COMMUNICABLE DISEASES

COMMUNICABLE DISEASE o Warm baths – causes bronchodilation

Infectious – “Prolonged” contact/exposure DIPHTHERIA
Contagious – “Easily” Transmitted Incubation Period (IP): 1-5 days
Epidemiology – Study of disease condition occurrence CA: Corynebacterium Diphtheriae
(geographical area) MOT: Direct contact, Soiled article (Fomite)
 Sporadic – Rare, Few cases, Isolated Pathognomonic Sign – Pseudomembranes
Ex. Leprosy, Lime’s Disease, Elephantiasis Types of Diphtheria
 Endemic – Constant, Common Nasal – white membranes on nasal septum
Ex. Coughs, Cold, Flu Nasopharyngeal – Bull’s neck; Dangerous (closure of
 Epidemic – Outbreak - Sudden inflation in cases, airway)
more than 50% of previous case Cutaneous – yellow spots in Skin
Ex. Dengue during rainy season Medical Management:
 Pandemic – Worldwide: several countries o Penicillin
Ex. Covid-19, Tuberculosis, HIV o Diphtheria Antitoxins: Modified bacteria ->
Chain of Infection (SHARE ME) stimulates immune response
 Susceptible Host - Human o Ice collar -> decrease pain on neck area
 Agent – Causative agent (bacteria, virus, spore, o Oxygen inhalation
fungi, protozoa) o Bedrest
 Reservoir – Home of agent o WOF: Closure of airway ->Bedside Tracheostomy
 Exit Nursing Management:
 Mode of Transmission – weakest link -> o Absolute bedrest for 2 weeks
Handwashing, PPE o Avoid Valsalva maneuver -> may cause rupture of
 Entry pseudomembranes
PERTUSSIS (Whooping Cough) o Soft Diet
- Bronchoconstriction -> mucus secretions
o Vit. C -> enhance tissue repair
Incubation Period (IP): 7-14 days
Causative Agent: Bordetella Pertussis
MEASLES (Rubeola/Morbilli/Tigdas)
MOT: Droplet and Direct Contact
Measles – Rubeola
Sign and Symptoms:
German Measles – Rubella
1. Catarrhal Stage: Not full blown
Incubation Period (IP): 2 weeks
Most contagious stage
CA: Rubeola Virus
Stage of increase communicability
MOT: Airborne (>3ft) and Droplet (<3ft)
Flu-like symptoms (Cough, colds, body malaise)
Pathognomonic Sign – Koplik’s Spots: Inflammatory
2. Paroxysmal Stage:
lesions in buccal mucosa
Hallmark: Paroxysms of cough
Sign and Symptoms:
3. Convalescent Stage: (Recovery stage)
1. Pre-eruptive (Catarrhal symptoms)
Recovery and healing
- Cough, Coryza (Rhinitis), Conjunctivitis ->
Medical Management:
Photophobia (Use dark-colored glasses/large brim
o Oxygen Therapy
hats/sunvisors)
o Fluid and Electrolyte Replacement
2. Eruptive
o Erythromycin and Ampicillin (Finish duration -> to Maculopapular rash, Intermittent fever
prevent drug resistance) 3. Convalescent Stage: (Recovery stage)
o Bedrest (Hastens recovery) - Symptoms will subside
o Gammaglobulins – enhances/activates immune Medical Management:
system -> Increase immune response. o Anti-viral: IsoPRINOsine
Nursing Management: o Antibiotics: Penicillin ->with complication
o Isolate the patient o Oxygen
Isolation – Communicable Disease o IV Fluids
Reverse Isolation - Immunocompromised Nursing Management:
o Medical Asepsis o Isolation
o Suction Machine o Quiet room/dim lights (reduce stimuli)
o Sunshine – enhances metabolism o TSB (Tepid Sponge Bath) -> Dec Fever
o Fresh air – enhances oxygenation o Bed Bath
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o Increase OFI o Use mitten in children
o MMR, Anti-measles vaccine
GERMAN MEASLES (RUBELLA/3 DAY)
Incubation Period (IP): 14-21 days FILARIASIS (Elephantiasis)
CA: Rubella Virus Incubation Period (IP): up to 82 days
MOT: Airborne, Droplet, Transplacental -> congenital CA: Wuchereria bancrofti
heart defects MOT: Mosquito Bite: Aedes Poecillus
Pathognomonic Sign – Forscheimer’s spots: pink rash Pathognomonic Sign – Elephantiasis
on soft palate (Diff of swallowing) Sign and Symptoms:
Sign and Symptoms: - Elephantiasis
1. Prodromal Stage: - Headache
- Low grade fever, Mild coryza, Lymphadenopathy - Chills and fever
2. Eruptive - s/Sx of inflammation: Rubor(Redness), Calor(heat),
Forscheimers, Testicular pain, polyarthralgia Tumor(Swelling), Dolor(pain) in arms, legs and
3. Convalescent Stage: (Recovery stage) scrotum
Medical Management: Diagnostics
o Symptomatic - Circulating filarial Antigen: Finger prick
Nursing Management: Medical Management:
o Isolation o DOC: Hetrazan
o Quiet room/dim lights (reduce stimuli) o Surgery for scrotal enlargement
o Mild liquid diet (nourishing diet) o Decreased Fortified salt
o Good ventilation Nursing Management:
o MMR o Sleep under mosquito nets
o Immune serum globulin: (+) exposure o Use mosquito repellants (OFF Lotion)

