Immunity and Infection

1. Immunity and Infection Chapter 13

2. The Chain of Infection • Links in the Chain • Transmitted through a chain (six links) • Pathogen - disease causing microorganism • Reservoir - natural environment of the pathogen: Person, animal or environmental component • Portal of Exit • Transmission • Direct transmission • Indirect transmission • Portal of entry • Penetration of the skin • Inhalation • Ingestion • New host • Breaking the Chain © 2008 McGraw-Hill Companies. All Rights Reserved.

3. Body’s Defense System • Physical and Chemical barriers • Skin, mucous membranes, respiratory tract • The Immune System • Immunological Defenders • Neutrophils • Macrophages • Natural killer cells • Dendritic cells • Lymphocytes • T-cells • Helper, Killer, and Suppressor • B-cells • Antibodies • Memory T and B cells © 2008 McGraw-Hill Companies. All Rights Reserved.

4. The Inflammatory Response • Histamine. • Dilation of blood vessels, heat, redness, and swelling. • The immune response • Phase 1 – Dendritic cells are drawn to the site • Phase 2 – Helper T cells multiply • Production of Killer T and B cells • Cytokines – chemical messengers • Phase 3 – Killer T cells strike • Cell-mediated immune • Anti-body mediated immune response • Phase 4 – Last Phase – • Suppressor T-cells • Slow down activity © 2008 McGraw-Hill Companies. All Rights Reserved.

5. The Immune Response © 2008 McGraw-Hill Companies. All Rights Reserved.

6. Immunity • An infected person will never get the same illness again. • Lymphocytes create amplification of the immune response are reserved by memory T and B cells • Symptoms and contagion • Incubation – viruses are multiplying in the body or when bacteria are actively multiplying • Will not feel symptoms until the second or third phase of the immune response cycle • Prodromal period – the infected host has acquired immunity © 2008 McGraw-Hill Companies. All Rights Reserved.

7. Immunization • The process of ‘priming’ the body to remember an encounter with a specific antigen. • Types of vaccines • VACCINE- Introduction of a killed or weakened pathogen to stimulate the body to produce antibodies. (active immunity). • PASSIVE IMMUNITY- Injection of antibodies produced by other human beings or animals. © 2008 McGraw-Hill Companies. All Rights Reserved.

8. Allergy: The Body’s Defense System Gone Haywire • Allergies • Allergens • Pollen, Dander, Dust mites, Molds, Food, Insects • The Allergic response • Immunoglobulin (IgE) • Anaphylaxis • Dealing with Allergies • Avoidance • Medication • Immunotherapy © 2008 McGraw-Hill Companies. All Rights Reserved.

9. © 2008 McGraw-Hill Companies. All Rights Reserved.

10. The Troublemakers: Pathogens and Disease • Bacteria – Microscopic single celled organism • Pneumonia • Meningitis • Strep Throat and other streptococcal infections • Toxic shock and other staphylococcal • Tuberculosis • Lyme Disease and other tickborne infections • Ulcers • Other Bacterial infections • Tetanus • Pertussis • Urinary tract infections © 2008 McGraw-Hill Companies. All Rights Reserved.

11. Antibiotic Treatment • Actions of Antibiotics • Antibiotic resistance • Proper antibiotics usage • Don’t take an antibiotic every time you are sick • Use antibiotics as directed • Never take an antibiotic without an prescription © 2008 McGraw-Hill Companies. All Rights Reserved.

12. Pathogens • Viruses – (parasites – take what they need) • Common Cold • Influenza • Measles, Mumps and Rubella • Chickenpox, Cold Sores, and other herpes-virus infections • Herpes simplex virus (HSV) types 1 and 2 • Epstein-Barr virus (EBV) • Viral Hepatitis • Human Papillomavirus (HPV) • Treatment © 2008 McGraw-Hill Companies. All Rights Reserved.

13. Pathogens • Fungi – • Primitive plant – Yeast infections, athletes foot, and ringworm • Candida albicans • Protozoa – • Microscopic single-celled animal – Malaria, African sleeping sickness, Giardiasis, Tricomonias, Trypanosomiasis, and Amoebic dysentary. • Parasitic worm – • Largest organism that can enter the body – Tapeworm, Hookworm, and Pinworm. • Prions - • Fetal degeneration disorders of the CNS, linked to “proteinaceous infectious particles. • Lack DNA and RNA © 2008 McGraw-Hill Companies. All Rights Reserved.

14. Emerging Infectious Diseases • Selected Infections of concern • West Nile virus • Severe acute respiratory syndrome (SARS) • Rotavirus • Escherichia coli • Hantavirus • Ebola © 2008 McGraw-Hill Companies. All Rights Reserved.

15. Factors Contributing to Emerging Infections • Drug Resistance • Poverty • Breakdown of public health measures • Environmental changes • Travel and Commerce • Mass food production and distribution • Human behaviors • Bioterrorism © 2008 McGraw-Hill Companies. All Rights Reserved.

