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intro to infectious disease
cmbm exam IV
127
Chemistry
Graduate
01/24/2010

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Term
what probably killed mozart?
Definition
strep throat
Term
what are the 3 outcomes if a microbe infects a host?
Definition
host resolves infection, latency (TB, herpes, toxoplasmosis), or death
Term
what does infectious disease result from?
Definition
an encounter of a potential pathogen with a susceptible host in conjunction with a suitable portal of entry
Term
what are the "sexy" infectious diseases that garner most of the media attention? how many deaths are they responsible for?
Definition
CJD, SARS, Ebola, Anthrax, Smallpox, Monkeypox, West Nile. < 1000 deaths
Term
what are the "killers" in terms of infectious disease? how many deaths are they responsible for? what is the order of the top 3 killers?
Definition
TB, HIV, ARI, Diarrhea, Malaria, Rotavirus, Hepatitis, Influenza. > 100,000 deaths. top three are: HIV 3m, TB 2m, Malaria 1m
Term
what does DALY stand for?
Definition
diability adjusted life years - a time-based measure that combines years of life lost due to premature mortality and years of life lost due to time lived in states of less than full health
Term
how many DALYs are lost to infectious and parasitic diseases?
Definition
445 million total
Term
what is the delicate balance between the host and their microorganism?
Definition
as long as the immune system is healthy, the host can fight back against the innoculum/virulence of the pathogen
Term
where do most pathogenic organisms start?
Definition
in an animal host
Term
what do organisms that transmit via direct transimission (sexual, kissing, animal bite, transplacental, droplet infection) have minimal ability to survive?
Definition
stressful conditions
Term
what is the difference between a droplet nuclei and droplet in terms of disease transmission?
Definition
droplet nuclei are <5mm in diameter, eg measles, TB, varicella. droplets are >5mm in diameter, close mucosal contact is needed, (within 2 m) eg SARS, influenza, pertussis, (whooping cough)
Term
what are the modes of transmission of infectious agents?
Definition
contact, (direct-body to body or indirect- fomites/environment, HCW's hands), large droplet, (>5um, travels 3 ft), small droplet, (<5um, airbone), endogenous, (auto-innoculation and device related, common, source and vector borne
Term
what are some examples of ways organisms that transmit indirectly?
Definition
vector borne, airborne (aerosol – e.g. TB, measles, chicken pox), vehicle borne, (water, food, blood, tissue, fomite, and surgical instruments). this is an example of adaptation for survival.
Term
what is an example of a reservoir for infectious disease? what growing problem is this related to?
Definition
a hospital full of C. difficle colonized patients (most w/noscomial infections), and only a few symptomatic patients with obvious infections (tip of the iceberg). this is related to growing antibiotic resistance.
Term
what is an index case? 1st, 2nd generation case?
Definition
and index case would be an unvaccinated pt traveling somewhere and bringing back a disease. 1st and 2nd generation cases would be siblins, schoolmates, and other children in contact who contract the disease
Term
what is isolation?
Definition
the process of separating persons known or suspected of being infectious from others, to prevent the spread of disease
Term
what is quarantine?
Definition
a compulsory period of isolation/sequestration imposed on a person(s), animal, or thing (exposed but asymptomatic) that might otherwise spread a disease
Term
what might be presenting symptoms of infectious disease?
Definition
fever, rash, lymphadenopthy, discharge, (diarrhea, urogenital, eye, etc), cough, mental status change, headache
Term
what is an example of an invasive infection?
Definition
candidemia which is a blood borne infection, the 4th leading infection in ICUs, where sterile body fluids become infected. the patient will have to be hospitalized and put on IV antifungal
Term
what does gram staining bacteria help?
Definition
it helping determing what kind of antibiotic should be used, ideally narrow spectrum antibiotics should be used
Term
what color are gram positive bacteria?
Definition
violet
Term
what color are gram negative bacteria?
Definition
red
Term
what are common intra-abdominal pathogens?
Definition
gram negatives, followed by anaerobes
Term
what are common skin and soft structure pathogens?
Definition
gram positive, (staph/strep/enterococcus)
Term
what do only 40% of physicians comply with?
