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COMMUNICABLE DISEASE
CHAIN OF INFECTION
Disease caused by an infectious agent that are transmitted
directly or indirectly to a well person through an agency, vector or
inanimate object
CONTAGIOUS DISEASE
Disease that is easily transmitted from one person to
another
INFECTIOUS DISEASE
Disease transmitted by direct inoculation through a break in
the skin
Lethargy
Fetal, shrimp or “C” position
- Tubercle Brudzi Spinal canal, subarachnoid space between L3-L4 or L4- L5
After: bedrest
Flat on bed to prevent spinal headache
COCCEMI
Slight involvement of the CNS
Pain and spasm of muscles
Transient paresis
(+) Pandy’s test (increased protein in the CSF)
2. Close contacts
Affects lower extremities
Urine retention and constipation
well-ventilated isolation 24-72
(+) HOYNE’S SIGN (when in supine position, head will fall
back when shoulders are elevated)
Biteinvasion
infected feces 3. Negri b
2. Pre-paralytic of an infected trea
Direct inoculatio
- Direct contact with phase2. Morphine Tthrough
– rismus
animal ISOLATION PRECAUTION a broke
wou
or meningetic
POLIO
respiratory
ABORTIVE TYPE secretions
Does not invade the CNS
typewith soiled
Headache 3.Enteric heatskin
Moist isolation Res
- Indirect
Sore throat
2. Excitement / C – onvulsions 2. Acti
linens and articles application iso
neurological imm CD-Bucud 3
immunized
Isolation
Tetracycline
BIRD FLU SARS
Face mask on the patient
Avian influenza virus, H5N1 Corona virus
•
•
•
importation of
Caregiver: use a face mask and eye goggles/glasses
Distance of 1 meter from the patient
Transport the patient to a DOH referral hospital
order # 280)
Medicine (RITM) (Alabang, Muntinlupa)
pain
MODE OF TRANSMISSION 3. Cook chicken
SARS
(Cebu City)
• Mindanao – Davao Medical Center (Bajada, Davao City)
SUSPECT CASE
Cough
Inhalation of feces and thoroughly
1. A person presenting after 1 November 2002 with a history of:
Respiratory droplets
High fever >38 0C AND
Cough or breathing difficulty AND
discharge of an infected bird
Difficulty breathing
CD-Bucud 4
• Suffocation, cyanosis or death
One or more of the following exposures during the 10 days
WOUND OR CUTANEOUS DIPHTHERIA
prior to the onset of symptoms:
• Yellow spots or sores in the skin
Close contact, with a person who is a suspect or
probable case of SARS PERTUSSIS
CATARRHAL STAGE
History of travel, to an area with recent local
transmission of SARS • Lasts for 1 to 2 weeks
Residing in an area with recent local transmission of • Most communicable stage
SARS • Begins with respiratory infection, sneezing, cough and
2. A person with an unexplained acute respiratory illness resulting fever
in death after 1 November 2002, but on whom no autopsy has been
performed :
• Cough becomes more frequent at night
AND PAROXYSMAL STAGE
• Lasts for 4 to 6 weeks
One or more of the following exposures during the 10 days
prior to the onset of symptoms: • Aura: sneezing, tickling, itching of throat
Close contact, with a person who is a suspect or • Cough, explosive outburst ending in “whoop”
probable case of SARS • Mucus is thick, ends in vomiting
History of travel, to an area with recent local • Becomes cyanotic
transmission of SARS
• With profuse sweating, involuntary urination and
Residing in an area with recent local transmission of exhaustion
SARS CONVALESCENT STAGE
PROBABLE CASE • End of 4th-6th week
1. A suspect case with radiographic evidence of infiltrates • Decrease in paroxysms
consistent with pneumonia or respiratory distress syndrome on Chest
x-ray.
