Image one	DISEASE PROCESSES ©David B. Fankhauser, Ph.D., Professor of Biology and Chemistry University of Cincinnati Clermont College, Batavia OH 45103	Image Two
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Black 2nd, p. 386-, Alcamo p. 521- , TFC 7^th, 406-425, TFC 8^th: 408-436, Bauman 2^nd: 405-435

Normal flora     indigenous microbes act to crowd out pathogens and microbial antagonism.

(P 406)                (Notably: (p 408) skin, oral cavity, respiratory, small and large intestine, vagina)

Portal of Entry:                (p 409) oral, respiratory, mucous membrane, conjunctiva, anus, parenterally

Portal of Exit:                  (p 420) via excretions or secretions.

PATTERNS OF DISEASE: SIGNS, SYMPTOMS AND SYNDROMES (p. 414)

Disease can be either         fulminating        (lightening) rapid onset

                                           insidious             slow onset

Pathogenicity:                  ability to cause disease

              Virulence:                         severity of disease, affected by invasiveness and toxigenicity (factors: p 417)

              Attenuation:                    repeated subculture, transposal of virulence through abnormal host

Stages: (p 419)

Incubation    no signs or symptoms

Prodromal    redness, swelling, headache, aches and pains

Invasive         fever (pyrogens), swollen lymph glands, rashes, nasal congest, cough, sore throat, pain, nausea, vomiting, diarrhea

Acme            Full development of above signs and symptoms

Decline         signs and symptoms decline

              crisis: rapid reversal

              lysis: slow reversal

convalescence: regain strength, tissues repaired

TRANSMISSION (p. 420)

Direct             person to person: handshake, intercourse, kissing, can include herpes, gonorrhea

                       droplet: influenza, measles, pertussis, strep throat

                       Animal to person: rabies, leptospirosis, toxoplasmosis

Indirect  ingestion of contaminated food or water (Salmonella, Trichinella)

                       fomites (inanimate) p :                          linens for pinworms, needles for hepatitis B

                       Vectors (animate) p 423:                      mechanical :                                    flies

                                                                                      Biological:                                       malaria, yellow fever

Reservoir is infected animal cats for Toxoplasma,

                                                                                      person (carrier)                                 typhoid fever

Nosocomial:   (p. 430):      Staph: 34%,

E. coli & Pseudomonas 32%,

Clostridium: 17%,

fungal (Candida): 10%

DISEASES (p 424):

Communicable, contagious (easily communicable), non-communicable (tetanus)

              endemic:              steady low level of cases in an area

              epidemic              significant increase within a given population

              pandemic:            significant increase world-wide

HOW IS DISEASE CAUSED?

Dose

Bacteria:

              adherence via adhesins, pili (p 410)

              Colonization

              Invasion

              glycocalyx inhibition of phagocytosis (p 418)

              Exotoxins, endotoxins (p 416)

              Neurotoxins, enterotoxins

              hemolysins, leukocidins, leukostatin (inhibit phagocytosis), hyaluronidase, coagulase, streptokinase, collagenase

Viruses:

              cytopathic effect (CPE) cytocidal or noncytocidal

              inclusion bodies

              productive infection, non-productive infection