COMMUNICABLE DISEASE

CHAIN OF INFECTION
Disease caused by an infectious agent that are transmitted directly
or indirectly to a well person through an agency, vector or inanimate
object

CONTAGIOUS DISEASE
Disease that is easily transmitted from one person to another
INFECTIOUS DISEASE
Disease transmitted by direct inoculation through a break in the
skin

INFECTION
-Entry and multiplication of an infectious agent into the tissue of the INFECTIOUS AGENT
host Any microorganism capable of producing a disease
INFESTATION RESERVOIR
- Lodgement and development of arthropods on the surface of the
body
Environment or object on which an organism can survive and
multiply
PORTAL OF EXIT
ASEPSIS
- Absence of disease – producing microorganisms The venue or way in which the organism leaves the reservoir
SEPSIS MODE OF TRANSMISSION
- The presence of infection The means by which the infectious agent passes from the portal of
exit from the reservoir to the susceptible host
MEDICAL ASEPSIS PORTAL OF ENTRY
-Practices designed to reduce the number and transfer of pathogens Permits the organism to gain entrance into the host
-Clean technique SUSCEPTIBLE HOST
SURGICAL ASEPSIS A person at risk for infection, whose defense mechanisms are
-Practices that render and keep objects and areas free from unable to withstand invasion of pathogens
microorganisms
STAGES OF THE INFECTIOUS PROCESS
-Sterile technique
Incubation Period – acquisition of pathogen to the onset of signs
and symptoms
CARRIER – an individual who harbors the organism and is capable
of transmitting it without showing manifestations of the disease Prodromal Period – patient feels “bad” but not yet experiencing
actual symptoms of the disease
CASE – a person who is infected and manifesting the signs and Period of Illness – onset of typical or specific signs and symptoms
symptoms of the disease
of a disease
Convalescent Period – signs and symptoms start to abate and
SUSPECT – a person whose medical history and signs and client returns to normal health
symptoms suggest that such person is suffering from that particular
disease MODE OF TRANSMISSION
CONTACT – any person who had been in close association with an CONTACT TRANSMISSION
infected person Direct contact – involves immediate and direct transfer from
person-to-person (body surface-to-body surface)
HOST Indirect contact – occurs when a susceptible host is exposed to a
- A person, animal or plant which harbors and provides nourishment contaminated object
for a parasite DROPLET TRANSMISSION
RESERVOIR Occurs when the mucous membrane of the nose, mouth or
- Natural habitat for the growth, multiplication and reproduction of conjunctiva are exposed to secretions of an infected person within a
microorganism distance of three feet
VEHICLE TRANSMISSION
ISOLATION Transfer of microorganisms by way of vehicles or contaminated
- The separation of persons with communicable diseases from other items that transmit pathogens
persons AIRBORNE TRANSMISSION
QUARANTINE
- The limitation of the freedom of movement of persons exposed to
Occurs when fine particles are suspended in the air for a long time
communicable diseases or when dust particles contain pathogens
VECTOR-BORNE TRANSMISSION
Transmitted by biologic vectors like rats, snails and mosquitoes
STERILIZATION – the process by which all microorganisms
including their spores are destroyed TYPES OF IMMUNIZATION
DISINFECTION – the process by which pathogens but not their ACTIVE – antibodies produced by the body
spores are destroyed from inanimate objects NATURAL – antibodies are formed in the presence of active
CLEANING – the physical removal of visible dirt and debris by infection in the body; lifelong
washing contaminated surfaces ARTIFICIAL – antigens are administered to stimulate antibody
production
CONCURRENT PASSIVE – antibodies are produced by another source
- Done immediately after the discharge of infectious materials / NATURAL – transferred from mother to newborn through placenta
secretions or colostrum
TERMINAL ARTIFICIAL – immune serum (antibody) from an animal or human
- Applied when the patient is no longer the source of infection is injected to a person
BACTERICIDAL SEVEN CATEGORIES OF ISOLATION
- A chemical that kills microorganisms
STRICT- prevent highly contagious or virulent infections
BACTERIOSTATIC
- An agent that prevents bacterial multiplication but does not kill Example: chickenpox, herpes zoster
microorganisms CONTACT – spread primarily by close or direct contact
Example: scabies, herpes simplex
RESPIRATORY – prevent transmission of infectious distances
over short distances through the air

CD-Bucud 1
Example: measles, mumps, meningitis Place the patient in a supine position, flex his leg at the hip and knee
TUBERCULOSIS – indicated for patients with positive smear or then straighten the knee; pain and resistance indicates meningitis
chest x-ray which strongly suggests tuberculosis
ENTERIC – prevent transmission through direct contact with feces
SIGNS AND SYMPTOMS OF MENINGOCOCCEMIA
Example: poliomyelitis, typhoid fever
DRAINAGE – prevent transmission by direct or indirect contact with
purulent materials or discharge
Ex. Burns DIC
UNIVERSAL – prevent transmission of blood and body-fluid borne
pathogens
URTI: Micro-
Vasculitis:
Example: AIDS, Hepatitis B cough, sore thrombosis
petechial
throat,
rash in the Purpura
CENTRAL NERVOUS SYSTEM fever,
trunk and
headache, Hypotension
extremities
ENCEPHALITIS MENINGITIS MENINGO- nausea and
COCCEMIA vomiting Shock

