Professional Documents
Culture Documents
I. EPI DISEASES
MODE OF PATHOGNOMONIC
DISEASE CAUSATIVE AGENT MANAGEMENT/TREATMENT PREVENTION
TRANSMISSION SIGN
1. Tuberculosis Mycobacterium Airborne-droplet 1. Usually asymptomatic Diagnostic test: Respiratory precautions
tuberculosis 2. Low-grade afternoon Sputum examination or the Acid-fast bacilli Cover the mouth and
Other names: Direct invasion fever (AFB) / sputum microscopy nose when sneezing to
Koch’s Disease TB bacillus through mucous 3. Night sweating 1. Confirmatory test avoid mode of
Consumption Koch’s bacillus membranes and 4. Loss of appetite 2. Early morning sputum about 3-5 cc transmission
Phthisis Mycobacterium bovis breaks in the skin 5. Weight loss 3. Maintain NPO before collecting sputum Give BCG
Weak lungs (very rare) 6. Easy fatigability – due 4. Give oral care after the procedure BCG is ideally given at
(rod-shaped) to increased oxygen 5. Label and immediately send to laboratory birth, then at school
Most hazardous period for development of clinical Incubation period : demand 6. If the time of the collection of the sputum is entrance. If given at 12
disease is the first 6-12 months after infection 4 – 6 weeks 7. Temporary amenorrhea unknown, discard months, perform
Highest risk of developing disease is children under 8. Productive dry cough Chest X-ray is used to: tuberculin testing
3years old 9. Hemoptysis 1. Determine the clinical activity of TB, whether (PPD), give BCG if
it is inactive (in control) or active (ongoing) negative.
TREATMENT: SCC/Short Course Chemotherapy, Direct –observed treatment short course/DOTS;
2. To determine the size of the lesion: Improve social
Rifampicin (R), Isoniazid (H), Pyrazinamide (Z), Ethambutol (E), Streptomycin (S) a. Minimal – very small conditions
CATEGORY
SIDE
CATEGORY
CATEGORY EFFECTS:
1:3:662: 8 b. Moderately advance – lesion is < 4 cm
monthsmonths
Rifampicin
months SCC
SCC SCC c. Far advance – lesion is > 4 cm
Indications:
Indications:
Indications:body fluid SIDE EFFECTS: Tuberculin Test – purpose is to determine the
> new
> new > treatment
(-) smearfailure
(+)
discoloration PTB Ethambutol history of exposure to tuberculosis
>with > relapse
minimal
(-)smear PTB lesions
hepatotoxic with Optic neuritis Other names:
> return
on CXR
extensive after default
permanent Blurring of vision Mantoux Test – used for single screening, result
Same
parenchymalmeds with
lesions
discoloration (Not to be givento interpreted after 72 hours
Intensive Phase:3ofmos
Category
on CXR 1
contact lensesP&E 2 children below 6 y.o. due Tine test – used for mass screening read after 48
R&I 1 tab each;
>Intensive
Extrapulmonary
Isoniazid Phase: 2TB to inability to complain hours
tabs each
>months
severe concominant blurring of vision) Interpretation:
Streptomycin
Peripheral –1
R&Ineuropathy
HIV 1 tab each;
disease
vial/day IM for P&Efirst 2 Inability to recognize 0 - 4 mm induration – not significant
2 tabs
Intensive each
months Phase:
= 56 2
vials (if green from blue 5 mm or more – significant in individuals who
(Give Vit
Continuation
months given for > Phase:
2mos can Streptomycin are considered at risk; positive for patients who
B6/Pyridoxine)
4 months
R&I : 1 tabnephrotoxicity
cause each; P&E Damage to 8th CN are HIV-positive or have HIV risk factors and are
Pyrazinamide
2R&I
tabs 1 tab
each each Ototoxic of unknown HIV status, those who are close
Continuation
hyperuricemia Phase: 5
Continuation Phase: Tinnitus contacts with an active case, and those who have
/gouty
monthsarthritis
CATEGORY 4:
4 months nephrotoxic chest x-ray results consistent with tuberculosis.
