Chinese General Hospital College of Nursing

Communicable Diseases
Pocholo Santos
COMMUNICABLE DISEASE o Body’s own pop of microorganisms - “microbial
antagonism principle”
 It is an illness caused by an infectious agent or its toxic  Second – inflammatory response
products that are transmitted directly or indirectly to a well o Phagocytic cells and WBC to destroy invading
person through an agent, vector or inanimate object. microorganism manifesting the cardinal signs
 Third – immune response
TWO TYPES: o Natural/Acquired
o Active/passive
 Infectious Disease - Not easily transmitted by ordinary
contact but require a direct inoculation through a break in RISK FACTORS
the previously intact skin or mucous membrane
 Contagious Disease - easily transmitted from one person  Age, sex, and genes
to another through direct or indirect means.  Nutritional status, fitness, environmental factors
 General condition, emotional and mental state
 Immune system
Terminologies  Underlying disease ( diabetes mellitus, leukemia, transplant)
 Treatment with certain antimicrobials ( prone to fungal
Disinfection –destruction of pathogenic microorganism infection), steroids, immunoisuppresive drugs etc.
outside the body by directly applying physical or chemical
means. CHAIN OF INFECTION
Concurrent – method of disinfection done
immediately after the infected individual discharges
infectious material/secretions. This method of
disinfection is when the patient is still the source of
infection
Terminal – applied when the patient is no longer
the source of infection.
Disinfectant -chemical used on non living objects
Antiseptic – chemical used on living things.
Bactericidal – kills microorganism
Sterilization – complete destruction of all microorganism

General Principles

 Pathogens move through spaces or air current

 Pathogens are transferred from one surface to
another whenever objects touch
 Hand washing removes microorganism
 Pathogens are released into the air on droplet nuclei
when person speaks, breaths, sneezes
 Pathogens are transferred by virtue of gravity
 Pathogens move slowly on dry surface but very
quickly through moisture MODE OF TRANSMISSION

 Contact transmission
INFECTION o Direct contact - person to person
o Indirect - thru contaminated object
 invasion and multiplication of microorganisms on the tissues o Droplet spread - contact with respiratory
of the host resulting to signs and symptoms as well as secretions thru cough, sneezing, talking. Microbes
immunologic response can travel up to 3 feet.
 injures the patient either by:  Airborne Transmission
o competing with the host’s metabolism  Vector Borne Transmission
o cellular damage produced by the microbes  Vehicle Borne Transmission
intracellular multiplication.
EMERGING INFECTIOUS DISEASES
CLASSIFICATION ACCORDING TO INCIDENCE
 Developing resistance to antibiotics eg: anti tb drugs, MRSA,
 Sporadic - disease that occur occasionally and irregularly VRE
with no specific pattern  Increasing numbers of immunosuppressed patients.
 Endemic – those that are present in a population or  Use of indwelling lines and implanted foreign bodies has
community at times. increased.
 Epidemic – diseases that occur in a greater number than
what is expected in a specific area over a specific time. INFECTION CONTROL MEASURES
 Pandemic – is an epidemic that affects several countries or
continents  Universal Control Measures – All blood, blood products
and secretions from patients are considered as infected
CAUSES OF INFECTION

 Some bacteria develop resistance to antibiotics Work Practice Control

 Some microbes have so many strains that a single vaccine
can’t protect against all of them ex. Influenza  Used needles and sharps shall not be bent, broken,
 Most viruses resist antiviral drugs recapped. Used needles must not be removed from
 Opportunistic organisms can cause infection in disposable syringes.
immunocompromised patients  Eating, drinking, smoking, applying cosmetics or
 Most people have not received vaccinations . handling contact lenses are prohibited in work areas.
 Increased air travel can cause the spread of virulent  Foods and drinks shall not be stored in refrigerators,
microorganism to heavily populated area in hours freezers where blood or other infectious materials are
 Use of immunosupressive drugs and invasive procedures stored.
increase the risk of infection  All procedures involving blood or other potentially
 Problems with the body’s lines of defense infectious materials shall be performed in such a
manner as to minimize splashing, or spraying.
THREE LINES OF DEFENSE
 Masking – Wear mask if needed. Patient with infectious
 First line of defense respiratory diseases should wear mask.
o Mechanical Barriers
 Handwashing – Practice it with soap and water.
o Chemical Barriers
 Chinese General Hospital College of Nursing
Communicable Diseases
Pocholo Santos
 Gloving – Wear gloves for all direct contact with patients.  Adult TB
Change gloves and wash hands every after each patient. o afternoon rise in temperature
 Gowning - Wear gown during procedures which are likely o night sweats
to generate splashes of blood or sprays of blood and body o weight loss
fluids, secretions or excretions. o cough dry to productive
 Eye protection (goggles) – wear it to prevent splashes. o Hemoptysis
 Environmental disinfection – Clean surfaces with o sputum AFB (+)
disnfectant (70% alcohol,diluted bleach)  Milliary TB - very ill, with exogenous TB like Pott’s disease
 Primary Infection
ISOLATION PRECAUTIONS o Asymptomatic
o No manifestations even at CXR, Sputum AFB
 separation of patients with communicable diseases from  Primary Complex
others so as to reduce or prevent transmission of infectious o Minimal manifestation
agents. o Lymphadenopathy
7 Categories Recommended in isolation

 Strict isolation – prevent spread of infection from patient

to patient/staff.- handwashing, infectous materials must be
discarded, use of single room, use of mask, gloves and gowns
and (-) pressure if possible
 Contact isolation – prevent spread by close or direct
contactRespiratory isolation – prevent transmission thru air.
 TB isolation – for (+)TB or CXR suggesting active PTB.
 Enteric Isolation – direct contact with feces
 Drainage/secretion precaution- prevent infection thru Diagnosis
contact with materials or drainage from infected person.
 Universal Precaution – for handling blood and body  Tuberculin testing
fluids.( bloods, pleural fluid, peritoneal fluid etc.)  Chest X-Ray
 Sputum AFB
PREVENTION

