Infectious Diseases

INFECTIOUS DISEASES OF THE SKIN

Viral Infections of the Skin 1. Chickenpox (varicella)

- an acute, generalized viral infection

- S/S: fever, mild constitutional symptoms & rashes (vesicles) in the skin & mucous membranes .
(rashes start at the face and trunk and spread to the different parts of the body)

- usually a mild, self-limiting disease

- complications: pneumonia, secondary bacterial infections, hemorrhagic complications, encephalitis, Reyes syndrome (severe encephalitis with liver damage) ~

 2. Shingles (herpes zoster)

- is a reactivation of the varicella virus - S/S: inflammation of the sensory ganglia of cutaneous nerves producing fluid-filled blisters, pain & paresthesia (numbness & tingling) - Etiologic agent: Varicella-zoster virus (VZV) also known as human herpesvirus 3; a DNA virus - Reservoir: infected humans - Mode of transmission: person to person by direct contact, droplet or airborne spread of vesicle fluid or respiratory secretions of persons with chickenpox ~

 3. German Measles (rubella)

- a mild, febrile viral disease - S/S: a fine, pinkish, flat rash begins 1 2 days before onset of symptoms which starts on the face and

neck and spread to the trunk, arms & legs

- etiologic agent: Rubella virus (a RNA virus) - reservoir: infected humans - mode of transmission: droplet spread or direct contact with nasopharyngeal secretions of infected persons ~

 4. Measles (Rubeola)

- an acute, highly communicable viral disease - S/S: fever, conjunctivitis, cough, light sensitivity, Koplik spots in mouth & red blotchy skin rash. The rash begins on the face on the 3rd to 7th day & then becomes generalized (cephalocaudal spread) - EA: Measles (rubeola) virus; a RNA virus - R: infected humans - MOT: airborne transmission by droplet spread; direct contact with nasal or throat secretions or with articles freshly spoiled with nose & throat secretions. ~

 5. Warts

- many varieties of skin & mucous membrane lesions including common warts (verrucae vulgaris), venereal warts & plantar warts. Most are harmless.

- EA: human papillomavirus (HPV) ~

 Bacterial Infections of the Skin 1. Acne

- a common condition in which pores become clogged with dried sebum, flaked skin, & bacteria; leads to the formation of blackheads & whiteheads - EA: Propionibacteium acnes (anaerobic Gram (+) bacilli) ~

 2. Anthrax (Woolsorters disease)

- can affect the skin, lungs & GIT depending on the portal of entry - cutaneous anthrax is composed of blackened lesions (eschars) caused by neurotoxin

- EA: Bacillus anthracis, an anearobic, encapsulated, spore-forming gram-positive rod - R: anthrax-infected animals. Spores may be present in soil, animal hair, wool, skins and hides
- MOT: entry of endospores through breaks in the skin; inhalation of spores or ingestion of bacteria in contaminated meat ~

 3. Gas Gangrene (Myonecrosis)

- gases released from the infecting pathogen cause pockets of gas to develop in the infected tissues which rapidly destroys muscle tissues.

- EA: Clostridium spp. especially Clostridium perfringens

(a Gram-positive or Gram-variable bacilli) - R: soil - MOT: direct contact when soil containing clostridial spores enters an open wound ~

 4. Leprosy (Hansens disease)

Types: 1. Lepromatous leprosy skin nodules which can also involve the nasal mucosa and eyes 2. Tuberculoid leprosy skin lesions with peripheral nerve involvement which leads to loss of sensation - EA: Mycobacterium leprae (an acid-fast bacillus) - R: infected humans

- MOT: prolonged close contact ~

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 Fungal Infections of the skin 1. Dermatophytoses/Dermatomycoses/Tinea (Ringworm) Infections

- S/S: some fungal infections cause irritation, scaling, redness to severe itching, swelling and blister formation - EA: Microsporum, Epidermophyton & Trichophyton spp. (collectively called dermatophytes) - R: infected humans, animals, & soil - MOT: direct or indirect contact with lesions of infected persons or animals; contaminated floors, shower areas, locker room benches, barber clippers, combs, hair brushes, clothing. ~

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 Viral and Bacterial Ear Infections

1. Otitis Externa ( Swimmers Ear)

- infection of the ear canal with itching, pain, a malodorous discharge, tenderness, swelling, redness, and impaired hearing - EA: Escherichia coli Pseudomonas aeruginosa Proteus vulagaris Stapylococcus aureus - MOT: contaminated swimming pool water, indigenous microflora or articles inserted in the ear canal ~

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 2. Otitis Media

- often develops as a complication of the common cold - S/S: persistent & severe earache, temporary hearing loss, pressure in the middle ear, bulging of the eardrum.