2.Tonsilopharyngeal
•
1. Diphtheria
1. Respiratory
Excoriated nares and upper lip
droplets anti-toxin
TONSILOPHARYNGEAL DIPHTHERIA
• Low grade fever Heart
2. Paroxysmal Resp
Decreased
2. Direct contact with-respiratory
Requires skin testing
• Sore throat
•3.Laryngeal
• Bull-neck appearance
failure secretions
in or
3.with
Convalescent
Pseudomembrane- Group of pale yellow membrane over
arr
tonsils and at the back of the throat as an inflammatory
•
abdomen
CNS involvement – manifested by headache, stiff neck, 2. Chronic amoebic 1. Stool ex
dysentery
delirium, double vision
• Deafness as a result of mumps
NURSING MANAGEMENT
1. Prevent complications 2. Blood e
−
−
Scrotum supported by suspensory
Use of sedatives to relieve pain
- Enlarged liver
− Treatment: oral dose of 300-400 mg cortisone followed by
3. Sigmoidoscopy
100 mg every 6 hours
- Large sloughs of intestinal
−
2. Diet
Nick in the membrane
5. Avo
CHOLERA CHICKENPOX
TYPHOID FEVE
MAIN PROBLEM
MAIN PROBLEM
Acute bacterial disease of the A highly
An infection affecting
contagious the
disease
GIT characterized by profuse characterized
Peyer’s patches of the sma
by vesicular
secretory diarrhea intestines
eruptions on the skin and
ETIOLOGIC AGENT mucous membranes
CHOLERA CHICKENPOX
TYPHOID typhi
ETIOLOGIC AGENTFEVE
Vibrio cholerae Salmonella Vari
SIGNS AND SYMPTOMS
INCUBATION PERIOD PERIODFever (ladder-like)
OF COMMUNICABILITY
INCUBATION PERIOD
Rice-water stool
1 to 3 days One daydays
10-21 before
1 to 3 eruption
weeks
Rose spots
of 1 st lesion and five days
Abdominal
MODE cramps MODE
OF TRANSMISSION OF TRANSMISSION
Diarrhea
after appearance of last1. D
CHOLERA
Vomiting crop
1. Fecal-oral CHICKENPOX
TYPHOID FEVE
transmission 2. D
TYPHOID STATE
2. 5 F’s SIGNS AND SYMPTOMS
TREATMENT MODALITIES 3. I
Intravascular SIGNS AND SYMPTOMS
1.Chloramphenicol
Sordes
1.Lactated Ringer’s PROD
Dehydration • Rashes : Centrifugal
drug of choice
solution Subsultus Tendinum
PERIO
distribution
Shock 2. Ampicillin/
Coma vigil
- Feve
2. Oral rehydration •Rash stages: macule
Amoxicillin –- Head
for
CHOLERA
therapy
CHICKENPOX
TYPHOID FEVE
Carphologia
papule vesicle
typhoid carriers
NURSING MANAGEMENT
pustule - Mala
crust
3. Antibiotic therapy COMPLICATIONS
3. Cotrimoxazole – f
1. Maintain and restore the fluid
- Tetracycline – drug SCARRING severe– most
cases with
common
and electrolyte balanceassociated with
•complication;
Pruritus
of choice relapses
staphylococcal or streptococcal
2. Enteric isolation
infections from scratching
- Cotrimoxazole
INTEGUMENTARY SYSTEM
3.
- Chloramphenicol Sanitary disposal of
NECROTIZING excretaFASCIITIS
most severe complication
CD-Bucud 7
A contagious
Encourage notexanthematous
1.Vitamin A – helps
A benign communicable
going to school: Encephalitis
disease
usually 7with
dayschief symptoms to
prevent eye damage
exanthematous disease cau
the upper respiratory tract and blindness
by rubella virus
Disinfection of clothes and linen
ETIOLOGIC AGENT
MEASLES
with nasopharyngeal discharges MEASLES
2. GERMAN
Antipyretics –MEASL
for
Filterable virus of
by sunlight or boiling
fever Rubella virus
paramyxoviridae NURSING MANAGEMENT
PERIOD OF COMMUNICABILITY
3. Penicillin – given
INCUBATION PERIOD
4 days before and 5 days after only when
One week 1. secondary
Darkened
before rood
and four
10-12 days 14-21 dayssets in
infection
the appearance of rashes after the appearance of rasb
2. Diet: should
MODE OF TRANSMISSION
SIGNS
KOPLIK’S AND
SPOT SYMPTOMS
(Rubeola) Droplet method3. Warm saline
1.SCABIES
- Bluish white spots surrounded by a red halo
MAIN PROBLEM eye irritation
2. Direct contact with ofrespiratory discharges
- Appear on the buccal mucosa opposite the premolar teeth
PRE-ERUPTIVE STAGE mite resultingPRE-ERUPTIVE
FORCHEIMER’S SPOTS (Rubella)
- small, red lesions
Infestation the skin produced by the burrowing action STAGE
of a parasite
in skin irritation and formation of vesicles and pustules
Cough F
Sarcoptes scabiei
pyretics CD-Bucud 8
Coryza Headache
INCUBATION PERIOD
AIDS
Within 24 hours
MODE OF TRANSMISSION
Direct contact
Indirect contact
Sarcoptes scabiei
1. Yellowish white in color
2. Barely seen by the unaided eye
3. Female parasite burrows beneath the epidermis to lay eggs
4. Males are smaller and reside on the surface of the skin