16. How to Support Your Immune System • How to support your immune system • Public Health • Taking care of yourself • Nutrition • Exercise • Rest • Moderation of Lifestyle • Controlling Stress © 2008 McGraw-Hill Companies. All Rights Reserved.

17. Sexual Transmitted Diseases The United States has the highest rate of Sexual Transmitted Diseases of any developed nation © 2008 McGraw-Hill Companies. All Rights Reserved.

18. The Major STDS(STD’s) • Seven different STDs pose major health threats • HIV/AIDS • Hepatitis • Syphilis • Chlamydia • Gonorrhea • Herpes • HPV © 2008 McGraw-Hill Companies. All Rights Reserved.

19. Acquired Immunodeficiency Syndrome (AIDS) • Leading cause of death in many parts of the world. • Worldwide, AIDS is the leading cause of death for people age 15-59 • Approximately 65 Million people around the world are infected with Human Immunodeficiency Virus (HIV). • More than 25 million have died worldwide • Human immunodeficiency virus (HIV) is the virus which causes AIDS. © 2008 McGraw-Hill Companies. All Rights Reserved.

20. Approximate number of people living with HIV/AIDS in 2006 © 2008 McGraw-Hill Companies. All Rights Reserved.

21. HIV Infection and AIDS • By 2004, an estimated 1,000,000 Americans were believed to be living with HIV, with an estimated annual incidence of 40,000 cases • Estimated 1.5 million Americans have died • 2006, researchers discovered a group of chimpanzees in Cameroon that carry SIVspc • 1930s Genetic evidence shows that SIV first spread to humans • What is HIV Infections? • HIV attacks and invades CD4 T-cells, monocytes and macrophages. • AIDS opens the possibility for a opportunistic infections. • Once initial symptoms resolve, the asymptomatic period may last from 2 to 20 years. © 2008 McGraw-Hill Companies. All Rights Reserved.

22. Transmitting the Virus • HIV lives only within cells and body fluids. • 3 primary means of transmission are: (1)Specific kinds of sexual contact, (2) direct exposure to infected blood, and (3) HIV-infected women to her fetus. • Sexual contact • Direct contact with infected blood. • Mother-to-Child transmission. • Not through casual contact. © 2008 McGraw-Hill Companies. All Rights Reserved.

23. Populations of Special Concern for HIV infection • Most common exposure has been sexual activity between men; injection drug use, and heterosexual contact. • African American men and women are vastly overrepresented among people newly diagnosed with AIDS. • See “HIV/AIDS Among African Americans and Latinos” © 2008 McGraw-Hill Companies. All Rights Reserved.

24. © 2008 McGraw-Hill Companies. All Rights Reserved.

25. Symptoms of HIV Infection • Few days or weeks, half the people will develop (Flu like symptoms) • Fever, fatigue, rashes, headache, swollen lymph nodes, body aches, night sweats, sore throat, nausea and diarrhea. • Specialized test HIV RNA assay. • Pneumocystis Carinii pneumonia (protozoal infection). • Kaposis sarcoma. • Difficult to treat yeast infections in women • Tuberculosis © 2008 McGraw-Hill Companies. All Rights Reserved.

26. Diagnosing HIV Infection and AIDS • Most common is tests for the presence of antibodies to the virus. • HIV antibody test • ELISA (first test) if positive then the. • Western blot (second test) • IF HIV-positive then check the status of the CD4-t cells. • New diagnostic test – HIV Replication Capacity. © 2008 McGraw-Hill Companies. All Rights Reserved.

27. Diagnosing HIV Infection and AIDS • Treatment (NO CURE). • Antiviral drugs. • Reverse transcriptase inhibitors. • Zidovudine (AZT). • Protease inhibitors. • Highly active antiretroviral therapy (HAART). • Structured intermittent therapy. • Fusion inhibitors • Enfuvirtide (Fuzeon) • Inhibit the fusion of viral and cell membranes • Post-Exposure prophylaxis. • Treatment for opportunistic infections. • HIV and Pregnancy © 2008 McGraw-Hill Companies. All Rights Reserved.

28. © 2008 McGraw-Hill Companies. All Rights Reserved.

29. Prevention • Make careful choices about sexual activity. • Do Not share drug needles. • Participate in an HIV educational program. © 2008 McGraw-Hill Companies. All Rights Reserved.

30. Chlamydia Trachomatis • Most prevalent bacterial STD in the U.S. • Bacterial infection - • Can cause sterility in men and women • WOMEN infects the cervix and to urethra, fallopian tubes & ovaries, PID, bladder infections. • MEN- Epididymitis, urethra to testes, urethritis, bladder infections, watery discharge. • Symptoms –ASYMPTOMATIC :Discharge, pain and burning while urinating, vaginal bleeding, painful intercourse, abdominal pain, nausea, fever, inflammation of rectum or cervix, swelling and pain in the testes. © 2008 McGraw-Hill Companies. All Rights Reserved.

