The state of complete physical, mental and social well beings is called health.

Health simply does not simply

means disease free condition or physical fitness. Health is affected by-
a. Genetic disorders – the defect which child inherits from it parents.
b. Infection from microbes or other organisms.
c. Life style- includes food and water we take, exercise and rest.
Good health can be maintained by

 Balanced diet.

 Personal hygiene

 Regular exercise

 Awareness about the disease and their effect

 Immunization against the infectious disease

 Proper disposal of wastage

 Control of vectors

 Maintenance of hygienic food and water.

PATHOGENS :
A pathogen is an infectious agent that causes a disease or illness to its host.
It disrupts the normal physiology of organisms, either plants or animals and expresses a number of
symptoms.
The human body contains many natural defence mechanisms against some common pathogens.
A pathogen may be described in terms of its ability to produce toxins, enter tissues, colonize and share
nutrients and its ability to induce immunosuppression in the host.
Major classes of pathogenes are described below :
Viruses - adenovirus, picorna virus, retro virus, papovavirus,polyoma virus etc.
Bacteria - mycobacterium, streptococcus, shigella and salmonella.
Fungi - saprophytic pathogenic fungi.
Prions - protein pathogens that do not contain nucleic acids.
Parasites - protozoon parasites and helminth parasites.
Disease - Diseases can be broadly grouped into infectious and non-infectious.

a) Infectious disease -Diseases which are easily transmitted from one person to another, are called
infectious diseases e.g AIDS, common cold, malaria, tuberculosis etc
b) Non-infectious disease – Diseases which cannot transmitted from one person to another, are called
non- infectious diseases e.g cancer, hypertension, diabetes etc.

1. Acquired diseases - Acquired diseases occur only after birth. These may be either communicable or non-
communicable.
(a) Communicable diseases - These are infectious and spread from infected persons to healthy persons
through pathogens.
Communicable diseases may be contagious or non-contagious.
Contagious diseases are transmitted through contact. e.g. syphilis, chicken pox, measles and leprosy.
Non-contagious diseases are transmitted through agencies like water, air, food and vector organisms.
(b) Non communicable diseases - It doesn’t spread from person to person. These are of four types:
(i) Degenerative diseases - These occur due to degenerative changes in some vital organs. (e.g.,
Cardiovascular diseases, Brain diseases, arthritis etc.).
(ii) Deficiency diseases - These are caused due to deficiencies in food or hormone. [e.g., Kwashiorkor
(Protein deficiency), Pellagra (Vitamin-B5 deficiency), Goitre (Iodine deficiency), Diabetes mellitus
(Insulin deficiency).
(iii) Cancer - These are caused by several physical and chemical agents, collectively known as cancer
causing agnets or carcinogens.
(iv) Allergy - These are caused by several allergens (foreign substances). e.g., asthma.
2. Congenital diseases - These are inherited genetic disorders. e.g. colour blindness.
Common Diseases in Humans:

 The disease causing microorganisms like bacteria, virus, fungus, protozoa, helminthes are called
pathogen.
 The pathogen can enter the body by various means and multiply and interfere with normal vital
activities resulting in morphological and functional damage.