(increase
Chronic fluid
R&I :(*Referral
1 tab each
R&Iintake)
: 1 tab each 10 mm or greater – significant in individuals
needed)
E : 2 tabs who have normal or mildly impaired immunity
6 Communicable Disease Nursing
NATIONAL TB
MANAGEMENT OFCONTROL
CHILDRENPROGRAM: WITH TUBERCULOSIS - for TB symptomatic s children
Vision: A country where TB is no longer a public health problem *a TB symptomatic child with either known or
Mission: BCG
Prevention: Ensure that TB DOTS
immunization Services
to all infantsare available, accessible,
(EPI) and exposure to a TB case shall be referred
unknown
affordable to the communities in collaboration with LGUs and others for tuberculin testing
CaseGoal: To reduce prevalence and mortality from TB by half by the
Finding: year
* (+) 2015 but (-) tuberculin test and unknown
contact
(Millennium
- cases Development
of TB in children Goal) and identified in 2
are reported contact but (+) tuberculin test shall be referred for
Targets:
instances: (a) 1. Cure was
patient at least 85% of
screened thewas
and sputum
foundsmear (+) patients CXR
symptomatic discovered
examination
2. Detect at
of TB after consultaion (b)least
patient70%was new sputumtosmear
reported (+) TB cases
have been *(-) CXR, repeat tuberculin test after 3 months
Objectives:
exposed to an adult 1. Improve
TB patient access to and quality of services * INH chemoprophylaxis for three months shall be
2. Enhance stakeholder’s
- ALL TB symptomatic children 0-9 y.o, EXCEPT sputum health-seeking behavior given to children less than 5y.o. with (-) CXR; after
positive child shall 3. Increase
be subjectedand sustain supporttesting
to Tuberculin for TB(Note:
control activities
which tuberculin test shall be repeated
Only a trained PHN 4. Strengthen
or main health management of TB control
center midwife shall doactivities at all levels
KEY POLICIES:
tuberculin testing and reading which shall be conducted once a Treatment (Child with TB):
week*Case
eitherfinding:
on a Monday or Tuesday. Ten children shall be Short course regimen
- DSSM
gathered shall betothe
for testing primary
avoid diagnostic tool in NTP case finding
wastage. PULMONARY TB
- No TB Dx shall be made based on CXR results alone Intensive: 3 anti-TB drugs (R.I.P.) for 2 months
- All TBtosymptomatic
- Criteria be TB symptomatic shall be asked to undergo
(any three DSSM before treatment
of the following:) Continuation: 2 anti-TB drugs (R&I) for 4 months
- Only contraindication
* cough/wheezing of 2 weeks for orsputum
more collection is hemoptysis
- PTB symptomatic
* unexplained fever of 2shallweeks be asked
or more to undergo other tests (CXR EXTRA-PULMONARY
and culture), TB
only after three sputum specimens yield negative
* loss of appetite/loss of weight/failure to gain weight/weight results in DSSMIntensive: 4 anti-TB drugs (RIP&E/S) for 2 months
- Only trained med techs / microscopists shall perform DSSM Continuation: 2 anti-TB drugs (R&I) for 10 months
faltering
- Passive
* failure case finding
to respond shall be
to 2 weeks of implemented in all health
appropriate antibiotic stations
therapy
for lower respiratory tract infection
*Treatment:
* failure to regainDomiciliary
previous state treatment
of health – preferred modea viral
2 weeks after of care
DSSM
infection or exanthem (e.g. measles)– basis for treatment of all TB cases PERIOD OF COMMUNICABILITY OF
*Hospitalization is recommended: massive hemoptysis, pleural effusion,
TUBERCULOSIS:
military TB, TB meningitis, TB pneumonia,
-Conditions confirming TB diagnosis (any 3 of the following:) & surgery is needed orwithas long as bacillus is contained in the
complications
* (+) history of exposure to an adult/adolescent TB case sputum
*All
* (+) patients
signs undergoing
and symptoms treatmentofshall
suggestive TB be supervised Primary complex in children is NOT
*National
* (+) tuberculin & test
LGUs shall ensure provision of drugs to all smear (+) TB cases contagious
*Quality of fixed-dose
* abnormal CXR suggestive combination
of TB (FDC) must be ensured Good compliance to regimen renders
*Treatment
* Lab shall be based
findings suggestive on recommended
or indicative of TB category of treatment regimen person not contagious 2-4 weeks after
DOTS Strategy – internationally-recommended TB control strategy initiation of treatment
- forFive
children
Elements withofexposure
DOTS: (RUSAS)to TB
* a child w/ exposure to a TB
Recording & reporting system enablingregistered adult patient assessment
outcome shall of all patients
undergo physical exam and tuberculin
Uninterrupted supply of quality-assured drugs testing
* a child with productive
Standardized SCC forcough all TBshall
casesbe referred for sputum
exam, for (+) sputum smear
