Communicable Diseases

Chickenpox (Varicella)
Varicella Zoster Virus
 Clinical Manifestations: slight fever, malaise, and anorexia for 1st 24
hours, rash highly pruritic
 Distribution: centripetal, spreading to face and proximal extremities
but sparse on distal limbs and less on areas not exposed to heat

 Therapeutic Management: Supportive  Diphenhydramine or

antihistamines to relieve itching

 Nursing Management: maintain standard, airborne, and contact

precautions, administer skin care: give bath and change clothes and
linens daily, administer calamine lotion, keep child’s fingernails short
and clean, apply mittens if child scratches, remove loose crusts, teach
child to apply pressure to pruritic area rather than scratching it, avoid
use of aspirin.

Diphtheria (Corynebacterium diphtheriae)

 Clinical Manifestations: resembles common cold, malaise, anorexia,
sore throat, low grade fever, lymphadenitis (bulls’ neck), fever
hoarseness cough
 Therapeutic Management: Equine antitoxin IV, antibiotics (Penicillin),
complete bed rest
 Nursing Management: follow standard and droplet precautions until
two cultures are negative for Diphtheriae, administer antibiotics,
administer complete care to maintain bed rest

Erythema Infectiosum (Fifth Disease)

Human Parvovirus B19
 Clinical Manifestations: Stage 1: erythema on face, chiefly on face
(slapped face appearance) disappears by 1-4 days Stage 2:
maculopapular red spots appear, symmetrically distributed on upper
and lower extremities, rash progresses from proximal to distal Stage 3:
rash subsides but reappears if skin is irritated or traumatized
 Therapeutic Management: symptomatic and supportive: give
antipyretics and analgesics

Exanthem Subitum (Roseola Infantum)

Human Herpesvirus Type 6
 Clinical Manifestations: persistent high fever for 3-7 days in child who
appears well, bulging fontanel, discrete rose-pink macules or
 maculopapules appearing first on trunk, then spreading to neck, face,
and extremities, nonpruritic, fades on pressure lasts 1-2 days
 Therapeutic Management: antipyretics to control fever
 Nursing Care: use standard precautions, teach parents measures for
lowering temperature

Mumps
Paramyxovirus
 Clinical Manifestations: fever, headache, malaise, and anorexia for 24
hours, followed by earache that is aggravated by chewing, by third day
parotid glands enlarges and reaches maximum size accompanied by
pain and tenderness
 Therapeutic Management: symptomatic supportive analgesics for pain
and antipyretics for fever, IV fluids if needed for child who refuses to
drink
 Nursing Care Management: maintain isolation, droplet and contact
precautions, encourage rest and decreased activity, give analgesics for
pain, encourage fluids and soft, bland foods, apply hot or cold
compresses to neck

Measles (Rubeola)
 Clinical Manifestations: fever and malaise, followed in 24 hours by
coryza, cough, conjunctivitis, Koplik spots (small, irregular red spots
with a minute, bluish white center first seen on buccal mucosa), begins
as erythematous maculopapular eruption on face and gradually
spreads downward
 Therapeutic Management: bed rest during febrile period, antipyretics,
vitamin A supplementation
 Nursing Management: maintain isolation until fifth day of rash,
encourage rest, instruct parents to administer antipyretics, dim lights if
photophobia is present, use cool mist vaporizer, skin care

Pertussis (Whooping Cough)

Bordetella pertussis
 Clinical Manifestations: symptoms of upper respiratory tract infection
symptoms continue for 1-2 weeks, cough most common at night,
during paroxysms cheeks become flushed or cyanotic, eyes bulge, and
tongue protrudes, vomiting frequently follows attack- Infants (frequent
vomiting of mucus and formula or breast milk)
 Therapeutic Management: antimicrobial therapy
 Nursing Management: obtain nasopharyngeal culture, encourage oral
fluids, ensure adequate oxygenation, provide humidified oxygen
Rubella (German Measles)
Rubella Virus
 Clinical Manifestations: low grade fever, headache, malaise, anorexia,
mild conjunctivitis, coryza, sore throat, cough, lymphadenopathy, rash
first appears on face and rapidly spreads downward to neck, arms,
trunk, and legs
 Nursing Care: institute droplet precautions, administer antipyretics,
analgesics for discomfort, avoid contact with pregnant woman

Scarlet Fever
Group A B-hemolytic streptococcus
 Clinical Manifestations: abrupt high fever, increased pulse, vomiting,
headache, chills, malaise, abdominal pain, halitosis, tonsils enlarged,
white strawberry tongue for first 2 days, by 4th or 5th day red
strawberry tongue, rash appears 12 hours after prodromal signs; red
pinhead sized punctate lesions rapidly become generalized but are
absent on face
 Therapeutic Management: full course of penicillin, antipruritic
 Institute standard and droplet precaution, ensure compliance with oral
antibiotic, encourage rest, relieve discomfort of sore throat, encourage
fluids during febrile phase, discuss procedures for preventing spread of
infection (discard toothbrush, avoid sharing drinking and eating
utensils)