Communicable Diseases 3

COMMUNICABLE DISEASES 3
JAKE N. FABIAN, LPT, RN

CAUSATIVE AGENTS
SOURCE OF INFECTION
Mosquito :______________
• CHARACTERISTICS OF
THE FEMALE
MOSQUITO
• D-
• L-
• S-
• U-
INCUBATION PERIOD:______
MODE OF TRANSMISSION
MOSQUITO BITE
Peak months:
DIAGNOSTIC TEST
OTHER DX TESTS
PLATELET COUNT
VIRAL ISOLATION
SEROLOGIC TEST
STAGES OF DHF
A. ____________
–High fever, abdominal pain and
headache
–Flushing and vomiting,
conjunctival infection, epistaxis
STAGES OF DHF
B. _____________
–Decreasing temperature, severe
abdominal pain, vomiting and
frequent bleeding from GIT
–MONITOR SIGNS OF
HYPOVOLEMIC SHOCK
STAGES OF DHF
C. _______________
Generalized flushing
Appetite regained
BP stable
GRADE LEVELS OF DHF
Grade I
Fever, (+) TT, abdominal pain
Grade II
Spontaneous bleeding( Gum bleeding, epistaxis, rashes,
petechiae)
Grade III
Circulatory failure/ HYPOVOLEMIC SHOCK
Grade IV
Profound shock with undetectable P and BP
NURSING MANAGEMENT
ICE PACKS
TSB AND INCREASE FLUID INTAKE
Monitor vital signs
DIET:
CALAMINE LOTION
BORIC ACID/SALINE COMPRESS
MEDICAL MANAGEMENT
IV Fluids –
ORESOL: (75ML/KG IN 4-6 HOURS OR UP TO 2-
3L IN ADULTS)
___________: FOR FEVER
__________: severe headaches and for joint
and myalgia
No Aspirin!!!!!
BT
CHICKENPOX
CHICKEN POX
• CAUSATIVE AGENT:
SOURCES OF INFECTION
Secretions of respiratory tract
direct contact
coughing or sneezing
Lesions od skin/scabs: through
direct contact with the fluid from a
blister or from direct contact with a
sore from a person with shingles.
Incubation Period: __________________
Period Of Communicability: 1-2 days before the
rash appears and continue to be contagious until
all the blisters are crusted over (usually 6-8 days)
DIAGNOSTIC TEST:
________________-Vigorously swab the base of
the lesion, applying enough pressure to collect
epithelial cells without causing bleeding-and
collect vesicular fluid.
________________- performed by obtaining a
scraping from the base of a fresh vesicular lesion
after it has been unroofed, spreading and drying
the collected material on a glass slide, staining
the result with Giemsa, and examining the
material with a microscope for the characteristic
presence of multinucleated giant cells.
Clinical manifestations
Fever
Maculo-papular
rash for a few
hours, vesicular of
3-4 days and
leaves granular
scabs
PATTERN:
 ______
 Maculo-papulo-
vesicular and is
surrounded by an
erythematous base
that break easily and
form crusts
 highly pruritic
 Distribution: Lesions
are more on covered
than on exposed
parts of the body
 usually develops on
the scalp and body,
and then spreads to
the face, arms, and
legs.
Nursing MANAGEMENT
bed rest
Fluids
Control of fever: ___________________
Daily lukewarm/tepid baths
________________: Adding 1 to 2 cups to a lukewarm
bath and soaking for up to 20 minutes, three times a
day can help provide relief. Adding ingredients such as
oatmeal or chamomile tea may also reduce symptoms.
Cut fingernails short and keep clean
don mittens
MEDICAL MANAGEMENT
•____________: to
relieve itchiness
•___________: hastens
the acute stage
PREVENTION
VARIVAX,OKA
• Given for a person more than 13
years old who never had
chickenpox
LEPTOSPIROSIS
Leptospirosis
OTHER NAMES:
Well’s disease
Mud fever
Trench fever
Flood fever
Spiroketal jaundice
Japanese seven days fever
CAUSATIVE AGENT
__________________________
Present in blood for 7-10 days
CSF for 5-12 days
Urine after first week
Mode of Transmission
Direct contact: especially open

