Systems Plus College Foundation Balibago, Angeles City College of Nursing

Submitted by: Hermie Joy G. Maglaqui NUR06A

Submitted to: Angelo P. Angeles, RN, MAN Instructor (NCM104)

Date: December 9, 2011

Table of Contents
All about Communicable Disease Disease affecting the Integumentary System Measles German Measles Chicken Pox Herpes Zoster Leprosy Anthrax Impetigo Scabies Disease affecting the Central Nervous System Meningitis Poliomyelitis Tetanus Rabies Disease affecting the Circulatory System Malaria Dengue Leptospirosis Disease affecting the Gastrointestinal System Viral Gastroenteritis Hepatitis A Salmonellosis Typhoid Fever Amoebic Dysentery Cholera Ascariasis Disease affecting the Respiratory System Pertussis Tuberculosis Pneumonia Swine Flu SARS Sexually Transmitted Diseases Gonorrhea Syphilis Genital Warts Vaginitis AIDS 3 4 5 7 9 11 13 15 17 18 20 21 23 25 27 29 30 32 34 36 37 39 41 43 45 47 49 51 52 54 56 58 60 62 63 65 67 69 71

COMMUNICABLE DISEASE
COMMUNICABLE DISEASE Is any disease that can be transmitted directly or indirectly from one person to another INFECTION Is a condition caused by the entry and multiplication of pathogenic microorganisms within the host body. It is also an invasion of an organisms (bacteria, helminths, fungi, parasite, ricketsia and prion) FUNDAMENTALS OF STANDARD PRECAUTION HANDWASHING GLOVES MASKS, GOGGLES, FACE SHIELDS AIR FILTERS GOWNNS ISOLATION STRICT ISOLATION CONTACT ISOLATION RESPIRATORY ISOLATION TUBERCULOSIS ISOLATION ENTERIC PRECAUTION DRAINAGE/SECRETION PRECAUTION BLOOD/BODY FLUIDS PRECAUTION AIRBORNE PRIVATE ROOM NEGATIVE AIR PRESSURE VENTILATION SAFEGUARDS air from room is not recirculated to other areas DOOR SHOULD BE KEPT CLOSED BARRIER TO SMALL PARTICLES masks HEPA high efficiency particulate air COVER MOUTH OF PATIENT WITH MASK DURING TRANSPORT DROPLET PRIVATE ROOM WEAR MASK IF WORKING WITHIN 3 FEET WEAR MASKS UPON ENTRY INTO THE ROOM COVER MOUTH OF PATIENT WITH MASK DURING TRANSPORT CONTACT PRIVATE ROOM WEAR GLOVES GLOVES ARE REMOVED BEFORE EXITING FROM THE ROOM HANDS ARE WASHED THOROUGHLY NOTHING IS TOUCHED BEFORE EXITING THE ROOM GOWN IS WORN WHEN ENTERING THE ROOM REMOVE GOWN CAUTIOUSLY BEFORE LEAVING THE ROOM PATIENT CARE ITEMS SHOULD BE RESTRICTED TO SINGLE PATIENT DIAGNOSTIC TOOLS COLLECTION OF SPECIMEN PRINCIPLES TYPES OF SPECIMEN COLLECTION BLOOD URINE STOOL SPUTUM WOUNDS THROAT LABORATORY TESTS
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ISOLATION It is necessary when a person is known or suspected to be infected with pathogens that can be transmitted by direct or indirect contact. The principle behind isolation technique is to create a physical barrier that prevents the transfer of infectious agents. To do this you have to know how the organisms are transmitted. Transmission-Based Precautions Airborne Droplets Contact

MICROSCOPY CULTURE

ANTIBIOTIC SUSCEPTIBILITY TESTING WHITE BLOOD CELL COUNT

MEASLES

OVERVIEW Measles, also called Rubeola, is a highly contagious respiratory infection that's caused by a virus. It causes a total-body skin rash and flu-like symptoms, including a fever, cough, and runny nose. Though rare in the United States, 20 million cases occur worldwide every year. Since measles is caused by a virus, there is no specific medical treatment and the virus has to run its course. But a child who is sick should be sure to receive plenty of fluids and rest, and be kept from spreading the infection to others. CAUSATIVE AGENT Measles is caused by an RNA paramyxovirus. INCUBATION PERIOD The incubation period is commonly 10 days from exposure to the onset of fever, and 14 days to the appearance of rash. MODE OF TRANSIMISSION Droplet / Airborne RISK FACTORS No vaccination. People who have not received the vaccine for measles are much more likely to develop the disease. Vitamin A deficiency. People who don't have enough vitamin A in their diets are more likely to contract measles and to have more-severe symptoms. SIGNS AND SYMPTOMS Measles Rash; Blotchy rash Skin of a patient after 3 days of measles infection. Fever; Cough; Runny nose
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Red, watery eyes (conjunctivitis) Feeling run down, achy (malaise) Tiny white spots with bluish-white centers found inside the mouth (Kopliks spots) Three to five days after the start of symptoms, a red or reddish-brown rash appears. The rash usually begins on a persons face at the hairline and spreads downward to the neck, trunk, arms, legs, and feet. When the rash appears, a persons fever may spike to more than 104 degrees Fahrenheit. DIAGNOSTIC/LAB TEST Clinic observation Nose and Throat Swabbing Leukopenia or leukocytosis Complement fixation or hemagglutinin test TREATMENT Sponge baths with lukewarm water may reduce discomfort due to fever. Drink plenty of fluids to help avoid dehydration. Pain relievers and fever reducers such as acetaminophen(Tylenol, Liquiprin Drops, and other brands) and ibuprofen(Advil, Motrin and other brands) can help with symptoms when used according to directions. Remember never to give aspirin to children or teenagers because it may cause a disease known as Reye syndrome. PREVENTION The most effective way to prevent measles is through immunization. Measles-mumps-rubella (MMR) vaccine this vaccine protects against both red measles and German measles. A special immunization --immune globulin-- may be necessary for certain high-risk people after they are exposed to measles. These include children younger than 1 year, children with weakened immune systems, and pregnant women. If you have been exposed to measles, contact your physician to determine if you need immune globulin

GERMAN MEASLES

OVERVIEW Rubella commonly known as German measles or 3-day measles is an infection that primarily affects the skin and lymph nodes. It is caused by the rubella virus (not the same virus that causes measles), which is usually transmitted by droplets from the nose or throat that others breathe in. It can also pass through a pregnant woman's bloodstream to infect her unborn child. It's a generally mild disease in children; the primary medical danger of rubella is the infection of pregnant women because it can cause congenital rubella syndrome in developing babies. CAUSATIVE AGENT RNA virus of Toga virus group INCUBATION PERIOD 14-21 days MODE OF TRANSMISSION Droplet / Airborne direct contact with Nasopharyngeal secretions Indirect contact with fomites Mother to Infant (Transplacental) RISK FACTORS Lack of immunization against Rubella or immunosuppression; and Exposure to an active case of rubella SIGNS AND SYMPTOMS
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It often begins with slight fever and swollen glands Rash begins on the face and spreads to the body Rash is comprised of small flat pink spots and lasts around five days, which may be itchy Aching joints; Headache; Sore throat Enlarged glands high in the back of the neck and behind the ears DIAGNOSTIC/LAB TEST IgM and IgG tests may be ordered on a newborn when the mother was diagnosed with a rubella infection during pregnancy and/or when a newborn is born with birth defects such as hearing loss, cardiovascular abnormalities, cataracts, and/or central nervous system disease that could be due to CRS. Since IgM and IgG rubella antibodies take some time to appear after infection, the tests may be repeated in 2 to 3 weeks to see if the antibody levels have become detectible (when initially absent) and to determine whether the levels are rising or falling over time. TREATMENT Apparently, no cure or further drug treatment is needed for the condition since it usually goes away on its own. The disease is caused by a virus thus antibiotic therapy is not effective to kill the pathogen. Medication such as paracetamol can be given to get rid of fever. Ways on how to treat it revolves around getting bed rest, drinking lots of water, and providing relief to the patient. PREVENTION It can cause serious side effects and malformations during pregnancy. Therefore, women are encouraged to be immunized before puberty stage. In children, measles vaccination is available for use to those without the history of measles or 9 months after being born. Mumps Measles Rubella (MMR) vaccine is also another option for two-year old kids. Isolate family members and avoid exposure to infected person as possible. Provide comfort to the patient, and administer sponge bath to alleviate discomfort. Follow medication and treatment regularly.

