Communicable Diseases  Antiseptic alcohol 

human skin
Stages of Illness
1. Incubation 3. Mode of Exit
 Entry of microorganism to onset of the  Respiratory via coughing, sneezing, talking
S/S o Most common
 Is varied  GIT via oral-fecal route
 Will depend on the immunity of the client  GUT via urine
 Skin via open wounds such as lacerations,
2. Prodromal period bites
 General S/S  Reproductive via secretions
o Body malaise  How to break:
o Loss of appetite o Handwashing
o Fever
o headache 4. Mode of Transmission
 Not specific to the condition itself  Weakest link of the chain
 “Constitutional S/S”  Vertical transmission
o Mother to child, most common
3. Illness stage during pregnancy
 Pathognomonic S/S  Horizontal transmission
 Appearance of hall mark signs o Direct contact: actual contact
 Classical S/S o Indirect contact: through
 Pneumonia  rusty sputum linens/used instruments
 Diphtheria  pseudo membranes o Droplets: close spray; LESS
THAN 3 FT AWAY
4. Convalescent/Recovery  Meningitis
o Airborne: GREATER THAN 3 FT
AWAT
Chain of infection  Microorganisms have the
 Nurse’s role  break the chain capacity to be carried by
the air waves and currency
1. Agent  PTB
 Property of your microorganism o Vector: animals, such as
 Bacteria, virus, fungi, helminthics mosquitos, rats, snails
 How to break:  Dengue
o Proper identification of microorganism o Vehicle route: food, water
through Culture and Sensitivity  How to break:
o Institute specific precautions per
2. Reservoir disease
 Place of nourishment, growth, and o Airborne, droplet precautions
multiplication o Isolation
 Majority in the alkaline environment o Quarantine
o Sugar-like
 Inanimate objects, such as used towels 5. Mode of Entry
 Humans  Same as mode of exit
o Clinical: Symptomatic
o Carrier: Asymptomatic but positive 6. Susceptible host
for microorganism, present inside  With lowered immune defenses
o Contact: with close association  Y: young  immune
o Suspect: exposed but waiting for  O: old  weak defenses, 60 years old and
diagnosis and manifests some S/S above
 How to break:  W: weak, with immunosuppression 
o Environmental sanitation cancer, chemotherapy
o Sterilization and disinfection process  How to break:
 Sterilization  killing of all o Vaccination
microorganisms, including o Nutrition
spores via autoclaving o Rest/Sleeping pattern
 Disinfection  except spores,  Not more than 10 hours
such as chlorine, alcohol o Exercise
 Disinfectant alcohol  Moderate, walking
 inanimate objects  30 minutes accumulation
 o Antitoxins
Common Communicable Diseases o 2-3 months immunity
1. Poliomyelitis
 NOT hereditary 2. Meningitis
 Infection in the lower motor neurons  Inflammation of the meninges of the
o Paresis: weakness brain and spinal cord
o Paralysis: loss of function  CA: Neisseria meningitides
 Spasms are common  For children below 5 years old, CA is
 CA: poliovirus Haemophilus influenza B
o Enterovirus: lives in GIT o Prevention: Hib vaccine
 MOT: oral-fecal route  Prevention for children above 5 years old:
 Types Penta vaccine
o Abortive  no CNS involvement  MOT:
 positive headache o Droplets
 fever  Signs of meningeal irritation:
 sore throat o Nuchal rigidity
 there is recovery within 72 o Brudzinski sign
hours  Upon flexion of neck,
o Pre-paralytic  slight CNS there is involuntary
involvement flexion of hips
 Positive pain manifested by o Kernig’s sign
muscle spasm  Position is Supine knees
 Positive transient paresis flexed and no pain, but
o Paralytic  total CNS involvement when you extend, there is
 Asymmetric lower extremity pain
paralysis o Positive opisthotonos  arching of
 Positive urine retention and back
constipation o Alternation of LOC  lethargic
 Diagnostic test: Pandy’s test o Restlessness, inconsolable crying
o Increased protein (CHON) in the CSF  earliest sign
o Through lumbar puncture o Signs of increasing ICP