Access to quality-assured sputum child, startmicroscopy
treatment immediately
* TBSustained
asymptomatic but (+) tuberculin
political commitment test and TB symptomatic
but (-) tuberculin test shall be referred for CXR examination
7 Communicable Disease Nursing
5. Poliomyelitis Legio debilitans Fecal – oral route Paralysis Diagnostic test: OPV vaccination
Polio virus Muscular weakness Frequent hand washing
Other name: Enterovirus Incubation period: Uncoordinated body CSF analysis / lumbar tap
Infantile paralysis 7 – 21 days movement Pandy’s test
Attacks the anterior horn Hoyne’s sign – head lag
of the neuron, motor is after 4 months Management:
affected Rehabilitation involves ROM exercises
Man is the only reservoir (!Safety)
6. Measles RNA containing Droplet secretions 1. Koplik’s spots – No specific diagnostic test Measles vaccine
paramyxovirus from nose and throat whitish/bluish pinpoint Disinfection of soiled
Other names: patches on the buccal Management: articles
Morbilli Incubation period: cavity Supportive and symptomatic Isolation of cased from
Rubeola Period of 10 days – fever 2. cephalocaudal diagnosis until about 5-7
Communicability: 14 days – rashes appearance of days after onset of rash
4 days before and 5 days appear maculopapular rashes
after the appearance of (8-13 days) 3. Stimson’s line –
rash bilateral red line on the
lower conjunctiva
7. Hepatitis B Hepatitis B virus Blood and body 1. Right-sided Abdominal Diagnostic test: -Hepatitis B immunization
fluids pain -Wear protected clothing
Other names: Placenta 2. Jaundice Hepatitis B surface agglutination (HBSAg) test -Hand washing
Serum Hepatitis 3. Yellow-colored sclera -Observe safe-sex
Incubation period: 4. Anorexia Management: -Sterilize instruments used
45 – 100 days 5. Nausea and vomiting > Hepatitis B Immunoglobulin in minor surgical-dental
6. Joint and Muscle pain procedures
7. Steatorrhea Diet: high in carbohydrates -Screening of blood
8. Dark-colored urine products for transfusion
9. Low grade fever
MODE OF PATHOGNOMONIC
DISEASE CAUSATIVE AGENT MANAGEMENT/TREATMENT PREVENTION
TRANSMISSION SIGN
1. Cholera Vibrio cholera Fecal-oral route Rice watery stool Diagnostic Test: Proper handwashing
Vibrio coma Stool culture Proper food and water
Other names: Ogawa and Inaba bacteria 5 Fs Period of Treatment: sanitation
El tor Communicability: Oral rehydration solution (ORESOL) Immunization of Chole-vac
Incubation Period: 7-14 days after onset, IVF
Few hours to 5 days; occasionally 2-3 months Drug-of-Choice: tetracycline (use straw; can cause
usually 3 days staining of teeth). Oral tetracycline should be
administered with meals or after milk.
2. Amoebic Entamoeba histolytica Fecal-oral route Abdominal cramping Treatment: Proper handwashing
Dysentery Bloody mucoid stool Proper food and water
Protozoan (slipper-shaped Tenesmus - feeling of Metronidazole (Flagyl) sanitation
body) incomplete defecation * Avoid alcohol because of its Antabuse effect can
(Wikipedia) cause vomiting
3. Shigellosis Shigella bacillus Fecal-oral route Abdominal cramping Drug-of-Choice: Co-trimoxazole Proper handwashing
Bloody mucoid stool Proper food and water
Other names: Sh-dysenterae – most 5 Fs: Finger, Foods, Tenesmus - feeling of Diet: Low fiber, plenty of fluids, easily digestible sanitation
Bacillary infectious Feces, Flies, incomplete defecation foods Fly control
dysentery Sh-flesneri – common in Fomites (Wikipedia)
the Philippines
Sh-connei Incubation Period:
Sh-boydii 1 day, usually less
than 4 days
4. Typhoid fever Salmonella typhosa Fecal-oral route Rose Spots in the Diagnostic Test: Proper handwashing
(plural, typhi) abdomen – due to Typhi dot – confirmatory test; specimen is feces Proper food and water
5 Fs bleeding caused by Widal’s test – agglutination of the patient’s serum sanitation
perforation of the
Incubation Period: Peyer’s patches Drug-of-Choice: Chloramphenicol
Usual range 1 to 3
weeks, average 2 Ladderlike fever
weeks
5. Hepatitis A Hepatitis A Virus Fecal-oral route Fever Prophylaxis: “IM” injection of gamma globulin Proper handwashing
Anorexia (early sign) Hepatitis A vaccine Proper food and water
Other names: 5 Fs Headache Hepatitis immunoglobulin sanitation
Infectious Jaundice (late sign) Avoid alcohol Proper disposal of urine
10 Communicable Disease Nursing
Hepatitis / Incubation Period: Clay-colored stool Complete bed rest – to reduce the breakdown of fats and feces
Epidemic 15-50 days, Lymphadenopathy for metabolic needs of liver Separate and proper
Hepatitis / depending on dose, Low-fat diet; increase carbohydrates (high in sugar) cleaning of articles used by
Catarrhal Jaundice average 20-30 days patient
In convalescent period, patient may have difficulty
with maintaining a sense of well-being.