CHICKEN POX

OVERVIEW Chickenpox, also known as varicella, is a highly contagious and self-limited infection that most commonly affects children between 5-10 years of age. The disease has a worldwide distribution and is reported throughout the year in regions of temperate climate. The peak incidence is generally during the months of March through May. Lifelong immunity for chickenpox generally follows the disease. If the patient's immune system does not totally clear the body of the virus, it may retreat to skin sensory nerve cell bodies where it is protected from the patient's immune system. The disease shingles (also known as "zoster") represents release of these viruses down the length of the skin nerve fiber and produces a characteristic painful rash. Shingles is most commonly a disease of adults. CAUSATIVE AGENT Human herpesvirus 3 (alpha) or varicella zoster virus (VZV) is the causative agent. INCUBATION PERIOD 14-16 days (13-17 days in some books) MODE OF TRANSMISSION Chickenpox transmission is mainly person to person by airborne respiratory droplets but also by direct contact with vesicle fluid of chickenpox cases, or contact with the vesicle fluid of patients with herpes zoster. Indirect contact occurs through articles freshly soiled by discharges from vesicles of infected persons. Scabs are not infective. RISK FACTORS

People at risk of contracting chickenpox include anyone who hasn't been vaccinated or who has never had the disease. People who've been vaccinated against chickenpox are usually immune to the virus. The same is true of anyone who has had chickenpox in the past. People who have not contracted chicken pox People who have not been vaccinated for chicken pox SIGNS AD SYMPTOMS A red, itchy rash, initially resembling insect bites, on your face, scalp, chest and back Small, liquid-filled blisters that break open and crust over Fever; Mild headache; dry cough General feeling of unease and discomfort (malaise) or irritability The chickenpox rash goes through these three phases: Raised pink or red bumps (papules), which break out in different spots over several days Fluid-filled blisters (vesicles), forming from the raised bumps over about one day before breaking and leaking Crusts and scabs, which cover the broken blisters and take several more days to heal DIAGNOSTIC/LAB TEST Confirmation of the diagnosis is generally only required when the clinical picture is atypical. It is made by: isolation of the virus in cell cultures visualization by electron microscopy serological tests for antibodies immunofluorescence on lesion swab or fluid nucleic acid testing or PCR TREATMENT For most health children, chickenpox symptoms can be controlled with soothing baths or antihistamines to decrease itching. Acetaminophen may help control fever, headache, or muscle pain. Do not give aspirin to children with chickenpox, because this can increase the childs risk of Reye syndrome. A prescription drug called acyclovir is FDA approved to treat the symptoms of chickenpox in persons older than age. The drug should help reduce the severity of chickenpox symptoms, especially in older children and teenagers, if taken within 24 hours of the rashs first appearance. However, this drug is generally only used in severe cases of chickenpox and in patients who have weakened immune systems, such as persons with cancer and who have had an organ transplant. PREVENTION The best way to prevent illness is by vaccine. Protection is not life long and further vaccination is necessary five years after the initial immunization. People with chickenpox should remain at home until no new lesions are forming and all present lesions have crusted. This is generally a period of four to five days for persons with a healthy immune system. Infected persons with compromised immune systems may continue to form new lesions and remain infectious for a longer period of time.

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HERPES ZOSTER

OVERVIEW Zoster is a common, predominantly dermal, and neurologic disorder caused by the varicella-zoster virus (VZV), a virus morphologically and antigenically identical to the virus causing varicella (chickenpox). CAUSATIVE AGENT Varicella Zoster Virus Herpes Virus Varicallae HHV-3 INCUBATION PERIOD Unknown Believed to be 13 to 17 days MODE OF TRANSMISSION Direct contact Indirect contact Droplet / Airborne RISK FACTORS Anyone who has had chickenpox can get herpes zoster.
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Weak immune system and being older than 50. Cancer, HIV infection, and certain drugs weaken the immune system. SIGNS AND SYMPTOMS Presence or absence of low grade fever Headache, body malaise, muscle pain 24 to 48 hours before eruption Vesiculo-Pustular Rashes Painful and the pain persists for up to 2 months Unilateral distribution which follows the nerve pathway Crusts DIAGNOSTIC/LAB TEST Characteristic skin rash Tissue culture technique Smear of Vesicle Fluid Microscopy TREATMENT If the eye is affected (ophthalmic herpes) or looks like it may become affected, your doctor is likely to ask an eye specialist (ophthalmologist) to see you as a matter of urgency. The treatment is likely to involve specific anti-viral eye drops, and possibly treatment by mouth as well. Your doctor may want to prescribe a specific anti-viral agent, possibly in the form of treatment to be applied, or in the form of tablets. These are more likely to be used in someone whose eye is affected, or whose immune system is adversely affected by drugs or illness. Antibiotics: If any of the blisters become infected with ordinary germs (bacteria) the area becomes more red and sore (inflamed) and may take longer to heal. The doctor may treat this with antibiotics, in the form of a cream, or by mouth. PREVENTION Avoid too much animal food and keep the immune system strong If you have shingles you should stay away from other people until the blisters have dried (usually about seven days), as there are virus particles in the blister fluid. Eat a well-balanced diet rich in essential vitamins and minerals Get enough sleep Exercise regularly Reduce stress

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LEPROSY

OVERVIEW Leprosy is a disease caused by the bacteria Mycobacterium leprae, which causes damage to the skin and the peripheral nervous system. The disease develops slowly (from six months to 40 years!) and results in skin lesions and deformities, most often affecting the cooler places on the body (for example, eyes, nose, earlobes, hands, feet, and testicles). The skin lesions and deformities can be very disfiguring and are the reason that infected individuals historically were considered outcasts in many cultures. Although human-to-human transmission is the primary source of infection, three other species can carry and (rarely) transfer M. leprae to humans: chimpanzees, mangabey monkeys, and nine-banded armadillos. CAUSATIVE AGENT Mycobacterium leprae, an acid fast, Gram+, rod-shaped obligate intracellular organism. Grown in armadillos. It cannot be grown in agar medium. INCUBATION PERIOD Variable 5 months to 8 years
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MODE OF TRANSMISSION Droplet Contact with infected soil Inoculation through break on skin or mucous membrane Intimate skin to skin contact RISK FACTORS At highest risk are those living in endemic areas with poor conditions such as inadequate bedding, contaminated water, and insufficient diet, or other diseases that compromise immune function.

SIGNS AND SYMPTOMS Numbness and loss of temperature sensation (cannot sense very hot or cold temperatures) Loss of sensations of touch Pain Eventually deep pressure is decreased or lost. relatively painless ulcers, skin lesions of hypopigmented macules (flat, pale areas of skin) eye damage (dryness, reduced blinking) loss of digits facial disfigurement develop DIAGNOSTIC/LAB TEST clinical observations tissue biopsy or smear Lepromin Test TREATMENT Multidrug therapy (MDT) is the cornerstone of the leprosy elimination strategy as it cures patients, reduces the reservoir of infection and thereby interrupts its transmission. MDT also prevents disabilities through early cure. For purposes of treatment, leprosy is divided into two types: Pauci-bacillary(PB) leprosy : 1-5 skin lesions Regimen of two drugs Rifampicin and Dapsone for 6 months; Multi-bacillary(MB) leprosy : >5 skin lesions Regimen of three drugs Rifampicin,Clofazimine and Dapsone for 12 months; The drugs are provided in different blister packs for PB and MB leprosy and for Adults and Children in each type.

