Natural history of disease: progression of a disease process in an individual over time, in the

absence of treatment. For example, untreated infection with HIV causes a spectrum of clinical
problems beginning at the time of seroconversion (primary HIV) and terminating with AIDS and
usually death. It is now recognized that it may take 10 years or more for AIDS to develop after
seroconversion.(43) Many, if not most, diseases have a characteristic natural history, although
the time frame and specific manifestations of disease may vary from individual to individual and
are influenced by preventive and therapeutic measures.
http://www.cdc.gov/osels/scientific_edu/ss1978/lesson1/Section9.html
A study that follows a group of people over time who have, or are at risk of developing, a specific
medical condition or disease. A natural history study collects health information in order to
understand how the medical condition or disease develops and how to treat it.
http://www.cancer.gov/dictionary?cdrid=538640
1. What problem while doing promotive and preventif?

2. What can causes of fever?

An infection - such as strep throat, flu, chickenpox or pneumonia

Rheumatoid arthritis
Some medications
Over-exposure of skin to sunlight (sunburn)
Heat stroke - may be caused either by exposure to high temperatures (nonexertional heat
stroke) or prolonged strenuous exercise.
Silicosis - a type of lung disease caused by long-term exposure to silica dust.
Amphetamine abuse
Alcohol withdrawal

http://www.medicalnewstoday.com/articles/168266.php
3. How the mechanism of infection
a. Entrance of bacteria/bacteria attachment
Bacteria attach to :
1. Mucose membrane
Respiratory tract
Digestion tract
Urinary tract
Conjungtive
2. Skin
3. Inner organ
b. Adhession-Colonization
the bacteria attach to the surface of host cells, adhesion occurs in epithelial cells
c. Invassion
The process of bacterial entry into the host cell / tissue and spread throughout the
body; access deeper bacterial infection that can begin the process
d. Intracellular

After the invasion, the microbes are able to survive and reproduce in the host cell
Microbes capable of living in the host cell 2 types:
Non-phagocytic cells: epithelial cells, the cells endoteliat
 Phagocytic cells: macrophages, neutrophils

Bacteria survive in the cytosol, food vacuoles (lysosomes), vacuoles

Bacteria can kill host cells visually:

Lowering the pH of the vacuole
Production of protease enzyme
e. Breaking organ/tissue

Infections are typically caused by invading viral or bacterial

organisms. They enter the body through several possible routes and
multiply within the body.
The body has evolved defenses to infectious microorganisms for
millions of years. The battle continues today.
Regularly a healthy immune system is able to detect and eliminate the
viral/bacterial organism early or following a short course of infection.
However, a chronic infection infection may develop in which a
stalemate is reached between the bodys immune system and the
advancement of the organism.
In extreme cases the microorganism overwhelms the bodies immune
defense or is not detected and/or attacked properly by the immune
system.
The infectious agent may release toxins that cause harm, cause a
general inflammatory response, and/or may destroy cells of the body.
http://www.symptom-diagnosis.com/infection-symptoms

4. How to prevent infection

a. get some exercise and fresh air during
b. maintain a high standard of personal hygiene
c. always to wash your hands when you have been to the toilet and before you
are about to prepare or eat food.
d. take a daily shower or bath, if possible. However, it is not advisable to share
towels or flannels with other family members because of the possible risk of
cross-infection.
Source : Souhami, Hochhaser. Cancer and Its Management (6th edition). 2010. Wiley-
Blackwell.

vaccinations
frequent hand washing
 antibiotics given ahead of the infection
wear gown, mask, gloves in highly contagious environments
avoid animal borne diseases via no contact with their waste, saliva, dander
http://health.rush.edu/healthinformation/hie%20multimedia/1/001925.aspx