Immunization – introduction of specific antibody to produce Prevention

immunity to certain disease.
 BCG
 Natural – passive (from placenta), active (thru
 Avoid overcrowding
immunization & recovery from diseases)
 Improve nutritional status
 Artificial – passive (antitoxins), active (vaccine, toxoid)
Treatment
Maintain vaccine potency by preventing:
 DOTS
 Heat and sunlight
 6 months of RIPE
 Freezing
 Respiratory isolation,
 Antiseptic/ disinfectants/ detergents lessen the potency of
vaccine. Use water only when cleaning fridge/ref.  Take medicines religiously – prevent resistance
 COLD CHAIN SYSTEM – maintenance of correct  Stop smoking
temperature of vaccines, starting from the manufacturer, to  Plenty of rest
regional store, to district hospital, to the health center to the  Nutritious and balance meals, increase CHON, Vit. A, C
immunizing staff and to the client.
MENINGITIS
DISEASES ACQUIRED THRU RESPIRATORY
 Acute meningococcemia - with or without meningitis
TUBERCULOSIS o Waterhouse Friederichsen Syndrome
 Inflammation of the meninges usually some combination of
 Chronic respiratory disease affecting the lungs characterized headache, fever, stiff neck, and delirium
by formation of tubercles in the tissues---> caseation –-->  Meningococcemia: cerebrospinal fever
necrosis ---> calcification.  Etiologic agent: Neisseria meningitides
 AKA: Phthisis, Consumption, Koch’s, Immigrant’s dse  Incubation: 2-10 days
 Etiologic agent: – Mycobacterium tuberculosis  MOT: droplet
 Incubation period: 2 – 10 wks.
 Period of communicability: all throughout the life if not
treated
 MOT: Droplet
 Sources of infection – sputum, blood, nasal discharge,
saliva
 Classification
1. Inactive – asymptomatic, sputum is (-), no cavity on
chest X ray
2. Active – (+) CXR, S/S are present, sputum (+) smear
 Classification 0-5
1. Minimal – slight lesion confined to small part of the
lung Diagnostics
2. Moderately advanced – one or both lungs are
involved, volume affected should not extend to one  Lumbar tap, CSF - high WBC and CHON, low glucose
lobe, cavity not more than 4 cm.
3. Far advance – more extensive than B Manifestations

Manifestations  Sudden onset of fever x 24h

 Petechiae, Purpuric rashes
 Primary Complex (TB in children): non contagious  Meningeal irritation
o children swallow phlegm o Stiff neck
o fever o Opisthotonus
o cough o Kernig’s sign
o anorexia o Brudzinski sign
o weight loss
 ALOC
o easy fatigability
 S/S of Increase ICP
 Chinese General Hospital College of Nursing
Communicable Diseases
Pocholo Santos
Nursing Management  Period of communicability: 7 days post exposure to 3
wks post disease onset
 Administer prophylactic antibiotics: Rifampicin - drug of  MOT – DropleT
choice
 Aquaeous Pen
 Mannitol
 Dexamethasone
 Priority: AIRWAY, SAFETY
 Maintain seizure precaution
 Respiratory precaution
 Handwashing
 Suction secretions

DIPTHERIA

 Acute contagious disease characterized by generalized Manifestation

toxemia coming from localized inflammatory process
 Etiologic agent: Corynebacterium Diptheria (Klebs loffer  rapid cough 5-10x in one inspiration ending a high pitched
bacillus) whoop.
 Incubation period: 2-5 days  Catarrhal – slight fever in PM, colds, watery nasal
 Period of communicability: variable, ave:2-4 weeks discharge, teary eyes, nocturnal coughing, 1-2 weeks
 MOT – Droplet, direct or intimate contact, fomites,  Paroxysmal – Spasmodic stage; 5-10 successive forceful
discharge from nose, skin, eyes coughing ending with inspiratory whoop, involuntary
micturition and defecation, choking spells, cyanosis
Manifestations  Convalescent – 4th- 6th week; diminish in severity,
frequency
 Pseudomembrane - grayish white, smooth, leathery and
spider web like structure that bleeds when detached Complications
 Types of Respiratory Diptheria
o Nasal  Otitis media
 serous to serosanginous purulent  Acute bronchopneumonia
discharge  Atelectasis or emphysema
 Pseudomebrane on septum  Rectal prolapse, umbilical hernia
 Dryness/ excoriation on the upper lip  Convulsions (brain damage - asphyxia, hemorrhage)
and nares
o Pharyngeal Diagnostics
 pharyngeal pseudomembrane
 bull neck ( cervical adenitis)  Elevated WBC
 Difficulty swallowing  Nasopharyngeal swab
o Laryngeal
 Sorethroat, pseudomemb Nursing Management
 Barking, dry mettallic cough
 Prevention:
o DPT
Complications
 Parenteral fluids
 Erythromycin - drug of choice
 Due to Toxemia
o Toxic endocarditis  Prone position during attack
o Neuritis  Abdominal binder
o Toxic nephritis  Adequate ventilation, avoid dust, smoke
 Isolation
 Due to Intercurrent Infection
o Bronchopneumonia  Gentle aspiration of secretions
o Respiratory failure
MEASLES
Diagnostics
 Sources of infection – secretions from eyes, nose and
 Nose and throat swabs - culture of specimen form beneath throat
membrane
 Pathognomonic sign:
 Virulence test o Koplik’s spots
 Shick’s test : test for susceptibility to diptheria
 Moloney’s test: for hypersensitivity to diphtheria

Management

 Penicillin, Erythromycin
 Diptheria Antitoxin – after – skin test if (+), fractional
dose
 Supportive
o O2, if laryngeal obstruction – tracheostomy
o CBR for 2 weeks
o Increase fluids, adequate nutrition- soft food, rich
in Vit C
o Ice collar
 Isolation till 3 negative cultures

Prevention
Manifestations
 DPT
 Pre eruptive stage / Prodromal (10-11 days)
o Coryza, Cough, Conjunctivitis
PERTUSIS (WOOPHING COUGH)
o Koplik’s Spots, whitish spot at the inner cheek
o Fever, photophobia
 Repeated attacks of spasmodic coughing with series of
explosive expirations ending in long drawn force inspiration  Eruptive stage
 Etiologic agent: Bordetella pertusis or Haemiphilus o Maculopapular rashes
pertussis o Rash is fully developed by 2nd day
 Incubation period: 7-14 days o High grade fever –on and off
 Chinese General Hospital College of Nursing
Communicable Diseases
Pocholo Santos
o Anorexia, throat is sore  Acute and highly contagious viral disease characterized by
 Convalescence (7-10 days) vesicular eruptions on the skin
o Desquamation of the skin  Infectious agent – Herpes zoster virus or Varicella zoster
 Incubation period – 10 -21 days
Diagnostics  Period of communicability: 1 day before eruption up to 5
days after the appearance of the last crop
 Nose and throat swab  MOT: airborne, direct, indirect
o Direct contact thru shedding vesicles,
Treatment o Indirect thru linens or fomites

 Antiviral drugs- Isoprenosine Manifestations

 Antibiotics – if with complications
 Supportive – O2, IVF  Pre eruptive: Mild fever and malaise
 Eruptive: rash starts from trunk
Complications  Lesions - red papules then becomes milky and pus like
within 4 days,
 Bronchopneumonia  Pruritis
 otitis media  Stages of skin affectations
 encephalitis o Macule – flat
o Papule – elevated above the skin diameter about 3
cm
Nursing Management o Vesicle
o Pustule
 Preventive – measles vaccine at 9 months, MMR 15 o Crust – scab , drying on the skin
months and then 11-12; defer if with fever, illness
 Isolation - contact/respiratory Complications
 TSB , Skin care – daily cleansing wash
 Oral and nasal care  pneumonia
 Plenty of fluids  sepsis
 Avoid direct glare of the sun- due to photophobia
Treatment