Typhoid

Typhoid fever (enteric fever) is a life-threatening disease caused by the bacterium, Salmonella typhii.
it affects about 21.5 million persons every year (1 million in India).
Patients with acute typhoid fever may contaminate the surrounding water through defaecation.
The bacterium multiplies in the gall bladder, bile ducts and liver and passes into the bowel. The bacteria can
survive for weeks in water or dried sewage.
Symptoms :
The incubation period is usually 1 to 2 weeks and the duration of illness is about 4 to 6 weeks. The patient
experiences :
 Poor appetite
 Abdominal pain
 Headache
 Generalised ache and pain
 Lethargy
 Intestinal bleeding or perforation after two to three weeks of infection
 Diarrhoea or constipation
Fever may sustain for 103-104 degree F.
Rose spots on the abdomen of a person with typhoid fever may appear.
Chest congestion develops in many patients, and abdominal pain and discomfort are common.
Typhoid is diagnosed by WIDAL TEST. From third weeks onward patient feels better.
Treatment
Typhoid fever is treated with antibiotics.
Reduced susceptibility to fluroquinolones (e.g. ciprofloxacin) and the emergence of multi-drug resistance
has complicated the treatment procedure, especially in those who have acquired infection from South Asia.
Persons who donot get treatment may continue to have fever for weeks or months and as many as 20% may
die from complications of the infection.
Prevention and control
There are several ways one can practice to avoid typhoid bacteria contraction.
 Avoid apparently contaminated food and drink.
 Get vaccinated against typhoid fever.
 Drink packaged water or boiled water brought to room temperature. Bottled carbonated water is
proved to be safer than uncarbonated water.
 Drinks used without ice unless the ice is made from bottled or boiled water.
 Eat food that has been thoroughly cooked and that is still hot and steaming.
 Raw vegetables and fruits may be washed properly and then peeled.
 Avoiding street food, because these are contaminated through air and water.
Typhoid fever vaccines present. There are two types of vaccines :
1. Vi antigen vaccine - It is an inactivated vaccine available in injectable form. Vi antigen vaccine is given
in a dose of 0.5 ml. intramuscularly as a single dose.
2. Oral ty21a vaccine - This is an oral live vaccine. It is a course of three capsules given orally on alternate
days. The capsule should be swallowed intact and not opened or chewed Liquid form of vaccine more
effective than the capsule form.
For a long-term protection one has to revaccinate every 3 years.

Pneumonia

Pneumonia is a lung infection accompanied by cough, fever and difficulty in breathing, may be
inflammation in the air sacs and fluid may accumulate.
It often clears up in 2 to 3 weeks.
Old persons, babies and people with other diseases may become seriously ill.
More than 10 million cases have been documented every year in India.
Pneumonia may be caused in the daily life, called community-associated pneumonia, while in a hospital or
nursing home, called healthcare-associated pneumonia.
Causes
Pathogens like bacteria and viruses usually cause pneumonia.
Patients may be more likely to be infected following a cold or flu.
These illnesses make it difficult for the lungs to fight infection, so it is easier to cause pneumonia.
With a long-term or chronic, disease like asthma, heart disease, cancer or diabetes also likely to get
pneumonia.
Symptoms :
1. Cough - secrete much mucus (sputum) from the lungs, it causes irritation leading to severe coughing.
Mucus may be rusty or green or with blood.
2. Fever.
3. Feeling of breathlessness.
4. Severing as though there is a chilled ambience.
5. Chest pain feels pain when one coughs or breaths.
6. Fast heart beat
7. Feeling extremely tired and weak
8. Nausea and vomiting
9. Diarrhoea
Diagnosis :
Primarily, a physical examination is conducted.
Patient undergo chest xray and a blood test. In an extreme case, the mucus
from the lungs may be pathologically examined to find out presence of causative pathogens.
Treatment :
If diagnosed to be caused by bacteria, antibiotics are prescribed.
One needs to take the full course of the prescribed antibiotics. Plenty of rest, sleep and intake of rehydration
drink are required. Smoking is totally prohibited.
If caused by a virus usually is not treated with antibiotics. Sometimes antibiotics may be used to prevent
complications.
But more often rest and treating cough with conventional medicines work.

Common Cold / Rhinitis :

It is one of the most common infectious diseases of human, caused by about 200 types of Rhino viruses and
a small bacterium, Dialister pneumosintes.
They infect nose and upper respiratory passage causing inflamation of mucus membranes. There is
inflammation of the nasal tract, nasal congestion, flow of mucus, sneezing, sore throat, hoarseness, cough,
tireness, headache and slow fever.
Some persons also suffer from allergic rhinitis.
Common cold spreads through oozing droplets from talking and sneezing, direct contact, hand shake and
using common articles like pen, pencil, books, cups, door handles, computer key boards, computer mouse
etc. It cures automatically after 3- 7 days.
Medicines are taken to reduce severity of nasal irritation and clearing the nasal tract.

Malaria

In india annually 5 lakhs peoples die due to this.

