BharatNotes
Overview
Human diseases and epidemics represent a high-yield topic across both UPSC Prelims and Mains. While the Health, Nutrition & Disease chapter (Chapter 2) covers public health policy and government schemes, this chapter provides a detailed scientific classification of diseases — bacterial, viral, protozoan, and non-communicable — with pathogen-transmission-symptom tables essential for Prelims. It also covers vaccine technology, India's immunisation programme, disease eradication milestones, and major epidemics and pandemics.
Exam Strategy: Prelims frequently tests pathogen-disease-vector matching, vaccine types, and disease eradication facts. Mains (GS3 — Science & Technology; GS2 — Health) asks about pandemic preparedness, disease elimination programmes, and the intersection of science with public health policy.
Classification of Diseases
| Basis | Types |
|---|---|
| By Communicability | Communicable (infectious) and Non-communicable |
| By Pathogen | Bacterial, Viral, Fungal, Protozoan, Helminthic |
| By Transmission | Airborne, Waterborne, Vector-borne, Sexually transmitted, Contact |
| By Duration | Acute (short-term) and Chronic (long-term) |
Part I — Bacterial Diseases
Major Bacterial Diseases
| Disease | Causative Bacterium | Transmission | Key Symptoms | Treatment |
|---|---|---|---|---|
| Tuberculosis (TB) | Mycobacterium tuberculosis | Airborne (droplet nuclei) | Persistent cough (2+ weeks), blood in sputum, weight loss, night sweats, fever | DOTS therapy (Directly Observed Treatment, Short-course); first-line drugs: isoniazid, rifampicin, pyrazinamide, ethambutol |
| Cholera | Vibrio cholerae | Waterborne (contaminated water/food) — faecal-oral route | Profuse watery diarrhoea ("rice-water stool"), severe dehydration, vomiting | Oral Rehydration Solution (ORS); antibiotics (doxycycline, azithromycin) in severe cases |
| Typhoid | Salmonella typhi | Waterborne — faecal-oral route (contaminated food/water) | Step-ladder fever (rising day by day), headache, abdominal pain, rose spots on abdomen | Antibiotics (ciprofloxacin, azithromycin); Widal test for diagnosis |
| Plague | Yersinia pestis | Vector-borne (rat flea — Xenopsylla cheopis); also airborne (pneumonic plague) | Bubonic: swollen lymph nodes (buboes); Pneumonic: severe pneumonia; Septicaemic: bloodstream infection | Antibiotics (streptomycin, gentamicin); historically caused pandemics — the Black Death (1346-53) killed ~30-60% of Europe's population |
| Leprosy (Hansen's Disease) | Mycobacterium leprae | Prolonged close contact; droplet infection from nose | Skin lesions, nerve damage, loss of sensation in extremities, deformities if untreated | Multi-drug therapy (MDT): dapsone, rifampicin, clofazimine; India eliminated leprosy as a public health problem in 2005 (prevalence <1 per 10,000) |
| Diphtheria | Corynebacterium diphtheriae | Airborne (respiratory droplets) | Sore throat, greyish-white membrane in throat, fever, swollen neck glands | Antitoxin + antibiotics; DPT vaccine (preventable) |
| Tetanus | Clostridium tetani | Wound infection (spores enter through cuts) | Muscle spasms (lockjaw), stiffness, difficulty swallowing | Tetanus immunoglobulin + antibiotics; TT vaccine (preventable) |
| Pertussis (Whooping Cough) | Bordetella pertussis | Airborne (respiratory droplets) | Severe coughing fits with a "whoop" sound, vomiting after cough | Antibiotics (erythromycin); DPT vaccine (preventable) |
Prelims Tip: TB, Diphtheria, Pertussis, and Tetanus are all covered under India's Universal Immunisation Programme. The BCG vaccine protects against TB; the DPT vaccine covers Diphtheria, Pertussis, and Tetanus.
