Human Health & Diseases

"Good Humor Hypothesis" of Health This was asserted by the early Indian Ayurveda System and
Hippocrates. According to them, health was the state of mind and body where there was a
balance of certain "humors" (liquids). It was believed that a person with a more amount of black
bile in their body had a hot personality and fever. The four different humors are Blood, Phlegm,
Yellow bile, and Black bile. William Harvey disapproved of this theory by discovering the Human
blood circulation theory.
World Health Organization (WHO) According to WHO, Health is not just the "absence of disease"
and "physical fitness". It can be defined as a state of complete physical, mental, and social well-
being of an individual.
Factors affecting Human Health
● Genetic disorders
● Infection (pathogen)
● Life style
Health can be maintained by a balanced diet, personal hygiene, regular exercise, yoga,
vaccination against infectious diseases, proper disposal of waste, control of vectors, and
maintenance of hygienic food and water.
Disease When the functioning of one or more organs or systems of the body is adversely affected
with signs and symptoms, we say we have a disease. Diseases can be classified into two types:
● Congenital Diseases:
○ Present since birth.
○ Genetic in nature.
○ May be due to gene mutation, chromosomal aberration, or environmental effects.
○ Inheritable.
○ Examples: Hemophilia, Color blindness, Sickle-cell anemia.
● Acquired diseases:
○ Can be acquired during a lifetime.
○ Communicable diseases: Examples: Beriberi, diabetes.
○ Non-Communicable diseases: Allergies-Hypersensitivity to a particular
substance.
Terminology
● Pathogen: An organism that is capable of producing a disease. Pathogens include
Bacteria, Fungi, Viruses, Protozoans, and Helminths.
● Pathogenicity: The ability of the pathogen to gain entrance and produce symptoms of a
disease.
● Virulence: The degree of pathogenicity.
● Parasite: An organism that lives at the expense of another organism called the host, for
food and shelter. All parasites are pathogens.
● Infection: It is the interaction between the host and the parasite, having a competition for
superiority.
● Epidemiology: Study of the nature and spread of communicable diseases.
● Endemic: Any disease that is constantly present in a particular geographical area or
population at a relatively stable rate. Example: Malaria in certain parts of Africa.
● Epidemic: A sudden increase in the number of disease cases above what is normally
 expected in a population or area. Example: Dengue fever outbreak in a city.
● Pandemic: An epidemic that spreads across countries and continents,
affecting a large number of people worldwide. Examples: COVID-19 (2020),
Spanish Flu (1918).
Communicable (Infectious) Diseases Transmitted from one person to another.
Can be categorized on the basis of the causative parasite/pathogen into
Bacterial, Viral, Fungal, Protozoic, and Helminthic.
(1) Bacterial Diseases (a)
Typhoid
● Caused by a rod-shaped, acid-resistant bacterium called Salmonella typhi.
● Mostly attacks the small intestine of individuals.
● Present in the stool and urine of the infected person.
● Mode of Transmission: Generally enters the small intestine through food
and water contaminated with bacteria and migrates to other organs
through blood.
● Classic Case: Typhoid Mary (Mary Mallon) a cook by profession.
● Symptoms: Sustained high fever (39^{\circ}C - 40^{\circ}C), weakness,
stomach pain, constipation with low pulse rate, abdominal pain with
frequent stools, loss of appetite. In severe cases, intestinal perforation and
death can occur.
● Incubation Period: 1-3 days.
● Control: Good sanitation, screening of housefly population, control of water
supply. The patient is given antibiotics such as terramycin, chloromycetin,
sulfamethoxazole-trimethoprim, etc..
● Diagnostic Test: WIDAL test. It measures agglutinating antibodies against
H and O antigens of S. typhi.
(b) Pneumonia
● A serious disease of the lungs caused by Streptococcus pneumoniae and
Haemophilus influenzae.
● Usually present in the alveoli of the lungs.
● Mode of Transmission: Inhaling the droplets/aerosols released by an infected
person or by sharing glasses and utensils with an infected person.
● Symptoms: Alveoli get filled with fluid leading to severe problems in
respiration. In general cases, fever, chills, cough, and headache. In severe
cases, lips and fingernails turn bluish in color.
● Incubation Period: 1-3 days.
● Treatment & Control: Antibiotics such as penicillin, streptomycin, ampicillin are
given.
● Diagnostic Test: Blood test, Chest X-ray, pulse oximetry, sputum test.