- EA: 1. Bacterial : Streptococcus pneumoniae (a Gram (+) diplococcus Haemophilus influenzae ( a Gram (-) bacillus Moxarella catarrhalis ( a Gram (-) diplococcus)
2. Viral: measles virus parainfluenza virus respiratory syncitial virus (RSV) ~

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 INFECTIOUS DISEASES of the EYES

Bacterial Infections of the Eyes 1. Bacterial conjunctivitis

- S/S: irritation, reddening of the conjunctiva, edema of the eyelids, mucopurulent discharge, sensitivity to light; highly contagious - EA: Haemophilus influenzae Streptococcus pneumoniae - R: infected humans - MOT: contact with eye and respiratory discharges, contaminated fingers, clothing, eye makeup, eye medications, ophthalmic instruments, and contact lens-wetting and lens-cleaning agents ~

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 2. Gonocccal Conjunctivitis/Gonorrheal Opthalmia Neonatorum

- acute redness & swelling of conjunctiva, purulent discharge. The patient may develop corneal ulcers and perforation which may lead to blindness. -EA: Neisseria gonorrhea - a Gram (-), kidney shaped diplococci; also known as gonococcus - R: infected humans (the maternal cervix) - MOT: via contact with the infected birth canal during delivery; adult infection can result from finger-to-eye contact with infectious genital secretions ~

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 INFECTIOUS DISEASES of the UPPER RESPIRATORY TRACT Viral infections of the Upper Respiratory Tract 1. The Common Cold, Acute Viral Rhinitis, Acute Coryza

- a viral infection of the lining of the nose, sinuses, throat and large airways - S/S: coryza (profuse discharge from the nostrils, sneezing, runny eyes, sore throat, chills, and malaise - EA: rhinovirus (most common), coronavirus, parainfluenza virus, adenovirus, & enteroviruses - R: infected humans - MOT: via respiratory secretions by way of hands and fomites; direct contact with or inhalation of airborne droplets ~

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 Bacterial Infections of the Upper Respiratory Tract

1. Streptococcal Pharyngitis, Strep Throat

- S/S: fever, sore throat (beefy red throat with white patches of pus on pharyngeal epithelium), headache, enlarged tonsils, enlarged & tender cervical lymph nodes.

- Complications: middle ear infection, rheumatic fever & glomerulonephritis - EA: Streptococcus pyogenes (-hemolytic, Gram-positive streptococci) - R: infected humans

- MOT: direct contact; aerosol droplets, secretions from patients

& nasal carriers, and contaminated dust, or handkerchiefs, contaminated milk & milk products ~

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2. Diptheria - an acute, contagious bacterial disease primarily involving the tonsils, pharynx, larynx & nose
- a cytotoxin causes the formation of a tough, adherent,

grayish-white membrane in the throat which may cause dyspnea ~

-S/S: sore throat, swollen and tender cervical lymph nodes,

tonsillitis, swelling of the neck; symptoms related to laryngeal obstruction (dyspnea, inspiratory stridor, hoarseness or aphonia, suprasternal, supraclavicularand subcostal retractions, dry metallic cough)
- EA: Corynebacterium diptheriae, a pleomorphic, gram (+) bacilli;

toxigenic (produces diphtheria toxin)

- R: discharge from nose, skin, eyes, or pharyngeal lesions of infected

persons
- MOT: airborne droplet, direct contact, contaminated fomites, raw milk ~

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 INFECTIONS OF THE LOWER RESPIRATORY TRACT

Bacterial Infections of the Lower Respiratory Tract

1. Pneumonia - an acute nonspecific infection of the alveoli and lung tissues. - S/S: fever, productive cough acute chest pain, chills & shortness

of breath

- EA : Streptococcus pneumoniae, Haemophilus influenzae, Staphylococcus aureus, & Klebsiella pneumoniae - may be caused by Gram (+) or Gram (-) bacteria, mycoplasmas, chlamydias, viruses, fungi or protozoa. - R: infected humans, soil and bird droppings - MOT: droplet inhalation , direct oral contact with contaminated hands and fomites, or inhalation of yeasts & fungal spores ~

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 2. Tuberculosis - an acute or chronic mycobacterial infection of the LRT

- S/S: malaise, low to moderate afternoon fever, night sweats, weight loss, productive cough; shortness of breath, chest pain, hemoptysis and hoarseness in advanced stages. It may involve the lymph nodes to cause systemic disease i.e., the kidneys, urinary bladder, bones, intestines may be involved (miliary tuberculosis) - R: Mycobacterium tuberculosis (an cid-fast, Gram-positive to Gram-variable bacillus). It is sometimes referred to as the tubercle bacillus. - MOT: airborne droplets during coughing, sneezing, singing or talking; prolonged direct contact ~

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3. Pertussis (Whooping Cough)

- a highly contagious, acute bacterial infection. - S/S: 2 stages: 1. Prodromal or catarrhal stage: mild, cold-like symptoms 2. Paroxysmal stage: severe uncontrollable coughing fits which may lead to eye bleeding, rib fracture, rectal prolapse or hernia - EA: Bordetella pertussis (a small, encapsulated, nonmotile Gram-positive coccobacillus that produces endo- & exotoxins) - R: infected humans - MOT: airborne via droplets produced by coughing ~

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 Viral Infections of the Lower Respiratory tract

1. Influenza (Flu) - S/S: fever, chills, headache, generalized body pains, sore throat,

cough, nasal discharge, nausea, vomiting, diarrhea

- EA: Influenza viruses, types A, B, & C; RNA viruses Type A - causes severe symptoms & are associated with pandemic & widespread epidemics Type B - causes less severe symptoms & more localized outbreaks Type C - do not cause epidemics or significant disease. - R: infected humans - MOT: via airborne spread/droplet; direct contact - IP: Respiratory precautions ~

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 Fungal Infections of the Lower Respiratory Tract

1. Cryptococcosis

- a deep mycosis usually presenting as meningitis, although infection of the lungs, kidneys, prostate, skin & bone also occur; a common infection in AIDS patients.

- EA: Cryptococcus neoformans (an encapsulated yeast) - R: pigeon nests, pigeon & other bird droppings; soil - MOT: via inhalation of yeasts (not transmitted from person to person) - IP: Strict precaution ~

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 2. Histoplasmosis

- a systemic mycosis; primary lesion is in the lungs. - EA: Histoplasma capsulatum (a dimorphic fungus that grows as a mold in soil & as a yeast in animal and human hosts)

- R: soil containing bird, chicken droppings; bat dropping in caves

- MOT: inhalation of conidia (asexual spores) from soil - IP: Strict precaution ~

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 VIRAL INFECTIONS OF THE ORAL AREA

1. Cold sores, Fever Blisters, Herpes Labialis - are superficial clear vesicles on an erythematous base

which may appear on face & lips. They crust & heal within a few days.

- EA: Herpes simplex virus (HSV) type 1 and 2 ~

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 BACTERIAL INFECTIONS OF THE ORAL CAVITY 1. Dental caries (Tooth decay or cavities) - starts when the external surface (enamel) of a tooth is dissolved

by organic acids produced by masses of organisms attached to the tooth (dental plaque) followed by enzymatic destruction of the protein matrix, cavitation & bacterial invasion.

- EA (most common): Streptococcus mutans

2. Gingivitis* - inflammation of the gingiva or gums .

3. Periodontitis*

- inflammation of the periodontium (tissues that support the teeth, including the gingiva & supporting bone) * EA: Bacteroides, Porphyromonas, Fusobacterium, Prevotella, Actinomyces & Treponema spp. ~

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 BACTERIAL INFECTIONS OF THE GIT 1. Bacterial Gastritis & Ulcers - S/S: gastritis is suspected when a person has upper abdominal pain

with heartburn or nausea; may also cause duodenal ulcers. Pain is characterized by gnawing, burning or aching pain.

- EA: Helicobacter pylori (a Gram + bacillus) - R: infected humans

- MOT: probably by ingestion

meals occurring during daytime; relieved by vomiting

*Gastric ulcer: pain on the left epigastric area 30 mins 1 hour after * Duodenal ulcer: pain on the right epigastric area especially when

stomach is empty; relieved by food but occurs 2 -3 hours after meals; occurring during night time.

- both cause nausea, vomiting & abdominal cramps. ~

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 2. Cholera - an acute bacterial diarrheal disease characterized by passing out

profuse watery stools, vomiting & rapid dehydration.