Definition
hand washing, extremely important in patient care. it was pioneered by Ignac Semmelweis who discovered the importance of hand washing in patient care after a study of puerperal sepsis in women giving birth
whose deliveries were done by medical students vs. midwives
Term
what is traditional (long sleeves, neck tie, jewelry) physician attire changing to? why?
Definition
sleeves rolled up, gloves, mask, plastic apron, no tie,
no jewelry - to keep disease from spreading
Term
what is the definition of public health?
Definition
the art and science of preventing disease, promoting health, and
extending life through the organized efforts of society
Term
what does the "superior doctor" do?
Definition
prevents the disease instead of just treating it
Term
what was the first cancer vaccine?
Definition
hepatitis B vaccine, causes the hepatocelluar carcinoma
Term
what was the second cancer vaccine?
Definition
gardasil/cervarix for HPV which can cause cervical cancer, (men can also be vaccinated)
Term
what has been one of the major public health interventions?
Definition
vaccines
Term
what is a public health intervention that has been helpful with HIV?
Definition
condoms
Term
what has been a major public health intervention in terms of diarrhael related deaths?
Definition
oral rehydration therapy
Term
are insecticides/bed nettings, potable water improvements and TB education public health interventions?
Definition
yes
Term
non-infectious diseases such as cancer can be caused by infectious agents?
Definition
yes, 16-18% of cancers are caused by infectious agents such as HPV, helicobacter pylori, HBV, EBV, HIV, and helminths.
Term
what causes kaposki's sarcoma? burkitt's lymphoma?
Definition
HHV-8 causes kaposki's sarcoma. EBV causes burkitt's lymphoma
Term
what are some contributing factors to growing antimicrobial/antibiotic resistance?
Definition
fear of malpractice suits, patient volume, time and expectations (some doctors find it easier to just write out a prescription), lack of knowledge of natural course of viral disease, diagnostic and prescribing habits, need to return to work, school or day care, release of enormous quantities of antibiotics into agriculture, fisheries, and animal husbandry, inappropriate use, company sponsored symposium (CME)
Term
what are some environments were antbiotic resistance develops?
Definition
community hospitals, tertiary hospitals, VA, daycare, feedlots
Term
what is a better way to refer to bronchitis so that pts don't expect antibiotics they dont need?
Definition
"chest cold"
Term
what are internationally notifiable infectious diseases that must be reported to the world health organization for quarantine?
Definition
plague, cholera, yellow fever, smallpox, wild type poliovirus, SARS,
novel influenza
Term
where do infectious threats come from?
Definition
bioterrorism,new infections emerging, “old” Infections resurging, anti-microbial resistant infections, infections that produced chronic disease
Term
what is norovirus associated with?
Definition
cruise ships
Term
what is the highest WHO alert level, when did H1N1 get there?
Definition
alert level 6, H1N1 appeared in april, and was at level 6 by june 11
Term
what are the pandemic phases?
Definition
1. no new subtype in human 2. circulating animal subtype posing risk to humans 3. human infection with a new subtype 4.small clusters and localized spread 5. large clusters 6.increased and sustained transmission
Term
what was important about the H1N1 pandemic?
Definition
it was the first time in history that we have been able to follow a pandemic from the start
Term
what are the essential elements in management of acute respiratory illnesses?
Definition
cough ettique, hand-washing, and social distancing
Term
what are "super-spreaders" of SARS?
Definition
aerosol and fomites
Term
Antisepsis
Definition
the process used to decontaminate the skin of a patient/HCW
Term
Attack rate
Definition
proportion of persons at risk who develop symptoms of that disease
Term
Bacteremia
Definition
the presence of viable bacteria in the blood
Term
Biofilm
Definition
organized communities of (mixed) microorganisms enclosed in a self-produced polymeric matrix attached to an inert or a living surface. Bacteria are difficult to culture in vitro because of their reduced metabolic and divisional rate
Term
Booster effect
Definition
antibody levels rise higher after revaccination than they did after initial vaccination.
