovery period – clinical symptoms gradually disappear, function
and structure of injured organs are restored.

Type of disease course

1. Typical course – the disease has the main symptoms and syndromes that are characteristic to
it.
2. Atypical course – the disease has the main symptoms and syndromes characteristic to it but
they are effaced (unmanifested), unapparent (subclinical form).
3. Carrying of infection – in spite of the presence of initiator in organism clinical symptoms of
the disease are not present, completely missing.

Obligatory steps for infection of microorganism

1. Attachment +/- entry into body
2. Local or general spread in the body – evade immediate local defense
3. Multiplication – typical clinical signs
4. Evasion of host defenses (microbial answer to host defense)
5. Shedding from body – leave body at a site and on a scale that ensures spread in new organisms
(transmission)

Causes damage to host (pathology, disease)

Types of transmission – horizontal, vertical

Vertical can be pre-natal, peri-natal, post-natal, and germ line
Host defense
1st line  skin and mucous membrane, few bacteria are found below larynx due to cough reflex
Non-specific immune response factors  phagocytic cells
Specific immune response factors  antibodies

Tissue reactions
1. Multiplication of microorganisms, production of toxins, decreased host defense, host dies or,
2. Equilibrium between microorganism and host – latent period
3. Host > Microorganism

Pathogenesis of infections
1. Toxin – can interact with adjacent or far situated cells (distant cells)
2. Virulence factors
3. Microbial adherence – microorganisms bind to surface of host, that adhere by fibrilla, specific
adherence organ cells – fimbria (can attach to all cells)
Viral infections – neurotropic virus grow in blood and then cross blood brain barrier. After
viremia invades cerebral capsule etc.

Manifestation of infection
Fever > 37.8C orally 38.2C rectally
Pyrogens cause fever. They may be exogens – microorganisms, microbial products, LPS of
Gram negative bacteria on endogens cause fever by affecting metabolism in hypothalamic
thermoregulation center.

Systemic response
Hematological manifestations –
a) Leucocytosis -  Neu :  immature circulatory neu
b) Anemia – acute bleeding, chronic
c) DIC
d) Thrombocytopenia

Cardiopulmonary Manifestation –
a) Tachycardia / bradycardia (dengue, plague)
b) Hypotension
c) Hyperventilation with marked respiratory alkalosis
d) Adult respiratory distress syndrome

Renal Manifestations – proteinuria, oliguria, azotemia

Hepatic Manifestations – liver dysfunction

GIT Manifestations – upper GIT bleeding caused by sepsis

CNS Manifestations – confusion, coma, stupor

Endocrine and Metabolic Manifestations – Hypoglycemia, not common in sepsis

Major pathogens can be:

1. Viruses, DNA or RNA 4. Protozoa
2. Bacteria 5. Worms
3. Fungi 6. Rickettsia

Most common diseases

1. Diarrhea, 2. TB, 3. Helminthiasis, 4. Malaria, etc…
Newly identified infectious agent – 1999, Napah virus

Guidelines for health provision

Education – what is infectious diseases, how to avoid them
Control – epidemiological surveillance, vaccination