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Communicable and
Non-Communicable Diseases…
A Public Health Perspective
 Communicable disease: a disease that can
be spread to a person from another person,
an animal or object. Ex: common cold,
influenza, tuberculosis, etc.

 Non-communicable disease a disease that

can NOT be spread from person to person.
Ex: cancer, heart disease, cirrhosis, etc.

 Common Pathogens:
Viruses, Bacteria, Fungi & Protozoa
Communicable versus
non-communicable diseases
Communicable diseases Non-communicable diseases
 Sudden onset  Gradual onset

 Single cause  Multiple causes

 Short natural history  Long natural history

 Short treatment schedule  Prolonged treatment

 Cure is achieved  Care predominates

 Single discipline  Multidisciplinary

 Short follow up  Prolonged follow up

 Back to normalcy  Quality of life after

treatment
Epidemiologic triad
Few Important Terminologies related to
Communicable Diseases…

1. Infection
 Infection is the entry and development or
multiplication of an infectious agent in the body of
man or animals. An infection does not always cause
illness.
 There are several levels of infection (Gradients of
infection):
 Colonization (S. aureus in skin and normal nasopharynx)
 Subclinical or inapparent infection (polio)
 Latent infection (virus of herpes simplex, virus which is not
spreading more)
 Manifest or clinical infection
2. Contamination
 The presence of an infectious agent on a body
surface, on or in clothes, beddings, toys, surgical
instruments or dressings, or other articles or
substances including water and food.

3. Infestation
 It is the lodgment, development and
reproduction of arthropods on the surface of the
body or in the clothing, e.g. lice, itch mite. This
term could be also used to describe the invasion
of the gut by parasitic worms, e.g. ascariasis.
Contagious disease
 A contagious disease is the one that is transmitted
through contact. Examples include scabies, trachoma,
STD and leprosy.
4. Vector of infection
 An insect or any living carrier that transports an
infectious agent from an infected individual or its wastes
to a susceptible individual or its food or immediate
surroundings. Both biological and mechanical
transmissions are encountered.
5. Reservoir
 Any person, animal, arthropod, plant, soil, or substance,
or a combination of these, in which an infectious agent
normally lives and multiplies, on which it depends
primarily for survival, and where it reproduces itself in
such a manner that it can be transmitted to a susceptible
host. It is the natural habitat of the infectious agent.
7. Epidemic
 “The unusual occurrence in a community of disease,
specific health related behavior, or other health related
events clearly in excess of expected occurrence”
 (epi= upon; demos= people)
 Epidemics can occur upon endemic states too.

8. Endemic
 It refers to the constant presence of a disease or
infectious agent within a given geographic area or
population group. It is the usual or expected frequency of
disease within a population.
 (En = in; demos = people)
9. Pandemic
 An epidemic usually affecting a large proportion of the
population, occuring over a wide geographic area such
as a section of a nation, the entire nation, a continent or
the world, e.g. Influenza pandemics.

10. Exotic
 Exotic diseases are those which are imported into a
country in which they do not otherwise occur, as for
example, rabies in the UK.

11. Sporadic
 The word sporadic means “scattered about”. The cases
occur irregularly, haphazardly from time to time, and
generally infrequently. The cases are few and separated
widely in time and place that they show no or little
connection with each other, nor a recognizable common
source of infection.
Dynamics of disease Transmission (Chain
of Infection)

I II III

Source or Reservoir Modes of transmission Susceptible host

I. Carriers
 It occurs either due to inadequate treatment or immune
response, the disease agent is not completely
eliminated, leading to a carrier state.

 It is “an infected person or animal that harbors a

specific infectious agent in the absence of (visible)
clinical disease and serves as a potential source of
infection to others.
(II) : Modes of transmission

Mode of transmission

Direct Indirect
transmission transmission
Vehicle-borne
Direct contact
Vector-borne:•
Droplet infection

Contact with soil

Air-borne
Inoculation into skin or mucosa Fomite-born
Trans-placental (vertical) Unclean hands
and fingers
(III) : Susceptible host

 An infectious agent seeks a susceptible host

aiming “successful parasitism”.

