Anindya Widhi Cantika

STEP 7

1. Apa saja macam-macam agent?

Biological:
Bacteria: organisme uniseluler yang bisa mereproduksi diri mereka sendiri, ukurannya lebih
besar dari virus, biasanya dilengkapi oleh flagella
Virus: Memiliki kapsid sebagai pelindung, memiliki RNA.
Fungi: multiseluler, bisa hidup di tubuh manusia, tanaman dan benda mati sebagai parasite
Protozoa: sering hidup di air, parasite (Giardia)
Prions : abnormal, transmissible agents that are able to induce abnormal folding of normal
cellular prion proteins in the brain, leading to brain damage and the characteristics signs and
symptoms of the disease. Prion diseases are usually rapidly progressive and always fatal. Prion
adalah pembawa penyakit menular yang hanya terdiri dari protein. Prion tidak dapat dimusnahkan
dengan panas, radiasi, atau formalin. Prion menyebabkan berbagai penyakit degenerasi seperti
kuru, scrapie, Creutzfeldt-Jakob disease (CJD), dan bovine spongiform encephalopathy (BSE
atau sapi gila).

Sumber: CDC : Understanding the Epidemiologic Triangle Through Infectious Disease

2. Bagaimana transmisi agent?

Direct Kontak fisik secara langsung (permukaan tubuh ke permukaan
tubuh lain)
antara host yang suseptibel
Contoh: Berjabat tangan, berciuman, coitus.
Contoh penyakit: sexually transmitted disease
One to One
Indirect Agen infeksius terdapat di permukaan sebuah objek lalu tersentuh
Contact
oleh host yang suseptibel
Contohpenyakit: RSV, Norwalk, rhinovirus, dll
Droplet Kontak tetapi transmisinya melalui udara, droplet biasanya < 1 m
Contoh: Batuk, bersin
Contoh penyakit: Flu, Meningococcus, pertussis
Airborne, Transmisi dengan aerosol (airborne particles <5µm) yang
Waterborne mengandung organisme dalam nuclei atau di debu. Dan bisa di
sebarkan melalui system ventilasi udara.
Examples of transmission: Via ventilation system in a hospital;
Examples of infections: TB; varicella; measles; chickenpox;
smallpox (and maybe influenza: controversial, as more likely via
droplets).
Non-
Vehicle A single contaminated source spreads the infection (or poison) to
contact
multiple hosts. This can be a common source or a point source.
Examples of transmission - Point source: Food-borne outbreak
from infected batch of food; cases typically cluster around the site
(such as a restaurant); IV fluid; medical equipment.
Common source: The cyanide poisoning of Tylenol in Chicago in
1982. Cases may be widely dispersed due to transport &
distribution of the vehicle (here, a medication)
 Precautions: Normal safety and disinfection standards. Package
medicines in tamper-proof containers.
Vectorborne Transmission by insect or animal vectors.
Example of infections: Mosquitoes and malaria.
Precautions: Protect via barriers (window screens, bed nets);
insect sprays; culling animals.

Sumber: Public Health Agency Guidelines

PW Ewald. Evolution of infectious disease. New York: Oxford University Press, 1994.
Centers for Disease Control and Prevention. Principles of epidemiology, 2nd ed.
Atlanta: U.S. Department of Health and Human Services;1992.
3. Apa factor-faktor yang mendukung adanya agent?

4. Apa saja karakteristik agent?

Infectivity– Kemampuan untuk menginfeksi host

Pathogenicity – Kemampuan untuk menyebabkan penyakit pada host
Virulence– Tingkat kerusakan yang dihasilkan oleh agen
Immmunogenicity – Kemampuan untuk merangsang respon imun host

Sumber: UCLA School of Public Health : Microbiological Classification of Infectious Diseases

