Defense Mechanisms

Objectives
To define the following terms: endemic, epidemic, pandemic, sporadic, zoonoses, communicable disease, resistance To understand the different mechanisms of defense of man (host) against the disease agent

Reservoir
any vehicle in which an infectious agent lives and multiplies, on which it depends primarily for survival, and where it reproduces itself in such manner that it can be transmitted to a susceptible host

Modes of Transmission
1.

Direct Transmission results from actually touching the infected reservoir

Modes of Transmission
a. Vertical Transmission
Infection that is transmitted from a parent to its offspring via infected semen or ovum, through the placenta (transplacental), in the birth canal, via milk or due to direct contact, such as with contaminated teat skin

Modes of Transmission
b. Horizontal (Lateral) Transmission
Any form of infection transmission between individuals that is not vertical transmission Direct contact, sexual

Modes of Transmission
2. Indirect transmission - transfer of an agent by the following means

Modes of Transmission
a. Vehicle transmission Water (typhoid), Food (Staphylococcal food poisoning), serum/plasma or surgical instruments (HIV, Hepatitis B)

Modes of Transmission
b. Vector Transmission arthropod bite (Dengue fever, Malaria)

Modes of Transmission
c. Airborne transmission inhalation of droplets containing disease agents which remain suspended in the air for a period of time (Pneumonia, PTB)

Communicable Disease

Illness due to specific infectious agent or its toxic products arising through transmission from reservoir to susceptible host

Communicable Disease
MAN MAN

MAN

VECTOR, VEHICLE, INTERMEDIATE HOST

MAN

Terms used to describe the periodicity of communicable disease occurrence

Endemic Epidemic Pandemic Sporadic Epizootic/Enzootic Zoonoses

Endemic indicates a disease is more or less constantly occurring in a geographic area; continuous occurrence throughout a period of time, of the usual number of cases in a given locality

Sporadic

applies to occasional or infrequent occurrence of a disease; intermittent occurrence of a few isolated & unrelated cases in a given locality

Epidemic sudden increase in prevalence of a disease which is more or less constantly present or endemic in a community; occurrence is of unusually large number of cases in a relatively short period of time

Epidemic disproportionate relationship between the number of cases and the period of occurrence; determined by the relative largeness of number in comparison with the usual number of cases The more acute is the disproportion, the more urgent and serious is the problem

Pandemic refers to epidemic occurring within more than one country or territory; simultaneous occurrence of the same disease in several countries

Epizootic/Enzootic

refers to disease common in animals diseases of animals transmissible to man (e.g. rabies from dogs/cats, brucellosis from cattles)

Zoonoses

General and Specific Defense Mechanisms

I.

Mechanical A. Natural barriers Intact skin, respiratory cilia and secretions, mucous membranes, vibrissae

General and Specific Defense Mechanisms

B. Filtration Lymph nodes, tonsils, kidneys, liver and spleen

General and Specific Defense Mechanisms

II. Internal Defense A. Humoral-(also called the antibodymediated system) is the aspect of immunity that is mediated by macromolecules found in extracellular fluids such as secreted antibodies, complement proteins and certain antimicrobial peptides.

General and Specific Defense Mechanisms

B. Cellular action INFLAMMATION Leucocyte infiltration Phagocytosis Fibrous tissue barriers Antibody production

General and Specific Defense Mechanisms

B. Cellular action Formation of specific circulating antibodies

General and Specific Defense Mechanisms

B. Cellular action Bacteriolysins/bacterilysins - cause death and lysis of the bacteria

General and Specific Defense Mechanisms

B. Cellular action Opsonins - antibodies which after fixation to a bacterial cell renders it more susceptible to phagocytosis

General and Specific Defense Mechanisms

B. Cellular action Complement fixing antibodies Neutralizing antibodies Agglutininsconglomerates organisms Precipitins- precipitate protein products of

General and Specific Defense Mechanisms

III. Immunity specific defense mechanism of resistance brought about by the interaction of specific agent and humoral/cellular factors of the host

General and Specific Defense Mechanisms

III. Immunity A. Active results from the introduction of an antigen into the antibody 1. Naturally acquired from the invasion of a pathogen as a result of a subclinical/clinical or no actual disease

General and Specific Defense Mechanisms

III. Immunity A. Active 2. Artificially acquired from the introduction of a living attenuated/dead pathogen or its component (toxin, toxoid)
e. g. BCG, DPT, Polio vaccine

General and Specific Defense Mechanisms

III. Immunity B. Passive results from the introduction of a serum containing specific antibodies which were produced in other persons or animals

General and Specific Defense Mechanisms

III. Immunity B. Passive 1. Naturally acquired gained before birth by the fetus from circulating antibodies from the mother

General and Specific Defense Mechanisms

III. Immunity B. Passive 2. Artificially acquired injection of immune sera into the host e..g. ATS-Tetanus ERIG- Rabies

PREVENTIVE MEDICINE

The science and art of preventing disease, prolonging life and promoting physical and mental health and efficiency

PREVENTIVE MEDICINE

For..
Groups and Communities by Organized Mass Action (Public Health Practice) Individual and Families by Private Patient Care (Medical and Dental Practice)

HYGIENE
commonly referred to as Environmental Sanitation study the nature of health with a view to its promotion and preservation

SANITATION

the science and art of conservation and promotion of public health through its control of environment.

