BB2716: Medical Microbiology

Week 1: Introduction to Course

Dr. Anthony G. Tsolaki

anthony.tsolaki@brunel.ac.uk
 Timetable
Lectures (Term 1)
Tuesday 2pm-3pm
LECT-B

Friday 10am-11 pm
LECT-A

Also available on HW notice board

Lecture notes available on Blackboard
Check regularly for updates and module information
Use general discussion/chat to ask informal questions

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 Timetable
Practicals (Thursday) HW135

Practical 1: Diagnostic mycology

Elion(w3, 13th Oct 2016) 2pm-5pm
Hodgkin(w4, 20th Oct 2016) 2pm-5pm
Southern (w5, 27th Oct 2016) 2pm-5pm
Baltimore(w7, 10th Nov 2016) 2pm-5pm

Groups available on Blackboard and HW Notice Board

Attendance recorded

3
 Brunel Blackboard
Blackboard

Course syllabus
Lecture notes and further references
Dates of Practicals and Exams
Announcements

Check regularly!

4
 Assessment

1 MCQ exam (formative to be

confirmed)
Week 17 (Jan 2017)

End of year exams (BB2805)

End April - May 2017

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 Lecturers
Dr. Anthony G. Tsolaki Dr. Beatrice Nal-Rogier

Bacterial pathogens Parasitic and Helminth

pathogens
Viral pathogens Fungal pathogens

anthony.tsolaki@brunel.ac.uk Beatrice.Nal-
Room HW234 Rogier@brunel.ac.uk
Room HW237
Tel: 01895 266077
Tel: 01895 266341

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 Essential Reading

Mims Medical
Microbiology Medical Microbiology,
5th Edition, by Murray, Rosenthal and
Pfaller,
Richard Goering, 7
Hazel Dockrell, Mark 7th Edition, Elsevier
 Essential Reading

Color Atlas of Medical

Microbiology Human Virology
Hart and Shears, 2nd Collier and Oxford
Edition 4th Edition
8
 Recommended Reading

Microbiology in
Immunology
clinical practice :

Shanson, 3rd Roitt I, Roth D, Brostoff J and Mal

edition, 9
 Recommended Reading

Medical Microbiology and Notes on Medical

Infection at a Glance Microbiology
Stephen Gillespie, Timbury et al.,
Kathleen Bamford ISBN 0-3230-3575-2
10
Recommended Reading

Foundations of Parasitology
(2013)

Roberts LS and Janovy J

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 Definitions
Microbiology: the study of microorganisms

Microorganisms/microbes: microscopic organisms

Pathogens: microorganisms susceptible to cause

disease

Infectious disease: disease caused by an infectious

agent, a pathogen

Medical Microbiology: The study of microorganisms

that are of medical importance and susceptible of
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causing disease in Human beings
 Microorganisms

Can be found in every ecosystems

They populate the healthy human body by the billions

(normal flora)

participants in bodily functions (example: bacteria

present in the intestinal tract)

Few species of microorganisms are harmful to humans and

can cause disease

production of toxic compounds

direct infection

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 Disease

Disturbance in the state of health.

Clinically evident illness

characteristic medical signs
symptoms

Microbes cause disease in the course of stealing

space, nutrients, and/or living tissue from their hosts
(e.g. humans)

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o cause Disease, microbes must be able to:
Gain access to the host (contamination)
Adhere to the host (adherence)
Replicate on the host (colonization)
Invade tissues (invasion)
Harm the host: production of toxins, alteration of host
functions, destruction of host tissues (damage)

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 Microbes/Infectious Agents

Procaryotes (bacteria)

Fungi

Protozoa

Helminths

Viruses

Prions

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Relative sizes of disease
causing organisms
 The top 7 killers/infections responsible for the greatest number of
deaths in the world (data from 1997)
Examples of emerging infectious diseases
 BB2716: Medical Microbiology

Week 1: Infectious Disease Epidemiology

Dr. Anthony G. Tsolaki

anthony.tsolaki@brunel.ac.uk
 What is infectious disease
epidemiology?
Epidemiology Infectious disease epidemiology
Deals with one population Two or more populations
Risk case A case is a risk factor
Identifies causes The cause often known
 What is infectious disease
epidemiology?
Two or more populations
Humans
Infectious agents
Helminths, bacteria, fungi, protozoa, viruses, prions
Vectors
Mosquito (protozoa-malaria), snails (helminths-schistosomiasis)
Blackfly (microfilaria-onchocerciasis) bacteria?
Animals
Dogs and sheep/goats Echinococcus
Mice and ticks Borrelia
What is infectious disease
epidemiology?
A case is a risk factor
Infection in one person can be transmitted to others
 What is infectious disease
epidemiology?
The cause often known
An infectious agent is a necessary cause

What is infectious disease epidemiology then used for?