 Four stages are required for successful parasitism:

1. Portal of entry
2. Site of election inside the body
3. Portal of exit
4. Survival in external environment

Incubation period: The period between exposure

and onset of clinical symptoms is called
'incubation period'.
Common Communicable Diseases
1. The common cold is a respiratory infection
caused by over 200 different viruses. Symptoms
include congestion, sore throat and cough. It
can be spread through direct and indirect
contact. Treatment includes rest, liquids and
over the counter medications. Prevention
techniques include handwashing and avoiding
contact with infected persons.
2. Small pox (virus)
 Disease is caused due to small pathogens which
are known as “ virolla virus”
 Incubation period- 7 to 17 days
3.Cholera (bacteria)
 It is a intestinal infection caused by intake of
contaminated food and water with a bacterium vibrio
cholerae
Nonvalent
 Two type of vaccine
Bivalent
 Range from a few hours to 5 days
 Average is 1-3 days

4. Dengue (virus)
 Dengue is a mosquito-borne disease flavi- virus found in
tropical & sub- tropical region of the world, mostly in
urban
 Day biting Aedes mosquitos spred this
 Incubation period- 4 to 10 days.
 The first dengue vaccine, dengvaxia by sanofi pasteur.
5. Diphtheria (bacteria)
 Is caused by corynebacterium dephtheriae
bacterium
 It is primarily infect the throat and upper
airways & produce toxin other organs.
6. Hepatitis A (HAV), B (HBV) (Virus)
 It is a liver disease, acute called epidemic jaundice
caused by HAV.
 Incubation period- 14 to 28 days.

Hepatitis B
 It cause liver failure, liver cirrhosis & liver cancer.

 It is chronic as well as acute, called (serum hepatitis)

caused by HBV.
 Incubation period – 1.5 to 6 months.

Hepatitis E(Virus)
 Acute liver failure

 Mainly occur through the continued drinking water.

 There is no vaccine.
Hepatitis C- is associated with blood transfusion.
Incubation period- 14 to 180 days
7. Influenza (VIRUS)
Also known as haemophilus. more commonly called “flu”,
is a respiratory infection caused by several groups of
viruses.
 It is responsible for sever phemonia.
 It is a respiratory disease.it also called plague.
 Incubation period- 1 to 4 days.
 Symptoms include high fever, fatigue, muscle and joint
aches. It is spread through direct contact with infected
people and water droplets in the air from coughs and
sneezes.
Treatment includes rest, liquids, and over the counter
medications. Prevention includes avoiding contact with
infected persons and vaccines.
8. Tuberculosis(Bacteria)
 Caused by tubercle bacillus, myobacterium.
 World deadliest communicable disease.
 Incubation period- 2 to 2 weeks
 Vaccine- BCG( Bacille Calmatte Guerin).
 2 billion people infected with microbes that cause TB.
 Not everyone develops active disease
 A person is infected every second globally
 22 countries account for 80% of TB cases.
 >50% cases in Asia, 28% in Africa (which also has the
highest per capita prevalence)
 In 2005, there were 8.8 million new TB cases; 1.6 million
deaths from TB (about 4400 a day)
 Highly stigmatizing disease 
9. Tuberculosis and HIV
 A third of those living with HIV are co-infected
with TB
 About 200,000 people with HIV die annually from TB.
 Most common opportunistic infection in Africa
 70% of TB patients are co-infected with HIV in some
countries in Africa

 Impact of HIV on TB

 TB is harder to diagnose in HIV-positive people.
 TB progresses faster in HIV-infected people.
 TB in HIV-positive people is almost certain to be fatal if
undiagnosed or left untreated.
 TB occurs earlier in the course of HIV infection than
many other opportunistic infections.
10. Malaria(parasite)
 This is caused by mosquito namely anopheles
 Genus plasmodium (p vivex virus)
 Every year, 500 million people become severely ill with
malaria
 causes 30% of Low birth weight in newborns 
Globally.
 >1 million people die of malaria every year. One child
dies from it every 30 seconds
 40% of the world’s population is at risk of malaria. Most
cases and deaths occur in SSA.
 Malaria is the 9th leading cause of death in LICs and
MICs
 11% of childhood deaths worldwide attributable to malaria
 SSA children account for 82% of malaria deaths worldwide
12. Measles (viral)
 Measles is a highly contagious viral disease among
young children
 Incubation period – 10 to 12 days.

13. Mumps (infection virus)

 It is sometimes called as infections parotitis.
 It affect salivary glands. generally after 5-9 years old.
 It also causes- menisgities, orcalitis and deafness. very
rarely it causes encephalitis and per neurological
damage.
14. Pertussis (bacteria)
 Caused by Bordetella pertussis, a bacteria that lives in the mouth, 
nose, throat.
 Disease of a respiratory tract.
 It also cause complications..
I. Paroxysmal cough- Whooping cough, bronchiectasis or lung
injury.
II. Apnoea- temporary cessation of breathing, especially during
sleep.
III. Pneumonia
IV. Seizures- a disorder in which brain cells is disturbed. It is not a
disease, is a symptom of many other disease.
V. Encephalopathy – disease affect your brain.
it is a coughing spells.
15. Polio (poliomyelitis) (virus)
 It invades the nervous system. Causes paralysis in the matter of 
hours.
i. No cure for polio
ii. Only type 1 vaccine is being used .
 Incubation Period- 7 to 21 Days.