GERMAN MEASLES  Zovirax 500mg tablet 1 tab BID X 7 days

 Acyclovir
 Mild viral illness caused by rubella virus.  Oral antihistamine
 AKA: Rubella; 3-Day Measles  Calamine lotion
 Incubation period– from exposure to rash 14 -21d  Antipyretics
 Period of communicability – one week before and and 4
days after onset of rashes. Worst when rash is at it’s peak. Nursing Management
 MOT: Droplet, nasal ceretions, transplacental in congenital
 Strict isolation until all vesicles scabs disappear
 Hygiene of patient
 Cut finger nails short
Manifestations  Baking soda - pruritus

 Prodromal – low grade fever, headache , malaise, colds, Prevention

lymph node involvement on 3rd to 5th day
 Eruptive – Forscheimer’s spots: pinkish rash on soft  Live attenuated varicella vaccine
palate, rash on face, spreading to the neck, arms and trunk  VZIG - effective if given 96h post exposure
o lasts1-5 days with no pigmentation or
desquamation
o muscle pain HERPES ZOOSTER

Treatment  Acute inflammatory disease known to be caused by herpes

virus varicellae or VZ virus
 symptomatic treatment  Infection of the sensory nerve charac by extremely painful
infection along the sensory nerve pathway
Complications  Occurs as reinfection of VZ virus
 MOT
 Encephalitis, neuritis o Direct
 Rubella syndrome – microcephaly, mental retardation, o Indirect – airborne
deaf mutism, congenital heart disease  Incubation: 1-2 weeks
 RISK for congenital malformation
o 100% when maternal infection happens on first
trimester of pregnancy.
o 4% - second/third trimester

Nursing Management

 Isolation. Bed rest

 Room darkened – photophobia
 Encourage fluid
 like measles tx

Prevention

 MMR, Pregnant women should avoid exposure to rubella

Diagnostic procedure
patients
 Administration of Immune serum globulin one week after
exposure to rubella.  Hx of chickenpox
 Pain and burning sensation over lesions of vesicles along
CHICKENPOX nerve pathway
 Smear of vesicle fluid- giant cells
 Viral cultures of vesicle fluid
 Electron microscopy
 Chinese General Hospital College of Nursing
Communicable Diseases
Pocholo Santos
 Giemsa-stained scraping – multinucleate giant epithelial
cells Treatment Modalities

Signs and Symptoms  Antiviral drugs

 NSAIDS – Acetaminophen
 Burning, itching, pain then erythematous patches followed
by crops of vesicles Nursing Interventions
 Eruptions are unilateral
 Lesions may last 1-2 weeks  Symptomatic
 Fever, regional lymphadenopathy  Application of warm/ cold compress
 Paralysis of cranial nerve, vesicles at external auditory canal  Oral care, warm salt water gargle
 Paralytic ileus, bladder paralysis, encephalitis  Diet – semi solid, soft food easy to chew
o Acid foods/fluids – fruit juices may increase
discomfort
Complications
DISEASES ACQUIRED THRU GIT
 Opthalmia herpes – blindness because of damage of
gasserian ganglion  Diseases caused by Bacteria
 Geniculate herpes – deafness because of infection of 7th o Typhoid Fever
CN (AKA: Ramsay Hunt Syndrome) o Cholera
o Dysentery
Nursing Intervention
 Diseases caused by Virus
o Poliomyelitis
 Compress of NSS or alluminum acetate over lesions o Infectious Hepatitis A
 Analgesics, sedatives – weeks to mos  Diseases caused by Parasites
 Steroids o Amoebiasis
 Keep blister covered with sterile powder esp after break o Ascariasis
 Prevent bacterial invasion
 Encourage proper disposal of secretions and usage of gown THYPHOID FEVER
and mask
 infection of the GIT affecting the lymphoid
MUMPS tissues(ulceration of Peyer’s patches) of the small intestine
 Etiologic Agent: Salmonella typhosa and typhi, Typhoid
 Acute viral disease manifested by swelling of one or both of bacillus
the parotid glands, with occasional involvement of other  Incubation period: 1-2 weeks
glandular structures,particularly testes in male.
 Period of communicability: as long as the patient is
 Etiologic agent – filterable virus of paramyxovirus group excreting the microorganism,
usually found in saliva of infected person.
 MOT: fecal-oral route, contaminated water, milk or other
 AKA: Epidemic/ infectious parotitis food
 Incubation period: 14 -25 days.  Sources of Infection
 Period of communicability – 6d before and 9d post o A person who recovered from the disease can be
onset of parotid gland swelling potential carrier.
 48 hrs immediately preceding the onset of swelling is the o Ingestion of shellfish taken from waters
highest communicability. contaminated by sewage disposal
 MOT: direct, indirect - droplet, airborne o Stool and vomitus of infected person are sources of
infection.

Clinical Manifestations

 sudden headache, earache , loss of appetite

 swelling of the parotid gland
 pain is related to extent of the swelling of the gland which
reaches it’s peak in 2 days and continues for 7-10 days. Clinical Manifestations
 fever may reach 40 C during acute stage,
 one gland may be affected first and 2 days later the other  Ladderlike fever
side is involved  Nausea, vomiting and diarrhea
 RR is fast, skin is dry and hot, abdomen is distended
Complications  Head-ache, aching all over the body
 Worsening of symptoms on the 4th and 5th day
 Orchitis – testes are swollen and tender to palpation.  Rose spots
 Oophoritis- pain and tendeness of the abdomen
 Mastitis
 Deafness may happen Complications
 Meningo-encephalitis –possible
 Hemorrhage, Peritonitis, Pneumonia, Heart failure, Sepsis
Diagnostics
Diagnostics
 Viral Culture 1. Viral culture
 WBC count  WBC – elevated
 Blood Culture – (+) S. typhosa
 Stool Culture (+)
Prevention  Widal test – blood serum agglutination test
o antigen – active typhoid
 MMR Vaccine o H antigen- previously infected or vaccinated
 Chinese General Hospital College of Nursing
Communicable Diseases
Pocholo Santos
o Vi antigen – carrier Nursing Management

Treatment  Medical Asepsis

 Enteric precaution
 Chloramphenicol – drug of choice  VS monitoring
 Paracetamol  I and O
 Good personal hygiene
Nursing Management  Proper excreta disposal
 Concurrent disinfection.
 Restore FE balance  Environmental sanitation
 Bedrest
 Enteric precautions Prevention
 Prevent falls/safety precautions
 WOF intestinal bleeding  protection of food and water supply from fecal
o Bloody stools contamination.
o Sweating  Water should be boiled/ chlorinated.
o Pallor  Milk should be pasteurized.
 NPO, BT  Sanitary disposal of human excreta
 Environmental sanitation.
CHOLERA
DYSENTERY
 an acute bacterial disease of the GIT characterized by
profuse diarrhea, vomiting, loss of fluid.  Acute bacterial infection of the intestine characterized by
 Etiologic agent: Vibrio cholerae, V. comma diarrhea and fever
 Pathognomonic sign: rice watery stool  Etiologic Agent: Shigella group
 Incubation period: 2-3 days  Shigella flesneri - commmon in the Philippines
 Period of Communicability: entire illness, 7-14d  Shigella boydii, S. connei,
 MOT: fecal oral route  S. dysenteria – most infectious, habitat exclusively in man,
they develop resistance to antibiotics
 Incubation period – 7 hrs. to 7 days

 Period of communicability – during acute infection until

the feces are (-)
 MOT – fecal-oral route, contaminated water/ milk/ food.

