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CHAIN OF INFECTION

CHAIN OF INFECTION. STI POINT OF VIEW. Chain of Infection . Vector – infected person Pathogen – Bacteria or Virus Reservoir – where “it lives” Portal of Exit – Mode of Transmission Portal of Entry Susceptible Host. Vector: Person with STI. Considerations Behavior of the person

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CHAIN OF INFECTION

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  1. CHAIN OF INFECTION STI POINT OF VIEW

  2. Chain of Infection • Vector – infected person • Pathogen – Bacteria or Virus • Reservoir – where “it lives” • Portal of Exit – • Mode of Transmission • Portal of Entry • Susceptible Host

  3. Vector: Person with STI • Considerations • Behavior of the person • Precautions • Number of partners • Stage of infection • Active • Latent

  4. Reservoir Virus Bacteria Mucous Membranes Throat Vagina Urethral opening of Penis Anus/Rectum Infected Secretions Vaginal fluids Cervical Fluids Semen Pre-ejaculate • Skin • HPV lives in skin cells • Nerve Endings • Herpes Simplex 2 lives in nerve endings • Blood • HIV • Hepatitis B • (greater concentrations, more infectious than HIV) • Semen – HIV, HBV • Vaginal fluids -- ditto • Cervical fluids -- ditto

  5. Infectious Agent • Virus • HIV • Herpes Type 2 (genital) • Human Papilloma Virus • Hepatitis B Virus • Bacteria • Chlamydia • Gonorrhea

  6. Portal of Exit Virus Bacteria Contact with other mucous membrane Gonorrhea Chlamydia Syphilis • Through shedding of infected skin cells • Herpes • HPV • Released in body fluids • HIV • HBV

  7. Mode of Transmission Virus Bacteria Oral sex Gonorrhea Chlamydia Put in throat by penis Intercourse – Anal and Vaginal Either partner Gonorrhea Chlamydia Infected mucous membranes rub • Intercourse – Anal and Vaginal • Receptive partner • HIV • HBV • Frottage – Rubbing • HPV • Herpes

  8. Portal of Entry Virus Bacteria See portal of exit • See portal of exit • Immune cells at top levels of mucous membranes • HIV • Wall of colon or rectum and micro-tears • HIV • Mucous Membrane of vagina • Cervix

  9. Susceptible Host Viral Bacteria Uninfected Person Never infected before Infected before but treated and cured Can get infected again and again and again… • Uninfected Person • No Immunity • From having the infection before • From getting the antibodies from another person • From vaccination • Immune system stressed • Not taking preventive drugs • HIV – • Pre Exposure Prophylaxis • Social and sexual networks

  10. Breaking the chain

  11. Vector Control • Behavior Modification • Social Support • Address Social Determinants – Quality of Life • Medical Treatment • Patient Education

  12. Reservoir Virus Bacteria Drain the reservoir Antibiotics will rid of infection • Dry up the reservoir by using • Anti-Viral Drugs • Reduce viral activity • Less infectious

  13. Portal of Exit Virus Bacteria Condoms! Anti-Microbials -- ?? NOT spermcides… • Condoms! • Anti-Microbials (under investigation) • Microbicides link

  14. Mode of Transmission Virus Bacteria ABSTAIN until symptoms are cleared Condoms! OUTERcourse!!! • Intercourse – Anal and Vaginal • OUTERcourse!!! • Receptive partner • HIV • HBV • Frottage – Rubbing • HPV • Herpes • ABSTAIN during outbreak

  15. Portal of Entry Virus Bacteria Condoms! • Condoms!

  16. Susceptible Host Viral Bacteria Get Tested Women under 25 who have sex (yearly for Chlamydia) MSM – every six months to one year Every 3 months for syphilis in bigger cities. Get Told (you’ve been exposed) • Get Tested • Get Vaccinated! • Hepatitis B • HPV • Prevention for High Risk • Anti-Viral PrEP (HIV) • Pre • Exposure • Prophylaxis • Truvada • Work with specialist • Monthly check ups • Work toward risk reduction

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