EPIDEMIC PAROTITIS
SIGNS AND SYMPTOMS
An acute viral disease manifested by
swelling of one or both parotid glands with
occasional involvement of other glandular,
structure, particularly the testes in male
ETIOLOGIC AGENT
The causative organism is a filterable
virus of paramyxovirus group usually
found in the saliva of an infected person.
Man is the only natural reservoir.
MODE OF TRANSMISSION
It is spread by direct contact with a person
who has the disease or by contact with
articles in his/her immediate environment
which have become freshly soiled with
secretion from the nasopharynx.
INCUBATION PERIOD
The incubation period is from 14-25 days
(the average is 18 days).
PERIOD OF COMMUNICABILITY
The disease is communicable 6 days
before and 9 days after onset of parotid
gland swelling; the 48-hour period
immediately preceding onset of swelling is
considered the time of highest
communicability.
PATHOGNOMONIC SIGN
Swollen parotid glands
- pain swelling in front of ear, angle
of jaws and down the neck
- fever
- malaise
- loss of appetite
- swelling of one or both testicles
(orchitis)
DIAGNOSTIC TESTS
- Complication fixation test – show a
presumptive evidence of infection
- Hemo-agglutination inhibition test –
used to determine immune status
- Neutralization test – determines
immunity to mumps
- Viral cultures – isolation of virus
from the pharynx a few days before
and at least 5 days after parotid
swelling
- Serum amylase determination –
the most useful test in making early
presumptive diagnosis for mumps
MANAGEMENT AND TREATMENT
- Anti-viral drugs
- Relief of pain from parotid swelling
can be afforded by the application
of hot or cold, which ever is
preferred by the patient
FILARIASIS

A parasitic disease caused by an African

eye worm, a microscopic thread-like worm Chronic Stage

ETIOLOGIC AGENT - Hydrocele

- Lymphedema
Wuchereria bancrofti - Elephantiasis

- A 4-5 cm long thread-like worms DIAGNOSTIC TESTS

that affect the body’s lymph nodes
and lymph vessels.
- Organisms are usually found in
stem of “gabi”, stalk of banana and
abaca
VECTOR
The disease is transferred from person to
person by mosquito bites.
INCUBATION PERIOD
The incubation period which starts from
the entry of the infective larvae to the
development of clinical manifestation is
variable. Nevertheless, it ranges from 8-
16 months.
PATHOGNOMONIC SIGN
- Nocturnal Blood Examination
(NBE) – taken at patient’s
residence/hospital after 8:00 PM
- Immunochromatographic Test
(ICT) – it is the rapid assessment
method ; an antigen test that can
be done at daytime
MANAGEMENT AND TREATMENT
- Administration of
Diethlycarbamazine Citrate (DEC)
or Hetrazan
- Mild cases of lymphedema can be
treated by lymphovenous
anastomosis distal to the site of the
lymphatic destruction

Elephantiasis - Chyluria is operated on by ligation

and stripping of the lymphatics of
SIGNS AND SYMPTOMS the pedicle of the affected kidney
while hydrocoeles can be managed
Acute Stage by inversion or resection of the
tunica vaginalis
- Lymphadenitis
- Lymphangitis
- Funiculitis
- Epidydimits
- Orchitis
FOOT AND MOUTH DISEASE
A highly contagious and sometimes fatal
viral disease of cloven-hoofed animals,
including domestic animals such as cattle,
water buffalo, sheep, goats and pigs, as
well as antelope, bison and other wild
bovids, and deer. It is caused by foot-and-
mouth disease virus.
ETIOLOGIC AGENT
Coxsackievirus group A, mainly type 16,
is the infectious agent.
MODE OF TRANSMISSION
HFMD is transmitted by direct contact with
fluid from the vesicular lesions, direct
contact with nose and throat discharges
and faeces of an infected person, and
aerosol droplet spread.
INCUBATION PERIOD
The incubation period is from three to
seven days.
PERIOD OF COMMUNICABILITY
It is communicable during the acute stage
of disease from nose and throat
secretions and as long as there is fluid in
the lesions. Viruses persist in the stools
for several weeks.
SIGNS AND SYMPTOMS
• Fever
• Sore throat
• Feeling of being unwell (malaise)
• Painful, red, blister-like lesions on
the tongue, gums and inside of the
cheeks
• A red, nonitchy, possibly blistery
rash on palms of the hands and
soles of the feet, and sometimes the
buttocks
• Irritability in infants and toddlers
• Loss of appetite
DIAGNOSTIC TESTS
Identification of the agent
• ELISA
• Complement fixation test
• Virus isolation: inoculation of
primary bovine thyroid cells and
primary pig, calf and lamb kidney
cells; inoculation of BHK-21 and IB-
RS-2 cell lines; inoculation of mice
Serological tests
• ELISA
• Virus neutralization test
MANAGEMENT AND TREATMENT
There's no specific treatment for hand-
foot-and-mouth disease. Signs and
symptoms of hand-foot-and-mouth
disease usually clear up in seven to 10
days.
A topical oral anesthetic may help relieve
the pain of mouth sores. Over-the-counter
pain medications other than aspirin, such
as acetaminophen (Tylenol, others) or
ibuprofen (Advil, Motrin, others) may help
relieve general discomfort.
GARDIANELLA VAGINITIS