Identification of causes of new, emerging infections, e.g. HIV, vCJD, SARS
Surveillence of infectious disease
Identification of source of outbreaks
Studies of routes of transmission and natural history of infections
Identification of new interventions
 Infectious Disease

Definitions Tetanus Measles vCJD

Infectious diseases
Caused by an infectious agent
Communicable diseases
Transmission directly or indirectly from an infected person
Transmissible diseases
Transmission through unnatural routes from an infected person

Note
Infections are often subclinical infections vs infectious diseases!
Antonyms not well-defined
Non-communicable diseases virus involved in pathogenesis of diabetes?
Chronic diseases HIV?

(www)
Routes of transmission
Direct Indirect
Skin-skin Food-borne
Herpes type 1 Salmonella
Mucous-mucous Water-borne
STI Hepatitis A
Across placenta Vector-borne
toxoplasmosis Malaria
Through breast milk Air-borne
HIV Chickenpox
Sneeze-cough Ting-borne
Influenza Scarlatina

Exposure
A relevant contact depends on the agent
Skin, sexual intercourse, water contact, etc

(www)
(www)
Some Pathogens that Cross the
Placenta
Modes of Disease Transmission
Exposure to Infectious Agents

No infection Clinical Sub-clinical Carrier

Death Carrier Immunity No immunity

Outcome
 Timeline for Infection

Infection
Dynamics of Latent Infectious Non-infectious
infectiousness period period

Susceptible
Time
Infection

Dynamics of Incubation Symptomatic Non-diseased

disease period period

Susceptible
Time
 Transmission
Cases
Index the first case identified
Primary the case that brings the infection into a population
Secondary infected by a primary case
Tertiary infected by a secondary case

T
S
Susceptible P
S
Immune
S
T
Sub-clinical

Clinical
 Person-to-Person Transmission

Data from studies in England (1952)

Measles Chickenpox Rubella
Children exposed 251 238 218
Children ill 201 172 82

attack rate 0.80 0.72 0.38

Attack rate = ill

exposed
 Epidemiologic Triad

Disease is the result of

forces within a
dynamic system
consisting of:
agent of infection
host
environment
 Factors Influencing Disease
Transmission

Agent Environment
Weather
Infectivity
Housing
Pathogenicity
Geography
Virulence
Occupational
Immunogenicity setting
Antigenic Air quality
stability
Food
Survival

Age
Sex
Genotype
Host Behaviour
Nutritional status
Health status
 Epidemiologic Triad-Related Concepts

Infectivity (ability to infect)

(number infected / number susceptible) x 100
Pathogenicity (ability to cause disease)
(number with clinical disease / number infected)
x 100
Virulence (ability to cause death)
(number of deaths / number with disease) x 100
All are dependent on host factors
The iceberg concept of infectious disease

poliomyelitis in a child
0.1-1% of infections are
clinically apparent classical
clinical disease less severe
disease

rubella
50% of infections are
clinically apparent

asymptomatic infection
Spectrum
of virulence

rabies
100% of infections
are clinically apparent
Kochs postulates to identify the
microbial cause of specific diseases
Microbe must be present in
every case of the disease
Microbe must be isolated from a
disease host and grown in pure
culture
Disease must be reproduced
when a pure culture is introduced
into a non-disease susceptible
host
Microbe must be recoverable
Robert Koch (1843-1910) from an experimentally infected
host
Kochs Postulates
Endemic - Epidemic - Pandemic
Cases

Time

Endemic
Transmission occur, but the number of cases remains
constant
Epidemic
The number of cases increases
Pandemic
When epidemics occur at several continents global
epidemic
Reading assignment

Chapter 31: Strategies for control: an

introduction