© 2004 Aeras© 2004 Aeras 11

Introduction to Clinical Introduction to Clinical Research PracticeResearch Practice

Clinical Infectious Diseases 1Clinical Infectious Diseases 1

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ObjectivesObjectives

State the difference between health and State the difference between health and illnessillness

Differentiate between infectious and non-Differentiate between infectious and non-infectious diseaseinfectious disease

Identify three microbes and a disease Identify three microbes and a disease they cause they cause

List two methods for transmission of List two methods for transmission of infectious agentsinfectious agents

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ObjectivesObjectives

Identify defenses a human has to fight off Identify defenses a human has to fight off infectioninfection

Differentiate between the following terms: Differentiate between the following terms:

epidemic, endemic, pandemic, carrierepidemic, endemic, pandemic, carrier

Recognize ways in which to protect Recognize ways in which to protect him/herself against infectious diseaseshim/herself against infectious diseases

Explain why DOTS is needed for TB Explain why DOTS is needed for TB

preventionprevention

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Health vs. IllnessHealth vs. Illness

Health:Health:A state of wellbeing A state of wellbeing without disease.without disease.

Illness: Illness: A state of being A state of being unable to function unable to function normally.normally.

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Diseases Cause IllnessDiseases Cause Illness

In the process, some diseases can In the process, some diseases can weaken and kill people.weaken and kill people.

Millions of people throughout the Millions of people throughout the world suffer from diseases which world suffer from diseases which could either be prevented or cured.could either be prevented or cured.

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Types Of Disease Types Of Disease

There are two main types of disease:There are two main types of disease:

Non-infectious Non-infectious diseases do not diseases do not spread from a sick person to a spread from a sick person to a healthy person.healthy person.

InfectiousInfectious diseases are spread from diseases are spread from person to person.person to person.

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Non-Infectious DiseasesNon-Infectious Diseases

Something wears out or Something wears out or goes wrong in the body.goes wrong in the body.

Something from outside Something from outside harms or troubles the harms or troubles the body.body.

Likely to occur when Likely to occur when lacking the right kind or lacking the right kind or amount of food.amount of food.

People are born with a People are born with a particular problem.particular problem.

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Infectious DiseasesInfectious Diseases

These diseases are mainly These diseases are mainly caused by tiny organisms caused by tiny organisms called: called:

Bacteria Bacteria

VirusesViruses

ParasitesParasites

These are called germs or These are called germs or pathogens.pathogens.

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BacteriaBacteria Bacteria are very small living Bacteria are very small living

organisms.organisms. One million would fit on the head of a One million would fit on the head of a

pin.pin. Antibiotics are the main kind of Antibiotics are the main kind of

medicine which can be used to cure medicine which can be used to cure bacterial diseases.bacterial diseases.

However, some disease have become However, some disease have become resistant to antibiotics so that new resistant to antibiotics so that new ones constantly have to be developed.ones constantly have to be developed.

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Some Important Bacterial Some Important Bacterial DiseasesDiseases

Tuberculosis Tuberculosis Pneumonia Pneumonia Tetanus Tetanus Boils, soresBoils, sores GonorrheaGonorrhea SyphilisSyphilis

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VirusesViruses Viruses are smaller than bacteria.Viruses are smaller than bacteria. Like bacteria, they can produce very Like bacteria, they can produce very

quickly.quickly. Antibiotics do not cure disease caused Antibiotics do not cure disease caused

by viruses.by viruses. Although there are no medicines Although there are no medicines

which can cure viral diseases, which can cure viral diseases, vaccines are effective against some vaccines are effective against some (such as polio and measles).(such as polio and measles).

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Some Important Viral Some Important Viral DiseasesDiseases

FluFlu Hepatitis Hepatitis

AA RabiesRabies Warts Warts AIDSAIDS

MeaslesMeasles ChickenpChickenp

oxox MumpsMumps PolioPolio ColdsColds

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ParasitesParasites

A parasite is an organism that lives A parasite is an organism that lives in or on a second organism .in or on a second organism . Some parasites do not cause any harm.Some parasites do not cause any harm. Some can cause harm to its human Some can cause harm to its human

“host”.“host”. A tapeworm is an example of a A tapeworm is an example of a

parasite.parasite.

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Important Diseases CausedImportant Diseases CausedBy ParasitesBy Parasites

Dysentery – caused by Dysentery – caused by tapeworms or amoebas.tapeworms or amoebas.

Malaria – caused by Malaria – caused by parasite in mosquitoes.parasite in mosquitoes.

