INFECTIOUS DISEASES

Disease Pathogen Incubation Diagnostics Signs and symptoms Treatment

period Clinical Manifestations Drug of choice
Dengue Dengue virus 3-14 days Full blood count Case Definition for Dengue without Warning Signs Supportive management
fever (leukopenia with or Probable dengue: Lives in or travels to dengue-
Vector: Aedes without endemic area, with fever, plus any two of the Hydration
aegypti thrombocytopenia) following: Blood product transfusion in
mosquito • Headache • Body malaise • Myalgia • Arthralgia severe cases
Dengue NS1 antigen • Retro-orbital pain • Anorexia • Nausea •
test Vomiting • Diarrhea • Flushed skin • Rash Paracetamol for fever and pain
(petechial, Hermann’s sign) relief
Dengue IgM antibody AND
test • Laboratory test, at least CBC (leucopenia with or *reference: Revised Dengue
without thrombocytopenia) and/or dengue NS1 Clinical Case Management
Confirmatory test: antigen test or dengue IgM antibody test (optional) Guidelines 2011 (DOH, 2015)
viral culture isolation Confirmed dengue: • Viral culture isolation • PCR
or PCR
Case Definition for Dengue with Warning Signs
Lives in or travels to dengue-endemic area, with
fever lasting for 2-7 days, plus any of the following:
• Abdominal pain or tenderness • Persistent
vomiting • Clinical signs of fluid accumulation •
Mucosal bleeding • Lethargy, restlessness • Liver
enlargement
• Laboratory: increase in Hct and/or decreasing
platelet count Confirmed dengue: • Viral culture
isolation • PCR

Case Definition for Severe Dengue Lives in or

travels to a dengue-endemic area with fever of 2-7
days and any of the above clinical manifestations
for dengue with or without warning signs, plus any
of the following:
• Severe plasma leakage, leading to: - Shock - Fluid
accumulation with respiratory distress
• Severe bleeding
• Severe organ impairment
- Liver: AST or ALT >1000
- CNS: e.g., seizures, impaired consciousness
 - Heart: e.g., myocarditis
- Kidneys e.g., renal failure
Note: Above manifestations and/or laboratory
parameters require strict observation, monitoring,
and appropriate medical intervention.

Malaria Protozoan 7-30 days Gold standard: Nonspecific symptoms:

parasites: P. Microscopy Headache, lassitude, fatigue, abdominal First line: Artemether +
Plasmodium falciparum = discomfort, muscle and joint aches, fever, chills, lumefantrine
falciparum, 9-14 days Other tests: rapid perspiration, anorexia, vomiting, malaise Artesunate + amodiaquine
plasmodium P. vivax = diagnostic test Artesunate + mefloquine
vivax, 12-17 days Severe malaria: Artesunate + SP
plasmodium P. malariae Coma, metabolic acidosis, severe anemia, Dihydroartemisinin + piperaquine
ovale, 18-40 days hypoglycaemia, acute renal failure, acute 2nd line: quinine + tetracycline or
plasmodium pulmonary edema doxycycline or clindamycin
malariae,
plasmodium Pregnant women in first trimester:
knowlesi Quinine + clindamycin

Pregnant women on 2nd-3rd

trimester: mefloquine +
artemisinin derivative

Prophylaxis according to CDC:

atovaquone-proguanil,
doxycycline, mefloquine

Tuberculosis Mycobacterium 2-12 weeks Sputum microscopy Cough of 2 weeks or more H – isoniazide
tuberculosis – TB culture Night sweats R – rifampicin
acid fast Weight loss Z – pyrazinamide
bacterium Other test: Chest Anorexia E – Ethambutol
xray, chest CT scan Unexplained fever and chills S – Streptomycine
Chest pain
Fatigue Category 1 (all new cases of
Body malaise pulmonary and extrapulmonary TB
except meninges,bones and joints)
2HRZE/4HR

Category 1a (meninges, bones,

joints) 2HRZE/10HR
 Category II (for retreatment of
confirmed rifampicin-sensitive
pulmonary and extra-PTB except
meninges, bones, joints)
2HRZES/1HRZE/5HRE

Category IIa (for retreatment of

confirmed rifampicin-sensitive
exta-PTB, meninges, bones, joints)
2HRZES/1HRZE/9HRE

*reference: Clinical practice

guidelines for diagnosis,
treatment, prevention and control
of tuberculosis in adult Filipinos,
2016 update
Tetanus Clostridium 7-10 days Clinical Initial symptoms: muscle aches, trismus, myalgia DOC: Metronidazole
tetani – Severe: generalized muscle spasm, cardiovascular Other drug: Penicillin
anerobic, gram instability, labile BP, tacy- or bradycardia, pyrexia,
positive, spore- increased respiratory and GI secretions Human tetanus immunoglobulin
forming rod
*reference: Harrison’s Principle of
Internal Medicine, 19th edition