6. Paralytic Dinoflagellates Ingestion of raw of Numbness of face Treatment: 1. Avoid eating shellfish
Shellfish inadequately cooked especially around the 1. No definite treatment such as tahong, talaba,
Poisoning (PSP I Phytoplankton seafood usually mouth 2. Induce vomiting halaan, kabiya, abaniko
Red tide bivalve mollusks Vomiting and dizziness 3. Drink pure coconut milk – weakens the during red tide season
poisoning) during red tide Headache toxic effect 2. Don’t mix vinegar to
season Tingling 4. Sodium bicarbonate solution (25 grams in ½ shellfish it will increase
sensation/paresthesia and glass of water) toxic effect 15 times
Incubation Period: eventful paralysis of Advised only in the early stage of illness greater
30 minutes to hands because paralysis can lead to aspiration
several hours after Floating sensation and NOTE: Persons who survived the first 12 hours after
ingestion weakness ingestion have a greater chance of survival.
Rapid pulse
Dysphonia
Dysphagia
Total muscle paralysis
leading to respiratory
arrest and death
MODE OF PATHOGNOMONIC
DISEASE CAUSATIVE AGENT MANAGEMENT/TREATMENT PREVENTION
TRANSMISSION SIGN
1. Syphilis Treponema pallidum Direct contact Primary stage (4-6 Diagnostic test: Abstinence
(a spirochete) Transplacental (after weeks): painless chancre Dark field illumination test Be faithful
Other names: 16th week AOG) at site of entry of germ Fluorescent treponemal antibody absorption test Condom
Sy
Secondary syphilis (6-8
Incubation Period: Through blood with serous exudates – most reliable and sensitive diagnostic test for
weeks: generalized rashes, 10 to 90 days (3 months);
Bad Blood transfusion Syphilis; serologic test for syphilis which involves
The poxtender discrete average of 21 days
generalized Indirect contact with Tertiary stage (one to 35 antibody detection by microscopic flocculation of
Lues venereal mucus
lymphadenopathy, contaminated years) : Gumma, syphilitic the antigen suspension
Morbus
patches, gallicus
flu-like symptoms, articles endocarditis and VDRL slide test, CSF analysis, Kalm test,
condylomata, patchy alopecia meningitis Wasseman test
Primary and secondary sores will go even without treatment but the germs continue
Latent stage (one to two Treatment:
to to
spread throughout the body. Latent syphilis may continue 5 to 20+ years with NO
50 years): non-infectious Drug of Choice: Penicillin (Tetracycline if resistant
symptoms, but the person is NO longer infectious to other people. A pregnant
mother can transmit the disease to her unborn child (congenital syphilis). to Penicillin)
2. Gonorrhea Neiserria gonorrheae Direct contact – Thick purulent yellowish Diagnostic test: Abstinence, Be faithful
genitals, anus, discharge Culture of urethral and cervical smear Condom
Other names: mouth Burning sensation upon Gram staining
GC, Clap, Drip, urination / dysuria Prevention of gonococcal
Stain, Gleet, Incubation Period: Treatment: ophthalmia is done through
Flores Blancas 2 – 10 days Drug of Choice: Penicillin the prophylactic use of
ophthalmic preparations
with erythromycin or
tetracycline
3. Trichomoniasis Trichomonas vaginalis Direct contact Females: Diagnostic Test: Abstinence
white or greenish-yellow Culture Be faithful
Other names: Incubation Period: odorous discharge Condom
Vaginitis 4 – 20 days; average vaginal itching and Treatment:
Trich of 7 days soreness Drug of Choice: Metronidazole (Flagyl) Personal Hygiene
painful urination
Males:
Slight itching of penis
Painful urination
Clear discharge from penis
4. Chlamydia Chlamydia trachomatis Direct contact Females: Diagnostic Test: Abstinence
12 Communicable Disease Nursing
4. ARC (AIDS Related Not everybody is in danger of becoming infected HIV/AIDS Prevention
Complex) with HIV through sex. and Control Program:
a. a group of symptoms
indicating the disease is Never give live attenuated (weakened) vaccines e.g. Goal: Contain the
likely to progress to AIDS oral polio vaccine. transmission of HIV /AIDS
b. fever of unknown origin and other reproductive tract
c. night sweats HIV positive pregnant women and their partner must infections and mitigate
d. chronic intermittent be informed of the potential risk to the fetus. their impact
diarrhea
e. lymphadenopathy LECTURE DISCUSSION
f. 10% body weight loss – best method to use in
teaching about safe sex
5. AIDS
a. manifestation of severe Priority intervention when
immunosuppression caring for AIDS patient:
b. CD4 Count: <200/dL Use disposable gloves
c. presence of variety of when in contact with non-
infections at one time: intact skin.
