Overview of Infection and Disease Part B
Overview of Infection and Disease
Difference Between Infection and Disease
Microorganisms can be present in a host without causing disease.
Steps for Microorganisms to Cause Disease
Entrance (Portal of Entry)
Microorganisms must gain entrance into the organism.
Portal of Entry Definition: An opening in the skin or into the body where the microorganism can enter.
Examples of portals of entry:
Eyes
Respiratory tract
Gastrointestinal tract
Genitourinary tract
Skin openings (pores, hair follicles, cuts, bites, blisters)
Importance of Portal of Entry:
Different organisms have specific portals of entry that determine whether they can cause disease.
Example: E. coli on skin may not cause disease, but ingested E. coli can indeed cause harm.
Adherence to Tissue
After entering, microorganisms must adhere to tissues to remain inside long enough to cause disease.
Mechanisms of Adherence:
Fimbriae: Short hair-like extensions on the organism's surface that allow sticking to surfaces.
Hooks: Some organisms can bore into tissue, e.g., Treponema pallidum (syphilis).
Capsule/Glycocalyx: A sticky layer that helps the organism attach and resist removal.
Surviving the Host's Defenses
After adherence, pathogens must evade the immune response:
Preventing Phagocytosis:
Some pathogens produce leukocidins, toxins that destroy white blood cells, forming a clear zone around colonies on agar.
Slime Layer/Capsule: Inhibits phagocyte engulfment.
Intracellular Survival: Some pathogens (e.g., Mycobacterium tuberculosis, Mycobacterium leprae) can survive inside phagocytes.
Antigen Variation: Pathogens can change surface proteins (antigens) (e.g., influenza virus changes hemagglutinin and neuraminidase) to escape recognition by the immune system.
Causing Disease
Pathogens can cause disease through various mechanisms:
Toxins: Production of exotoxins and endotoxins.
Exotoxin:
Secreted during cell growth.
Typically proteins/enzyme that can cause disease in very small amounts.
Examples: Botulinum toxin (causes paralysis), tetanus toxin.
Mostly produced by Gram-positive organisms.
Endotoxin:
Part of the outer membrane of Gram-negative bacteria.
Released upon cell death.
Causes similar symptoms regardless of source (fever, inflammation, hemorrhage, diarrhea).
Requires a higher dose to cause harm compared to exotoxins.
Host Defense Damage: Damage can also be inflicted by the host's own immune response trying to eliminate the pathogen.
Viral Pathogenesis: Certain viruses can induce changes in host DNA, potentially leading to diseases like cancer.
Transmission to New Hosts
Organisms must exit the host to find and infect new hosts, with methods including:
Coughing and sneezing
Skin lesions (exiting through skin cells)
Urine or feces
Blood
Insect bites (vector transmission)
Summary of Key Statistics
ID50 (Infectious Dose 50):
Number of pathogen cells required to infect 50% of a population.
Lower ID50 indicates higher pathogenicity.
LD50 (Lethal Dose 50):
Number of pathogen cells needed to kill 50% of a population.
Lower LD50 indicates higher lethality.
Conclusion
The cycle of infection involves multiple steps: entering the body, adhering, surviving immune defenses, causing disease, and transmitting to new hosts. Understanding each step is essential for studying infectious diseases and developing control strategies.