It

deals with health problems that are common to groups and communities such as: Water supply Milk and Food Supplies Garbage Collection Sewage and Drainage Insect Control

ECOLOGY

Study of mutual relationship between living organism and their environment.

COMMUNICABLE DISEASE

An illness due to specific infectious agent or its toxic products, arising through transmission of that agent or its products from reservoir to susceptible hosts, either directly from an infected person or animal or indirectly through the agency of an intermediate plant or animal host or a vector or the inanimate environment.

CONTAGIOUS DISEASE
It implies transmission through direct contact. The term communicable is more comprehensive than either infectious or contagious.

DISINFECTION

Is killing of pathogenic agents outside the body by chemical or physical means directly applied

TYPES

Concurrent disinfection- application of disinfection as soon as possible after the discharge of infectious material from the body of an infected person

Terminal

Disinfection- indicates the process of rendering immediate physical environment of the patient free from possibility of conveying the infection to others

Defining other Terms

Infection- the entry and development or multiplication of a pathogen in the body of man and animals Contamination- the presence of a pathogenic agent on a body surface or on an inanimate article or substance

Infectious disease- a disease of man or animal resulting from an infection Infestation- lodgement, development and reproduction of arthropods on the surface of the body or in the clothing of man, or fur of animals

Resistance-

is the sum total of body mechanisms which interpose barriers to the progress of invasion of infectious agents

Statistics

Branch of science dealing with the frequency of any occurrence of different attributes of things.

Biostatistics/Vital Statistics

A special branch of statistical study which deals with the data and laws of human motality, morbidity and natality

INDICATORS OF STATE OF COMMUNITY HEALTH

A.Vital

Indices

1. Crude birth rate- measure of fertility 2. Crude death rate- risk of dying from any cause
B.Disease

Indices 1. Morbidity A. Incidence Rate- risk of developing the disease

B. Prevalence Rate- proportion of population suffering from a disease at a given instant of time. 2. Mortality A. Cause-Specific Mortality RateRisk of dying from a specific disease

B. Age-Specific Mortality Rate- Risk of dying for a specific age group C. Case-fatality rate- killing power of a disease, also reflects care given to patients D. Proportionate Mortality Rateproportion of total deaths ascribed to a specific disease

E. Maternal Mortality Rate- risk of a woman dying associated with pregnancy, delivery and puerperium F. Stillbirth or Fetal Mortality Raterisk of losing the product of concepttion before delivery

G. Infant Mortality rate- risk of dying during the first year of life H. Neonatal Mortality Rate- risk of dying during the first 28 days of life I. Perinatal Mortality Rate- sum f stillbirth and neonatal death rates

Human Morbidity

Number of people who are ill of a certain disease in a certain locality for a certain specific period of time

Human Mortality

Number of people who die in a certain locality for a certain specific period of time

Human Natality

Number of births in a certain locality during a certain specific period of time

Resources for Health, Sanitation, Housing, Public Utilities

Rural health units and their sub-centers Chest clinics, malaria eradication units and schistosomiasis control units-DOH Puericulture centers Tuberculosis Clinics and hospitals of PTBS

Clinics run by large industrial firms Clinics Run by Phil. Med. Asso. Community hospitals and health centers run by Phil Med. Care Commission Voluntary health facilities run by religious and civic groups

Government Agencies Involved in Health

DOH- primary government agency in the field of health and runs the bulk of the govt health facilities The Phil. Medical Care Commissionmakes available medical care through a health insurance scheme with evolutionary coverage that initially included employees and population

The Office of the President- through the PGH and the University of the Phil Infirmary-provides health service to the general population Govt Agencies- DND, Bureau of Prisons, DECS- for limited and segments of population

Mixed Center Health Services

Puericulture Center Phil Tuberculosis Society- dedicated to the detection and treatment of TB and for this purpose operates QI, mobile xrays and provl chest clinics

Phil Cancer Society- Principally dedicated to cancer detection, educational campaign to make people cancer conscious Phil National red Cross Phil Mental Health Association Phil Heart Center Association