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Diptheria host and pathogens with cause.ppt
- 1. 33.1 Airborne Pathogens
• Aerosols are important for person-to-person
transmission of many infectious diseases
• Most pathogens survive poorly in air, thus, are
effectively transmitted only over short distances
• Respiratory infections
– Different pathogens characteristically colonize the
respiratory tract at different levels
– The upper and lower respiratory tracts offer
different environments and favor different
microbes
© 2012 Pearson Education, Inc.
- 3. 33.2 Streptococcal Diseases
• Streptococcus pyogenes (group A Streptococcus;
GAS)
– Commonly found in low numbers in the upper
respiratory tract of healthy individuals
– Causative agent of “strep throat”
– Can also cause infections of the inner ear,
mammary glands, and skin
• Infections occur if host defenses are weakened or
a new, highly virulent strain is introduced
© 2012 Pearson Education, Inc.
- 7. 33.2 Streptococcal Diseases
• Streptococcus pyogenes (cont’d)
– Certain GAS strains carry a lysogenic
bacteriophage that encodes exotoxins responsible
for symptoms of toxic shock syndrome and scarlet
fever
– Untreated or insufficiently treated infections can
lead to other diseases (e.g., rheumatic fever)
© 2012 Pearson Education, Inc.
- 9. 33.3 Diphtheria and Pertussis
• Diphtheria
– A severe respiratory disease that typically
infects children
– Caused by Corynebacterium diphtheriae
• A bacterium that forms irregular rods during
growth
– Preventable and treatable
© 2012 Pearson Education, Inc.
- 11. 33.3 Diphtheria and Pertussis
• Corynebacterium diphtheriae
– Spreads by airborne droplets and enters the body
via the respiratory route
– Previous infection or immunization provides
resistance
– Pathogenic strains lysogenized by bacteriophage
produce a powerful exotoxin that causes
• Tissue death
• The appearance of the pseudomembrane in the
patient’s throat
© 2012 Pearson Education, Inc.
- 13. 33.3 Diphtheria and Pertussis
• Diagnosis of Diphtheria
– C. diphtheriae must be isolated from the throat
• Prevention of Diphtheria
– Vaccine
• Treatment of Diphtheria
– Antibiotics
– Diphtheria antitoxin available for acute cases
• Early administration necessary
© 2012 Pearson Education, Inc.
- 14. 33.3 Diphtheria and Pertussis
• Pertussis (whooping cough)
– An acute, highly infectious respiratory disease
– Caused by infection with Bordetella pertussis
– Observed frequently in school-age children
– Characterized by a recurrent, violent cough
– There has been a consistent upward trend of
infections since the 1980s
– Inadequately immunized children, adolescents,
and adults are at high risk for acquiring and
spreading pertussis
© 2012 Pearson Education, Inc.
- 15. Figure 33.8
Year
1977 1982 1987 1992 1997 2002 2007
9
8
7
6
5
4
3
2
1
0
Pertussis
(incidence
per
100,000
population)
© 2012 Pearson Education, Inc.
- 16. 33.3 Diphtheria and Pertussis
• Diagnosis
– Made by fluorescent antibody staining of a
nasopharyngeal swab specimen
– Also made by actual culture of the organism
• Prevention
– Vaccine soon after birth
• Treatment
– Antibiotics
– But elimination is helped by the immune response
© 2012 Pearson Education, Inc.
- 17. 33.4 Mycobacterium, Tuberculosis, and
Hansen’s Disease
• Tuberculosis is caused by Mycobacterium
tuberculosis
• Hansen’s disease (leprosy) is caused by
Mycobacterium leprae
• All mycobacteria are acid-fast due to the
waxy mycolic acid content of their cell walls
© 2012 Pearson Education, Inc.
- 19. 33.4 Mycobacterium, Tuberculosis, and
Hansen’s Disease
• Tuberculosis
– Worldwide infectious disease of humans
– Incidence is increasing
– M. tuberculosis transmitted by airborne droplets
– Cell-mediated immunity plays a critical role in
the prevention of active disease after infection
– Classified as a primary (initial) infection or
postprimary infection (reinfection)
© 2012 Pearson Education, Inc.