Clinical manifestations

 Acute, profuse, watery diarrhea.

 Initial stool is brown and contains fecal material becomes Clinical Manifestations
“rice water”
 Nausea/ Vomiting  Fever esp. in children
 S/s of Dehydration  Nausea, vomiting and headache
 poor tissue trugor, eyes are sunken  Anorexia, body weakness
 Pulse is low or difficult to obtain, BP is low and later  Cramping abdominal pain (colicky)
unobtainable.  Diarrhea – bloody and mucoid
 RR – rapid and deep  Tenesmus
 Cyanosis – later  Weight loss
 Voice becomes hoarse– speaks in whisper
 Oliguria or anuria
 Conscious, later drowsy Diagnostics
 Deep shock
 Death may occur as short as four hours after onset.  Fecalysis
 Usually first or 2nd day if not treated  Rectal Swab/culture
 Principal deficits  Bloods – WBC elevated
o Severe dehydration - circulatory collapse  Blood culture
o Metabolic acidosis – loss of large volume of
bicarbonate rich stool. RR rapid and deep Treatment
o Hypokalemia – massive loss of K. abdominal
distention – paralytic ileus  Antibiotics- Ampicillin, Cotrimoxazole, Tetracycline
 IVF
Diagnostics  Anti diarrheal are Contraindicated

 Fecal microscopy Nursing Management

o Rectal swab
o Stool exam  Maintain fluid and electrolyte balance
 Restrict food until nausea and vomiting subsides.
 Enteric precaution
Treatment  Excreta must be disposed properly.
 Prevention- food preparation, safe washing facilities, fly
 IVF- rapid replacement control
 Oral rehydration
 Strict I and O POLIOMYELITIS
 Antibiotics – Tetracycline, Cotrimoxazole.
 Chinese General Hospital College of Nursing
Communicable Diseases
Pocholo Santos
 An acute infectious disease caused by any of the 3 types of  Footboard to prevent foot drop
poliomyelitis virus which affects mainly the anterior born  Fluids, NTN, Bedrest
cells of the spinal cord and the medulla, cerebellum and the  Enteric and strict precautions
midbrain
 AKA: Acute anterior poliomyelitis, heinmedin disease, HEPATITIS A
infantile paralysis
 Etiologic Agent: Poliovirus (Legio Debilitans)  Inflammation of the liver caused by hepatitis A virus
 3 Types of Poliovirus  AKA: infectious hepatitis
o Type I - most paralytogenic, most frequent  Incubation period: 2-6weeks
o Type II - next most frequent  MOT: oral-fecal/ enteric transmission
o Type III - least frequent associated with paralytic  Diagnostic test: liver function (SGOT/SGPT)
disease
 3 Strains
o Brunhilde
o Laasing
o Leon
 MOT: Fecal-Oral
 Incubation period: 7-14 days ave (3-21 days)
 Period of communicability: 7-16 days before and few
days after onset of s/s

Sign and Symptoms

 Febrile episodes with varying degrees of muscle weakness

 Occasionally progressive Flaccid Paralysis

Clinical Manifestations

 Prodromal/ pre icteric

o S/S of URTI
o Weight loss
o Anorexia
o RUQ pain
o Malaise
 Icteric
o Jaundice
o Acholic stool
o Bile-colored urine

Diagnostic tests
 3 Types of Paralysis
o Spinal Paralytic
 HaV Ag, Ab, SGOT, SGPT
 Flaccid paralysis
 Autonomic involvement
Nursing Interventions
 Respiratory difficulty
o Bulbar Form
 Rapid & serious  Provide rest periods
 Vagus and glossopharyngeal nerves  Increase CHO, mod Fat, low CHON
affected  Intake of vits/minerals
 Cardiac and respiratory reflexes altered  Proper food preparation/handling
 Pulmo edema  Handwashing to prevent transmission
 Hypertension, impaired temp regulation
 Encephalitic s/s AMOEBIASIS
o Bulbospinal
 Combination  involves the colon in general but may involve the liver or
 Minor Polio lungs as well
o Inapparent / subclinical  Etiologic agent: Entamoeba histolytica
o Abortive: recover within 72 hours; flulike;  Incubation: 3-4 weeks
backache; vomiting  Period of communicability: duration of illness
 Major Polio  MOT: fecal oral route
o Paralytic: asymmetrical weakness, paresthesia, o Indirect - Ingestion of food contaminated with
urinary retention, constipation E.Histolytica cysts, polluted water supply,
o Non paralytic: slight involvement of the CNS; exposure to flies, unhygienic food handlers.
stiffness and rigidity of the spine, spasms of o Direct contact – sexual, oral, or anal, proctogenital
hamstring muscles, with paresis
o Tripod position: extend his arms behind him for
support when upright
o Hoyne’s sign: head falls back when he is in
supine position with the shoulder elevated
o Meningeal irritation: (+) Brudzinski, Kernig’s
sign