SIGNS AND SYMPTOMS
SIGNS AND SYMPTOMS
• Thin, pencil-mark lines on the skin OPPORTUNISTIC INFECTIONS
• Itching, especially at night
• Rashes and abrasions on the skin
PRIMARY LESIONS
NODULAR LESIONS
1. Pneumocystis carinni
SECONDARY LESIONS
TREATMENT MODALITIES pneumonia
AIDS
• SCABICIDE : Eurax ointment (Crotamiton)
• PEDICULICIDE : Kwell lotion (Gamma Benzene
Hexachloride) – contraindicated in young children and
pregnant women 2. Oral candidiasis
• Topical steroids
• Hydrogen peroxide : cleanliness of wound
• Lindane Lotion
NURSING MANAGEMENT 3. Toxoplasmosis
•
•
Apply cream at bedtime, from neck to toes
Instruct patient to avoid bathing for 8 to 12 hours
SIGNS AND SYMPTOMS
•
•
Dry-clean or boil bedclothes
Report any skin irritation
4. Acute/chronic diarrhea
• Family members and close contact treatment
• Good handwashing
• Terminal disinfection 5. Pulmonary tuberculosis
SEXUALLY TRANSMITTED DISEASES
MALIGNANCIES
AIDS AIDS
SYPHILIS
1. Kaposi’s sarcoma
2. Non-Hodgkin’s lymphoma
SIGNS AND SYMPTOMS
MAIN PROBLEM
Final and most serious stage Infectious disease caus
of HIV disease, which causes
severe damage to the immune
by a spirochete
system AIDS AIDS
SYPHILIS
ETIOLOGIC AGENT
MODE OF TRANSMISSION SIGNS AND SYMPTOMS
Retrovirus – Human T-cell
• Sexual
lymphotropic virus III contact – oral, anal orpallidum
Treponema
(HTLV-3) vaginal sex
INCUBATION PERIOD
•Blood transfusion
3 to 6 months to 8 to 10 years 10-90 days
•Mother -to-child CD-Bucud 9
AIDS CHLAMYDIA
SYPHILIS
DIAGNOSTIC PROCEDURESCOMPLICATIONS Women
Asymptomatic
Bleeding after intercourse urination
ONYCHOMYCOSIS
and (females)
• Red, swollen darkened nailbeds
2-3 weeks
resistance as invaginal
cancer
• Purulent discharge
• Separation of pruritic nails from nailbeds
in-between
MODE menses
OF TRANSMISSION Yellow or bloody
DIAPER RASH
• Scaly, erythematous, papular rash
discharge
• Covered with exudates
Sexual contact:3.Oral,
Increase
vaginalinorestrogen
Unusual vaginal discharge CD-Bucud 10
anal sex
level in pregnant women
• Appears below the breasts, between fingers, axilla, groin
and umbilicus
THRUSH
• Cream-colored or bluish-white patches on the tongue,
mouth or pharynx
• Bloody engorgement when scraped
MONILIASIS
• White or yellow discharge
• Pruritus
• Local excoriation
• White or gray raised patches on vaginal walls with local
inflammation
1. Antifungals 1. Antivirals
- Fluconazole (Diflucan) - Acyclovir (Zovirax)
- Ketoconazole (Nizoral)
- Imidazole (Nystatin)
- Used for oral thrush
- 48 hours until
symptoms disappear
- Cotrimoxazole
CD-Bucud 11
VECTOR-BORNE DISEASES
DENGUE
DENGUE MALARIA
DIAGNOSTIC PROCEDURES
MAIN PROBLEM
1. TORNIQUET TEST
An acute febrile disease - An acute
Screening testand chronic parasi
for dengue
- Adisease DENGUE
test for the tendency for blood
capillaries to break down or produc
The most DENGUE
common arboviral
petechial
The most
MALARIA
hemorrhage
deadly vector-born
illness transmitted globally
- disease by
Performed in the worldthe skin of
examining
TREATMENT MODALITIES
the forearms after the arm veins
ETIOLOGIC AGENT
INCUBATION PERIOD P. Falciparum
have been occluded– for
125days
minutes
Dengue virus types 1, 2, 3 and 4 1. Analgesics
Plasmodium andfalciparum
antipyretics
- To detect unusual capillary fragility
3-14 days P. Vivax – 14 days
- acetaminophen
Chikungunya virus Plasmodium
2. PLATELET COUNT vivax
SCHISTOSOMIASIS
2. Volume
P. Ovale
- Confirmatory
expanders
– 14 days
testovale
for dengue
DENGUE
O’nyong’nyong virus Plasmodium MALARIA
- Used in the treatment of
-intravascular
Decreased
P. Malariaecount – is30confirmatory
volume days
deficits
West Nile
MODE virus
OF TRANSMISSION Plasmodium malariae
- Example:
MAIN Lactated Ringers
PROBLEM
VECTOR
Bite of an infected mosquito
3. Blood transfusion – for severe
A slowly progressive disease
Aedes aegypti bleeding Anopheles flavirostris
caused
Blood bytransfusion,
a blood fluke contamina
(Aedes albopictus) syringetherapy
4. Oxygen or needle
SCHISTOSOMIASIS
ETIOLOGIC AGENT
DENGUE 5. Sedatives
MALARIA
Trans-placentally
White stripes on the back and 1. SCHISTOSOMA
Brown in color JAPONICUM
legs (Tiger mosquito) - Intestinal tract, endemic in the
INCUBATION
Philippines PERIOD
SIGNS AND(2SYMPTOMS
Day biting hours after sunrise
At
2.