- 21. 33.4 Mycobacterium, Tuberculosis, and
Hansen’s Disease
• Spread of tuberculosis is prevented by
– Hospitalization of patients in negative-pressure
rooms
– Use of face masks for healthcare workers
• Treatment
– Antimicrobial therapy with isoniazid
• Treatment usually requires a 9-month regimen
• Affects the synthesis of mycolic acid in
mycobacteria
© 2012 Pearson Education, Inc.
- 22. 33.4 Mycobacterium, Tuberculosis, and
Hansen’s Disease
• Hansen’s disease (leprosy)
– M. leprae is the causative agent
– The armadillo is the only experimental animal
that has been successfully used to grow
M. leprae
– Most serious form is characterized by folded,
bulblike lesions on the body
© 2012 Pearson Education, Inc.
- 24. 33.4 Mycobacterium, Tuberculosis, and
Hansen’s Disease
• Pathogenicity of M. leprae
– Due to a combination of delayed hypersensitivity
and the invasiveness of the organism
– Transmission is by both direct contact and
respiratory routes
– Incubation times vary from several weeks to years
– The incidence of leprosy worldwide is low
© 2012 Pearson Education, Inc.
- 25. 33.6 Viruses and Respiratory Infections
• Viruses are less easily controlled by
chemotherapeutic methods
• The most prevalent human infections are caused
by viruses
• Most viral diseases are acute, self-limiting
infections
• A few serious viral diseases have been effectively
controlled by vaccination (e.g., smallpox and
rabies)
© 2012 Pearson Education, Inc.
- 26. 33.6 Viruses and Respiratory Infections
• Measles (rubeola or 7-day measles)
– Often affects susceptible children as an acute,
highly infectious, often epidemic disease
(Figure 33.14)
– Caused by a paramyxovirus
• Negative-strand RNA virus
– Virus enters the nose and throat by airborne
transmission
© 2012 Pearson Education, Inc.
- 28. 33.6 Viruses and Respiratory Infections
• Measles (cont’d)
– Used to be a common childhood illness
– Now only occurs in rather isolated outbreaks
• Due to widespread immunization programs that
began in the mid-1960s
– Over 600,000 deaths per year worldwide
– Proof of immunization required for enrollment in
U.S. public schools
© 2012 Pearson Education, Inc.
- 29. 33.6 Viruses and Respiratory Infections
• Mumps
– Caused by a paramyxovirus (like measles)
– Highly infectious
– Spread by airborne droplets
– Characterized by inflammation of the salivary
glands
© 2012 Pearson Education, Inc.
- 31. 33.6 Viruses and Respiratory Infections
• Rubella (German measles or 3-day measles)
– Caused by a positive-strand RNA virus of the
togavirus group
– Disease symptoms resemble measles but are
generally milder and less contagious
– Routine childhood immunization is practiced in
the U.S.
© 2012 Pearson Education, Inc.
- 32. 33.6 Viruses and Respiratory Infections
• In the U.S., the incidence of measles, mumps,
and rubella has decreased significantly since
the implementation of the MMR vaccine
© 2012 Pearson Education, Inc.
- 33. Figure 33.15
Measles
Mumps
Rubella
1987 1992 1997 2002 2007 2012
19651970197519801985
400
200
0
1987 1992 1997 2002 2007 2012
19651970197519801985
1987 1992 1997 2002 2007 2012
19651970197519801985
1960
150
100
50
0
0
10
20
30
25
20
15
10
5
0
5
6
7
4
3
2
1
0
0.7
0.6
0.5
0.4
0.3
0.2
0.1
0.0
Cases
per
100,000
population
Cases
per
100,000
population
Cases
per
100,000
population
Vaccine
licensed
© 2012 Pearson Education, Inc.
- 34. 33.6 Viruses and Respiratory Infections
• Chicken pox (varicella)
– Common childhood disease characterized by a
systemic papular rash
– Caused by varicella-zoster virus (VZV), a
herpesvirus
– VZV is highly contagious and transmitted by
infectious droplets
– A vaccine is presently used in the U.S.
© 2012 Pearson Education, Inc.
- 36. 33.6 Viruses and Respiratory Infections
• Chicken pox (cont’d)
– VZV virus establishes a lifelong latent
infection in nerve cells
– The virus occasionally migrates to the skin
surface, causing a painful skin eruption
(shingles)
© 2012 Pearson Education, Inc.