oral candidiasis
leukoplakia
AIDS dementia complex
Acute encephalopathy
Diarrhea, hepatitis
Anorectal disease
Cytomegalovirus
Pneumonocystis carinii
pneumonia (fungal)
TB
Kaposi’s sarcoma (skin
cancer; bilateral purplish
patches)
Herpes simplex
Pseudomonas infection
Blindness
14 Communicable Disease Nursing
Deafness
IV. ERUPTIVE DISEASES
MODE OF PATHOGNOMONIC
DISEASE CAUSATIVE AGENT MANAGEMENT/TREATMENT PREVENTION
TRANSMISSION SIGN
1. Chickenpox Human (alpha) herpes Droplet spread Vesiculo-pustular rashes No specific diagnostic exam Case over 15 years of age
virus 3 (varicella-zoster Treatment is supportive. should be investigated to
Other names: virus), a member of the Direct contact Centrifugal appearance of eliminate possibility of
Varicella Herpesvirus group rashes – rashes which Drug-of-choice: smallpox.
Indirect through articles begin on the trunk and Acyclovir / Zovirax ® (orally to reduce the number Report to local authority
freshly soiled by spread peripherally and of lesions; topically to lessen the pruritus) Isolation
discharges of infected more abundant on covered Concurrent disinfection of
Period of persons body parts NEVER give ASPIRIN. Aspirin when given to throat and nose discharges
Communicability: children with viral infection may lead to Exclusion from school for
From as early as 1 to 2 Incubation Period: Pruritus development of REYE’S SYNDROME. 1 week after eruption first
days before the rashes 2-3 weeks, commonly appears
appear until the lesions 13 to 17 days Nursing Diagnoses: Avoid contact with
have crusted. Disturbance in body image susceptibles
Impairment of skin integrity
2. German Rubella virus or RNA- Droplet Forscheimer spots – red Diagnostic Test: MMR vaccine (live
Measles containing Togavirus pinpoint patches on the Rubella Titer (Normal value is 1:10); below 1:10 attenuated virus)
(Pseudoparamyxovirus) Incubation Period: oral cavity indicates susceptibility to Rubella. - Derived from chick
Other Names: Three (3) days embryo
Rubella German measles is Maculopapular rashes Instruct the mother to avoid pregnancy for three Contraindication:
Three-day teratogenic infection, can Headache months after receiving MMR vaccine. - Allergy to eggs
Measles cause congenital heart Low-grade fever - If necessary, given in
disease and congenital Sore throat MMR is given at 15 months of age and is given divided or fractionated
cataract. Enlargement of posterior intramuscularly. doses and epinephrine
cervical and postauricular should be at the bedside.
lymph nodes
3. Herpes Zoster Herpes zoster virus Droplet Painful vesiculo-pustular Treatment is supportive and symptomatic Avoidance of mode of
(dormant varicella zoster Direct contact from lesions on limited portion transmission
Other names: virus) secretion of the body (trunk and Acyclovir to lessen the pain
Shingles shoulder)
Cold sores
Low-grade fever
4. Dengue Dengue virus 1, 2, 3, and Bite of infected Classification (WHO): Diagnostic Test: 4 o’clock habit
Hemorrhagic 4 and Chikungunya virus mosquito (Aedes
15 Communicable Disease Nursing
Fever Aegypti) - characterized Grade I: Torniquet test (Rumpel Leads Test / capillary Chemically treated
Types 1 and 2 are by black and white a. flu-like symptoms fragility test) – PRESUMPTIVE; positive when 20 mosquito net
Other names: common in the stripes b. Herman’s sign or more oetechiae per 2.5 cm square or 1 inch Larva eating fish
H-fever Philippines c. (+) tourniquet sign square are observed Environmental sanitation
Daytime biting Antimosquito soap
Period of Low flying Grade II: Platelet count – CONFIRMATORY; (Normal is Neem tree (eucalyptus)
communicability: Stagnant clear water a. manifestations of Grade 150 - 400 x 103 / mL)
Unknown. Presumed to Urban I plus spontaneous Eliminate vector
be on the 1st week of bleeding Treatment:
illness up to when the Incubation Period: b. e.g. petechiae, Supportive and symptomatic Avoid too many hanging
virus is still present in the Uncertain. Probably 6 ecchymosis purpura, gum Paracetamol for fever clothes inside the house
blood days to 1 week bleeding, hematemesis, Analgesic for pain
melena Residual spraying with
Occurrence is sporadic Manifestations: Rapid replacement of body fluids – most important insecticide
throughout the year Grade III: treatment
First 4 days: a. manifestations of Grade Daytime fumigation
Epidemic usually occur Febrile/Invasive Stage II plus beginning of ORESOL
during the rainy seasons - starts abruptly as fever circulatory failure Use of mosquito repellants
(June to November) - abdominal pain b. hypotension, Blood tansfusion
- headache tachycardia, tachypnea Wear long sleeves, pants,
Peak months: September - vomiting Diet: low-fat, low-fiber, non-irritating, non- and socks
and October - conjunctival infection Grade IV: carbonated. Noodle soup may be given. ADCF
-epistaxis a. manifestations of Grade (Avoid Dark-Colored Foods)
III plus shock (Dengue For the control of H-fever,
4th – 7th days: Shock Syndome) ALERT! No Aspirin knowledge of the natural
Toxic/Hemorrhagic history of the disease is
Stage important.