Malaria is caused by a protozoon parasite, Plasmodium, which is transmitted by a vector; female anopheles
mosquito.
The parasite was first discovered by Charles Laveran (1880). Sir Ronald Ross, a doctor in the India army,
first observed oocysts of Plasmodium in female Anopheles.
Symptoms
Clinical symptoms of the disease are chill, fever with period of latency, enlargement of spleen and
secondary anaemia. A typical attack of malaria comprises three successive stages.
(a) Cold stage or Rigor stage : The fever comes with rigor and sensation of extreme cold, which lasts from
15 minutes to an hour.
(b) Hot stage or Febrile stage : The temperature of the body increases to 106° F, which lasts for about 2 to
6 hours, associated with intense headache.
(c) Sweating stage or Defervescent stage : Fever comes down with profuse sweating, which lasts for 2 to 4
hours.
Life Cycle :
Malarial parasite is a digenetic parasite and has two cycles of development.
Its asexual cycle takes place in human, which is the primary host and sexual cycle takes place in the
intermediate host, female anopheles mosquito.
Human Cycle :
Infective form of Plasmodium is known as sporozoites. Sporozoites are 11-12µ long slender, uni-nucleated.
Sickle-shaped structure present in the salivary glands of infected mosquito. When an infected female
Anopheles mosquito bites a healthy man, a large number of sporozoites enter into the blood stream of man.
Within half an hour, sporozoites enter the liver cells and undergo asexual multiplication called schizogony.
1. Asexual Schizogony:-
Schizogony is the asexual phase of reproduction of Plasmodium. It takes place in liver cells and RBC’s of
man. Schizogony can be divided into following phases:
a) Pre-erythrocytic schizogony
b) Exo-erythrocytic schizogony
c) Erythrocytic schizogony
d) Post- erythrocytic schizogony
a. Pre-erythrocytic schizogony:
In the liver cells, sporozoites grow to form a large and spherical schizont. Schizont divides by multiple
fission and forms a large number of cryptozoites. They may either pass into the blood circulation to start
erythrocytic schizogony or enter fresh liver cells to start Exo-erythrocytic schizogony. Pre-erythrocytic
schizogony takes 8 days to complete.
b. Exo-erythrocytic schizogony:
After re-entering fresh liver cell each cryptozoites divides to form a large number of metacryptozoites
similar to pre-erythrocytic schizogony.
Meta-cryptozoites are two types:
Smaller micro-metacryptozoites and larger macro-metacryptozoites. The micro-metacryptozoites enter the
RBC’s to start erythrocytic schizogony, while the macro-metacryptozoites invade fresh liver cells to
continue exo-erythrocytic schizogony. It takes normally 4 days to complete.
c. Erythrocytic schizogony:-
As stated above, the erythrocytic schizogony begins when the RBC’s of blood are attacked either by pre-
erythrocytic cryptozoites or by exo-erythrocytic micro-metacryptozoites. It takes normally in 8 to 12 days
after above 2 phases. Stages of erythrocytic schizogony are:
i. Trophozoite Stage:-
The merozoites (cryptozoites and micro- metacryptozoites) after entering into the blood stream, feed on
erythrocytes, become rounded and modify into trophozoite.
ii. Signet Ring Stage:-
As the merozoites grow a vacuole appears in the center and the nucleus is pushed to one side. It gives a ring
like appearance and known as signet ring stage.
The parasite ingests haemoglobin and decomposes it into protein and haematin. Protein is use as food
whereas unused haematin forms toxic. Yellowish brown malarial pigment, haemozoin.
iii. Amoeboid Stage: –
As the signet ring parasite grows, vacuole disappears and the parasite becomes amoeboid in appearance,
thrusting out pseudopodial processes. This stage is called amoeboid stage. At this stage RBC develops
numerous granules, the Schuffner’s granules.
iv. Schizont Stage:-