a. Clean your hands up

Use soap and warm water. Rub your hands really
well for at least 15 seconds. Rub your palms,
fingernails, in between your fingers, and the
backs of your hands.
Or, if your hands do not look dirty, clean them with
alcohol-based hand sanitizers. Rub the sanitizer all
over your hands, especially under your nails and
between your fingers, until your hands are dry.
Clean your hands before touching or eating food.
Clean them after you use the bathroom, take out
the trash, change a diaper, visit someone who is
ill, or play with a pet.
b. Make sure health care providers clean their hands and wear gloves
Doctors, nurses, dentists and other health care
providers come into contact with lots of bacteria
and viruses. So before they treat you, ask them
if theyve cleaned their hands.
Health care providers should wear clean gloves
when they perform tasks such as taking throat
cultures, pulling teeth, taking blood, touching wounds
or body fluids, and examining your mouth or private
parts. Dont be afraid to ask them if they should
wear gloves.
c. Cover your mouth and nose while sneezing or coughing
Many diseases are spread through sneezes and
coughs. When you sneeze or cough, the germs can
travel 3 feet or more! Cover your mouth and nose to
prevent the spread of infection to others.
Use a tissue! Keep tissues handy at home, at
work and in your pocket. Be sure to throw away
used tissues and clean your hands after coughing
or sneezing.
If you dont have a tissue, cover your mouth and
nose with the bend of your elbow or hands. If you
use your hands, clean them right away
d. If you are sick, avoid close contact with others
If you are sick, stay away from other people or
stay home. Dont shake hands or touch others.
When you go for medical treatment, call ahead
 and ask if theres anything you can do to avoid
infecting people in the waiting room.
e. Get shots to avoid disease and fight the spread of infection
Make sure that your vaccinations are currenteven
for adults. Check with your doctor about shots you
may need. Vaccinations are available to prevent
these diseases:
Chicken pox Mumps
Measles Diphtheria
Tetanus Hepatitis
Shingles Meningitis
Flu (also known as influenza)
Whooping cough (also known as Pertussis)
German measles (also known as Rubella)
Pneumonia (Streptococcus pneumoniae)
Human papillomavirus (HPV)
http://www.jointcommission.org/assets/1/18/Infection_Control_Brochure.pdf
http://www.cdc.gov
5. What factor influence the infections disease
a. Endogenous factor : age, underlying disease, immunity, sex
b. Exogenous factor : periods of treatment, health care team, medical instrument
http://repository.usu.ac.id/bitstream/123456789/3455/1/paru-parhusip4.pdf

factors that influencing infection disease are : using of antibiotic, periods of treatment,
following disease, treatmentfor wound, device, and material to cure the wound, rooms
hygiene, and visitor density.
http://eprints.undip.ac.id/4295/1/2968.pdf
1. microorganism as infectious agent
2. host (patient)
3. environment
http://www.livestrong.com/article/162084-a-nosocomial-infection/
6. In What condition that we can find malaise ?
The main characteristics of malaise are lack of energy to perform tasks that one is capable of
completing in on a normal day
http://relaxation.blog.co.uk/2012/07/26/malaise-and-fatigue-14240307/
sweating, heart palpitations, rise in blood pressure, salivation, nausea, vomiting and diarrhoea.
Signs and symptoms usually begin two to five days after a person becomes infected, but they
may take as many as 10 days to appear.
http://www.netdoctor.co.uk/travel/diseases/scorpions_and_spiders.htm
7. Solution
8. Example of infection disease?
Sample list of viral infections disease types:
HPV
AIDS
SARS
rabies
 rubella
roseola
mumps
measles
norovirus
lassa fever
yellow fever
poliomyelitis
conjunctivitis
viral hepatitis
Dengue fever
common cold
influenza ~ flu
viral meningitis
West Nile virus
viral pneumonia
viral encephalitis
smallpox ~ variola
Colorado tick fever
viral gastroenteritis
roseola sixth disease
chickenpox ~ varicella
fifth disease parvovirus
herpes simplex & zoster
cytomegalovirus infection
infectious mononucleosis
Marburg, ebola haemorrhagic fever
progressive multifocal leukencephalopathy
hand, foot and mouth disease ~ coxsackie
Sample list of bacterial infectious diseases types:
stye
MRSA
E. coli
typhus
plague
Q fever
tetanus
cholera
anthrax
syphilis
pink eye
impetigo
botulism
tularemia
trachoma
 chalazion
listeriosis
diphtheria
gonorrhea
blepharitis
chlamydia
brucellosis
shigellosis
psittacosis
melioidosis
nocardiosis
scarlet fever
tuberculosis
legionellosis
leptospirosis
typhoid fever
salmonellosis
Lyme disease
campylobacteriosis
bacterial meningitis
cat scratch disease
Hansens disease leprosy
pertussis whooping cough
pneumococcal pneumonia
UTI ~ cystitis, pyelonephritis
Rocky Mountain spotted fever
Sample list of fungal infectious disease types:
candidiasis
aspergillosis
blastomycosis
histoplasmosis
cryptococcosis
coccidioidomycosis
tinea cruris ~ jock itch
tinea capitis ~ ringworm
tinea pedis ~ athletes foot
Sample list of parasitic infections disease types:
malaria
scabies
myiasis
filariasis
taeniasis
giardiasis
amebiasis
ascariasis
 babesiosis
trichuriasis
fascioliasis
pediculosis
isosporiasis
enterobiasis
toxocariasis
trichinellosis
clonorchiasis
cysticercosis
leishmaniasis
dracunculiasis
toxoplasmosis
trichomoniasis
fasciolopsiasis
onchocerciasis
echinococcosis
hymenolepiasis
metagonimiasis
chagas disease
schistosomiasis
trypanosomiasis
gnathostomiasis
cryptosporidiosis
diphyllobothriasis
African trypanosomiasis
free living amebic infection
http://health.rush.edu/healthinformation/hie%20multimedia/1/001925.aspx

