SUBJECT CODE: BHCM 3163

SUBJECT NAME: PRINCIPLE OF

HEALTHCARE & DISEASE PREVENTION

WEEK: 2
TOPIC: DISEASE CONCEPTS

PREPARED BY:
MS. ZAYAN NABILAH
 Course Learning Outcomes

 Disease causes and transmission

 Disease classification
 Stages of disease
 Immunity
 Portal of entry to the human body
 Later stages of infection
Difference between ENDEMIC, EPIDEMIC
and PANDEMIC
 What Is Disease?

 Disease is an interruption, cessation, or

disorder of body functions, systems, or
organs
 Diseases arise from infectious agents,
inherent weaknesses, lifestyle, or
environmental stresses
 Environment – all that is external to the human
host (physical, biological, social, cultural, etc.)
The Triangle of Epidemiology

HOST
Impacts exposure
susceptibility and response

Time

ENVIRONMENT
INFECTIOUS AGENT
Impacts opportunity for
Cause
exposure
 Causes of Disease

 Identifying the causes of

disease and the mechanisms
by which it spreads remains a
primary focus in epidemiology

 The science and study of the

causes of disease and their
mode of operation is referred
to as etiology
 Disease Transmission

 The ability of a disease to be transmitted from one

person to another or to spread through the
population is called communicability
 HIV/AIDS
 When an infectious disease is
contagious, or capable of being
communicated or transmitted, it is
called a communicable disease
 Cholera
 Influenza
 Cryptosporidiosis
 What are two general types of disease
transmission?

⚫ Vertical transmission – transmission from an individual to its

offspring through sperm, placenta, milk, or vaginal
⚫ Horizontal transmission – transmission of infectious agents
from an infected individual to a susceptible contemporary
 Pathogens
⚫ Organisms or substances such as prions, bacteria, viruses,
fungi, or parasites that are capable of producing diseases
(esp. when immune system is weakened)
⚫ The ability to get into a susceptible host and cause disease
is termed invasiveness
⚫ The disease-evoking power of a pathogen is called
virulence
⚫ Toxins – kill pathogens by poisoning them
⚫ Antibiotics work against pathogens because of their toxicity
(contains elements that are more toxic to bacteria)
 What are two general classifications of
disease?
⚫ Acute – disorder with sudden onset, relatively severe, and
short duration of symptoms (eg: burns, heart attack, cholera, etc.)
⚫ Chronic – less severe but of long and continuous duration,
lasting over long periods, if not a lifetime (eg: diabetes, cancer, athritis,
etc.)
Examples of diseases according to
selected classifications
 What are the major stages in the disease
process?

 Stages relevant to most health-related states or events

1. Stage of susceptibility (at risk of getting infected)
2. Stage of pre-symptomatic disease
• Incubation period (time interval between infection and the
appearance of clinical symptoms )
• Latency period (time interval between infection & becoming
infections)
3. Stage of clinical disease (has clinical signs & symptoms)
4. Stage of recovery, disability, or death
Natural course of communicable
disease
 Breaking the Cycle

 Viability (ability to survive) – The capacity of the

pathogen or disease-causing agent to survive
outside the host and to exist or thrive in the
environment
 Viability – Guinea worm is 1 year
 Solution – Break the cycle for 1 year
 What are the five major categories of
disease?

 Congenital and hereditary diseases

 Allergies and inflammatory diseases
 Degenerative diseases
 Metabolic diseases
 Cancer
 Congenital and Hereditary Diseases

 Familial tendencies toward certain inborn

abnormalities
 Injury to the embryo or fetus by environmental
factors
 Examples – Down syndrome, hemophilia, heart disease at an early age
 Allergies and Inflammatory Diseases

 Body reacting to an invasion of or injury by a

foreign object or substance.