MAIN PROBLEM Death

- Acute infection of
- Inflammation of - Inflammation of the bloodstream and
the brain the meninges developing vasculitis
ENCEPHALITIS MENINGITIS MENINGO-
ETIOLOGIC AGENT - Streptococcus COCCEMIA
- Arboviruses - Staphylococcus
- Pneumococcus SIGNS AND SYMPTOMS Vasculitis
- Tubercle bacillus
Stiff neck Nuchal rigidity
- Neisseria meningitides
Waterhouse-
INCUBATION PERIOD
Photophobia Opisthotonus Friderichsen
5-15 days 1-10 days 3-4 days syndrome
MODE OF TRANSMISSION Lethargy Brudzinski’s
Bite of infected
Petechiae with
mosquito Respiratory droplets Convulsions Kernig’s sign the development
of hemorrhage
SIGNS AND SYMPTOMS OF ENCEPHALITIS INCIDENCE

Virus enters neural cells 5-10 years old < 5 years old 6 months–5
years old

DIAGNOSTIC EXAM
Disruption in Perivascular Inflammatory  Informed consent
cellular congestion reaction  Empty bowel and bladder
functioning  Fetal, shrimp or “C” position
 Spinal canal, subarachnoid space between L3-L4 or L4- L5
Lethargy  After: bedrest
Headache Fever
Convulsions  Flat on bed to prevent spinal headache
Photophobia Sore throat
Seizures ENCEPHALITIS MENINGITIS MENINGO-
Vomiting COCCEMIA
Stiff neck
TREATMENT MODALITIES

Dexamethasone Ceftriaxone

Mannitol Penicillin
SIGNS AND SYMPTOMS OF MENINGITIS
Anticonvulsants Chloramphenicol
Antipyretics

PREVENTION

1. Japanese 1. HiB vaccine Rifampicin

encephalitis
Ciprofloxacin
VAX

THREE SIGNS OF MENINGEAL IRRITATION

OPISTHOTONUS
State of severe hyperextension and spasticity in which an individual’s
head, neck and spinal column enter into a complete arching position
BRUDZINSKI’S SIGN
Place the patient in a dorsal recumbent position and then put hands
behind the patient’s neck and bend it forward.
If the patient flexes the hips and knees in response to the
manipulation, positive for meningitis
KERNIG’S SIGN

CD-Bucud 2
 ENCEPHALITIS MENINGITIS MENINGO-  Recovery within 72 hours and the disease passes by unnoticed
COCCEMIA PRE-PARALYTIC OR MENINGETIC TYPE
NURSING MANAGEMENT  Slight involvement of the CNS
1. Side boards  Pain and spasm of muscles
1. Comfort: quiet, 1. Respiratory 2. Close contacts  Transient paresis
well-ventilated isolation 24-72  (+) Pandy’s test (increased protein in the CSF)
room hours after onset H – ouse PARALYTIC TYPE
of antibiotic I – nfected person  CNS involvement
2. Skin care:
therapy kissing
cleansing bath,  Flaccid paralysis
change in 2. Room protected S – ame daycare  Asymmetric
position against bright center  Affects lower extremities
lights  Urine retention and constipation
3. Eliminate S – hare mouth
mosquito instruments  (+) HOYNE’S SIGN (when in supine position, head will fall back
3. Safety: side-lying when shoulders are elevated)
breeding sites:
position and 3. Antibiotics as
CULEX
raised side rails prophylaxis
mosquito

POLIOMYELITIS RABIES TETANUS

RABIES
PRODROMAL/INVASION PHASE
MAIN PROBLEM  Fever
Acute infection of Acute viral disease Acute infectious  Anorexia
the CNS – muscle of the CNS – by disease with systemic  Sore throat
spasm, paresis and saliva of infected neuromuscular  Pain and tingling at the site of bite
paralysis animals effects  Difficulty swallowing
EXCITEMENT OR NEUROLOGICAL PHASE
ETIOLOGIC AGENT Rhabdovirus Clostridium tetani  Hydrophobia (laryngospasm)
Legio debilitans Bullet-shaped  Aerophobia (bronchospasm)
Anaerobic
 Delirium
Affinity to CNS Gram positive  Maniacal behavior
Killed by sunlight, Drumstick  Drooling
UV light, formalin appearance TERMINAL OR PARALYTIC PHASE
 Patient becomes unconscious
Resistant to
 Loss of urine and bowel control
antibiotics
 Progressive paralysis
POLIOMYELITIS RABIES TETANUS  Death

INCUBATION PERIOD
POLIOMYELITIS RABIES TETANUS
2-8 weeks
7-21 days Distance of bite to Adult: 3 days-3
COMPLICATION
brain weeks
Paralysis of RESPIRATORY
Extensiveness of the Neonate: 3-30 days DEATH
respiratory muscles FAILURE
bite
Resistance of the
host DIAGNOSTIC PROCEDURES
MODE OF TRANSMISSION 1. Throat washings 1. Blood exam
1. Stool culture
- Direct contact with 2. Flourescent rabies
infected feces 2. CSF culture antibody (FRA)
Bite of an infected Direct inoculation
- Direct contact with 3. Negri bodies
respiratory secretions
animal through a broken
skin ISOLATION PRECAUTION
- Indirect with soiled
linens and articles
Enteric isolation Respiratory
POLIOMYELITIS RABIES TETANUS isolation

POLIOMYELITIS RABIES TETANUS

SIGNS AND SYMPTOMS R – isus sardonicus
1. Abortive type 1. Prodromal / O – pistothonus TREATMENT MODALITIES 1. Tetanus immune
invasion 1. Analgesics 1. Local globulin (TIG)
2. Pre-paralytic phase T – rismus treatment of 2. Tetanus antitoxin
or meningetic 2. Morphine
wound (TAT)
type 2. Excitement / C – onvulsions 3. Moist heat 3. Penicillin G
neurological 2. Active
3. Paralytic type H – eadache application
phase immunization 4. Tetracycline
4. Bed rest 5. Diazepam
3. Terminal / I – rritability Lyssavac
paralytic type 5. Rehabilitation Imovax
6. Phenobarbital
L – aryngeal
7. Tracheostomy
spasm Antirabies vax
8. NGT feeding
2. Passive
POLIO immunization
ABORTIVE TYPE
 Does not invade the CNS
 Headache
 Sore throat

