1.

Dengue
• Mosquito-borne viral infection
• CA: Dengue Virus with 4
serotypes (DENV 1-4)
• Vector: Female Aedes aegypti
• AKA Yellow fever mosquito or
tiger mosquito
• MOT: Bite of mosquito
• Incubation period: 3-14 days,
commonly 5-7days
 Diagnostic tests
1. Tourniquet Test or Rumpel-Leads test
✓ Measures the coagulability of the blood by applying
tourniquet on a client’s extremity and observing the
amount of petechiae produced
✓ Contraindication: With fistula, arteriovenous shunt or
undergone mastectomy
✓ Procedure:
▪ Place sphygmomanometer on the upper arm
▪ Inflate the BP cuff to a point midway between
systolic and diastolic pressure for 5 minutes
▪ Release the cuff and make an imaginary 1-inch
(2.5cm) square just below the cuff at the
antecubital fossa
▪ Inspect and count the number of petechiae in a 1-
inch (2.5 cm ) square
✓Interpretation:
✓(+) more than 20 petechiae
2. Capillary refill Test or Nail Blanch Test
✓ Capillary refill at which the blood refills empty capillary
✓ It measures dehydration and decreased peripheral
perfusion
✓ Procedure:
▪ Hold the hand higher than the heart-level
▪ Press the soft pad until it turns white or blanching
occurs
▪ Release the pressure
▪ Measure the time needed for the color to return or
once pressure released
✓Interpretation:
▪ (N) less than 3 seconds
▪ More than 3 seconds-warning sign
3. Platelet count and hematocrit count
✓ Confirmatory test for dengue
✓ Normal platelet count: 150k-400k cu.mm
✓ Normal hematocrit: F= 36-46 % and M=41-53%
4. Hemagglutination-inhibition (HI) Test
✓ Test required paired sera
✓ Based on the ability of dengue virus antibodies to
inhibit agglutination
5. Dengue NS1 Kit
✓Rapid detection of Dengue antigen by dropping
blood samples on a cartridge similar to a pregnancy
test kit
✓It is requested in 1-5 days of illness
 Classification
1. Dengue without warning
2. Dengue with warning signs
3. Severe dengue
 Management
• Give paracetamol every 4-6 hours. TSB if necessary
• Do not give Aspirin (Acetylsalicylic acid), ibuprofen,
or any NSAID’s
• Increase fluid intake
• Avoid dark-colored foods that can mask bleeding
• For nose bleeding, maintain an elevated position
and apply a cold compress to promote
vasoconstriction
• In cases of shock place the client on dorsal
recumbent to promote circulation
 2. Malaria
• CA: Plasmodium
Falcifarum, vivax, ovale,
malariae (Protozoa)
• MOT: Vector: Female
anopheles Mosquito
• Incubation: 7days or
longer
• World Malaria Report: as
of 2020(November) 229
million cases
Signs and symptoms

Recurrent fever preceded by chills and profuse sweating

Body malaise

Anemia
 Laboratory/Diagnostic Exam
✓Hx of having been in a malaria-endemic area:
Palawan and Mindoro
✓Blood smear
 Treatment
1. Chloroquine phosphate 250 mg-all species
except for P. Malariae
2. Sulfadoxine 50 mg- for resistant P. Falciparum
3. Primaquine-for relapse P. vivax and P. ovale
4. Pyrimethamine 25 mg/tab
5. Quinine sulfate 300mg/tab
6. Tetracycline HCL 250 mg/cap
7. Quinidine sulfate 200mg/durules
 3. Filariasis
• CA: Wuchereria bancrofti,
Brugia malayi and Brugia
timori
• MOT: Bite of mosquito
• Incubation period: 8-
16months
• Vector: Aedes poecilus,
Culexquinquefasciatus
 Signs and Symptoms
✓ Acute stage
✓ filarial fever and lymphatic inflammation tha occurs
frequently as 10 times per year and usually abates
spontaneously after 7 days
✓ Lymphadenitis (Inflammation of the lymph nodes)
✓ Lymphangitis (Inflammation of the lymph vessels)
✓ Chronic Stage (10-15 years from the onset of the first
attack)
✓ Hydrocele (Swelling of the Scutum)
✓ Lymphedema (Temporary swelling of the upper and lower
extremities)
✓ Elephantiasis (enlargement and thickening of the skin of
the lower or upper extremities)
 Laboratory/Diagnostic
✓Circulating filarial Antigen (DFA)-finger prick

Treatment
✓Diethylcarbamazine citrate (Hetrazan)