 No cure  o If untreated, seizures
 Nursing care considerations:  Diagnostic test
o Emotional support, allow parents to o Lumbar puncture with CSF
verbalize feelings; catharsis analysis
o Educate parents about the disease  Invasive procedure,
o Enteric isolation  proper disposal of therefore we need an
wastes informed consent
o Moist, hot packs for spasms  Ensure empty bladder
o Firm bed  Knee chest, fetal, shrimp,
o Promote comfort C position
o Reposition every 2 hours  Site: L4-L5, subarachnoid
o Monitor respiratory function, consult space
the doctor if DoB  Site can also be L3-L5 if
o Exercise, passive or active ROM L4 is not in the choices
 Prevention o Post lumbar puncture:
o Vaccines  OPV  Position: flat on bed to
apply pressure
Types of Immunity  Position should be prone
 Natural active for 30-60 minutes, the
o Experienced the disease process supine for 6 hours after
o Lifetime protection  Prevent spinal headache by
 Natural passive increasing oral fluids
o Via breastfeeding  Results
o 6 months-12 months immunity o Bacterial
 Artificial active  Cloudy CSF
o Toxoid vaccines, weakened or  Increasing protein
attenuated vaccines  Decreased glucose
o 10-15 years immunity o Viral
 Artificial passive  Clear CSF, as if like there
o Immunoglobulins is no problem
  Increasing protein
 Normal glucose  because
there is no bacteria that
is eating the glucose
 Nursing considerations
o Medications
 DOC: Penicillin G
 Dexamethasone: can cross
the brain barrier
 Osmotic diuretic: mannitol
 Anticonvulsant
Phenytoin (Dilantin)
 SE: gingival
hyperplasia
 Avoid irritants
such as alcohol,
acidic juices and
fruits, spicy foods,
too hot or too cold
foods or drinks
 Use soft bristled
brush
o Chemoprophylactic agents
 Ciprofloxacin
 Rifampicin
 Give before care for
patient
o Respiratory isolation  24-72
hours after initiation
antibiotics
o Droplet precautions
 Placarding
 Use of mask
 Distance: greater than 3
ft away
o Seizure precaution
 Avoid bright/glaring lights
 Raise side rails of the bed
 No loud noises
 No bangings
 Safety is the
important DURING
 Airway is most important
AFTER
o Proper disposal of secretions
o Prevention: Hib vaccines and Penta
vaccines
3. Tetanus
 Acute infection of CNS with prominent
systematic neuromuscular effects
 CA: Clostridium tetani
 MOT: open wounds or used unsterilized
instruments
 Upon penetration, there are 2 toxins
o Tetanospasmin
 spasms and stiffness of
voluntary muscles
 locked jaw
 sardonic grin
 opisthotonos  arching of
back
 sensitive to light, noise, and
environment
 laryngeal and pharyngeal
spasms  MEDICAL
EMERGENCY bc total airway
destruction, there must be be
the TRACHEOSTOMY SET at
the bedside
DOC: o Tetanolysin
 RBC destruction
 Anemia (s/s)
 Nursing care considerations
o Medications
 DOC: Penicillin G
o Neutralize the toxins by Tetanus
immunoglobulins (Tig)
o Control spasms
 Diazepam  SE: addiction,
hypnosis, anticholinergic
effects
o Respi support
 Ensure patent airway
o Provide a non-stimulating environment
 Semi-dark, quiet, room
 Avoid sudden stimulus
 Wound care
of  Use of sterilized instruments
 Preventions:
o Tetanus toxoid vaccine  IM, deltoid
region, 0.5 mL
4. Rabies
 Fatal
 Acute viral infection of CNS
 Rhabdovirus
o bullet-shaped virus
o High affinity with CNS
o Killed by direct sunlight or formalin
most o Resistant to antibiotics
 MOT: bite of an infected animal
 S/S through stages
o Invasive/Prodromal stage
 Pain (burning) at bite site
 Fever, Anorexia
 Pain at different parts of your
body
o Excitement stage
 Nuchal rigidity
 Involuntary twitching
 Profuse drooling of saliva
 Severe and painful muscle
spasms
 Hydrophobia and Aerophobia
 Generalized seizure
o Paralytic
 Unconscious progressive
paralysis
 Respiratory failure
 Diagnostic
 o Assess the status of biting animal   Colic/gaseous distention of
