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Immunity and Infection
Chapter 13
The Chain of Infection
• Links in the Chain
– Transmitted through a chain (six links)
• Pathogen - disease causing microorganism
• Reservoir - natural environment of the
pathogen: Person, animal or
environmental component
• Portal of Exit
• Transmission
– Direct transmission
– Indirect transmission
• Portal of entry
– Penetration of the skin
– Inhalation
– Ingestion
• New host
– Breaking the Chain
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Body’s Defense System
• Physical and Chemical barriers
– Skin, mucous membranes, respiratory tract
• The Immune System
– Immunological Defenders
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Neutrophils
Macrophages
Natural killer cells
Dendritic cells
Lymphocytes
– T-cells
» Helper, Killer, and Suppressor
– B-cells
» Antibodies
– Memory T and B cells
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The Inflammatory Response
• Histamine.
• Dilation of blood vessels, heat, redness, and swelling.
• The immune response
– Phase 1 – Dendritic cells are drawn to the site
– Phase 2 – Helper T cells multiply
• Production of Killer T and B cells
• Cytokines – chemical messengers
– Phase 3 – Killer T cells strike
• Cell-mediated immune
• Anti-body mediated immune response
– Phase 4 – Last Phase –
• Suppressor T-cells
• Slow down activity
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The Immune Response
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Immunity
• An infected person will never get the same
illness again.
• Lymphocytes create amplification of the
immune response are reserved by memory T
and B cells
• Symptoms and contagion
– Incubation – viruses are multiplying in the body or
when bacteria are actively multiplying
• Will not feel symptoms until the second or third phase of
the immune response cycle
– Prodromal period – the infected host has
acquired immunity
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Immunization
• The process of ‘priming’ the body to remember
an encounter with a specific antigen.
• Types of vaccines
– VACCINE- Introduction of a killed or weakened
pathogen to stimulate the body to produce
antibodies. (active immunity).
– PASSIVE IMMUNITY- Injection of antibodies
produced by other human beings or animals.
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Allergy: The Body’s Defense
System Gone Haywire
– Allergies
– Allergens
• Pollen, Dander, Dust mites, Molds, Food, Insects
– The Allergic response
• Immunoglobulin (IgE)
• Anaphylaxis
– Dealing with Allergies
• Avoidance
• Medication
• Immunotherapy
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The Troublemakers: Pathogens
and Disease
• Bacteria – Microscopic single celled organism
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Pneumonia
Meningitis
Strep Throat and other streptococcal infections
Toxic shock and other staphylococcal
Tuberculosis
Lyme Disease and other tickborne infections
Ulcers
Other Bacterial infections
• Tetanus
• Pertussis
• Urinary tract infections
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Antibiotic Treatment
• Actions of Antibiotics
• Antibiotic resistance
• Proper antibiotics usage
– Don’t take an antibiotic every time you
are sick
– Use antibiotics as directed
– Never take an antibiotic without an
prescription
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Pathogens
• Viruses – (parasites – take what they need)
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Common Cold
Influenza
Measles, Mumps and Rubella
Chickenpox, Cold Sores, and other herpes-virus
infections
• Herpes simplex virus (HSV) types 1 and 2
• Epstein-Barr virus (EBV)
– Viral Hepatitis
– Human Papillomavirus (HPV)
• Treatment
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Pathogens
• Fungi –
– Primitive plant – Yeast infections, athletes foot, and ringworm
– Candida albicans
• Protozoa –
– Microscopic single-celled animal – Malaria, African sleeping
sickness, Giardiasis, Tricomonias, Trypanosomiasis, and Amoebic
dysentary.
• Parasitic worm –
– Largest organism that can enter the body – Tapeworm,
Hookworm, and Pinworm.
• Prions -
– Fetal degeneration disorders of the CNS, linked to “proteinaceous
infectious particles.
