Communicable Disease Nursing

SEMI FINAL TRANS

2. Emerging strains of some microbes that cannot
be protected by a single vaccine
TERMINOLOGIES
3. Resistance of virus to some antiviral meds
• INFECTION 4. Occasionally arising infectious agents (e.g. HIV,
- the implantation and successful replication of anthrax, Ebola)
an organism in host tissue resulting to signs and 5. Localization of some microbes in areas of the
symptoms as well as immunologic response. body difficult to treat
• CARRIER 6. Opportunistic organisms causing infection in
- an individual who harbors the organism and is immuno-compromised patients
capable of transmitting it to susceptible host 7. Most people have not received immunization
without showing manifestations of the disease. 8. Increased air travel can cause spread of virulent
• CONTACT organisms to a heavily populated area in hours.
- Is a person or animal who is in close association 9. Use of biologic warfare and bioterrorism
with an infected person, animal, or freshly 10. The expanded use of immunosuppressive drugs
soiled materials. and invasive procedures increases the risk of
• ISOLATION infection.
- separation from other persons of an individual
suffering from a communicable disease. Chain of Infection
• HABITAT
- Is a place where an organism lives or where the Infectious/ Causative Agent
organism is usually found.  Any microbe capable of producing a disease
• HOST 1. Bacteria
- Is a person, animal, or plant on which a 2. Spirochete
parasite depends for its survival 3. Viruses
• RESERVOIR 4. Rickettsiae
- composed of one or more species of animal or 5. Chalmydiae
plant in which an infectious agent lives and 6. Fungi
multiplies for survival and reproduces itself in 7. Protozoa
such a manner that it can be transmitted to 8. Parasites
man.
• SURVEILLANCE Reservoir
- the act of watching 1. Human reservoir
• COMMUNICABLE DISEASE a. Frank Cases or the very ill
- an illness caused by an infectious agent or its b. Sub-clinical or ambulatory
toxic products that are transmitted directly or c. Carrier
indirectly to a well person through an agency, a • Incubatory carrier: a person incubating
vector or an inanimate object. the illness
• INFECTIOUS DISEASE • Convalescent carrier: a person at the
- transmitted not only by ordinary contact but recovery stage of illness but continues
requires direct inoculation of the organism to shed the pathogenic organism
through a break in the skin or mucous • Intermittent carrier: occasionally sheds
membrane. the pathogenic organism
• Chronic or sustained carrier: always has
WHY INFECTION OCCURS? the infectious organisms in his or her
1. Resistance developed by bacteria to some system.
antibiotics 2. Animals
3. Nonliving things
Communicable Disease Nursing
SEMI FINAL TRANS
Susceptible Host
– not possessing immunity to a particular
The Portal of Exit pathogen
- path or way in which the organisms leave the
reservoir
1. Respiratory system
2. Genitourinary system
3. Gastrointestinal tract
4. Skin and mucous membrane
5. Placenta

Mode of Transmission means by which the infectious

agent passes through the portal of exit of the reservoir
to the susceptible host.
 the easiest link to break the chain of infection.
1. Contact Transmission
a. Direct – person-to-person transfer ILLNESS FOLLOWING AN ENTRANCE OF PATHOGEN
b. Indirect – susceptible person comes in contact INTO THE BODY DEPENDS ON THE HOST:
with contaminated object 1. Age, sex, genes, and constitution;
c. Droplet spread – contact with respiratory 2. Nutritional status, fitness, environmental
secretions when the infected person coughs, factors;
sneezes, or talks 3. General condition, physical, emotional, and
2. Air-borne transmission – Spread by air current mental state;
and is inhaled by susceptible host. 4. Absence of or abnormal immunoglobulins;
3. Vehicle transmission – through articles or 5. Co-morbid states
substances that harbor the organism until it is 6. Treatment with certain antimicrobials,
ingested or inoculated into the host. corticosteroids, radiation, or
4. Vector-borne transmission – occurs when immunosuppressive drugs.
intermediate carriers transfer the microbes to
another living organism.
COURSE OF INFECTIOUS DISEASE
1. INCUBATION PERIOD
- time of infection to appearance of signs and
symptoms