wounds with water, urine, moist
soil infected wild or domestic
animals, mainly rat rodents)
Incubation Period
______________
Average : of 10 days
Clinical manifestations
_______________Phase:
– Abrupt fever
– Headache
– Myalgia
– Nausea and vomiting
– Cough and chest pain
_______________Phase:
– Jaundice, hemorrhage, renal failure, myocarditis
DIAGNOSTIC TEST
BACTERIAL CULTURE
EXAM OF BLOOD AND CSF:
______
URINE: ______
MEDICAL Management
__________: 2M units q
6h/IM/IV
__________: 100 MG q12 PO
(common side effect)
___________: 500mg q12 PO
LEPROSY
Leprosy
• Chronic disease of the skin and peripheral
nerves
CAUSATIVE AGENT: _________________
MODE OF TRANSMISSION
• Prolonged skin – to – skin contact
• AIRBORNE: inhalation of Droplet from
coughing and sneezing
Early Signs and Symptoms
• C – change in skin color (reddish or white)
• L – loss of sensation on the skin lesion
• L – loss of sweating and hair growth over the
lesion
• U – ulcer that does not heal
• M – muscle weakness or paralysis of
extremities
• P – painful or thickened nerves
Late Signs and Symptoms
• M – _______(loss of eyebrow)
• L– _________inability to close eyelids
• S – sinking of nosebridge
• C – clawing of fingers and toes
• C – ___________(fixed tightening of muscle,
tendons, ligaments, or skin.) and chronic
ulcers
• E – enlargement of the breast
Classification
• Paucibacillary • Multibacillary
– Tuberculoid and – Lepromatous and
indeterminate borderline
– Incubation period:
_____ – Incubation
period:_______
– Non-infectious – Infectious
– Less than 5 lesions – More than 5 lesions
– Few bacilli – Numerous bacilli
– Treatment: – Treatment: _______
______
DIAGNOSTIC TEST
• __________________
• A skin biopsy involves removing a small
section of skin
MEDICAL Management
Ambulatory
chemotherapy:
Domiciliary treatment:
RA _________
Paucibacillary
• Adult
– Day 1
• ________600mg (once a month) and _____ 100mg
(daily)
– Day 2-28
• _______100mg (DAILY)
– 6 blister packs to be taken monthly within a
maximum period of 9 months
Paucibacillary
• Child (10 to 14 years)
– Day 1
• Rifampicin 450mg (once a month) and Dapsone 50mg
(daily)
– Day 2-28
• Dapsone 50mg (DAILY)
• 6 blister packs to be taken monthly within a maximum
period of 9 months
Multibacillary (MB Regimen)
• MB Adult
• Day 1
– __________600mg (once a month)
– __________300mg (once a month and 100mg
daily)
– __________100mg daily
• Day 2-28
– ___________50mg and ________100mg
• 12 blister packs to be taken monthly within a a
mAximum period of 18 months
Multibacillary (MB Regimen)
MB Child (10 to 14 years old)
• Day 1
– Rifampicin 450mg once a month
– Clofazimine 150mg once a month and 50 mg every other day
– Dapsone 50mg daily
• Day 2-28
– Clofazimine 50mg every other day
– Dapsone 50mg
• 12 blister packs to be taken monthly within a mximum
period of 18 months
• Children less than 10 years
– PB child: R 300mg D 25mg
– MB Child: R 300mg D 25mg C 100mg
PREVENTION
AVOIDANCE OF SKIN TO SKIN