(c) STD (Sexually Transmitted Diseases)
● Examples: Gonorrhea & Syphilis.
● Also called veneral diseases.
● Transmitted through sexual contact with an infected person.
● Mainly caused by protozoa, bacteria, and viruses. There are more than 30
STDs.
(i) Gonorrhea
● Caused by Neisseria gonorrhoeae.
● Mostly present in the urinogenital mucosa.
● Can only be transmitted through sexual contact.
● Symptoms: Burning sensation in micturition, plus discharge from penis and
vagina.
● Can be cured by antibiotics and can be prevented by avoiding sexual and
 non-sexual contact with an infected person.
● Diagnostic Test: Nucleic Acid Amplification Test (NAAT).
(ii) Syphilis
 ● Caused by the bacteria Treponema pallidum.
● Usually present in the oral, genital, and rectal mucosa.
● Can be transmitted through skin-to-skin and sexual contact.
Other Bacterial Diseases
● Tuberculosis (TB) - Mycobacterium tuberculosis
● Whooping Cough (pertussis) - Bordetella pertussis
● Diphtheria - Corynebacterium diphtheriae
● Plague (Black death) - Yersinia pestis
● Dysentery - Shigella sonnei, s. flexneri, s. dysenteriae
● Meningitis - Neisseria meningitides
● Food poisoning (Botulism) - Clostridium perfringens
● Tetanus - Clostridium tetani
● Leprosy - Mycobacterium leprae
● Cholera - Vibrio cholerae
● Anthrax - Bacillus anthracis
(II) Viral Diseases (a) Common Cold
● Caused by Rhino viruses and Adeno viruses.
● Usually present in the mucosa membranes of the respiratory tract.
● Mode of Transmission: Droplets from coughs and sneezes of an infected
person are directly inhaled or transmitted through contaminated objects
like pens, books, etc..
● Symptoms: Infects the nose and respiratory passage but not the larynx.
Nasal congestion and discharge, sore throat and hoarseness, cough,
headache, tiredness. Lasts for 3-7 days.
● Control: Taking bed rest, avoiding direct contact with the patient, gargling
with warm salt water. Antihistamines and decongestants may be used.
(b) Dengue
● Caused by Dengue virus (Arbo virus).
● Transmitted by the biting of the female Aedes aegypti mosquito.
● Incubation Period: About 4-10 days.
● Symptoms: Sudden high fever (up to 40^{\circ}C), severe headache (behind
eye-orbital pain), muscle and joint pain (Break-bone fever), nausea,
vomiting. In severe cases, bleeding from gums/noses, blood vomit/stool, and
organ impairment can occur.
● Treatment & Control: No specific antiviral treatment. Only supportive care and
adequate fluid intake.
● Diagnostic Test: ELISA test, RT-PCR for viral RNA.
Other viral diseases
● Chikungunya - Chikungunya virus (CHIKV)
● Smallpox (highly contagious) - Variola virus
● Chicken pox - Varicella zoster virus (VZV)
● Measles - Rubeola virus
● Poliomyelitis (polio) (highly infectious in infants & children) - Polio virus
● Hepatitis A, E - water (by oral-fecal route)
● Hepatitis B, C, D - Blood (by parenteral route)
● SARS (Severe Acute Respiratory Syndrome) - Coronavirus
● Bird flu - H5N1 influenza virus
● Swine flu - H1N1 influenza virus
● Rabies - Rabies virus
● Influenza - Orthomyxo virus
(III) Protozoan Diseases (a) Malaria
● History of Malaria: Earlier thought to be caused by foul gases from marshes
(Italian:
mala - bad, aria - air).
● The term "malaria" was given by Macculoch (1837).
● Charles Laveran (1880) discovered malaria parasite (P. vivax, P. malariae) in
the RBC of a patient.
● Stephens discovered P. ovale & Welch discovered P. falciparum.
● Lancisi suspected that malaria occurred where mosquitoes were found.
● Sir Ronald Ross (Doctor in Indian Army) established a relationship between
mosquitoes and malaria on 20th August 1897. He discovered oocysts of
plasmodium on the stomach of a female Anopheles mosquito and won the
Nobel prize in 1902.
● Malaria day is 20th August.
● Mosquito day is 29th August.
● Key Points:
○ The parasite has a digenetic life cycle, meaning it completes its life
cycle in two hosts.
○ I° host: Female Anopheles (sexual reproduction takes place).
○ II° host: Human (asexual reproduction takes place).
