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KHARKIV NATIONAL
MEDICAL UNIVERSITY
DEPARTMENT OF
INFECTIOUS DISEASES
INTRODUCTORY LECTURE
Associate professor D.V. Katsapov
INFECTOLOGY
science about infection
Parts:
MICROBIOLOGY, VIROLOGY - is science
about the pathogens.
EPIDEMIOLOGY - is science about reasons of
origin and routs of transmission of infectious agents
INFECTIOUS DISEASES
clinical symptoms,
diagnostics,
diff. diagnostics,
treatment
PANDEMICS FACTSHEET
•1st recorded pandemic of plague : in A.D. 542 in Egypt and
Ethiopia;. killed 100 million people.
•2nd great plague pandemic 14th century in Europe, Central
Asia, the North East, India, and China. 25 million people in
Europe alone died.
•3rd plague pandemic began in Burma in 1894; spread to China
and North America.
•MODERN ERA
•AIDS pandemic. HIV has infected more than 60 million men,
women and children and AIDS has cost the lives of nearly 20
million adults and children. Despite the intense international
response to the HIV/AIDS pandemic, HIV continues to spread,
causing more than 14,000 new infections every day, 95% of
these are in the developing world. (WHO review 2011)
•Influenza (H1N1) pandemic 2009
Present days
The 2014 Ebola outbreak is one of the
largest Ebola outbreaks in history and the
first in West Africa. It is affecting four
countries in West Africa: Guinea, Liberia,
Nigeria, and Sierra Leone;
 It is reported 3069 suspect and confirmed
cases of EVD, including 1752 laboratoryconfirmed cases, and 1552 deaths.

NEGLECTED TROPICAL DISEASES
(NTDS)
The neglected tropical diseases (NTDs)
represent a group of more than a dozen
major chronic infectious diseases, most of
them parasitic infections, with high
endemicity in the developing countries of
Africa, Asia, and the Americas.
 The conceptual framework of the NTDs
was formulated in the years following the
2000 launch of the Millennium Declaration

Ranking of NTDs by Disease Burden (DALYs) and
Comparison with HIV/AIDS, Tuberculosis, and Malaria.
Hotez PJ, Bottazzi ME, Franco-Paredes C, Ault SK, et al. (2008) The Neglected Tropical Diseases of Latin America and the Caribbean: A Review
of Disease Burden and Distribution and a Roadmap for Control and Elimination. PLoS Negl Trop Dis 2(9): e300.
doi:10.1371/journal.pntd.0000300
http://www.plosntd.org/article/info:doi/10.1371/journal.pntd.0000300
The Major NTDs in India and South Asia Ranked by
Prevalence.
Lobo DA, Velayudhan R, Chatterjee P, Kohli H, et al. (2011) The Neglected Tropical Diseases of India and South Asia: Review of Their
Prevalence, Distribution, and Control or Elimination. PLoS Negl Trop Dis 5(10): e1222. doi:10.1371/journal.pntd.0001222
http://www.plosntd.org/article/info:doi/10.1371/journal.pntd.0001222
MENA countries with the highest prevalence of NTDs.
Hotez PJ, Savioli L, Fenwick A (2012) Neglected Tropical Diseases of the Middle East and North Africa: Review of Their Prevalence,
Distribution, and Opportunities for Control. PLoS Negl Trop Dis 6(2): e1475. doi:10.1371/journal.pntd.0001475
http://www.plosntd.org/article/info:doi/10.1371/journal.pntd.0001475
History of department of
infectious diseases of KHNMU
- founded in 1923 on the base of infectious department of the Kharkov
military hospital (Sq. of Rudnev, 14), 55 beds
.
Professor
Z. Nesmelova
Headed
1923-1931
Professor
I. R. Braude
Headed
1932-1958
Professor
Т. Т. Chorna
Headed
1969-1991
Professor
V. N. Kozko
1992 г.
FORMS OF INFECTIOUS PROCESS
CARRIAGE
-TRANSITORY
-CONVALESCENT
-ACUTE
-CHRONIC
CLINICAL INFECTION
-TYPICAL
- ACUTE
- CHRONIC
- Slow infection
- ATHYPICAL
- LATENT
-COMBINED
INFECTION
Inapparent form– absence of clinical symptoms
•Reinfection – repeated infection
•Superinfection– infection with new agent on current of infectious
disease
•Endogenous infection
Exacerbation– repeated deterioration
Relapse – recurrence of symptoms after apparent recovery
Complication – (specific, nonspecific)
SPECIFIC PROPERTIES OF
PATHOGENIC MICROORGANISMS
INFECTIVITY- is ability to entry to the human organism,
survive and multiply,
functional damage.
causing
morphological
and
VIRULENCE- qualitative manifestation of pathogenicity
INFECTING DOSE
INFECTIVITY, BACTERIAL
- ASSOCIATION;
- ADHESION;
- INVASION;
- PRODUCTION OF TOXINS;
• ENDOCELLULAR
• EXTRACELLULAR
SPECIFIC PROPERTIES OF
PATHOGENIC MICROORGANISMS
INFECTIVITY, VIRAL
- ATTACHMENT;
- ENTRY;
- TRANSCRIPTION;
- TRANSLATION;
•INCLUSIONS;
•REDUSED HOST CELL FUNCTION;
•CELL INJURY, LYSIS, DEATH
•LATENCY
•NEOPLASM
NON-SPECIFIC PROTECTIVE MECHANISMS
Undamaged skin and mucosal layer
Secretion of fatty and sweat glands
lysozyme
Secretory Ig A
Phagocytes
Normal microflora
Acid gastric medium
cilia of respiratory mucosa
hematoencephalic barrier
Enzymes (hydrolase)
interferon
lymphoquin
prostaglandin
System of compliment
Non-specific inflammation
Excretory system
SCHEME OF PHAGOCYTOSIS
CYTOKINE

Family of polypeptide hormone-like macromolecules
with short life period, synthesized and by excreted by
cells, with messenger functions and providing cellular
integration and differentiation, regulation of growth,
apoptosis and other functions.