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ANTHRAX

OVERVIEW Anthrax is a serious illness caused by a spore-forming bacterium, Bacillus anthracis. Although anthrax affects mainly livestock and wild game, humans can become infected through direct or indirect contact with sick animals. Normally, anthrax isn't transmitted from person to person, but in rare cases, anthrax skin lesions may be contagious. Most often, anthrax bacteria enter your body through a wound in your skin. You can also become infected by eating contaminated meat or inhaling the spores. Signs and symptoms, which depend on the way you're infected, can range from skin sores to nausea and vomiting or shock. Prompt treatment with antibiotics can cure most anthrax infections contracted through the skin or contaminated meat. Inhaled anthrax is more difficult to treat and can be fatal. CAUSATIVE AGENT Bacillus anthracis
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INCUBATION PERIOD 1 to 7 days MODE OF TRANSIMISSION Direct/Indirect contact to infected animals RISK FACTORS To contract anthrax, you must come in direct contact with anthrax spores. This is more likely if you: Are in the military and deployed to an area with a high risk of exposure to anthrax Work with anthrax in a laboratory setting Handle animal skins, furs or wool from areas with a high incidence of anthrax Work in veterinary medicine, especially if you deal with livestock Handle or dress game animals in the United States, seasonal outbreaks of anthrax are common among livestock and game animals, such as deer SIGNS AND SYMPTOMS Cutaneous Anthrax This form of anthrax enters your body through a cut or other sore on your skin. It's by far the most common form of the disease. It's also the mildest with appropriate treatment, cutaneous anthrax is seldom fatal. Signs and symptoms of cutaneous anthrax include: A raised, itchy bump resembling an insect bite that quickly develops into a painless sore with a black center Swelling in the sore and nearby lymph glands DIAGNOSTIC/LAB TEST Skin testing. A sample of fluid from a suspicious lesion on your skin or a small tissue sample (biopsy) may be tested in a lab for signs of cutaneous anthrax. Blood tests. You may have a small amount of blood drawn that's checked in a lab for anthrax bacteria. Chest X-ray or computerized tomography (CT) scan. Your doctor may request a chest X-ray or CT scan to help diagnose inhalation anthrax. Endoscopy and stool samples. To diagnose intestinal anthrax, your doctor may examine your throat or intestine with an endoscope a thin, flexible tube with a tiny camera at its tip. In some cases, a sample of your stool may be checked for anthrax bacteria. Spinal tap (lumbar puncture). In this test, your doctor inserts a needle into your spinal canal and withdraws a small amount of fluid. A spinal tap is usually done only to confirm a diagnosis of anthrax meningitis. TREATMENT The standard treatment for anthrax is a 60-day course of an antibiotic, such as ciprofloxacin or doxycycline. Which single antibiotic or combination of antibiotics will be most effective for you depends on the type of anthrax you have, your age, overall health and other factors. Treatment is most effective when started as soon as possible. Although some cases of anthrax respond to antibiotics, advanced inhalation anthrax may not. By the later stages of the disease, the bacteria have often produced more toxins than drugs can eliminate. PREVENTION An anthrax vaccine for humans is available, but it's not 100 percent effective. The vaccine doesn't contain live bacteria and can't lead to infection, but it can cause side
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effects, ranging from soreness at the injection site to more-serious allergic reactions. The vaccine isn't recommended for children, pregnant women or older adults. The vaccine isn't intended for the general public. Instead, it's reserved for military personnel, scientists working with anthrax and people in other high-risk professions. If you live or travel in a country where anthrax is common and herd animals aren't routinely vaccinated, avoid contact with livestock and animal skins as much as possible. Also avoid eating meat that hasn't been properly cooked. Even in developed countries, it's important to handle any dead animal with care and to take precautions when working with or processing imported hides, fur or wool.

IMPETIGO

OVERVIEW Impetigo is a highly contagious skin infection that mainly affects infants and children. Impetigo usually appears as red sores on the face, especially around a child's nose and mouth. Although it commonly occurs when bacteria enter the skin through cuts or insect bites, it can also develop in skin that's perfectly healthy. CAUSATIVE AGENT Staphylococcus aureus (staph) Streptococcus pyogenes (strep). MODE OF TRANSMISSION Direct contact to infected person
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RISK FACTORS Attending school or child care Direct contact with an adult or child who has impetigo or with contaminated towels, bedding or clothing Crowded conditions Warm, humid weather impetigo infections are more common in summer SIGNS AND SYMPTOMS: Red sores that quickly rupture, ooze for a few days and then form a yellowish-brown Crust Itching Painless, fluid-filled blisters In the more serious form, painful fluid- or pus-filled sores that turn into deep ulcers MANAGEMENT/TREATMENT Topical antibiotics, such as mupirocin (Bactroban) Oral antibiotics, such as cephalexin (Keflex) or penicillins

SCABIES

OVERVIEW Scabies is an itchy skin condition caused by a tiny burrowing mite called Sarcoptes scabiei. The presence of the mite leads to intense itching in the area of its burrows. The urge to scratch may be especially strong while you're in bed at night. Scabies is contagious and can spread quickly through close physical contact in a family, child care group, school class or nursing home. Because of the contagious nature of scabies, doctors often recommend treatment for entire families or contact groups to eliminate the mite. CAUSATIVE AGENT Sarcoptes scabei
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MODE OF TRANSMISSION Direct contact to infected person SIGNS AND SYMPTOMS Itching, often severe and usually worse at night Thin, irregular burrow tracks made up of tiny blisters or bumps on your skin The burrows or tracks typically appear in folds of your skin. Though almost any part of your body may be involved, in adults scabies is most often found: Between fingers In armpits Around your waist Along the insides of wrists On your inner elbow Around breasts Around the male genital area On buttocks On knees On shoulder blades DIAGNOSTIC TEST To diagnose scabies, your doctor examines your skin, looking for signs of mites, including the characteristic burrows. When your doctor locates a mite burrow, he or she may take a scraping from that area of your skin to examine under a microscope. The microscopic examination can determine the presence of mites or their eggs. MANAGEMENT/TREATMENT Permethrin 5 percent (Elimite). Your doctor may recommend that you apply this cream which contains chemicals that kill scabies twice, with a week or so between each application. Permethrin is generally considered safe for children and adults of all ages, including women who are pregnant or nursing. Lindane. This medication also a chemical treatment is available as a cream, lotion and shampoo. Like permethrin, it's usually applied in two treatments, spaced about a week apart. This medication isn't safe for children younger than age 2 years, women who are pregnant or nursing, or people with weakened immune systems. Crotamiton (Eurax). This nonchemical medication is applied once a day for two to five days. Your doctor may recommend it if your baby has scabies. PREVENTION Clean all clothes and linen. Use hot, soapy water to wash all clothing, towels and bedding you used at least three days before treatment. Dry with high heat. Dryclean items you can't wash at home. Starve the mites. Consider placing items you can't wash in a sealed plastic bag and leaving it in an out-of-the-way place, such as in your garage, for a couple of weeks. Mites die if they don't eat for a week.

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MENINGITIS

OVERVIEW Meningitis is inflammation of the protective membranes covering the brain and spinal cord, known collectively as the meninges. The inflammation may be caused by infection withviruses, bacteria, or other microorganisms, and less commonly by certain drugs. Meningitis can be life-threatening because of the inflammation's proximity to the brain and spinal cord; therefore the condition is classified as a medical emergency. CAUSATIVE AGENT Escherichia coli Staphylococcus species Salmonella species Klebsiella pneumonia Aseptic meningitis Viral Rickettsial Spirochetes Fungal INCUBATION PERIOD Variable

MODE OF TRANSMISSION Droplet Direct invasion Hematogenous spread

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RISK FACTORS Age (usually younger than 5 years and 60 years old above) Pregnancy Working with animals Compromised immune system SIGNS AND SYMPTOMS: Fever and chills Nausea and vomiting Sensitivity to light (photophobia) Stiff neck (meningismus) Agitation Bulging fontanelles Poor feeding or irritability in children DIAGNOSTIC/LAB TESTS Blood Cultures - to see if it grows microorganisms, particularly bacteria Imaging - X-rays computerized tomography (CT) scans of the head, chest or sinuses may reveal swelling or inflammation Lumbar Puncture (Spinal Tap) to reduce the ICP due to an excess of the fluid and to introduce medications and anesthesia MANAGEMENT/TREATMENT O2 therapy IV antibiotics for two weeks (Penicillins, cephalosporins, aminoglycosides) Digitalis Mannitol Anticonvulsant or sedatives Paracetamol

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POLIOMYELITIS

OVERVIEW Commonly known as polio which is a transmittable and a very devastating disease. Polio is a very dangerous and highly infectious disease. A virus causes it. The virus invades the nervous system and totally paralyses in few hours. CAUSATIVE AGENT Polio v. (Legio debelitans) INCUBATION PERIOD 7-21 days MOD OF TRANSMISSION Ingestion via fecal-oral route by ingesting contaminated food or water borne vector-borne Direct and indirect contact with respiratory secretions and feces RISK FACTORS Lack of immunization Elderly Infants Pregnancy SIGNS AND SYMPTOMS Minor symptoms Fever Sore throat Abdominal pain
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Flu-like symptoms Severe symptoms Fever Muscle aches DIAGNOSTIC/LAB TEST Stool sample Throat swab MEDICAL MANAGEMENT Analgesic (for headache) Moist heat Bed rest Rehabilitation therapy PREVENTION Salk Vaccine killed viruses given IM Sabin Vaccine attenuated live viruses administered orally

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TETANUS (LOCKJAW)