- 37. 33.7 Colds
• Colds
– Viral infections transmitted via airborne droplets
– Infections are usually of short duration
– Symptoms milder than other respiratory
diseases
– Symptoms include rhinitis, nasal obstruction,
watery nasal discharges, and malaise
© 2012 Pearson Education, Inc.
- 38. Figure 33.18
Cases per 100 people per year
All other infectious diseases
Colds
Influenza
400
300
200
100
0
© 2012 Pearson Education, Inc.
- 39. 33.7 Colds
• The Common Cold
– Commonly caused by rhinoviruses (Figure 33.19)
• Positive-sense, single-stranded RNA viruses
• Nearly 115 different strains identified
– Approximately 15% of colds are due to
coronaviruses
– Approximately 10% of colds are due to other
viruses
© 2012 Pearson Education, Inc.
- 41. 33.7 Colds
• Each cold infection induces a specific,
protective immunity, but the large number of
viral cold pathogens precludes complete
protective immunity or vaccines
© 2012 Pearson Education, Inc.
- 42. 33.8 Influenza
• Influenza is caused by an RNA virus of the
orthomyxovirus group
• There are three different types of influenza
viruses (A, B, C)
• Influenza A is the most important human
pathogen
© 2012 Pearson Education, Inc.
- 44. 33.8 Influenza
• Influenza outbreaks occur annually due to the
plasticity of the influenza genome
– Antigenic shift
• Major change in influenza virus antigen due to
gene reassortment (Figure 33.22)
– Antigenic drift
• Minor change in influenza virus antigens due to
gene mutation
© 2012 Pearson Education, Inc.
- 46. 33.8 Influenza
• Influenza epidemics and pandemics occur
periodically
– 1957 outbreak of Asian flu
– 1997 outbreak of avian influenza
© 2012 Pearson Education, Inc.
- 47. Figure 33.23
Country of origin
Countrywide epidemic
Localized outbreaks
Routes of spread
© 2012 Pearson Education, Inc.
- 48. 33.8 Influenza
• Prevention
– Immunization
– Careful worldwide surveillance
• Treatment
– Use of various drugs
– Most effective when administered early
– Aspirin should be avoided
© 2012 Pearson Education, Inc.
- 49. 33.11 Hepatitis Viruses
• Hepatitis
– Liver inflammation caused by viruses or bacteria
– Sometimes results in acute illness followed by
destruction of liver anatomy and cells (cirrhosis)
– A restricted group of viruses is associated with
liver disease
– Hepatitis viruses are diverse
© 2012 Pearson Education, Inc.
- 50. 33.11 Hepatitis Viruses
• Hepatitis A virus (infectious hepatitis)
– Causes mild or, rarely, severe cases of liver
disease
• Hepatitis B virus (serum hepatitis; Figure 33.27)
– Causes acute, often severe disease that can lead
to liver failure and death
• Hepatitis D virus
– A defective virus that cannot replicate and
express a complete virus unless the cell is also
infected with hepatitis B
© 2012 Pearson Education, Inc.
- 52. 33.11 Hepatitis Viruses
• Hepatitis C virus
– Produces a mild disease initially, but most
individuals develop chronic hepatitis that can lead
to chronic liver disease
© 2012 Pearson Education, Inc.
- 53. 33.11 Hepatitis Viruses
• Incidence and Prevalence of Hepatitis
– Decreased significantly in the U.S. in the last
20 years (Figure 33.26)
– Viral hepatitis is still a major public health
problem
• Due to the high infectivity of the viruses and the
lack of effective treatment options
– Vaccines are available for Hepatitis A and B
viruses
© 2012 Pearson Education, Inc.
- 54. Figure 33.26
Hepatitis A
Hepatitis B
Hepatitis C
HAV vaccine
1995
HBV vaccine
1982
Year
Cases
per
100,000
population
20
15
10
5
0
1975 1980 1985 1990 1995 2000 2005 2010
© 2012 Pearson Education, Inc.
- 55. III. Sexually Transmitted Infections
• Sexually Transmitted Infections (STIs)
– Also called sexually transmitted diseases (STDs)
or venereal diseases
– Caused by a variety of bacteria, viruses, protists,
and even fungi
– Pathogens are generally only found in body fluids
from the genitourinary tract that are exchanged
during sexual activity
© 2012 Pearson Education, Inc.
