Introduction. Definition. Route. Causes. Cycle of infection. Prevention. Primary : Definition. Immunization . Children. Adult. Medical team.

Health education. Nutrition. Exercise. Personnel hygiene. Universal precautions .

Secondary : Definition.

Early TTT. Prevent complication.

Tertiary : Rehabilitation .

Hepatitis : Types .( A.B.C.E. G) Hepatitis C. Definition. S&S. Diagnosis. Complication. TTT. Medication . Long acting. Short acting.

Health education.

Prevention : Primary . Secondary. Tertiary .

Communicable diseases are diseases that are as a result of the causative organism spreading from one person to another or from animals to people. They are among the major causes of illnesses. These diseases affect people of all ages but more so children due to their exposure to environmental conditions that support the spread. Communicable diseases are preventable base on interventions placed on various levels of transmission of the .disease

Illness caused by specific microorganism

Infectious disease transmitted from one person to another

is a medical condition or disease which by definition is noninfectious and non-transmissible among people.

Direct contact:

An easy way to catch most infectious diseases is by coming in contact with a person or animal that has the infection.

Three ways infectious diseases can be spread through direct

contact are:

1- Person to person.
The most common way for infectious diseases to spread is through the direct transfer of bacteria, viruses or other germs from one person to another. This can occur when an individual with the bacterium or virus touches, coughs on or kisses someone who isn't infected. These germs can also spread through the exchange of body fluids from sexual contact or a blood transfusion. The person who passes the germ may have no symptoms of the disease, but may simply be a carrier.

2- Animal to person. Pets can carry many germs. Being bitten or scratched by an infected animal can make you sick and, in extreme circumstances, can be fatal. Handling animal waste can be hazardous, too. For example, you can acquire a toxoplasmosis infection by scooping your cat's litter box.

3- Mother to unborn child. A pregnant woman may pass germs that cause infectious diseases to her unborn baby. Some germs can pass through the placenta. Germs in the vagina can be transmitted to the baby during birth.

Indirect contact :
Disease-causing

organisms also can be passed by indirect

contact. Many germs can linger on an inanimate object, such as a tabletop, doorknob or faucet handle. When you touch a doorknob handled by someone ill with the flu or a cold, for example, you can pick up the germs he or she left behind. If you then touch your eyes, mouth or nose before washing your hands, you may become infected.

Insect

bites :

Some germs rely on insect carriers such as mosquitoes, fleas, lice or ticks to move from host to host. These carriers are known as vectors. Mosquitoes can carry the malaria parasite or West Nile virus, and deer ticks may carry the bacterium that causes Lyme disease.
Food

contamination :

Another way disease-causing germs can infect you is through contaminated food and water. This mechanism of transmission allows germs to be spread to many people through a single source. E. coli, for example, is a bacterium present in or on certain foods such as undercooked hamburger or unwashed fruits or vegetables.

Bacteria. such as strep throat, urinary tract infections and

tuberculosis.

 Viruses. Viruses cause a multitude of diseases ranging from the

common cold to AIDS.

Fungi. Many skin diseases, such as ringworm and athlete's foot, are
caused by fungi. Other types of fungi can infect your lungs or nervous system.

Parasites. Malaria is caused by a tiny parasite that is transmitted by

a mosquito bite. Other parasites may be transmitted to humans from animal feces.

1-The Infectious Agent:

-Any disease causing microorganism (pathogen).

2-The Reservoir:
-Where a microorganism normally lives and reproduces

3 - The Portal of Exit:

- Route of escape of the pathogen from the reservoir. Examples of portals of exit:

-Flu or cold - mucous secretions West Nile Virus - when the mosquito bites and feeds on the birds blood -Hepatitis A - stool SARS - droplet

4 - The Route of Transmission (Spread)

-the way the pathogen gets from the reservoir to the new host -:Methods of Transmission - Food/water/hands contaminated with stool from infected person; e.g., nor virus -Blood exposures, - sexual contact A.k.a. blood-borne; e.g. HIV, hepatitis B and C -Vector -borne E.g. Mosquitoes and West Nile virus, malaria - Unlikely methods of spread in courtroom

5 - The Portal of Entry:-Route through which the pathogen enters its new host

6 - The Susceptible Host :-

-A person who can get sick when they are exposed to a disease causing pathogen

A-

Primary prevention:

Definition:-

Health status
Health & without signs & symptoms of disease , illness ,or injury. Defined as, preventive measure that forestall the onset of illness or injury during the pre pathogenesis period. immunization forms one of the most important and cost effective strategies for the prevention of childhood sicknesses and disabilities and is thus a basic need for all children. The following schedule has been recommended by the Ministry of Health, Govt. of India and is one of the most widely followed by the child health care providers. NATIONAL IMMUNIZATION SCHEDULE BENEFICIARY Infants AGE
Birth 6 weeks 10weeks 14 weeks 9 months 18 months

VACCINE
BCG* and OPV** DPT&OPV DPT&OPV DPT&OPV Measles vaccine DPT&OPV(Booster dose) DT vaccine Tetanus toxoid

Children

5 years 10years

16years

Tetanus toxoid

*At birth or at the time of DPT/OPV ; ** dose called as Zero dose and can be given till 14 days of age ,if missed early.

ABBREVIATIONS: BCG=Bacillus calmittee Guerin; DPT=Diphtheria,Pertussis & Tetanus; OPV =Oral Polio Vaccine; DT=Diph & Tetanus vaccine.

Adult Vaccinations You Need :

Tetanus, diphtheria, pertussis (Td/Tdap): a booster is needed every 10 years. Apregnant woman who had a shot 10 or more years earlier should get a booster during the second or third trimester. Tdap should be given in place of Td for adults 19-64 years old who have never received Tdap in the past.

Human papillomavirus (HPV): three-dose series given to females age 11-26 who haven't already received the vaccination. Varicella (chickenpox): two-dose series given to adults with no evidence of immunity to the chickenpox virus. Pregnant women should not get this vaccine. Zoster (shingles): one-dose vaccine for adults 50 and older. Pregnant women should not get this vaccine. -Measles, mumps, rubella (MMR): one or more doses given to adults with no evidence of immunity. Pregnant women should not get this vaccine. -Influenza (flu): yearly vaccination given to adults 50 and older and any younger adults who would like to decrease their risk for infection. This is also recommended for younger adults with certain medical, occupational, and other indications including chronic heart or lung disease, diabetes, health care workers, or residents of nursing homes. The vaccine is available as a flu shot and nasal spray flu vaccine. The flu season can range from October to May, and the CDC recommends vaccination throughout the flu season. -Pneumococcal: given to adults 65 and older and adults with certain medical, lifestyle, or other indications including cigarette smokers and residents of nursing homes. A one-time booster is given five years later. - Hepatitis A: two-dose series given to adults with certain medical, occupational, lifestyle, or other indications including chronic liver disease, illegal drug use, and health care workers. -Hepatitis B: three-dose series given to adults with certain medical, occupational, lifestyle, or other indications including chronic liver disease, sexually active adults who are not in a monogamous relationship, injection drug use, and health care workers. - Meningococcal: one or more doses given to adults with certain medical or other indications; commonly given to college students living in dormitories or military recruits.

Travelers to some parts of the world or people with professions that bring them into contact with animals might need other vaccines. Be sure to ask your health care provider about which immunizations you need.

Immunization Information For Adults:fewer adults are fully vaccinated compared with children, yet adults are more likely to die from vaccine-preventable diseases than children. Adults need different vaccines depending on their health, age, lifestyle, and occupation. Most

adults should receive a seasonal flu vaccineannually. The pneumonia vaccine is also recommended annually for some adults. Other vaccinations may be necessary. For more information about which vaccines are right for you, consult with your healthcare provider

vaccine-preventable disease:
Diphtheria: A serious disease caused by bacteria that release a poison into the person's body. 5 to 10% of cases are fatal.

Hib (Haemophilus Influenzae Type B): A disease caused by bacteria that can cause meningitis and severe swelling of the throat, leading to blockage of the airway.

Hepatitis A: A viral infection of the liver that can cause fever, tiredness, loss of appetite, nausea, abdominal discomfort, dark urine, and jaundice. Hepatitis B: A serious viral infection of the liver that can cause chronic liver disease, including cirrhosis (scarring of the liver), liver failure, and liver cancer.

HPV (Human Papillomavirus): The most common sexually transmitted infection caused by a virus that infects the genital areas of men and women . Influenza, Seasonal (Flu): A common viral infection, normally one of two virus types A and B, that causes abrupt onset of fever, aching muscles, sore throat, and non-productive cough.

Measles: A viral disease with symptoms including fever, runny nose, cough, loss of appetite, conjunctivitis "pink eye," and a rash. Meningitis: A very serious bacterial disease that causes high fever, chills, lethargy, and a rash. About 9-12% of persons with meningococcal disease die.

Mumps: A viral disease that causes swelling of the salivary glands, headache, loss of appetite, and low-grade fever. Pertussis (Whooping cough): A serious bacterial infection that causes fever and uncontrolled bouts of coughing.

Pneumonia: A serious bacterial disease that can cause pneumonia, bacteremia, or meningitis.

Polio: A viral disease that can cause paralysis.

Rubella (German Measles): A viral disease that causes body rash, fever, and respiratory symptoms. Rotavirus: A virus that causes severe diarrhea, often accompanied by vomiting, fever, and dehydration, mostly in babies and young children.

Yellow Fever: A virus that causes fever, nausea, pain, and, in some cases, liver

damage.

Proof of Immunization
Most employers and schools require proof that you are immunized. You can get a copy of your immunization records from your physician (or your former pediatrician for childhood immunizations), the high school or college you attended (if you graduated recently), or from a previous employer. If your physician has retired, you may be able to access his/her records by calling Gorewood Systems (333-9090). You will need to know the doctor's name so that the company can tell you if that doctor has any patient records stored at his/her facility.

Where to Get Vaccinated:Pharmacies :Pharmacists can give some vaccinations. Check with your local pharmacy for more information.

Adult Immunization Clinics :If your regular healthcare provider does not offer routine recommended adult immunizations, you may contact one of the clinics listed here (who provide the vaccines listed below).

- The five food groups are: bread, cereals, rice, pasta, noodles vegetables, legumes fruit milk, yoghurt, cheese meat, fish, poultry, eggs, nuts, legumes. These foods provide the important nutrients the body needs

- To eat a healthy diet:

1. Eat enough food from each of the five food groups

every day. 2. Choose different varieties of foods from within each of the five food groups from day to day, week to week and at different times of the year. 3. Eat plenty of plant foods (bread, cereal, rice, pasta, noodles,vegetables, legumes and fruit); moderate amounts of animal foods (milk, yoghurt, cheese, meat, fish, poultry, eggs) in the proportions shown by the Guide; and small amounts of the extra foods, and margarines and oils. 4. Drink plenty of water.

Good nutrition enhances your quality of life and helps you prevent disease. It provides you with the calories and nutrients your body needs for maximum energy and wellness. NUTRITION: THE PROCESS BY WHICH THE BODY TAKES IN AND USES FOOD. NUTRIENTS: SUBSTANCES IN FOODS THAT YOUR BODY NEEDS TO GROW, TO REPAIR, AND TO PROVIDE ENERGY. CALORIES: UNITS OF HEAT THAT MEASURE THE ENERGY USED BY THE BODY AND ENERGY SUPPLIED TO THE BODY BY FOODS.

6 GROUPS OF NUTRIENTS: Carbohydrates Proteins Fats Vitamins Minerals Water

Dietary Management of Infection :Dietary management seeks to modify the course and outcome of infection by the improvement of food intake during disease and recovery, particularly in young children. This is applied principally through education programmes enabling mothers and carers to acquire and apply the necessary food resources and skills in an effective manner. The education may be formal, through the school system for example, but importantly includes information and counselling through health care workers. Under a number of circumstances, supplementary food, micronutrient supplements, and technologies such as for fermented and amylase-rich foods may be supplied as part of the services. A brief list of possible actions, related as appropriate to specific common diseases follows.

B-Second prevention :-

Health status -Disease , illness , or injury -Defined as, preventive measure that lead to early diagnosis and prompt treatment of a disease , illness , or an injury to limit disability , impairment, or dependency & prevent more sever pathogens. -Example of secondary prevention include personal and clinical screening , exams such as blood pressure, cholesterol , breast self examination the goal of such screening & exams is not to prevent the onset of the disease but rather to detect its presence during early pathogenesis, thus permitting early intervention or treatment and limiting disability. C-Tertiary prevention: Health status Disability , impairment , dependency. Defined as, preventive measure aimed at rehabilitation following significant pathogenesis.

Hepatitis: Viral disease Produces pathological changes in liver Three main hepatitis viruses Hepatitis A (viral hepatitis) Hepatitis B (serum hepatitis) Hepatitis C (non-A/non-B hepatitis)

Hepatitis non-ABC is a fourth class of hepatitis

Caused by infection with hepatitis D virus and newer hepatitis viruses E and G

Types
Hepatitis A (HAV)
What is it? HAV is a virus that causes inflammati on of the liver. It does not lead to chronic disease.

Hepatitis B (HBV)
HBV is a virus that causes inflammati on of the liver. The virus can cause liver cell damage, leading to cirrhosis (scarring of the liver) and cancer. 45 to 160 days. Average 120 days. Contact with infected blood, seminal fluid, vaginal secretions, contamina ted needles, including tattoo/bod y piercing tools. Infected mother to newborn. Human bite. Sexual contact. May have none. Some people

Hepatitis C (HCV)
HCV is a virus that causes inflammati on of the liver. This infection can lead to cirrhosis and cancer.

Hepatitis D (HDV)
HDV is a virus that causes inflammati on of the liver. It only infects people with HBV.

Hepatitis E (HEV)
HEV is a virus that causes inflammation of the liver. It is rare in the United States. There is no chronic state.

Incubatio n period

How is it spread?

15 to 50 days. Average 30 days. Transmitte d by fecal/oral route, through close person-toperson contact or ingestion of contamina ted food and water.

2 to 25 weeks. Average 7 to 9 weeks. Contact with infected blood, contaminat ed IV needles, razors and tattoo/body piercing tools. Infected mother to newborn. NOT easily spread through sex.

2 to 8 2 to 9 weeks. weeks. Average 40

days. Contact with infected blood, contamina ted needles. Sexual contact with HDVinfected person. Transmitted through fecal/oral route. Outbreaks associated with contaminate d water supply in other countries.

Symptom s

May have none. Adults may have light

Even fewer acute cases seen than any

Same as HBV.

Same as HBV.

stools, dark urine, fatigue, fever and jaundice (yellowing of the skin).

have mild flu-like symptoms, dark urine, light stools, jaundice, fatigue and fever.

other hepatitis. Otherwise same as HBV.

Hepatitis A (HAV)
Treatmen t of chronic disease Vaccine No specific treatment.

Hepatitis B (HBV)

Hepatitis C (HCV)

Hepatitis D (HDV) Interferon.

Hepatitis E (HEV) Supportive.

Interferon Interferon and anti- (pegintefer virals. on) along

with the antiviral ribavirin.

Two doses of vaccine, first dose at 12 months, second dose 6 months later.

At birth, a second dose between 1 and 2 months, third dose between 6 and 18 months. Infant born to infected mother, having sex with infected person or multiple partners, IV drug users, emergency responders , health care workers, men who have sex with men,

None.

HBV vaccine prevents HDV infection.

None.

Who is at risk?

Household or sexual contact with an infected person or living in an area with HAV outbreak. Travelers to developing countries, men who have sex with men and IV and non-IV

Anyone who had a blood transfusion or organ transplant before 1992, health care workers, IV drug users, dialysis patients, infants born to infected mother and having multiple

IV drug users, men who have sex with men, dialysis patients, healthcare workers, infants born to infected mothers and those having sex with a HDV infected person.

Travelers to developing countries, especially pregnant women.

drug users.

household contacts of chronically infected persons and dialysis patients.

sex partners.

Preventio n

Get a hepatitis A vaccine. Take immune globulin within two weeks of exposure. Wash hands with soap and water after going to the toilet. Use household bleach to clean surfaces contamina ted with feces, such as changing tables. Practice safe sex.

Get a hepatitis B vaccine. Take immune globulin within two weeks of exposure. Practice safe sex. Clean up infected blood with bleach and wear protective gloves. Don't share razors, toothbrush es or needles. Don't inject street drugs. Don't get a tattoo or body piercing.

Practice safe sex. Clean up spilled blood with bleach. Wear gloves when touching blood. Don't share razors or toothbrush es. Don't inject street drugs. Don't get a tattoo or body piercing.

Get a hepatitis B vaccine to prevent HBV infection. Practice safe sex.

Avoid drinking or using potentially contaminate d water. Wash your hands with soap and water after going to the toilet.

Prevention :There are no vaccine or immune globulin (IG) products available to prevent HCV infection.

A-Primary prevention ;
There is no vaccine for hepatitis C. The risk of infection can be reduced by avoiding:

unnecessary and unsafe injections; unsafe blood products; unsafe sharps waste collection and disposal; use of illicit drugs and sharing of injection equipment; unprotected sex with hepatitis C-infected people; sharing of sharp personal items that may be contaminated with infected

blood; tattoos, piercings and acupuncture performed with contaminated equipment.

B-Secondary and tertiary prevention

For people infected with the hepatitis C virus, WHO recommends:
education and counseling on options for care and treatment; immunization with the hepatitis A and B vaccines to prevent coinfection from these hepatitis viruses to protect their liver; early and appropriate medical management including antiviral therapy if appropriate; and regular monitoring for early diagnosis of chronic liver disease.

Treatment:_The rationales for treatment of chronic hepatitis are to reduce inflammation. _to prevent progression to fibrosis, cirrhosis, and HCC through the eradication of the virus in chronically infected patients, _to decrease infectivity and control the spread of the disease. Combination therapy results in better treatment responses than monotherapy; the highest response rates have been achieved with pegylated interferon in combination with ribavirin. Genotype determinations influence treatment decisions.

Currently the best indicator of effective treatment is a sustained viral response, defined by the absence of detectable HCV RNA in the serum as shown by a qualitative HCV RNA assay with lower limit of detection of 50 IU/mL or less at 24 weeks after the end of treatment. Interferon has been shown to normalize liver tests, improve hepatic inflammation and reduce viral replication in chronic hepatitis C and is considered the standard therapy for chronic hepatitis C. Currently, it is recommended for patients with compensated chronic hepatitis C (anti-HCV positivity, HCV RNA detection, abnormal ALT levels over at least 6 months, fibrosis shown by liver biopsy). Interferon-a is given subcutaneously at doses of 3 million units 3 times a week for 24 months *Side effects of interferon therapy:* fever * Hematologic * leukopenia *Alopecia *Neuropsiachiatric * depression *Weight loss *vomiting, *back pain *fatigue *diarrhea, *nausea, *joint aches, *Thrombocytopenia * insomnia

*abdominal pain,

*dizziness *Allergic and anaphylactic reactions

*Health education give to pt take interferon

therapy:
About side effect of the medication & important of control with it.