Blood / Vector-borne Diseases

Prevention: (CLEAN)
 C-hemically treated mosquito net
 L-arvae eating fish
 E-nvironmental sanitation
 A-nti-mosquito
 N-eem tree (oregano, eucalyptus)

Disease Agent/s Incubation Diagnostics Management / Drugs Other notes

Period
Dengue Hemorrhagic Flaviviridae (4 types) 2-7 days (+) Tourniquet Test (Rumpel-Leede Symptomatic & Symtomatic  Usual complication:
Fever Capillary-Fragility Test) Hemorrhage
Vectors  Avoid aspirins and IM
 Aedes Aegypti Clinical: injections
 Aedes Albopictus  Saddleback fever
 Culex Fatigans  Bleeding tendencies
Filiariasis Wuchereria Bancrofti & Bulgaria 8-16 months Blood smear (presence of microfiliaria) DOC: Dietylcarbamazine Citrate Two biological types
Malayi (DEC) • Nocturnal - microfilaria circulate
in peripheral blood at night (10pm
Vector: Mosquito – 2am)
• Diurnal - microfilaria circulate in
greater concentration at daytime
Leptospirosis Leptospires 4-14 days  Leptospira Agglutination Test Non-specific: Supportive and A.K.A. Weil’s Disease
symptomatic
Vector: Infected animal urine Other 2 types:
 Blood: 1st week Specific  Icteric
 CSF: 5th to the 12th day  First Choice: Doxycycline (within  Anicteric
 Urine: after the 1st week until 48 hours)
convalescent period  Alternative: Tetracycline 20-
40mg/kg/day
 Severely ill: Penicillin 50000
units/kg/day
 Critically ill: Chloramphenicol
(DOC)
Malaria Plasmodium (protozoa) 7 days or more  Malarial smear  Supportive and symptomatic A.K.A. “King of Tropical Diseases”
Types:  Quantitative Buffy Coat (QBC) –  Mainstay drug: Chloroquine
 Vivax fast result Infectious but not contagious
 Falcifarum  Travel in endemic areas
 Ovale Complications
 Malariae  Anemia
Clinical:  Encephalopathy
Vector: Female anopheles mosquito  Headache
 High-grade fever
  Fatigue
 Muscle pains
 Chills
 Dry cough
 Splenomegaly
 Nausea and vomiting
 Night sweats

CNS Disorders
Disease Agent / s Incubation Diagnostics Management / Drugs Other notes
Period
Bacterial Meningitis  N. Meningitides 2 – 10 days Clinical: Supportive and symptomatic Watch for signs of increased ICP
 H. Influenzae  Fever
 S. Pneumoniae  Altered LOC 0-2 months BP & Temp = increased
 M. Tuberculosis  Neck stiffness  E. Coli, GABHS RR & HR = decreased
 Pathologic reflexes: Kernig’s,  Ampicillin + Gentamycin Altered LOC
Primary Babinski, Brudzinski Irritability
 Blood to the meninges  Increased ICP 3 months – 5 years old N/V
 H. Influenzae, S., Pneumonia, N. Seizures
Secondary Laboratories: Meningitidis
 From other sources  Lumbar puncture  Ampicillin or Chloramphenicol
 Blood C/S
5 years or above
 S., Pneumonia, N. Meningitidis
 Penicillin or Chloramphenicol

TB meningitis

Intensive Phase
 Maintenance Phase

Fungal meningitis / Cryptococcal

meningitis
 fluconazole or amphotericin B
Meningococcemia Neisseria meningitides (gram (-) 1 – 3 days Laboratories: Supportive and symptomatic Highly contagious
 Blood Culture
MOT: Droplet or airborne  Gram stain (peripheral smear,
CSF & skin lesions)
Reservoir: human pharynx  CBC Antimicrobial
 Benzyl Penicillin 250-400000
Clinical u/kg/day
Meningococcemia  Chloramphenicol 100mg/kg/day
 Spiking fever
 Chills Chemoprophylaxis
 Arthralgia  Rifampicin 300-600mg q 12hrs x
 Rashes (hemorrhagic) 4 doses
  Ofloxacin 400mg single dose
Fulminant Meningococcemia  Ceftriaxone 125-250mg IM single
(Waterhouse Friderichsen) dose
 Septic shock
 Enlarging petecchial rash
Rabies Rhabdovirus 4 days to 19 Laboratory: Supportive and symptomatic A form of acute viral
years Fluorescent Antibody Test (FAT) encephalomyelitis
Bite or scratch of an infected animal NO TREATMENT
Clinical
Risk of developing rabies  Pain or numbness at the site of Prophylaxis
 Face bite: 60% bite
 Upper extremities: 15-40%  Hydrophobia
 Lower extremities: 10%  Aerophobia

Poliomyelitis Legio debilitans 7 – 12 days Diagnostic: Pandy’s Test Active – OPV (Sabin) and IPV (Salk)
 Brunhilde (permanent)
 Lansing and Leon (temporary) Clinical Immunity is acquired for 3 strains
Mild febrile illness  Legio Brunhilde (fatal)
Fecal oral route/droplets  Fever  Legio Lansing
 Malaise  Legio Leon
 Sore throat

Pre-paralytic stage
 Flaccid asymetrical ascending
paralysis (Landry’s sign)
 Hayne’s sign (head drop)
 Poker’s sign (opisthotonus)

Paralytic stage

Tetanus Clostridium Tetani (anaerobic 4 – 21 days Clinical Anti-toxin Toxins produced:

bacteria)  Trismus or lockjaw  Tetanus Anti-Toxin
 Risus sardonicus  Tetanus Ig Tetanospasmin
Introduced through skin abrasion  Abdominal rigidity  Neurotoxin
 Muscle spasms (generalized / Antimicrobial: Penicillin  Decreases GABA causing
localized) spasms
 Affects cranial nerves 5, 7 &
11

Tetanolysin
 Hemotoxin
 Causes anemia

HEPATO-ENTERIC DISEASES
Disease Agent/s Incubation Diagnostics Management / Drugs Other notes
Period
Schistosomiasis Schistosoma (fluke) 14 - 84 days Laboratories: Supportive and symptomatic Organs affected: liver and spleen
3 species  Fecalysis: Schistosoma eggs in
 S. Haematobium stool DOC: Praziquantel
 S. Mansoni  Rectal biopsy
 S. Japonicum (endemic in (Leyte,
Samar, Sorsogon, Mindoro, Clinical: Signs of renal and liver
Bohol) problems

Intermediate host: Oncomelania

Quadrasi (snail)
Typhoid Fever Salmonella Typhosa 1 – 3 weeks Clinical: (Weekly progression) A.K.A. Enteric Fever
 Chloramphenicol (DOC)
Carried by humans only (harbors in 1st: Step-ladder fever (Blood)  Amoxicillin
gallbladder)  Sulfonamides
2nd:  Ciprofloxacin
Fecal – oral route  Rose spot (pathognomonic)  Ceftriaxone
 Typhoid psychosis (URINE &
STOOL)
3rd
 (complications) intestinal
bleeding, perforation, peritonitis,
encephalitis,

4th: (lysis) decreasing S/SX

5th: (convalescent)
Hepatitis A Hepatitis A virus (RNA) 3 – 5 weeks Laboratories: Supportive and symptomatic A.K.A. infectious hepatitis

Fecal – oral  Anti HAV IgM – active infection  Prevention of spread – Pandemic
 Anti HAV IgG – old infection; no Immunization and Health
active disease Education
 Enteric and Universal
precautions
Hepatitis B Hepatitis B virus (DNA) 2 – 5 months Laboratory: Serology (best is  Assess LOC A.K.A. Serum hepatitis
duplication of HBV)  Bed rest
MOT:  ADEK deficiency intervention Main cause of postnecrotic
 Blood and other body fluids route  High CHO, Moderate CHON, cirrhosis and liver cancer
 Percutaneous Low fat
 Perinatal  FVE prevention
Hepatitis C Non-A, Non-B virus 2 – 6 weeks STAGES: ALL TYPES A.K.A. Post transfusion hepatitis

