Zoonoses, Reservoirs, and Pathogenesis
Zoonoses
- Zoonoses are diseases transmitted from animals to humans.
- Emerging diseases are often zoonotic.
- Routes of acquisition:
- Direct contact with animals or their waste products.
- Consuming improperly processed, refrigerated, or cooked animals.
- Arthropod vectors (especially blood-sucking insects like mosquitoes).
- Humans are usually dead-end hosts for zoonotic pathogens.
- Zoonotic diseases are difficult to eradicate because of the challenge of controlling animal reservoirs (e.g., mosquitoes, rodents, bats).
Common Zoonoses
- Helminths (worms): Reservoirs include dogs, sheep, cattle, and pigs.
- Protozoans (e.g., malaria, toxoplasmosis): Various animal reservoirs.
- Fungal infections (e.g., ringworm): Contact with domestic animals.
- Bacterial microbes:
- Bacillus anthracis (anthrax): Domestic livestock.
- Yersinia pestis (bubonic plague): Rodents.
- Lyme disease: Ticks found in deer; also birds, rodents, reptiles.
- Viral reservoirs:
- Rabies: Bats, skunks, foxes, or dogs.
Human Carriers
- Active Carriers: Infected individuals transmitting the pathogen.
- May or may not show signs/symptoms (asymptomatic).
- Asymptomatic individuals can still be infectious.
- Example: SARS-CoV-2 (COVID-19), where asymptomatic individuals spread the virus.
- Some may have a dormant period (e.g., AIDS).
- Passive Carriers: Not infected, but contaminated; mechanically transmit the pathogen.
- Example: Healthcare worker transferring pathogens on their skin/clothes to a new host.
- Healthy carriers often have natural resistance or defense systems.
Non-Living Reservoirs
- Soil, water, and food are common non-living reservoirs.
- Contamination often due to feces or urine (human or animal).
- Example: Bacillus anthracis spores in soil.
- Water and food: Common sources of foodborne illnesses.
Pathogenesis
- Pathology: The study of disease.
- Pathogenesis: Stages of disease development.
Key Definitions
- Contamination: Presence of microbes in or on the body (does not necessarily mean infection).
- Infection: Microbe has evaded host defenses, multiplied, and established itself in the body.
- May or may not result in disease.
- Disease: A step further; occurs after infection.
Stages of Pathogenesis
- Exposure or Contact
- Adhesion or Colonization: Microbe adheres to cells/tissues to establish a colony.
- Invasion: Pathogen moves beyond the original point of exposure, deeper into the body.
- Infection: Microbe establishes itself.
Pathogen Requirements for Disease
- Gain entry into the host.
- Travel to a location where it can establish an infection.
- Evade/overcome the host immune system.
- Cause damage (results in disease).
- Complete cycle: Pathogen exits the host and transmits to a new host.
Portals of Entry
- Sites where pathogens enter the body.
Major Pathways
- Skin
- Effective physical barrier, but compromised by breaks, insect bites, punctures.
- Mucous Membranes
- Line body cavities exposed to the environment (eye, ear, nose, mouth).
- Connected to respiratory and gastrointestinal tracts.
- Also found in the reproductive system (vagina), urinary system (urethra), and anus.
- Placenta
- Relevant to the fetus; connects mother and fetus.
- Parenteral Route
- Circumvents usual portals; pathogens enter through openings or cuts in the skin.
- Example: Pathogens entering through cuts from a knife or nail.
Skin
- Outer layer is dead cells, an effective barrier.
- Parenteral route: Pathogens enter through cuts/openings.
- Some pathogens burrow or secrete chemicals to digest the skin.
Mucous Membranes
- Moist, warm environment hospitable to pathogens.
- Respiratory Tract: Most common site of entry (nose, mouth, eyes).
- Viruses can enter through the conjunctiva of the eyes.
- Avoid touching the face to prevent pathogen entry.
- Gastrointestinal Tract: Pathogens must survive the acidic environment.
Placenta
- Tissue connecting mother and fetus.
- Most pathogens cannot cross, but some can (2% of pregnancies).
- Infections can cause spontaneous abortion, birth defects, or premature birth.
- Examples of pathogens that can cross the placenta:
- Protozoan: Toxoplasmosis
- Bacterium: Syphilis
- Viruses: Chickenpox, Hepatitis B, HIV, Rubella, Cytomegalovirus, Herpes
Parenteral Route
- Not a true portal of entry but a means to circumvent normal portals.
- Injury deposits pathogens into tissues.
- Example: Tattoo needles puncturing the skin.
Adhesion or Colonization
- Pathogen attaches to cells or tissues using adhesion factors.
- Adhesion Factors: Specialized structures or attachment molecules.
- Ligands on viruses and bacteria bind to host cell receptors (host specificity).
- Example: Virion spike proteins.
- Preventing adhesion can prevent disease.
- Block adhesion factors or receptors.
- Example: Cranberry juice prevents bacteria from adhering to urinary tract walls, preventing UTIs.
- Microbes lacking attachment proteins become avirulent.
Ligands and Receptors
- Ligands on microbes recognize glycoprotein receptors on host cells, enabling attachment.
- Without attachment, microbes are flushed out by bodily fluids.
- Example: E. Coli cells attaching to the mucous membrane of the intestines.
Biofilms
- Formed through adhesion factors.
- Bacteria attach to tissues/cells or other bacteria.
Invasion
- Pathogen moves/spreads to establish an infection.
- Spreads through local tissues or disseminates throughout the body.
- Virulence factors (exoenzymes, toxins) facilitate colonization and damage.
- Virulence Factors: Proteins/chemicals that allow the cell to invade and establish an infection.
- Some pathogens produce exoenzymes or toxins.
- Some produce factors that protect against the immune system (cloaking devices).
- Virulence factors determine the degree of damage.
H. Pylori Example
- Helicobacter pylori (H. pylori) invades the stomach lining.
- Produces virulence factors to pass through the mucus barrier.
- Releases urease to neutralize stomach acid.
- Liquefies mucin, allowing bacteria to swim through the protective barrier.
- H. pylori is a common cause of stomach ulcers.
Infection
- Pathogen establishes itself and multiplies after exposure, adhesion, and invasion.
Types of Infections
- Local: Confined to a small area near the portal of entry.
- Focal: Localized, but pathogens/toxins can spread to a secondary location.
- Systemic: Throughout the whole body.
- Type of infection depends on the virulence factors of the pathogen.
Recap Questions
- All of the following are examples of zoonotic diseases except what?
- Ringworm, rabies, chickenpox, or malaria.
- Answer: Chickenpox (transmitted human to human).
- Which of the following is an example of a parenteral route of infection?
- Inhaling contaminated air? Pathogens crossing the placenta? An infant being exposed to normal flora? Or stepping on a nail.
- Answer: Stepping on a nail (bypasses normal portals).
- What's the most frequently used portal of entry?
- Respiratory tract, skin, parenteral route, or placenta?
- Answer: Respiratory tract (eyes, nose, mouth).