OVERVIEW Tetanus is a serious bacterial disease that affects your nervous system, leading to painful muscle contractions, particularly of your jaw and neck muscles. Tetanus can interfere with your ability to breathe and, ultimately, threaten your life. Tetanus is commonly known as "lockjaw." CAUSATIVE AGENT Clostridium Tetani MODE OF TRANSMISSION Acquired from any type of wound contaminated by dust, soil, or animal excreta Rugged traumatic wounds and burns Scratch or bite Open fractures Dental extraction Circumcision Umbilical stump in newborns Babies delivered at home with faulty cord dressing Babies delivered by mothers without tetanus toxoid immunization RISK FACTORS Animal bites; Burns; Chronic otitis media, or middle ear infection;Crush injuries Dental procedures
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Elective surgical abortion Frostbite wounds Human bites Puncture wounds Surgery SIGNS AND SYMPTOMS Arrhythmias, or irregular heartbeats Coma Difficulty swallowing Difficulty breathing High blood pressure Irritability Neck pain or stiffness Restlessness Seizure DIAGNOSTIC/LAB TEST Spatula Test MEDICAL MANAGEMENT Antibiotics (penicillin, deoxycycline, and metronidazole) Anticonvulsant (diazepam, and Phenobarbital) Muscle relaxant (dantrium, dantrolene)

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RABIES

OVERVIEW Rabies is a disease humans may get from being bitten by an animal infected with the rabies virus. It is a severe viral infection of the CNS transmitted to humans through the saliva of infected/rabid animals (dogs, cats, mice, bats, raccoons, and skunks). Rabies virus is found in CNS, urine, saliva & blood & other dischargers. Rabies has been recognized for over 4,000 years. Yet, despite great advances in diagnosing and preventing it, today rabies is almost always deadly in humans who contract it and do not receive treatment. CAUSATIVE AGENT Rhabdovirus/Lyssavirus Bullet-shaped INCUBATION PERIOD In humans is 30-60 days, but it may range from less than 10 days to several years. SIGNS AND SYMPTOMS Anxiety, stress, and tension Delirium Drooling Convulsions Exaggerated sensation at the bite site Excitability or combative Hallucinations Loss of feeling in an area of the body Low-grade fever (102 F or lower) Numbness and tingling

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Swallowing difficulty (drinking causes throat spasms and the person may become hydrophobic) When these symptoms develop, the person will likely die from the disease. Less than 10 people have survived after developing such clinical rabies symptoms, and most of the few survivors had some previous level of treatment. When people develop clinical rabies, the best treatment is supportive care. DIAGNOSTIC/LAB TEST Clinical observation Virus isolation from saliva or throat Fluorescent rabies antibody (FRA) Negri bodies in the dogs brain TREATMENT Through washing of wound from bite/scratch with soap & running water for at least 3minutes Provide tetanus prophylaxis (ATS & TT) and antibacterial therapy aside from antirabies vaccines MANAGEMENT OF THE DOG WHO BITE Restrain the dog with a leash or confine in a cage Observe the dog for 14 days for any signs of rabies or submit the dog to a licensed veterinarian for observation Do not kill the dog, it is better to wait for the dog to die naturally If the dog dies within 14 days, call a veterinarian for proper submission of sample to the nearest diagnostic laboratory NURSING INTERVENTION Isolation of the patient Provide comfort for the patient Provide a restful environment Patient should not be bathed There should not be any running water in the room or within hearing distance

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MALARIA

OVERVIEW Malaria is an acute and chronic parasitic disease transmitted by the bite of infected mosquitoes and it is confined mainly to tropical and subtropical areas. This disease causes more disability and heavier economic burden than any parasitic disease. CAUSATIVE AGENT Plasmodium falciparum Plasmodium vivax Plasmodium malariae Plasmodium ovale

- attacks the red blood

MODE OF TRANSMISSION Bite of an infected Female Anopheles Mosquito Night time biting High-flying Rural areas Clear running water PATHOGNOMONIC SIGN Cold Stage: severe, recurrent chills (30minutes to 2 hours) Hot Stage: fever (4-6hours) Wet Stage: Profuse sweating Episodes of chills, fevers, and profuse sweating are associated with rupture of the red blood cells. Intermittent chills and sweating anemia / pallor Tea-colored urine Abdominal pain and enlargement
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NURSING CARE TSB (Hot Stage) Keep patent warm (Cold Stage) Change wet clothing (Wet Stage) Encourage fluid intake Avoid drafts MANAGEMENT Clinical method based on signs and symptoms of the patient and the history of his having visited a malaria endemic area Microscopic method based on the examination of the blood smear of patient through microscope (done by the medical technologist) QBC/Quantitative Buffy Coat Fastest Malarial Smear Best time to get the specimen is at height of fever because the microorganisms are very active and easily identified Chemoprophylaxis Only chloroquine should be given (taken at weekly intervals starting from 1-2 weeks before entering the endemic area). In pregnant women, it is given throughout the duration of pregnancy. TREATMENT Blood Schizonticides -Drugs acting on sexual blood stages of the parasites which are responsible for clinical manifestations Quinine- oldest drug used to treat malaria; from the bark of Cinchona tree ALERT: Cinchonism- quinine toxicity2 Chloroquine Primaquine- sometimes can also be given as chemoprophylaxis Fansidar- combination of pyrimethamine and sulfadoxine

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DENGUE

OVERVIEW OTHER NAME Classic Dengue Fever Dengue Hemorrhagic Fever Dengue Shock Syndrome CAUSATIVE AGENT Dengue virus 1, 2, 3, and 4 Chikungunya virus Types 1 and 2 are common in the Philippines Flavivirus in the Philippines Onyong-onyong West Nile INCUBATION PERIOD Uncertain, Probably 6days to 1 week PERIOD OF COMMUNICABILITY 1 day before and at the end of fever Presumed to be on the 1st week of illness up to when the virus is still present in the blood Occurrence is sporadic throughout the year Epidemic usually occur during the rainy seasons (June to November) Peak months: September and October

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MODE OF TRANSMISSION Bite of infected mosquito (Aedes Aegypti) - characterized by black and white stripes Daytime biting Low flying Stagnant clear water Urban MANIFESTATIONS First 4 days: Febrile/Invasive Stage Starts abruptly as fever Abdominal pain Headache vomiting conjunctival infection epistaxis 4th 7th days: Toxic/Hemorrhagic Stage Decrease in temperature Severe abdominal pain GIT bleeding Unstable BP (narrowed pulse pressure) Shock Death may occur 7th 10th days: Recovery/Convalescent Stage BP stable CLASSIFICATION Grade I: flu-like symptoms Hermans sign (+) tourniquet sign Grade II: manifestations of Grade I plus spontaneous bleeding o e.g. petechiae, ecchymosis purpura, gum bleeding, hematemesis, melena Grade III: manifestations of Grade II plus beginning of circulatory failure hypotension, tachycardia, tachypnea Grade IV: manifestations of Grade III plus profound shock (Dengue Shock Syndrome) o undetectable BP & undetectable pulse DIAGNOSTIC/LAB TEST Torniquet test (Rumpel Leads Test / capillary fragility test) Presumptive; positive when 20 or more petechiae per 2.5 cm square or 1 inch square are observed Platelet count confirmatory; (Normal is150 - 400 x 103/ mL) TREATMENT Paracetamol for fever Analgesic for pain Rapid replacement of body fluids most important treatment ORESOL Blood transfusion
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ALERT: No Aspirin PREVENTION 4 oclock habit Chemically treated mosquito net Larvivarous fish Environmental sanitation Antimosquito soaps & repellants (basil soap) Neem tree (eucalyptus & oregano)

LEPTOSPIROSIS

OVERVIEW Leptospirosis is caused by infection with bacteria of the genus Leptospira, and affects humans as well as other mammals, birds, amphibians, and reptiles. The disease was first described by Adolf Weil in 1886 when he reported an "acute infectious disease with enlargement of spleen, jaundice and nephritis". Leptospira was first observed in 1907 from a post mortem renal tissue slice. In 1908, Inada and Ito first identified it as the causative organism and in 1916 noted its presence in rats. CAUSATIVE AGENT Leptospira INCUBATION PERIOD 2 to 20 days MODE OF TRANSMISSION semen of infected animal contact with infected blood or body fluids RISK FACTORS Occupational exposure - farmers, ranchers, slaughterhouse workers, trappers,
35

veterinarians, loggers, sewer workers, rice field workers, and military personnel Recreational activities - fresh water swimming, canoeing, kayaking, and trail biking in warm areas Household exposure - pet dogs, domesticated livestock, rainwater catchment systems, and infected rodents

SIGNS AND SYMPTOMS Dry cough Fever Headache Muscle pain Nausea, vomiting, and diarrhea Shaking chills Less common symptoms include: Abdominal pain Abnormal lung sounds Bone pain Conjunctivitis Enlarged lymph glands Enlarged spleen or liver Joint aches Muscle rigidity Muscle tenderness Skin rash Sore throat DIAGNOSTIC/LAB TEST Complete blood count (CBC) Creatine kinase Liver enzymes Urinalysis TREATMENT Ampicillin Ceftriaxone Doxycycline Penicillin PREVENTION Avoid areas of stagnant water, especially in tropical climates. If you are exposed to a high risk area, taking doxycycline or amoxicillin may decrease your risk of developing this disease.