5. Apa saja macam-macam portal of entry?

Portal of entry adalah jalur pathogen untuk memasuki host yang suseptibel. Portal of entry itu
sendiri harus menyediakan akses pada jaringan dimana paotgen tersebut dapat berkembang biak
atau memberi efek toksik pada host. Kebanyakan agen infeksius menggunakan portal yang sama
dengan ketika pathogen tersebut keluar melalui host sebelumnya. Contohnya virus influenza yang
keluar melalui saluran pernafasan dan masuk ke host berikutnya melalui saluran pernafasan juga.
Kebalikannya, banyak pathogen yang menyebabkan gastroenteritis menggunakan jalur oro-fecal
karena pathogen tersebut keluar melalui feses dari host sebelumnya dan terbawa melalui
makanan, air ataupun benda-benda dan akhirnya sampai pada host yang baru melalui mulut.
Portal of entry yang lain adalah kulit, membrane mukosa dan darah (hepatitis B atau HIV)
 Sumber : Centers for Disease Control and Prevention. Principles of epidemiology, 2nd ed.
Atlanta: U.S. Department of Health and Human Services;1992.
6. Bagaimana cara menghambat pertumbuhan agent didalam dan diluar host?
Hand and Personal Hygiene: The use of hand sanitizers or hand rubs for infection control has
been evaluated in health care facilities, at home, and in day care centers and schools. Hand
sanitizer products containing alcohol tend to have greater activity against nonenveloped viruses
(e.g., respiratory syncytial virus, influenza, parainfluenza viruses, HIV, and herpes simplex virus)
than against enveloped viruses (e.g., rhinovirus, parechoviruses, enterovirus, adenovirus,
rotavirus,7 and caliciviruses).8 Washing one’s hands for an extended time, however, can enhance
the antiviral activity of hand sanitizers toward enveloped viruses. Picornaviruses (e.g.,
enteroviruses, rhinoviruses, and hepatitis A virus) are particularly difficult to eradicate from
hands or environmental surfaces but may be inactivated by high concentrations of alcohol and
extended hand-washing time. Nevertheless, for all of these viruses, hand sanitizers have been
shown to be more effective than routine hand washing (IFH, 2002a,c).
 DECONTAMINATION OF ENVIRONMENTAL SURFACES: Many of the common agents
causing infections in schools have been found to survive on hands and environmental surfaces
long enough to allow the transfer of infectious organisms from the environment to the hands.

7. Bagaimana mekanisme dari manifestasi agent ?

Sumber : Immunobiology: The Immune System in Health and Disease. 5th edition. Janeway CA Jr,
Travers P, Walport M, et al.New York: Garland Science; 2001.

8. Apa faktor penyebab agent masuk ke host ?

(i) Disease Agents:
• biological agents such as bacteria and viruses.

(ii) Host Factors: Some host factors that influence susceptibility to disease are:
Sex, Race , Age, Occupation, Nutrition, Heredity, Marital status, Socioeconomic status, Religious and
social customs, Immunization history And Previous history of disease
(iii) Environmental Factors: Many aspects of the environment influence both an agent’s survival and
growth, and a host’s contact with a disease agent. Some of the environmental factors are shown below
Temperature, Humidity, Altitude, Water, Radiation, Pollution, Housing conditions
Sumber: Principles of Infectious Disease Module I – Introduction to Epidemology
Brachman PS. Epidemiology. In: Baron S, editor. Medical Microbiology. 4th edition.
Galveston (TX): University of Texas Medical Branch at Galveston; 1996. Chapter 9

9. Apa saja manifestasi klinik yang muncul pada host yang terinfeksi H7N9?

Sumber: BUKU SAKU FLU BURUNG

 10. Bagaimana hubungan host, agent dan environment?

Agen yang berperan sebagai pemberi penyakit harus mampu menginfeksi host agar dapat
menimbulkan kerusakan pada host tersebut, hal ini bergantung pada lingkungan. Lingkungan
dapat mempengaruhi transmisi, perkembangan pathogen tersebut dan suseptibilitas host.
Suseptibilitas dari host sendiri juga dapat dipengaruhi factor intrinsic seperti kekebalan tubuh
untuk melawan pathogen yang masuk. Kemampuan host untuk melawan pathogen bergantung
pada status kesehatan, status gizi, dan umur.

Sumber: J Epidemiol Community Health 2003; 57:770 doi:10.1136/jech.57.10.770