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Submitted by: Shyma Go Abdulbayan Liezette Marie Bisnar-Baya Submitted to: Glorilyn Bacalso, RN
DENGUE HEMORRHAGIC FEVER (H-Fever)
Hemorrhagic Fever Dengue shock Philippine Hemorrhagic Fever Thai Hemorrhagic Fever Singapore Hemorrhagic Fever
Dengue Hemorrhagic Fever is an acute infectious viral disease usually affecting infants and young children. It is carried by mosquitoes and caused by any of four related dengue viruses. This disease used to be called break-bone fever because it sometimes causes severe joint and muscle pain that feels like bones are breaking.
People get dengue virus infections from the bite of an infected aedes mosquito. Mosquitoes become infected when they bite infected humans and later transmit infection to other people they bite. The two main species of mosquito, AEDES AEGPTI and AEDES ALBOPICTUS, have been responsible for all cases of dengue transmitted to person. The transmitter of the disease is a day biting mosquito which lays eggs in clear water container, such as flower
vases, cans, barrels, old rubber tires. Etc. The adult mosquito rest in dark place of the houses.
Sign and Symptoms: • First 4 days- febrile or invasive dtage starts abruptly as high fever, abdominal pain and headache, later flushing which may be accompanied by vomiting, conjuctival infection and epistaxis.
4th-7th days – Toxic or hemorrhagic stage- lowering of temperature, severe abdominal pain vomiting and frequent bleeding from gastrointestinal tract in the form of hematemesis or melena, Unstable B.P., narrow pulse pressure and shock. Death occurs. Tourniquet test which may be positive on 3rd day may become negative due to low or vasomotor collapse.
7th-10th days – convalescent or recovery stage generalized flushing with intervening areas of blanching appetite regained and blood pressure already stable.
Classification: Severe Frank Type- with flushing sudden high fever, severe hemorrhage, followed by sudden drop of temperature, shock and terminating in recovery or death. • Moderated- with high fever, but less hemorrhage, no shock. • Mild – with slight fever, with or without petechial hemorrhage but epidemiologically related to typical cases usually discovered in the course of investigation of typical cases. Test may include the following: • • • • Hematocrit Platelet count Electrolytes Coalgulation studies •
• • • •
Liver enzymes Blood gases Tourniquet test (causes pleichiae below the tourniquet) X-ray of the chest (may demonstrate pleural infusion)
Management: Supportive and asymptomatic treatment should be provided • For fever, give paracetamol for muscle pains. For headache, give analgesic, don’t give Aspirin. • Rapid replacement of body fluids in the most important treatment. • Include intensive monitoring and follow-up • Give Oresol to replace fluid as in moderate dehydration at 75 ml/kg in 4-6 hours or up to 2-3 in adults. Continue ORS intake until patient’s condition improves. Methods of Prevention and control The infected individual, contacts and environment • Recognition of the disease • Isolation of patient (screening or sleeping under the mosquito net) • Epidemiological investigation • Case finding and reporting • Health Education
Leprosy is a chronic human infectious disease caused by Mycobacterium leprae, a slow-growing intracellular parasite mainly of cells belonging to the monocyte-macrophage lineage.
Hansen’s disease is another name for leprosy. It is called after Dr. G.A. Hansen, the Norwegian doctor who discovered the M. leprae bacillus in 1873. As the word leprosy is related to the derogatory word ‘leper’ in countries such as Brazil, Japan and the United States the term ‘Hansen’s disease’ is preferred. Mode of Transmission • Airborne: inhalation of droplet/spray from coughing and sneezing of untreated leprosy patient Prolonged skin – to- skin contact
Signs and Symptoms
a. Early Sign & Symptoms
• • • • • • • • Change in skin color – either reddish or white Loss of sensation on the skin lesion Decrease/loss of sweating and hair growth over the lesion Thickened and or painful nerves Muscle weakness or paralysis of extremities Pain and redness of the eyes Nasal obstruction or bleeding Ulcer that do not heal
b. Late Sign & Symptoms • • • Loss of eyebrow (madarosis) Inability to close eyelids (lagopthalmus) Clawning of finger and toes
• • • • Examination
Contractures Sinking of nosebridge Enlargement of the breast in males or gynecomastia Chronic Ulcers
Slit Skin Smear (SSS) Immediate Treatment Multi-Drug Therapy (MDT) • Go to the nearest health center for immediate treatment
Prevention and Control
• • •
treat all leprosy cases to prevent spread of infection BCG vaccination avoid skin to skin contact with active, untreated leprosy case practice personal hygiene maintain body resistance by healthful living good nutrition Enough rest and exercises. clean environment
Ambulatory chemotherapy through use of Multi-drug therapy Domiciliary treatment ad embodied in R.A. 4073 which advocates home treatment.