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VIRAL GASTROENTERITIS

OVERVIEW Viral gastroenteritis is an intestinal infection marked by watery diarrhea, abdominal cramps, nausea or vomiting, and sometimes fever. The most common way to develop viral gastroenteritis often called stomach flu is through contact with an infected person or ingestion of contaminated food or water. If you're otherwise healthy, you'll likely recover without complications. But for infants, older adults and people with compromised immune systems, viral gastroenteritis can be deadly. There's no effective treatment for viral gastroenteritis, so prevention is key. In addition to avoiding food and water that may be contaminated, thorough and frequent hand-washing is your best defense. CAUSATIVE AGENT Norovirus, Sapovirus and Astrovirus INCUBATION PERIOD 1 to 2 days A mild, self limiting illness usually develops 10 to 70 hours after contaminated food or water is consumed and lasts for 2 to 9 days. MODE OF TRANSMISSION Viral gastroenteritis is predominantly spread via the fecal-oral route RISK FACTORS Young children Older adults Schoolchildren, churchgoers or dormitory residents Anyone with a weakened immune system

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SIGNS AND SYMPTOMS The main symptoms of viral gastroenteritis are watery diarrhea vomiting Other symptoms include headache fever chills abdominal pain DIAGNOSTIC/LAB TEST identification of the virus in host tissue isolation and identification of the virus in secondary host system demonstration of a virus-specific antibody response Electron Microscopy ELISA (Enzyme-linked immunosorbent assay) TREATMENT drinking plenty of liquids such as fruit juices, sports drinks, caffeine-free soft drinks, and broths to replace fluids and electrolytes gradually reintroducing food, starting with bland, easy-to-digest foods such as rice, potatoes, toast or bread, cereal, lean meat, applesauce, and bananas getting plenty of rest giving oral rehydration solutions such as Pedialyte, Naturalyte, Infalyte, and CeraLyte giving infants breast milk or full strength formula, as usual, along with oral rehydration solutions PREVENTION People can reduce their chances of getting or spreading viral gastroenteritis if they wash their hands thoroughly with soap and warm water for 20 seconds after using the bathroom or changing diapers and before eating or handling food disinfect contaminated surfaces such as countertops and baby changing tables with a mixture of 2 cups of household bleach and 1 gallon of water

39

HEPATITIS A

OVERVIEW Hepatitis is a general term that means inflammation (irritation and swelling) of the liver. Inflammation of the liver can result from infection, exposure to alcohol, certain medications, chemicals, poisons, or from a disorder of the immune system. Hepatitis A refers to liver inflammation caused by infection with the hepatitis A virus (HAV). The other two common types are hepatitis B and hepatitis C; however, there are other named types such as D, E, F, and G, and more types may be discovered in the future. Moreover, these infections are somewhat diffe rent from hepatitis A, and from each other. CAUSATIVE AGENT Hepatitis A (HAV) is caused by a small undeveloped symmetrical RNA virus INCUBATION PERIOD usually between 25 to 30 days MODE OF TRANSMISSION Close contact with an infected person who has not washed his or her hands after using the bathroom Consuming food or water contaminated with the virus, usually caused by food handlers who are infected and do not thoroughly wash their hands or who wash food with contaminated water RISK FACTORS You're at increased risk of hepatitis A if you: Are a man who has sexual contact with other men Use injected or noninjected illicit drugs Receive clotting-factor concentrates for hemophilia or another medical condition
40

SIGNS AND SYMPTOMS Yellowing of the skin or eyes (also called jaundice) Not feeling very hungry Stomach pain Dark urine ; Diarrhea Nausea Low-grade fever DIAGNOSTIC/LAB TEST A blood test showing the presence of IgM anti-HAV in serum confirms the diagnosis of acute hepatitis A infection. TREATMENT There is no specific treatment for hepatitis A, only the management of symptoms. The infection will clear up within a couple of months, and the patient will be immune to the virus. About 1 in 100 persons infected with hepatitis A will develop severe infection that may require a liver transplant, especially among those co-infected with chronic hepatitis B, chronic hepatitis C, or HIV/AIDS. PREVENTION Hepatitis A vaccine provides long-term protection. The vaccine is licensed for use in persons 2 years of age and older. To prevent person-to-person spread, good personal hygiene and proper sanitation are important. Always wash hands with soap and warm water after using the toilet and changing a diaper and before eating or preparing food. Immune globulin is recommended for short-term prevention against hepatitis A in all age groups. Immune globulin is a sterile preparation of antibodies. Immune globulin shots can lower the risk of disease in close contacts, household members, and sex partners of infected persons.

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SALMONELLOSIS

OVERVIEW Salmonellosis is an illness caused by Salmonella bacteria. If the bacteria find their way into a person's stomach and intestines, they can cause cramps, nausea, vomiting, and diarrhea. There are several different types, or strains, of Salmonella bacteria, and they all can make you sick. CAUSATIVE AGENT A disease caused by infection with Salmonella spp. Bacteria INCUBATION PERIOD Generally requires an 8-48 hour incubation period and may last from 2-5 days MODE OF TRANSMISSION Transmission is via person to person or animal to person spread via the fecal-oral route. Ingestion of the organisms via contaminated or improperly cooked foods also occurs. RISK FACTORS Infants Elderly individuals People with weak immune system

42

People who have pets and abdominal problems

SIGNS AND SYMPTOMS Possible signs and symptoms include Nausea; Vomiting Abdominal pain; Diarrhea Fever; Chills Headache Muscle pains Blood in the stool DIAGNOSTIC/LAB TEST Salmonella infection can be detected by testing a sample of your stool. However, this test may not be very useful because most people have recovered from their symptoms by the time the test results return. TREATMENT Because salmonella infection can be dehydrating, replacement of fluids and electrolytes is the focus of treatment. Severe cases may require hospitalization and fluids delivered directly into a vein (intravenous). In addition, your doctor may recommend: Anti-diarrheals. Medications like loperamide (Imodium) can help relieve cramping, but they may also prolong the diarrhea associated with salmonella infection. Antibiotics. If your doctor suspects that salmonella bacteria have entered your bloodstream, or if you have a severe case or a compromised immune system, he or she may prescribe antibiotics to kill the bacteria. Antibiotics are not of benefit in uncomplicated cases. In fact, antibiotics may prolong the period in which you carry the bacteria and can infect others, and they can increase your risk of relapse. PREVENTION Washing your hands thoroughly can help prevent the transfer of salmonella bacteria to your mouth or to any food you're preparing. Store raw meat, poultry and seafood away from other foods in your refrigerator If possible, have two cutting boards in your kitchen one for raw meat and the other for fruits and vegetables Never place cooked food on an unwashed plate that previously held raw meat Avoid eating raw eggs

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TYPHOID FEVER

OVERVIEW Typhoid fever is a systemic bacterial disease contracted by consuming food or water that has been contaminated with the bacterium Salmonella Typhi. Typhoid fever is characterized by insidious onset of sustained fever, marked headache, malaise, nausea and severe loss of appetite. It is sometimes accompanied by hoarse cough and constipation or diarrhea. In apparent or mild illness occurs, especially in endemic areas. CAUSATIVE AGENT Salmonella typhi INCUBATION PERIOD an average 1014-days MODE OF TRANSMISSION Typhoid is transmitted mainly by fecal-oral route RISK FACTORS Worldwide, children are at greatest risk of getting the disease, although they generally have milder symptoms than adults do.
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Have close contact with someone who is infected or has recently been infected with typhoid fever Have an immune system weakened by medications such as corticosteroids or diseases such as HIV/AIDS Drink water contaminated by sewage that contains S. typhi

