= Primary pathogens
= Primary pathogens cause disease as a result of their presence or activity within the normal, healthy host, and their intrinsic= Opportunistic pathogens
= Opportunistic pathogens can cause an infectious disease in a host with depressed resistance (immunodeficiency) or if they have unusual access to the inside of the body (for example, via Major trauma, trauma). Opportunistic infection may be caused by microbes ordinarily in contact with the host, such as pathogenic bacteria or fungi in the gastrointestinal or the upper respiratory tract, and they may also result from (otherwise innocuous) microbes acquired from other hosts (as in ''Clostridium difficile (bacteria), Clostridium difficile'' colitis) or from the environment as a result of Physical trauma, traumatic introduction (as in surgical wound infections or compound fractures). An opportunistic disease requires impairment of host defenses, which may occur as a result of genetic defects (such as chronic granulomatous disease), exposure to antimicrobial drugs or immunosuppressive chemicals (as might occur following poisoning or cancer chemotherapy), exposure to ionizing radiation, or as a result of an infectious disease with immunosuppressive activity (such as with measles, malaria or HIV disease). Primary pathogens may also cause more severe disease in a host with depressed resistance than would normally occur in an immunosufficient host.= Secondary infection
= While a primary infection can practically be viewed as the root cause analysis, root cause of an individual's current health problem, a secondary infection is a sequela or complication (medicine), complication of that root cause. For example, an infection due to a burn or penetrating trauma (the root cause) is a secondary infection. Primary pathogens often cause primary infection and often cause secondary infection. Usually, opportunistic infections are viewed as secondary infections (because immunodeficiency or injury was the predisposing factor).= Other types of infection
= Other types of infection consist of mixed, iatrogenic, nosocomial, and community-acquired infection. A mixed infection is an infection that is caused by two or more pathogens. An example of this is appendicitis, which is caused by ''Bacteroides fragilis'' and ''Escherichia coli''. The second is an iatrogenic infection. This type of infection is one that is transmitted from a health care worker to a patient. A nosocomial infection is also one that occurs in a health care setting. Nosocomial infections are those that are acquired during a hospital stay. Lastly, a community-acquired infection is one in which the infection is acquired from a whole community.Infectious or not
One manner of proving that a given disease is infectious, is to satisfy Koch's postulates (first proposed by Robert Koch), which require that first, the infectious agent be identifiable only in patients who have the disease, and not in healthy controls, and second, that patients who contract the infectious agent also develop the disease. These postulates were first used in the discovery that Mycobacteria species cause tuberculosis. However, Koch's postulates cannot usually be tested in modern practice for ethical reasons. Proving them would require experimental infection of a healthy individual with aContagiousness
Infectious diseases are sometimes called contagious diseases when they are easily transmitted by contact with an ill person or their secretions (e.g., influenza). Thus, a contagious disease is a subset of infectious disease that is especially infective or easily transmitted. Other types of infectious, transmissible, or communicable diseases with more specialized routes of infection, such as vector transmission or sexual transmission, are usually not regarded as "contagious", and often do not require medical isolation (sometimes loosely called quarantine) of those affected. However, this specialized connotation of the word "contagious" and "contagious disease" (easy transmissibility) is not always respected in popular use. Infectious diseases are commonly transmitted from person to person through direct contact. The types of contact are through person to person and droplet spread. Indirect contact such as airborne transmission, contaminated objects, food and drinking water, animal person contact, animal reservoirs, insect bites, and environmental reservoirs are another way infectious diseases are transmitted.By anatomic location
Infections can be classified by the anatomic location or organ system infected, including: * Urinary tract infection * Skin infection * Respiratory tract infection * Odontogenic infection (an infection that originates within a tooth or in the closely surrounding tissues) * Vaginal infections * Intra-amniotic infection In addition, locations ofPrevention