Part II — Viral Diseases
Major Viral Diseases
| Disease | Virus | Transmission | Key Symptoms | Vaccine Available? |
|---|---|---|---|---|
| HIV/AIDS | Human Immunodeficiency Virus (HIV-1, HIV-2) | Sexual contact, blood transfusion, mother-to-child, contaminated needles | Progressive destruction of immune system (CD4+ T cells); opportunistic infections | No vaccine; Antiretroviral Therapy (ART) controls viral load |
| Dengue | Dengue virus (4 serotypes: DENV-1 to DENV-4) | Vector-borne — Aedes aegypti mosquito | High fever, severe headache, pain behind eyes, joint/muscle pain, rash; severe dengue: plasma leakage, organ damage | Dengvaxia vaccine (limited use); mainly prevention through vector control |
| COVID-19 | SARS-CoV-2 (coronavirus) | Airborne (respiratory droplets and aerosols); contact | Fever, cough, breathlessness, loss of taste/smell; severe: pneumonia, ARDS, organ failure | Yes — mRNA vaccines (Pfizer-BioNTech, Moderna), viral vector (AstraZeneca/Covishield), inactivated (Covaxin) |
| Influenza | Influenza virus (Types A, B, C) | Airborne (respiratory droplets) | Fever, body ache, cough, fatigue | Annual flu vaccine (updated each year due to antigenic drift) |
| Rabies | Rabies virus (Lyssavirus) | Animal bite (saliva of infected animal — dogs, bats, monkeys) | Hydrophobia (fear of water), agitation, hallucinations; nearly 100% fatal once symptoms appear | Yes — post-exposure prophylaxis (PEP) with rabies vaccine is highly effective if given promptly |
| Ebola | Ebola virus (5 species; Zaire ebolavirus most lethal) | Contact with infected blood, body fluids, or contaminated surfaces | Fever, severe headache, vomiting, diarrhoea, haemorrhage; case fatality rate up to 90% | rVSV-ZEBOV vaccine (Ervebo) approved 2019 |
| Poliomyelitis | Poliovirus (3 types) | Faecal-oral route (contaminated water/food) | Most infections asymptomatic; 1 in 200 causes irreversible paralysis | OPV (Oral Polio Vaccine — Sabin) and IPV (Injectable — Salk); India certified polio-free on 27 March 2014 |
| Measles | Measles virus (Morbillivirus) | Airborne (one of the most contagious diseases) | Fever, cough, runny nose, Koplik spots (white spots inside mouth), red rash | Yes — MMR vaccine (Measles, Mumps, Rubella) |
Hepatitis — Types A through E
| Type | Virus | Transmission | Chronicity | Vaccine |
|---|---|---|---|---|
| Hepatitis A | HAV | Faecal-oral (contaminated food/water) | No — acute only | Yes |
| Hepatitis B | HBV | Blood-borne (blood, sexual contact, mother-to-child) | Yes — can become chronic; causes liver cirrhosis, cancer | Yes — part of UIP in India |
| Hepatitis C | HCV | Blood-borne (blood transfusion, needles, rarely sexual) | Yes — often becomes chronic | No vaccine; curable with Direct-Acting Antivirals (DAAs) |
| Hepatitis D | HDV | Blood-borne — but only co-infects with Hepatitis B | Yes — worsens HBV prognosis | HBV vaccine prevents HDV (since HDV requires HBV) |
| Hepatitis E | HEV | Faecal-oral (contaminated water) | No — usually acute; dangerous in pregnant women | Vaccine exists (Hecolin) but not widely available |
Prelims Tip: Remember the simple rule: Hepatitis A and E are waterborne (faecal-oral); Hepatitis B, C, and D are blood-borne. Only Hepatitis B and C can become chronic. The HBV vaccine also prevents HDV.
Part III — Protozoan Diseases
Major Protozoan Diseases
| Disease | Causative Organism | Transmission | Key Symptoms |
|---|---|---|---|
| Malaria | Plasmodium species (see table below) | Vector-borne — female Anopheles mosquito | Cyclical fever with chills, anaemia, enlarged spleen; cerebral malaria (P. falciparum) can be fatal |
| Kala-azar (Visceral Leishmaniasis) | Leishmania donovani | Vector-borne — sandfly (Phlebotomus argentipes) | Prolonged fever, weight loss, enlarged spleen and liver, anaemia, darkening of skin; endemic in Bihar, Jharkhand, UP, West Bengal; elimination target: <1 case/10,000 at sub-district level |
| Sleeping Sickness (African Trypanosomiasis) | Trypanosoma brucei | Vector-borne — tsetse fly (Glossina) | Fever, headache, joint pain; later stage: confusion, sleep disturbance, coma |
| Amoebic Dysentery | Entamoeba histolytica | Faecal-oral (contaminated water/food) | Bloody diarrhoea, abdominal cramps, liver abscess |
| Giardiasis | Giardia lamblia | Faecal-oral (contaminated water) | Diarrhoea, bloating, nausea, malabsorption |
Malaria — Plasmodium Species
| Species | Common Name | Severity | Fever Pattern | Geographic Distribution |
|---|---|---|---|---|
| P. falciparum | Malignant malaria | Most severe; causes cerebral malaria; can be fatal | Irregular or continuous | Predominant in Africa; most deadly globally |
| P. vivax | Benign tertian | Less severe but can relapse (dormant liver forms — hypnozoites) | Every 48 hours (tertian) | Most widespread globally; dominant in India and Asia |
| P. malariae | Quartan malaria | Mild; can persist for decades | Every 72 hours (quartan) | Tropical regions worldwide |
| P. ovale | Ovale tertian | Mild; can relapse | Every 48 hours | West Africa primarily |
| P. knowlesi | Knowlesi malaria | Can be severe; zoonotic (from macaque monkeys) | Daily (quotidian) | Southeast Asia (Malaysia, Borneo) |
Prelims Tip: There are 5 Plasmodium species that cause malaria in humans. P. falciparum is the deadliest; P. vivax is the most widespread outside Africa and is the dominant species in India. The vector is always the female Anopheles mosquito.
Vector-Borne Diseases — Quick Reference
| Disease | Vector | Pathogen |
|---|---|---|
| Malaria | Female Anopheles mosquito | Plasmodium spp. |
| Dengue | Aedes aegypti mosquito | Dengue virus |
| Chikungunya | Aedes aegypti/albopictus mosquito | Chikungunya virus |
| Zika | Aedes aegypti mosquito | Zika virus |
| Japanese Encephalitis | Culex mosquito | JE virus |
| Kala-azar | Sandfly (Phlebotomus) | Leishmania donovani |
| Sleeping Sickness | Tsetse fly (Glossina) | Trypanosoma brucei |
| Plague (Bubonic) | Rat flea (Xenopsylla cheopis) | Yersinia pestis |
| Typhus | Body louse / flea | Rickettsia spp. |
| Filariasis (Elephantiasis) | Culex mosquito | Wuchereria bancrofti |
Prelims Tip: Aedes aegypti transmits dengue, chikungunya, Zika, and yellow fever. Anopheles transmits only malaria. Culex transmits Japanese Encephalitis and filariasis.
Part IV — Non-Communicable Diseases (NCDs)
NCDs account for approximately 66% of all deaths in India (WHO estimate). The four major NCDs are cardiovascular diseases, cancer, chronic respiratory diseases, and diabetes.
Major NCDs
| Disease | Key Facts |
|---|---|
| Cardiovascular Diseases (CVDs) | Leading cause of death globally; includes heart attacks and strokes; risk factors: hypertension, high cholesterol, smoking, obesity, physical inactivity, diabetes |
| Cancer | Uncontrolled cell division; major types in India: oral, lung, breast, cervical; risk factors: tobacco, alcohol, radiation, genetic mutations, viral infections (HPV for cervical cancer) |
| Diabetes Mellitus | Type 1: autoimmune destruction of insulin-producing beta cells in pancreas (juvenile onset); Type 2: insulin resistance (adult onset, linked to obesity/lifestyle) — accounts for ~95% of cases; India has the second-highest number of diabetics globally |
| Chronic Obstructive Pulmonary Disease (COPD) | Progressive lung disease causing obstructed airflow; includes chronic bronchitis and emphysema; risk factors: smoking, air pollution, biomass fuel exposure |
Part V — Vaccines and Immunisation
Types of Vaccines
| Vaccine Type | Mechanism | Examples |
|---|---|---|
| Live Attenuated | Contains weakened form of the pathogen; triggers strong, long-lasting immunity | BCG (TB), OPV (Polio), MMR (Measles, Mumps, Rubella), Yellow Fever |
| Inactivated (Killed) | Contains killed pathogen; weaker immune response, may need boosters | IPV (Polio — Salk), Rabies vaccine, Hepatitis A vaccine, Covaxin (COVID-19) |
| Toxoid | Contains inactivated toxin (not the pathogen itself); targets bacterial toxins | DPT vaccine — tetanus and diphtheria components are toxoids |
| Subunit / Recombinant | Contains only specific proteins or antigens from the pathogen | Hepatitis B vaccine (HBsAg protein), HPV vaccine, Corbevax (COVID-19) |
| mRNA | Delivers mRNA encoding a pathogen protein; cells produce the protein, triggering immunity; mRNA is broken down by the body after use | Pfizer-BioNTech (Comirnaty), Moderna (Spikevax) — both for COVID-19 |
| Viral Vector | Uses a harmless virus to deliver pathogen genetic material into cells | AstraZeneca/Covishield (COVID-19), Sputnik V, Johnson & Johnson |
Prelims Tip: mRNA vaccines do NOT alter human DNA. The mRNA provides temporary instructions to cells to produce a protein (spike protein in COVID-19), which the immune system then recognises and attacks. The mRNA is broken down and eliminated by the body.
India's Universal Immunisation Programme (UIP)
India's UIP, launched in 1985, is one of the largest immunisation programmes in the world.
| Aspect | Details |
|---|---|
| Launched | 1985 (expanded from the EPI — Expanded Programme on Immunisation started in 1978) |
| Coverage Target | All pregnant women and 85% of infants against vaccine-preventable diseases |
| Original 6 Antigens (1985) | BCG (tuberculosis), DPT (diphtheria, pertussis, tetanus), OPV (polio), Measles, and Tetanus Toxoid for pregnant women |
| Current Coverage | Covers 12 vaccine-preventable diseases including Hepatitis B (2007-08), Pentavalent (2014), Measles-Rubella (2017), Rotavirus, PCV (Pneumococcal), JE (in endemic districts), IPV |
| Mission Indradhanush | Launched December 2014 to achieve full immunisation coverage for children and pregnant women in low-coverage districts; Intensified Mission Indradhanush (IMI) launched 2017 |
Part VI — Disease Eradication and Elimination
Key Milestones
| Disease | Status | Key Date/Details |
|---|---|---|
| Smallpox | Eradicated globally | Last naturally occurring case: 26 October 1977 (Ali Maow Maalin, Somalia); WHO certified global eradication on 8 May 1980; the only human disease ever eradicated |
| Polio | Eliminated in India | India's last wild poliovirus case: 13 January 2011 (Howrah, West Bengal); WHO South-East Asia Region (including India) certified polio-free on 27 March 2014; global eradication ongoing — endemic in Afghanistan and Pakistan |
| Guinea Worm Disease | Nearly eradicated globally | Cases reduced from 3.5 million (1986) to fewer than 15 (2023); led by the Carter Center |
| Tuberculosis (TB) | India's 2025 elimination target missed (ahead of global SDG target of 2030); India now realigns efforts toward the global 2030 elimination target | India carries the world's highest TB burden; NTEP (National TB Elimination Programme) driving efforts; Ni-kshay digital platform |
| Malaria | Elimination target in India | National Framework for Malaria Elimination (2016-2030); India aims for malaria-free status by 2030 |
| Leprosy | Eliminated as public health problem in India (2005) | Prevalence reduced to <1 per 10,000 population at national level; however, some states still have higher prevalence |
| Yaws | India declared yaws-free | India declared yaws-free in May 2016 by WHO |
Prelims Tip: Smallpox is the ONLY human disease eradicated. Polio is eliminated from India (no cases since 2011) but not eradicated globally. Rinderpest (a cattle disease) was declared eradicated in 2011 — the only animal disease eradicated.
Part VII — Major Epidemics and Pandemics
| Pandemic/Epidemic | Period | Pathogen | Estimated Deaths | Key Facts |
|---|---|---|---|---|
| Black Death | 1346-1353 | Yersinia pestis (Bubonic Plague) | 75-200 million | Spread via rat fleas along trade routes; killed 30-60% of Europe's population |
| Spanish Flu | 1918-1920 | H1N1 Influenza virus | 50-100 million globally; ~18 million in India | Infected ~500 million people (~1/3 of world population); India was among the worst-hit countries |
| HIV/AIDS Pandemic | 1981-present | HIV | ~40 million deaths (cumulative) | First identified in 1981; no cure but ART controls the virus; UNAIDS coordinates global response |
| COVID-19 | 2019-present | SARS-CoV-2 | ~7 million confirmed (likely significantly higher) | Declared pandemic by WHO on 11 March 2020; led to development of mRNA vaccines within a year; India faced severe Delta wave (April-June 2021) |
| Ebola (West Africa) | 2014-2016 | Zaire ebolavirus | ~11,300 | Largest Ebola outbreak; primarily Guinea, Liberia, Sierra Leone |
India's Public Health Response Mechanisms
| Mechanism | Details |
|---|---|
| Integrated Disease Surveillance Programme (IDSP) | India's disease surveillance network; renamed Integrated Health Information Platform (IHIP) in 2021; digitised, real-time disease outbreak monitoring |
| National Centre for Disease Control (NCDC) | Nodal body for disease surveillance and outbreak investigation; headquartered in Delhi |
| WHO International Health Regulations (IHR) | International framework requiring countries to report public health emergencies of international concern (PHEIC) to WHO; India is a signatory |
| One Health Approach | Recognises the interconnection between human, animal, and environmental health; critical for addressing zoonotic diseases (diseases that jump from animals to humans — e.g., Nipah, COVID-19, Ebola) |
Part VIII — Fungal and Helminthic Diseases
Common Fungal Diseases
| Disease | Causative Organism | Affected Area | Transmission |
|---|---|---|---|
| Ringworm | Trichophyton, Microsporum | Skin, scalp, nails | Direct contact; contaminated surfaces |
| Candidiasis (Thrush) | Candida albicans | Mouth, throat, genitals | Opportunistic — occurs when immune system is weakened |
| Aspergillosis | Aspergillus species | Lungs | Inhalation of fungal spores; risk in immunocompromised patients |
| Mucormycosis (Black Fungus) | Mucor, Rhizopus | Sinuses, brain, lungs | Inhalation of spores; surged during COVID-19 Delta wave (2021) in India, particularly in diabetic and steroid-treated patients |
Common Helminthic (Worm) Diseases
| Disease | Causative Organism | Transmission | Symptoms |
|---|---|---|---|
| Ascariasis | Ascaris lumbricoides (roundworm) | Faecal-oral (contaminated soil/food) | Abdominal pain, malnutrition, intestinal obstruction |
| Filariasis (Elephantiasis) | Wuchereria bancrofti | Vector-borne — Culex mosquito | Swelling of limbs (lymphedema), lymphatic damage; India runs National Programme for Elimination of Lymphatic Filariasis (NPELF) with annual mass drug administration (albendazole + DEC) in endemic districts |
| Tapeworm Infection | Taenia solium (pork), T. saginata (beef) | Undercooked contaminated meat | Abdominal discomfort; cysticercosis if larvae invade tissues |
| Hookworm Disease | Ancylostoma duodenale | Larvae penetrate bare feet from contaminated soil | Iron-deficiency anaemia, fatigue |
Frequently Asked Prelims Questions — Pattern
| Question Pattern | Answer |
|---|---|
| Which Plasmodium species is most fatal? | P. falciparum |
| Vector for malaria? | Female Anopheles mosquito |
| Vector for dengue? | Aedes aegypti mosquito |
| Vector for kala-azar? | Sandfly (Phlebotomus) |
| Only human disease eradicated? | Smallpox (certified 1980) |
| India polio-free since? | Last case January 2011; WHO certified 27 March 2014 |
| What does BCG vaccine prevent? | Tuberculosis |
| What does DPT vaccine prevent? | Diphtheria, Pertussis, Tetanus |
| UIP launched in? | 1985 |
| Hepatitis types transmitted through water? | Hepatitis A and E |
| Hepatitis types transmitted through blood? | Hepatitis B, C, D |
| What is a zoonotic disease? | Disease transmitted from animals to humans |
| What is herd immunity? | Indirect protection when sufficient population is immune |
| mRNA vaccines — do they alter DNA? | No — mRNA is temporary; broken down after use |
Key Terms for Quick Revision
| Term | Meaning |
|---|---|
| Pathogen | A microorganism that causes disease (bacteria, virus, fungus, protozoan) |
| Vector | An organism (usually insect) that transmits a pathogen from one host to another |
| Zoonosis | Disease transmitted from animals to humans (e.g., rabies, Nipah, COVID-19) |
| Pandemic | Worldwide spread of a new disease affecting large numbers across multiple countries |
| Epidemic | Sudden increase in disease cases above the expected level in a community |
| Endemic | Constant baseline presence of a disease in a geographic area (e.g., malaria in India) |
| Herd Immunity | When a sufficient proportion of a population is immune, providing indirect protection to those not immune |
| DOTS | Directly Observed Treatment, Short-course — WHO-recommended strategy for TB treatment |
| ART | Antiretroviral Therapy — treatment regimen for HIV/AIDS |
| PHEIC | Public Health Emergency of International Concern — WHO's highest alert level |
| mRNA Vaccine | Vaccine using messenger RNA to instruct cells to produce a pathogen protein, triggering immunity |
| Live Attenuated Vaccine | Vaccine containing a weakened (but living) form of the pathogen |
| Hypnozoite | Dormant form of P. vivax and P. ovale in the liver, causing malaria relapses |
| Antigenic Drift | Gradual mutations in virus genes causing small changes in surface proteins; reason flu vaccines are updated annually |
| Antigenic Shift | Major genetic reassortment in viruses (e.g., influenza) producing a new subtype; can cause pandemics |
| Case Fatality Rate (CFR) | Proportion of people diagnosed with a disease who die from it |
| Incubation Period | Time between infection and appearance of first symptoms |
| Quarantine | Isolation of healthy individuals who may have been exposed to a disease |
| Seroprevalence | Proportion of a population with antibodies against a specific pathogen |
Sources: WHO (who.int); CDC (cdc.gov); National Health Mission (nhm.gov.in); Britannica; Wikipedia.