- 56. 33.12 Gonorrhea and Syphilis
• Gonorrhea and syphilis are preventable,
treatable bacterial STIs
• The overall pattern of disease differs between
the two
– Gonorrhea is prevalent and often
asymptomatic in women
– Syphilis has low prevalence and exhibits very
obvious symptoms
© 2012 Pearson Education, Inc.
- 57. Figure 33.28
Year
Birth control pills
Penicillin
World War II
Reported
cases
per
100,000
population
Syphilis
Gonorrhea
500
400
300
200
100
0
1920 1925 1930 1935 1940 1945 1950 1955 1960 1965 1970 1975 1980 1985 1990 1995 2000 2005 2010
© 2012 Pearson Education, Inc.
- 58. 33.12 Gonorrhea and Syphilis
• Gonorrhea
– Caused by Neisseria gonorrhoeae
– Symptoms in females
• Characterized by a mild vaginitis that often goes
unnoticed
• Untreated gonorrhea can lead to pelvic
inflammatory disease
– Symptoms in males
• Characterized by a painful infection of the
urethral canal
© 2012 Pearson Education, Inc.
- 60. 33.12 Gonorrhea and Syphilis
• Syphilis
– Caused by Treponema pallidum
– Often transmitted at the same time as gonorrhea
– T. pallidum can be transmitted from an infected
woman to the fetus during pregnancy (congenital
syphilis)
– Three stages: primary, secondary, and tertiary
– Penicillin highly effective for primary and
secondary stages
© 2012 Pearson Education, Inc.
- 62. 33.13 Chlamydia, Herpes, and HPV
• Chlamydia trachomatis causes a number of
sexually transmitted diseases
– Nongonococcal urethritis (NGU)
– Lymphogranuloma venereum
© 2012 Pearson Education, Inc.
- 64. 33.13 Chlamydia, Herpes, Trichomoniasis,
and HPV
• Herpes simplex 1 virus (HSV-1)
– Infects the epithelial cells around the mouth
and lips
– Causes cold sores
– May occasionally affect other body sites
– Spread via direct contact or through saliva
– Lesions heal without treatment in 2 to 3 weeks
© 2012 Pearson Education, Inc.
- 65. 33.13 Chlamydia, Herpes, Trichomoniasis,
and HPV
• Herpes simplex 2 virus (HSV-2)
– Infections are associated primarily with anogenital
region
– Causes painful blisters on penis of male and cervix,
vulva, or vagina of females
– Typically transmitted through sexual contact and
most easily transmitted when active blisters are
present
– Genital herpes are presently incurable, however, a
limited number of drugs are successful in controlling
the infectious blister stage
© 2012 Pearson Education, Inc.
- 66. 33.13 Chlamydia, Herpes, Trichomoniasis,
and HPV
• Human papillomavirus (HPV)
– Causes several different infections
• Many infections are asymptomatic but some
progress to genital warts
• Can cause cervical neoplasia, and a few progress
to cervical cancers
– There is an effective HPV vaccine
© 2012 Pearson Education, Inc.
- 67. 33.14 Acquired Immunodeficiency
Syndrome: AIDS & HIV
• AIDS
– Recognized as a distinct disease in 1981
– Human immunodeficiency virus (HIV) is the
causative agent
• HIV
– As many as 1.4 million people worldwide may
be infected
© 2012 Pearson Education, Inc.
- 68. 33.14 Acquired Immunodeficiency
Syndrome: AIDS & HIV
• HIV is divided into two types:
– HIV-1 is the more virulent type
– HIV-2 is less virulent and causes a milder, AIDS-
like disease
• Opportunistic infections are common in AIDS
patients
© 2012 Pearson Education, Inc.
- 71. 33.14 Acquired Immunodeficiency
Syndrome: AIDS & HIV
• HIV Pathogenesis
– HIV infects cells that contain the CD4 cell surface
protein
– Most commonly infected are macrophages and
T-helper cells
– HIV also interacts with coreceptors on target cells
© 2012 Pearson Education, Inc.