SIGNS AND SYMPTOMS poor appetite abdominal pain headaches; generalized aches and pains fever, often up to 104 F lethargy (usually only if untreated) intestinal bleeding or perforation (after two to three weeks of the disease) diarrhea or constipation DIAGNOSTIC/LAB TEST Body fluid or tissue culture For the culture, a small sample of your blood, stool, urine or bone marrow is placed on a special medium that encourages the growth of bacteria. In 48 to 72 hours, the culture is checked under a microscope for the presence of typhoid bacteria. A bone marrow culture often is the most sensitive test for S. typhi. TREATMENT Antibiotic therapy is the only effective treatment for typhoid fever. Ceftriaxone an injectable antibiotic is an alternative for women who are pregnant and for children who may not be candidates for ciprofloxacin. These drugs can cause side effects, and long-term use can lead to the development of antibioticresistant strains of bacteria. Supportive therapy Drinking fluids. This helps prevent the dehydration that results from a prolonged fever and diarrhea. If you're severely dehydrated, you may need to receive fluids through a vein in your arm (intravenously). Eating a healthy diet. Non bulky, high-calorie meals can help replace the nutrients you lose when you're sick. PREVENTION Safe drinking water Improve sanitation and adequate medical care Wash your hands Avoid drinking untreated water Avoid drinking untreated water Choose hot foods

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AMOEBIC DYSENTERY

OVERVIEW Amoebic dysentery is most common in tropical areas but can be seen anywhere in the world. This illness normally lasts about 2 weeks, but if not treated is can reoccur. When amebic dysentery spreads beyond the intestines to other parts of the body (such as the liver, lung, or brain) it is referred to as extraintestinal amebiasis. Amebic dysentery infections are most severe in the very young, the elderly, and in those who may be taking daily corticosteroids. CAUSATIVE AGENT Entamoeba histolytica INCUBATION PERIOD 3-4 weeks, sometimes 5 days to few months MODE TRANSMISSION Fecal-Oral route RISK FACTORS Certain people may be at a higher risk for getting amebiasis. These include: Travelers who recently visited tropical regions of the world Immigrants from areas where the disease is common
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Men who have sex with men SIGNS AND SYMPTOMS Anemia Indigestion Intermittent diarrhea with foul-smelling stool that may be preceded by constipation. Dehydration Blood and mucus in the stool Gas and Abdominal Bloating Abdominal cramps and tenderness Fever Fatigue Chills Pain in the upper right portion of the abdomen Nausea Vomiting TREATMENT Involves taking antibiotic drugs to kill the parasites, the commonly used antibiotics are Metranidizole and Tinidazole Bed rest and drinking a solution (containing salt and glucose) to replace losses from the diarrhea and for rehydration may also be necessary. Painkillers and muscle relaxants are given to treat stomach or abdominal pain. Complicated cases may require hospitalization. If dehydration is severe, intravenous fluids may be required. It is very important not to consume alcohol during treatment. After treatment, regular stool tests will be taken to ensure that the parasite is completely eradicated, as amoebiasis has a tendency to recur at intervals. PREVENTION To help reduce your chances of getting amoebic dysentery, take the following steps when travelling to a country that has poor sanitary conditions: Drink only bottled water or water that has been boiled for at least one minute Do not eat fresh fruit or vegetables that you do not peel yourself Do not eat or drink unpasteurized milk, cheese, or dairy products Do not eat or drink anything sold by street vendors

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CHOLERA

OVERVIEW Cholera is an infection of the small intestine that is caused by the bacterium Vibrio cholerae. The main symptoms are profuse watery diarrhea and vomiting. Transmission occurs primarily by drinking or eating water or food that has been contaminated by the diarrhea of an infected person or the feces of an infected but asymptomatic person. The severity of the diarrhea and vomiting can lead to rapid dehydration and electrolyte imbalance and death in some cases. The primary treatment is with oral rehydration solution (ORS) to replace water and electrolytes, and if this is not tolerated or doesn't provide quick enough treatment, intravenous fluids can also be used. Antibiotics are beneficial in those with severe disease to shorten the duration and severity. Worldwide it affects 35 million people and causes 100,000130,000 deaths a year as of 2010. Cholera was one of the earliest infections to be studied by epidemiological methods. CAUSATIVE AGENT Vibrio cholerae INCUBATION PERIOD 3-4 weeks, sometimes 5 days to few months MODE TRANSMISSION Eating or drinking contaminated water RISK FACTORS Exposure to contaminated or untreated drinking water Living in or traveling to areas where there is cholera SIGNS AND SYMPTOMS Abdominal cramps Dry mucus membranes or mouth
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Dry skin Excessive thirst Glassy or sunken eyes Lack of tears Lethargy Low urine output Nausea Rapid dehydration Rapid pulse (heart rate) Sunken "soft spots" (fontanelles) in infants Unusual sleepiness or tiredness Vomiting Watery diarrhea that starts suddenly and has a "fishy" odor TREATMENT The objective of treatment is to replace fluid and electrolytes lost through diarrhea. Depending on your condition, you may be given fluids by mouth or through a vein (intravenous). Antibiotics may shorten the time you feel ill. The World Health Organization (WHO) has developed an oral rehydration solution that is cheaper and easier to use than the typical intravenous fluid. This solution of sugar and electrolytes is now being used internationally. PREVENTION The U.S. Centers for Disease Control and Prevention does not recommend cholera vaccines for most travelers. (Such a vaccine is not available in the United States.) Travelers should always take precautions with food and drinking water, even if vaccinated. When outbreaks of cholera occur, efforts should be directed toward establishing clean water, food, and sanitation, because vaccination is not very effective in managing outbreaks.

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ASCARIASIS

OVERVIEW Ascariasis is an intestinal infection caused by a parasitic roundworm. While globally it is the most common human infection caused by worms, ascariasis is rare in the United States. It occurs most often in areas with poor sanitation or crowded living conditions. CAUSATIVE AGENT Ascaris lumbricoides MODE TRANSMISSION Contact with soil mixed with human feces that contain ascaris eggs RISK FACTORS Age. Most people who have ascariasis are 10 years old or younger. Children in this age group may be at higher risk because they are more likely to play in dirt. Warm climate. Ascariasis worms thrive in milder climates. In the United States, ascariasis is more common in the Southeast. But it's more prevalent in developing countries with warm temperatures year-round. Poor sanitation. Ascariasis is more widespread in developing countries where human feces are allowed to mix with local soil. SIGNS AND SYMPTOMS Vague abdominal pain Nausea and vomiting Diarrhea or bloody stools If you have a heavy intestinal infestation a large number of worms you may experience: Severe abdominal pain
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Fatigue Vomiting Weight loss A worm in vomit or stool DIAGNOSTIC/LAB TEST Stool test About two months after you ingest ascariasis eggs, the worms mature and begin laying thousands of eggs a day. These eggs travel through your digestive system and eventually can be found in your stool. To diagnose ascariasis, your doctor will examine your stool for the microscopic eggs and larvae. But eggs will not appear in stool until at least 40 days after you are infected. And if you are only infected with male worms, you won't have any eggs at all. Blood tests Your blood can be tested for the presence of an increased number of a certain type of white blood cell, called eosinophils. Ascariasis can elevate your eosinophils, but so can several other types of health problems. Imaging tests X-rays. If you are infested with a large number of worms, the mass of worms may be visible in an X-ray of your abdomen. In some cases, a chest X-ray can reveal the larvae in your lungs. Ultrasound. An ultrasound may show if any worms are in your pancreas or liver. This technology uses sound waves to create images of internal organs. CT scans or MRIs. Both these types of tests create detailed images of your internal structures, so they can detect worms that are blocking ducts in your liver or pancreas. Computerized tomography (CT) combines X-ray images taken from many different angles, while magnetic resonance imaging (MRI) uses radio waves and a strong magnetic field. TREATMENT Albendazole (Albenza) Ivermectin (Stromectol) Mebendazole PREVENTION Practice good hygiene. Ascariasis is spread by ingesting parasite eggs from contaminated soil. Before handling food, always wash your hands with soap and water, and wash fresh fruits and vegetables thoroughly. Use care when traveling. Ascariasis is the most common roundworm infection in the world, with higher infection rates in developing and warm-climate countries. When traveling, use only bottled water and avoid raw vegetables unless you can peel and wash them yourself. As a rule, eat only foods that are hot and cooked.