A vaginal infection caused by bacteria

called gardinella vaginalis.

ETIOLOGIC AGENT

Gardinella vaginalis but sometimes varies.

SIGN AND SYMPTOMS

Most people do not have any symptoms,

especially rare in males. Female
symptoms may include the following

- a slight grayish or yellow odorous

vaginal discharge
- mild itching or burning sensation

DIAGNOSTIC TEST

- Microscopic slide
- Chemical Analysis of vaginal
material
- Culture test from the infection site

MANAGEMENT AND TREATMENT

Curable with antibiotics and vaginal

creams or suppositories
GERMAN MEASLES

A mild viral illness caused by rubella virus. DIAGNOSTIC TEST

ETIOLOGIC AGENT This is usually made on the basis of the

Rubella virus (Family – togaviridae;
Genus Rubivirus)
INCUBATION PERIOD
From exposure to the appearance of rash,
is usually 14-21 days.
PERIOD OF COMMUNICABILITY
Approximately one weak before and four
days after the onset of rashes, but is at
worst when the rash is at its peak. Highly
communicable infants with congenital
Rubella may shed virus for months after
birth
story and the symptoms and signs.
Laboratory tests are unlikely to be of
practical value except in a pregnant
woman. The widespread testing of women
during pregnancy has shown how
unreliable the diagnosis can be. Many
women who have been told categorically
that they have had it prove to be negative
on the blood test, and vice versa.
MANAGEMENT AND TREATMENT
Very little treatment is necessary, but it
consists essentially of symptom relief like
for pain and fever

MODE OF TRANSMISSION

- Direct contact with nasopharyngeal

secretions
- Air droplets
- Transplacental in confenital rubella
- Infants with congenital rubella shed
large quantities of virus in their
pharyngeal secretions and urine
which serve as source of infection
to other contacts

PATHOGNOMONIC SIGN

Forscheimer’s spots, a mild enanthem of

petechial lesions
GONORRHEA
A sexually transmitted bacterial disease
involving the mucosal lining of the genitor-
urinary tract, the rectum and pharynx.
ETIOLOGIC AGENT
Neisseria gonorrhoeae or gonococcus
- gram negative coccus found in
pairs
- non-spore-former, non-motile
- it is fragile and does not survive
long outside the body
- it is readily killed by drying, sunlight
or ultraviolet light
- may be killed by ordinary
disinfectant
MODE OF TRANSMISSION
- by contact with exudates from the
mucous membrane of infected
person, usually a result of sexual
activity
- direct contact with contaminated
vaginal secretions of the mother as
the baby comes out of the birth
canal
- it may be acquired through sexual
contact (orogenital, anogenital)
between opposite and same sex
- may also be transmitted through
fomites
INCUBATION PERIOD
3-21 days (average 3-5 days)
PERIOD OF COMMUNICABILITY
The period of communicability of the
disease is variable. The infected person
remains communicable as long as the
organisms are present in secretions and
discharges.
PATHOGNOMONIC SIGN
Thick purulent discharge
DIAGNOSTIC TEST
In female – culture of specimen taken
from the cervix and anal canal (inoculation
of specimen on Thayer-Martin medium.
The medium contains antibiotic that inhibit
the growth of microorganisms.)
In male – gram stain
MANAGEMENT AND TREATMENT
- for uncomplicated gonorrhea in
adults – ceftriaxone 125-250 mg IM
single dose; doxycycline 100 mg
orally BID x 7days.
- For pregnant women – ceftriaxone
125-250 mg IM single dose plus
erythromycin 500 mg orally x 7days
- Acqueous procaine penicillin 4-
million nits injected intramuscularly
after a negative skin test
- Direct fluorescent antibody test
HELMINTHIASIS