○ Infective stage of plasmodium: Sporozoites.
○ Feeding stage: Trophozoites/Cryptozoites.
● Life cycle of Plasmodium:
○ The life cycle of plasmodium involves both asexual (in human) and
sexual (in female Anopheles mosquito) reproduction.
● Asexual cycle in Human:
○ The asexual cycle in humans is called Schizogony.
○ When an infected female Anopheles mosquito bites a healthy person, it
injects the sporozoites into the blood of the human.
○ These then enter into the liver cells to form
trophozoites/cryptozoites (feeding stage), which undergo
endogenous multiple fission called schizogony (Hepatic Schizogony)
to form a large number of merozoites.
○ The merozoites then enter into RBC to form a signet ring, amoeboid
shape, and rosette stages are produced.
○ This results in a dark-brown coloration of Hemoglobin to form a
poisonous Hemozoin granules that causes fever and shivering.
○ Later on, Erythrocytic schizogony leads to the formation of a large
number of merozoites (in every 48 hours).
○ Here the merozoites behave as male (micro) and female (macro)
gametocytes in the stomach of the mosquito, where they carry out
sexual reproduction.
● Sexual cycle in Mosquito:
○ When a female Anopheles mosquito bites an infected person, the
gametocytes enter the stomach where they fuse to form the zygote.
○ Then the diploid zygote transforms into oocyst/ookinete/vermicule,
which passes out through the stomach wall to form the oocyst.
○ The oocyst divides to form sporoblast and then a large number of
sporozoites (by sporogony) which move into the saliva of the
mosquito, ready to infect another healthy individual.
● Signs, Symptoms, Treatment & Diagnosis:
○ Incubation period: About 7-15 days (varies).
 ○ Initial symptoms: Fever, headache, and chills.
○ Classical symptoms of malaria: A cyclic recurrence of high fever
followed by sweating and sudden shivering (lasts for 4-6 hours).
○ Can be diagnosed by Rapid antigen test and blood test.
○ Anti-malaria drugs like chloroquine (from paledrin), plasmaschin,
primaquine, etc. are used.
○ Vaccination is not possible, because the parasite does not
produce any antibodies/antitoxins in the human blood.
● Control of Malaria:
○ Prevention of mosquito bites by using mosquito nets and insect
repellents.
○ Spraying insecticides and draining stagnant water where mosquitoes lay
eggs (DDT and gammexane (BHC)).
○ Mosquito larvae can be controlled by using biological agents like
Gambusia, sticklebacks, and mollie fish in ponds and ditches.
○ Anti-malaria drugs should be taken orally.
○ NMEP (National Malaria Eradication Programme) was launched by the
Govt. of India in 1958 to control malaria.
● Types of Malaria: 4 species.
1. P. vivax - Benign Tertian malaria (48 hours).
2. P. malariae - Quartan malaria (72 hours).
3. P. ovale - Mild tertian malaria (48 hours).
4. P. falciparum - Malignant malaria/Brain malaria/Black water fever.
● Quotidian malaria: When more than one species of plasmodium species
attack the patient.
● Pigment dots formed in cytoplasm of RBC:
○ P. vivax - Yellow Schuffner's dots.
○ P. falciparum - Green Maurer's dots.
○ P. malariae - Brown Ziemann's dots.
○ P. ovale - Brown Jame's dots.
(b) Amoebiasis (Amoebic dysentery)
● Caused by a protozoan parasite Entamoeba histolytica.
● It is a monogenetic parasite, meaning it has a single host that infects humans
only.
● The parasite usually lives inside the colon of humans and dissolves the
mucous lining and intestinal wall.
● The disease spreads by contaminated food and water.
● The infective stage is a quadri-nucleated cyst/tetra-nucleated cyst.
● Mode of transmission and Infection:
○ Houseflies (mechanical carriers).
○ Quadri-nucleated cysts are carried to the alimentary canal of a healthy
man through contaminated food and water.
○ These then dissolve to form octanucleated forms called metacyst,
which undergo multiple fissions to form 8 uni-nucleate daughters
called amoebulae.
● Life Cycle:
○ It involves three stages.
○ (i) Mature Trophozoite (Feeding stage) (Magna Form): Lives inside the
intestinal wall and dissolves the lining of the mucosa by proteolytic
enzymes, then divides (binary fission) to make new cells.
○ (ii) Pre-cystic Stage (Minuta form): Trophozoites enter into the pre-cystic
and
 minuta stage, which feed on glycogen and chromatid bars.
