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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

CHAIN OF INFECTION

STI POINT OF VIEW

chain of infection1
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
Vector: Person with STI
  • Considerations
    • Behavior of the person
      • Precautions
      • Number of partners
    • Stage of infection
      • Active
      • Latent
reservoir
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
infectious agent
Infectious Agent
  • Virus
      • HIV
      • Herpes Type 2 (genital)
      • Human Papilloma Virus
      • Hepatitis B Virus
  • Bacteria
    • Chlamydia
    • Gonorrhea
portal of exit
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
mode of transmission
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
portal of entry
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
susceptible host
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
vector control
Vector Control
  • Behavior Modification
  • Social Support
  • Address Social Determinants – Quality of Life
  • Medical Treatment
  • Patient Education
reservoir1
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
portal of exit1
Portal of Exit

Virus

Bacteria

Condoms!

Anti-Microbials -- ??

NOT spermcides…

  • Condoms!
  • Anti-Microbials (under investigation)
    • Microbicides link
mode of transmission1
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
portal of entry1
Portal of Entry

Virus

Bacteria

Condoms!

  • Condoms!
susceptible host1
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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