31. Chlamydia Trachomatis • Spread - vaginal and anal intercourse, from the birth canal to the fetus • Diagnosis - Examination of tissue samples or urine • Treatment - Both partners treated fully with antibiotics • Protection © 2008 McGraw-Hill Companies. All Rights Reserved.

32. Gonorrhea • 700,000 new cases every year in the U.S. • Bacterial infection -Can cause sterility, arthritis and heart problems • PID, can cause ectopic pregnancy, premature labor and still birth, arthritis, rashes • Symptoms – • Women - Asymptomatic - Frequent burning urination, menstrual irregularities, pelvic pain, discharge. • Males – thick yellow-white discharge, painful urination. © 2008 McGraw-Hill Companies. All Rights Reserved.

33. Gonorrhea • Spread - Vaginal, anal and oral sex. • Diagnosis - Microscopic exam of discharge. • Treatment - Oral antibiotics - People often have chlamydia at same time. • Protection © 2008 McGraw-Hill Companies. All Rights Reserved.

34. Pelvic Inflammatory DiseasePID • Progressive infection that harms a women’s reproductive system. Can lead to sterility, ectopic pregnancy and chronic pain - treated or not. • Caused by chlamydia and gonorrhea. • Symptoms - long and painful periods, discharge, spotting, low abdominal pain, fever, chills, nausea, vomiting, pain during intercourse. © 2008 McGraw-Hill Companies. All Rights Reserved.

35. Pelvic Inflammatory DiseasePID • Treatment - Antibiotics, bed rest, sexual abstinence and maybe surgery to remove scarring • Diagnosis - Pelvic Exam, cultures, laparoscopy • Protection © 2008 McGraw-Hill Companies. All Rights Reserved.

36. Human Papillomavirus Infection • More than 80% of sexually active individuals will have been infected with HPV by the age of 50. • Symptoms • Small bump on the skin or a large, warty growth • Cauliflower-like mass • May cause irritation and bleeding • How is it spread • Diagnosis • Appearance of the lesions • Women who are positive should have a Pap test very 12 months • Treatment • Removed by cryosurgery, electrocautery or laser surgery • Protection © 2008 McGraw-Hill Companies. All Rights Reserved.

37. Genital Herpes • 45 million have been diagnosed • Two forms - Herpes simples virus-1 and -2. • Type 1 is associated with cold sores and fever blisters. • 50-80% of U.S. adults have anitibodies to HSV-1 • Both are sexually transmitted. • Remains in the body for life. • Symptoms – 90% have no symptoms • Recurring rash, pain ulceration's. • Primary outbreak - pain and discomfort around infected area, itching, burning during urination. • 2-20 days after infection - may years before outbreak. © 2008 McGraw-Hill Companies. All Rights Reserved.

38. Genital Herpes • Spread - Touching, sexual intimacy - including kissing, vaginal, oral and anal sex • Diagnosis - Examination of sores and culturing of fluid taken from sores • Treatment - No cure - symptoms are relieved by drugs • Protection - Refrain for sex during out break • HSV-1 and 2 can cause miscarriages or still births along with serious health issues of newborns © 2008 McGraw-Hill Companies. All Rights Reserved.

39. Hepatitis B Virus (HBV) • Can cause liver disease and death • Preventable with vaccination. • 750,000 total acquired sexually • Transmission - Semen, saliva, blood and urine • Symptoms - Extreme fatigue, headache, fever, hives, lack of appetite, nausea, vomiting, tenderness in lower abdomen • Diagnosis and Treatment • Blood Test • No cure • Prevention © 2008 McGraw-Hill Companies. All Rights Reserved.

40. Syphilis • Syphilis organism remains in the body for life and leads to disfigurement, neurological disorders, or death. • Effective antibiotics and condom use. • Symptoms – • Primary phase- 3 weeks - 90 days - painless sores and wet ulcers (chancre) and swollen glands. • Secondary Phase - 3-6 weeks - up to 2 years body rash, mild fever, fatigue, sore throat (Flu like symptoms), and hair loss. • Late phase (tertiary)- Damage to organs and nervous system. © 2008 McGraw-Hill Companies. All Rights Reserved.

41. Other STD’s • Trichomoniasis • Bacterial vaginosis (BV) • Pubic Lice • Scabies © 2008 McGraw-Hill Companies. All Rights Reserved.

42. What You Can Do • Education. • Diagnosis and Treatment • Get vaccinated • Be alert for symptoms • Get tested • Inform your partners • Get Treated • Prevention • Use a barrier defense. • Know your potential partner. • Ask. Are you ready to have sex? © 2008 McGraw-Hill Companies. All Rights Reserved.

43. Immunity and Infection Chapter 13