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WHOOPING COUGH (PERTUSSIS)

OVERVIEW Whooping cough is an infectious bacterial disease that causes uncontrollable coughing. The name comes from the noise you make when you take a breath after you cough. You may have choking spells or may cough so hard that you vomit. Anyone can get whooping cough, but it is more common in infants and children. It's especially dangerous in infants. The coughing spells can be so bad that it is hard for infants to eat, drink or breathe. CAUSATIVE AGENT Bordetella pertussis (or B. pertussis) INCUBATION PERIOD 7-14 days, disease is 6 weeks MODE OF TRANSMISSION Droplet SIGNS AND SYMPTOMS Catarrhal Stage - nasal catarrhal, frequent sneezing, teary-eyed cough Paroxysmal Stage - cough worsens: becomes rapid, successive, paroxysmal, ends in inspiratory whoop, followed by vomiting - force of coughing may cause involuntary micturation/defecation, bulging of eyes, intracerebral hemorrhage, abdominal hernia - vomiting signals end attack The first symptoms of whooping cough are similar to those of a common cold: runny nose; sneezing; mild cough; Low-grade fever After about 1 to 2 weeks, the dry, irritating cough evolves into coughing spells. During a coughing spell, which can last for more than a minute, the child may turn
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red or purple. At the end of a spell, the child may make a characteristic whooping sound when breathing in or may vomit. Between spells, the child usually feels well. Although it's likely that infants and younger children who become infected with B. pertussis will develop the characteristic coughing episodes with their accompanying whoop, not everyone will. However, sometimes infants don't cough or whoop as older kids do. They may look as if they're gasping for air with a reddened face and may actually stop breathing for a few seconds during particularly bad spells. Adults and adolescents with whooping cough may have milder or atypical symptoms, such as a prolonged cough without the coughing spells or the whoop. Convalescence DIAGNOSTIC/LAB TEST Borde-Gengou Culture nasopharyngeal swab TREATMENT Penicillin NURSING CARE Bed rest Proper positioning during attacks Nutritious diet Abdominal binders Adequate ventilation Close nursing observation during attacks Concurrent disinfection Avoid precipitating attacks PREVENTION Avoid mode of transmission Immunization

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TUBERCULOSIS

OVERVIEW A bacterial infection usually attacks the lungs. It is the inflammation of the lung tissue caused by invasion of mycobacterium TB or tubercle bacilli or acid fast bacilli- gram (+) aerobic, motile & easily destroyed by heat or sunlight. They can also damage other parts of the body. TB spreads through the air when a person with TB of the lungs or throat coughs, sneezes or talks. If you have been exposed, you should go to your doctor for tests. You are more likely to get TB if you have a weak immune system. CAUSATIVE AGENT Mycobacterium tuberculosis MODE OF TRANSMISSION Droplet infection SIGNS AND SYMPTOMS Productive cough- yellowish Low fever Night Sweats Dyspnea Anorexia, general body malaise, wt loss Chest/back pain Hemoptysis DIAGNOSTIC/LAB TEST Skin Test- Mantoux Test- infection of Purified CHON Deriative (PPD) DOH- 8-10mm induration
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 WHO- 10-14mm induration Result within 48-72hrs (+) Mantoux test- previous exposure to tubercle bacilli Sputum AFB- (+) to cultured microorganism CXR- pulmonary infiltrate caseosis necrosis CBC- increase WBC NURSING MANAGEMENT CBR Strict resp. isolation O2 inhalation Semi-fowler Force fluid to liquefy secretions DBCE Nebulize & suction Comfy & humid environment Diet- increase CHO & calories, CHON, Vit, minerals Short course chemotherapy PREVENTION If you test positive for latent TB infection, your doctor may advise you to take medications to reduce your risk of developing active tuberculosis. The only type of tuberculosis that is contagious is the active variety, when it affects the lungs. So if you can prevent your latent tuberculosis from becoming active, you won't transmit tuberculosis to anyone else. Protect your family and friends If you have active TB, keep your germs to yourself. It generally takes a few weeks of treatment with TB medications before you're not contagious anymore. Follow these tips to help keep your friends and family from getting sick: Stay home. Don't go to work or school or sleep in a room with other people during the first few weeks of treatment for active tuberculosis. Ventilate the room. Tuberculosis germs spread more easily in small closed spaces where air doesn't move. If it's not too cold outdoors, open the windows and use a fan to blow indoor air outside. Cover your mouth. Use a tissue to cover your mouth anytime you laugh, sneeze or cough. Put the dirty tissue in a bag, seal it and throw it away. Wear a mask. Wearing a surgical mask when you're around other people during the first three weeks of treatment may help lessen the risk of transmission. Finish your entire course of medication This is the most important step you can take to protect yourself and others from tuberculosis. When you stop treatment early or skip doses, TB bacteria have a chance to develop mutations that allow them to survive the most potent TB drugs. The resulting drugresistant strains are much more deadly and difficult to treat. Vaccinations In countries where tuberculosis is more common, infants are vaccinated with bacillus Calmette-Guerin (BCG) vaccine because it can prevent severe tuberculosis in children. The BCG vaccine isn't recommended for general use in the United States because it isn't very effective in adults and it causes a false-positive result on a TB skin test. Researchers are working on developing a more effective TB vaccine.

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PNEUMONIA

OVERVIEW Pneumonia is an inflammation of the lung parenchyma leading to pulmonary consolidation as alveoli is filled with exudates. CAUSATIVE AGENT Streptococcus pneumonia (pnemococcal pneumonia) Hemophilus pneumonia (bronchopneumonia) Escherichia coli Klebsiella P. Diplococcus P. MODE OF TRANSMISSION Droplet infection SIGNS AND SYMPTOMS Productive cough pathognomonic sign: greenish to rusty sputum Dyspnea with prolonged respiratory grunt Fever, chills, anorexia, general body malaise Wt loss Pleuritic friction rub Rales/crackles Cyanosis Abdominal distention leading to paralytic ileus DIAGNOSTIC/LAB TEST
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Sputum exam- could confirm presence of Pneumonia & TB Sputum GSCS (gram staining & culture sensitivity)- reveals (+) cultured microorganism CXR- pulmo consolidation CBC- increase WBC Erythrocyte sedimentation rate ABG- PO2 decrease NURSING MANAGEMENT Force fluids- 2-3 L/day Institute pulmonary toiletDeep breathing exercise Coughing exercise Chest physiotherapy- cupping Turning & reposition- Promote expectoration of secretions Semi-fowler Nebulize & suction Comfy & humid environment Diet: increase CHO or calories, CHON & vit. C Postural drainage- To drain secretions using gravity

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SWINE FLU (H1N1)

OVERVIEW Swine Influenza (swine flu) is a respiratory disease of pigs caused by Type A influenza viruses that causes regular outbreaks in pigs. Swine flu viruses have been reported to spread from person-to-person, but in the past, this transmission was limited and not sustained beyond three people. INCUBATION PERIOD 7 to 10 days MODE OF TRANSMISSION Droplet Influenza virus A (H1N1) is fatal to humans Exposure to droplets from the cough and sneeze of the infected person. Influenza A (H1N1) is not transmitted by eating thoroughly cooked pork The virus is killed by cooking temperatures of 160 F/70 C. SIGNS AND SYMPTOMS Symptoms of regular flu such as Fever ; Cough Headache; Fatigue Lack of appetite Runny nose Sore throat
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Vomiting or nausea Diarrhea DIAGNOSTIC/LAB TEST Nasopharyngeal (throat) swab Immuno fluorescent antibody testing to distinguish influenza A and B TREATMENT Antiviral medications may reduce the severity and duration of symptoms in some cases: Oseltamivir (Tamiflu) or zanamivir PREVENTION Cover your nose and mouth when coughing and sneezing Always wash hands withsoap and water Use alcohol- based handsanitizers Avoid close contact withsick people Increase your body'sresistance Have at least 8 hours of sleep Be physically active Manage your stress Drink plenty of fluids Eat nutritious food

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SEVERE

ACUTE

RESPIRATORY

SYNDROME (SARS)

OVERVIEW Severe acute respiratory syndrome (SARS) is a respiratory illness caused by a virus. It is a serious, potentially life-threatening viral infection caused by a previously unrecognized virus from the Coronaviridae family. This virus has been named the SARS-associated coronavirus (SARS-CoV). Previously, Coronaviridae was best known as the second-most-frequent cause of the common cold. INCUBATION PERIOD 2 10 days MODE OF TRANSMISSION Droplet SYMPTOMS A high fever Headache Body aches A dry cough Pneumonia, later on

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Prodromal Phase: Fever (>38C) Chills Malaise Myalgia Headache Infectivity is none to low Respiratory Phase: Within 2-7 days, dry non productive cough progressing to respiratory distress TREATMENT No specific treatment PREVENTIVE MEASURES AND CONTROL Establishment of triage Identification of patient Isolation of suspected probable case Tracing and monitoring of close contact Barrier nursing technique for suspected and probable case PREVENTION Utilize personal protective equipment (N95 mask) Hand washing Universal Precaution The patient wears mask Isolation