Diagnostics

 Throat swab, stool exam, LP

Nursing Interventions

 Supportive, Preventive – Salk and Sabin Vaccine

 NO morphine
 Moist heat application for spasms
 Airway: tracheotomy Clinical Manifestations
 Chinese General Hospital College of Nursing
Communicable Diseases
Pocholo Santos
 Intermittent fever DISEASES ACQUIRED THRU THE SKIN
 Nausea, vomiting, weakness
 Later : anorexia, weight loss, jaundice  Diseases caused by Trauma and Inoculation
 Diarrhea – watery and foul smelling stool often containing o Tetanus
blood streaked mucus o Rabies
 Colic and abdominal distention o Malaria
 Intestinal perforation –bleeding o DHF
o Leptospirosis
Diagnostics o Schistosomiasis
 Disease acquired thru Contact
 Stool Exam ( cyst, amoeba+++) O Leprosy
 WBC – elevated
TETANUS
Treatment
 an acute, often fatal, disease characterized by generalized
 Amoebacides – Metronidazole(Flagyl) 800mg TID X rigidity and convulsive spasms of skeletal muscles caused by
7days the endotoxin released by C. Tetani
 Bismuth gylcoarsenilate combined with Chloroquine  AKA: Lockjaw
 Antibiotic – Ampicillin, Tetracycline, Chloramphenicol  Etiologic Agent: Clostridium Tetani
 Fluid replacement – IVF, oral o Anerobic
o Spore forming, gram positive rod
Nursing Management  Sources:
o Animal and human feces
 Enteric precaution o Soil and dust
 Health education- boil drinking water (20-30 mins), Use O Plaster, unsterile sutures, rusty scissors, nails and
mineral water. pins
 Cover leftover food.  MOT:
 Avoid washing food from open drum/pail. o Direct or indirect contact to wounds
 Wash hands after defecating and before eating. o Traumatic wounds and burns
 Observe good food preparations. o Umbilical stump of the newborn
 Fly control o Dirty and rusty hair pins
o GIT- port of entry – rare
ASCARIASIS o Circumcision/ ear pearcing
 Incubation period: 3d-3week (ave:10d)
 Helminthic infection of the small intestine caused by
Ascaris Lumbrecoides
 MOT: fecal-oral
 Incubation period: 4-8 weeks
 Communicability: as long as mature fertilized female
worms live in intestine

Diagnostics

 Microscopic identification of eggs in stool

 CBC
 Hx of passing out of worms (oral or anal), Xray,

Signs and Symptoms

 Stomachache
 Vomiting
 Passing out of worms

Complications Signs and Symptoms

 Energy / Protein malnutrition  persistent contraction of muscles in the same anatomic area
 Anemia as the injury
 Intestinal obstruction  Local tetanus
 Cephalic tetanus - rare form
 otitis media (ear infections)
Treatment:  Generalized tetanus
o trismus or lockjaw
 Pyrantel Pamoate o stiffness of the neck
 Piperazine Citrate o difficulty in swallowing
 Mebendazole, Tetramizole o rigidity of abdominal muscles
 Dicyclomine Hcl, NSAIDS for abdominal pain o elevated temperature
 For intestinal obstruction o sweating
o Decompression o elevated blood pressure episodic rapid heart rate
o Fluid and electrolyte therapy  Neonatal tetanus - a form of generalized tetanus that occurs
o If persistent, laparotomy in newborn infants
 FF up stool exam 1-2 weeks after treatment
Diagnostics

Nursing Intervention  entirely clinical

 CSF – normal
 Isolation- not needed  WBC- normal or slight elevated
 Enteric precaution
 Handwashing Treatment
 Proper nutrition
 Maintenance of hydration / fluid balance / boil of water  Wounds should be cleaned
 Improve personal hygiene  Necrotic tissue and foreign material should be removed
 Proper food prep/handling  Tetanic spasms - supportive therapy and maintenance of an
 Administer meds (NSAIDS, MEBENDAZOLE) adequate airway
 Tetanus immune globulin (TIG)
 Chinese General Hospital College of Nursing
Communicable Diseases
Pocholo Santos
o help remove unbound tetanus toxin o Sensitive to light, sound, and changes in temp
o cannot affect toxin bound to nerve endings o Myalgia, numbness, tingling, burning or cold
o single intramuscular dose of 3,000 to 5,000 units sensation along nerve pathway; dilation of pupils
o contains tetanus antitoxin.  Stage of Excitement
 Oxygen o Marked excitation, apprehension
 NGT feeding o Delirium, nuchal stiffness, involuntary twitching
 Tracheostomy o Painful spasms of muscles of mouth, pharynx, and
 Adequate fluid, electrolyte, caloric intake larynx on attempting to swallow food or water or
 During convalescence the mere sight of them – hydrophobia
 Determine vertebral injury o Aerophobia
 Attend to residual pulmonary disability o Precipitated by mild stimuli – touch or noise
 Physiotherapy o Death – spasm from or from cardiac / respiratory
 TT failure
 Terminal Phase or Paralytic Stage
Nursing Interventions o Quiet and unconscious
o Loss of bowel and bladder control
 Prevention o Tachycardia, labored irregular respiration, steady
o DPT rising temp
Adverse Reactions o Spasm, progressively increasing paralysis
Local reactions (erythema, induration) o Death due to respiratory paralysis
Fever and systemic symptoms not common
Exagerated local reactions Treatment

 Prevention of CV and respiratory complications  No cure

o Adequate airway  No specific – symptomatic/ supportive – directed toward
o ICU – ET- MV alleviation of spasm
 Provide cardiac monitoring  Employ continuing cardiac and pulmonary monitoring
 KVO  Assess the extent and location of the bite – biting incident/
 Wound care (TIG, Debridement, TT) status of the animal
 Administer antibiotics as ordered o Severe exposure
o Penicillin o Mild exposure
 Care during tetanic spasm/ convulsion  Wound treatment (local care)
o Administer Diazepam – muscle rigidity/spasm o Cleanse thoroughly with soap and water (or
o Administer neuromuscular blocking agents ammonium compounds, betadine, or
(metocurin iodide) – relax spasms and prevent benzalkonium cl)
seizure o Anti rabies serum
 Keep on seizure precaution o Tetanus prophylaxis
 Parenteral nutrition o Antibiotics
 Avoid complications of immobility (contractures, pressure o Suturing should be avoided
sores)  Antirabies sera
 WOF urinary retention, fractures o Heterologous serum obtained by
hyperimmunization of different animal species i.e.
RABIES horses
o HRIG – Homologous reabies immunoglobulin –
 a viral zoonotic neuroinvasive disease that causes acute human origin
encephalitis  Rabies Vaccine
 Etiologic agent: Rhabdovirus  Active immunization
 AKA: Hydrophobia, Lyssa o Administered 3 years duration
 Negri bodies in the infected neurons – pathognomonic o Used for lower extremity bites
 Incubation period: 4-8 weeks; 10d-1yr o Lyssavac (purified protein embryo), Imovax, Anti-
 Period of communicability: 3-5 days before the onset of s/s rabies vaccine
until the entire course of disease  Passive immunization
 MOT: contamination of a bite of infected animals o 3 months
o Rabuman, Hyper Rab, Imogam
Diagnostics
Nursing Interventions
 History of exposure
 PE/ assessment of s/s  Isolation of patient
 Microscopic examination of Negri bodies using Seller’s May- o Provide comfort for the patient by:
Grunwald and Mann Strains o Place padding of bedside or use restraints
 Fluorescent Rabies Antibody technique / Direct o Clean and dress wound with the use of gloves
Immunofluorescent test o Do not bathe the patient, wipe saliva or provide
sputum jar
 Provide restful environment
o Quiet, dark environment
o Close windows, no faucets or running water should
be heard
o IVF should be covered
o No sight of water or electric fans