Parasite grows in size, becomes rounded and almost completely fills the RBC called Schizont.
v. Rosette Stage:-
The nucleus of schizont divides by multiple fission to form 6 to 24 daughter nuclei. These nuclei arrange at
the periphery, while the toxic haemozoin granules accumulate at the center of RBC. It appears as a flower
rose, so called rosette stage.
Nuclei of rosette stage are surrounded by a little cytoplasm and are develop into merozoites. With the
rupture of the RBC, these merozoites are liberated into the blood plasma along with toxic haemozoin. These
normally attack fresh RBC’s to repeat the erythrocytic cycle or may change into gametocytes. One complete
erythrocytic cycle takes 48 hours in Plasmodium vivax.
d. Post-erythrocytic schizogony:-
Sometimes, some merozoites produced in erythrocytic schizogony reach the liver cells and undergo
schizogony development in liver cells. This is called post-erythrocytic schizogony.
2. Sexual Gamogony:-
Formulation of gametocytes:
After many generations in about 4-5 is the blood some merozoites increase in size to form two types of
gametocytes; larger macro (9-10µ), less numerous and contain large nucleus. Macro gametocytes are larger
(10-12µ), more numerous and contain smaller nucleus.
Mosquito cycle : When a female Anopheles sucks the blood of a malaria patient, the gametocytes reach the
stomach of mosquito and formation of gametes take palace as follows:
a. Gametogenesis (gemetogony) :
i. Formulation of male gametes:
The nucleus of microgametocyte divides to form 6-8 daughter nuclei. The cytoplasm gives out same number
of flagella like projections and daughter nuclei enter in each projection. These projections separate from the
cytoplasm and form 6-8 haploid microgamete or male gametes. This process of formation of microgamete is
called exflagellation.
ii. Formation of female gamete:-
The mega gametocyte undergoes some reorganization to form a single haploid mega gamete or female
gamete which is ready for fertilization.
b. Fertilization:
The male gamete enters the female gamete through the fertilization cone formed at female gamete and form
diploid zygote or synkaryon. Fusion is anisogamous.
c. Ookinete stage:
The zygote remains inactive for sometimes and then elongates into a worm like Ookinete or vermicule,
which is motile. The Ookinete penetrates the stomach wall and comes to lie below its outer epithelial layer.
d. Oocyst stage:
The Ookinete gets enclosed in a cyst. The encysted zygote is called Oocyst. The Oocyst absorbs
nourishment and grows in size.
3. Asexual Sporogony
The nucleus of Oocyst divides repeatedly to form a large number of haploid daughter nuclei. At the same
time, the cytoplasm develops vacuoles and gives numerous cytoplasmic masses. The daughter nuclei pass
into each cytoplasmic mass and develop into slender sickle-shaped sporozoites are formed in each Oocyst.
Diagnosis :
Malaria can be diagnosed by a rapid diagnostic test (RDT). This test is used in the field by ASHA workers
and primary health centers, especially in remote areas.
Malaria can also be diagnosed by a laboratory blood test. It involves examining a drop of patient’s blood
under a microscope for ascertaining the presence of the parasite.
Treatment :
The following drugs are recommended for treating malaria fever. 1. Chloroquin 2. Primaquin 3. Atovaquon -
Proguanil combination 4. Artemether - Lumefantrine combination 5. Mefloquine 6. Quinine etc.
Prevention and control of Malaria :
(a) Use of mosquito repellents, bed-nets and screening of houses
(b) Use of domestic space spray including aerosol
(c) Destruction of mosquito larvae by larvicides or by introducing larvivorous fishes like Gambusia
(d) Filling of small scale drainage and other forms of water management
(e) Chemoprophylaxis or little dose of quinine in malaria prone area and chemotherapy by taking
medicines like Quinine, Paluidrine, Camoquin, Resochin, Mepacrine, Lavagnin, Daraprim etc.