- decrease in
temperature Environmental control is
- severe abdominal pain the most appropriate
- GIT bleeding primary prevention
- unstable BP (narrowed approach and control of H-
pulse pressure) fever.
- shock
- death may occur
- appetite regained
- BP stable
V. VECTOR-BORNE DISEASES
MODE OF PATHOGNOMONIC
DISEASE CAUSATIVE AGENT MANAGEMENT/TREATMENT PREVENTION
TRANSMISSION SIGN
1. Malaria Plasmodium Parasites: Bite of infected Cold Stage: severe, Early Diagnosis and Prompt Treatment *CLEAN Technique
Vivax anopheles mosquito recurrent chills (30 Early diagnosis – identification of a patient with *Insecticide – treatment of
Falciparum (most fatal; minutes to 2 hours) malaria as soon as he is seen through clinical mosquito net
most common in the Night time biting and/or microscopic method *House Spraying (night
Philippines) High-flying Hot Stage: fever (4-6 Clinical method – based on signs and symptoms time fumigation)
Ovale Rural areas hours) of the patient and the history of his having visited a *On Stream Seeding –
Malariae Clear running water malaria-endemic area construction of bio-ponds
Wet Stage: Profuse Microscopic method – based on the examination for fish propagation (2-4
-attacks the red blood sweating of the blood smear of patient through microscope fishes/m2 for immediate
cells (done by the medical technologist) impact; 200-400/ha. for a
Episodes of chills, fevers, delayed effect)
and profuse sweating are QBC/quantitative Buffy Coat – fastest *On Stream Clearing –
associated with rupture of Malarial Smear – best time to get the specimen is cutting of vegetation
the red blood cells. at height of fever because the microorganisms are overhanging along stream
- intermittent chills and very active and easily identified banks
sweating
- anemia / pallor Chemoprophylaxis *Avoid outdoor night
- tea-colored urine Only chloroquine should be given (taken at weekly activities (9pm – 3am)
- malaise intervals starting from 1-2 weeks before entering *Wearing of clothing that
- hepatomegaly the endemic area). In pregnant women, it is given covers arms and legs in the
- splenomegaly throughout the duration of pregnancy. evening
- abdominal pain and *Use mosquito repellents
enlargement Treatment: *Zooprophylaxis – typing
- easy fatigability Blood Schizonticides - drugs acting on sexual of domestic animals like
blood stages of the parasites which are responsible the carabao, cow, etc near
for clinical manifestations human dwellings to
NURSING CARE: 1. QUININE – oldest drug used to treat deviate mosquito bites
1. TSB (Hot Stage) malaria; from the bark of Cinchona tree; from man to these animals
2. Keep patent warm ALERT: Cinchonism – quinine toxicity
(Cold Stage) 2. CHLOROQUINE Intensive IEC campaign
3. Change wet clothing 3. PRIMAQUINE – sometimes can also be
(Wet Stage) given as chemoprophylaxis
4. Encourage fluid intake 4. FANSIDAR – combination of
17 Communicable Disease Nursing
MODE OF PATHOGNOMONIC
DISEASE CAUSATIVE AGENT MANAGEMENT/TREATMENT PREVENTION
TRANSMISSION SIGN
1. Leptospirosis Leptospira interrogans – Through contact of the Leptospiremic Phase Diagnosis Protective clothing,
bacterial spirochete skin, especially open - leptospires are present in Clinical manifestations boots and gloves
Other Names: wounds with water, blood and CSF Culture of organism Eradication of rats
- Weil’s Disease RAT is the main host. moist soil or vegetation - onset of symptoms is Examination of blood and CSF during the first Segregation of domestic
- Mud Fever Although pig, cattle, infected with urine of abrupt week of illness and urine after the 10th day animals
- Trench Fever rabbits, hare, skunk, and the infected host - fever Leptospira agglutination test Awareness and early
- Flood Fever other wild animals can - headache diagnosis
- Spirochetal also serve as reservoir Incubation Period: - myalgia Treatment: Improved education of
Jaundice 7-19 days, average of - nausea Penicillins and other related B-lactam antibiotics people
- Japanese Occupational disease 10 days - vomiting Tetracycline (Doxycycline) Avoid wading or
Seven Days affecting veterinarians, - cough Erythromycin swimming in water
fever miners, farmers, sewer - chest pain contaminated with urine
workers, abattoir workers, Most common complication: kidney failure of infected animals.
etc Immune Phase Concurrent disinfection
- correlates with the of articles soiled with
appearance of circulating urine.
