A Written Report on Scabies and Anthrax

In Partial Fulfillment of the Requirments

In NCM-101-RLE

Submitted to:
Ms. Kate Gatchalian,RN
Clinical Instructor

Submitted by:
Ms. Cristine Lace Cambronero
Practicing Clinical Instructor

Submitted by:
Ms.Sherie Gay L. Penecios
BSN-2P GROUP 3

OCTOBER 09,2009
 SCABIES

Definition:
-A communicable disease of the skin caused by Sarcopte scabiei and characterized by
the eruptive lesions producing of the female parasite into the skin.

Causative agent:
-the causative agent is the itch mite named Sarcoptes Scabiei.The female parasite is easily
visible with a magnifying glass and measures 0.33 to 0.45 mm. in length by 0.25 to 0.33
in beath.She burrows beneath the epidermis to lay her eggs, and sets up an intense
irritation.

Causes:
-Infestation with Sarcoptes Scabiei var.hominis(itch mite) cuases scabies.
Transmission of scabies occurs through direct,prolong skin contact or venerally.School-
aged Children and their families and intimate contacts of those with scabies are at
greatest risk for 2 to 3 days without a human host;therefore,inanimate objects can’t ruled
out as means of transmission.

Complication:
Persistent pruritis caused by secondary vmite sensitization is a complication of
scabies.Intense scrathing can lead to sever excoriation,tissue trauma,and secondary
bacterial infection.

Mode of transmission:
-Tranmission of the scabies occurs through direct, prolong skin contact with infected
person or their clothing and bedding.

Incubation:
-It occurs within 24 hours from the original contact,the length of time required from the
itch mite to burrow or infected skin and lay ova.

Signs and Symptoms:

● itching
● When secondarily infected the skin may feel hot and burning but this is a minor
discomfort
●When large areas are involved and secondary infection is severe there will be
fever,headache and malaise.Secondary dermatitis is common.

Diagnostic Tests:
-Superficial scraping from its burrow with a hypodermic needle or curette,and then
examined under low power of the microscopic or by hard lens to reveal the presence of
mite,ova,or mite feces.However,excoriation or inflammation of the burrow can make
such an identification difficult If scabies is strongly suspected but diagnostic tests offer
no positive identification of the mite,skin clearing with a therapeutic trial of a
pediculicide helps confirm the diagnosis.

Treatment:
● The whole family should b examined before undertaking treatment,as long as a
member of the family remains infected,others members will get the disease.
● Treatment is limited entirely to the skin
● Benzyl benzoate emulsion (Burroughs,Welcome)is cleaner to use and has more rapid
effect.
● kwell ointment is also effective.
●Apply a pediculicide—permethin cream or lindane lotion—in a thin layer over the
entire skin surface.The pediculicide is left on or 8 to 12 hours.To make certain that all
areas have been treated,this application should be repeated in about 1 week.
● Widespread bacterial infections require a systematic antibiotic such as ivermectin.
● An antipruritic emollient or topical steroid can reduce itching;an intralesional steroid
may resolve erythematous nodules.

Prevention and Control

● Good Personal hygiene-daily bath,washing the hands before and after eating, and after
using the toilet,cutting of fingernails.
● Regular changing of clean clothing beddings and towels.
● Eating the right kind of food like rich in vitamin A and Vitamin C such as green leafy
vegetable and plenty of fruits and fluids.
● Keeping the house clean.
● Improving the sanitation of the surroundings.

Nursing Intervention:
- have the patient’s fingernails cut short t minimize skin breaks from
scratching,which may lead to secondary bacterials infection.
- To prevent transmission to his amily or other patients,isolate the patient until
treatment is completed;use meticulous hand washing ;observe wound and skin
precautions or 24 hours afe treatment with a pediculicide;sterilize blod pressure
cuffs in a as autoclave before using them on other patients;isolate
linens,towels,clothing,and personal articles until the patient is
noninfectious;thoroughly disinfect the patient’s room after discharge;and have all
contaminated clothing and personal articles washed and disinfect.
- Suggest that the patient’s family and other clse personal cotacts be checked for
symptoms.Have the patient cnotify sexual contacts.if the patients is school-
age,notify te school of his condition.
- Be aler for complications associated with treatment,including contact dermatitis
and hypersensitivity reactions from repeated use of pediculicides.Remember tha
prolonged use o pediculicide may lead to excessive central nervous system
stimuation and seizures.
- Encourage the patient to verbalize his feelings about the infestation,including
embarrassment ,fear of rejection by others,and disturbed body image.
 ANTHRAX
(Malignant pustule,Malignant edema,Woolsorter disease,Ragpicker disease)

Anthrax-is an acute bacterial disease usually effecting the skin but which may very
rarely involve the oropharynx,lower respiratory tract,mediastinum or intestinal tract.

