Communicable Diseases

Definition

A communicable disease is any disease that can be transmitted from one organism to another.

Description

Agents that cause communicable diseases, called pathogens, are easily spread by direct or indirect contact. These pathogens include viruses, bacteria, fungi, and parasites. Some pathogens make toxins that harm the body's organs. Others actually destroy cells. Some can impair the body's natural immune system, and opportunistic organisms set up secondary infections that cause serious illness or death. Once the pathogens have multiplied inside the body, signs of illness may or may not appear. The human body is adept at destroying most pathogens, but the pathogens may still multiply and spread.




Selected infectious diseases and corresponding treatment





Selected infectious diseases and corresponding treatment

The pathogens responsible for some communicable diseases have been known since the mid-1800s, although they have existed for a much longer period of time. European explorers brought highly contagious diseases such as smallpox, measles, typhus and scarlet fever to the New World, to which Native Americans had never been exposed. These new diseases killed 50–90 percent of the native population. Native populations in many areas of the Caribbean were totally eliminated.

In some areas of the world, contaminated soil or water incubate the pathogens of communicable diseases, and contact with those agents will cause diseases to spread. In the 1800s, when Robert Koch discovered the anthrax bacillus (Bacillus anthracis), cholera bacillus (Vibrio cholerae), and tubercle bacillus (Mycobacterium tuberculosis), his work ushered in a new era of public sanitation by showing how waterborne epidemics, such as cholera and typhoid, could be controlled by water filtration.

ALICE HAMILTON (1869–1970)




Alice Hamilton.





Alice Hamilton.
(Courtesy of Library of Congress, George Grantham Bain Collection (Library of Congress), Bain News Service, publisher.)

Alice Hamilton was one of the first to associate environmental- related factors with certain illnesses. She noticed unsafe environmental conditions affected people's wellbeing and health. In 1902, during Chicago's typhoid fever epidemic, Hamilton linked the disease to inadequate sewage control. She determined flies, attracted to the sewage, were carrying and transmitting the disease.

In 1910, the governor of Illinois created the Occupational Disease Commission. It was the first of its kind, and he appointed Alice Hamilton director. Hamilton researched the health effects of employee exposure to lead, viscose rayon, and noxious fumes. She found that exposure had grave side effects, including loss of vision, paralysis, and death. Hamilton worked with governmental officials to change unsafe working conditions, campaign against child labor, and pass workers' compensation laws. She gained international attention for her advocacy for the common worker and was asked by the U.S. Commissioner of Labor to extend her work on a national level. Hamilton accepted this national position, working pro bono, from 1911–1921 when her position was eliminated.

Discoveries of the causes of epidemics and transmissible diseases led to the expansion of the fields of sanitation and public health. Draining of marshes, control of the water supply, widespread vaccinations, and quarantine measures improved human health. But, despite the development of advanced detection techniques and control measures to fight pathogens and their spread, communicable diseases still take their toll on human populations. For example, until the 1980s tuberculosis had been declining in the United States due in large part to the availability of effective antibiotic therapy. However, since 1985, the number of tuberculosis cases has risen steadily due to such factors as the emergence of drug-resistant strains of the tubercle bacillus, the increasing incidence of HIV infection which lowers human resistance to many diseases, poverty, and immigration.

Epidemiologists track communicable diseases throughout the world, and their work has helped to eradicate smallpox, one of the world's most deadly communicable diseases. A successful global vaccination campaign wiped out smallpox in the 1980s, and today, the virus exists only in tightly controlled laboratories in Moscow and in Atlanta at the Centers for Disease Control and Prevention. Scientists have debated whether to destroy the viruses or preserve them for study.

Communicable diseases continue to be a major public health problem in developing countries. In the small West African nation of Guinea-Bissau, a cholera epidemic hit in 1990. Epidemiologists traced its outbreak to contaminated shellfish and managed to control the epidemic, but not before it claimed hundreds of lives in that country. Some victims had eaten the contaminated shellfish, others were infected by washing the bodies of cholera victims and then preparing funeral feasts without properly washing their hands. Proper disposal of victims' bodies, coupled with a campaign to encourage proper hygiene, helped stop the epidemic from spreading.