CD-Bucud 3
 POLIOMYELITIS RABIES TETANUS BIRD FLU SARS
COMPLICATIONS
NURSING MANAGEMENT Severe viral pneumonia Severe viral
1. Adequate airway pneumonia
1. Enteric isolation 1. Isolation Acute respiratory distress
syndrome
2. Proper disposal 2. Optimum 2. Quiet, semi-dark
of secretions comfort environment Hypoxemia
Fluid accumulation in
3. Moist hot packs 3. Restful 3. Avoid sudden alveolar sacs
4. Firm / environment stimuli and light Respiratory failure
nonsagging bed 4. Emotional Severe breathing difficulties
5. Suitable body support
alignment 5. Concurrent Multiple organ failure
6. Comfort and and terminal
safety disinfection
DEATH
POLIOMYELITIS RABIES TETANUS BIRD FLU SARS
TREATMENT MODALITIES
PREVENTION 1. Aseptic
1. If the dog is
1. Amantadine/Rimantadine 1. No definitive treatment
Salk vaccine healthy handling of for SARS
umbilical cord - Generic flu drugs
2. If the dog dies or
- Inactivated shows signs - H5N1 developed resistance 2. Antiviral drugs
polio vaccine suggestive of 2. Tetanus toxoid (normally used to treat
rabies immunization 2. Oseltamivir (TAMIFLU) AIDS)
- Intramuscular Zanamavir (RELENZA)
3. If dog is not 3. Antibiotic - RIBAVIRIN
Sabin vaccine available for prophylaxis - Primary treatment
- Oral polio
observation - Within 2 days at onset of 3. Corticosteroids
- Penicillin symptoms
vaccine 4. Have domestic
dog 3 months to - Erythromycin - 150 mg BID x 2 days
- Per orem 1 year old
immunized - Tetracycline

BIRD FLU SARS

RESPIRATORY SYSTEM PREVENTION

1.Culling – killing of 1.Quarantine

BIRD FLU SARS sick or exposed
MAIN PROBLEM birds 2. Isolation
A new type of atypical pneumonia
Flu infection in birds that
affects humans that infects the lungs 2. Banning of 3. WHO alert
importation of on SARS
ETIOLOGIC AGENT
birds (Executive
Avian influenza virus, H5N1 Corona virus
order # 280)
(March 12,
2003)
INCUBATION PERIOD 3. Cook chicken
3-5 days 2-8 days thoroughly
MODE OF TRANSMISSION
NURSING MANAGEMENT
Inhalation of feces and Respiratory droplets BIRD FLU
discharge of an infected bird WHAT TO DO WITH A PERSON SUSPECTED TO HAVE BIRD
FLU
• Isolation
BIRD FLU SARS • Face mask on the patient
SIGNS AND SYMPTOMS • Caregiver: use a face mask and eye goggles/glasses
• Distance of 1 meter from the patient
Body weakness or muscle • Transport the patient to a DOH referral hospital
pain
Cough REFERRAL HOSPITALS
• National Referral Center – Research Institute for Tropical
Difficulty breathing Medicine (RITM) (Alabang, Muntinlupa)

Episodes of sore throat • Luzon – San Lazaro Hospital (Quiricada St., Sta. Cruz,
Manila)
Fever • Visayas – Vicente Sotto Memorial Medical Hospital
(Cebu City)
High fever >38’Celsius • Mindanao – Davao Medical Center (Bajada, Davao City)
SARS
Chills SUSPECT CASE
1. A person presenting after 1 November 2002 with a history of:
 High fever >38 0C AND
 Cough or breathing difficulty AND
CD-Bucud 4
 WOUND OR CUTANEOUS DIPHTHERIA
 One or more of the following exposures during the 10 days
• Yellow spots or sores in the skin
prior to the onset of symptoms:
 Close contact, with a person who is a suspect or PERTUSSIS
probable case of SARS CATARRHAL STAGE
 History of travel, to an area with recent local • Lasts for 1 to 2 weeks
transmission of SARS • Most communicable stage
 Residing in an area with recent local transmission of • Begins with respiratory infection, sneezing, cough and
SARS fever
2. A person with an unexplained acute respiratory illness resulting
in death after 1 November 2002, but on whom no autopsy has been
• Cough becomes more frequent at night
performed : PAROXYSMAL STAGE
AND • Lasts for 4 to 6 weeks
 One or more of the following exposures during the 10 days • Aura: sneezing, tickling, itching of throat
prior to the onset of symptoms: • Cough, explosive outburst ending in “whoop”
 Close contact, with a person who is a suspect or • Mucus is thick, ends in vomiting
probable case of SARS
• Becomes cyanotic
 History of travel, to an area with recent local
•With profuse sweating, involuntary urination and
transmission of SARS
exhaustion
 Residing in an area with recent local transmission of CONVALESCENT STAGE
SARS • End of 4th-6th week
PROBABLE CASE • Decrease in paroxysms
1. A suspect case with radiographic evidence of infiltrates consistent
with pneumonia or respiratory distress syndrome on Chest x-ray.
DIPHTHERIA PERTUSSIS
DIAGNOSTIC PROCEDURES
2. A suspect case of SARS that is positive for SARS coronavirus by
one or more assays.
 SCHICK’S TESTS  CBC– increase in
- Susceptibility and immunity to lymphocytes
diphtheria
3. A suspect case with autopsy findings consistent with the
pathology of SARS without an identifiable cause. -ID of dilute diphtheria toxin (0.1
cc)
(+) local circumscribed area of
DIPHTHERIA PERTUSSIS redness, 1-3 cm
MALONEY’S TEST
MAIN PROBLEM
Acute bacterial disease -Determines hypersensitivity to
Repeated attacks of spasmodic diphtheria anti-toxin
characterized by the elaboration coughing
of an exotoxin -ID of 0.1 cc fluid toxoid
ETIOLOGIC AGENT -(+) area of erythema in 24 hours
Corynebacterium diphtheriae or Bordetella pertussis
Klebs-Loeffler bacillus
DIPHTHERIA PERTUSSIS
INCUBATION PERIOD