– Lack DNA and RNA
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Emerging Infectious Diseases
• Selected Infections of concern
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West Nile virus
Severe acute respiratory syndrome (SARS)
Rotavirus
Escherichia coli
Hantavirus
Ebola
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Factors Contributing to
Emerging Infections
• Drug Resistance
• Poverty
• Breakdown of public health measures
• Environmental changes
• Travel and Commerce
• Mass food production and distribution
• Human behaviors
• Bioterrorism
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How to Support Your Immune
System
• How to support your immune system
– Public Health
– Taking care of yourself
• Nutrition
• Exercise
• Rest
• Moderation of Lifestyle
• Controlling Stress
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Sexual Transmitted Diseases
The United States has the highest rate of
Sexual Transmitted Diseases of any
developed nation
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The Major STDS
(STD’s)
• Seven different STDs pose major health
threats
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HIV/AIDS
Hepatitis
Syphilis
Chlamydia
Gonorrhea
Herpes
HPV
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Acquired Immunodeficiency
Syndrome (AIDS)
• Leading cause of death in many parts of the
world.
– Worldwide, AIDS is the leading cause of death for
people age 15-59
• Approximately 65 Million people around the
world are infected with Human
Immunodeficiency Virus (HIV).
• More than 25 million have died worldwide
• Human immunodeficiency virus (HIV) is the
virus which causes AIDS.
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Approximate number of people
living with HIV/AIDS in 2006
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HIV Infection and AIDS
• By 2004, an estimated 1,000,000 Americans were
believed to be living with HIV, with an estimated
annual incidence of 40,000 cases
• Estimated 1.5 million Americans have died
– 2006, researchers discovered a group of chimpanzees in
Cameroon that carry SIVspc
– 1930s Genetic evidence shows that SIV first spread to
humans
• What is HIV Infections?
– HIV attacks and invades CD4 T-cells, monocytes and
macrophages.
– AIDS opens the possibility for a opportunistic infections.
– Once initial symptoms resolve, the asymptomatic period
may last from 2 to 20 years.
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Transmitting the Virus
• HIV lives only within cells and body fluids.
• 3 primary means of transmission are:
(1)Specific kinds of sexual contact, (2) direct
exposure to infected blood, and (3) HIV-infected
women to her fetus.
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Sexual contact
Direct contact with infected blood.
Mother-to-Child transmission.
Not through casual contact.
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Populations of Special Concern
for HIV infection
• Most common exposure has been
sexual activity between men; injection
drug use, and heterosexual contact.
• African American men and women
are vastly overrepresented among
people newly diagnosed with AIDS.
– See “HIV/AIDS Among African Americans
and Latinos”
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Symptoms of HIV Infection
• Few days or weeks, half the people will
develop (Flu like symptoms)
– Fever, fatigue, rashes, headache, swollen lymph
nodes, body aches, night sweats, sore throat,
nausea and diarrhea.
• Specialized test HIV RNA assay.
• Pneumocystis Carinii pneumonia (protozoal
infection).
• Kaposis sarcoma.
• Difficult to treat yeast infections in women
• Tuberculosis
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Diagnosing HIV Infection and
AIDS
• Most common is tests for the presence
of antibodies to the virus.
– HIV antibody test
– ELISA (first test) if positive then the.
– Western blot (second test)
• IF HIV-positive then check the status of
the CD4-t cells.
• New diagnostic test – HIV Replication
Capacity.
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Diagnosing HIV Infection and
AIDS
• Treatment (NO CURE).
– Antiviral drugs.
• Reverse transcriptase inhibitors.
– Zidovudine (AZT).
• Protease inhibitors.
– Highly active antiretroviral therapy (HAART).
– Structured intermittent therapy.
• Fusion inhibitors
– Enfuvirtide (Fuzeon)
– Inhibit the fusion of viral and cell membranes
– Post-Exposure prophylaxis.
– Treatment for opportunistic infections.
– HIV and Pregnancy
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Prevention
• Make careful choices about sexual
activity.
• Do Not share drug needles.
• Participate in an HIV educational
program.
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Chlamydia Trachomatis
• Most prevalent bacterial STD in the U.S.
• Bacterial infection – Can cause sterility in men and women
• WOMEN infects the cervix and to urethra, fallopian
tubes & ovaries, PID, bladder infections.
• MEN- Epididymitis, urethra to testes, urethritis,
bladder infections, watery discharge.
• Symptoms –ASYMPTOMATIC : Discharge, pain
and burning while urinating, vaginal bleeding, painful
intercourse, abdominal pain, nausea, fever, inflammation
of rectum or cervix, swelling and pain in the testes.