Techniques like hand washing, wearing gowns, and wearing face masks can help prevent infections from being passed from one person to another. Asepsis, Aseptic technique was introduced in medicine and surgery in the late 19th century and greatly reduced the incidence of infections caused by surgery. Frequent hand washing remains the most important defense against the spread of unwanted organisms. There are other forms of prevention such as avoiding the use of illicit drugs, using a condom, wearing gloves, and having a healthy lifestyle with a balanced diet and regular exercise. Cooking foods well and avoiding foods that have been left outside for a long time is also important. Antimicrobials, Antimicrobial substances used to prevent transmission of infections include: * antiseptics, which are applied to living biological tissue, tissue/skin * disinfectants, which destroy microorganisms found on non-living objects. * antibiotics, called prophylactic when given as prevention rather as treatment of infection. However, long term use of antibiotics leads to resistance of bacteria. While humans do not become immune to antibiotics, the bacteria does. Thus, avoiding using antibiotics longer than necessary helps preventing bacteria from forming mutations that aide in antibiotic resistance. One of the ways to prevent or slow down the transmission of infectious diseases is to recognize the different characteristics of various diseases. Some critical disease characteristics that should be evaluated includeImmunity
Infection with most pathogens does not result in death of the host and the offending organism is ultimately cleared after the symptoms of the disease have waned. This process requires immune system, immune mechanisms to kill or inactivate the Inoculation, inoculum of the pathogen. Specific acquired immunity (medical), immunity against infectious diseases may be mediated by Antibody, antibodies and/or T lymphocytes. Immunity mediated by these two factors may be manifested by: * a direct effect upon a pathogen, such as antibody-initiated complement system, complement-dependent bacteriolysis, Opsonin, opsonoization, phagocytosis and killing, as occurs for some bacteria, * neutralization of viruses so that these organisms cannot enter cells, * or by T lymphocytes, which will kill a cell parasitized by a microorganism. The immune system response to a microorganism often causes symptoms such as a highHost genetic factors
The organism that is the target of an infecting action of a specific infectious agent is called the host. The host harbouring an agent that is in a mature or sexually active stage phase is called the definitive host. The intermediate host comes in contact during the larvae stage. A host can be anything living and can attain to asexual and sexual reproduction. The clearance of the pathogens, either treatment-induced or spontaneous, it can be influenced by the genetic variants carried by the individual patients. For instance, for genotype 1 hepatitis C treated with Pegylated interferon-alpha-2a or Pegylated interferon-alpha-2b (brand names Pegasys or PEG-Intron) combined with ribavirin, it has been shown that genetic polymorphisms near the human IL28B gene, encoding interferon lambda 3, are associated with significant differences in the treatment-induced clearance of the virus. This finding, originally reported in Nature, showed that genotype 1 hepatitis C patients carrying certain genetic variant alleles near the IL28B gene are more possibly to achieve sustained virological response after the treatment than others. Later report from Nature demonstrated that the same genetic variants are also associated with the natural clearance of the genotype 1 hepatitis C virus.Treatments
When infection attacks the body, ''anti-infective'' drugs can suppress the infection. Several broad types of anti-infective drugs exist, depending on the type of organism targeted; they include antibacterial ( antibiotic; including Mycobacterium#Pathogenicity, antitubercular), Antiviral drug, antiviral, Antifungal medication, antifungal and antiparasitic (including antiprotozoal andEpidemiology
In 2010, about 10 million people died of infectious diseases. The World Health Organization collects information on global deaths by ICD, International Classification of Disease (ICD) code categories. The following table lists the top infectious disease by number of deaths in 2002. 1993 data is included for comparison. The top three single agent/disease killers areHistoric pandemics