MALARIA

 Acute and chronic disease transmitted by mosquito bite

confined mainly to tropical areas.
 Etiologic agent – Protozoa of genus Plasmodia
o Plasmodium Falciparum (malignant tertian)
most serious, high parasitic densities in RBC with
tendency to agglutinate and form into
microemboli. Most common in the Philippines
Clinical Manifestations o P. Vivax - non life threatening except for the very
young and old.
 Prodromal Phase / Stage of Invasion Manifests chills every 48 hrs on the 3rd day
o Fever, anorexia, malaise, sorethroat, copious onward if not treated
salivation, lacrimation, perspiration, irritability, o P. malarie (Quartan) – less frequent, non life
hyperexcitability, restlessness, drowsiness, mental threatening, fever and chills occur every 72 hrs on
depression, marked insomia the 4th day of onset
 Chinese General Hospital College of Nursing
Communicable Diseases
Pocholo Santos
o P. ovale - rare Prevention
 Incubation period:
o 12days P. falciparum, 14 days P vivax and ovale, 30  Mosquito breeding places should be destroyed
days P. malariae  Insecticides, insect repellant
 Period of communicability  Blood donor screening
o If not treated /inadequate – more than 3 yrs. P
malariae, 1-2 yrs. P. vivax, 1 yr- P. falciparum DENGUE FEVER
 Mode of transmission
o Mosquito bite: Vector – female Anopheles  Is an acute febrile disease cause by infection with one of the
mosquito serotypes of dengue virus which is transmitted by mosquito
o Also by blood transfusion (Aedes aegypti).
 Dengue hemorrhagic fever – fatal characterized by
Diagnostics bleeding and hypovolemic shock
 Etiologic agent – Arbovirus group B –
 Malarial smear – film of blood is placed on a slide, stained  AKA: Chikungunya, O’ nyong nyong, west nile fever
and examined  Mode of Transmission: Bite of infected mosquito – Aedes
 Rapid diagnostic test (RDT) – done in field. 10 -15 mins Aegypti
result blood test  Incubation period – 3-14 days
 Period of communicability – mosquito all throughout
life
 Sources of infection
o Infected person- virus is present in the blood and
will be the reservoir when sucked by mosquitoes
o Stagnant water = any

Clinical Manifestions

 Rapidly rising fever with severe headache Diagnostics

 Shaking chills
 Diaphoresis, muscular pain  Torniquet test
 Splenomegaly, hepatomegaly  Platelet Count
 Hypotension  Hematocrit
o May lasts for 12 hours daily or every 2 days.
 Complicated Malaria Manifestations
o GIT
 Bleeding from GUT, N/V, Diarrhea,  Prodromal symptoms
abdominal pain, gastric, tyhoid, o malaise and anorexia up to 12 hrs.
choleric, dysenteric o Fever and chills, head-ache, muscle pain
o CNS or Cerebral Malaria o N &V
 Changes in sensorium  Febrile Phase
 Severe headache o Fever persists (39-40 C)
 N/V o Rash - more prominent on the extremities and
o Hemolytic
trunk
 Blackwater fever - Reddish to mahogany o (+) torniquet test- petechia more than 10.
colored urine due to hemoglobinuria
o Skin appears purple with blanched areas with
 Anuria – death
o Malarial lung disease varied sizes ( Herman’s sign)
o Generalized or abdominal pain
o Hemorrhagic manifestations – epistaxis, gum
bleeding
o
 Circulatory Phase
Management o Fall of temp on 3rd to 5th day
o Restless, cool clammy skin
 Antimalarial drugs – Chloroquine (all but P. Malarie), o Profound thrombocytopenia
quinine, Sulfadoxine (resistant P falciparum) Primaquine o Bleeding and shock
(relapse P vivax/ovale) o Pulse - rapid and weak
 RBC replacement/ erythrocyte exchange transfusion o Untreated shock --- coma – death
o Treated – recovery in 2 days

Nursing Management Classification

 Isolation of patient  Grade 1

 Use mosquito nets  Grade 2
 Eradicate mosquitos  Grade 3
 Care of exposed persons – case finding  Grade 4
 I and O
 BUN & creatinine – dialysis could be life saving Treatment
 ABG
 TSB, ice cap on head  No specific antiviral therapy for dengue
 Hot drinks during chilling, lots of fluid  Analgesic – not aspirin for relief of pain
 Monitoring of serum bilirubin  IV fluid
 Keep clothes dry, watch for signs of bleeding  BT as necessary
 O2 therapy
 Chinese General Hospital College of Nursing
Communicable Diseases
Pocholo Santos
Nursing Management  Parasitic disease caused by Schistosoma japonicum, S.
mansoni, S. Hematobium
 Kept in mosquito free environment  AKA: Bilharziasis, Snail fever
 Keep pt. at rest  Incubation period: 2-6 weeks
 VS monitoring  MOT: bathing, swimming, wading in water
 Ice bag on the bridge of nose and forehead. o Vector: Oncomelania quadrasi
 Observe for signs of shock – VS (BP low), cold clammy skin o Cercariae: most infective stage

Prevention Diagnostics
 Fecalysis
 Mosquito net o Identification of eggs
 Eradication of breeding places of mosquito  Liver and rectal biosy
o house spraying  Immunodiagnostic tests / circumoval precipitin test and
o change water of vases cercarial envelope reactions
o scrubbing vases once a week
o cleaning the surroundings
o keep water containers covered
o avoid too many hanging clothes inside the house

LEPTOSPIROSIS

 Infectious bacterial disease carried by animals whose urine

contaminates water or food which is ingested or inoculated
thru the skin.
 Etiologic agent: spirochete Leptospira interrogans
 found in river, sewerage, floods
 AKA: Weil’s disease, mud fever, Swineherd’s disease
 Incubation Period: 6 -15 days
 Period of Communicability – found in urine between 10-
20 days
 MOT – contact with skin of infected urine or feces of
wild/domestic animals; ingestion, inoculation

Diagnostics

 Clinical manifestations
 Culture Signs and Symptoms

 Swimmers itch
o Itchiness
o Redness and pustule formation at site of entry of
cercariae
o Diarrhea
o Abdominal pain
o Hepatosplenomegaly

