Standard case definition :

CHICKEN POX (varicella) Vesicular rash, mild fever, mild constitutional ssx Complications : Pneumonia, 2ry bacterial infection, Hge complications, encephalitis. Infection early preg : congenital varicella syndrome.

Mumps Suspected Case : ACUTE UNILATERAL @ BILATERAL TENDER SELF LIMITED SWELLING Of parotid @ other salivary glands. Confirmed case : Virus isolation, Abs elevation Complications : Orchitis, oophoritis, pancreatitis CNS : meningitis, meningoencephalitis Congenital heart.

Measles ( Rubeolla) FEVER >3 days ( > 38.5 ) Maculopapular rash Cough Coryza Conjunctivitis Confirmed case : Virus isolation, Abs elevation Complications : GIT : diarrhea RESP : bronchitis, bronchiolitis, pneumonia EAR : otitis media CNS : encephalitis, SSPE Vit A def : corneal ulcer, scarring.

German measles (Rubella) FEVER ( >37.2 ) Maculopapular rash Lymphadenopathy Confirmed case : Virus isolation, Abs elevation -RARE : NET Neuritis, encephalitis, thrombocytic purpura. -COMMON : JOINT arthralgia, arthritis -Congenital rubella synd Ear : HL Eye : cataract, glaucoma, retinopathy, microophthalmia CNS : microencephaly, MR Heart : Fallot tetralogy Other : bone lesions, splenomeg, hepatitis, TP World wide, except isolated and remote areas Winter, spring Both sexes. Unvac : child, young adults (5-9y), Vac : adults 18 days Rubella Vs Man (clinical, subclinical) Nasopharyngeal secretions

Place Time Person IP Agent Reservoir SOI

World wide Winter, early spring Children < 10y 2-3 w Varicella zoster, group Herpes Man (cases) DISCHARGE respiratory tract inf FLUID of vesicles (before dry) RARE : Pt with herpes zoster URT, skin and mucosal lesions CONTACT TRANSMISSION AIR BORNE TRANSPLACENTAL (congenital varicella) URT and skin 1-2 days before onset rash, until the lesions are crusted (5days)

RARE endemic, OUTBREAK (overcrowding) Winter, spring 5-9 y (most FREQ), severe in adults with FREQ complications 18 days Mumps Vs Man (clinical, subclinical) Saliva of infected person

Exit MOT

Inlet Period communica ble Vaccine

LAV

Mouth DROPLET CONTACT DIRECT : SALIVA infected INDIRECT : contaminated articles with nose, throat secretions Nose mouth 6 days before, 9 days after onset overt parotitis Max infectious : 48 hours before onset illness. Inapparent : communicable. LAV

Endemic, one of most common infectious dis in childhood. Any season, seasonal : winter Children, both sexes, may occur any age. Severe : malnourished 400X 10 d before ssx, 14 days before rash Measles Vs Man (cases) NO CARRIER Before app rash (prodromal rash) and early rash : Secretions nose, throat Resp discharge Nose mouth DROPLET, DIRECT (nasal, throat sec of cases) LESS common : INDIRECT (contaminated articles), AIR BORN Nose mouth 4 days before, 4 days after rash. Highly infectious (prodromal period) Decrease after app rash. LAV, monovalent @ combined MMR

Nose mouth placenta DROPLET, DIRECT, INDIRECT, TRANSPLACENTAL, AIR BORNE

Nose mouth 7 d before, 4 days after onset rash. Infants congenital rubella : for months after birth LAV, monovalent @ combined MMR

Standard case definition :

CHOLERA Suspected case : Endemic : acute watery diarrhea +/- vomiting in Pt >5y Non endemic : severe dehyd @ death from acute watery diarrhea +/- vomiting in Pt >5y Confirmed case : Isolation vibro O1/O139 from stools. More FREQ in mild cases among child. Complications : Severe dehyd, Acidosis, Circulatory collapse, Death within hours Heavily endemic, Neoepidemic : newly invaded cholera receptive area. Occasional outbreak Raining @ temperate : summer GAIPOS

