Fiedacan, Karen Mae F.

Ibarreta, Ana Sophia T. 

Ignacio, Jona May J. 
Lagutan, Niña Regeena T. 
Lamsen, Adelfa Mae O. 

Topic: How Microorganisms Cause Diseases

Objectives 
By the end of the presentation, viewers are expected to know the different routes
microbes utilize to cause infections. The viewers are also expected to know how microbes spread
and disseminate. Lastly, the viewers are expected to know how microbes are released from the
body and how they are transmitted.

Media Format:
The media format used is video utilizing both live action and animation. Live action was
chosen to represent actual events in daily life that can cause infections like skin abrasions,
ingestion of contaminated food and drinks as well as inhalation. Animation was chosen to further
show the events happening in the body when microbes breach the protective barriers of the body.

Introduction 
Humans harbor microbial flora in the different parts of the body. It is present in the gut,
skin and distal portions of the urogenital tract. These commensals protect the body by occupying
niches and competing with potential pathogens. Once the host is immunocompromised, however,
they can breach host defenses together with other pathogens, thus causing disease.
They are able to do so by the different routes of entry: 

 Skin
The skin acts as a strong mechanical barrier that protects the body from microorganisms.
Secretion of antimicrobial fatty acids, defensis and small peptides that are toxic to bacteria is
how the skin prevents infections from microbial pathogens. The skin creates and environmental
niche using these and other secretions. Mechanical injury of the epidermis is the most common
cause of skin infections and may range from small abrasions to large burns, and pressure-related
ulcers. Insect and animal bites may also contribute to the occurrence of infections in the skin
because some pathogens use them as vectors to penetrate the skin. Such vectors include fleas,
ticks, mosquitoes, mites, lice, and rebid animals. Microorganisms usually can not pass through
the intact skin, but the larvae of Schistosoma is an exception. These larvae release enzymes that
dissolve the adhesive proteins that holds keratinocytes together.

 Gastrointestinal Tract 
Most GIT pathogens are transmitted by food or drink contaminated by fecal matter. It is good
to know that the gut has several defenses. Acidic gastric secretions are highly effective in killing
microorganisms. Pancreatic enzymes and bile destroy viruses. Peyer patches produce IgA
antibodies to neutralize pathogens. The normal flora discourages colonization of foreign
microorganisms. 

Norovirus is inactivated  by acid, bile, and pancreatic enzymes. Intestinal protozoa and
helminths have acid-resistant outer coats. Shigella are also resistant to acid. When the body's
defenses weaken or are overcome, infections may occur. Mechanisms are as follows: 
1. Adhesion and local proliferation
            Bacteria like Vibrio cholerae binds to the intestinal epithelium and multiply. They  then
release exotoxins. 
2. Adhesion and mucosal invasion. 
Some pathogens invade the mucosa, causing ulceration, hemorrhage and inflammation.
Examples are Shigella, Salmonella, Campylobacter and Entamoeba histolytica. 
3. Hijacking of host pathways of antigen uptake. 
M cells deliver antigens to the underlying lymphoid tissues. They take up viruses such as
Poliovirus, serving as a free ride for it to cause disease.

Some organisms cause disease without establishing an infection. S. aureus releases an

exotoxin responsible for acute food poisoning. Antibiotic treatment, ileus, and loss of gastric
acidity diminish local defenses. Candida and other opportunistic organisms produce GIT
disturbances once the immune system weakens. 
  Respiratory Tract
An abundance of disease-causing agents, including viruses, bacteria, and fungi, enter the
human body primarily through inhalation of dust or aerosol particles, which are then trapped in the
mucociliary blanket lining the nose and the upper respiratory tract. Owing to ciliary action,
microorganisms trapped in the mucus layer are carried to the back of the throat, where they are
swallowed and cleared. However, particles smaller than 5 microns are transported into the alveoli,
where they are ingested or engulfed by resident alveolar macrophages or by neutrophils installed to
the lung by cytokines.
Diverse methods are employed by microorganisms, which infect the healthy respiratory
tract, to elude local defenses. Some pathogenic respiratory viruses evade local defenses by attaching
to and entering epithelial cells in the lower respiratory tract and pharynx. This is exemplified by
influenza viruses in which its bonding prompts the host cell to actively transport molecules into the
cell by engulfing the virus with its membrane, leading to viral entry and replication. Consequently,
the resulting damage to the respiratory epithelium brings about superinfection by S. pneumonia and
S. aureus, which oftentimes lead to serious pneumonias.
A good number of bacterial respiratory pathogens, which include Haemophilus influenzae,
M. pneumoniae, and Bordetella pertussis, release toxins to intensify their ability to cause infection
by disrupting ciliary activity. Primary resistance to killing, which follows phagocytosis, is another
form of mechanism used by pathogenic respiratory viruses in building respiratory infection. Such
mechanism is exemplified by Mycobacterium tuberculosis. Other pathogens lay the foundation for
disease when local or systemic defenses are disrupted. While chronic damage of mucociliary
defense mechanisms takes place among smokers and those with cystic fibrosis, acute injury
happens to patients undergoing mechanical ventilation and those who aspirate gastric acid.
Numerous pathogens cause respiratory infections primarily in the setting of systemic
immunodeficiency, like fungal infections by P. jiroveci in AIDS patients and by Aspergillus species
in patients with neutropenia.
 