With their potential for unpredictable and explosive impacts, infectious diseases have been major actors in human history. A pandemic (or global epidemic) is a disease that affects people over an extensive geographical area. For example: * Plague of Justinian, from 541 to 542, killed between 50% and 60% of Europe's population. * The Black Death of 1347 to 1352 killed 25 million in Europe over 5 years. The plague reduced the old world population from an estimated 450 million to between 350 and 375 million in the 14th century. * The introduction of smallpox, measles, and typhus to the areas of Central and South America by European explorers during the 15th and 16th centuries caused pandemics among the native inhabitants. Between 1518 and 1568 disease pandemics are said to have caused the population of Mexico to fall from 20 million to 3 million. * The first European influenza epidemic occurred between 1556 and 1560, with an estimated mortality rate of 20%. * Smallpox killed an estimated 60 million Europeans during the 18th century (approximately 400,000 per year). Up to 30% of those infected, including 80% of the children under 5 years of age, died from the disease, and one-third of the survivors went blind. * In the 19th century, tuberculosis killed an estimated one-quarter of the adult population of Europe; by 1918 one in six deaths in France were still caused by TB. * The Influenza Pandemic of 1918 (or the Spanish flu) killed 25–50 million people (about 2% of world population of 1.7 billion). Today Influenza kills about 250,000 to 500,000 worldwide each year.Emerging diseases
In most cases, microorganisms live in harmony with their hosts via mutualism (biology), mutual or commensalism, commensal interactions. Diseases can emerge when existing parasites become pathogenic or when new pathogenic parasites enter a new host. # Coevolution between parasite andGerm theory of disease
In Classical antiquity, Antiquity, the Ancient Greece, Greek historian Thucydides ( – ) was the first person to write, in his account of the plague of Athens, that diseases could spread from an infected person to others. In his ''On the Different Types of Fever'' (), the Greco-Roman physician Galen speculated that plagues were spread by "certain seeds of plague", which were present in the air. In the Sushruta Samhita, the ancient Indian physician Sushruta theorized: "Leprosy, fever, consumption, diseases of the eye, and other infectious diseases spread from one person to another by sexual union, physical contact, eating together, sleeping together, sitting together, and the use of same clothes, garlands and pastes." This book has been dated to about the sixth century BC. A basic form of contagion theory was proposed by Ancient Iranian medicine, Persian physician Ibn Sina (known as Avicenna in Europe) in ''The Canon of Medicine'' (1025), which later became the most authoritative medical textbook in Europe up until the 16th century. In Book IV of the ''Canon'', Ibn Sina discussed epidemics, outlining the classical miasma theory and attempting to blend it with his own early contagion theory. He mentioned that people can transmit disease to others by breath, noted contagion with tuberculosis, and discussed the transmission of disease through water and dirt. The concept of invisible contagion was later discussed by several medicine in the medieval Islamic world, Islamic scholars in the Ayyubid Sultanate who referred to them as ''najasat'' ("impure substances"). The fiqh scholar Ibn al-Haj al-Abdari (–1336), while discussing Islamic dietary laws, Islamic diet and Islamic hygienical jurisprudence, hygiene, gave warnings about how contagion can contaminate water, food, and garments, and could spread through the water supply, and may have implied contagion to be unseen particles. When the Black Death bubonic plague reached Al-Andalus in the 14th century, the Arab physicians Ibn Khatima () and Ibn al-Khatib (1313–1374) hypothesised that infectious diseases were caused by "minute bodies" and described how they can be transmitted through garments, vessels and earrings. Ideas of contagion became more popular in Europe during the Renaissance, particularly through the writing of the Italian physician Girolamo Fracastoro. Anton van Leeuwenhoek (1632–1723) advanced the science of microscopy by being the first to observe microorganisms, allowing for easy visualization of bacteria. In the mid-19th century John Snow (physician), John Snow and William Budd did important work demonstrating the contagiousness of typhoid and cholera through contaminated water. Both are credited with decreasing epidemics of cholera in their towns by implementing measures to prevent contamination of water. Louis Pasteur proved beyond doubt that certain diseases are caused by infectious agents, and developed a vaccine for rabies. Robert Koch provided the study of infectious diseases with a scientific basis known as Koch's postulates. Edward Jenner, Jonas Salk and Albert Sabin developed effective vaccines for smallpox andMedical specialists