Prevention and Control

✓Eradication of vectors
 1. Typhoid fever
• CA: Salmonella Typhosa
• MOT: Ingestion of
contaminated food or
water with feces or urine
of infected individuals
• Incubation: 7-14 days
• Fecal-oral-route
 Signs and Symptoms
Headache Ladder-like Fever Recovery
1. Prodromal

2. Fastigial

4. Convalescence
3. Defervescence
Fever curve gradually stage
temperature subsides
Anorexia
Rose spots Onset of
Lethargy on trunks complication
Diarrhea Spleenomeg s
Vomiting aly Hemorrhage
Abdominal peritonitis
pain
 Prevention
Treatment
and Control
• Chloramphenicol • Sanitary disposal of
• broad spectrum feces
antibiotic that is
effective against a • Handwashing
variety of susceptible • Avoid 5F’s
and serious bacterial • Feces, fomites,
infections but is not flies,food,fluids that
frequently used because carry the infection
of its high risk of bone
marrow toxicity. • Immunization with
typhoid vaccine
 2. Dysentery
• CA: Shigella dysenteriae
• MOT: Ingestion of
contaminated food or
water
• Incubation: 3-7 days
• Fecal-oral-route
Colicky abdominal pain with tenderness

High Grade

Diarrhea with straining

 Laboratory/ Prevention
Diagnostic and Control
• Stool Examination • Safe water supply
• Handwashing
• Nursing Care:
• Monitor intake and
Treatment output
• Observe signs of
• Co-trimoxazole,
dehydration
Chloramphenicol
• Increase fluid intake
 3. Cholera
• CA: Vibrio Cholerae (El
tor)
• MOT: Ingestion of
contaminated food or
water or milk
• Incubation: 1-3 days
• Fecal-oral-route
Signs and Symptoms

****RICE WATERY STOOL

 Laboratory/ Prevention
Diagnostic and Control
• Stool Examination • Boiling and chlorination of water
• Sanitary disposal of human waste
• Cholera vaccine with a dosage of
1.5ml at a minimum age of 12
months for 2 doses with 2 weeks
Treatment interval
• Nursing Care:
• Increase fluid intake
• Tetracycline,
• Administer oral rehydrating
Furazolidone solutions
 1. Ascariasis
• CA: Ascaris lumbricoides
(Round Worm)
• MOT: Fecal-oral
• Incubation: 8 weeks
• Laboratory/Diagnostic:
Stool examanination
 Signs and Prevention
symptoms and Control
• Abdominal pain • Proper disposal of feces
• Passing out of worms • Avoid using feces as
fertilizers
• Handwashing
Treatment • Proper washing of
vegetables before
• Mebendazole or consumption
Albendazole
 2. Enterobiasis
• CA: Enterobius
vermicularis or human
pinworm or seat
worm(Round Worm)
• MOT: Vehicle ingestion of
contaminated food
• Incubation: 4-6 hours
 Signs and Prevention
symptoms and Control
• Perineal itching- • Personal hygiene
disturbed sleep
• Nervousness • Handwashing
• irritability • Keeping fingernails short

Treatment
Laboratory
• Scotch tape swab • Mebendazole single
test in the dose repeated at 2nd
perineal region week of effectivity
 3. Ancylostosomiasis
• AKA: Hookworm infection
• CA: Ancylostoma duodenale
• MOT: Contact
• Incubation: 4-6 weeks

Laboratory
• Stool examination
 Signs and Prevention
symptoms and Control
• Dermatitis • Avoid walking
• Abdominal pain barefooted
• Anemia • Practice personal
• Mentally and physically hygiene
underdeveloped