CONTACT WITH LEPROMATOUS
CASE
BCG VACCINATION
GOOD PERSONAL HYGIENE
ADEQUATE NUTRITION
MALARIA
Malaria
CAUSATIVE AGENT: protozoan (Plasmodium
falciparum, P. vivax, P. ovale, P. malariae, P.
knowlesii)
SOURCE OF INFECTION: ____________
CHARACTERISTICS:
N-
H-
F-
R-
MODE OF TRANSMISSION:
• bite by an infected Anopheles mosquito
• through the use of dirty needles and syringes
• by a transfusion from an infected donor
INCUBATION PERIOD
• ______________
SIGNS AND SYMPTOMS
A. __________STAGE
 Chills/shakes/shiver, chatter teeth,
HOT STAGE
 High fever (>40 degrees, headache, skin is
red and hot to touch
B. __________
Diaphoresis
These three stages occur in a cycle usually on
the _______ day.
Later, patient will develop__________:
DIAGNOTIC TEST
• ______________: parasites can be identified
by examining under the microscope a drop of
the patient's blood, spread out on a
microscope slide.
• taken at the height of patient’s fever
Recommended Anti-Malaria Drugs
_______________: Drugs acting on the sexual
blood stages of the parasites which are responsible
for clinical manifestations
______________(ARALEN) 250 mgs:
ADDITIONAL INFO ON PREGNANCY AND
ENDEMIC AREAS….
____________50 mg:
____________300 mg: GIVEN DURING_____?but
W/F SIGNS OF NEUROLOGIC TOXICITY:
OTHER DRUGS:
Tetracycline hydrochloride 250 mg
Quinidine sulfate 200mg/durule
Quinidine gluconate 80 mgs
NURSING MANAGEMENT
• TSB
• INCREASE FLUID INTAKE
• MONITOR V/S AND ABNORMAL BLEEDING
• IRON-RICH FOODS
• Monitor fluid and electrolyte balance
• Maintain bed rest until the fever and other symptoms
have ceased
• encourage intake of nutrient-dense foods with
emphasis on fruits, vegetables, whole grains, and
legumes, especially those high in the immune-
stimulating nutrients selenium and vitamins A, C, and E
PREVENTION
• Use sprays and wear protective clothing to prevent
mosquito bites
• INSECTICIDE- soaking mosquito net in an insecticide
solution and dried
• _____________: construction of bio-ponds for larvivorous
fish propagation
• __________fish/sqm for immediate impact and about
__________fish/ha: delayed effect
• ______________: cutting of vegetation along stream
banks to expose the breeding stream to sunlight ,
rendering it unsuitable for mosquito vector habituation
Wearing of clothing that covers arms and legs
in the evening
Avoiding outdoor activities particularly during
vector’s peak biting hours: _________
Using mosquito repellents: mosquito coils,
soap lotion, etc.
Planting of neem tree or othe rherbal plants
______________: the typing of domestic
animals like carabao, cow near human
dwellings to deviate mosquito bite from
human to these animals.
HEPATITIS A
OTHER NAMES
INFECTIOUS HEPATITIS
EPIDEMIC HEPATITIS
CATTHARAL JAUNDICE
PREDISPOSING FACTORS
• POOR SANITATION
• CONTAMINATED WATER SUPPLIES
• UNSANITARY FOOD PREPARATION
• MALNUTRITION
• INCUBATION PERIOD:___________
• AVERAGE: 2,830 DAYS
• MODE OF TRANSMISSION:
SIGNS AND SYMPTOMS
INFLUENZA LIKE SYMPTOMS (HEADACHE)
MALAISE AND EASY FATIGABILITY
ANOREXIA AND ABDOMINAL PAIN
N/V
FEVER
LYMPHADENOPATHY
JAUNDICE ACCOMPANIED BY PRURITUS AND
URTICARIA
BILIRUBINEMIA WITH CLAY COLORED STOOLS
MANAGEMENT
• PROPHYLAXIS- IM INJECTION OF GAMMA
GLOBULIN
• COMPLETE BED REST
• DIET: __________________
PREVENTION
• PROPER DISPOSAL OF FECES AND URINE
• HANDWASHING
• SAFE WATER
• SANITARY FOOD PREPARATION
• SEPARATING AND PROPER CLEANING OF
ARTICLES USED BY PATIENTS
• ADDITONAL TOPICS:
• LEVELS OF PREVENTION
• SIDE EFFECTS OF ANTI-TB DRUGS
• POINTERS TO REVIEW
ADDENDUM
(READ SLIDES AT HOME)
Infectious Diarrheal Diseases
Cholera
Dysentery
Typhoid fever
Cholera
Etiologic Agent
◦ Vibrio el tor
◦ Vibrio cholerae
MODE OF TRANSMISSION
5FS
FOOD, FECES, FINGER,
FOMITES, FLY
• Incubation Period
– From few hours to five days, usually 3 days
• Period of Communicability
– 7-14 days after onset
– Occasionally 2-3 months
DIAGNOSTIC EXAM
• CULTURE: VOMITUS AND FECES
• DARK FIELD MICROSCOPY: Dark-field
microscopy is ideally used to illuminate
unstained samples causing them to appear
brightly lit against a dark background.
SIGNS AND SYMPTOMS:
 rice water stool:

characterized by sudden
onset of acute and profuse
colorless diarrhea
 Nausea and vomiting, severe
dehydration, vascular
collapse
Management
Prevention :
a) Case finding
b) Proper isolation
c) Health teaching on prevention
MANAGEMENT
• Fluid replacement
• Breast feeding in infants
• Coconut water: to replace potassium loss
• ORESOL replacement
Bacillary Dysentery/Shiggellosis
• Acute bacterial infection of the intestine
characterized by diarrhea, fever
• Etiologic Agent
– Shigella bacillus
– SH Flesneri, SH Boy-DII, SH Connei
Bacillary Dysentery/Shiggellosis
• Source of Infection: Feces of infected persons
• Incubation Period: 1 TO 4 days
• Mode of Transmission: 5Fs
• Diagnostic Test: stool exam
Management
• Sanitary disposal of human wastes
• Sanitary supervision of processing, preparation and serving of
food particularly those eaten raw
• Adequate provision for safe washing facilities
• Fly control
• Protection of purified water
• Isolation
• DIET: Low fiber diet, plenty of fluids, easily digestible foods
Typhoid (Enteric fever)
Background :
Systemic infection
Causative agent : Salmonella Typhosa
MOT : 5Fs
Incubation period : 1-3 weeks
SIGNS AND SYMPTOMS
• PATHOGNOMONIV SIGN: LADDER/STEPLIKE FEVER,
ROSE SPOTS
• (Peyer’s patches)
• Anorexia
• Headache
• GIT manifestations
• hepatomegaly
• Splenomegaly
DIAGNOSTIC EXAM
• CBC: LEUKOPENIA
• WIDAL TEST
• TYPHIDOT
Management :
TSB
Oral care
Proper TPR recording
Blood in stool and sudden acute abdominal pain
should be reported at once
Drug of choice : chloramphenicol / ampicillin
Nursing Care
• Tepid sponge bath
• Report bleeding from rectum, blood in the
stools, sudden acute abdominal pain,
restlessness, falling of temperature
• Vital signs monitoring

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COMMUNICABLE DISEASES 3

JAKE N. FABIAN, LPT, RN

Direct contact: especially open

AVOIDANCE OF SKIN TO SKIN

 rice water stool:

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