Chapter 10 (05/26) — Mechanisms of Infectious Disease Chapter 10 — Mechanisms of Infectious Disease

BIG IDEA 🦠

  • Infectious disease happens when a microorganism enters the body, survives, multiplies, and causes damage.

  • Infection depends on 3 things:

    • The infectious agent

    • A susceptible host

    • An environment that supports infection

KEY TERMS

Host

  • A living organism that supports another organism’s growth.

  • Example: A human body can be a host for bacteria, viruses, fungi, or parasites.

Infectious Disease

  • A disease caused by interaction with another organism.

  • The host becomes injured or damaged.

Colonization

  • Microorganisms are present and multiplying on or inside the body.

  • Important: Colonization does NOT always mean disease.

Microflora

  • Normal bacteria living on exposed body surfaces.

  • Example:

    • Skin bacteria

    • Gut bacteria

    • Vaginal flora

Virulence

  • The ability of a microorganism to cause disease.

  • High virulence = more likely to cause serious disease.

PATHOGENS

  • Pathogens are microorganisms that are very likely to cause disease.

  • They are usually not found without illness.

Examples:

  • Influenza virus

  • Strep bacteria

  • Candida fungus

  • Malaria parasite

SAPROPHYTES

  • Free-living organisms that grow on dead or decaying organic material.

  • They usually live in the environment.

TYPES OF HOST-MICROBE RELATIONSHIPS

Mutualism

  • Both the host and microorganism benefit.

Example:

  • Gut bacteria help digest food.

  • The bacteria get nutrients and shelter.

Commensalism

  • The microorganism benefits.

  • The host is not helped or harmed.

Example:

  • Some skin bacteria live on the skin without causing harm.

Parasitic Relationship

  • Only the microorganism benefits.

  • The host is harmed.

Example:

  • A parasite takes nutrients from the host and causes disease.

INFECTIOUS DISEASE CONCEPT

  • Infection occurs when:

    • A pathogen is present

    • The host is susceptible

    • The environment allows the pathogen to survive/spread

Simple way to remember:

Agent + Host + Environment = Infection Risk

COMMON AGENTS OF INFECTIOUS DISEASE

Viruses

  • Made of DNA or RNA inside a protein coat.

  • Cannot reproduce outside cells.

  • Must use the host’s cells to replicate.

Examples:

  • Influenza

  • Common cold

  • Measles

  • HIV

  • SARS-CoV-2

Treatment:

  • Antivirals

  • Antivirals usually slow viral replication.

Bacteria

  • Microscopic cells without a nucleus.

  • Can reproduce on their own.

  • Found on many surfaces.

Examples:

  • Strep throat

  • Sinus infections

  • Pneumonia

  • Food poisoning

Treatment:

  • Antibiotics

  • Antibiotics slow bacterial growth or kill bacteria.

Fungi

  • Include yeasts and molds.

  • Often infect body surfaces or body openings.

Examples:

  • Athlete’s foot

  • Candida yeast infections

Treatment:

  • Antifungals

  • Many antifungals target fungal cell walls or membranes.

Protozoa

  • Microscopic single-celled organisms.

  • Often found in contaminated water or transmitted by vectors.

Examples:

  • Malaria

  • Sleeping sickness

Treatment:

  • Antiprotozoals

  • These interfere with protozoa metabolism.

Worms / Helminths

  • Multicellular parasites.

  • Can live in body spaces or tissues.

Examples:

  • Roundworm

  • Tapeworm

  • Flukes

Treatment:

  • Antihelmintics

  • These interfere with worm metabolism.

Prions

  • Misfolded proteins.

  • Not bacteria, viruses, fungi, or parasites.

  • Cause serious neurodegenerative disease.

Examples:

  • Creutzfeldt-Jakob disease

  • Kuru

  • Mad cow disease

Treatment:

  • Still being researched.

  • Prions are very resistant to enzymes and treatment.

PRIONS

What They Are

  • Prions are abnormal misfolded proteins.

  • Normal protein = PrPC

  • Misfolded infectious protein = PrPSC

What They Do

  • Build up in nervous system tissue.

  • Damage neurons.

  • Cause brain degeneration.

Effects

  • Ataxia = poor coordination

  • Dementia

  • Death

Important

  • Prions are resistant to many treatments.

  • Accumulation is toxic to cells.

VIRUSES

Main Facts

  • Smallest obligate intracellular pathogen.

  • “Obligate intracellular” means they MUST live inside a host cell to reproduce.