ASCARIASIS TREATMENT AND MANAGEMENT

An infection caused by a Albendazole or mebendazole 15 cc

parasitic round worm, Ascaris as single dose
lumbricoides.
Piperazine Citrate – 75mg/kg, daily
ETIOLOGIC AGENT x 2 doses orally

Ascaris lumbricoides Pyrantel Pamoate – 1mg/kg as a

single dose, orally
They are elongated, cylindrical worms that
are tapered at the oral portion and pointed
at the anal end

They are creamy and pinkish yellow when

fresh

MODE OF TRANSMISSION

Transmitted through contaminated fingers

put into the mouth

Ingestion of food and drinks contaminated

with embryonated eggs

PATHOGNOMONIC SIGN

Vomiting, passing out of worm

DIAGNOSTIC TEST

Stool for ova – demonstration of a

fertilized or unfertilized eggs in the stool
“Kato Technics”

Abdominal X-ray – dense shadow of adult

ascaris which looks like strands of
spaghetti, “dot” sign

Routine blood counts – significant

eosinophelia
HELMINTHIASIS - Diarrhea
- Allergic reactions like urticaria
ANCYLOSTOMIASIS - Dilated pupils
- Malnourished and undersized
An intestinal parasite of humans children
that usually causes diarrhea or cramps - Perverted appetite
Hookworm infection occur mostly in - Pedal edema
tropical and sub-tropical countries
DIAGNOSTIC
ETIOLOGIC AGENT
Microscopic examination of feces for
Ancylostom duodenate – most the eggs
prevalent in Europe and Asia
Blood exam reveals eosinophilia
Necatar americanus – distributed in
Central and South America and West MANAGEMENT AND TREATMENT
Africa
Pyrantel embonate (Quantrel)
MODE OF TRANSMISSION
Tetrachloroethylene
This is usually accomplished
directly through the skin of the foot Carbon tetrachloride
(ground itch)

Ingestion of contaminated drinking

water or food

INCUBATION PERIOD

Hookworm ova appear in the stools

about 4-6 weeks after the larvae
penetrate the skin

Incubation period is 40-100 days or

2-8 weeks

PERIOD OF COMMUNICABILITY

Persons remain spreaders of

infection as long as they remain infected

SIGN AND SYMPTOMS

- small intestinal lesions

- IDA
- Abdominal pain
HELMINTHIASIS

ENTEROBIASIS PATHOGNOMONIC SIGN

An intestinal infection due to small Nocturnal itchiness

intestinal worm which infects only man
ETIOLOGIC AGENT
Enterobious vernicularis
- Formerly known as oxyuris
vermicularis
- Also known as seat worm or thread
worm
- Lives and breeds in small
intestines and upper portion of the
colon
MODE OF TRANSMISSION
DIAGNOSTIC TEST
Swabbing the perineal area with
cellophane-tipped applicator and
examining the cellophane microscopically
for eggs
MANAGEMENT AND TREATMENT
Piperazine hexahydrate 1 tsp. daily for
one week
All members of the family should be
treated for Pinworm at the same time.

Directly, where the eggs may be
transferred by hand from the anal
region to the mouth of the same
person thereby reinfecting him.
Indirectly, through contaminated
linens or beddings because the
eggs are not usually destroyed by
ordinary laundering
Toilet seats must be washed daily with
disinfectants
Patient should sleep alone and have
his/her own bedclothes, washcloths
Wash client’s hand and clean finger nails
before each meal

Swallowing or eating contaminated

food

INCUBATION PERIOD

1-2 weeks

PERIOD OF COMMUNICABILITY

As long as the person harbors the

organism, the person is capable of
transmitting the disease. It is
believed that “If one member of the
family has it, everybody will have it”
HEPATITIS A - jaundice and dark-colored urine
- abdominal pain
An inflammation of the liver that is not
really very severe and runs an acute DIAGNOSTIC TESTS
course, generally starting within 2-6
weeks after contact with the virus and HAV and HBV – complement fixation
lasting no longer than 2 months rate

ETIOLOGIC AGENT Liver function test – to determine the

presence and extent of liver damage
Hepatitis A virus and to check the progress of the liver