 Vertical Transmission
The most common means of transmission of certain pathogens, which may happen through
varied routes, refers to the vertical transmission of infectious agents from mother to baby during the
period immediately before and after birth. Transmission might occur across the placenta, in the
 breast milk, or through direct contact during or after birth. In all probability, placental-fetal
transmission develops when the mother is infected with a pathogen during pregnancy. The resulting
infections hamper fetal development although the degree and type of damage depend on the age of
the fetus when infection occurred. Rubella infection during the first trimester of pregnancy, for
instance, can lead to life-threatening conditions like heart malformations, mental retardation,
cataracts, or deafness, while rubella infection during the third trimester has little effect.
Transmission during birth is another mode of passage of a disease-causing agent that takes place
upon contact with infectious agents during passage at the birth canal exemplified by gonococcal
and chlamydial conjunctivitis. Pathogens transmitted in this manner include cytomegalovirus
(CMV), human immunodeficiency virus (HIV), and hepatitis B virus (HBV).

 Urogenital Tract
Urine is normally sterile. Regular emptying of urine during micturation protects the urinary tract.
Pathogens of the urinary tract like E. coli, enter through the urethra and attaches to the urothelium
to avoid being washed away. Women are more prone to urinary tract infections due to the short
length of the urethra. Obstruction of urine outflow or reflux of urine increases the risk for urinary
tract infections because it compromises normal defenses. Lactobacilli protect the vagina by
fermenting glucose to lactic acid making the environment acidic. Antibiotics kill lactobacilli and
allowing yeast to grow and develop candidiasis. The squamous mucosa of the cervix is resistant to
infection, however, minor trauma may expose immature proliferating epithelial cells making the
cervix more susceptible to infection by the human papilloma virus which is the main cause of
cervical carcinoma.

Spread and Dissemination of Microbes Within the Body

Some pathogens spread to distant sites via the lymphatics, blood, or nerves.  Extracellular
pathogens like S. aureus secretes hyaluronidases that break down tissues, allowing the organism to
advance unimpeded.  Organisms that travel through the lymphatics to the regional lymph nodes and the
blood may potentially lead to bacteremia. When it happens, the organism may spread to distant organs,
affecting the heart and bones. Certain viruses such as rabies and Varicella viruses travel along axons,
reaching the CNS. Blood-borne pathogens like Hepatitis B  and most fungi are transported free in
plasma, while HIV and malarial parasites are carried within cells. Their consequences depend on their
virulence, magnitude of the infection, pattern of seeding, and host immune status. Disseminated
viremia, bacteremia, funginemia, or parasitemia often produces severe illness and is a serious threat.
Major signs of spread are related to tissue seeding. These may take the form of a single large infectious
nidus like an abscess,  or multiple small sites like miliary tuberculosis. Rabies, poliovirus, and varicella
can cause characteristic patterns of disease because of tropism. Parasites like Schistosoma mansoni
localizes to blood vessels of the portal system and mesentery, leading to liver or intestinal damage. 

Release from the Body and Transmission of Microbes

      Infectious microbes utilize varied portal of exit to assure their passage from one host to another.
The release of microbes from the body is dependent on the location of infection, and may be achieved
by skin shedding, coughing, sneezing, voiding of urine or feces, during sexual contact, or through
insect vectors. While some pathogens are discharged periodically during disease outbreaks, others, like
the enteric pathogen S. typhi, may be released for long periods by asymptomatic carrier hosts. Upon
release from the body, some pathogens continue to live for extended periods of time in dust, food, or
water. Some fragile pathogens, however, survive outside the body for only short periods of time and
must be passed quickly from person to person, often by direct contact.
      Some respiratory pathogens, including influenza viruses, are dispersed in large droplets while
others, including M. tuberculosis and varicella-zoster virus, can travel longer distances because they are
scattered in small droplets. Most enteric pathogens are naturally dispersed through the fecal-oral route.
Examples of water-borne viruses involved in epidemic outbreaks that are spread in this manner include
hepatitis A and E viruses, poliovirus, and rotavirus. Other critical pathogens proliferate through fecal-
oral route include V. cholerae, Shigella, Campylobacter jejuni, and Salmonella. Some parasitic
helminthes (e.g., hookworms, schistosomes) lay eggs in stool that hatch as larvae, which are capable of
penetrating the skin of the next host. Sexual transmission is responsible for the spread of a wide variety
of pathogens, including viruses (e.g., Herpes simplex, HIV, human papilloma virus), bacteria (T.
pallidum, Gonococcus), protozoa (Candida) and even arthropods (Phthiris pubis, or crab lice).
  Besides the above-mentioned major routes of transmission, pathogens virtually employ
every possible means for spreading to a new host. Through the saliva, viruses that replicate in the
salivary gland or oropharynx, including Epstein-Barr virus and rabies virus. Protozoa and helminths
have evolved particularly complex life cycles through the involvement of intermediate hosts bearing
successive developmental stages of the pathogen. Other important human pathogens are protozoa that
are proliferated via blood meals taken by arthropod vectors (mosquitoes, ticks, mites). Through direct
contact, consumption of animal products, or invetebrate organisms are the modes how a small number
of pathogens can be transmitted from animals to humans (zoonotic infections).