16. Rabies (virus) lyssa virus type 1

 Also known as hydrophobia.
 It is a zoonotical viral disease which infects domestic & wild
animals.
 Affect central nervous system of warm blooded animals. Particularly 
mammals.
 Incubation period- 3 to 8 week (2 to 3 month).
17. Ratrovirus
 It is most common cause of severe diarryhoeal disease
in young children. throughout the world.
 Incubation period- approximately 2 days.
18. Rubella (virus)
 This infection just before conception and is early 
pregnancy may result is miscarriage.
 incubation period- 12 to 23 days.
19. Typhoid ( Bacteria)
 Intestinal fever
 Systematic infection caused by salmonella typhi, usually
through injection of contaminated food or water.
 Acute illness, prolonged level
 Vaccine= vi- ps, TY 21 

 Incubation period – 8 to 14 days.

20. Tetanus (bacteria)
 Clostridium tetani virus
 Caused when wound exposed to air and bacteria goes 
inside the wound.
 Incubation period- range 3 to 21 days.
average – 10 days.

21. Yellow fever (virus)

 Mosquito borne viral disease of human. Also called joundice.
 The flavivirus causes yellow fever.
 can’t spread through man to man but by mosquitos (female
name aedes aegypti)
 Incubation period- 3 to 16 days. 
22. Varicella or chicken pox (virus)
 It is caused by primary infection with the vericella- zoster
virus (VZV)
 Affect everyone at the middle age.
 Incubation period- 14 to 16 days.

23. Plague- spread by rats known as epigutic.

 Incubation period- 2 to 6 days.

24. Chicken pox

 V-Z virus (vericella zester)

 Incubation period- 14 to 16 days

23. Leprosy (bacterial)
 Hansen’s disease
 Mycobacterium leprae bacteria
 Incubation period- 2 to 10 years.
 Caused by leprosy bacillus germs.
 It is bumps on skin and nerve damage.
 Diamino diaphary sulphone is the main medicine.

24. Ringworm (fungal infection)

This disease is spread by fungets.
The germ which generates this disease is called “tinea”.
Some other terms -
1. Delirium- an acute disturbed state of mind.
2. Struma- swelling of the thyroid gland.
3. Scrofula- infection in neck lymphs nodes.
Sexually Transmitted Diseases

 Chlamydia
 Gonorrhea
 Genital Herpes
 Syphilis
 HIV/AIDS
Prevention

 Ways to prevent Infectious Disease

– Getting enough sleep, avoiding alcohol/cigarettes,
and eating a healthy diet.
– Getting vaccines when available.
– Staying away from disease carrying animals or
food/water that is dirty.
Personal Responsibility and action
 Improved hygiene and sanitation
 Hand washing, proper waste disposal, food 
preparation and handling.
 Information, education and behavior change
 Changing harmful household practices
 Livestock handling, knowledge about contagion
 Cultural and social norms
 Self reporting of illnesses and compliance with
interventions and treatment.
NON-COMMUNICABLE DISEASES
 NONCOMMUNICABLE DISEASES

⚫ Noncommunicable diseases are the leading

killer today and are on the increase.
⚫ Nearly 80% of these deaths occurred in low-
and middle-income countries.
⚫ NCDs are largely preventable by means of effective
interventions that tackle shared risk factors,
namely: tobacco use, unhealthy diet, physical
inactivity and harmful use of alcohol.

⚫ NCDs are not only a health problem but a

development challenge as well.
⚫ Around the world, NCDs affect women and men almost
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equally.
 1. Cardiovascular diseases
⚫ Cardiovascular disease is caused by disorders of the
heart and blood vessels, and includes coronary heart
disease (heart attacks), cerebrovascular disease (stroke),
raised blood pressure (hypertension), peripheral artery
disease, rheumatic heart disease, congenital heart
disease and heart failure.
⚫ Although heart attacks and strokes are major killers in
all parts of the world, 80% of premature deaths from
these causes could be avoided by controlling the main
risk factors: tobacco, unhealthy diet and physical
inactivity.

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 2. Cancer
⚫ Cancer is the uncontrolled growth and spread of
cells that arises from a change in one single cell. The
change may be started by external agents and
inherited genetic factors and can affect almost any
part of the body. The transformation from a normal
cell into a tumour cell is a multistage process where
growths often invade surrounding tissue and can
metastasize to distant sites.

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 Cancer: Interaction between a person’s genetic
factors and any of three categories of external
agents

⚫ physical carcinogens, such as ultraviolet and ionizing

radiation or asbestos;
⚫ chemical carcinogens, such as vinyl chloride, or
betnapthylamine (both rated by the International Agency
for Research into Cancer as carcinogenic), components
of tobacco smoke, aflatoxin (a food contaminant) and
arsenic (a drinking-water contaminant); and
⚫ biological carcinogens, such as infections from
certain viruses, bacteria or parasites.