7-14 days COMPLICATIONS Convulsions (brain

2-5 days
Toxins in the bloodstream
MODE OF TRANSMISSION damage from
1. Respiratory droplets asphyxia)
Myocarditis Peripheral Broncho-
2. Direct contact with respiratory secretions (epigastric paralysis pneumonia
Otitis media
or chest (tingling, (fever,
3. Indirect contact with articles pain) numbness, cough) (invading
paresis)
DIPHTHERIA PERTUSSIS organisms)
SIGNS AND SYMPTOMS Heart Respirat Bronchopneumonia
Decreased
failure in ory
arrest
(most dangerous
Types: Stages: respiratory
rate complication)
1.Nasal 1. Catarrhal DEATH
2.Tonsilopharyngeal
2. Paroxysmal
3.Laryngeal DIPHTHERIA PERTUSSIS
3. Convalescent
4.Wound or TREATMENT MODALITIES
cutaneous 1. Diphtheria anti-toxin 1. Erythromycin – drug of
- Requires skin testing choice
- Early administration 2. Ampicillin – if resistant
NASAL DIPHTHERIA aimed at neutralizing the to erythromycin
• Bloody discharge from the nose toxin present in the 3. Betamethasone
• Excoriated nares and upper lip circulation before it is (corticosteroid) –
TONSILOPHARYNGEAL DIPHTHERIA absorbed by the tissues decrease severity and
• Low grade fever 2. Antibiotic therapy length of paroxysms
• Sore throat
• Bull-neck appearance - Penicillin G 4. Albuterol
(bronchodilator)
•
Pseudomembrane- Group of pale yellow membrane over - Erythromycin
tonsils and at the back of the throat as an inflammatory
response to a powerful necrotizing toxins
LARYNGEAL DIPHTHERIA
• Hoarseness
• Croupy cough
• Aphonia
• Membrane lining thickens à airway obstruction
• Suffocation, cyanosis or death
CD-Bucud 5
 DIPHTHERIA
NURSING MANAGEMENT
1. Isolation: 14 days (until
2-3 cultures, 24 hours
apart)
2. Bedrest for 2 weeks
3. Care for nose and
throat (gentle swabbing)
4. Ice collar (decrease pain
of sore throat)
5. Diet (soft food, small
frequent feedings)
PERTUSSIS AMOEBIASIS SHIGELLOSIS
MAIN PROBLEM
1. Isolation: 4-6 weeks from
onset of illness Acute infection of the lining
Protozoal infection of the large
of the small intestine
intestine
2. Supportive measures
(bedrest, avoid ETIOLOGIC AGENT
excitement, dust, smoke
and warm baths) Entamoeba histolytica Shigella group
3. Safety (during - Prevalent in areas with ill 1. Shigella flesneri – most
paroxysms, patient sanitation common in the Philippines
should not be left alone) -Acquired by swallowing 2. Shigella connei
4. Suctioning (kept at 3. Shigella boydii
- Trophozoites: vegetative form
bedside for emergency
use) - Cyst: infective stage 4. Shigella dysenterae – most
infectious type

MUMPS AMOEBIASIS SHIGELLOSIS

MAIN PROBLEM
An acute contagious disease, with swelling of one or both of the SIGNS AND SYMPTOMS
parotid glands
1. Acute amoebic dysentery
ETIOLOGIC AGENT
Filterable virus of paramyxovirus group
Fever
- Diarrhea alternated with
INCUBATION PERIOD
12-26 days
constipation Abdominal pain
MODE OF TRANSMISSION - Tenesmus
Respiratory droplets - Bloody mucoid stools Diarrhea and
PERIOD OF COMMUNICABILITY
6 days before and 9 days after onset of parotid swelling 2. Chronic amoebic tenesmus
SIGNS AND SYMPTOMS dysentery
- Enlarged liver Bloody mucoid
PRODROMAL PHASE
F-ever (low grade) - Large sloughs of intestinal stool
H-eadache tissues accompanied by
M-alaise hemorrhage

