HOW MICROBES CAUSE

DISEASE.

Dr.Kedar Karki
 TERMS RELATED TO
VIRULENCE

MAJOR BACTERIAL VIRULENCE DETERMINANTS

 Virulence determinants.
• A pathogen may have one or many virulent
determinants. When a pathogen loses a crucial
virulence determinant it becomes avirulent.
Conversely, a normally non-virulent microbe
may gain virulent genes and suddenly become
virulent or a mildly pathogenic strain may gain
an additional virulence determinant and become
virulent. Virulent genes may occur through
mutations in the microbes genome, or by picking
up a plasmid .
Attachment system that bind
pathogens to their hosts.
 STEPS IN THE DISEASE
PROCESS
• INFECTION =
• INCUBATION PERIOD =
• INITIAL SYMPTOMS =
 SEPTICEMIA:
• This describes the case where the
pathogen grows massively within the host.
In effect the host becomes a virtual
"culture tube" for the pathogen. Bacteria
and viruses can be found in the blood and
all the organs. Death often ensues when
this happens.
 TOXINS:
• Toxins are products of a pathogen that
destroy/damage/inactivate one or more
vital component of the host thus allowing
the pathogen to survive and flourish.
 EXOTOXINS
• EXOTOXINS are toxins that are SECRETED
from the cell or leak out of the cell after it dies.
Generally they are soluble proteins and thus are
carried throughout the body in the blood or
lymph, doing damage at a distance from the
infection site. Toxins tend to target specific cells
in the body. Some are enzymes and others are
proteins that bind to and inhibit crucial cellular
activities which eventually lead to the death of
cells.
 ENDOTOXINS

• Endotoxins have a general basic structure, but

differ significantly in composition between
species. Endotoxins are released in relatively
small amounts as the cells grow, but in copious
amounts when the cells die. Different endotoxins
differ in their degree of toxicity, but all are heat
stable and can tolerate autoclaving. Endotoxins
harm many systems in the body and hence are
very dangerous. They are often responsible for
the cause of death of infections by G-v cells.
 ENZYMES:
• Pathogens use a variety of enzymes to
assist them in establishing infection and
producing a disease. There are virulence
determinant enzymes that dissolve the
glue between cells, thus allowing the
bacteria to spread rapidly through the
tissue. There are enzymes (hemolysins)
that #lyse red blood cells and others that
lyse white blood cells. There are enzymes
that degrade DNA, lipids and proteins.
 ATTACHMENT SYSTEMS:
• Since many of the nonspecific defenses
involve mechanically flushing away
pathogens, a common virulence
determinant of pathogens are cell
components that stick the bacteria to the
target cells.
 SELF DESTRUCTION:
• Pathogens frequently cause disease by
tricking the host cells into doing something
they normally wouldn't do. One trick is to
induce the host system to produce self-
destructive chemicals that kill or inhibit
its own cells.
 CHANGING ANTIGENS:
• Pathogens often evade a host's immune
system by frequently changing its surface
antigens. The HIV, malaria and sleeping
sickness pathogens use this strategy to
avoid destruction. In these cases a
pathogen produces a few antigenic
variants as its population increases.
 CAMOUFLAGE:
• In this case the pathogen camouflages
itself so the host doesn't recognize the
invader as being "nonself" and thus
dangerous.
 INITIAL SYMPTOMS =
• These refer to the first symptoms that
clearly demonstrate an illness. Since
symptoms vary widely between hosts this
is a statistical matter.
 ACUTE =
• This refers to the classical clinical or
textbook symptoms, where the disease
is in full flower and the patient is usually
seriously or clearly ill.
 The symptoms and outcome of
every disease is dependent on a
mixture of many factors.
• The GENETICS of the host.
• The GENETICS infectious agent; virulent
determinants, virulence plasmids etc.
• The PHYSICAL CONDITION of the host.
• The STRESS encountered by the host
during the disease.
• The AGE & SEX of the host.
• The TREATMENT of the victim.
SUBCLINICAL or asymtomatic
• is very common for people to have a
disease and not show any identifiable
symptoms and yet to become as immune
as another person who almost dies from
the same disease.
 RECOVERY =
• Period during which the symptoms decline
and the patient recovers. Recovery may
take many paths.
 Six major ones are listed below.

• In many cases the etiological agent is totally

eliminated and the patient returns to full health.
•
• Some carriers appear to be fully recovered, but
the disease may be progressing slowly towards
a fatal outcome, such as may occur with syphilis,
#HIV and tuberculosis. Magic Johnson is
probably such a case.
 Six major ones are listed below.

• In other cases, the patient shows a full

recovery but the infectious agent is still
present. Under these conditions the
patient becomes a CARRIER and remains
capable of shedding (spreading) the
virulent form of the infectious agent for
some period, perhaps for the remainder of
their lives. This is the case for diseases
like Typhoid, Herpes and HPV (Human
Papilloma Virus).
 Six major ones are listed below.

• Some carriers, like those with herpes (shingles)

and hepatitis have occasional outbreaks of the
disease throughout their lives, but they are rarely
fatal.

• In other cases, the patient recovers and

eliminates the infectious agent, but their immune
system has been damaged and they
subsequently fall victim to an autoimmune
disease like rheumatoid arthritis.
 Six major ones are listed below.

• In many cases a disease becomes

CHRONIC. The victim makes a partial
recovery, but they are still less well than
normal and continuously demonstrate
symptoms of ill-health or have frequent
relapses. Many infestations (worms and
other large parasites) take this path. Lyme
disease can become chronic.
MAJOR BACTERIAL VIRULENCE
DETERMINANTS
MAJOR BACTERIAL VIRULENCE DETERMINANTS