WHO classification of Leprosy which is the basis of modern management or Multi-Drug Therapy (MDT) is the use of 2 or more drugs for the treatment of
leprosy. It is proven effective cure for leprosy and renders patients noninfectious a week after starting treatment. Further, MDT makes home treatment of leprosy patient possible. Paucibacillary (tuberculoid and indeterminate) • • Non-infectious types Duration of treatment 6-9 months All paucibacillary leprosy cases shall be treated with the PB regimen as follow Medicines: (Rifampicin, Dapsone) Patient with single skin lesion and a negative slit skin smear may be treated with a single dose of the ROM regimen as follows: (Rifampicin, Ofloxacin,Minocycline) Duration of treatment 6 blister packs to be taken monthly within a maximum period of 9 months.
Multi-bacilary leprosy • • All Multi-bacilary leprosy cases shall be treated with the MB regimen as follow Medicines: (Rifampicin, Clofazimine, Dapsone,) Duration of treatment 12 blister packs to be taken monthly within a maximum period of 18 months.
Completion of treatment • All patients who have complied with the above mentioned treatment protocols are considered cured and no longer regarded as a case of leprosy, even if some sequelae of leprosy remain.
Chicken Pox (Varicella)
Chickenpox is a highly contagious illness caused by primary infection with varicella zoster virus (VZV). The word chickenpox comes from the Old English word "gican" meaning "to itch" or from the Old French word "chiche-pois" for chickpea, a description of the size of the lesion.
Source of infection: Secretion of respiratory tract infected persons. Lession of skin are of little consequence. Scabs themselves are not infective. Description: Acute infectious disease of sudden onset with slight fever, mild constitutional symptoms and eruptions which are maculo-popular for a few hour, vesicular for 3-4 days and leaves granular scabs. Lesions are more on covered than on exposed parts of the body and may appear on scalp and mucous membrane of upper respiratory tract. Mode of transmission: Direct contact or droplet spread. Indirect through article freshly soiled by discharges of infected persons. One of the most readily communicable diseases, especially in the early stages of eruption. Incubation Period: 2-3 weeks, commonly 13 to 17 days. Period of Communicability: Not more than one day before and more than 6 days after appearance of the first crop of vesicle. Prevention and control
• Avoid crowded areas during epidemics • Isolate known cases • Vaccine is available as precautionary measure and as per doctor’s advise.
Leptospirosis is a worldwide zoonic disease caused by bacteria called Leptospires, Leptospiara interrogans.
Rat is the main host to leptospirosis although pigs, cattle, rabbits, hare, skunk and other wild animals can also severe as reservoir host. It is an occupational disease affecting veterinarians, miners, farmers, sewer workers, abattoir workers, etc. Incubation Period: Ranges from 7-19 days, with average of 10 days. Mode of Transmission: Through contact of the skin, especially open wounds with water, moist soil or vegetation contaminated with urine of infected host. Sign and Symptoms: Clinical manifestations are variable with different degrees of severity. It has two Clinical Phase: 1. Leptospiremic phase- leptospires are present in the blood and Cerebro Spinal Fluid (CSF). Onset of sign and symptoms are abrupt with fever, headache, myalgia, nausea, vomiting, and cough and chest pain. 2. Immune phase- correlates with the appearance of circulating IgM.
Treatment: • • • Penicillin and other related B-lactam antibiotics Tetracycline Erythromycin in patients allergic to penicillin
Prevention and Control: • • Health Teaching Use of protective clothing boots and gloves especially by workers with occupational hazardous. Stringent Community-wide rat eradication program. Segregate domestic animal potentially infected from man’s living, working and recreation areas. Isolate the patients and concurrent disinfection of soiled articles. Report all cases of leptospirosis. Investigation of contacts and source of infection. Chemoprophylaxis in group at high risk of infected host.
• • •
Rabbies is an acute viral encephalomyelitis caused by the rabies virus, A rhabdovirus. Of the genus lyssavirus. It is fatal once sign and symptoms appear. Two kinds of rabies: • • Urban or canine rabies- is transmitted by dogs Sylvatic rabies- is a disease of wild animals and bats which sometimes spread to dogs, cats and livestock.
Mode of Transmission:
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