Structure

  • Genetic material:

    • DNA or RNA

  • Protein coat:

    • Capsid

  • Some viruses also have:

    • Envelope

Viruses Are Classified By

  • Genome type

  • Physical characteristics

  • Replication method

  • Transmission method

  • Type of disease

  • Tissue they infect

How Viruses Affect Host Cells

Viruses can:

  • Kill the host cell by lysis

  • Stay latent in the cell

  • Actively replicate and cause disease

  • Transform the host cell into a cancerous/malignant cell

Latent Virus

  • Virus hides in the body without actively causing symptoms.

  • Can reactivate later.

Example:

  • Herpes virus can become latent and return later.

BACTERIA

Main Facts

  • Bacteria are prokaryotes.

  • Prokaryote = cell without a nucleus.

  • They have a rigid cell wall.

  • They reproduce by cellular division.

Bacteria Are Grouped By

Shape

  • Cocci = round

  • Bacilli = rod-shaped

  • Spirilla = spiral-shaped

Gram Stain

  • Gram-positive

  • Gram-negative

Oxygen Use

  • Aerobes = need oxygen

  • Anaerobes = do not need oxygen

RICKETTSIA, ANAPLASMA, CHLAMYDIA, COXIELLA

These organisms have features of both viruses and bacteria.

Virus-like Features

  • They are obligate intracellular pathogens.

  • This means they must live inside cells.

Bacteria-like Features

  • Have rigid peptidoglycan cell walls.

  • Reproduce by cellular division.

  • Contain RNA and DNA.

PARASITES

Protozoa

  • Single-celled animals.

Transmission

  • Person-to-person contact

  • Sexual transmission

  • Contaminated water

  • Contaminated food

  • Vectors such as mosquitoes

Helminths

  • Worms.

Examples:

  • Tapeworms

  • Roundworms

  • Flukes

Transmission

  • Ingesting fertilized eggs

  • Penetration through skin

Arthropods

  • Small organisms such as:

    • Mites

    • Lice

    • Fleas

EPIDEMIOLOGY TERMS

Epidemiology

  • Study of how infectious diseases spread in humans.

It looks at:

  • Factors

  • Events

  • Circumstances

  • Transmission patterns

Incidence

  • Number of NEW cases in a specific population during a specific time.

Simple:

  • New cases

Prevalence

  • Number of ACTIVE cases at a specific time.

Simple:

  • Total current cases

INCIDENCE OF DISEASE

Endemic Disease

  • Disease regularly found in a specific geographic area.

  • Incidence and prevalence are expected and stable.

Example:

  • Malaria is endemic in some regions.

Epidemic

  • Sudden unexpected increase in disease above normal levels.

Simple:

  • More cases than expected in one area.

Pandemic

  • Disease spreads beyond continental boundaries.

Simple:

  • Worldwide or multi-continent spread.

MODES OF TRANSMISSION

Transmission = how a pathogen spreads.

Portal of Entry

  • How the pathogen enters the body.

The pathogen must enter the body, reach tissues, and cause disease.

1. Penetration

  • Pathogen enters through broken skin or damaged mucous membranes.

Examples:

  • Cuts

  • Needlestick injuries

  • Open wounds

2. Direct Contact

  • Pathogen moves directly from infected tissue or secretions to another person.

Examples:

  • Touching infected fluid

  • Sexual contact

  • STIs

3. Ingestion

  • Pathogen enters through the mouth and GI tract.

Examples:

  • Hepatitis A

  • Food poisoning

  • Contaminated food/water

4. Inhalation

  • Pathogen enters through the respiratory tract.

Examples:

  • Chickenpox

  • Pneumonia

  • Common cold

  • Flu

  • Tuberculosis

  • COVID-19

MECHANISMS OF DISEASE PRODUCTION

Microbes cause disease by damaging tissue.

They can:

  • Enter host cells and directly kill them

  • Trigger immune responses that damage host tissue

  • Produce virulence factors

VIRULENCE FACTORS

Virulence factors are substances or traits that help microbes cause disease.

Main types:

  • Toxins

  • Adhesion factors

  • Evasion factors

  • Invasion factors

TOXINS

Toxins alter or destroy normal host cell function.

Endotoxins

  • Found in the cell wall of gram-negative bacteria.

  • Made of lipopolysaccharides, or LPS.

  • Activate inflammation.

Simple:

  • Endotoxins are part of the bacteria’s outer structure.

  • When released, they can cause strong inflammation.

Exotoxins

  • Proteins released by bacteria during growth.

  • Damage host cells.