PAROTITIS
F-ace pain
AMOEBIASIS SHIGELLOSIS
E-arache DIAGNOSTIC TESTS
S-welling of the parotid glands
1. Stool exam
COMPLICATIONS 2. Blood exam
• Orchitis – the most notorious complication of mumps
3. Sigmoidoscopy
• Oophoritis – manifested by pain and tenderness of the
abdomen TREATMENT MODALITIES
• CNS involvement – manifested by headache, stiff neck,
delirium, double vision 1. Metronidazole – drug 1. Cotrimoxazole – drug
• Deafness as a result of mumps
of choice of choice
NURSING MANAGEMENT
1. Prevent complications 2. Tetracycline
− Scrotum supported by suspensory 3. Chloramphenicol
− Use of sedatives to relieve pain
− Treatment: oral dose of 300-400 mg cortisone followed by 100
mg every 6 hours AMOEBIASIS SHIGELLOSIS
− Nick in the membrane
NURSING MANAGEMENT
2. Diet
- Soft or liquid diet 1.Enteric isolation
- Sour foods or fruit juices are disliked
3. Respiratory isolation 2. Boil water for
4. Comfort: ice collar or cold applications over the parotid glands may drinking
relieve pain
5. Fever: aspirin, tepid sponge bath 3. Handwashing
6. Concurrent disinfection: all materials contaminated by these
secretions should be cleansed by boiling 4. Sexual activity
7. Terminal disinfection: room should be aired for six to eight hours
5. Avoid eating
uncooked leafy
GASTROINTESTINAL TRACT vegetables

CD-Bucud 6
 CHOLERA TYPHOID FEVER CHICKENPOX HERPES ZOSTER
MAIN PROBLEM
MAIN PROBLEM
Acute bacterial disease of the An infection affecting the
GIT characterized by profuse Peyer’s patches of the small
A highly contagious disease An acute viral infection of
characterized by vesicular the sensory nerve
secretory diarrhea intestines
eruptions on the skin and
ETIOLOGIC AGENT mucous membranes
Vibrio cholerae Salmonella typhi ETIOLOGIC AGENT
Varicella zoster virus
INCUBATION PERIOD INCUBATION PERIOD

1 to 3 days 1 to 3 weeks 10-21 days 13-17 days

MODE OF TRANSMISSION MODE OF TRANSMISSION
1. Droplet method
1. Fecal-oral transmission 2. Direct contact
2. 5 F’s 3. Indirect contact

CHOLERA TYPHOID FEVER CHICKENPOX HERPES ZOSTER

SIGNS AND SYMPTOMS
Fever (ladder-like) PERIOD OF COMMUNICABILITY

Rice-water stool One day before eruption

Rose spots One day before eruption
of 1st lesion and five days
Abdominal cramps of 1st rash and five to six
Diarrhea after appearance of last
days after the last crust
Vomiting crop
TYPHOID STATE
SIGNS AND SYMPTOMS
Intravascular Sordes
PRODROMAL
Dehydration
Subsultus Tendinum PERIOD
Shock Coma vigil
- Fever (low-grade)
- Headache
Carphologia
- Malaise

CHOLERA TYPHOID FEVER CHICKENPOX HERPES ZOSTER

TREATMENT MODALITIES • Rashes
SIGNS AND SYMPTOMS
1.Chloramphenicol –
1.Lactated Ringer’s -Unilateral, band-like
drug of choice • Rashes : Centrifugal distribution
solution distribution -Dermatomal
2. Ampicillin/
2. Oral rehydration Amoxicillin – for •Rash stages: macule - Erythematous base
therapy typhoid carriers papule vesicle - Vesicular, pustular or
3. Antibiotic therapy pustule crust crusting
3. Cotrimoxazole – for •Regional
- Tetracycline – drug severe cases with lymphadenopathy
• Pruritus
of choice relapses •Pruritus
- Cotrimoxazole •Pain – stabbing or
burning
- Chloramphenicol
CHOLERA TYPHOID FEVER CHICKENPOX HERPES ZOSTER
NURSING MANAGEMENT
COMPLICATIONS
RAMSAY-HUNT
1. Maintain and restore the fluid SYNDROME - Involvement of
SCARRING – most common
and electrolyte balance complication; associated with
the facial nerve in herpes zoster
with facial paralysis, hearing
staphylococcal or streptococcal
2. Enteric isolation infections from scratching
loss, loss of taste in half of the
tongue
3. Sanitary disposal of excreta NECROTIZING FASCIITIS –
GASSERIAN
most severe complication
GANGLIONITIS –
4. Adequate provision of safe Involvement of the optic nerve
REYE SYNDROME –
drinking water abnormal accumulation of fat in resulting to corneal anesthesia
the liver plus increase of
ENCEPHALITIS – acute
5. Good personal hygiene pressure in the brain resulting to
inflammatory condition of the
coma, therefore leading to
brain
DEATH

INTEGUMENTARY SYSTEM

CD-Bucud 7
 - Soft palate to mucus membrane
CHICKENPOX HERPES ZOSTER
MEASLES GERMAN MEASLES
TREATMENT MODALITIES

1. Antihistamines – 4. Corticosteroids – anti- SIGNS AND SYMPTOMS ERUPTIVE STAGE

symptomatic relief of itching inflammatory and decreased 2. ERUPTIVE STAGE 1. Rash
pain Rashes
Ex. Diphenhydramine - pinkish, maculopapular
Ex. Prednisone - Elevated papules
(Benadryl) - Begins on the face
- Begin on the face and behind
the ears - Spread to trunk or limbs
2. Analgesics and antipyretics - Spread to trunk and
extremities - No pigmentation or
Ex. Acetaminophen desquamation
Color: Dark red – purplish hue
– yellow brown 2. Posterior auricular and
3. Antiviral agents – for patient to
3. Stage of Convalescence suboccipital
experience less pain and faster lymphadenopathy
resolution of lesions when used within - Desquamation
48 hours of rash onset - Rashes fade from the face
downwards
Ex. Acyclovir (Zovirax)