IgM
2. Rabies Rhabdovirus of the genus Bite or scratch (very Sense of apprehension Diagnosis: Have pet immunized at 3
lyssavirus rare) of rabid animal Headache history of bite of animal months of age and every
Other Names: Fever culture of brain of rabid animal year thereafter
Lyssa Degeneration and necrosis Non-bite means: Sensory change near site demonstration of negri bodies
Hydrophobia of brain – formation of leaking, scratch, organ of animal bite Never allow pets to roam
Le Rage negri bodies transplant (cornea), Spasms of muscles of Management: the streets
inhalation/airborne deglutition on attempts to *Wash wound with soap immediately. Antiseptics
Two kinds of Rabies: (bats) swallow e.g. povidone iodine or alcohol may be applied Take care of your pet
a. Urban or canine – Source of infection: Fear of *Antibiotics and anti-tetanus immunization
transmitted by dogs saliva of infected water/hydrophobia *Post exposure treatment: local wound National Rabies
animal or human Paralysis treatment, active immunization (vaccination) and Prevention and Control
b. Sylvatic – disease of Delirium passive immunization (administration of rabies Program
wild animals and bats Incubation period: Convulsions immunoglobulin) Goal: Human rabies is
which sometimes spread 2 – 8 weeks, can be *Consult a veterinarian or trained personnel to eliminated in the
to dogs, cats, and livestock years depending on “FATAL once signs and observe the pet for 14 days Philippines and the
severity of wounds, site symptoms appear” country is declared rabies-
of wound as distance *Without medical intervention, the rabies victim free
19 Communicable Disease Nursing
from brain, amount of would usually last only for 2 to 6 days. Death is
virus introduced, and often due to respiratory paralysis.
protection provided by
clothing
3. Bubonic Bacteria (Yersinia pestis) Direct contact with the Fever and lyphadenitis Streptomycin, tetracycline, chloramphenicol Environmental Sanitation
Plague infected tissues of
Vector: rat flea rodents
MODE OF
DISEASE CAUSATIVE AGENT PATHOGNOMONIC SIGN MANAGEMENT/TREATMENT PREVENTION
TRANSMISSION
1. Leprosy Mycobacterium leprae Airborne-droplet Early signs: Diagnostic Test: Avoid prolonged skin-to-
Change in skin color – either Slit Skin Smear - determines the presence of M. skin contact
Other names: Prolonged skin-to- reddish or white leprae; optional and done only if clinical diagnosis
Hansenosis skin contact Loss of sensation on the skin is doubtful to prevent misclassification and wrong BCG vaccination –
Hansen’s disease lesion treatment practical and effective
Loss of sweating and hair growth Lepromin Test – determines susceptibility to preventive measure
-an ancient Thickened and painful nerves leprosy against leprosy
disease and is a Muscle weakness or paralysis or
leading cause of extremities Treatment: Good personal hygiene
permanent Pin and redness of the eyes Ambulatory chemotherapy through use of MDT
physical disability Nasal obstruction or bleeding Domiciliary treatment as embodied in RA 4073 Adequate nutrition
among the Ulcers that do not heal which advocates home treatment
communicable Health education
diseases Late Signs: PAUCIBACILLARY (tuberculoid and
Madarosis indeterminate); noninfectious type Major activity of leprosy
Loss of eyebrows Duration of treatment: 6 to 9 months control program:
Inability to close eyelids Procedure: casefinding and treatment
(lagophthalmos) Supervised: Rifampicin and Dapsone once a month with effective drugs
Clawing of fingers and toes on the health center supervised by the rural health
Contractures midwife Prevent deformities by
Chronic ulcers Self-administered: Dapsone (side effect: itchiness of self-care, exercise, and
MDT Facts: Sinking of the nosebridge the skin) everyday at the client’s house physical therapy.