Filariasis :

It is a disease causd by a digenetic nematode parasite Wuchereria bancrofti which is transmitted to human
by mosquitoes like Culex.
The disease causes lymphoedema (lymphatic obstruction of lymphatic vessels and glands), lymphadenitis
(infection of lymph nodes), lymphangitis (infection of lymph vessels), elephantiasis (enormous enlargement
of scrotum, feet, hands, legs, etc.)
The life cycle is completed in two hosts. The primary host is human and the secondary host is a female
mosquito.
The female is viviparous and gives birth to as many 50,000 microfilariae per day.
The microfilariae find their way into the blood stream where they live upto 70 days without any
development.
The life cycle completes in 10 to 14 days through the following stages.
(a) Exsheathing : The micro-filariae comes out of the sheath within 1-2 hours of ingestion in the stomach of
the mosquito.
(b) First stage larva : After exsheathment, the larva penetrates the stomach wall of the mosquito in 6-12
hours and migrates into the thoracic muscles where it grows and develops into a sausage-shaped form.
(c) Second stage larva : The larva grows in size and develops in the alimentary canal but remains inactive.
(d) Third stage larva : In this stage, the larva becomes active and infective. It migrates to the proboscis of
the mosquito and is ready to be transmitted to a new host.
Treatment :
Detection and treatment of human carrier : The present strategy to detect and treat by drugs like diethyl
carbamazine (DEC) in 12 doses at the rate of 6 mg per kg body-weight daily to be completed in two weeks.
Prevention and control :
(i) Recurrent anti larval measures in endemic urban areas;
(ii) Use of larvicides like pyrosene oil;
(iii) Removal of aquatic plants like pistia:
(iv) Destruction of derelict water bodies and swamps;
(v) Anti-adult vector measures like spraying pyrethrins;
(vi) Avoidance of mosquito bite by using mosquito net; and
(vii) Using larvivorous fishes like Gambusia.

Amoebiasis

The term amoebiasis is a condition of harbouring Entamoeba histolytica with or without clinical
manifestations.
Amoebiasis may be intestinal or extra-intestinal.
The intestinal amoebiasis symptoms of amoebic dysentery, non-dysenteric colitis, amoeboma and amoebic
appendicitis bringing about many complications like intestinal perforation, peritonitis and haemorrhage.
The extra-intestinal amoebiasis occurs in the liver, lungs, brain, spleen and skin etc.
The more common among these is hepatic amoebiasis.
The causative agent, E. histolytica is a lumen-dwelling protozoon parasite and exists in two forms : (i)
trophozoite or magna or feeding stage (ii) Cystic or minuta or infective stage.
The cysts, which are the infective forms are monogenetic parasite and its only host is human. Its feeding
stage; the trophozoite is monopodial, i.e., with one pseudopodium and no contractile vacuole.
The pathogenic magna form and nonpathogenic minuta form.
Magna form affects the mucosa and submucosa causing ulcers. The minuta form is found in the lumen of the
intestine and forms the tetra-nucleate encysted mature cyst.
The mature cyst bears two chromatoid bodies and four nuclei. This is the infective state is released from the
body of the host through faecal matter.
Transmission :
It is due to intake of cyst contaminated water and food. The infection may also be caused by flies,
cockroaches and rodents which carry the cysts and contaminate food and drink.
The incubation period is 3 to 4 weeks.
Symptoms :
Amoebasis causes 6-10 loose motions per day with blood stained mucous.
Loose motion may be altered by constipation and massive infection leads to ulceration of the gut, liver,
lungs and brain.
Treatment :
Infections usually can be treated effectively by oral dose of Metronidazole at the rate of 400-800 mg for ten
days.
The other drugs are Mexaform, Enteroquinol, Diodoguin, Tinidazole, Enterovioform and Tinidafylplus.
Prevention and control :
Primarily, prevention is defaecation in open air.
Water filtration and boiling are effective measures against amoebiasis.
Vegetables should be properly washed before use.
Safe disposal of human excreta is crucial to controlling amoibiasis.
Intestinal amoebasis is diagnosed by examining the faces of the patient to identify the trophozoites and
cysts.
Extra intestinal amoebiasis is diagnosed by the serological tests, counter immuno-electrophoresis (CIE) and
ELISA.