- EA: Vibrio cholerae (a Gram + bacillus that secrete an exotoxin called choleragen)

- R: infected humans; water reservoir

- MOT: fecal - oral route (ingestion of feces - contaminated water & food) ~

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 3. Typhoid Fever or Enteric Fever

- a systemic bacterial infection characterized by fever, severe headache, malaise, anorexia, rash in the trunk in about 25% of patients; nonproductive cough & constipation. - EA: Salmonella typhi (typhoid bacillus), a Gram (-) bacilli that release endotoxin & produce exotoxins. - R: infected humans - MOT: fecal - oral route (food or water contaminated with feces; feces to food by flies) ~

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 4. Salmonellosis

- gastroenteritis with sudden onset of headache, abdominal pain, diarrhea, nausea, & vomiting; may cause severe dehydration. - EA: Salmonella typhimurium & S. enteritidis (Gram- negative bacilli that invade intestinal cells, release endotoxins & produce cytotoxins and enterotoxins) - R: infected humans; domestic & wild animals (poultry, swine, cattle) - MOT: ingestion of unpasteurized milk, meat, poultry, raw fruits & vegetables; fecal-oral route (through contaminated food & water); person to person (through food handlers) ~

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 5. Enterotoxigenic E. coli Diarrhea/Travellers Diarrhea

- S/S: profuse watery stools with or without mucus or blood, vomiting, abdominal cramps, dehydration & low-grade fever. - EA: enterotoxigenic Escherichia coli - R: infected humans - MOT: fecal oral ~

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 6. Botulism - a neuromuscular disease involving a flaccid type of paralysis.

It is the most severe form of food poisoning often resulting in death. Botulism toxin may cause nerve damage, visual difficulty, respiratory failure, flaccid paralysis of voluntary muscles, brain damage & coma within 1 week if untreated.

- EA: Clostridium botulinum (a spore-forming Gram-negative anaerobic bacillus that produces botulinum toxin) - R: dust, soil, contaminated food, inadequately treated homecanned foods, neutral pH foods & lightly-cured foods.

3 types of botulism: 1. Classic food-borne botulism ingestion of food containing

botulinum toxin. The exotoxin is produced in vitro. 2. Infant botulism ingestion of spores, which germinate in the infants GIT & produce toxin in vivo. 3. Wound botulism similar to tetanus in that clostridial spores enters a wound, germinate & produce toxin in vivo: - IP: strict precaution ~
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7. Staphylococcal Food Poisoning/Staphylococcal Food Intoxication

- a gastrointestinal intoxication with an abrupt & often violent onset with severe nausea, abdominal cramps, vomiting & diarrhea. Severe dehydration may be fatal.

- EA: enterotoxin-producing strains of S. aureus growing in foods

- R: infected humans - MOT: ingestion of S. aureus contaminated food ~

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 VIRAL INFECTIONS OF THE GIT

1. Viral Gastroenteritis/Viral Enteritis/Viral Diarrhea - occurs mostly in infants & children; adults are also infected -self-limiting (lasting 24 48 hours)

- S/S: nausea, vomiting, diarrhea, abdominal pain, myalgia, headache, malaise & low-grade fever.
- EA: infants - enteric adenoviruses, astroviruses, caliciviruses, rotaviruses children & adults Norwalk virus & rotaviruses - R: infected humans, possibly contaminated water - MOT: fecal- oral; airborne transmission & contact with contaminated fomites; may cause hospital epidemics

- IP: enteric precaution ~

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2. Viral Hepatitis
Disease Type A Hepatitis; HAV Infection; Infectious Hepatitis; Epidemic Hepatitis
Type B Hepatitis; HBV Infection; Serum Hepatitis

Name/Type of Virus Hepatitis A virus; HAV (a non-enveloped linear RNA virus)

Mode of Transmission Fecal-oral; Person to person; Infected food handlers Fecally-contaminated food & water
Sexual or household contact with an infected person; mother to infant before or during birth; injected drug use; tattoing; needlesticks & other types of nosocomial transmission Parenteral

Hepatitis B virus; HBV (an enveloped circular DNA virus)

Type C Hepatitis; Hepatitis C virus; HCV; non A Non B HCV Infection; hepatitis virusa (an enveloped, linear Non-A Non-B Hepatitis RNA virus) Type D Hepatitis; Delta Hepatitis Hepatitis D virus; HDV; delta virus (an enveloped circular RNA virus)

Exposure to infected blood & body fluids; contaminated needles; sexual transmission; coinfection with HBV is necessary Fecal-oral transmission; primarily via fecal-contaminated drinking water; also person to person Parenteral
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Type E Hepatitis