 Inflammatory diseases is a condition that are

characterized by inflammation. For example:
asthma, hepatitis, inflammatory bowel disease
etc.
 Degenerative Diseases

 Deterioration of body systems, tissue, and functions

 Often associated with the aging process
 Eg: arteriosclerosis, arthritis, gout etc.
 Metabolic Diseases

 Cause the dysfunction, poor function, or malfunction

of certain organs or physiological processes within
the body leading to disease states
 Example – Cells may no longer utilize glucose normally causing diabetes
 Cancer

 Characterized by abnormal growth of cells that

form a variety of tumors, both benign and
malignant
 Common modes of entry into the body of
infectious disease agents
 Respiratory
 Oral
 Reproductive
 Intravenous (administered into veins)
 Urinary
 Skin
 Gastrointestinal (stomach or intestines)
 Conjunctival (tissues that lines the inside of the eyelids)
 Transplacental (across or through the placenta)
 Zoonosis and Disease in Humans

 Animals can be the host, vector, or source of

certain infections and diseases
 A zoonosis (plural, zoonoses) is an infectious
organism in vertebrate animals (e.g., rabies or
anthrax) that can be transmitted to humans
through direct contact, a vector
 The word comes from the Greek words zoon
(animal) and nosos (ill)
 Common Zoonotic Diseases
• AIDS • Dengue fever • Salmonellosis
• Amebiasis • Dermatophilosis • Shigellosis
• Anthrax • Leprosy • Streptococcus
• Bovine papular • Lyme disease infections
stomatitis • Pasteurellosis • Tetanus
• Brucellosis • Plague • Trichinosis
• California • Q-fever • Tularemia
encephalitis • Rabies • Yellow fever
• Cat-scratch fever • Rat-bite fever • Zoonotic
• Colorado tick • Rickettsialpox scabies
fever • Rocky mountain
• Cowpox spotted fever
 Notifiable Diseases in the United States

 Notifiable diseases are those of considerable public

health importance because of their seriousness
 Such diseases
 Cause serious morbidity or death
 Have the potential to spread
 Can be controlled with appropriate intervention
 Immunity and Immunizations Against
Infectious Diseases

 According to the Centers for Disease Control and

Prevention, if fewer than 80% of the children in a
given area have been inoculated for one of the
contagious diseases, the danger of serious
outbreaks or localized epidemics remains; every
unvaccinated child is at risk.
 What Is Active Immunity?

 Active immunity – The body produces its own

antibodies. This can occur through a vaccine or in
response to having a specific disease pathogen
invade the body.
 What Is Passive Immunity?

 Passive immunity – acquired through

transplacental transfer of a mother’s immunity to
diseases to the unborn child
 Vaccines
• Anthrax • Mumps
• Cervical Cancer (HPV) • Pertussis
• Cholera • Plague
• Chickenpox • Pneumonia
• Diphtheria • Polio
• German measles (rubella) • Rabies
• Haemophilus influenzae type b (Hib) • Smallpox
• Hepatitis A • Spotted fever
• Hepatitis B • Tetanus
• Influenza • Tuberculosis
• Japanese encephalitis • Typhoid fever
• Lyme disease • Typhus
• Measles • Whooping cough
• Meningitis • Yellow fever
 What Is Herd Immunity?

 Viewed as the resistance a population has to the

invasion and spread of an infectious disease
 Based on the notion that if a population or group is
mostly protected from a disease by immunizations
(say 80% or more), then the chance of a major
epidemic occurring is highly limited
Estimated herd immunity thresholds
for vaccine-preventable diseases
 Is there a changing emphasis in
epidemiology?

 Increasing life expectancy in modern times and higher

levels of chronic disease has produced a change in the
emphasis of epidemiologic studies
 Host-Related Control and Prevention

 Quarantine applies to persons who have been

exposed to a contagious disease but may or may
not become ill
 Host-Related Control and Prevention

 Isolation applies to persons who are known to be ill

with a contagious disease. It is often conducted on an
inpatient basis in hospitals or nursing homes. Most
state laws, as well as accrediting organizations,
require one or two beds to be kept, designated, and
equipped in a hospital or nursing home as isolation
beds.
 Portals of Entry to the Human Body

• Different modes of entry into the body have been identified.

Respiratory Skin Conjunctival

Oral Mucous membrane Transplacental
Reproductive Open wounds Tubes inserted into
Intravenous Gastrointestinal the body cavities
Urinary (urinary catheters,
feeding tubes)
Natural Course of Communicable Disease
 Later Stages of Infection

 The Prodromal period is the second stage of illness and the

period in which signs and symptoms of a disease first appear.
 Disease transmission is greatest during prodromal period
because of high communicability of the disease at this stage.
 The following terms help to characterize disease further:
 Fastigium

 The period when the disease is at its maximum severity or intensity.