Clinical Manifestations
Source of Infection
 Rats, dogs, mice  Abdominal pain
Manifestations  Cough
 Septic Stage  Diarrhea
o Early - Fever (40 ‘C), tachycardia, skin flushed,  Eosinophilia - extremely high eosinophil granulocyte count.
warm, petechiae  Fever
o Severe – (Multiorgan)Conjunctival affectation,  Fatigue
jaundice, purpura, ARF, Hemoptysis, head-ache,  Hepatosplenomegaly - the enlargement of both the liver and
abdominal pain, jaundice the spleen.
 Toxic stage – with or w/o jaundice, meningeal irritation,  Colonic polyposis with bloody diarrhea (Schistosoma
oliguria– shock, coma , CHF mansoni mostly)
 Convalescence – recovery  Portal hypertension with hematemesis and splenomegaly (S.
mansoni, S. japonicum);
Management  Cystitis and ureteritis with hematuria  bladder cancer;
 Pulmonary hypertension (S. mansoni, S. japonicum, more
 IV antibiotic rarely S. haematobium);
o Pen G Na  Glomerulonephritis; and central nervous system lesions.
o Tetracycline
o Doxycycline
 Dialysis – peritoneal Complications
 IVF
 Supportive  Pulmonary hypertension
 Symptomatic  Cor pulmonale
 Myocardial damage
Nursing Interventions  Portal cirrhosis

 Isolation of patient – urine must properly disposed Treatment

 Care of exposed persons – keep under close surveillance
 Control measures  Trivalent antimony
o Cleaning of the environment/ stagnant water o Tartar emetic – administered thru vein
o Eradicate rats o Stibophen (Fuadin) – given per IM
o Avoid bathing or wading in contaminated pool of  Praziquantel – per orem
water  Niridazole
o vaccination of animals (cattles,dogs,cats,pigs)

SCHISTOSOMIASIS Nursing Interventions

 Chinese General Hospital College of Nursing
Communicable Diseases
Pocholo Santos
 Administer prescribed drugs as ordered  Charecterized by opportunistic infections when T4/CD4
 Prevent contact with cercaria-laden waters in endemic areas count drops <200
like streams  MOT – sexual contact with infected – unprotected, injection
 Proper sanitation or disposal of feces of blood/products, placental transmission
 Creation of a program on snail control – chemical or
changing snail environment History

LEPROSY  1959 - African man

 1981- 5 homosexual men
 Chronic systemic infection characterized by progressive  1982-Designated as disease by CDC
cutaneous lesions  1983- HIV 1 discovered
 Etiologic agent: Mycobacterium leprae  1987- 1.5 million HIV-infected in USA
 Acid fast bacilli that attack cutaneous tissues, peripheral  1994- WHO reports 8-10 mil. Worldwide & protease
nerves producing skin lesions, anesthesia, infection and inhibitors introduced
deformities.  1999-First clinical trials for HIV vaccine
 Incubation period – 5 1/2 mo - eight years.
 MOT – respiratory droplet, inoculation thru break in skin
and mucous membrane. The Immune System

Diagnosis  Macrophages
 Humoral response
 Identification of signs and symptoms  Cell-mediated response
 Tissue biopsy  RNA virus
 Tissue smear  Retrovirus
 Bloods – inc. ESR  Reverse transcriptase
 Lepromin skin test  Protease
 Mitsuda reaction

Manifestations

 Corneal ulceration, photophobia –blindness

 Lesions are multiple, symmetrical and erythematous–
macules and papules
 Later lesions enlarge and form plaques on nodules on
earlobes, nose eyebrows and forehead
 Foot drop
 Raised large erythemathous plaques appear on skin with
clearly defined borders. – rough hairless and hypopigmented
– leaves an anesthetic scar.
 Loss of eyebrows/eyelashes
 Loss of function of sweat and sebaceous glands
 Epistaxis

Diagnostics

 ELISA
Prevention  Western Blot
 CD4 count
 multiple drug therapy  Viral load testing
 sulfone  Home test kits
 rehab
 occupational Health HIV/AIDS Spectrum
 isolation
 moral support

Prevention

 Report cases and suspects of leprosy

 BCG vaccine may be protective if given during the first 6
months.

Nursing Interventions

 Isolation of patient – until causative agent is still present

 Care of exposed persons
 Household contact – Diaminodiphenylsulfone for 2 years
 Observe carefully for symptoms of the disease

DISEASES ACQUIRED THRU SEXUAL CONTACT

HIV/AIDS

 Chronic disease that depresses immune function

 Chinese General Hospital College of Nursing
Communicable Diseases
Pocholo Santos

Manifestations Nursing Management

 Minor signs – cough for one month, general pruritus,  Administer Antiviral meds as ordered
recurrent herpes zoster, oral candidiasis, generalized  Universal precaution
lymphadenopathy  Reverse isolation
 Major signs – loss of weight 10% BW, chronic diarrhea  gloves, needle stick injury prevention
1month up, prolonged fever one month up.  Assist in early diagnosis and management of complications
 Persistent lymphadenopathy  4 C’s
 Cytopenias (low) o Compliance – info, + drugs
 PCP o Counselling – education
 Kaposis sarcoma o Contact tracing – tracing out and tx for partners
 Localized candida o Condoms – safe sex
 Bacterial infections
 TB GONORRHEA
 STD
 Neurologic symptoms  a curable infection caused by the bacteria Neisseria
gonorrhoea
Criteria for Diagnosis of AIDS  AKA: Clap, Drip, G. vulvovaginitis
 MOT: transmitted during vaginal, anal, and oral sex
 CD4 counts of 200 or less  Incubation period: 3-10 days initial manifestations
 Evidence of HIV infection and any of  Period of communicability: considered infectious from
o Thrush the time of exposure until treatment is successful
o Bacillary angiomatosis
o Oral hairy leukoplakia Manifestations
o Peripheral neuropathy
o Vulvovaginal candidiasis  Urethritis – both male and female
o Shingles  S/S: dysuria and purulent discharge
o Idiopathic thrombocytopenia  Cervicitis
o Fatigue, night sweats, weight loss  Upper Genital Tract – females (PID), Endometritis,
o Cervical dysplasia, carcinoma in situ Salpingitis, Pelvic Abscess

 Evidence of HIV infection and any one of the following: Complications

o Bronchial candidiasis  PID
o Esophageal candidiasis  Infertility
o CMV disease  Upper Genital Tract – male
o CMV retinitis  Epididymitis, Prostatitis, Seminal Vesiculitis
o HIV encephalopathy  Disseminated Gonococcal Infection (DGI)
o Histoplasmosis  Tenosynovitis or Polyarthritis, skin lesions and fever
o Kaposi’s Sarcoma  Anorectal Infection
o Herpes simplex ulcers, bronchitis, pneumonia  Pharyngeal Infection
 Gonococcal Conjuctivitis
Treatment  Opthalmia Neonatorum
 Meningitis, Endocarditis
 Started in CD4 counts of <200
 Viral load >10,000 copies Diagnosis
 All symptomatic regardless of counts
 Note: CD4 reflects immune system destruction. Viral load-  Culture & Sensitivity
degree of viral activity  Blood tests for N. gonorrhoeae antibodies
 Nucleoside Reverse Transcriptase Inhibitors
o Blocks reverse transcriptase Treatment
o Acts by binding directly to the reverse
transcriptase enzyme  Antibiotics
o Not used alone o Penicillin
o Rapid development of resistance o Single dose Ceftriaxone IM + doxycycline PO BID
for 1 week
Generic Trade Dose Notes o Prophylaxis: Silver nitrate, Tetracycline,
Erythromycin
Zidovudine AZT, ZDV, 300 mg. Taken with food
Retrovir Bid Nursing Interventions