CHICKENPOX HERPES ZOSTER

MEASLES GERMAN MEASLES
NURSING MANAGEMENT
COMPLICATIONS 1. Encephalitis
Strict isolation
2. Congenital rubella syndrome
Prevent secondary infection (cut Pneumonia - Spontaneous abortion
fingernails short, wear mittens) - Intrauterine growth retardation
Otitis media (IUGR)
Eliminate itching: calamine - Thrombocytopenia purpura
lotions, warm baths, baking soda
paste
Severe diarrhea (leading “blueberry muffin skin”
- Cleft lip, cleft palate, club foot
to dehydration)
- Heart defects (PDA, VSD)
Encourage not going to school:
usually 7 days Encephalitis - Eye defects (Cataract,
glaucoma)
Disinfection of clothes and linen - Ear defects (Deafness)
with nasopharyngeal discharges - Neurologic (microcephaly,
by sunlight or boiling mental retardation, behavioral
disturbances

MEASLES GERMAN MEASLES MEASLES GERMAN MEASLES

TREATMENT MODALITIES
MAIN PROBLEM

A contagious exanthematous A benign communicable 1.Vitamin A – helps 1. Aspirin – help reduce

disease with chief symptoms to exanthematous disease caused prevent eye damage inflammation and
the upper respiratory tract by rubella virus and blindness fever
ETIOLOGIC AGENT 2. Antipyretics – for
Filterable virus of Rubella virus fever
paramyxoviridae
3. Penicillin – given
INCUBATION PERIOD only when secondary
10-12 days 14-21 days infection sets in
MODE OF TRANSMISSION
1. Droplet method
2. Direct contact with respiratory discharges
3. Indirect with soiled linens and articles

MEASLES GERMAN MEASLES MEASLES GERMAN MEASLES

PERIOD OF COMMUNICABILITY
4 days before and 5 days after
the appearance of rashes
NURSING MANAGEMENT
1. Darkened room to relieve photophobia
One week before and four days
after the appearance of rashes 2. Diet: should be liquid but nourishing

SIGNS AND SYMPTOMS 3. Warm saline solution for eyes to relieve

eye irritation
PRE-ERUPTIVE STAGE PRE-ERUPTIVE STAGE
4. For fever: tepid sponge bath and anti-
Cough Fever pyretics
Coryza Headache 5. Skin care: during eruptive stage, soap is
omitted; bicarbonate of soda in water or
Conjunctivitis Malaise lotion to relieve itchiness
Fever (high-grade) Coryza 6. Prevent spread of infection: respiratory
Photophobia Conjunctivitis isolation

KOPLIK’S SPOT (Rubeola)

- Bluish white spots surrounded by a red halo SCABIES
- Appear on the buccal mucosa opposite the premolar teeth MAIN PROBLEM
FORCHEIMER’S SPOTS (Rubella) Infestation of the skin produced by the burrowing action of a parasite
- small, red lesions mite resulting in skin irritation and formation of vesicles and pustules
ETIOLOGIC AGENT
Sarcoptes scabiei
CD-Bucud 8
INCUBATION PERIOD
Within 24 hours
AIDS SYPHILIS
MODE OF TRANSMISSION
Direct contact SIGNS AND SYMPTOMS
Indirect contact
OPPORTUNISTIC INFECTIONS

Sarcoptes scabiei 1. Pneumocystis carinni

1. Yellowish white in color pneumonia
2. Barely seen by the unaided eye
3. Female parasite burrows beneath the epidermis to lay eggs 2. Oral candidiasis
4. Males are smaller and reside on the surface of the skin 3. Toxoplasmosis
SIGNS AND SYMPTOMS
4. Acute/chronic diarrhea
• Thin, pencil-mark lines on the skin
5. Pulmonary tuberculosis
• Itching, especially at night
• Rashes and abrasions on the skin MALIGNANCIES
PRIMARY LESIONS 1. Kaposi’s sarcoma
NODULAR LESIONS
2. Non-Hodgkin’s lymphoma
SECONDARY LESIONS
TREATMENT MODALITIES
• SCABICIDE : Eurax ointment (Crotamiton) AIDS SYPHILIS
• PEDICULICIDE : Kwell lotion (Gamma Benzene
Hexachloride) – contraindicated in young children and SIGNS AND SYMPTOMS 1. PRIMARY SYPHILIS
pregnant women
• Topical steroids - CHANCRE: small, painless,
• Hydrogen peroxide : cleanliness of wound pimple-like ulceration on the
• Lindane Lotion penis, labia majora, minora
NURSING MANAGEMENT and lips
• Apply cream at bedtime, from neck to toes - May erupt in the genitalia,
• Instruct patient to avoid bathing for 8 to 12 hours anus, nipple, tonsils or eyelids
• Dry-clean or boil bedclothes
• Report any skin irritation - Lymphadenopathy
• Family members and close contact treatment
• Good handwashing
• Terminal disinfection

SEXUALLY TRANSMITTED DISEASES

AIDS SYPHILIS AIDS SYPHILIS

SIGNS AND SYMPTOMS 2. SECONDARY SYPHILIS

MAIN PROBLEM
Final and most serious stage
of HIV disease, which causes
severe damage to the immune
system
ETIOLOGIC AGENT
Retrovirus – Human T-cell
lymphotropic virus III
(HTLV-3)
- Skin rash
Infectious disease caused
- Mucous patches
by a spirochete
- Hair loss
- CONDYLOMATA LATA:
coalescing papules which
form a gray-white plaque
Treponema pallidum frequently in skin folds

INCUBATION PERIOD

3 to 6 months to 8 to 10 years 10-90 days

AIDS SYPHILIS AIDS SYPHILIS

MODE OF TRANSMISSION SIGNS AND SYMPTOMS 3. TERTIARY SYPHILIS
• Sexual contact – oral, anal or - 1 to 10 years after infection
vaginal sex - Appear on the skin, bones,
mucus membrane, URT, liver
•Blood transfusion and stomach

