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Date: 30.09.2017

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We are concerned with what these organisms do to people, rather than details of their biology. Everyone in the class will probably want to skim the section of a good pathology book to review basic microbiology and tissue reactions. The study of infectious disease is especially interesting because the etiologies of most of these diseases is clear -- damage by an invader.

And if the invaders can be killed, the disease can be arrested. Today, only a few fools and crooks deny that micro-organisms cause disease. Yet the microbe is seldom the whole story or the "single" cause.

Most infectious agents are, in some sense, opportunists "secondary invaders". Staph aureus takes advantage of dirt and body hair. Propionibacterium acnes flourishes in a milieu of chocolate and testosterone. Folk wisdom relates the common cold to body chilling. Often, known immune deficiency congenital, acquired, iatrogenic provides the portal. We all know the dread infections seen in patients on chemotherapy, by organisms once considered "non-pathogens".

The Epstein-Barr virus causes infectious mono if that in healthy people, but causes cancer in AIDS victims and boys with X-linked immunodeficiency. Patients given glucocorticoids often have major problems with superficial fungi ringworm , and worse. Diabetics have ineffective neutrophils and high glucose, facts that make them vulnerable to Candida infections. Often, therapy itself provides the gateway for the infectious agent.

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Candida flourishes in intravenous hyperalimentation catheters, E. And for many if not most organisms, it is often unclear why one person who meets the microbe becomes very sick, and the next person is spared. The polio virus usually causes only a GI upset if that , and only a few people go on to become paralyzed. Histoplasmosis is usually trivial, but sometimes overwhelms a person who was in robust good health.

AIDS only gets transmitted during the most intimate body-fluid sharing. The manifestations of Lyme disease are protean and unpredictable. However, a few organisms, when found, always indicate disease. The organism and its host have a mutually advantageous arrangement mitochondria producing ATP, E.

The organism does the host no good and no harm worthless bugs in the gut, hepatitis B carrier Parasite: The organism thrives by actually doing harm to the host i. The organism lives off dead stuff i.

INFECTIOUS DISEASES

The parasite or saprophyte is making somebody sick. A commensal, parasite, or saprophyte has been detected, other than what most people carry, whether or not somebody is sick. An infection that results because tissues are made vulnerable by another infection. Orders of magnitude more infectious agents than you "should" have, because of a fundamental change in your relationship with your parasite.

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The prime example is strongyloidiasis, where the worm changes its life cycle in the immunosuppressed. A multicellular animal usually an arthropod that transmits an infectious micro-organism. Inanimate objects that carry infectious organisms.

This is why we care whether our silverware looks clean A clinically healthy person who is shedding an infectious organism, and can make others sick. Hospital pathogens are the result of decades of selection for antibiotic-resistance and the ability to infect the very-sick An outbreak of infectious disease. A never-ending epidemic Pandemic: An epidemic involving the whole world Zoonosis: R0 -- the average number of people that the average patient infects.

If it is more than one, an epidemic results. If it is less than one, an epidemic does not result. Depends on the bug and even more on the circumstances.

Sometimes you can diagnose disease based on the finding of a particular organism for example, F. On other occasions, a positive result may be misleading for example, Staph epidermidis from a blood culture contaminated by skin flora, a single high antistreptolysin-O titer , or a negative result may not rule out infection i. Today, the final "fifth postulate", which establishes the micro-organism as agent of the disease, is the demonstration of a virulence gene.

Viruses are the most frequent causes of human illnesses. The largest virus worth remembering is the smallpox virus 0. The smallest human pathogens include poliovirus 0. Each virus must 1 attach to the cell, 2 penetrate it, 3 un-coat, and 4 replicate. These stages together constitute the virus cycle. An "eclipse phase" almost always occurs between un-coating and replication; a virus integrated into the host genome, able to replicate with the dividing cell, is a provirus.

Viremia means viruses in the bloodstream. Except for some respiratory viruses, all viruses probably travel via the blood. As with any infection, it is a mistake to think of a single virus causing a single clinical syndrome. Here is a simplified taxonomy of the viruses mentioned in this unit and a few others: