Microbiology and Parasitology - Lab

Module #19 Student Activity Sheet

Name: Jemimah Grace Dantes Class number:

Section:A4 Schedule: 8:00-4:00PM Date:

LESSON TITLE: POLIOMYELITIS AND RABIES Materials:

Pen, paper, index card, book, and class List
LEARNING OUTCOMES:
At the end of the lesson, the nursing student can:
1. Describe what is polio and rabies; Reference:
2. Explain the mode of transmission of polio and rabies;
3. Identify the etiologic agent of polio and rabies; Navales D., (2010). Handbook of Common
4. Enumerate the signs and symptoms of polio and rabies; and, Communicable and Infectious Diseases 3 rd
5. Outline the different nursing management of polio and rabies. Edition, Philippines: C&E Publishing Inc.

A. LESSON PREVIEW/REVIEW (5 minutes)

Instruction: Enumerate the 4 types of pneumonia and explain briefly.

1. Bacterial pneumonia
2. Viral pneumonia
3. Mycoplasma pneumonia
4. Fungal pneumonia
This is caused by bacteria, the most common of which is streptococcus pneumoniae. The
pneumonia might just affect one small area of your lung, or it may encompass all of both of your
lungs.
Responsible for about one-third of all pneumonia cases, this type is caused by various viruses,
includingflu (influenza). People may be more likely to get bacterial pneumonia if they first have
viral pneumonia. Viral pneumonia is usually not as serious as bacterial and typically goes away
more quickly.
Also known as walking pneumonia, this type is considered atypical because its symptoms and
physical signs may vary. Also, it causes a milder illness. It most often occurs in older children and
young adults.
Fungi from soil or bird droppings can cause pneumonia in people who inhale large amounts of
these organisms. One type, pneumocystis jirovecii pneumonia (PCP), generally affects people with
weak immune systems, including those with AIDS.

B.MAIN LESSON (50

minutes) Content and Skill-

Building Poliomyelitis

Poliomyelitis/ Infantile Paralysis/ Heine-Medin Disease is an acute infectious disease characterized by changes in the CNS which may
result in pathologic reflexes, muscle spasms, and paresis (slight or partial paralysis) or paralysis. It is a disease of the lower motor
neurons. There is anterior horn involvement, such as that it is named anterior poliomyelitis.

Causative Agent: Legio Debilitans (Brunhilde, Lansing, Leon)

Incubation Period: 7 – 21 days

Period of Communicability:
⎯ First three days to three months of illness

This document is the property of PHINMA EDUCATION Page 1

 Microbiology and Parasitology - Lab
Module #19 Student Activity Sheet

Name: Jemimah Grace Dantes Class number:

Section:A4 Schedule: 8:00-4:00PM Date:
⎯ Most contagious during the 1st few days of active disease

Mode of Transmission:
⎯ Virus is transmitted through person-to-person by:
⎯ Direct contact with oropharyngeal secretions and feces.

This document is the property of PHINMA EDUCATION Page 2

 Microbiology and Parasitology - Lab
Module #19 Student Activity Sheet

Name: Jemimah Grace Dantes Class number:

Section:A4 Schedule: 8:00-4:00PM Date:

⎯ Indirect through flies and contaminated water, food, utensils, and other articles.
⎯ Through carriers.

Risk factors:
⎯ 60% of patients are under 10 years-old.
⎯ Males are more prone than females.
⎯ Environmental and hygienic conditions.

Types:
1. The abortive
⎯ Does not invade the CNS
⎯ Headache and sore throat
⎯ Fever
⎯ Occasional vomiting
⎯ Low lumbar pain
⎯ Recovers within 72 hours
2. Non-paralytic
⎯ All signs of abortive type are observed.
⎯ Spasms of hamstring (thigh) muscles
⎯ Pain in the neck, back, arms, legs, and abdomen
⎯ Inability to place the head in between the knees
⎯ (+) Pandy’s test (CSF test to detect elevated levels of protein)
⎯ Transient paresis with meningeal irritation
3. Paralytic
⎯ Signs of abortive, non-paralytic are observed.
⎯ (+) Hoyne’s sign (When supine, patient’s shoulders are lifted, head falls backward.
⎯ Paralysis occurs
⎯ Less tendon reflexes
⎯ (+) Kernig’s and Brudzinski’s tests
⎯ Muscle paresis
⎯ Hypersensitivity to touch