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 Cancer:
risk factors for cancer
⚫ tobacco use
⚫ unhealthy diet
⚫ insufficient physical activity
⚫ the harmful use of alcohol
⚫ Infections (hepatitis B, hepatitis C(liver cancer), human
papillomavirus (HPV; cervical cancer), Helicobacter
pylori (stomach cancer)
⚫ Radiation
⚫ variety of environmental and occupational exposures of
varying importance

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 3. Chronic respiratory diseases:
Quick facts and figures

⚫ Survey data from 2005–20015 indicate that over half of all

children aged 13–15 years in many countries in the
European Region are exposed to second-hand tobacco
smoke at home. Second-hand smoke causes severe
respiratory health problems in children, such as asthma
and reduced lung function; and asthma is now the most
common chronic disease among children throughout
the Region.

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 Chronic respiratory diseases:
Quick facts and figures
⚫ According to the latest available data for 2000–2016,
over 12% of infant deaths in the world are due to
respiratory diseases.
⚫ Indoor air pollution from biological agents related to
damp and mould increases the risk of respiratory disease
in children and adults. Children are particularly
susceptible to the health effects of damp, which include
respiratory disorders such as irritation of the respiratory
tract, allergies and exacerbation of asthma. Damp is
often associated with poor housing and social conditions,
poor indoor air quality and inadequate housing hygiene.

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 4. Diabetes

⚫ Diabetes is a chronic disease that occurs when the pancreas

does not produce enough insulin (a hormone that regulates
blood sugar) or alternatively, when the body cannot
effectively use the insulin it produces. The overall risk of
dying among people with diabetes is at least double the risk
of their peers without diabetes.
⚫ There is an emerging global epidemic of diabetes that
can be traced back to rapid increases in overweight,
obesity and physical inactivity.

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 Diabetes: Health implications
Elevated blood sugar is a common effect of uncontrolled
diabetes, and over time can damage the heart, blood
vessels, eyes, kidneys, and nerves.
Some health complications from diabetes include:
⚫ Diabetic retinopathy
⚫ Diabetic neuropathy
⚫ Diabetes is among the leading causes of kidney failure; 10-20% of
people with diabetes die of kidney failure.
⚫ Diabetes increases the risk of heart disease and stroke; 50% of
people with diabetes die of cardiovascular disease (primarily heart
disease and stroke).
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 Diabetes: Control
⚫ People with type 1 diabetes require insulin; people with type 2
diabetes can be treated with oral medication, but may also require
insulin.
⚫ Blood pressure control
⚫ Foot care

Other cost saving interventions include:

⚫ Screening and treatment for retinopathy (which causes blindness);
⚫ Blood lipid control (to regulate cholesterol levels);
⚫ Screening for early signs of diabetes-related kidney disease and
treatment.
These measures should be supported by a healthy diet,
regular physical activity, maintaining a normal body weight
and avoiding tobacco use.
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 Obesity
⚫ Obesity is one of the greatest public health challenges of the 21st
century. Its prevalence has tripled in many countries of the WHO
European Region since the 1980s, and the numbers of those
affected continue to rise at an alarming rate, particularly among
children.
⚫ In addition to causing various physical disabilities and
psychological problems, excess weight drastically increases a
person’s risk of developing a number of noncommunicable
diseases (NCDs), including cardiovascular disease, cancer and
diabetes.
⚫ The risk of developing more than one of these diseases (co-
morbidity) also increases with increasing body weight.

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 Obesity
⚫ Overweight and obesity
are defined as "abnormal
or excessive fat
accumulation that may
impair health“

⚫ Body mass index (BMI) – the

weight in kilograms divided by
the square of the height in
meters (kg/m2) – is a commonly
used index to classify
overweight and obesity in
adults.WHO defines overweight
as a BMI equal to or more than
25, and obesity as a BMI equal
to or more than 30.

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 Noncommunicable diseases:
Current status and trends in risk factors
⚫ Common, preventable risk factors underlie most NCDs.
These risk factors are a leading cause of the death and
disability burden in nearly all countries, regardless of
economic development.
⚫ The leadingrisk factor globally for mortality is:
1. raised blood pressure (responsible for 13%of
deaths globally),
2. followed by tobacco use (9%),
3. raised blood glucose (6%),
4. physical inactivity (6%),
46 5. overweight and obesity (5%).
 Noncommunicable diseases:
Prevention and Control of NCDs
⚫ Millions of deaths can be prevented by stronger implementation of
measures that exist today.
⚫ These include policies that promote government-wide action
against NCDs:
1. stronger anti-tobacco controls
2. promoting healthier diets,
3. physical activity,
4. reducing harmful use of alcohol;
5. along with improving people's access to essential health care.

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