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The Spread Of DiseaseThe Spread Of Disease

Disease germs can Disease germs can enter the body by:enter the body by:

breathing.breathing. swallowing.swallowing. breaks in the breaks in the

skin.skin. through body through body

openings. openings.

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KissingKissing Sneezing Sneezing Body fluid Body fluid

exchangeexchange

Direct TransmissionDirect Transmission Indirect TransmissionIndirect Transmission

Using a dirty Using a dirty telephonetelephone

Touching a dirty Touching a dirty keyboardkeyboard

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First Lines Of DefenseFirst Lines Of Defense

SkinSkin

Mucous membranes Mucous membranes

in your nose and in your nose and

throatthroat

TearsTears

Tiny hairs in your Tiny hairs in your

nosenose

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How Does It Work?How Does It Work?

When a harmful microbe is present, When a harmful microbe is present, these protectors:these protectors:

Block them from entering your Block them from entering your body, orbody, or

Wash them away.Wash them away.

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Second Line Of DefenseSecond Line Of Defense

The The immune systemimmune system is is a a complex system that works to complex system that works to clear infection from the body. clear infection from the body.

It includesIt includes highly specialized cells highly specialized cells and tissues that protect the body and tissues that protect the body from foreign substances.from foreign substances.

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How the Immune System How the Immune System WorksWorks

If germs enter the If germs enter the bloodstream:bloodstream:

They are attacked They are attacked by white blood by white blood cells that dissolve cells that dissolve foreign microbes, foreign microbes, call other defences call other defences to fight them to fight them

OR…OR…

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Your Body Develops Your Body Develops AntibodiesAntibodies

Antibodies Antibodies go after go after germs. germs.

If you are exposed If you are exposed to a germ, your to a germ, your immune system can immune system can produce antibodies produce antibodies to “fight” the germsto “fight” the germs

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One Way to Avoid DiseaseOne Way to Avoid Disease

A A vaccinevaccine is made is made to help you from to help you from becoming sick from becoming sick from a particular disease. a particular disease.

After a vaccination, After a vaccination, your body will be your body will be able to fight that able to fight that disease in the disease in the future.future.

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Other Ways Of Preventing Other Ways Of Preventing DiseaseDisease

Hand washing is the single most effective way to prevent the spread of infections.

Wash your hands often and thoroughly, paying special attention to the area around and under your fingernails.

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When an infectious When an infectious disease spreads to disease spreads to many people in an many people in an area at the same time, area at the same time, it's called an it's called an epidemicepidemic..

When an epidemic When an epidemic happens in many happens in many places in the world at places in the world at once, it's called a once, it's called a pandemicpandemic. .

Disease Terminology

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When an infectious disease When an infectious disease keeps occurringkeeps occurring within a within a specific area, region, or specific area, region, or locality, it’s regarded as locality, it’s regarded as endemicendemic to the area. to the area.

Disease Terminology

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Disease TerminologyDisease Terminology

The branch of medical science The branch of medical science that studies the distribution that studies the distribution and causes of health and and causes of health and disease in populations is disease in populations is epidemiologyepidemiology. .

A living creature that is infected A living creature that is infected with a disease and can pass it with a disease and can pass it to others but does not itself to others but does not itself display any of the symptoms is display any of the symptoms is called a called a carriercarrier..

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About TuberculosisAbout Tuberculosis It is also known as TB.It is also known as TB. TB is an infectious disease.TB is an infectious disease. It is caused by It is caused by Mycobacterium tuberculosisMycobacterium tuberculosis.. Primarily affects the body by causing Primarily affects the body by causing

problems with the lungs and one’s ability to problems with the lungs and one’s ability to breathe. breathe.

TB is transmitted through the air from an TB is transmitted through the air from an infected person to another person.infected person to another person.

Not everyone exposed to TB will become Not everyone exposed to TB will become infected. infected.

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Common Symptoms of TBCommon Symptoms of TB

Symptoms of TB vary, but depending on Symptoms of TB vary, but depending on the stage can include:the stage can include:

Feeling sick or weak.Feeling sick or weak. Weight loss.Weight loss. Fever.Fever. Night sweats.Night sweats. Coughing.Coughing. Chest pain.Chest pain. Coughing up blood.Coughing up blood.

