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INTRODUCTORY LECTURE

INTRODUCTORY LECTURE. Associate professor D.V. Katsapov. KHARKIV NATIONAL MEDICAL UNIVERSITY DEPARTMENT OF INFECTIOUS DISEASES. INFECTOLOGY science about infection. Parts : MICROBIOLOGY, VIROLOGY - is science about the pathogens.

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INTRODUCTORY LECTURE

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  1. INTRODUCTORY LECTURE Associate professor D.V. Katsapov KHARKIV NATIONAL MEDICAL UNIVERSITY DEPARTMENT OF INFECTIOUS DISEASES

  2. INFECTOLOGY science about infection • Parts: • MICROBIOLOGY, VIROLOGY - is science about the pathogens. • EPIDEMIOLOGY - is science about reasons of origin and routs of transmission of infectious agents • INFECTIOUS DISEASES • clinical symptoms, • diagnostics, • diff. diagnostics, • treatment

  3. PANDEMICS FACTSHEET • 1st recorded pandemic of plague : in A.D. 542 in Egypt and Ethiopia;. killed 100 million people. • 2nd great plague pandemic 14th century in Europe, Central Asia, the North East, India, and China. 25 million people in Europe alone died. • 3rd plague pandemic began in Burma in 1894; spread to China and North America. • MODERN ERA • AIDS pandemic. HIV has infected more than 60 million men, women and children and AIDS has cost the lives of nearly 20 million adults and children. Despite the intense international response to the HIV/AIDS pandemic, HIV continues to spread, causing more than 14,000 new infections every day, 95% of these are in the developing world. (WHO review 2011) • Influenza (H1N1) pandemic 2009

  4. Present days • The 2014 Ebola outbreak is one of the largest Ebola outbreaks in history and the first in West Africa. It is affecting four countries in West Africa: Guinea, Liberia, Nigeria, and Sierra Leone; • It is reported 3069 suspect and confirmed cases of EVD, including 1752 laboratory-confirmed cases, and 1552 deaths.

  5. NEGLECTED TROPICAL DISEASES (NTDS) • The neglected tropical diseases (NTDs) represent a group of more than a dozen major chronic infectious diseases, most of them parasitic infections, with high endemicity in the developing countries of Africa, Asia, and the Americas. • The conceptual framework of the NTDs was formulated in the years following the 2000 launch of the Millennium Declaration

  6. Ranking of NTDs by Disease Burden (DALYs) and Comparison with HIV/AIDS, Tuberculosis, and Malaria. Hotez PJ, Bottazzi ME, Franco-Paredes C, Ault SK, et al. (2008) The Neglected Tropical Diseases of Latin America and the Caribbean: A Review of Disease Burden and Distribution and a Roadmap for Control and Elimination. PLoS Negl Trop Dis 2(9): e300. doi:10.1371/journal.pntd.0000300 http://www.plosntd.org/article/info:doi/10.1371/journal.pntd.0000300

  7. The Major NTDs in India and South Asia Ranked by Prevalence. Lobo DA, Velayudhan R, Chatterjee P, Kohli H, et al. (2011) The Neglected Tropical Diseases of India and South Asia: Review of Their Prevalence, Distribution, and Control or Elimination. PLoS Negl Trop Dis 5(10): e1222. doi:10.1371/journal.pntd.0001222 http://www.plosntd.org/article/info:doi/10.1371/journal.pntd.0001222

  8. MENA countries with the highest prevalence of NTDs. Hotez PJ, Savioli L, Fenwick A (2012) Neglected Tropical Diseases of the Middle East and North Africa: Review of Their Prevalence, Distribution, and Opportunities for Control. PLoS Negl Trop Dis 6(2): e1475. doi:10.1371/journal.pntd.0001475 http://www.plosntd.org/article/info:doi/10.1371/journal.pntd.0001475

  9. History of department of infectious diseases of KHNMU - founded in 1923 on the base of infectious department of the Kharkov military hospital (Sq. of Rudnev, 14), 55 beds . Professor Z. Nesmelova Headed 1923-1931 Professor I. R. Braude Headed 1932-1958 Professor Т. Т. Chorna Headed 1969-1991 Professor V. N. Kozko 1992 г.