MOT: Stage I Health workers are at greater risk

Blood  Pre-icteric for 1-21 days
Percutaneous  Anorexia, nausea and vomiting,
Hepatitis D Dormant HBV After hepatitis B LBM, weight loss RUQ pain, fatty
infection
Hepatitis E Hepatitis A diagnosed between 20 to food intolerance, fever, chills and A.K.A. Enteric hepatitis
30 headache
Often leads to liver cancer
Fecal – oral Stage II
 Icteric for 2-6 weeks
 Jaundice, pruritus, acholic stool,
hepatomegaly

Stage III
 Pre-coma
 Ammonia level increases –
encephalopathy
 Jaundice, pruritus, weight gain,
ascites, dark-tea colored urine
(urobilirubin), S/sx of ADEK
deficiency

Stage IV
 Recovery (lifetime carrier) or
death

Eruptive Fever
Disease Agent / s Incubation Diagnostics Management / Drugs Other notes
Period
Measles Rubeola (paramyxoviridae, RNA) 7 – 14 days Clinical: Supportive and symptomatic A.K.A. 7 Day Fever, Hard Red
 Malaise Measles
MOT: droplets, airborne  Cough
*Contagious 4 days before rash and 4  Conjunctivitis Extremely contagious
days after rash  Fever
 Koplik’s spots (1-2 mm blue white Breastfed babies have 3 months
spots on red background along immunity for measles
2nd molars)
 Photophobia Complications:
Most common: otitis media
Most serious: bronchopneumonia
and encephalitis

German Measles Rubella virus, Toga virus (RNA)
MOT: droplets, transplacental
•Contagious 5 days before and 5
days after rash and probably during
catarrhal stage
10 – 21 days Clinical:
 Forschheimer’s (petecchial lesion
on buccal cavity or soft palate)
 Cervical lymphadenopathy, low
grade fever
 Oval, rose red papules about the
size of pinhead
Supportive and symptomatic A.K.A. Rotheln Disease, 3-Day
Measles
Active - rubella vaccine and MMR
Lifetime Immunity
Complications to pregnant
women:
•1st trimester: Congenital
anomalies
 •2nd trimester: Abortion
3rd Trimester: Premature delivery
Roseola Infantum Human herpes virus 6 Clinical: Supportive and symptomatic A.K.A. Exanthem Subitum, Sixth
 Spiking fever which subsides 2 - 3 disease
MOT: probably respiratory secretions days
 Face and trunk rashes appear
3 months - 4 years old (peak 6 - 24 after fever subsides
months)  Mild pharyngitis and lymph node
enlargement

Chicken Pox  Herpes zoster virus (shingles) 14-21 days Clinical: Supportive and symptomatic A.K.A. Varicella
 Varicella zoster virus (chicken
pox)  Fever  Oral acyclovir Active : Varicella vaccine
 Malaise  Tepid water and wet compresses
MOT: Respiratory route  Headache for pruritus Passive: VZIG, ZIG – given 72
* Contagious 1 day before rash and 6  Rashes  Aluminum acetate soak for VZV -96 hours
days after first crop of vesicles o Maculopapulovesicular  Potassium Permanganate within exposure
(covered areas),
o Centrifugal Lifetime Immunity
o Starts on face and trunk and
spreads to entire body
•Leaves a pitted scar (pockmark)
Small Pox Pox virus (DNA) 1 – 3 weeks Clinical: Rashes Supportive and symptomatic Last case was 1977
 Maculopapulovesiculopustular
Man to man transmission only  Centripetal
 contagious until all crusts
disappeared

Laboratory:
Paul’s Test