The medicine, medical treatment of infectious diseases falls into the specialty (medicine), medical field of infectious disease (medical specialty), Infectious Disease and in some cases the study of propagation pertains to the field of Epidemiology. Generally, infections are initially diagnosed by primary care physicians or internal medicine specialists. For example, an "uncomplicated" pneumonia will generally be treated by the internist or the pulmology, pulmonologist (lung physician). The work of the infectious diseases specialist therefore entails working with both patients and general practitioners, as well as Research, laboratory scientists, immunology, immunologists, bacteriologists and other specialists. An infectious disease team may be alerted when: * The disease has not been definitively diagnosed after an initial workup * The patient is immunocompromised (for example, in AIDS or after chemotherapy); * The infectious agent is of an uncommon nature (e.g. tropical diseases); * The disease has not responded to first line antibiotics; * The disease might be dangerous to other patients, and the patient might have to be isolatedSociety and culture
Several studies have reported associations between pathogen load in an area and human behavior. Higher pathogen load is associated with decreased size of ethnic and religious groups in an area. This may be due high pathogen load favoring avoidance of other groups, which may reduce pathogen transmission, or a high pathogen load preventing the creation of large settlements and armies that enforce a common culture. Higher pathogen load is also associated with more restricted sexual behavior, which may reduce pathogen transmission. It also associated with higher preferences for health and attractiveness in mates. Higher fertility rates and shorter or less parental care per child is another association that may be a compensation for the higher mortality rate. There is also an association with polygyny which may be due to higher pathogen load, making selecting males with a high genetic resistance increasingly important. Higher pathogen load is also associated with more collectivism and less individualism, which may limit contacts with outside groups and infections. There are alternative explanations for at least some of the associations although some of these explanations may in turn ultimately be due to pathogen load. Thus, polygyny may also be due to a lower male: female ratio in these areas but this may ultimately be due to male infants having increased mortality from infectious diseases. Another example is that poor socioeconomic factors may ultimately in part be due to high pathogen load preventing economic development.Fossil record
Evidence of infection in Fossil, fossil remains is a subject of interest for paleopathologists, scientists who study occurrences of injuries and illness in extinct life forms. Signs of infection have been discovered in the bones of carnivorous dinosaurs. When present, however, these infections seem to tend to be confined to only small regions of the body. A skull attributed to the early carnivorous dinosaur ''Herrerasaurus ischigualastensis'' exhibits pit-like wounds surrounded by swollen and porous bone. The unusual texture of the bone around the wounds suggests they were affected by a short-lived, non-lethal infection. Scientists who studied the skull speculated that the bite marks were received in a fight with another ''Herrerasaurus''. Other carnivorous dinosaurs with documented evidence of infection include ''Acrocanthosaurus'', ''Allosaurus'', ''Tyrannosaurus'' and a tyrannosaur from the Kirtland Formation. The infections from both tyrannosaurs were received by being bitten during a fight, like the ''Herrerasaurus'' specimen.Molnar, R. E., 2001, "Theropod paleopathology: a literature survey": In: ''Mesozoic Vertebrate Life'', edited by Tanke, D. H., and Carpenter, K., Indiana University Press, pp. 337–63.Outer space
A 2006 Space Shuttle experiment found that ''Salmonella typhimurium'', a bacterium that can cause food poisoning, became moreSee also
* Bioinformatics Resource Centers for Infectious Diseases * Biological hazard * Blood-borne disease * Coinfection * Copenhagen Consensus * Cordon sanitaire (medicine), Cordon sanitaire * Disease diffusion mapping * Epidemiological transition * Foodborne illness * Gene therapy * History of medicine * Hospital-acquired infection * Eradication of infectious diseases * Human Microbiome Project * Infection control * Isolation (health care) * List of bacterial vaginosis microbiota * List of causes of death by rate * List of diseases caused by insects * List of epidemics * List of infectious diseases * Mathematical modelling of infectious disease * Multiplicity of infection * Neglected tropical diseases * Sentinel surveillance * Social distancing * Spatiotemporal Epidemiological Modeler (STEM) * Spillover infection * Threshold host density * Transmission (medicine) * Ubi pus, ibi evacua (Latin: "where there is pus, there evacuate it") * Vaccine-preventable diseases * Waterborne diseasesReferences
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