changes of behavior and observe for the abdomen
14 days. DO NOT KILL ANIMAL  Watery diarrhea and foul-
o Assess the location and extent of bite smelling stools
 Is it near the brain?  Blood streak mucus
 Examination o Chronic amoebic dysentery
o Brain biopsy  to assess Negri bodies  Anorexia
of the dog when it dies at the vet  Weight loss
o Virus culture  confirmatory test  Wasting
 According to AO 2009-27 (Revised  Diagnostic test
Management of Bite Victims) o Sigmoidoscopy
o There must be a local wound care  Scattered ulcerations with
 wash the wound with soap and water yellowish and erythematous
for 10 minutes, then apply antiseptic, DO borders of colon
NOT COVER WOUND bc direct sunlight o Blood exam
kills the virus  Leukocytosis  ongoing
 but if the bite is an AVULSION, then infection
cover the wound bc it poses a risk for o Stool exam
infection  White and yellow pus with
o Category of exposure plenty of amoeba
 Category 1: licking by animals  Nursing care considerations
 intact skin o DOC: Metronidazole
 Category 2: minor o Can also give tetracycline,
scratches/abrasions  sulfadoxine, streptomycin
VACCINE + observe the dog o Enteric precaution
 Category 3: bite  Rig + o Handwashing  before and after use
VACCINE + dog observation of toilet
 Active vaccines o Boil drinking water
o Purified vero cell rabies vaccine o Avoid washing foods with water from
(Verorab) open drums
o Purified chick embryo cell vaccine o Cover leftovers
(Rabipur) o Avoid eating uncooked foods
 Passive vaccines o Mouth care
o Hrig  human rabies immunoglobulin o Keep the client warm
o Erig  equine rabies immunoglobulin o Force fluids if SEVERE
 Post-exposure prophylaxis guidelines DEHYDRATION
o NO CONTRAINDICATION TO o FLY control
RABIES
o Nursing care: 2. Cholera
 Dim lit room  Acute bacterial infection characterized by:
 Quiet environment o Profuse diarrhea
 IVF  wrap the tubing o Vomiting
o Emotional support o Massive loss of fluids and electrolytes
o Be a responsible pet owner  S/S:
o Rice, watery stools with inoffensive
Common GIT d/o odor, slightly fishy
o Acute, profuse, watery diarrhea
1. Amoebiasis o NO TENESMUS
 Protozoan infection of the colon o Washer woman’s hands  sign of
 CA: Entamoeba histolytica severe dehydration
 Source: human waste o Sighs of hypovolemic shock
 MOT: o Electrolyte imbalance
o Oral-fecal route  Nursing care considerations
o Ingestion of uncooked o Treatment modalities
veggies/contaminated foods  IVF  severe dehydration
 S/S:  ORS/Oresol
o Acute amoebic dysentery  Oresol  1 pack of
 Slight attacks of diarrhea ORS and then pour in
with periods of constipation clean water for 24
 Positive tenesmus  intestinal hours
cramping
  ORS bought
pharmacies
 Antibiotics  DOC:
Tetracycline, if no
Tetra,
Cotrimoxazole
 Chloramphenicol
o Maintain and fluid electrolyte balance
o Enteric precaution
o Sanitary disposal of human wastes
o Food safety
o Personal hygiene
3. Typhoid fever
 Bacterial infection affecting your Peyer’s
patches
o Lymphoid tissues of small intestines
 CA: Salmonella typhi or typosa
 MOT:
o Oral-fecal route
o Ingestion of contaminated foods
 S/S:
o Continuous, ladder-like fever
o Rose spots in your abdomen
o Anorexia, weight loss
 Diagnostic
o Typhidot: confirmatory test
o Rectal swab
 Nursing care considerations:
o DOC: Chloramphenicol
o Ampicillin/Amoxicillin
o Cotrimoxazole  readily available in
BHC
o Maintain an enteric isolation
o Sanitary disposal of waste products
o Provision of your safe drinking water
o All food handlers must have a food
certificate signed by municipal/city
health officer
o Handwashing or personal hygiene
4. Chicken pox
 Acute, highly communicable/contagious viral
disease
 CA: Varicella zoster/Herpesvirus
 Humans = only source of infection
 MOT: airborne
 S/S through stages:
o Pre-eruptive stage
 Mild fever
 Body malaise
o Eruptive stage
 Rashes, starting from
trunk/unexposed areas to the
exposed areas/extremities
 Vesicular lesions that are
pruritic
 Stinging pain if person pricked
the vesicles
 Nursing considerations:
from o Reduce the number of vesicular
lesions through acyclovir (Zovirax)
and take it within 24 hours after the
eruption of the vesicles
give o Reduce pruritus by giving
antihistamines or calamine lotion, and
oatmeal bath
Other diseases
1. Measles or Rubeola
 Acute contagious
 Most common and serious in childhood
diseases
 CA: filterable paramyxoviridae/rubeolavirus
 Will give you immunity
 MOT:
o Airborne
o Indirect contact with respiratory
discharges
 S/S through stages:
o Pre-eruptive stage
 Fever
 Rhinitis
 Conjunctivitis
 Common colds
 Kolpik spots 
pathognomonic/hall mark sign
of measles found in the
BUCCAL CAVITY
 Stimson’s lime or eye  red
lining on the lower conjunctiva
o Eruptive stage
 Maculopapular rashes first
seen in the cheeks to the
bridge of the nose to the
earlobes and along the hairline
 spread now towards the
trunk and extremities
 Dark red or purplish-
blue in color
 Slight yellow-brown
 HIGH FEVER (on and off)
 Sore throat
o Convalescent stage
 Recovery
 Fading of rashes
 Fever subsides
 Restoration of appetite
 Treatment modalities
o Vitamin A  help prevent eye damage
 Severe measles  pus draining
from eye
o Antipyretics
o Supportive therapy  IVF and oxygen
therapy
o Provide semi-dark room
o Skin care  cleansing bath with warm
water
o Saline solution to eyes  warm saline,
to reduce eye irritation
 o Prevent spread of infection   Low flying
respiratory isolation  Stagnant waters
o Proper disposal of waste  Common in urban areas
products/secretions  S/S:
o Prevention: Measles vaccine o Fever of 39-40 degrees Celsius
accompanied by headache
2. German Measles o Rashes
 CA: Rubella virus o Positive abdominal pain
 MOT: airborne-droplet o Vomiting
 S/S through stages: o Cold clammy extremities
o Prodromal period o If untreated, signs of shock
 Low grade fever o Positive tourniquet test  probability
 Headache test only
 Conjunctivitis  Diagnostics
o Eruptive o Tourniquet test
 Forscheimmer spots are found  20 or more
in the soft palate, pinkish rash  20 petechial rashes inside 2.5
 Male  testicular pain cm2 or 1 sq inch
 Nursing care:  Inflame on the upper arm and
o Symptomatic treatment rashes will appear on the lower
o Same with measles arm
 Just a probability test
3. Scabies o Platelet count
 Positive infestation of the skin o Dengue test kit
 CA: Sarcoptes scabie  burrowing action  Classifications
mostly at night time o Grade 1
 MOT:  Fever
o direct contact  General s/s
o sleeping in infested bed  Positive tourniquet test
 S/S: o Grade 2
o Skin irritation  Positive tourniquet test
o Formation of vesicles and pustules  Spontaneous bleeding of gums,
o Thin, pencil like marks in the skin nose, GIT
o Night itching  rashes and abrasions o Grade 3
 Nursing care:  Grade 2 +
o Pediculicide  permethrin cream or  Circulatory failure  weak
lindane lotion pulse, narrow pulse pressure,
 Leave for 10-12 hours hypotension, cold clammy
 Neck to entire body extremities and. Restlessness
 Do not take a bath for 8-12  Signs of shock
hours o Grade 4
o Neosporin ointment  Profound shock
o Antihistamine  Undetectable BP and pulse
o Dry clean and boil items/clothing  Nursing considerations
o If 1 family member is affected, apply o Analgesics
same treatment to all members o IVF  replacement of plasma
o Report skin irritation o Prepare for blood transfusion
o Handwashing o No isolation
o Mosquito-free environment
4. Dengue o Bed rest
 Acute, febrile disease o Diet
 CA: denguevirus 1,2,3,4  parasite of  no choco-colored/dark foods
platelets  no iron
 After acquiring it 4 times, you are totally o No aspirin bc it is an anti-platelet
immune o No invasive procedures
 All ages affected but common in children o No rectal manipulation if too much