Complications:
⎯ Respiratory failure
⎯ Circulatory collapse
⎯ Electrolyte imbalance
⎯ Bacterial infection
⎯ Urinary problems related to retention or paralysis of the urinary bladder
⎯ Abdominal distension

Diagnostic procedures:
⎯ Isolation of the virus from throat swabs
⎯ Stool culture
⎯ CSF analysis

Treatment:
⎯ Analgesic
⎯ Moist heat application
⎯ Bed rest is necessary
⎯ Paralytic polio requires rehabilitation using PT, braces, corrective shoes, and in some cases, orthopedic surgery.

This document is the property of PHINMA EDUCATION Page 3

 Microbiology and Parasitology - Lab
Module #19 Student Activity Sheet

Name: Jemimah Grace Dantes Class number:

Section:A4 Schedule: 8:00-4:00PM Date:

Management:
⎯ Enteric isolation
⎯ Perform neurologic assessment, but don’t demand any vigorous muscular activity.
⎯ Check BP regularly
⎯ Watch out for fecal impaction due to immobility.
⎯ Wash hands after every contact with the patient.
⎯ Apply hot packs on the affected limb to relieve pain and muscle shortening.
⎯ Dispose excreta and vomitus properly.
⎯ Oral care and skin care.

Prevention and Control:

⎯ OPV
⎯ Proper disposal of GIT secretions
⎯ Isolation
⎯ Standard precaution
⎯ Sanitation of the premises and proper food handling to avoid contamination by flies.

Rabies

Rabies/ Hydrophobia/ Lyssa is an acute viral infection communicated to man through saliva of infected animal.

Etiologic Agent: Rhabdovirus

Incubation period:
⎯ 10 days to 15 years in human
⎯ Incubation period depends on the following:
✔ Distance of the bite to the brain
✔ Extensiveness of the bite
✔ Species of animal
✔ Richness of the nerve supply in the area of bite
✔ Resistance of the host

Period of Communicability:
⎯ 3 to 5 days before the onset of symptoms until the entire course of illness.

Mode of Transmission:
⎯ Bite of an infected animal.
⎯ Virus is present in the saliva of an infected animal.
⎯ Direct contact of saliva to the mucous membrane.

Clinical manifestations:
Prodromal (Invasion) Phase
⎯ Characterized by fever, anorexia, malaise, sore throat, copious salivation, lacrimation, perspiration, irritability,
hyperexcitability, apprehensiveness, restlessness or drowsiness, mental depression, melancholia, and marked insomnia.
⎯ Pain at the site of the bite.
⎯ Sensitivity to light, sound, and temperature.
⎯ Anesthesia, numbness, and tingling, burning and cold sensations to the site of the bite.
⎯ Mild dysphagia.

This document is the property of PHINMA EDUCATION Page 4

 Microbiology and Parasitology - Lab
Module #19 Student Activity Sheet

Name: Jemimah Grace Dantes Class number:

Section:A4 Schedule: 8:00-4:00PM Date:

Excitement (Neurological) Phase

⎯ Characterized by marked excitation and apprehension. Terror may occur.
⎯ Delirium associated with nuchal rigidity, involuntary twitching or generalized convulsion
⎯ Exhibit maniacal behavior; eyes are fixed and glossy and skin is cold and clammy
⎯ Aerophagia
⎯ Profuse drooling
⎯ Tonic or clonic contractions of the muscles
⎯ Death from cardiac/respiratory failure
Terminal/Paralytic phase
⎯ The patient becomes quiet and unconscious
⎯ Loss of bowel and urinary control
⎯ Spasms cease and there is progressive paralysis
⎯ Tachycardia and labored irregular respirations
⎯ Death due to respiratory paralysis, circulatory collapse or heart failure.