Portal of Entry
- a venue where the organism gains entrance into
the susceptible host
Communicable Disease Nursing
SEMI FINAL TRANS
2. PERIOD OF PRODROMAL SYMPTOMS/ PRODROMAL 3. Used needles and other sharps shall not be
PERIOD sheared, bent, broken, recapped, or re-
- early symptoms that may mark the onset of a sheathed by hand.
disease 4. Eating, drinking, smoking, applying cosmetics or
3. PERIOD OF INVASION lip balm, or handling contact lenses are
- the disease reaches its full development and prohibited in work areas where there is
maximum intensity potential occupational exposure.
- also referred to as Fastigium or Acme 5. Food and drinks shall not be stored in
4. COMMUNICABLE PERIOD refrigerators, freezers, or cabinets where blood
- period after infection when an infectious or other potentially infectious materials are
agent can be transmitted to another host. stored.
5. LATENT PERIOD 6. All procedures involving blood or other
- period after infection when an infectious potentially infectious materials shall be
agent cannot be transmitted to another performed in such a manner as to minimize
6. DEFERVESCENCE OR DECLINE splashing, spraying, and aerosolization.
- The stage during which the manifestations 7. Mouth pipetting/suctioning is prohibited.
subside.
THE USE OF BARRIER APPARELS
OCCURRENCE 1. MASKING
1. SPORADIC DISEASE  All staff should wear mask.
- occasional and irregular (e.g., Tetanus, herpes,  Patients with respiratory problems
skin diseases, leprosy in Manila) should be asked to wear mask
2. EPIDEMIC DISEASES 2. HANDWASHING
- disease attacks a large number of people in a  Practice proper hand washing with the
community at the same time, or during the same use of soap and water.
season, and in which disease tends to spread rapidly to  Wash hands before and after patient
others (e.g. cholera, dengue) contact and after removing the gloves.
3. ENDEMIC 3. GLOVING
- those that are present in a population or
 Wear gloves for all direct contact with
community at times; usually involves few people during
patients.
specific periods (typhoid fever in Manila, dysentery)
4. PANDEMIC  Change gloves and wash hands after
- an epidemic that affects several countries or every contact with each patient.
continents (e.g., HIV/AIDS, SARS) 4. GOWNING