○ (iii) Cystic Stage: The pre-cystic stage produces a resistant wall around
itself during unfavorable conditions to the cystic form. This then
changes to binucleated and then tetra-nucleated cysts (infective stage)
which come out in human feces.
● Treatment & Control:
○ Anti-protozoan drugs like emetine, enteroquinol, etc. are used.
○ Washing hands properly before taking food.
○ Educating people not to use open spaces for defecation.
● Symptoms: Constipation, abdominal pain and cramps, and stool with excess
mucus and blood clots.
● Diagnosis: Blood and stool test.
(IV) Helminthic Diseases (a) Ascariasis
● It is an infectious disease of the human intestinal tract, caused by Ascaris
lumbricoides
(Roundworm).
● It is an endoparasite (Nematoda / Roundworm).
● Mode of Transmission:
○ Eggs of the parasite are excreted along with the feces of an infected
person into contaminated soil, water, and vegetables.
○ Eggs hatch inside the intestine of a new host, then to larvae, which
then settle as adults in the digestive system (Rhabditiform larva).
● Symptoms: Internal bleeding, muscular pain, fever, blockage of the intestinal
passage, presence of live worms in the fecal matter, loss of appetite, and
weight loss. Eosinophilia (increase in No. of Eosinophils).
● Diagnosis & Treatment:
○ Examination of stool samples.
○ Anti-helminthic drugs like piperazine, mebendazole, levamisole, and
pyrantel are taken.
● Control:
○ Avoiding open defecation.
○ Using hygienic toilet facilities.
○ Washing hands and utensils properly.
○ Protection of food from dirt and soil.
(b) Filariasis (Elephantiasis)
● It is caused by a Helminth parasite Wuchereria bancrofti, W. malayi and Brugia
timori.
● It spreads by female Culex mosquito (C. fatigans).
● It is a digenetic parasite (Human and Female Culex).
● The infective stage is the microfilariae (found in lymph glands, lymph vessels,
etc.) which cause enlargement of legs, arms, breast, scrotum, etc..
● There are 3 subtypes:
○ (i) Lymphatic Filariasis.
○ (ii) Subcutaneous Filariasis (Loa Loa).
○ (iii) Serous cavity Filariasis (mansonella spp.).
● Mode of Transmission:
○ When an infected female Culex mosquito bites a healthy human,
microfilariae are injected into the bloodstream, then to the lymph
vessels and lymph node.
○ After 9th moulting, they become sexually mature.
○ Live up to 4-5 years. (8-16 months incubation period) .
● Signs & Symptoms:
 ○ Edema with thickening of skin and underlying tissue.
○ Extreme enlargement of legs called elephantiasis.
○ Hydrocele (enlargement of testes due to accumulation of lymphatic
fluid).
○ The patient suffers from periodic fever, associated with headache
and mental depression.
● Control, Treatment & Diagnosis:
○ Breeding ground of mosquitoes should be destroyed by spraying DDT
and BHC.
○ Mosquito nets should be used.
○ Hetrazan, diethyl-carbamazine citrate should be taken.
○ NFEP (National Filariasis Eradication Programme) was launched by the
Govt. of India to control Filariasis.
○ ICT Filariasis test should be done.
(V) Fungal Diseases (a) Ringworm (Dermatophytosis)
● It is a fungal infection of the skin, caused by many fungal species that
belong to the genera Trichophyton and Microsporum.
● They feed on keratin in the skin, hair, and nails.
● Mode of Transmission:
○ Spreads by sharing clothes, combs, etc..
○ Close contact with infected persons also causes it.
● Symptoms:
○ Appearance of red patches on the skin with itching sensation.
○ It may cause blisters and oozes.
○ Lesions are accompanied by intense itching.
● Test & Treatment:
○ Skin test and biopsy test can be done.
○ Anti-fungal drugs like Nystatin, Fluconazole, and Itraconazole are taken.
○ Keeping skin clean and dry.
○ Avoiding touching pets with bald spots.
○ The patient should be kept isolated.
○ Avoiding sharing of clothes and combs.
● Different species of Ringworm:
○ Tinea capitis - affects the scalp (bald spots).
○ T. Faciei - Face.
○ T. unguium - Nail.
○ T. manus - Palm.
○ T. pedis - Feet (Athlete's foot) between the fingers.
○ T. Corporis - Body.
○ T. barbae - Beard.