 Diagnosis is easiest at or directly after the differential point.
 Many respiratory illnesses produce the same symptoms in the prodromal
stage, making diagnosis difficult.
 In this stage, even though the disease is highly communicable, patients do
not spread it much.
 Usually in this phase of the disease, the sick person is home in bed or in
hospital
 Defervescence

 The period when the symptoms of the illness are declining.

 As patients feel that they are recovering from a disease in this
period, they may not take care of themselves.
 If the immune system is weakened and cannot effectively fight
off the pathogens, a relapse may occur at this stage.
 This is also a period when the likelihood of transmission of the
disease is quite high because patients may be up and about,
although not yet recovered and still infectious.
 Convalescence

 Recovery period
 Those affected may still be infectious at this point but are feeling
much better.
 They may be out and about, spreading the disease.
 Defection

 Period during which the pathogen is killed off or brought

into remission by the immune system.
 In some diseases, defection and convalescence may be
the same stage.
 If isolation is required, it is in the defection stage that
isolation is lifted.
 What Is Malnutrition?

 A condition that arises when

the body does not get the right
amount of vitamins, minerals,
and other nutrients to maintain
healthy tissues and proper
organ function. Malnutrition
occurs in people experiencing
either undernutrition or
overnutrition.
 Undernutrition

 A consequence of consuming too little essential

vitamins, minerals, and other nutrients, or excreting
them faster than they can be replenished
 Inadequate intake may result from excessive
dieting, severe injury, or serious illness
 Excessive loss may result from diarrhea, heavy
sweating, heavy bleeding, or kidney failure
 Overnutrition

 The consumption of too much food, eating too

many of the wrong things, too little physical
activity and exercise, or taking too many
vitamins or dietary supplements
What are some common nutritional deficiency
diseases and disorders?
⚫ Kwashiorkor – protein deficiency
⚫ Marasmus – protein-calorie malnutrition, chronic
undernutrition
⚫ Iron-deficiency anemia
⚫ Folic acid-deficiency anemia
⚫ Vitamin B12-deficiency anemia
⚫ Xerophthalmia – vitamin A deficiency
⚫ Endemic goiter – iodine deficiency
⚫ Beriberi – thiamine deficiency
What are some common nutritional deficiency
diseases and disorders?
⚫ Ariboflavinosis – riboflavin deficiency
⚫ Pellagra – niacin and amino acid tryptophan
deficiency
⚫ Scurvy – vitamin C deficiency
⚫ Rickets – vitamin D deficiency
⚫ Tetany – mineral deficiency
⚫ Osteomalacia and osteoporosis – impaired calcium
and phosphorus metabolism affecting bone
formation
 Selected Chronic Diseases and
Conditions
 Cardiovascular disease, cancer, chronic obstructive
pulmonary disease, diabetes mellitus, and mental
health disorders
 Chronic diseases are not typically caused by an
infectious agent (pathogen), but result of genetic
susceptibility, lifestyle, or environmental exposures
 Some exceptions are cancers of the cervix, liver,
and stomach
 Characteristics of Chronic
Diseases
 The latency period for chronic diseases is typically
more difficult to identify than is the incubation
period for acute infectious diseases
 This is explained by the multifactorial etiology that
characterizes many chronic diseases
 Disability

 Umbrella term for impairments, activity limitations,

and participation restrictions
 Impairments – any loss or abnormality of psychological, physiologic, or anatomic
structure or function
 Activity limitations – difficulties an individual may have in executing activities
 Participation restrictions – problems an individual may experience in involvement in
life situations
 Communicable Disease Prevention and
Control

1. Remove, eliminate, or contain the cause or source of

infection.
2. Disrupt and block the chain of disease transmission.
3. Protect the susceptible population against infection and
disease.
 REFERENCES

 Merrill, Ray M. (2021). Introduction to Epidemiology (8th ed.). Jones and Bartlett Learning
Publisher.
Thank you
 STUDY QUESTIONS

 1. Discuss how infectious and non-infectious diseases relate to

communicable and non-communicable diseases and conditions.
 2. List and explain the different general classifications of
diseases.
 3. Classifications were given of major infectious diseases. List
the five modes of transmission.
 4. List three general sources of infectious diseases.
 5. How do incubation periods differ from latency periods?
 6.Choose five infectious diseases and identify the typical
incubation periods for these diseases.
 7. Explain the concept of notifiable diseases.
 8. Explain and discuss herd immunity.