  10. FORMS OF INFECTIOUS PROCESS • Inapparent form– absence of clinical symptoms • Reinfection – repeated infection • Superinfection– infection with new agent on current of infectious disease • Endogenous infection • Exacerbation– repeated deterioration • Relapse – recurrence of symptoms after apparent recovery • Complication – (specific, nonspecific)

  11. SPECIFIC PROPERTIES OF PATHOGENIC MICROORGANISMS

  12. SPECIFIC PROPERTIES OF PATHOGENIC MICROORGANISMS • INFECTIVITY, VIRAL • - ATTACHMENT; • - ENTRY; • - TRANSCRIPTION; • - TRANSLATION; • INCLUSIONS; • REDUSED HOST CELL FUNCTION; • CELL INJURY, LYSIS, DEATH • LATENCY • NEOPLASM

  13. NON-SPECIFIC PROTECTIVE MECHANISMS Undamaged skin and mucosal layer Secretion of fatty and sweat glands lysozyme Secretory Ig A Phagocytes Normal microflora Acid gastric medium cilia of respiratory mucosa hematoencephalic barrier Enzymes (hydrolase) interferon lymphoquin prostaglandin System of compliment Non-specific inflammation Excretory system

  14. SCHEME OF PHAGOCYTOSIS

  15. CYTOKINE • Family of polypeptide hormone-like macromolecules with short life period, synthesized and by excreted by cells, with messenger functions and providing cellular integration and differentiation, regulation of growth, apoptosis and other functions. • IL– interleukin; • INF – interferon; • TNF– tumor necrosis factor; • CSF – colony stimulating factor; • CHC – chemokine. • For today it is identified more than 100 cytokines

  16. HUMAN IMMUNE RESPONSE SYSTEM • NATURAL FACTORS (nonspecific) 4-5 hrs Cellular:macrophages, neutrophils, NK-cells; Humoral:IgG (natural), compliment etc. • EARLY INDUCTABLE ANSWER, 96 hrs Cellular:NK-cells, macrophages, neutrophils; Humoral:IL, CSF, TNF. • SPECIFIC ADAPTIVE ANSWER Cellular:lymphocytes, macrophages; Humoral:specific antibodies IgМ, IgG, cytokines. Major histocompatibility complex – HLA; Th1 – cellular:γ-INF, NK, CD8; Th2 – humoral: IL- 4, 5, 6, 10.

  17. CLASSIFICATION OF INFECTIOUS DISEASES

  18. PECULIARITIESOF INFECTIOUS DISEASES • Connection with specific pathogen, • Contagiousness, • Epidemic spread • Exacerbations, relapses, chronic course • Immune reactions, formation of specific immunity • Carriage of infection • Cyclic clinical course • Incubation period • Prodromal period • Climax • Convalescence

  19. CLINICAL PECULIARITIES OF INFECTIOUS DISEASES • General intoxication, • Fever(duration, character) • Febriscontinua • Febrisremittens • Febrisintermittens • Febrisreccurens • Febrishectica • Febrisundulans • Febrisirregularis • CNS affection, meningeal syndrome, • Affection of skin and mucous membranes (exanthema, enanthema), • Joints affection, • Lymphadenopathy, • Catarrhal and respiratory syndrome, • CVS affection, • Dyspeptic syndrome, • Hepatolienal syndrome.

  20. LABORATORY INVESTIGATION • ANAMNESIS OF DESEASE (A. morby) • EPIDEMIOLOGICAL ANAMNESIS (A. epidemica) • PHISICAL EXAMINATION • LABORATORY INVESTIGATION • Mycroscopy • Culturing • Immunological (serological) • Biochemical • Imaging • Molecular genetic (PCR)

  21. TREATMENT • ANTIBIOTICS • Sensitivity • Dosage, concentration • Method of administration, • Side effects • Scheme and duration • Stable concentration • ANTIVIRAL DRUGS • ANTI PROTOZOAL DRUGS

  22. TREATMENT • SPECIFIC IMMUNOTHERAPY • immunoglobulin • Gamma - globulin • Blood serum • Immune serum (antitoxic, antimicrobial) • NONSPECIFIC IMMUNOTHERAPY • Immunostimulant • Immunosupressor • Interferon, inductors • Human immunoglobulin

  23. TREATMENT • DEZINTOXICATION (PO, IV) • Colloid solutions • Sorbents • REHYDRATION (PO, IV) • Polyionic crystalloid solutions • DESENSIBILIZATION • DYSBIOSIS CORRECTION • ENZYMES • VITAMINS • SYMPTOMATIC TREATMENT

  24. PROPHYLAXIS • SPECIFIC IMMUNOPROFILAXIS • Vaccines (active) • Primary (toxoids, pertussis, polio, hepatitis B, haemophilus influenzae type B, MMR) • With special indications (influenza, meningococcal) • Specific antisera (passive) • normal human immunoglobulin • hyperimmune serum • animal sera • NONSPECIFIC IMMUNOPROFILAXIS • Immunostimulant • Interferon, inductors

  25. THANK YOU FOR ATTENTION!

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