It reduces communicability period of leprosy Enlargement of the breast
in 4-6 weeks time. (gynecomastia) MULTIBACILLARY (lepromatous and
It prevents development of resistance to borderline); infectious type
drugs. Duration of treatment: 24-30 months
It shortens the duration of treatment. Procedure:
20 Communicable Disease Nursing
3. Scabies Sarcoptes scabiei Direct contact with Itching Diagnosis: Personal hygiene
- An itch mite infected individuals Appearance of the lesion Avoid playing with dogs
parasite When secondarily infected: Intense itching Laundry all clothes and
Incubation Skin feels hot and burning Finding of causative mite iron
Period: Maintain the house clean
24 hours When large and severe: fever, Treatment: (limited entirely to the skin) Environmental sanitation
headache, and malaise Examine the whole family before undertaking Eat the right kind of food
treatment Regular changing of clean
Benzyl benzoate emulsion (Burroughs, Welcome) – clothing, beddings and
cleaner to use and has more rapid effect towels
Kwell ointment
4. Pediculosis Pediculosis Direct contact Itchiness of the scalp Kwell shampoo Proper hygiene
Capitis (head lice)
Other name: Corporis (body lice) Common in school One tbsp water + one tbsp vinegar
Phthipiasis Pubis (crab lice) age
MODE OF PATHOGNOMONIC
DISEASE CAUSATIVE AGENT MANAGEMENT/TREATMENT PREVENTION
TRANSMISSION SIGN
1. Ascariasis Ascaris lumbricoides Fecal-oral route Pot-bellied Diagnostic Test: Fecalysis Proper handwahing
Voracious eater
Other names: (nematode) 5 Fs: Finger, Foods, Thin extremities Treatment:
Roundworm Feces, Flies, Fomites Antihelminthic: Mebendazole / Pyrantel Pamoate
Giant worms
2. Taeniasis Taenia solium – pork Eating inadequately Muscle soreness Diagnostic Test: Fecalysis Proper handwahing
Taenia saginata – beef cooked pork or beef Scleral hemorrhage
Other name: Dyphyllobotruim latum – Treatment: Cook pork and beef
Tape worm fish 5 Fs: Finger, Foods, Antihelminthic: Mebendazole / Pyrantel Pamoate adequately
Feces, Flies, Fomites
3. Capillariasis Trichuris trichuria Eating inadequately Abdominal pain Diagnostic Test: Fecalysis Proper handwahing
cooked seafood Diarrhea
Other name: Capillararia borborygmi Treatment: Cook seafoods adequately
Whip worm Philippinensis 5 Fs: Finger, Foods, Antihelminthic: Mebendazole / Pyrantel pamoate
Feces, Flies, Fomites
4. Enterobiasis Enterobium vermicularis Inhalation of ova Nocturnal anal itchiness Diagnostic Test: Fecalysis / tape test Proper handwahing
Toilet seat
22 Communicable Disease Nursing
MODE OF PATHOGNOMONIC
DISEASE CAUSATIVE AGENT MANAGEMENT/TREATMENT PREVENTION
TRANSMISSION SIGN
1. Pneumonia Bacteria: Droplet Rusty sputum Diagnosis: Avoid mode of
Pneumococcus, Fever and chills Based on signs and symptoms transmission
Types: streptococcus Incubation Period: Chest pain Dull percussion on affected lung
a. Community pneumoniae, 2 – 3 days Chest indrawing Sputum examination – confirmatory Build resistance
Acquired staphylococcus aureus, Rhinitis/common cold Chest x-ray
Pneumonia (CAP) Klebsiella pneumonia Productive cough Turn to sides
b. Hospital / (Friedlander’s bacilli) Fast respiration Management:
Nosocomial Vomiting at times Bedrest Proper care of influenza
c. Atypical Virus: Convulsions may occur Adequate salt, fluid, calorie, and vitamin intake cases
Haemophilus influenzae Flushed face Tepid sponge bath for fever
Dilated pupils Frequent turning from side to side
Fungi: Pneumonocystis Highly colored urine with Antibiotics based on CARI of the DOH
carinii pneumonia reduced chlorides and
increased urates Oxygen inhalation
Suctioning
Expectorants / mucolytics
Bronchodilators
Oral/IV fluids
CPT
2. Mumps Mumps virus, a member Direct contact Painful swelling in front Supportive and symptomatic MMR vaccine
of family of the ear, angle of the
Other name: Paramyxoviridae Source of infection: jaws and down the neck Sedatives – to relieve pain from orchitis Isolate mumps cases
23 Communicable Disease Nursing
crystallization
C. Symptoms of menigeal Anti-inflammatory (Dexamethasone) – to relieve
irritation cerebral edema
- nuchal rigidity (stiff Antimicrobial (Penicillin)
neck) – earliest sign Anticonvulsany (Diazepam / Valium)
- Kernig’s sign – when
knees are flexed, it cannot
be extended Complications:
- Brudzinski signs – pain Hydrocephalus
on neck flexion with Deafness (Refer the child for audiology testing)
automatoc flexion of the and mutism
knees Blindness
- convulsion
- poker soine (poker face /
flat affect)
- Increased ICP
(Cushing’s triad:
hypertension,
bradycardia, bradypnea)
and widening pulse
pressure