POLIOMYELITIS Suspected case : Child <15y : AFP acute flaccid paralysis ( any person any age) Confirmed case : Isolation wild polio Vs from stools cases @ contacts Complications : Muscle : permanent paralysis, deformity, disability Resp m involve and death PPS : after 30-40y : muscle pain, weakness/ paralysis Polio free : Western pacific, America, Europe

ENTERIC FEVER Suspected case : 2 major, atleast 1 minor : Major - Sustained fever, >2d decreasing not reach base line, Headache, Abdominal discomfort Minor non productive cough, relative bradycardia Confirmed case : + blood culture, isolation (urine, stool) Complications : Intestinal He, perforation. SEVERE- cerebral dysfunc. MAY OCCUR : non sweating fever, mental dullness, slight HL, parotitis. Sporadic, epidermic, endemic. Substandard sanitation Paratyphoid : sporadic, limited outbreak. B most common. SUMMER hot humid, outdoor, fly Child, young adult (5-20y) M>F 8-14 d S Typhi, Paratyphoid ABC Man (cases, carrier) *Carrier temporary, chronic

Place

BRUCELLOSIS Suspected case : Fever > 3d PROFUSE NIGHT SWEATING FATIGUE MALAISE +/- WAH : Wt loss, arthralgia, headache Confirmed case : Isolation 4X increase in Brucella agglutination TITRE btwn acute and convalescent phase (2 w apart) SINGLE serum titre (tube agglutination) > 1 : 160 *Complications ** World wide

Time Person

Temperate : summer, no pattern tropical Developing : young child, adoslescent Developed : adults, M: F = 3 : 1 7-14 days Polio serotype : P1, P2, P3 MAN (clinical, subclinical, temporary faecal carrier), NO CHRONIC CARRIER Faecal and pharyngeal secretions of case

IP Agent Reservoir SOI

5 days Vibrio cholera serogroup O1, O139 Man ( cases, carrier- contact, convalescent) Water, food, drink contaminated with stool @ vomitus Pt. Cooked food with polluted water Anus mouth INGESTION CONTAMINATED FOOD DRINK FLY VECTOR DIRECT, INDIRECT WITH STOOL Pt

Seasonal : temperate, cold climates ACUTE : spring, summer ** Adult MALE If food poisoning : M=F Occup dis of animal breeding 1-3 w, can be 6-7 m Brucella Gram : abortus, cannis, suis, melitensis. Cattle, swine, sheep, goat, dog TISSUE, BLOOD, URINE, MILK PLACENTA, VAGINAL DISCHARGE, ABORTED FETUS

Exit MOT

Anus mouth nose child in developing : FAECES - INFECT not paralysis Developed : DROPLET DIRECT CONTACT with resp discharge INDIRECT INGESTION CONTAMINATED FOOD with FAECES

Anus, urethra Common vehicle :Ingestion FOOD WATER Vector : FLY FAECO ORAL contaminated HAND INDIRECT

Contact : with SOI, skin abrasions, conjunctiva Common vehicle : ingestion milk@products, drink water with stool AIRBORNE- lab, meat process plant DUST TRANSMISSION Vector : TICK BITES

Inlet

Mouth

MOUTH NOSE

MOUTH

MOUTH, CUTS and ABRASIONS SKIN CONJUNCTIVA URT

Period communica ble Vaccine

+ stool = 10-14 d (IP, illness, convalescence) Intermittent shed : chronic biliary carrier OLD, ORAL Vac **

Highly : 7-10 days before @ after ssx Vs excreted in stools : 3-6 w

7 days thoughout convalescence UNTREATED typhoid : discharge bact 3 months after ssx INACTIVATED WHOLE CELL Vac Vi conjugate polysac Vac Oral Ty21a Vac

NON COMMUNICABLE

SABIN (LAV) SALK inactivated