9. What are the symptons and sign of infections?

General Signs and Symptoms of Infection

Malaise: One of the most common symptoms of a systemic infection, or an infection that is
moving through your body, is that you will feel tired and lacking in energy. You may sleep more
than usual, or not feel up to doing your normal activities. These feelings are also common for
patients who are recovering from surgery who do not have an infection. The difference is that
when recovering from surgery most people feel a bit better each day, rather than feeling better for
a few days then suddenly feeling exhausted and lethargic as can happen with infection.

Fever: A fever is often accompanied by feeling chilled. A fever can also decrease your appetite,
lead to dehydration and a headache. A low-grade fever (100 F or less) is common in the days
following surgery, a fever of 101 or more should be reported to the surgeon.
http://surgery.about.com/od/aftersurgery/qt/SignsInfections.htm
 A temperature of more than 38C
Your skin feels hot to touch
Feeling cold or shivery
Aching muscles
Feeling tired
Stinging or pain when you pass urine
Diarrhoea
Headache
Feeling confused or dizzy
Sore mouth or pain when swallowing
Coughing or shortness of breath
Pain, redness, discharge, swelling or heat at the site of a wound or intravenous line such
as acentral line or PICC line
Pain anywhere in your body that was not there before your treatment
http://www.cancerresearchuk.org/cancer-help/coping-with-cancer/coping-
physically/fever/cause/infection/symptoms-of-infections
10. What are the media transmisi infection?
Horizontal transmission is the transfer of a pathogen
from an infected animal to a nave animal, independent of
the parental relationship of those individuals.

Vertical transmission is the transfer of a pathogen from a

parent, usually the dam, to the offspring through
reproduction.
Airborne Transmission

Airborne diseases are caused by pathogenic microbes small enough to be discharged from an infected
person via coughing, sneezing, laughing and close personal contact or aerosolization of the microbe. The
discharged microbes remain suspended in the air on dust particles, respiratory and water droplets. Illness
is caused when the microbe is inhaled or contacts mucus membranes or when secretions remaining on a
surface are touched.

Direct contact may be with an infected animal in the same group

or with an animal from a reservoir population. Reservoir hosts
serve as habitat for the pathogen to survive and may or may not
become ill from the infection.

Indirect contact via vectors or fomites also allows transmission

of disease agents. The term vector is sometimes used in a broad
sense to signify anything that allows the transport and/or
transmission of a pathogen. However, according to a strict,
ecological definition, vector-borne transmission occurs when a
living creature, because of its ecological relationship to others,
acquires a pathogen from one living host and transmits it to
another. Thus vector-borne transmission is a form of indirect
horizontal transmission in which a biological intermediary, often
an arthropod, carries a disease agent between animals.

Vectors may be either biological or mechanical. A biological

vector is a vector that supports replication of the pathogen. The
disease agent and the biological vector are considered to have a
long-standing ecological relationship. Biological vectors are
usually persistently infected with the disease agent and may even
be a required part of that organisms life cycle. A mechanical
vector, on the other hand, is a vector that carries the pathogen
but the pathogen is not altered while on the vector. Infection in
mechanical vectors tends to be short-lived and a mechanical
vector is considered little more than a flying fomite.

Fomites are inanimate objects that can carry infectious agents

from one animal to another. Examples of fomites include used
needles, dirty clippers, contaminated clothing or vehicles, and
contaminated food and water supplies. Iatrogenic
transmission is a specific form of horizontal transmission by
fomites in which the veterinarian or physician accidentally
furthers the spread of a disease agent via routes such as
contaminated instruments or vaccines.

http://www.vet.uga.edu/vpp/archives/ivm/ENG/Modes/routes.htm

11. What is the goal of preventif and promotinf effort?

The primary goal of preventive maintenance is to prevent the failure of equipment
before it actually occurs
Source John M Gross, Fundementals of Preventive Maintenance, American Management
Association, Pg 228
The goal of health promotion is to empower individuals and communities to achieve
the highest possible levels of well-being available to them.
http://www.utoronto.ca/chp/MoreAboutHP.htm
12. Classification of infection?
13. Why the doctor give explanation about the natural history of disease to prevent
people being infected?
14. Why we must know natural history of disease