Term
Carrier
Definition
an asymptomatic person who is colonized with a microorganism and has a positive culture
Term
Case Fatality rate
Definition
(CFR) the percentage of people diagnosed as having a specific disease who die as a result of that disease
Term
Cluster
Definition
a group of two or more cases (with the same subtype) among persons (in different households) sharing at least one meal/food item at an event
Term
Cold chain
Definition
the standard recommendations for storage, and transportation of the vaccine, including appropriate equipment
Term
Colonization
Definition
presence/multiplication of microorganisms in/on a host in a non-sterile site, without apparent evidence of invasiveness or tissue injury
Term
Contact
Definition
a person who may have been exposed to the excreta/secretions of an infected person
Term
Contagious
Definition
capable of being spread by contact with sick persons
Term
Contamination
Definition
presence of microorganisms on body surface without tissue invasion or presence of microorganisms on inanimate objects.
Term
Control
Definition
reduction of disease incidence, prevalence, and morbidity/mortality to a locally accepted level as a result of deliberate efforts requiring continuous intervention
Term
DALYs
Definition
to weigh and cumulate the burden imposed by premature death plus years lived with disabilities due to the diseases and conditions considered
Term
Diagnosis
Definition
confirming a disease process in symptomatic patients
Term
Disease
Definition
(Dis-ease) clinical expression of signs and symptoms
Term
(Dis-ease) clinical expression of signs and symptoms
Definition
reduces but does not eliminates, the microbial burden.
Term
Dissemination
Definition
invasion of non-contiguous organs secondary to hematogenous spread.
Term
Elimination
Definition
can also be defined as reduction in the prevalence of disease to the point at which it ceases to be a public health problem.
Term
Empiric
Definition
carefully considered presumptive Rx prior to making the microbiological diagnosis
Term
Endemic
Definition
low level frequency of disease at moderately regular intervals, constant presence of a disease/infectious agent in a given geographic area.
Term
low level frequency of disease at moderately regular intervals, constant presence of a disease/infectious agent in a given geographic area.
Definition
low level frequency of disease at moderately regular intervals, constant presence of a disease/infectious agent in a given geographic area.
Term
Eradication
Definition
reduction of disease incidence to zero (worldwide); intervention efforts are no longer required
Term
Exposure
Definition
Contact with a microbe or harboring a microbe w/o clinical evidence of disease (eg anthrax, TB).
Term
Extinction
Definition
eradication of the pathogen and the destruction of all laboratory isolates
Term
Fomite
Definition
an object that can harbor a pathogenic organism (door knob, diaper changing table, keyboard, stethoscope, thermometer, long necktie)
Term
Food security
Definition
access by all members at all times to enough food for an active, healthy life (USDA)
Term
Gold Standard
Definition
a relatively irrefutable standard that constitutes recognized and accepted evidence that a certain disease exists
Term
Health
Definition
(WHO) a state of complete physical, mental and social well-being and not merely the absence of disease/infirmity.
Term
Health literacy
Definition
the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions (IOM)
Term
Host
Definition
a person/living animal affording subsistence or lodgment to an infectious agent under natural condition.
Term
Incidence
Definition
the rate at which people without disease develop disease (number of new cases per year) measures appearance of disease. It is the gold standard for assessing prevention.
Term
Incubation Period
Definition
time interval between initial contact with infectious agent (exposure) and first appearance of symptoms
Term
Infection
Definition
multiplication of infectious agent in host; clinical, histological or immunological evidence of host injury.
Term
Infectivity
Definition
ability of a pathogen to enter, survive and multiply in host.
Term
Invasive
Definition
an illness, in which isolation of the organism from a normal sterile site occurs, e.g. CSF, blood, synovial fluid, amniotic/pleural/peritoneal fluid.
Term
Isolation
Definition
the process of separating persons known or suspected or being infectious from others, to prevent the spread of disease
Term
Latency
Definition
carriership of the pathogen’s genome in a seropositive individual with a primary low-grade, persistent infection, but w/o signs of active replication
Term
Neglected diseases
Definition
are those that exhibit a considerable and increasing global burden, and impair the ability of those infected to achieve their full potential, both developmentally and socio-economically
Term
Nosocomial Infection (Health-care associated)
Definition
hospital/nursing home-acquired infection after 72 hours of admission.
Term
Opportunist
Definition
organism causing disease in a compromised host.
Term
Outbreak
Definition
occurrence of two or more symptomatic cases in different households with a common exposure
Term
Pandemic
Definition
spread of epidemic among continents
Term
Parasite
Definition
an organism living in or on another living organism (a host), which obtains part or all of its organic nutrients from the host, and causes a degree of damage to its host.