Diagnostic test:
⎯ Virus isolation from the patient’s saliva or throat
⎯ FRA (Fluorescent rabies antibody) most definitive diagnosis
⎯ Presence of Negri bodies in the dog’s brain

Treatment:
⎯ Thoroughly wash the wounds from the bite and scratches with soap and running water for at least 3 minutes.
⎯ Check the patient’s immunization status. Give tetanus toxoid if needed.
⎯ Anti-rabies vaccine

Management:
⎯ Isolate the patient
⎯ Give emotional and spiritual support.
⎯ Prevent injury, especially during hyperactive episodes
⎯ Darken the room and provide a quiet environment.
⎯ Should not bathe the patient. No presence of running water in the room, or within the hearing distance of the patient.
⎯ Wrap the IVF to be given.
⎯ Concurrent and terminal disinfection.

Prevention and Control:

⎯ Vaccination of all dogs.
⎯ 10 to 14 days confinement of any dog that has bitten a person.
⎯ Responsible pet owner.

This document is the property of PHINMA EDUCATION Page 5

 Microbiology and Parasitology - Lab
Module #19 Student Activity Sheet

Name: Jemimah Grace Dantes Class number:

Section:A4 Schedule: 8:00-4:00PM Date:

CHECK FOR UNDERSTANDING (30 minutes)

You will answer and rationalize this by yourself. This will be recorded as your quiz. One (1) point will be given to correct answer and
another one (1) point for the correct ratio. Superimpositions or erasures in you answer/ratio is not allowed. You are given 30 minutes
for this activity:

Multiple Choice

1. The following are the three strains of polio virus EXCEPT?

a. Brunhilde
b. Lansing
c. Leon
d. Tansing
ANSWER: D
RATIO: Causative Agent: Legio Debilitans (Brunhilde, Lansing, Leon)

2. The incubation period of poliomyelitis is?

a. 7 – 35 days
b. 5 – 21 days
c. 7 – 14 days
d. 1 – 7 days
ANSWER: B
RATIO: Incubation Period: 7 – 21 days

3. The polio virus is transmitted though person-to-person by the following except:

a. Direct contact
b. Droplets
c. Indirect contact
d. Through carriers.
ANSWER: A
RATIO: Virus is transmitted through person-to-person by direct contact with oropharyngeal secretions and feces.

4. The most definitive diagnostic exam for rabies is?

a. Virus Isolation
b. Negri bodies
c. Culture and sensitivity
d. Fluorescent rabies antibody
ANSWER: D
RATIO: FRA (Fluorescent rabies antibody) most definitive diagnosis

This document is the property of PHINMA EDUCATION Page 6

 Microbiology and Parasitology - Lab
Module #19 Student Activity Sheet

Name: Jemimah Grace Dantes Class number:

Section:A4 Schedule: 8:00-4:00PM Date:

5. The following are the prevention and control for rabies. EXCEPT?
a. Vaccination of all dogs
b. Unleashing dogs
c. 10 to 14 days confinement of any dog that has bitten a person.
d. Responsible pet owner.
ANSWER: B
RATIO: Vaccination of all dogs, 10-14 days confinement of any dog that has bitten a person, an responsible owner are the following
prevention and control of rabies.

RATIONALIZATION ACTIVITY (THIS WILL BE DONE DURING THE FACE TO FACE INTERACTION)
The instructor will now rationalize the answers to the students. You can now ask questions and debate among yourselves. Write the
correct answer and correct/additional ratio in the space provided.

1. ANSWER:
RATIO:

2. ANSWER:
RATIO:

3. ANSWER:
RATIO:

4. ANSWER:
RATIO:

5. ANSWER:
RATIO:

This document is the property of PHINMA EDUCATION Page 7

 Microbiology and Parasitology - Lab
Module #19 Student Activity Sheet

Name: Jemimah Grace Dantes Class number:

Section:A4 Schedule: 8:00-4:00PM Date:

C. LESSON WRAP-UP (5 minutes)

AL Activity: CAT: 3-2-1

Instructions:
1. As an exit ticket at the end of the class period
2. Record three things you learned from the lesson.
3. Next, two things that you found interesting and that you’d like to learn more about.
4. Then, record one question you still have about the lesson.

Three things you learned:

1. Description of polio and rabies
2. The mode of transmission of polio and rabies
3. The etiologic agent of polio and rabies

Two things that you’d like to learn more about:

1. The signs and symptoms of polio and rabies
2. The different nursing management of polio and rabies

One question you still have:

1. So far, nothing

This document is the property of PHINMA EDUCATION Page 8