  • Can cause cell dysfunction or death.

Simple:

  • Exotoxins are poisons bacteria release.

Enterotoxins

  • A type of exotoxin that affects the GI tract.

  • Causes:

    • Vomiting

    • Diarrhea

ADHESION FACTORS

  • Help microbes attach to the host.

  • If a microbe cannot attach, it may be washed away.

Simple:

  • Adhesion factors help germs “stick.”

EVASION FACTORS

  • Help microbes avoid the immune system.

Example:

  • Encapsulation

Encapsulation

  • Some bacteria have a capsule.

  • The capsule makes it harder for immune cells to recognize and destroy them.

Simple:

  • Capsule = protective shield.

INVASION FACTORS

  • Help microbes enter tissues and spread.

  • Often involve enzymes that break down barriers.

Simple:

  • Invasion factors help germs “break in.”

COMMUNITY-ACQUIRED VS NOSOCOMIAL

Community-Acquired Infection

  • Infection acquired outside of a healthcare setting.

Example:

  • Getting the flu from school, work, or home.

Nosocomial Infection

  • Infection acquired in a healthcare setting.

Also called healthcare-associated infection.

Example:

  • Infection acquired in hospital.

STAGES OF INFECTIOUS DISEASE

1. Incubation Period

  • Time between exposure and symptom development.

  • The pathogen is present, but symptoms may not show yet.

Simple:

  • You were exposed, but you do not feel sick yet.

2. Prodromal Stage

  • Early symptoms begin.

  • Symptoms are usually vague.

Examples:

  • Feeling tired

  • Mild fever

  • Headache

  • Body aches

Simple:

  • You can tell something is starting, but it is not full-blown yet.

3. Acute Stage

  • Microbe rapidly multiplies.

  • Symptoms are strongest.

  • Disease has maximum impact.

Simple:

  • This is the “fully sick” stage.

4. Convalescent Stage

  • Infection is controlled.

  • Pathogen is being eliminated.

  • Symptoms improve.

  • Tissue repair begins.

Simple:

  • Recovery stage.

5. Resolution

  • Microbe is fully eliminated.

  • No remaining signs or symptoms.

Simple:

  • Infection is gone.

DIAGNOSING INFECTIOUS DISEASE

Diagnosis depends on:

  • Finding the likely pathogen or evidence of it

  • Matching symptoms with an infectious process

Criteria for Diagnosis

1. Recovering the Pathogen

  • Pathogen is found from the infected site.

Examples:

  • Blood sample

  • Sputum

  • Urine

  • Wound culture

  • Stool sample

2. Clinical Signs and Symptoms

  • Symptoms must match an infection.

Examples:

  • Fever

  • Redness

  • Swelling

  • Pain

  • Drainage

  • Cough

  • Diarrhea

LAB TECHNIQUES FOR DIAGNOSIS

Culture

  • Growing the microorganism outside the body.

Purpose:

  • Identify the pathogen.

  • Help choose treatment.

Serology / Antigen Detection

  • Looks for immune markers or pathogen antigens.

Simple:

  • Checks if the body has reacted to the pathogen or if pieces of the pathogen are present.

DNA and RNA Sequencing

  • Looks for genetic material of the pathogen.

Simple:

  • Identifies the organism by its genetic code.

HIGH-YIELD STUDY SUMMARY 🚨

  • Host = organism that supports another organism.

  • Infectious disease = damage caused by interaction with another organism.

  • Colonization = microbes present and multiplying, but not always disease.

  • Virulence = ability to cause disease.

  • Pathogens = microbes likely to cause disease.

  • Mutualism = both benefit.

  • Commensalism = microbe benefits, host unaffected.

  • Parasitic = microbe benefits, host harmed.

  • Viruses need host cells to reproduce.

  • Bacteria reproduce on their own.

  • Fungi include yeasts and molds.

  • Protozoa are single-celled parasites.

  • Helminths are worms.

  • Prions are misfolded proteins causing brain degeneration.

  • Incidence = new cases.

  • Prevalence = active cases.

  • Endemic = expected in a region.

  • Epidemic = sudden increase.

  • Pandemic = spread across continents.

  • Portal of entry = how pathogen enters.

  • Toxins damage host cells.

  • Adhesion factors help microbes stick.

  • Evasion factors help microbes hide.

  • Invasion factors help microbes spread.

  • Incubation = exposed, no symptoms yet.

  • Prodromal = early symptoms.

  • Acute = most severe symptoms.

  • Convalescent = recovery.

  • Resolution = infection gone.