INFECTION CONTROL & work practice control  Wear gown during procedures which
MEASURES are likely to generate splashes or sprays
1. Employees shall wash their hands as soon as of blood and body fluids, secretions, or
possible after the removal of gloves or other excretions.
protective equipment and after hand contact 5. EYE PROTECTION (goggles)
with blood or other potentially infectious
materials.  Wear goggles for aerosol/splash-
2. All personal protective equipment shall be generating procedures.
removed immediately upon leaving the work
 Avoid aerosols
area.
6. ENVIRONMENTAL DISINFECTION
Communicable Disease Nursing
SEMI FINAL TRANS
 Clean surfaces daily with disinfectant Types of Antigen/vaccines
(diluted household bleach, 70 percent
1. Inactivated (killed organism)
alcohol) 
a. Not long lasting
PREVENTIVE ASPECT OR CARE OF PATIENTS WITH b. Multiple doses needed
COMMUNICABLE DISEASE c. Booster dose needed
2. Attenuated (live organism)
Health education
a. Single dose needed
 Educate the family and the client with
b. Long lasting immunity
respect to:
 the availability and importance of
Environmental Sanitation
prophylactic immunization
• Water Supply Sanitation
 the manner in which infectious illness is • Proper Excreta and sewage disposal
spread and the methods of avoiding the • Food Sanitation
spread • Waste Management
 the importance of seeking medical
advice for any sign of health problem WHAT DAMAGES VACCINES?
 the importance of environmental
cleanliness and personal hygiene • Heat and sunlight (especially live vaccines)
 the means of preventing contamination • Freezing damages the killed vaccines and
of food and water supply toxoids.
• Use water only in cleaning the
Immunization refrigerator/freezer. Antiseptics, disinfectants,
 the introduction of specific protective and detergents or alcohol may lessen the
antibodies or the production of cellular potency of vaccines.
immunity in a susceptible person or NOTE: KEEP ALL VACCINES AT THE CORRECT COLD
animal TEMPERATURE (0-8 degrees Celsius)
Immunity
 a condition of being secure against any
The Cold Chain System
particular disease
Types of Immunity Maintenance of correct temperature for vaccines starts
from the manufacturer
1. Natural
↓
 Passive – acquired through placental Airport
transfer (Maternal) ↓
 Active – acquired through recovery Central Vaccine Store
from a certain disease (Infection) ↓
Regional Store
2. Artificial ↓
 Passive – acquired through the District Hosp.
administration of antitoxin, antiserum, ↓
convalescent serum, and Health Centers or Outreach Service → Dispensary →
gammaglobulins (Antibody transfer) Immunizing Staff → Client
 Active – acquired through the
administration of vaccine and
toxoid (Immunization)
PATIENT ISOLATION PRECAUTIONS (Veenema, 2007).
Communicable Disease Nursing
SEMI FINAL TRANS
STANDARD PRECAUTIONS • Wear a mask when working within 3 feet of the
patient.
• Wash hands after patient contact.
• Limit movement and transport of the patient.
• Wear gloves when touching blood, body fluids, Place a mask on the patient if they need to be
secretions, excretions, and contaminated items. moved.
• Conventional diseases requiring droplet
• Wear a mask and eye protection, or a face precautions: invasive haemophilus influenza
shield, during procedures likely to generate and meningococcal disease, drug-resistant
splashes or sprays of blood, body fluids, pneumococcal disease, diphtheria, pertussis,
secretions, or excretions. mycoplasma, GABHS, influenza, mumps,
• Handle used patient-care equipment and linen rubella, parvovirus.
in a manner that prevents the transfer of • Biothreat diseases requiring droplet
microorganisms to people or equipment. precautions: pneumonic plague

• Use care when handling sharps and use a CONTACT PRECAUTIONS

mouthpiece or other ventilation device as an • Standard precautions plus:
alternative to mouth-to-mouth resuscitation • Place the patient in a private room or cohort
when practical. them with someone with the same infection if
Standard precautions are employed in the care of ALL possible.
patients. • Wear gloves when entering the room. Change
gloves after contact with infective material.
AIRBORNE PRECAUTIONS • Wear a gown when entering the room if contact
with patient is anticipated or if the patient has
• Standard precautions plus:
diarrhea, a colostomy, or wound drainage not
• Place the patient in a private room that has
covered by a dressing.
monitored negative air pressure, a minimum six
• Limit the movement or transport of the patient
air exchanges per hour, and appropriate
from the room.
filtration of air before it is discharged from the
room.
CONTACT PRECAUTIONS
• Wear respiratory protection when entering the
• Dedicate use of noncritical patient-care
room.
equipment (such as stethoscopes) to a single
• Limit movement and transport of the patient.
patient, or cohort of patients with the same
Place a mask on the patient if he or she needs
pathogen. If not feasible, adequate disinfection
to be moved.
between patients is necessary.
• Conventional diseases requiring airborne
• Conventional diseases requiring contact
precautions: measles, varicella, pulmonary
precautions: MRSA, Clostridium difficile, RSV,
tuberculosis
parainfluenza, enteroviruses, enteric infections
• Biothreat diseases requiring airborne
in the incontinent host, skin infections (HSV,
precautions: smallpox
impetigo, lice, scabies), hemorrhagic
conjunctivitis
DROPLET PRECAUTIONS • Biothreat diseases requiring contact
precautions: viral hemorrhagic fevers
• Standard precautions plus:
• Methicillin-Resistant Staphylococcus aureus
• Place the patient in a private room or cohort
• Respiratory Syncytial Virus
them with someone with the same infection. If
not feasible, maintain at least 3 feet between
patients.
Communicable Disease Nursing
SEMI FINAL TRANS