Night2 biting
least
SCHISTOSOMAmonths (9 PM-3 AM)
MANSONI
and 2 hours before sunset) FEVER
FEVER - Africa
Breeds on clear, flowing and
Breeds on clear stagnant water MODE OF TRANSMISSION
shaded streams
CHILLS
HEADACHE 3. SCHISTOSOMA HAEMATOBIUM
- Middle East countries likeIngestion
Iran and Iraq
MALAISE
Urban-based PROFUSE SWEATIN
Rural-based CD-Bucud 12
Skin penetr
SCHISTOSOMIASISSCHISTOSOMIASIS
LEPTOSPIROS
SCHISTOSOMIASIS
stream MAIN PROBLEM
LEPTOSPIROS
A parasitic disease
ETIOLOGIC AGENT
caused by an African eye worm
- 1 tablet
Wuchereria
Brugia malayi
bancrofti BID for 3 months
2. Clings to grasses and leaves
Brugia timori
INCUBATION PERIOD
- 1 tablet OD for 3 months
8 to 16 months
MODE OF TRANSMISSION
SIGNS AND SYMPTOMS
3. Greenish brown in color ACUTE STAGESeptic or Leptospiremic St
Person-to-person by mosquito bites
SCHISTOSOMIASIS
(swimmer’s itch) LEPTOSPIROS
• Lymphedema (temporary swelling of the upper and lower
extremities)
M – (enlargement
• Elephantiasis yalgiaand thickening of the skin of
the upper and lower extremities, scrotum and breast
2. Katayama syndrome
N – ausea
LABORATORY EXAMINATIONS
• Nocturnal blood examination (NBE) – taken at patient’s
C - ough
SIGNS AND SYMPTOMS
residence/hospital after 8PM
Immune or Toxic Stage
V an–antigen
method; omiting
• Immunochromatographic test (ICT)
test done at daytime
– rapid assessment
TREATMENT
H – eadacheSTAGE
CHRONIC and fever •
-CLasts for 4 to 30 days
Diethylcarbamazine Citrate (DEC) or HETRAZAN – an
– ough
individual treatment kills almost all microfilaria and a good
proportion of adult worms.
A – norexia and lethargy PREVENTION AND CONTROL
• Measures aimed to control vectors
1. Hepatic: pain, abdominal
-CIritis,
– hestheadache, pain meninge
• Environmental sanitation such as proper drainage and
SCHISTOSOMIASIS
R – ash LEPTOSPIROS
distension, hematemesis, melena
manifestations
• Spraying with insecticides
PREVENTION AND CONTROL
cleanliness of surroundings
2. Intestinal: fatigue, abdominal pain, •• Measures aimed to protect individuals and families:
M - yalgia - Oliguria, anuria with ren
Use of mosquito nets
dysentery • Use of long sleeves, long pants and socks
failure
DIAGNOSTIC PROCEDURES •• Application of insect repellants
Screening of houses
3. Urinary: dysuria, urinary
frequency,
1. hematuria
Fecalysis - Shock, coma and congest
heart failure
4. Cardiopulmonary: palpitations,
dyspnea on exertion
2. Kato-Katz Technique
5. CNS: seizures, headache, back
3. Cercum
pain ova precipitin test
and paresthesia
(COPT) CD-Bucud 13