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GONORRHEA

OVERVIEW Gonorrhea is a sexually transmitted disease (STD). Gonorrhea is caused by Neisseria gonorrhoeae, a bacterium that can grow and multiply easily in the warm, moist areas of the reproductive tract, including the cervix (opening to the womb), uterus (womb), and fallopian tubes (egg canals) in women, and in the urethra (urine canal) in women and men. The bacterium can also grow in the mouth, throat, eyes, and anus. CAUSATIVE AGENT Neisseria Gonorrhoeae INCUBATION PERIOD Ranges from as early as 2 days to as late as 14 MODE OF TRANSMISSION Mainly through vaginal, anal and oral sex. Bacteria are transmitted through vaginal and seminal fluids. Infection can show up in the genital tract, mouth or rectum. RISK FACTORS people who do not use condoms during vaginal, anal or oral sex who have multiple sex partners, or whose partners have multiple sex partners have a history of sexually transmitted diseases those who are under the age of 30 have an increased risk of being infected with gonorrhea. SIGNS AND SYMPTOMS Males with Gonorrhea Urethritis and dysuria
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Redness and edema of urinary meatus Purulent urethral discharge Females with Gonorrhea Abscess formation on Bartholins and Skenes gland. This ascends and can cause endocervicitis and endometritis that gives the women an hypogastric pain. If left untreated it could lead to Pelvic Inflammatory Disease that could bring about sterility. DIAGNOSTIC/LAB TESTS Culture and sensitivity Mucosal scraping Cervical smear or pap smear MANAGEMENT/TREATMENT Antibiotic Penicillin Cephalosporin PREVENTION Safe sex practices. Abstinence, Long-term mutually monogamous relationship, and mutual masturbation without direct contact. Education and counseling. Behavior modification. Advise the client to avoid promiscuity. Use of condoms.

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SYPHILIS

OVERVIEW Syphilis is a sexually transmitted disease (STD) caused by the bacterium Treponema pallidum. It has often been called the great imitator because so many of the signs and symptoms are indistinguishable from those of other diseases. The name "syphilis" was coined by Hieronymus Fracastorius (Girolamo Fracastoro). Fracastorius was a true Renaissance man; he wrote on the temperature of wines, the rise of the Nile, poetry, the mind, and the soul; he was an astronomer, geographer, botanist, mathematician, philosopher and, last but not least in the present context, a physician. In 1530 he published the poem "Syphilis sive morbus gallicus" (Syphilis or the French Disease) in which the name of the disease first appeared. CAUSATIVE AGENT Treponema pallidum INCUBATION PERIOD Around 10-90 days with an average of 21 days MODE OF TRANSMISSION Sexual contact, but in rare cases blood transfusion. SIGNS AND SYMPTOMS Primary Stage There is a presence of chancre (Painless, moist ulcer that heals spontaneously) which takes 3-6 weeks to heal and regional lymphadenopathy. Secondary Stage or Infectious Stage Highly communicable. Flu-like symptoms
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Fever, malaise Skinrashes, Condyloma lata (Lesions that are fused together, are highly infectious and found under the breast and genitals) Oral mucous patches Patchy alopecia in the pubic region (Thinning of the pubic hair) Generalized lymphadenopathy Latent Phase Gumma. An infiltrating tumor in the skin, bom, and liver. Cardiovascular changes. Aortitis, aneurysms. CNS Degeneration. Presence of paresthesia, abnormal reflexes, shooting pain, dementia, psychosis. DIAGNOSTIC/LAB TESTS Darkfield microscopy Serologic test Fluorescent Treponema Antibody Absorption Test (FTA-ABS) Venereal Disease Research Laboratory (VDRL) Rapid Plasma Reagin (RPR) MANAGEMENT/TREATMENT Antibiotic Therapy PREVENTION Safe sex practices. Abstinence, Long-term mutually monogamous relationship, and mutual masturbation without direct contact. Education and counseling. Behavior modification. Advise the client to avoid promiscuity. Use of condoms.

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GENITAL WARTS

OVERVIEW Genital warts, sometimes called venereal warts, are growths or bumps contracted through sexual contact. They're caused by certain types of the human papillomavirus (HPV), which is one of the most common sexually transmitted diseases (STDs). There are currently many different strains of the HPV virus. CAUSATIVE AGENT: Human papilloma virus RISK FACTORS Multiple sexual partners Not knowing if someone you had sex with had STDs Early age when you start to be sexually active Tobacco and alcohol use Stress and other viral infections (such as HIV or herpes) at the same time SIGNS AND SYMPTOMS Genital warts can be raised or flat, and are usually flesh-colored. They may appear as cauliflower-like growths. Sometimes they are so small and flat that they cannot be seen with the naked eye. Common places to find genital warts: Females most often have warts inside or around the vagina or anus, on the skin around these areas, or on the cervix. Males most often have warts on the penis, scrotum, groin area, or thighs, as well as inside or around the anus in those who have anal intercourse. Both males and females may have warts on the lips, mouth, tongue, palate, or throat (larynx)
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Other symptoms are rare, but may include: Increased vaginal discharge Itching of the penis, scrotum, anal area, or vulva Vaginal bleeding, with or after sexual intercourse DIAGNOSTIC/LAB TESTS A Pap smear may note changes caused by HPV. Women with these types of changes often need more frequent Pap smears for a period of time. An HPV DNA test can identify whether you have a high-risk type of HPV that is known to cause cervical cancer. This test may be done: As a screening test for women over age 30 In women of any age who have a slightly abnormal Pap test result MANAGEMENT/TREATMENT Imiquimod (Aldara) Podophyllin and podofilox (Condylox) Trichloroacetic acid (TCA) Surgical treatments include: Cryosurgery Electrocauterization Laser therapy Surgical excision (cutting them out) PREVENTION Safe sex practices. Abstinence, Long-term mutually monogamous relationship, and mutual masturbation without direct contact. Education and counseling. Behavior modification. Advise the client to avoid promiscuity. Use of condoms.

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VAGINITIS

OVERVIEW Vaginitis is an inflammation of the vagina that can result in discharge, itching and pain. The cause is usually a change in the normal balance of vaginal bacteria or an infection. Vaginitis can also result from reduced estrogen levels after menopause. CAUSATIVE AGENT Bacterial

vaginosis;

Yeast

infections ;

Trichomoniasis

INCUBATION PERIOD 4-28 days and can survive up to 24hrs on wet surface SIGNS AND SYMPTOMS Change in color, odor or amount of discharge from your vagina Vaginal itching or irritation Pain during intercourse Painful urination Light vaginal bleeding or spotting DIAGNOSTIC/LAB TESTS Culture and sensitivity Mucosal scraping Cervical smear or pap smear MANAGEMENT/TREATMENT
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Common medications used include: Flagyl (metronidazole) Doxycycline Azithromycin Some self-care techniques include vinegar douches or sitz baths in a solution of 1 teaspoon of vinegar for every gallon of water, and eating yogurt containing live acidophilus cultures. Sstudies have not proven whether or not these are effective. PREVENTION Keep the vaginal area clean and dry Avoid excessive douching and strong soaps and detergents Wear cotton underwear that absorbs moisture and keeps the vagina dry Clean from front to back after a bowel movement Do not leave tampons or diaphragms in the vagina for long periods Avoid deodorized tampons Decrease intake of sweets, bread, and alcohol Eat yogurt or take acidophilus tablets, especially if you are taking antibiotics

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ACQUIRED (AIDS)

IMMUNODEFICIENCY

SYNDROME

OVERVIEW A severe immunological disorder caused by the retrovirus HIV, resulting in a defect in cell-mediated immune response that is manifested by increased susceptibility to opportunistic infections and to certain rare cancers, especially Kaposi's sarcoma. It is transmitted primarily by exposure to contaminated body fluids, especially blood and semen. CAUSATIVE AGENT Human Immunodeficiency Virus (HIV) INCUBATION PERIOD From infection to development of detectable antibodies is 1-3 months, but from HIV infection to AIDS diagnosis is 2 months to 20 years or even more. MODE OF TRANSMISSION Person to person through sexual contact Sharing/use of HIV contaminated needles, syringes and surgical instruments Transfusion of infected blood or its components SIGNS AND SYMPTOMS: Lympadenopathy Anorexia
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Weight loss Fever DIAGNOSTIC/LAB TESTS ELISA serologic test for antibodies against HIV p24 serologic test for circulating HIV antigen PCR polymerase chain reaction for viral nucleic acid sequences MANAGEMENT/TREATMENT Antiretroviral Therapy (ART) zidovudine (azidothymidine, AZT) Cotrimazole or aerosolized pentamidine for prevention of Pneumocystis carinii PREVENTION Safe sex practices. Abstinence, Long-term mutually monogamous relationship, and mutual masturbation without direct contact. Education and counseling. Behavior modification. Advise the client to avoid promiscuity. Use of condoms.

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