•Mother-to-child - GUMMA: chronic, superficial

nodule or deep
•Indirect contact through soiled granulomatous lesion that is
solitary, painless, indurated
articles

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 AIDS SYPHILIS CHLAMYDIA GONORRHEA
DIAGNOSTIC PROCEDURES COMPLICATIONS
Women

1.ELISA 1.Dark Field Pelvic inflammatory

disease
Illumination test Ectopic pregnancy
2. Western blot
Sterility
2. Flourescent
3. RIPA
Treponemal Men

4. PCR Antibody Epididymitis

Absorption Test Newborn

Sterility
Conjunctivitis Newborn
3. VDRL Otitis media Gonococcal ophthalmia
Pneumonia

AIDS SYPHILIS CHLAMYDIA GONORRHEA

TREATMENT MODALITIES TREATMENT MODALITIES
1. Penicillin G Benzathine 1. Cefixime
1. Antivirals - Disease < 1 year: 2.4 M units 1. Azithromycin
once in two injection sites (Zithromax) - Drug of choice
- Shorten the clinical
- Disease > 1 year: 2.4 M units because of oral
course, prevent - Drug of choice because
in 2 injection sites x 3 doses efficacy, single dose
complications, prevent of single-dose treatment
development of 2. Doxycycline – if allergic to effectiveness and lower
penicillin
2. Ciprofloxacin
latency, decrease cost
transmission 3. Tetracycline 3. Ceftriaxone
2. Doxycycline
- if allergic to penicillin
- Example: Zidovudine - Secondary drug of 4. Erythromycin
- Contraindicated for
(Retrovir) pregnant women choice

CANDIDIASIS HERPES SIMPLEX

CHLAMYDIA GONORRHEA MAIN PROBLEM

A viral disease
Mild superficial fungal characterized by the
MAIN PROBLEM
appearance of sores and
Sexually transmitted disease caused by a bacteria infection
blisters on the skin
Purulent inflammation of mucous
ETIOLOGIC AGENT
membrane surfaces
ETIOLOGIC AGENT Herpes simplex virus
Chlamydia trachomatis Neisseria gonorrhea
Candida albicans types 1 and 2
INCUBATION PERIOD INCUBATION PERIOD
2-3 weeks (males)
2-10 days
2-3 weeks 2-12 days
Asymptomatic (females)
MODE OF TRANSMISSION

Sexual contact: Oral, vaginal or anal sex

CANDIDIASIS HERPES SIMPLEX

CHLAMYDIA GONORRHEA MODE OF TRANSMISSION

1. Rise in glucose as in TYPE 1
SIGNS AND SYMPTOMS Women diabetes mellitus - Respiratory droplets
Women Bleeding after intercourse
2. Lowered body - Direct exposure to
Abdominal or pelvic pain Burning sensation during resistance as in cancer infected saliva
Bleeding after intercourse and urination
in-between menses Yellow or bloody vaginal 3. Increase in estrogen - Kissing and sharing
Unusual vaginal discharge discharge level in pregnant women utensils
4. Broad-spectrum TYPE 2
Men
antibiotics are used
Burning with urination - Sexual or genital
contact
Swollen, painful testicles
White, yellow or
Discharge from the penis green pus from the SIGNS AND SYMPTOMS (Candidiasis)
penis ONYCHOMYCOSIS
• Red, swollen darkened nailbeds
• Purulent discharge
• Separation of pruritic nails from nailbeds
DIAPER RASH
• Scaly, erythematous, papular rash
• Covered with exudates
CD-Bucud 10
 • Appears below the breasts, between fingers, axilla, groin
and umbilicus
THRUSH
• Cream-colored or bluish-white patches on the tongue,
mouth or pharynx
• Bloody engorgement when scraped
MONILIASIS
• White or yellow discharge
• Pruritus
• Local excoriation
• White or gray raised patches on vaginal walls with local
inflammation
CANDIDIASIS HERPES SIMPLEX
TREATMENT MODALITIES

1. Antifungals 1. Antivirals
- Fluconazole (Diflucan) - Acyclovir (Zovirax)
- Ketoconazole (Nizoral)
- Imidazole (Nystatin)
- Used for oral thrush
- 48 hours until
symptoms disappear
- Cotrimoxazole

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VECTOR-BORNE DISEASES DENGUE MALARIA

DENGUE MALARIA DIAGNOSTIC PROCEDURES 1. CLINICAL DIAGNOSIS

1. TORNIQUET TEST - Based on triad symptoms, 50%

MAIN PROBLEM
An acute febrile disease
The most common arboviral
illness transmitted globally
ETIOLOGIC AGENT
Dengue virus types 1, 2, 3 and 4
Chikungunya virus
O’nyong’nyong virus
An acute and chronic parasitic
disease
The most deadly vector-borne
disease in the world
Plasmodium falciparum
Plasmodium vivax
Plasmodium ovale
- Screening test for dengue
- A test for the tendency for blood
capillaries to break down or produce
petechial hemorrhage
- Performed by examining the skin of
the forearms after the arm veins
have been occluded for 5 minutes
- To detect unusual capillary fragility
2. PLATELET COUNT
- Confirmatory test for dengue
- Decreased count is confirmatory
accuracy
2. BLOOD SMEAR
- Definitive diagnosis of infection is
based on demonstration of malaria
parasites in blood film
3. RAPID DIAGNOSTIC TEST
- Uses immunochromatographic
methods to detect Plasmodium-
specific antigens
- Takes about 7 to 15 minutes
- Sensitivity and specificity > 90%