Acquired immunodeficiency syndrome (AIDS) is caused by the human immunodeficiency virus (HIV). Spread by contact with bodily fluids of an HIV-infected person, the virus weakens and eventually destroys the body's immune system. Researchers assert that the virus originated in monkeys and was first transmitted to humans about 100 years ago.

New diseases deadlier than AIDS exist, including several variations of hemorrhagic fever and avian flu (H5N1 influence). Virologists point out that viruses, like human populations, constantly change. Rapidly increasing human populations provide fertile breeding grounds for microbes, including viruses and bacteria. Pathogens can literally travel the globe in a matter of hours.

For example, the completion in 1990 of a major road through the Amazon rain forest in Brazil led to outbreaks of malaria in the region. In 1985, used tires imported to Texas from eastern Asia transported larvae of the Asian tiger mosquito, a dangerous carrier of serious tropical communicable diseases. Deforestation and agricultural changes can unleash epidemics of communicable diseases. Outbreaks of Rift Valley fever followed the construction of the Aswan High Dam, most likely because breeding grounds were created for mosquitoes which spread the disease. In Brazil, the introduction of cacao farming coincided with epidemics of Oropouche fever, a disease linked to a biting insect that thrives on discarded cacao hulls.

In March 2009, a novel virus that was ultimately named 2009 H1N1 influenza virus (alternately, Type A/H1N1) resulted in cases of influenza (flu) in Mexico and the United States. A subsequently confirmed case of H1N1 flu first produced symptoms in a patient in the United States as early as 28 March 2009. The novel virus was detected as early as 16 April 2009. From an outbreak in Mexico, the virus quickly spread globally to become an official global pandemic.

Another important factor in the spread of communicable diseases is the speed and frequency of modern travel. A recent example of the perils of such fluidity in travel was exposed during a 2003 outbreak of severe acute respiratory syndrome (SARS).

Continued rapid transportation of humans around the world is likely to accelerate the movement of communicable diseases. Poverty, lack of adequate sanitation and nutrition, and the crowding of people into megacities in the developing countries of the world only exacerbate the situation. The need for study and control of these disease is likely to grow in the future.

See also Anthrax ; Avian flu ; Cholera ; HIV/AIDS ; Malaria ; Measles ; Pandemic ; Parasites ; Sanitation ; Severe acute respiratory syndrome (SARS) ; Smallpox ; Tuberculosis ; Typhus ; Vaccination ; Viruses .

Resources

BOOKS

Battin, M. Pabst. The Patient as Victim and Vector: Ethics and Infectious Disease. New York: Oxford University Press, 2009.

Dworkin, Mark S. Outbreak Investigations Around the World: Case Studies in Infectious Disease Field Epidemiology. Sudbury, MA: Jones and Bartlett Publishers, 2009.

Kimbell, Ann Marie. Risky Trade: Infectious Disease in the Era of Global Trade. Aldershot, UK: Ashgate Publishing, 2006.

Palladino, Michael A., and Stuart Hill. Emerging Infectious Diseases. New York: Benjamin Cummings, 2005.

WEBSITES

Centers for Disease Control and Prevention (CDC). “Emerging Infectious Diseases.” http://www.cdc.gov/ncidod/diseases/eid/index.htm (accessed November 6, 2010).

National Geographic Society. “Infectious Disease Quiz.” http://science.nationalgeographic.com/science/health-and-human-body/human-diseases/infectious-diseasequiz.html (accessed November 6, 2010).

World Health Organization (WHO). “Report on Infectious Diseases.” WHO Programs and Projects. http://www.who.int/infectious-disease-report/ (accessed November 6, 2010).

Linda Rehkopf

  This information is not a tool for self-diagnosis or a substitute for professional care.