Hepatitis E virus; HEV; a spherical, noneveloped RNA virus Hepatitis G virus; HGV; a linear RNA virus

Type G Hepatitis

 SEXUALLY TRANSMITTED DISEASES OF THE GENITAL TRACT VIRAL STDs: 1. Genital Herpes - a localized primary lesion in males (penis, anus);

the principal sites are the cervix & vulva in females. - characterized by itching & soreness followed by a small patch of redness & a group of painful blisters. - EA: herpes simplex virus type 2 - R: infected humans - MOT: direct sexual contact: oral-genital, oral-anal, anal-genital; could also be transmitted from mother to fetus or from mother to neonate ~

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 2. Genital Wart/Condyloma Acuminatum

- starts as soft, moist, pink or red swellings which may grow rapidly & may develop stalks. Their rough surfaces give them the appearance of small cauliflowers.

- in males: penis
- in females: vulva, vaginal wall, cervix , skin surrounding the vaginal area, anus & rectum - EA: human papillomavirus - R: infected humans - MOT: sexual contact; mother to neonate ~

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 BACTERIAL STDs: 1. Gonorrhea - gonococcal infection may include: in males: urethritis & epididymitis s/s: urethral discharge & dysuria after 2-7 days

in females: cervicitis, pelvic inflammatory diseases, vulvovaginitis s/s: asymptomatic for weeks to months during which time, severe damage to the reproductive system may occur
- EA: Neisseria gonorrhea (gonococcus), a Gram-positive diplococci - R: infected humans

- MOT: sexual contact (direct mucous membrane to mucous membrane contact); from mother to neonate ~

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 2. Syphillis - occurs in 3 stages: 1. Primary syphilis painless lesion known as chancre 2. Secondary syphilis skin rash in palms & soles after 4-6 weeks

later; with fever & mucus membrane lesions followed by a long latent period (as long as 5-20 years) 3. Tertiary syphilis damage to the CNS, CVS, visceral organs, bones, sense organs & other sites - EA: Treponema pallidum

(a Gram-variable tightly-coiled spirochete)

- R: infected humans - MOT: sexual contact; direct contact with lesions, body secretions, mucous membranes, blood, semen, saliva, & vaginal discharges; blood transfusions; mother to fetus - IP: strict precautions ~

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 VIRAL INFECTIONS OF THE CIRCULATORY SYSTEM 1. Human Immunodeficiency Virus/Acquired Immunodeficiency

Syndrome (AIDS)

- S/S of HIV infection occur within several weeks to months after HIV infection - initial symptoms may mimic any infections or other forms of viral infection. (fever, rash, headache, lymphadenopathy, myalgia, arthralgia, weight loss, depression, GI distress, night sweats, rash, & oral or genital ulcers.

- 90% of persons infected with HIV ultimately develop AIDS. Immunosuppression or suppression of the patients immune system occurs because the virus invades & destroys T- cells. - ultimately, persons with AIDS die of overwhelming infections caused by a variety of pathogens.
- one of the most serious complications of AIDS: Kaposis sarcoma (a rare form of skin cancer) ~
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 - EA: HIV virus type 1 (HIV-1) & type 2 (HIV-2). These are viruses in

the family Retroviridae (retroviruses)

- R: infected humans

- MOT:

1. direct sexual contact (homosexual or heterosexual); 2. sharing of contaminated needles & syringes by IV drug users; 3. transfusion of contaminated blood & blood products; 4. transplacental transfer from mother to child; 5. breastfeeding by HIV-infected mothers; 6. transplantation of HIV-infected tissues or organs; 7. needlestick, scalpel & broken glass injuries ~

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 2. Mumps/Infectious Parotitis

- an acute viral infection characterized by fever, swelling & tenderness of the salivary glands that causes complications (orchitis in males & oophoritis in females)

- EA: mumps virus - R: infected humans - MOT: droplet spread & direct contact with saliva of infected person - IP: strict precautions ~

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 3. Dengue Hemorrhagic Fever (H-Fever) - an acute febrile infection of sudden onset with clinical

manifestations in 3 stages: 1. Febrile or Invasive stage (1st 4 days): abrupt, high fever, headache, abdominal pain, vomiting & epistaxis. 2. Toxic/Hemorrhagic stage (4th 7th day): lowering of temperature, severe abdominal pain (a sign of GI bleeding) which could lead to shock & death (due to hypovolemia). 3. Convalescence or Recovery stage (7th -10th day) - EA: Dengue virus type 1,2,3, & 4 and Chinkunguya virus - MOT: mosquito bite (Aedes aegypti) - IP: Strict precaution ~