Ascariasis

It is the infection of the intestinal tract by the adult nematode parasite, Ascaris lumbricoides.
Adult female worms are more than 12 inches in length, while adult males are smaller.
Children are infected more often than adults.
Symptoms :
Moderate to heavy infections express symptoms that may vary depending on which part of the body is
infected.
In the lungs : After the ingestion of ascaris eggs, they hatch in the small intestine and the larvae migrate
through the blood or lymph into the lungs.
Symptoms similar to asthma or pneumonia with persistent cough, shortness of breath and wheezing are
expressed.
After spending 6 to 10 days in the lungs, the larvae travel to the throat, where these are coughed up and
swallowed.
In the intestine : The larvae mature into adult worms in the small intestine, where they live until they die.
In mild or moderate ascariasis, there is mild abdominal pain, nausea and vomitting and diarrhoea or bloody
stool.
Heavy infection, a large number of worms may be present and may cause severe abdominal pain, fatigue,
vomitting and weight loss.
Epidemiology :
Ascaris lives in the lumen of small intestine. Around 2,40,000 fertilized eggs are laid by the female per day
and are passed out with the faecal matter of the host.
The first larval stage is called rhabditiform larva, which undergoes first moulting to produce second larval
stage within 2-3 weeks and this is the infective stage of Ascaris.
When human ingests these embryonated eggs they hatch in the intestine.
They larvae penetrate the gut wall and are carried to the liver. From liver they invade lungs through the
blood supply.
They are coughed up through the trachea and then swallowed to reach the intestine. They take about 60-80
days to become mature adults. Each adult has a lifespan of 6-12 months.
Copulation takes place in the intestine of the host.
Ascaris is a soil transmitted helminth and its eggs remain viable for months and years.
Contamination of the soil by Ascaris eggs is due to open air defaecation.
Diagnosis :
Infection with Ascaris is confirmed by a pathological examination of the stool.
Sometimes a whole worm is passed in the stool or is coughed up.
Treatment :
Effective drugs like Piperazine, Mebendazole, Levamisole, Pyrantel, and oil of Chinopodium are
administered.
Mass treatment of periodic deworming at intervals of 2-3 months may be undertaken in areas, where hygin
is poor and protein malnutrition is prevalent.
Prevention and Control :
Avoid contact with the soil that may have been contaminated with human faeces.
Donot defaecate outdoors
Dispose off diapers properly
Wash hands with soap and water before handling food
When travelling to countries where sanitation and hygiene are poor, avoid water or food that may be
contaminated
Wash, peel off or cook all raw vegetables and fruits before eating.
Ringworm :
Ringworms are pathogenic microscopic fungi called dermatophytes.
They cause superficial skin infections, also known as tinea.
They live and grow on parts of the skin, hair and nails.
Ringworm infection is characterised by a red ring of small blisters or a red ring of scaly skin that grows
outword as the infection spreads.
Symptoms :
The following are the types of ringworms or tinea :
1. Tinea barbae : Ringworm of the bearded area of the face and neck, with swelling and marked crusting.
2. Tinea capitis : Ringworm of the scalp, commonly affects children, mostly in late childhood or
adolescence.
3. Tinea corporis : Rignworm of the general skin of the body. It often produces round spots of classic
ringworms. Sometimes, these spots have an active outer border as they slowly grow and advance.
4. Tinea cruris : Ringworm of the groin tends to have a reddish-brown colour and extends from the folds of
the groin down onto one or both thighs.
5. Tinea faciei : Ringworm on the face except in the area of the beard. It causes red, scaly patches with
indistinct edges.
6. Tinea manus : Ringworm involving the hands particularly the palms and the spaces between the fingers.
7. Tinea pedis : Ringworm in the athlete’s feet may cause scaling and inflamation in the toe webs.
8. Tinea unguium : Fungal infection of the fingernails and more often, the toe nails.
Treatment :
Topical treatment : When the fungus affects the skin of the body or the groin, antifungal creams can clean
the condition in around two weeks. Drugs containing Clotrimazole [e.g., Cruex, Desenex and Lotrimin
(cream and lotion)], Miconazole (e.g., Monistat cream), Ketoconazole (e.g., Nizoral cream), Econazole
(Spectazole), Naftifine (Naftin) and Terbinafine (Lamisil cream and solution).
Systemic treatment : when not responded to the external application, oral medications are essential for
penetrating into depper areas of injection.