IL – interleukin;
INF – interferon;
TNF – tumor necrosis factor;
CSF – colony stimulating factor;
CHC – chemokine.
For today it is identified more than 100 cytokines





HUMAN IMMUNE RESPONSE SYSTEM
I.
NATURAL FACTORS (nonspecific) 4-5 hrs
Cellular: macrophages, neutrophils, NK-cells;
Humoral: IgG (natural), compliment etc.
II.
EARLY INDUCTABLE ANSWER, 96 hrs
Cellular: NK-cells, macrophages, neutrophils;
Humoral: IL, CSF, TNF.
III.
SPECIFIC ADAPTIVE ANSWER
Cellular: lymphocytes, macrophages;
Humoral: specific antibodies IgМ, IgG, cytokines.
Major histocompatibility complex – HLA;
Th1 – cellular: γ-INF, NK, CD8;
Th2 – humoral: IL- 4, 5, 6, 10.
CLASSIFICATION OF INFECTIOUS DISEASES
Mechanism,
factors
Groups of
infections
Human
Animals
Environment
Alimentary
-water
-food
Intestinal
Typhoid,
paratyphoid A,
shigellosis,
cholera, polio
Paratyphoid B,
salmonellosis,
brutcellosis,
other
Botulism,
iersiniosis,
clostrydiosis, etc.
Air-droplet
Respiratory
tract
Diphtheria,
influenza, measles,
etc.
Ornithosis, etc.
Aspergillosis,
muromycosis, etc.
Transmissive
(flies, fleas, lice,
etc.)
Blood
Louse-borne
typhus, malaria,
viral hepatitis B,C
Plague,
tularemia, tickborne
encephalitis, etc.
Hospital
infections
Contact
-direct;
-indirect
Cutaneous
covering
Gonorrhea,
trachoma, etc.
Anthrax,
hydrophobia
Tetanus,
dermatomicosis
Vertical
Innate
measles, syphilis, Toxoplasmosis,
other
lysteriosis
PECULIARITIES OF INFECTIOUS DISEASES





Connection with specific pathogen,
Contagiousness,
Epidemic spread
Exacerbations, relapses, chronic course
Immune reactions, formation of specific
immunity
Carriage of infection
Cyclic clinical course


I.
II.
III.
IV.
Incubation period
Prodromal period
Climax
Convalescence
CLINICAL PECULIARITIES OF
INFECTIOUS DISEASES
 General intoxication,
 Fever(duration, character)







Febris continua
Febris remittens
Febris intermittens
Febris reccurens
Febris hectica
Febris undulans
Febris irregularis
 CNS affection, meningeal syndrome,
 Affection of skin and mucous membranes (exanthema, enanthema),
 Joints affection,
 Lymphadenopathy,
 Catarrhal and respiratory syndrome,
 CVS affection,
 Dyspeptic syndrome,
 Hepatolienal syndrome.
LABORATORY INVESTIGATION
ANAMNESIS OF DESEASE (A. morby)
EPIDEMIOLOGICAL ANAMNESIS (A. epidemica)
PHISICAL EXAMINATION
LABORATORY INVESTIGATION
•Mycroscopy
•Culturing
•Immunological (serological)
•Biochemical
•Imaging
•Molecular genetic (PCR)
TREATMENT
ANTIBIOTICS
Sensitivity
Dosage, concentration
Method of administration,
Side effects
Scheme and duration
Stable concentration
ANTIVIRAL DRUGS
ANTI PROTOZOAL DRUGS
TREATMENT
SPECIFIC IMMUNOTHERAPY
immunoglobulin
Gamma - globulin
Blood serum
Immune serum (antitoxic, antimicrobial)
NONSPECIFIC IMMUNOTHERAPY
Immunostimulant
Immunosupressor
Interferon, inductors
Human immunoglobulin
TREATMENT
DEZINTOXICATION (PO, IV)
Colloid solutions
Sorbents
REHYDRATION (PO, IV)
Polyionic crystalloid solutions





DESENSIBILIZATION
DYSBIOSIS CORRECTION
ENZYMES
VITAMINS
SYMPTOMATIC TREATMENT
PROPHYLAXIS
SPECIFIC IMMUNOPROFILAXIS
Vaccines (active)
Primary (toxoids, pertussis, polio, hepatitis B, haemophilus influenzae type B, MMR)
With special indications (influenza, meningococcal)
Specific antisera (passive)
normal human immunoglobulin
hyperimmune serum
animal sera
NONSPECIFIC IMMUNOPROFILAXIS
Immunostimulant
Interferon, inductors
THANK YOU FOR ATTENTION!