West Nile virus Plasmodium malariae DENGUE MALARIA

DENGUE MALARIA TREATMENT MODALITIES 1. Chloroquine

1. Analgesics and antipyretics
2. Primaquine
INCUBATION PERIOD P. Falciparum – 12 days - acetaminophen
3. Pyrimethamine
3-14 days P. Vivax – 14 days 2. Volume expanders
- Used in the treatment of 4. Sulfadoxine
P. Ovale – 14 days intravascular volume deficits
5. Quinine
P. Malariae – 30 days - Example: Lactated Ringers
MODE OF TRANSMISSION 6. Quinidine
3. Blood transfusion – for severe
bleeding
Bite of an infected mosquito
4. Oxygen therapy
Blood transfusion, contaminated
syringe or needle 5. Sedatives

Trans-placentally
SCHISTOSOMIASIS LEPTOSPIROSIS
DENGUE MALARIA
MAIN PROBLEM
VECTOR A slowly progressive disease A zoonotic infectious disease
caused by a blood fluke
Aedes aegypti Anopheles flavirostris
ETIOLOGIC AGENT
(Aedes albopictus)
1. SCHISTOSOMA JAPONICUM Leptospira interrogans
White stripes on the back and Brown in color - Intestinal tract, endemic in the
legs (Tiger mosquito) Philippines

Day biting (2 hours after sunrise 2. SCHISTOSOMA MANSONI

Night biting (9 PM-3 AM)
and 2 hours before sunset) - Africa

Breeds on clear stagnant water Breeds on clear, flowing and

3. SCHISTOSOMA HAEMATOBIUM
shaded streams
- Middle East countries like Iran and Iraq

Urban-based Rural-based
SCHISTOSOMIASIS LEPTOSPIROSIS
DENGUE MALARIA
INCUBATION PERIOD
SIGNS AND SYMPTOMS At least 2 months 7 to 19 days

FEVER FEVER
MODE OF TRANSMISSION
HEADACHE CHILLS
Ingestion
MALAISE PROFUSE SWEATING Skin penetration
RASH Contact with the skin

EPISODES OF
BLEEDING

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SCHISTOSOMIASIS LEPTOSPIROSIS SCHISTOSOMIASIS LEPTOSPIROSIS

VECTOR TREATMENT MODALITIES

1st line drugs
Oncomelania quadrasi 1. Praziquantel (Biltricide)
1. Thrives in fresh water 1. Penicillin G – drug of choice
- Taken for 6 months
stream 2. Doxycycline
- 1 tablet BID for 3 months
2. Clings to grasses and leaves 2nd line drugs
- 1 tablet OD for 3 months
3. Greenish brown in color 3. Ampicillin
4. Size is as big as the smallest 4. Amoxicillin
grain of palay

SCHISTOSOMIASIS LEPTOSPIROSIS FILARIASIS

MAIN PROBLEM
A parasitic disease caused by an African eye worm
ETIOLOGIC AGENT
SIGNS AND SYMPTOMS Septic or Leptospiremic Stage Wuchereria bancrofti
ACUTE STAGE F – ever (remittent Brugia malayi
Brugia timori
1. Cercarial dermatitis H – eadache INCUBATION PERIOD
(swimmer’s itch) 8 to 16 months
M – yalgia
MODE OF TRANSMISSION
2. Katayama syndrome N – ausea Person-to-person by mosquito bites
C - ough ACUTE STAGE
V – omiting
H – eadache and fever • Lymphadenitis (inflammation of lymph nodes)
C – ough
A – norexia and lethargy • Lymphangitis (inflammation of lymph vessels)
C – hest pain • Male genitalia affected leading to funiculitis, epididymitis
R – ash and orchitis (redness, painful and tender scrotum)
CHRONIC STAGE
M - yalgia
• Develop 10-15 years from onset of first attack

SCHISTOSOMIASIS LEPTOSPIROSIS • Hydrocele (swelling of the scrotum)

• Lymphedema (temporary swelling of the upper and lower
extremities)
SIGNS AND SYMPTOMS Immune or Toxic Stage • Elephantiasis (enlargement and thickening of the skin of
the upper and lower extremities, scrotum and breast
CHRONIC STAGE - Lasts for 4 to 30 days
1. Hepatic: pain, abdominal - Iritis, headache, meningeal LABORATORY EXAMINATIONS
distension, hematemesis, melena manifestations • Nocturnal blood examination (NBE) – taken at patient’s
2. Intestinal: fatigue, abdominal pain, residence/hospital after 8PM
- Oliguria, anuria with renal
dysentery
failure • Immunochromatographic test (ICT) – rapid assessment
3. Urinary: dysuria, urinary method; an antigen test done at daytime
frequency, hematuria - Shock, coma and congestive TREATMENT
heart failure
4. Cardiopulmonary: palpitations, • Diethylcarbamazine Citrate (DEC) or HETRAZAN – an
dyspnea on exertion individual treatment kills almost all microfilaria and a good
5. CNS: seizures, headache, back
proportion of adult worms.
pain and paresthesia PREVENTION AND CONTROL
• Measures aimed to control vectors
SCHISTOSOMIASIS LEPTOSPIROSIS • Environmental sanitation such as proper drainage and
cleanliness of surroundings
• Spraying with insecticides
DIAGNOSTIC PROCEDURES PREVENTION AND CONTROL
1. Fecalysis • Measures aimed to protect individuals and families:
• Use of mosquito nets
2. Kato-Katz Technique • Use of long sleeves, long pants and socks
• Application of insect repellants
3. Cercum ova precipitin test
(COPT) • Screening of houses

- Confirmatory test for

schistosomiasis

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