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 VIRAL INFECTIONS OF THE CNS

1. Poliomyelitis

- S/S: may manifest as a minor illness with fever, malaise, headache, nausea & vomiting but may progress to severe muscle pain, stiffness of the neck & back, with or without flaccid paralysis - EA: poliovirus (a RNA virus) - R: infected humans - MOT: person to person primarily via fecal-oral route; also by throat secretions ~

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 2. Rabies - a usually fatal acute viral encephalomyelitis with mental

depression, restlessness, headache, fever, malaise, ascending paralysis, salivation, spasm of throat muscles induced by a slight breeze or drinking water, convulsions & death caused by respiratory failure.

- EA: rabies virus (also called rhabdovirus) - R: wild & domestic animals (dogs, foxes, coyotes,wolves, jackals, skunks, raccoons & bats) - MOT: bite of a rabid animal ~

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 BACTERIAL INFECTIONS OF THE CNS

1. Tetanus (Lockjaw)

- an acute neuromuscular disease induced by bacterial exotoxin called (tetanoplasmin) with painful muscular contractions primarily of the masseter muscle & neck muscles; spasms, rigid paralysis & death by respiratory failure. - EA: Clostridium tetani (a motile Gram-positive anaerobic, sporeforming bacillus) - R: soil contaminated with human or animal feces (C. tetani is an indigenous intestinal microorganism of humans & animals) - MOT: through open wound, punctured wound or needlestick injury (under anaerobic conditions, spores of C. tetani germinate into vegetative C. tetani cells which produce exotoxin in vivo) - IP: strict precaution ~
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SEVERE ACUTE RESPIRATORY DISTRES S SYNDROME - A newly identified respiratory illness characterized by fever & pneumonia which rapidly becomes severe % in some cases may lead to death. - EA: a new strain of coronavirus which belong to the same family that causes the common cold. -S/S: high grade fever, headache, body aches, dry cough, overall feeling of discomfort and dyspnea after 2 7 days. Most common cause of death is respiratory failure. -MOT: a. droplet spread b. close person to person contact c. contact with contaminated objects *most cases have involved people who cared for or lived with someone with the illness or had direct contact with infectious material from a person with SARS. *people who were exposed but do not show s/s cannot infect others.~
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Measures to prevent outbreak:

1. Voluntary home confinement - limitation of movement of a person who has traveled to a SARS affected area for 14 days if he/she has no s/s.

2. Quarantine
- the imposed limitation of movements of persons who have been exposed to a person with communicable disease. 3. Isolation - the total separation of a person sick of a communicable disease. Isolation precautions are observed. ~

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MENINGOCOCCEMIA or MENINGOCOCCAL MENIGITIS - an acute communicable disease that occurs sporadically in the Philippines . It commonly affects children but can occur in adults in crowded living areas. - EA: Nesseria meningitidis (a gram-negative diplococcus which are sensitive to light and changes in temperature) - S/S: sudden onset of fever, nausea, vomiting & a petecchial rash (a small red or purple spots that does not disappear when pressure is applied) that becomes larger & are located mainly in the extremities. The patient becomes progressively sicker with symptoms of meningitis (headache, stiff neck, back pain, changes in mental status, seizures or convulsions) in later stages. The patient may also be asymptomatic, or may produce only an acute nasopharyngitis. - MOT: a. close personal contact (direct contact with nasopharyngeal secretions of infected persons) b. airborne (droplet) spread ~

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*Incubation period varies from 2 10 days *Infected persons can transmit the disease even before the manifestation of s/s *Patients under antibiotic therapy will usually not be infectious after 24 hours & carriers without symptoms continue to shed the bacteria indefinitely until they are detected and treated.~

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Preventive measures: 1. Preventive antibiotic medication - is recommended to persons in close contacts with meningococcal patients: a. household members b. visitors who stayed overnight within 7 days before the illness c. persons who stayed in the same room with a case for 4 hours or more d. anyone directly exposed to the patients nasopharyngeal secretions 2. Wear personal protective devices 3. Handwashing 4. Proper disposal of soiled articles 5. Avoid sharing of eating or drinking utensils 6. Avoid crowded places to minimize exposure ~

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