Didanosine ddI, Videx 200 mg bid Peripheral  Case finding

neuropathy  Health teaching on importance of monogamous sexual
relationship
 Treatment should be both partners to prevent reinfection
Zalcitibine ddC,Hivid .75 mg TID No antacids
 Instruct possible complications like infertility
 Educate about s/s and importance of taking antibiotic for the
Stavudine d4T, Zerit 400 mg bid Peripheral
entire therapy
neuropathy

Lamivudine 3TC, Epivir 150 mg bid Used as SYPHILIS

resistance
develops
 a curable, bacterial infection, that left untreated will progress
through four stages with increasingly serious symptoms
Lamiduvine/ Combivir 150/300 Bone marrow  Etiologic agent: Treponema pallidum
Zidovudine mg toxicity
 AKA: Lues, The pox, Bad blood
 Type of Infection: Bacterial

 Modes of transmission :
 Protease Inhibitors o Through sexual contact/ intercourse, kissing
o Introduced in 1995 o abrasions
o Acts by blocking protease enzyme o Can be passed from infected mother to unborn
o Indinavir (Crixivan) child (transplacental)
o CDC Guidelines
 Combination of 2 NRTI + PI Symptoms
 Chinese General Hospital College of Nursing
Communicable Diseases
Pocholo Santos
 Primary syphilis (10 – 90 days after infection)  Etiologic agent: hepatitis B virus (HBV)
o Chancre – a firm, painless skin ulceration  Source of infections: Blood and body secretions
localized at the point of initial exposure to the
bacterium appear on the genitals Risk factors
o can also appear on the lips, tongue, and other body
parts  multiple sex partners or diagnosis of a sexually transmitted
 Secondary syphilis (last 2 – 6 weeks) disease
o syphilis rash - an infectious brown skin rash  Sex contacts of infected persons
that typically occurs on the bottom of the feet and  Injection-drug users
the palms of the hand  Household contacts of chronically infected persons
o condylomata lata - flat broad whitish lesions  Infants born to infected mothers
o Fever, sore throat, swollen glands, and hair loss  Infants/children of immigrants from areas with high rates of
can also be experienced HBV infection
 Third stage  Health-care and public safety workerr
o Will manifest 1 – 10 years after the infection  Hemodialysis patients
o characterised by gummas - soft, tumor-like
growths Complications
o seen in the skin and mucous membranes – occurs
in bones  Lifelong infection
o joint and bone damage
 Liver cirrhosis
o increasing blindness
 Liver cancer
o numbness in the extremities, or difficulty in
 Liver failure
coordinating movements.
 Death
 neurosyphilis
Signs ans Symptoms
o generalized paresis of the insane which results in
personality changes, changes in emotional affect,
 Jaundice
hyperactive reflexes
 Pruritus
 cardiovascular syphilis
o aortitis, aortic aneurysm, Aneurysm of sinus of  Fatigue
valsalva and aortic regurgitation, - death  RUQ - Abdominal pain
 Loss of appetite
 Nausea, vomiting
 Joint pain

Prevention

 Hepatitis B vaccine has been available since 1982.

 Routine vaccination of 0-18 year olds
 Vaccination of risk groups of all ages
 Immune globulin if exposed

Medical Management

 Interferon alfa-2b
 Lamivudine
 Consequences in Infants  Telbivudine
o congenital syphilis  Entecavir
o extremely dangerous  Adefovir dipivoxil
o Deformities
o Seizures Nursing Interventions
o Blindness
o Damage to the brain, bones, teeth, and ears.  Blood and body secretions precautions
 Prevention- Hepa B vaccine
Test and diagnosis  Proper rest periods
 Prevent stress – physio/psychological
 Venereal Disease Research Laboratory (VDRL) test  Proper NTN, increase in CHO, high in CHON, low fats, Vit. K
 Flourescent treponemal antibody absorption (FTA – Abs) rich foods and minerals
 Micro hemagglutination test (MHA - TP)  Assistance to prevent injury, promote safety AAT
 CSF examination  WOF s/s bleeding, edema
 Health education on safe sex


Treatment SEVERE OF ACUTE RESPIRATORY SYNDROME

 Syphilis is easily treatable when early detected  An acute and highly contagious respiratory disease in
 Penicillin & other antibiotics humans
 Prevention  Etiologic agent: SARS coronavirus
 Abstinence  November 2002 and July 2003, with 8,096 known infected
 Mutual monogamy cases and 774 deaths
 Latex condoms for vaginal and anal sex  Incubation period: 2-3days
 MOT: Airborne
Nursing interventions
Signs and Symptoms
 Case finding
 Health teaching and guidance along preventive measures  flu like: fever, myalgia, lethargy, gastrointestinal symptoms,
 Utilization of community health facilities cough, sore throat
 Assist in interpretation and diagnosis  fever above 38 °C (100.4 °F)
 Reinforce ff up treatment  Shortness of breath
 VD control program participation  Symptoms usually appear 2–10 days following exposure
 Medical examination of patient’s contacts
 require mechanical ventilation

HEPATITIS B
Diagnostics
 serious disease caused by a virus that attacks the liver
 Chinese General Hospital College of Nursing
Communicable Diseases
Pocholo Santos
 Chest X-ray (CXR)- abnormal with patchy infiltrates  Travel to any of the regions identified by
 WBC and PLT CT. - LOW the WHO as areas with recent local
 ELISA test detects antibodies to SARS transmission of SARS (affected regions
o but only 21 days after the onset of symptoms as of 10 May 2003 were parts of China,
 Immunofluorescence assay can detect antibodies 10 Hong Kong, Singapore and the province
days after the onset of the disease of Ontario, Canada).
o labour and time intensive test
 Polymerase chain reaction (PCR) test that can detect  probable case of SARS
genetic material of the SARS virus in specimens ranging
from blood, sputum, tissue samples and stools o above findings plus positive chest x-ray findings of
atypical pneumonia or respiratory distress
 CXR - increased opacity in both lungs, indicative of syndrome
pneumonia
Treatment
 SARS may be suspected
 supportive with antipyretics, supplemental oxygen and
o fever of 38 °C (100.4 °F) or more AND ventilatory support as needed.
 Suspected cases of SARS must be isolated, preferably in
negative pressure rooms, with full barrier nursing
o Either a history of:
precautions taken for any necessary contact with these
patients
 Contact (sexual or casual) with someone
 steroids
with a diagnosis of SARS within the last
 antiviral drug
10 days OR
 SARS vaccine