Communicable Disease Basics

Objectives

n Describe three ways infectious agents can be transmitted

n Describe at least three ways to decrease risk of infections in public settings

n List three examples of common infectious diseases and how to reduce risk of
infection

Chain of Infection

Chain of Infection

n Model used to understand the infection process

n Each link represents step in transmission of infection

n Each link has to be present and in order for an infection to occur

1 - The Infectious Agent

1) -any disease causing microorganism (pathogen)

Infectious agents are:

Chai
n Bacterial

n Viral

n Fungal

n Parasitic

2 - The Reservoir

-Where a microorganism normally lives and reproduces

Examples of reservoirs:

n Humans

n Animals

n Water

n Food

3 - The Portal of Exit

-route of escape of the pathogen from the reservoir.

Examples of portals of exit:

n Flu or cold - mucous secretions

n West Nile Virus - when the mosquito bites and feeds on the bird’s blood

n Hepatitis A - stool

n SARS - droplet, contact

4 - The Route of Transmission (Spread)

-the way the pathogen gets from the reservoir to the new host

Transmission:
Respiratory Droplets

n From respiratory tract (i.e., nose, mouth) secretions of infected person

– E.g. cough, sneeze

n Do not circulate in air for long time or travel far (mostly < 3 feet)

n Many diseases spread by respiratory droplets; e.g. flu, cold, pertussis, SARS

n Can spread germs directly or indirectly

Droplet Transmission

-Agent is coughed or sneezed out into the air and floats on droplets

Direct Spread by Droplets

n Close contact with infected person (<3 ft)

n Infected person coughs, sneezes, talks, sings

n Droplets land directly on mucous membranes (eyes, nose, mouth) of

susceptible person

Indirect Spread by Droplets

-Droplets with the infectious agent land on a table, doorknob etc.

-Someone touches contaminated object

-Touch nose, mouth, eyes with contaminated hand

Airborne Transmission
 n Germs stay suspended in air on small particles

n Uncommon method of transmission

n Only occurs for certain germs, such as tuberculosis

= Less commonly for flu, SARS

Airborne - This Needs to be Breathed in to be Infectious

Other Methods of Transmission

n Food/water/hands contaminated with stool from infected person; e.g.,

norovirus

n Blood exposures, sexual contact

– a.k.a. blood-borne; e.g. HIV, hepatitis B and C

n Vector-borne

– E.g. Mosquitoes and West Nile virus, malaria

n Unlikely methods of spread in courtroom

What Do You Need to Do?

n Make sure that you have available for staff and patient use an adequate
supply of:

– surgical masks

– tissues

– alcohol hand rub

– trash cans with foot pedals to lift lid for disposing of tissues/masks

5 - The Portal of Entry

-route through which the pathogen enters its new host

Respiratory System

n Inhale germs

Other Portals of Entry

Ingestion

Sexual Contact

Breaks in Protective Skin Barrier

6 - The Susceptible Host

-A person who can get sick when they are exposed to a disease causing
pathogen

What Is the Purpose of Respiratory Hygiene?

n To reduce the transmission of airborne diseases

Hand Hygiene

n Wash hands frequently with soap and warm water for at least 20 seconds

n Alcohol hand gels

n Use gloves where contact with body secretions and excretions is taking place

n Cover Your Cough!

Cough Etiquette

n Limit close contact (<3 feet) with coughing clients

n Cover cough/sneeze with tissue

n Offer mask to coughing clients

Keep a clean environment

n Clean contaminated surfaces with commercial germicidal cleanser or wipes

Maintain vaccinations for employees

n Flu shot- every year for age >50 and high-risk groups

n Tetanus shot every 10 years

n Hepatitis B for persons who may contact objects contaminated with blood

n Pneumovax (“pneumonia” vaccine) for age ≥65

n Hepatitis A
 What Are Some of the Airborne Diseases of Concern?

n Pertussis

n Tuberculosis

n Influenza

n Common colds

Pertussis (Whooping Cough)

n Droplet and contact transmission

n Runny nose and prolonged severe cough

n A bacterial infection

n Most dangerous for babies

n Vaccine preventable for children aged 7 and under

Tuberculosis

Agent

n Caused by bacterium, Mycobacterium tuberculosis

Reservoir

n Humans

Latent TB Infection vs. Active TB Disease

Latent TB Infection

n Person infected with TB bacteria

n Bacteria kept dormant by person’s immune system

n Not sick or contagious

n 10% develop TB disease over life time

n Infection detected by TB skin test

Influenza
(Flu)

n Agent

n Virus
n Reservoir

n Humans

n Animals (e.g. birds, pigs)

– Generally different strains

What Can You Do to Reduce Your Chances of Getting Sick?

n Encourage coughing clients to wash their hands (or use alcohol hand rub)

n Wash your own hands frequently

n Wipe down counters, pens, phones, computer keyboards, etc. with

disinfectant cleaner as needed

n CoughOffer mask to coughing clients

n etiquette- cover with tissue

Recommendations

n Staff and clients should have access to:

– Hand washing facilities

– Tissues

– Trash cans for disposing of tissues

n Consider having alcohol hand rub available