- 73. Figure 33.39
Nucleocapsid
Nucleus
gp 120
CCR5
CD4
Target
cell
Interaction of HIV with a
host cell
Fusion of the HIV envelope with the host cell
HIV gp120 protein binds CD4
receptor and CCR5 receptor
Interaction of the
virus with a receptor–
coreceptor pair on
the host cell
The viral envelope
and host membrane
coalesce
The nucleocapsid
is inserted into
the host cell,
beginning the
viral infection
HIV
© 2012 Pearson Education, Inc.
- 74. 33.14 Acquired Immunodeficiency
Syndrome: AIDS & HIV
• HIV infection does not immediately kill the
host cell
• Infection results in a progressive decline in
CD4 cells
• As the number of CD4 cells declines, cytokine
production falls, leading to reduction of the
immune response
© 2012 Pearson Education, Inc.
- 75. Figure 33.40
Symptom-
free
Swollen lymph glands Subclinical immune
dysfunction
Oppor-
tunistic
infections
Systemic
immune
deficiency
Time (months) after HIV exposure
HIV
RNA
copies
per
ml
Death
CD4
T cells
per
mm3 of
blood
Normal
range
for T cells
Significantly
depressed
T cells
Severe
T cell
depletion
106
104
102
1000
900
800
700
600
500
400
300
200
100
0
0 6 12 18 24 30 36 42 48 54 60 66 72 78 84
© 2012 Pearson Education, Inc.
- 76. 33.14 Acquired Immunodeficiency
Syndrome: AIDS & HIV
• HIV infection can be diagnosed with an HIV-EIA,
HIV-immunoblot, or rapid tests
– These fail to detect infection in individuals who
recently acquired the HIV and have not made a
detectable antibody
• RT-PCR can detect HIV RNA directly from blood
and estimate the number of viruses present
– This is useful for early detection and monitoring
the progression of infection
© 2012 Pearson Education, Inc.
- 77. 33.14 Acquired Immunodeficiency
Syndrome: AIDS & HIV
• Treatment
– Four classes of drugs delay the symptoms of
AIDS and prolong the life of those infected with
HIV
• Nucleoside reverse transcriptase inhibitors
• Nonnucleoside reverse transcriptase inhibitors
• Protease inhibitors
• Fusion inhibitors
– Highly active antiretroviral therapy (HAART) is
used
© 2012 Pearson Education, Inc.
- 78. 33.14 Acquired Immunodeficiency
Syndrome: AIDS & HIV
• There is not an effective vaccine for HIV
• Prevention for the spread of HIV infection
requires education and avoidance of high-risk
behavior
© 2012 Pearson Education, Inc.
Editor's Notes
- Figure 33.1 High-speed photograph of an unstifled sneeze.
- Figure 33.3 Streptococcus pathogens.
- Figure 33.4 Typical lesions of impetigo.
- Figure 33.5 Erysipelas.
- Figure 33.6 Scarlet fever.
- Figure 33.7 Corynebacterium and diphtheria.
- Figure 33.7 Corynebacterium and diphtheria.
- Figure 33.8 Bordetella and pertussis.
- Figure 33.9 Mycobacteria.
- Figure 33.10 Tuberculosis X-ray.
- Figure 33.12 Lepromatous leprosy lesions on the skin.
- Figure 33.14 Measles in children.
- Figure 33.16 Mumps.
- Figure 33.15 Viral diseases and vaccines.
- Figure 33.17 Chicken pox.
- Figure 33.18 Colds and influenza.
- Figure 33.19 Common cold viruses.
- Figure 33.21 Electron micrograph of influenza virus.
- Figure 33.22 Influenza virus reassortment.
- Figure 33.23 An influenza pandemic.
- Figure 33.27 Hepatitis B virus (HBV).
- Figure 33.26 Hepatitis in the United States.
- Figure 33.28 Reported cases of gonorrhea and syphilis in the United States.
- Figure 33.29 The causative agent of gonorrhea, Neisseria gonorrhoeae.
- Figure 33.30 The syphilis spirochete, Treponema pallidum.
- Figure 33.32 Cells of Chlamydia trachomatis (arrows) attached to human fallopian tube tissues.
- Figure 33.37 Kaposi’s sarcoma.
- Figure 33.38 Human lymphocyte releasing HIV.
- Figure 33.39 Infection of a CD4 target cell with the AIDS virus, HIV.
- Figure 33.40 Decline of CD4 T lymphocytes and progress of HIV infection.