MODE OF TRANSMISSION Bile examination in stool and urine

By ingestion of contaminated drinking SGOT – serum glutamic oxaloacetic

water or ice, uncooked fruits and transminase
vegetables, grown in or washed with
contaminated water SGPT – serum glutamic pyruvic
transaminase
Fecal-oral pathway
ALT – serum alanine transaminase
By infected food handlers
IgM level
INCUBATION PERIOD
MANAGEMENT AND TREATMENT
The incubation period for hepatitis A
ranges from 15 -60 or 3-5 weeks; mean , No specific treatment, although bed
30 days. rest is essential

PERIOD OF COMMUNICABILITY High carbohydrate, low fat, low protein

diet
The infected patient is capable of
transmitting the organism a week before Vitamin supplement specially the B
and a week after the appearance of complex group
symptoms
IV therapy is occasionally necessary
CLINICAL MANIFESTATIONS
Isoprinosine (methisoprenot), may
Prodromal enhance the cell-mediated immunity of
the T-lymphocytes
- flu-like illness with chills and high
fever Administer alkalies, belladonna, and
- diarrhea, fatigue and generalized anti-emetics to control dyspepsia and
body malaise malaise
- loss of appetite
- nausea and vomiting
HEPATITIS B

Considered to be more serious than CLINICAL MANIFESTATIONS

hepatitis A due to the possibility of
severe complications such as massive
damage and hepatocarcinoma of the
liver.
ETIOLOGIC AGENT
The disease is caused by Hepatitis B
virus
MODE OF TRANSMISSION
Direct transmission from person-to-
person contact via infected body
secretions and stool passed out by
clients who are recipients of plasma-
derive products and hemodialysis
patients
Prodromal period
- fever, vomiting, abdominal
discomfort, malaise and anorexia
- nausea, fever and chills
- jaundice, dark urine and pale stools
- urticaria or arthralgia
DIAGNOSTIC TESTS
Compliment fixation test
Radio-immunoassay-hemaglutinin test
Liver function test
Bile examination in blood and urine

Through contaminated needles and Blood count

syringes
Serum transaminase – SGOT, SGPT,
Transmission can occur through ALT
infected blood or body fluids
introduced at birth HbsAg

Through sexual contact MANAGEMENT AND TREATMENT

INCUBATION PERIOD Hepatitis Immune Globulin (HGIg)

The incubation period is 50-189days
or 2-5 months; mean – 90 days
PERIOD OF COMMUNICABILITY
should be administered within 72
hours to those exposed directly to
hepatitis B virus either by ingestion, by
prick or by inoculation

The patient is capable of transmitting

the virus during the latter part of the
incubation period and during the acute
phase. The virus may persist in the
blood for many years.
ACQUIRED IMMUNO DEFICIENCY
SYNDROME (AIDS)
This condition progressively reduces
the effectiveness of the immune
system and leaves individuals
susceptible to opportunistic infections
and tumors.
ETIOLOGIC AGENT
Human Immunodeficiency Virus
PATHOPHYSIOLOGY
We produce antibodies against
specific infections. When HIV infection
takes place, anti-HIV antibodies are
produced but they do not appear
immediately. This has been called “the
window effect”. In some cases,
antibodies to HIV become detectable
4-6 weeks after the infection.
When HIV is in the circulation, it
invades several types of cells; the
lymphocytes, macrophages, the
Langerhans cells and neurons within
the CNS.
HIV attacks the body’s immune
system. The organism attaches to a
protein molecule called CD4 which are
found in the surface of T4 cells. Once
the virus enters the T4, it inserts its
genetic materials into the T4 cell dies
after having been used to replicate
HIV.
The virus mutates rapidly making it
more difficult for the body’s immune
system to “recognize” the invaders and
HIV infection progress through several
stages.
MODE OF TRANSMISSION
Sexual contact with infected person
Injection of infected blood or blood
products
Perinatal or vertical transmission
PATHOGNOMONIC SIGN
Opportunistic and malignant
manifestations, T4 below 200/dl.
(Opportunistic infection - infection that
occurs because of a weakened
immune system. Opportunistic
infections are a particular danger for
people with AIDS. The HIV virus itself
does not cause death, but the
opportunistic infections that occur
because of its effect on the immune
system can.)
DIAGNOSTIC TESTS
EIA or ELISA – Enzyme Link
Immunosorbent Assay (standard
screening test for HIV)
Particle agglutination (PA) test
Western blot analysis – confirmatory
diagnostic test
Radio immuno-precipitation assay
(RIPA)
MANAGEMENT AND TREATMENT
Reverse transcriptase inhibitors
Protease inhibitors
4 C’s (Compliance, Counseling,
Contact and Condom)