Treatment
• Mebendazole
 4. Schistosomiasis
• AKA: Blood fluke
• CA: Shistosoma Japanicum, S.
Mansoni, S. haematobium
• Vector: Oncomelania
quadrasi (Snail)
• Incubation: 2 months
• MOT: Indirect contact
 Signs and
symptoms Treatment
• Rash at the site of
• Praziquantel (Biltricide)
inoculation
• Oxamniquine for S.
• Enlargement of the
mansoni ans S.
abdomen
haematobium
• Diarrhea
• Body weakness Diagnostic/ Laboratory
• Stool examination
 Prevention and Control
• Proper waste management
• Improve irrigation and agricultural practices
• Treat/eradicate snail-breeding sites
• Encourage annual stool exam for endemic
areas
• Use of molluscicides
 1. Rabies
• fatal but preventable
viral disease
• bitten or scratched by a
rabid animal
• CA: Rhabdovirus
• MOT: Bite of rabid animal
• Source: Saliva of an
infected animal or human
• Incubation period: 20 t0
90 days for humans
• 1 week to 7.5 months for
dogs
 Signs and Symptoms
A. Dog
▪ At first withdrawn
▪ Change in mood
▪ Shows nervousness and
apprehension
▪ Unusual salivation
▪ Paralysis starts on the hind
legs spreading toward the
entire body
▪ death
Signs and Symptoms
B. Human
• Incubation period
– flu-like symptoms
• Prodromal stage
– headache, pain, and numbness sensation at the site of the
bite, depression, penile erection, or spontaneous
ejaculation for males
• Acute neurologic phase
– Spastic – anxiety, confusion, insomnia
– Dementia – intense excitement, DOB, swallowing, drooling,
hydrophobia
– Paralytic – flaccid ascending symmetric paralysis, coma and
death
 Management
1. PEP ( Post Exposure Prophylaxis)
❖Immediate treatment of a bite victim after rabies
exposure
❖Administer anti-tetanus serum/tetanus anti-toxin and
suture if severe wounds
❖Observe the dog for 10 days, if possible for signs of
rabies
A. Recommended vaccines that provide
active immunity that is infiltrated in and
around the wound for the first dose of
vaccine
1. PVCV (Purified vero cell vaccine) = 0.1 ml
2. PDEV (Purified duck embryo vaccine) =
0.2 ml
IM-3 doses (0-7-21)
ID-4 doses (0-3-7-30)
B. Recommended immunoglobulins that
provide passive immunity administered
IM route distant from the site of vaccine
inoculation. The vaccine is given in a
single dose at Day 0 based on the weight
of an individual.
1. Equine rabies = KBW x 0.2 ml
2. Human Rabies = KBW x 0.133 ml

Administered at the deltoid

 Prevention and control
• Dog vaccination
• Avoiding dog bites
• Immunization of the people
• Pre-exposure prophylactic tx is given for high-risk
individuals like laboratory technicians and
veterinarians
• Integrated case management
❖ Veterinary must be alerted
• Responsible Pet Ownership
❖ Main responsibility of the owner:
❖ Owners are mandated to provide adequate
care and sustenance
❖ Owners are liable for the damage and harm
caused by their pets
• Training course on Rabies and Animal
Bite Management
• Disease free zone
• Post mortem review
Zero by 30
 2. Leptospirosis
• CA: Leptospira interrogans
(bacteria)
• MOT: Inoculation into broken
skin, mucous membrane or
ingestion of contaminated food
and water with urine of animals
• Source of infection: Urine of
rodents, pet animals and farm
animals
• Incubation: 7-13 days
 Signs and Symptoms
STAGES

Sepsis Immune/toxic Convalescence

• High fever • Anicteric - • Symptoms

• Calf pain Disorientation disappears
• Abdominal • Icteric - • Relapse may
pain jaundice occur 4-5th
week
 Diagnostic/
Laboratory Treatment
• Blood/Urine culture • Penicillin or
done on the 1st week Tetracyline
• Leptospira • Doxycycline
agglutination test
(LAT) done on the 2nd
to 3rd week Prevention/Control
• Eradication of rodents
• Avoid wading in flood
water
 3. Scabies
• CA: Itch mite, Sarcoptes
scabei
• MOT: Prolonged skin to skin
with infected humans or
indirect contact with
infested linens or clothing
• Incubation: 4-8 weeks
Laboratory/ Diagnostic
 Ink Test

3. Mineral oil or
Fluorescence tetracycline
test
 Treatment
• Permithin Cream or scabicide lotion

Prevention/Control
• Laundry and iron soiled clothes
• Practice personal hygiene
• Terminal disinfection
• Contact isolation/Contact precaution
 4. Anthrax
• CA: Bacillus anthacis
• MOT and signs and symptoms
1. Cutaneous (Skin) Anthrax = handling sick animals or
contaminated animal wool, hair, hides, or bone meal
products
2. Inhalation anthrax = breathing anthrax spores into
the lungs/woolsorter’s disease
3. Gastrointestinal anthrax = difficult to diagnosis
▪ It can produce sores in the mouth and throat
▪ A person who has eaten contaminated products may feel
throat pain or have difficulty swallowing
Laboratory/Diagnostic
• Gram Staining (+)

Treatment
• Formaldehyde
• Fluoroquinolones
• ciprofloxacin
Prevention/Control
• BioThrax, although it is called Anthrax Vaccine
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