Causative Agent:
-Bacillus Anthracis is a gram positive,encapsulated,spore,forming non-motile rod.

Mode of transmission:
-Cutaneuos infection is by contact with tissues of
animals(cattle,sheep,goats,horses,pigs,and others) dying of the disease;possibly by biting
flies that had partially fed on such animals;contaminated hair,wool,hides or products
made rom them such as drums or brushes;or contact with soil associated with infected
animals or contaminated bone meal used in gardening.

Causes:
-ANTHRAX is caused by the bacteria bacillus antracis,which exists in the soil as spores
that can live for years.Transmission to humans usually occus hrough exposure to,or
handling o.infeced animals or animals products.Anthrax spores can enter the body hrough
abraded or broken skin (cutaneous anthrax,by inhalation( inhalational anthrax).or
ingestion of undercooked meat from an infected animal(GI anthrax).Anthrax isn’t known
to spread from person to person.

Complication:
Without treatmen,all forms of anthrax can lead to septicemia and death.

Nursing IntrventionS:
-Any case of anthrax in either livestock or human beings must be reported to the
appropriate public health department.
-Supportive measures ar specific to the type f anthrax exposure.

Patient’s Teaching:
-Teac the patient and family members about the disease and its transmission.Inform them
that anthrax isn’t transmitted from person to person.
-Tell the patient and family members that an anthrax vaccine is available but,due to
limited supplies,it’s now administered only to U.S military personnel and isn’t available
for routine civilian use.
-
Incubation Period:
-A few hours to 7 days most cases occur within 48 hours of exposure

Signs and Symptoms:

Three clinical forms are recognized:

● the cutaneous form is the most common and is contracted by contact with infected
animals usually (carcasses) or contaminated wool,hides and fur.The exposed part of the
skin begins to itch and a papule appears in the inoculation site.This papules becomes a
vesicle and then evolves into depressed black eshars.The lesion is not painful and often
untreated which will result to septicemia and death when not treated early.the case
fatality rate is 5-20%.

● The pulmonary form is contracted by inhalation of B.anthracis spores.at the onset of

illness the symptoms are mild and resembles that of common upper respiratory tract
infection.After 3-5 days,the symptoms become acute with fever,shock and death
results.The case fatality is high.

● The gastrointestinal anthrax is contracted by ingestion of meat from infected animals

and is manifested as violent gastroenteritis with vomiting and bloody stools.Mortality
ranges from 25-75%.

Diagnostic Tests:
-Anthrax can be diagnosed through cultures of the blood,skin lesions,or sputum of an
exposed patient.If B. anthracis is isolated,the diagnosis is
comfirmed.Additionally,specific antibodies may be detected in the blood.
Treatment:
-the treatment that’s initiated as soon as exposure to anthrax is suspected is essential to
preventing anthrax infection;early treatment may also help prevent death.Many
antibiotics are effective against anthrax;However,the most widely used are
penicillin,ciprofloxacin, and doxycycline.

Methods of Control:

● Immunize high risk persons with cell free vaccine prepared from a culture filtrate
containing the protection antigen.
● Educate employees handling potentially contaminated articles about modes of anthrax
transmission,care of skin abrasions and personal antigen.

● Control dusts and property ventilates in hazardous industries especially those that
handle raw animals materials.

● Thoroughly wash,disinfectant or sterilize hair,wool and bone meal or other feed of

animal origin prior to pressing.

● Do not sell the hides of animal expose to anthrax nor use their carcasses as food or feed
supplements ( eg.bone or blood meal)

● If anthrax is suspected do not necropsy the animal but aseptically collect a blood
sample for culture.Avoid contamination of the area.

● Control effluents and trade waste of rendering plants handling potentially infected
animals and those from factories that manufacture products from hair,wool,bones or
hides likely to be contaminated.

●Promptly immunize and annually re-immunize all animals at risk.

Questions:

1. What form of anthrax is contracted by ingestion of meat from infected animals?

Answer: Gastointestinal anthrax
2. How scabies is transmitted?
Answer: Direct, prolong skin contact
3. What disease is characterized by the eruptive lesions into the skin caused by
female parasite?
Answer: Scabies
4. What is the causative agent of anthrax?
Answer: Bacillus Anthracis.
5. Give at least one drug to treat anthrax except for penicillin?
Answer:ciprofloxacin,doxycycline
6. What bacterial disease is usually effect the skin but which may very rarely involve
the oropharynx,lower respiratory tract,mediastinum or intestinal tract?
Answer: Anthrax
7.