Term
Pasteurization
Definition
the critical reduction of pathogens in a substance, especially a liquid, at a temperature and for a period of time that destroys objectionable organisms without major chemical alteration of the substance (milk, fruit juice).
Term
Pathogen
Definition
microorganism capable of causing disease by its ability to cross epithelial barriers and/or intact cells.
Term
Pathogenesis
Definition
changes that occur when the host interacts with the microorganism
Term
Pathogenicity
Definition
ability to produce disease.
Term
Pathogenicity islands
Definition
novel genes working together to enhance the virulence potential of a species
Term
Prevalence
Definition
number of people who have the disease/currently infected (measures existence of disease).
Term
Prevention
Definition
action aimed at eradicating, eliminating or minimizing the impact of disease and disability
Term
Probiotic
Definition
a preparation of or a product containing viable, defined microorganisms in sufficient numbers, which alter the microflora (by implantation or colonization) exerting beneficial health effects in the host
Term
Prophylactic
Definition
antimicrobial Rx from the earliest possible moment to prevent an infection that is common and important enough to justify such a commitment
Term
Quarantine
Definition
compulsory period of isolation (sequestration) imposed on a person/s, animal or thing that might otherwise spread a contagious disease
Term
Quorum sensing
Definition
cell-to-cell signaling mechanism in which bacteria respond to hormone-like molecules (auto inducers) produced by other growing bacteria of the same species in the same environment.
Term
Recrudescence
Definition
a new outbreak after a period of abatement or inactivity
Term
Reinfection
Definition
infection with the same organism (genus) but different species
Term
Relapse
Definition
infection with the very same organism/pretherapy isolate (genus and spp
Term
Reproductive rate
Definition
the extent to which an infectious disease spreads in a population (the average number of susceptible people infected by an index case over his lifetime). To maintain an epidemic, its reproductive rate must be greater than one. Measure of transmissibility of an infection.
Term
Reservoir
Definition
source of a microorganism in the environment/host
Term
Resident flora
Definition
colonizes deeper skin layers, multiplies in hair follicles (e.g. coagulase negative Staphylococci, Corynebacteria).
Term
Resistance
Definition
a relative insensitivity of a microbe to an antimicrobial drug as tested in vitro and compared with other isolates of the same species
Term
a relative insensitivity of a microbe to an antimicrobial drug as tested in vitro and compared with other isolates of the same species
Definition
test(s) done on asymptomatic patients to identify those at an increased risk of a disease
Term
Sensitivity
Definition
percentage of people with the disease who test positive (inclusion of the infected), “detection rate”.
Term
Septicemia
Definition
systemic disease associated with presence and persistence of pathogenic microorganisms or their toxins in the blood
Term
Sequela/e
Definition
an after effect of disease or injury, a secondary result.
Term
Specificity
Definition
percentage of people without the disease who test negative (exclusion of the noninfected). In other words, the ability to reject the Dx correctly
Term
Sporadic
Definition
occasional cases of disease at fairly regular intervals
Term
Sterilization
Definition
completely eliminates or destroys all forms of microbial life.
Term
Subclinical infection
Definition
reaction between pathogen and host is limited by host’s immune response.
Term
Success
Definition
large-scale disease program (national scope), uses cost-effective interventions, has been sustained for >5 years, and has a major health impact.
Term
Surveillance
Definition
the continuing scrutiny of all aspects of occurrence and spread of a disease that are pertinent to effective control.
Term
Symptoms
Definition
(Greek) “to fall together” or coincide (manifestation of illness)
Term
Therapeutic
Definition
treatment based on the presence of established infection
Term
Transient flora
Definition
colonizes superficial skin layers for short periods and is usually
acquired by contact with a patient or contaminated environment (e.g. Staph. aureus, gram-negative bacilli, Candida
Term
Triage
Definition
sorting, screening and prioritizing victims in a resource-constrained environment.
Term
Vector
Definition
a living transmitter of disease (mosquito, tick, fly).
Term
Virulence
Definition
(Latin – virulentus “full of poison”) ability of microorganism to produce disease in a given set of circumstances (quantitative measure of pathogenicity). In other words it is the degree of harm imposed on the host.
Term
Zoonosis
Definition
diseases and infections which are naturally transmitted between vertebrate animals and man.
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