INTRODUCTION

OF INFECTIOUS DISEASE

The First Teaching Hospital of Zhengzhou

University, Department of Infectious Disease

Gu Junsheng
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 SUMMARIZATIONS

A new subject:
Infectious Disease-- one of the
most important clinical courses.

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 SUMMARIZATIONS
• In the past…
• Nowadays:
• HIV/AIDS
• Bacillus anthracis/`Anthrax
• Prion/v CJD (New Variant Creutzfeldt-Jackob Disease)
• SARS
• Bird flu
• In the future
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 SUMMARIZATIONS
Our topics of this term:
Measles
Epidemic Encephalitis B
Viral Hepatitis
AIDS
SARS
Epidemic Hemorrhagic Fever
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 SUMMARIZATIONS
Our topics of this term:
Cholera (By Sun Changyu)
Epidemic Cerebrospinal Meningitis
Typhoid Fever (By Yu Zujiang)
Bacillary Dysentery
Bacteremia and Septicemia
FUO
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 Definitions

• Infectious Disease:
• Caused by virus, bacteria,
chlamydia, rickettsia, prion, fungus,
spirochete, protozoa, helminth etc.

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 Definitions

• Infectious Disease
• Communicable disease
• Noncommunicable disease

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 Definitions

• Communicable Disease:
• Caused by upper microorganisms
• And be communicable

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INFECTION AND IMMUNITY
Definitions:
Infection: Interaction between pathogen and
the host (results in different consequence)
Opportunistic infection:
During evolutionary process of microorganisms
balance commensalism imbalance
opportunistic infection

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 Pathogenecity of Pathogen

• Pathogenecity:
• Invasiveness: adherence
• Virulence: exotoxin, endotoxin & other virulence factor
• Quantity:
• Variability:

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Immune Response of the Host
During the Infection Process

• Nonspecific immunity
• Specific immunity:

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 Immune Response of the Host
During the Infection Process
• Nonspecific immunity:
skin
• Natural barrier: mucosa
• Phagocytosis BBB

`complement
• Humoral factors lysozyme interleukin
cytokines TNF

interferon-γ

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 Immune Response of the Host
During the Infection Process

• Specific immunity:
• Cell-Mediated Immunity
• intracellular autoeciousness
• T-cell
• regulates humoral immunity
•

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 Immune Response of the Host
During the Infection Process

• Specific immunity:
• Humoral Immunity
• B-cell plasma cell
immunoglobulin:
IgA IgD IgE IgG IgM

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 Infection Process
(Infection spectrum)
• Clearance of pathogen
• Covert infection /subclinical infection
• Overt infection /clinical infection
• Carrier state
• Latent infection

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 Infection Process
(Infection spectrum)
• Clearance of pathogen:
• Cleared by:
• [Link] immunity
• [Link] immunity(prior, foregoing)
• vaccination
• Immunoglobulin active immunity
• passive immunity
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 Infection Process
(Infection spectrum)
• Covert infection /subclinical infection:
• 1. Very light damage
• 2. Asymptomatic
• 3. Only induces specific immune
response and can be tested by
immunological tests
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 Infection Process
(Infection spectrum)
• Overt infection /clinical infection:
• [Link] (the damage is severe)
• [Link] in:
• clearance of pathogen always with a
stable post-infection immunity or
• chronic carrier state
• latent infection
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 Infection Process
(Infection spectrum)
• Carrier state:
• Common character:
• 1. Asymptomatic
• 2. Carrying & discharging pathogen

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 Infection Process
(Infection spectrum)
• Latent infection:
• The pathogen and the host cant not beat each other.
• Latent infection can become overt infection when stress
comes or immunity is inhibited.
• Asymptomatic
• No pathogen discharged
• [Link]-zoster virus
(chichenpox in children & herps zoster in adults)

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 Infection Process

• The most common type:

• The most typical type:

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 Infection Process
• Questions: difference between each
type?
• The difference between type 1
(clearance of pathogen) and type 2 (covert
infection/subclinical infection) ?
• The difference between carrier state
and latent infection ?

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 Basic Conditions of
the Process of Communicable Disease

Sources of infection:
patients
covert infection ones
carriers
infected animals

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 Basic Conditions of
the Process of Communicable Disease
Routes of transmission:
respiratory tract
digestive tract
contact
blood
sex
`arthropod

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 Basic Conditions of
the Process of Communicable Disease

Routes of transmission:
horizontal transmission
vertical transmission
congenital transmission

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 Basic Conditions of
the Process of Communicable Disease

Susceptible persons:
different susceptibility of different groups

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 Basic Character of Communicable Disease

• Pathogen
• Infectivity
• Epidemiologic feature
• Post-infection immunity

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 Basic Character of Communicable Disease

• Pathogen:
• virus, bacteria, chlamydia,
rickettsia, prion, fungus, spirochete,
protozoa, helminth, etc.

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 Basic Character of Communicable Disease

• Infectivity
• Communicable

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 Basic Character of Communicable Disease

• Epidemiologic feature :
• sporadic occurrence: normal
• epidemic: with a higher morbidity than
that in normal time
• pandemic:in a large area
• epidemic outbreak:in a short time

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 Basic Character of Communicable Disease

• Post-infection immunity:
• IgM
• IgG

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 Clinical Features

• Phases of the course:

• Incubation period
• Prodromal period
• Period of apparent manifestation
• Convalescent period

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 Clinical Features

• Phases of the course:

• Incubation period:
• asymptomatic

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 Clinical Features

• Phases of the course:

• Prodromal period:
• nonspecific clinical manifestations such
as: headache, fever, fatigue, inappetent, etc.

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 Clinical Features

• Phases of the course:

• Period of apparent manifestation:
• specific rashes, hepatomegaly, splenomegaly,
jaundice etc.

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 Clinical Features

• Phases of the course:

• Convalescent period:

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 Clinical Features

• Other features:
• recrudescence
• relapse

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 Common Symptoms & Signs

• Pyrexia:
• effervescence
• fastigium
• defervescence

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 Common Symptoms & Signs

• Eruption
• Following rashes can be seen in eruptive
infectious disease.
• 1. maculopapule

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 Common Symptoms & Signs

• Eruption
• Following rashes can be seen in eruptive
infectious disease.
• 2. petechia

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 Common Symptoms & Signs
• Eruption
• Following rashes can be seen in eruptive
infectious disease.
• 3.`vesicle

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 Common Symptoms & Signs

• Eruption
• Following rashes can be seen in eruptive
infectious disease.
• 4. urticaria

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 Common Symptoms & Signs

• Toxemic symptoms:
Discomfort, fatigue, inappetent,
headache, etc caused by metabolite and
toxins of the pathogen.

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 Common Symptoms & Signs

• Reaction of the Monocyte-Macrophage system:

hepatomegaly
splenomegaly
lymphadenectasis

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 DIAGNOSIS

• Diagnosis of communicable disease should

be depended on information from:
• 1. Epidemiology
• 2. History of disease: symptoms & signs
• 3. Laboratory tests

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 TREATMENT
• General treatment:
• Supportive treatment:
• Etiologic treatment:
• Symptomatic treatment:
• Rehabilitative therapy:

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 PREVENTION
• Management of the source of infection:
• I. plague, cholera, SARS, AIDS
• II. viral hepatitis, measles, epidemic
hemorrhagic fever, epidemic cerebrospinal
meningitis, typhoid fever, bacillary dysentery
• III. mumps, [Link]

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 PREVENTION
• Cut off the transmitting route:

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 PREVENTION
• Protection of the susceptible persons:

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