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Protecting Yourself and Protecting Yourself and Others Others

Stay healthy and eat properly.Stay healthy and eat properly. Implement policies to protect staff Implement policies to protect staff

and patients.and patients. Work toward rapid identification, Work toward rapid identification,

isolation, evaluation, and isolation, evaluation, and treatment of persons likely to treatment of persons likely to have TB.have TB. Provide the specified ventilation in rooms and Provide the specified ventilation in rooms and buildings.buildings.

Use respiratory protection in designated Use respiratory protection in designated situations.situations.

Limit exposure to patients with TB.Limit exposure to patients with TB.

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TB PreventionTB Prevention

TB can be prevented if people are TB can be prevented if people are immunized.immunized.

Treat TB early to limit exposure of others.Treat TB early to limit exposure of others. If one person in a house has TB, everyone If one person in a house has TB, everyone

else should be tested for the disease.else should be tested for the disease. An infected person should never spit on An infected person should never spit on

the floor and should cover his mouth the floor and should cover his mouth when coughing or sneezing.when coughing or sneezing.

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Treating TuberculosisTreating Tuberculosis Like many Like many bacterialbacterial infectious infectious

diseases, TB can be treated diseases, TB can be treated by antibiotics.by antibiotics.

However, the bacterium that However, the bacterium that causes TB is resistant to many causes TB is resistant to many of the antibiotics.of the antibiotics.

To avoid resistance to the one To avoid resistance to the one antibiotic that may be antibiotic that may be prescribed, TB treatment calls prescribed, TB treatment calls for 2-3 antibiotics given for 2-3 antibiotics given together over a long period.together over a long period.

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Problems Treating TBProblems Treating TB TB treatment often involves TB treatment often involves

taking several types of medicine taking several types of medicine over 6 months to a year.over 6 months to a year.

Taking these medicines every Taking these medicines every day for 6 months is difficult, so day for 6 months is difficult, so sometimes people do not take sometimes people do not take them.them. Failure to take TB medicine keeps Failure to take TB medicine keeps the person from getting better and the person from getting better and helps the TB bacteria become helps the TB bacteria become “resistant” to those medicines and “resistant” to those medicines and could spread TB to others.could spread TB to others.

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DOTSDOTS for TB Treatmentfor TB Treatment DOTS is a program that DOTS is a program that

provides somebody to help a provides somebody to help a person to take the medicine person to take the medicine and prevent TB resistance. and prevent TB resistance.

Directly Observed Treatment Short-course Directly Observed Treatment Short-course (DOTS)(DOTS) is a treatment program that ensures is a treatment program that ensures that people take their medicine.that people take their medicine.

In DOTS, a TB-infected person must report to In DOTS, a TB-infected person must report to a health professional who will observe the a health professional who will observe the actual swallowing of the medicine.actual swallowing of the medicine.

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Key Points To RememberKey Points To Remember

Health is a state of well-being without Health is a state of well-being without disease.disease.

There are two main types of disease, There are two main types of disease, infectious and non-infectious.infectious and non-infectious.

Disease are mainly caused by tiny organisms Disease are mainly caused by tiny organisms called bacteria, viruses and parasites.called bacteria, viruses and parasites.

Infectious diseases are transmitted directly Infectious diseases are transmitted directly (sneezing, kissing) or indirectly (using a dirty (sneezing, kissing) or indirectly (using a dirty telephone).telephone).

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Key Points To RememberKey Points To Remember The key defenses that a human has to fight off The key defenses that a human has to fight off

disease include keeping germs out (skin, nose disease include keeping germs out (skin, nose hairs, etc.,) and the immune system, that hairs, etc.,) and the immune system, that fights germs when they enter the body.fights germs when they enter the body.

Hand washing is a good way of protecting Hand washing is a good way of protecting oneself against infectious diseases.oneself against infectious diseases.

TB is an infectious disease caused by bacteria TB is an infectious disease caused by bacteria that can be treated and cured with antibiotics.that can be treated and cured with antibiotics.

TB can develop resistance to antibiotics, so TB can develop resistance to antibiotics, so taking medicine, with the support of the DOTS taking medicine, with the support of the DOTS program if needed, is very important.program if needed, is very important.

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This presentation is produced by Aeras Global TB Vaccine FoundationSM in collaboration with the University of Cape Town and the South African Tuberculosis Vaccine Initiative.

A special thanks to Professor Greg Hussey, Professor Maurice Kibel, Marie Buchanan, Hons.B.Soc.Sc., Marijke Geldenhuys, MSHS CRA, Dr. Sylvia Silver, D.A., and Jen Page, M.Ed. for their contributions and support for this presentation.

Clinical Infectious Disease 1Clinical Infectious Disease 1