 MOT: bleeding
o Bite of aedes aegypti DOH Programs
 Day biting  2 hours within  ABKD program
sunrise and 2 hours before o Aksyon barangay kontra dengue
sunset o 4 oclock habit
 o Replacement of water in our vases o Monitor neurologic toxicity for
o Cleaning of roof gutters clients taking quinine as manifested
o Avoid hanging too many clothes by muscle twitching, confusion,
 Operation Kaya-Kulob (Upside Down) convulsions, coma
o All bottles must be placed upside o Watch our for abnormal bleeding
down o Zooprophylaxis 
o Glasses, vases o Stream cleaning
 4S o Stream seeding  larva eating fish
o Search and destroy of breeding (mosquito fish)
places o Avoid going outdoors
o Seek early consultation o Rest  signs of anemia brought about
 Fever of 39 celsius, on and off by the destruction of the RBC
o Self-protective measures
 Lotion (off lotion) Common Respiratory diseases
 Mosquito net 1. Diphtheria
o Say yes to fogging (outbreak)  Acute bacterial infection of respiratory tract
 Say no to indiscriminate  CA: Corynebacterium diphtheriae or Klebs-
fogging Loeffler bacillus
 MOT:
5. Malaria o Droplets
 Parasitic infection  Types
 CA: plasmodium  parasite of RBC o Nasal
 MOT:  Bloody discharges from the
o Bite of infected female anopheles nose
mosquito  Excoriation of nares and upper
o Night biting  9 pm-3am lips
o Breeds in clear, running streams of o Tonsillo-pharyngeal
water, and shaded  Low grade fever
o Brown in color  Sore thoat
o Does not bite a person in motion  Presence of pseudo
 S/S: membranes  hall mark sign
o Shaking chills  Bull neck appearance  due to
o Profuse sweating air trapping
o Spleen (storage of RBC)  liver (bc o Laryngeal
highly vascular)  Hoarseness of the voice
o Hot  fever  Croupy cough
o Cold  chills  If untreated, there is now
o Wet  profuse sweating aphonia
 Diagnostic  Suffocation  death
o Malarial smear  Nursing care:
 Blood is put in the film and is o Erythromycin
stained o Penicillin
o RDT o Diphtheria anti-toxin
 Rapid diagnostic test  Will need skin testing
 Blood test for malaria  Neutralize toxin
 Nursing care o Supportive therapy
o Chloroquine  Nutrition is soft to liquid diet
 SE: itchiness  Do NOT eat solid food bc it
 Other countries DOC will cause obstruction 
o Quinine  SEVERE MALARIA with suffocate and aspiration
positive bleeding  Bed rest
o Sulfadoxine  Laryngeal obstruction 
o Primoquine  for relapses tracheostomy at bed side
o DOC: Artemether-Lumefrantine (Co- o Isolation
artem)  only in the PH setting  14 days until 2-3 cultures are
 Promote absorption of this negative
drug, diet must be HIGH FAT o Ice collar
o Erythrocyte exchange transfusion o For pseudomembrane, do not peel off
o Blood transfusion bc it will cause bleeding
o Monitor I/O o Proper disposal of respiratory
o Increase fluid intake secretions
 o Prevention:
 DPT vaccine
 0.5 ml
 IM vastus lateralis
 6-10-14 weeks interval

2. Pertussis
 Infectious disease characterized by repeated
attacks of spasmodic/whooping cough
 CA: Bordetella pertussis
 MOT:
o Droplet
 S/S through stages
o Catarrhal stage
 General S/S
 HIGHLY COMMUNICABLE
STAGE
 Rhinorrhea
 Sneezing
 Lacrimation
o Paroxysmal
 Positive spasmodic/whooping
cough
 Recurrent, explosive cough
that ends with a whoop
 Increasing number of
consecutive coughs,
uncontrollable  d/t to AIR
HUNGER
 Trigger  dust
 Nose bleeding, ocular/eye
pain, abdominal pain, testicular
pain
o Convalescent
 Decreasing number of
consecutive coughs

 Nursing care
o DOC: erythromycin
o If resistant, give ampicillin
o Betamethasone  to decrease
severity and length of cough; anti-
inflammatory
o Bronchodilator
o Suction secretions at bedside
o Provide dust free environment
o Proper disposal of respiratory
secretions
o Warm bath to increase comfort
o Prevention
 DPT vaccine
o Isolate the client from onset of
illness
o Health education