傳染病學緒論華中科技大學同濟醫(yī)學院

1、What is an Infectious Disease?What is an Infectious Disease?Current SituationThe Incidence Rate of Communicable Diseases in ChinaCurrent SituationThe Proportion of Different Communicable Diseases by Etiology in China, 1950s-2002s Transmitted by sex or bloodGastrointestinalVector-borne and natural en

2、demicLeading Causes of DeathReemerging Infectious DiseaseNatural Environment DestroyinfectionimmunityBolus of infection x virulenceimmunityDisease =infectionxdiseaseInnate immunityno diseaserecoveryadaptive immunityre-infectionno diseasex Infection spectrumPrimary InfectionRepeated InfectionMixed In

3、fectionSuperinfectionSecondary InfectionPathogen eradicationOvert infectionClinical InfectionLatent infectionPathogen eradicationCarrierPatientCarrierCovert infectionSubclinical infectionBacteremia/viremiaClinical Outcomes of InfectionPathogenic effectiveness of micro-organismsVariability (HBV mutat

4、ion)ImmunityNonspecificimmunitySpecificimmunityNatural barrierPhagocytosisHumoral factorCellular immunitycomplementcytokinelysozymeHumoral immunityIgMIgAIgEIgGImmune Response in Infection ProcessCells of the Immune SystemT cells classificationHow does the immune system work?Infection and ImmuneInfec

5、tion and Immune(herpes simplex)n Initial infection by herpes simplex virus in the skin is cleared by an effective immune response.n But residual infection persists in sensory neurons.n When the virus is reactivated, the skin is re-infected. This can be repeated endlessly.Pathogenesis of Infectious D

6、iseasendocrine disturbanceDevelopment of infectious diseaseInjury of cells and tissuesDisorder of pathophysiologyCell and Tissue Damage Induced by Micro-organisms BacteriaCell and Tissue Damage Induced by Micro-organisms viruses Harmful Host Responses to Infectious AgentsEnterovirus PathogeneisColon

7、ized herdEpidemic ProcessSource of infectionRoute of transmissionSusceptible populationWhy do people get sick?New pathogens or changes in pathogens (HIV, Nile-like virus)Changes in environmental conditions(natural or man-made)Host Factors(Age, gender, ethnicity, immune status,Nutritional status, beh

8、avior)Source of InfectionOther effective factors:Climate Temperature, HumiditySociety Sanitation, Cultural Background, WarRoutes of TransmissionHIVs Transmission RoutesSusceptible PopulationChain of TransmissionPortal of exitPortal of entryAgentSusceptible HostMode of transmissionReservoirPerson to

9、person transmissionAgentHostEnvironment Age Sex Genotype Behaviour Nutritional status Health status Infectivity Pathogenicity Virulence Immunogenicity Antigenic stability Survival Weather Housing Geography Occupational setting Air quality FoodFactors Influencing Disease TransmissionDistribution due

10、to SocioeconomicCharacteristics of Infectious DiseasesnPathogennInfectivity: isolation of patientsnEpidemiologic feature: continue with next slidenPost-infection immunityBasic features Level of EpidemicClinical PhagenProdromal period (前驅(qū)期前驅(qū)期)nRecovery phase (恢復期恢復期)nSequela (后遺癥后遺癥): functionally no

11、t fully recovered 1. Effervescence (increasing) 2. Fastigium (peaking) 3. Defervescence (decreasing)Symptoms and signsFever ProcessSymptoms and signsFever typesSustained Fever Remittent FeverIntermittent Fever (septic fever)Relapsing Fever (Undulant Fever)Saddle Type FeverIrregular FeverFever typeSu

12、stained Fever Remittent FeverIntermittent Fever (septic fever)Undulant FeverRelapsing FeverIrregular FeverSkin EruptionMacule(班疹班疹)Maculo-papule(班丘疹班丘疹)Roseola(玫瑰疹玫瑰疹)Skin EruptionPetechiae(出血疹出血疹)EcchymosisThe Time Rash Appears Day 1 RDay 2 Day 3 SDay 5 T Day 6 Other SymptomsConjunctiva congestedEn

13、largement of lymph nodes n Toxemic symptoms Bleeding Coma n Mononuclear-phagocyte system responseDiagnosisLaboratory Testn Light Microscopy H & E stained sections Special Stains: Gram, Acid Fast, Giemsa n Culture Bacterial, Mycobacterial, Fungal, Viraln Immune Test Serologic Studies ELISA Immuno

14、peroxidase Stains Direct Fluorescent Antibodiesn Polymerase Chain ReactionTreatmentAntibiotic TherapyThe main classes of antibioticsAntibiotic ResistanceAntiviral TherapyInterferonLamivudineAntiparasitic DrugsProphylaxisProphylaxisLaw of the peoples Republic of China on Prevention and Treatment of I

15、nfections DiseasesLaw of the peoples Republic of China on Prevention and Treatment of Infections DiseasesLaw of the peoples Republic of China on Prevention and Treatment of Infections DiseasesLaw of the peoples Republic of China on Prevention and Treatment of Infections DiseasesnArticle 30 When dise

16、ase prevention and control institutions， medical agencies， blood collectors and supplies or their staff members on duty find the epidemic situation of infectious diseases or the this Law or the outbreak and prevalence of other infectious diseases or the infectious diseases the causes for the sudden

17、outbreak of which are uncertain， they shall report in adherence to the principle of territorial control in respect of report on epidemic situation and in accordance with the contents， procedure， from and time limit prescribed by the State Council or by the health administration department under the

18、State Council.Brief ReviewnWhat is an Infectious Disease?nCurrent SituationnPathogenesisnEpidemiologynClinical ManifestationnDiagnosisnTreatmentPerferences1.Paul D. Hoeprich, M.colin Jordan, Allan R. Ronald Infectious Diseases . J.B. Lippincoott Company. Philadelphia 1994.2.Vallejo M, Molina A, Mosq

19、uera J, et al . Early Hospital Mortality due to infectious diseases. An Med Interna. 2003 Jul;20(7):347-350. 3. Tarasevich IV, Shaginyan IA, Mediannikov OY. Problems and perspectives of molecular epidemiology of infectious diseases. Ann N Y Acad Sci. 2003 Jun;990:751-6. 4.Cornelis GR. Bacterial infectious diseases. A rejuvenated field. Cell. 2003 Jul 11;114(1):12-3. 5.Mouthon L, Lortholary O. Intravenous immunoglobulins in infectious diseases: where do we stand? Clin Microbiol Infect. 2003 May;9(5):333-8. 6.Enserink M. Infectious diseases. U.S. monkeypox out