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Chlamydia Trachomatis
• Spread - vaginal and anal intercourse,
from the birth canal to the fetus
• Diagnosis - Examination of tissue samples
or urine
• Treatment - Both partners treated fully with
antibiotics
• Protection
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Gonorrhea
• 700,000 new cases every year in the
U.S.
• Bacterial infection - Can cause sterility,
arthritis and heart problems
– PID, can cause ectopic pregnancy,
premature labor and still birth, arthritis,
rashes
• Symptoms –
– Women - Asymptomatic - Frequent burning
urination, menstrual irregularities, pelvic pain,
discharge.
– Males – thick yellow-white discharge, painful
urination.
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Gonorrhea
• Spread - Vaginal, anal and oral
sex.
• Diagnosis - Microscopic exam of
discharge.
• Treatment - Oral antibiotics People often have chlamydia at
same time.
• Protection
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Pelvic Inflammatory Disease
PID
• Progressive infection that harms a women’s
reproductive system. Can lead to sterility,
ectopic pregnancy and chronic pain treated or not.
• Caused by chlamydia and gonorrhea.
• Symptoms - long and painful periods,
discharge, spotting, low abdominal pain,
fever, chills, nausea, vomiting, pain during
intercourse.
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Pelvic Inflammatory Disease
PID
• Treatment - Antibiotics, bed rest, sexual
abstinence and maybe surgery to
remove scarring
• Diagnosis - Pelvic Exam, cultures,
laparoscopy
• Protection
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Human Papillomavirus
Infection
• More than 80% of sexually active individuals will
have been infected with HPV by the age of 50.
• Symptoms
– Small bump on the skin or a large, warty growth
– Cauliflower-like mass
– May cause irritation and bleeding
• How is it spread
• Diagnosis
– Appearance of the lesions
– Women who are positive should have a Pap test very
12 months
• Treatment
– Removed by cryosurgery, electrocautery or laser
surgery
• Protection
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Genital Herpes
• 45 million have been diagnosed
• Two forms - Herpes simples virus-1 and -2.
• Type 1 is associated with cold sores and fever
blisters.
– 50-80% of U.S. adults have anitibodies to HSV-1
• Both are sexually transmitted.
• Remains in the body for life.
• Symptoms – 90% have no symptoms
– Recurring rash, pain ulceration's.
– Primary outbreak - pain and discomfort around
infected area, itching, burning during urination.
– 2-20 days after infection - may years before outbreak.
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Genital Herpes
• Spread - Touching, sexual intimacy -
including kissing, vaginal, oral and
anal sex
• Diagnosis - Examination of sores and
culturing of fluid taken from sores
• Treatment - No cure - symptoms are
relieved by drugs
• Protection - Refrain for sex during out break
• HSV-1 and 2 can cause miscarriages or still births
along with serious health issues of newborns
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Hepatitis B Virus (HBV)
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Can cause liver disease and death
Preventable with vaccination.
750,000 total acquired sexually
Transmission - Semen, saliva, blood and urine
Symptoms - Extreme fatigue, headache,
fever, hives, lack of appetite, nausea,
vomiting, tenderness in lower abdomen
• Diagnosis and Treatment
– Blood Test
– No cure
– Prevention
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Syphilis
• Syphilis organism remains in the body
for life and leads to disfigurement,
neurological disorders, or death.
• Effective antibiotics and condom use.
• Symptoms –
– Primary phase- 3 weeks - 90 days - painless sores
and wet ulcers (chancre) and swollen glands.
– Secondary Phase - 3-6 weeks - up to 2
years body rash, mild fever, fatigue, sore
throat (Flu like symptoms), and hair loss.
– Late phase (tertiary)- Damage to organs
and nervous system.
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Other STD’s
• Trichomoniasis
• Bacterial vaginosis (BV)
• Pubic Lice
• Scabies
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What You Can Do
• Education.
• Diagnosis and Treatment
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Get vaccinated
Be alert for symptoms
Get tested
Inform your partners
Get Treated
• Prevention
– Use a barrier defense.
– Know your potential partner.
• Ask. Are you ready to have sex?
Chapter 13
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Immunity and Infection
Chapter 13