CHICKENPOX (Varicella) DENGUE

- Fluid-filled pus vesicles  Dengue Fever
Incubation Period (IP): 14-21 days - A.K.A Breakbone fever, Dandy Fever, Infectious
CA: Herpesvirus varicellae Thrombocytopenic Purpura
MOT: Direct and Fomites (Highly communicable)  Dengue Hemorrhagic Fever
Sign and Symptoms: - Bleeding and Hypovolemic shock
- Rash -> unexposed part: trunk area  Dengue Shock Syndrome
- Macule -> Papule -> vesicle (fluid-filled) -> pustule - Most lethal –> profound shock
(pus-filled) -> Crust Incubation Period (IP): 3-14days (2 weeks)
- Celestial maps -> scabs -> Crust CA: Flaviviruses/Arboviruses
Medical Management: Reservoir: Mosquitoes (Aedes Aegypti), Humans
o Anti-viral: ZOverax/Acyclovir MOT: Blood Meal/Mosquito Bite
o Antihistamines Pathognomonic Sign – Herman’s Sign (Skin appears
o Calamine Lotion purple, Fragile capillaries)
o No to Salicylates ( CP + Aspirin = Reye’s Syndrome)
-> Dec blood sugar level, Inc blood acidity and Diagnostic Procedure:
ammonia o Rumpel Leed test/ Tourniquet test
o Antipyretics Criteria:
Salicylates (ASA) - 6 months or older
Antiplatelet - Fever for 3 days or more
Antipyretic - No signs of hemorrhagic fever
Analgesic - Presumptive screening test
Anti-inflammatory effect - BP cuff -> pressure midway D/S (applied to
Side effect: Bleeding elbow for about 5mins)
Nursing Management: - Count petechiae in antecubital fossa
o Respiratory Isolation until all vesicles have crusted (>10/square inch)
o Disinfect linens under sunlight/boiling o Platelet count (Decreased) - confirmatory
o Cut fingernails o Dengue Spot test – detection of IgG and IgM
antibodies to dengue virus
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o Dengue Ns1 -detection of dengue antigen - Cercum ova precipitin test - confirmatory
o Dengue Duo – Dengue Spot test + Dengue Ns1 Medical Management:
o Praziquantel for 6 months
Sign and Symptoms:
Dengue fever: Nursing Management:
- Sudden onset of fever (39-40 C), chills and o Reduce snail density
convulsions - expose to sunlight
- Frontal headache, ocular pain, myalgia, arthralgia - remove weeds
- Malaise and anorexia, Headache - Proper irrigation
- Rash: Maculopapular rash - Prevent bathing on snail infested areas
- Abdominal pain and tenderness: hepatic
Dengue Hemorrhagic fever: RABIES
- Result of 2nd dengue infection - A.K.A Lyssa/Hydrophobia
- Hemorrhagic manifestation Incubation Period (IP): 2 weeks
Epistaxis Ecchymosis CA: Rhabdovirus/Rhabdoviridae-> rhabdo(bullet) –>
Hematemesis Hematochezia (fresh) Melena (dry BBB (Blood-Brain Barrier)
blood) Herman sign Sign and Symptoms:
 Prodromal/Invasion
WHO DHF Grading Scale: - Salivation, Irritability, pain on bite site
Grade I: No shock, (+) tourniquet test  Excitement/Neurological
Grade II: GI + Spontaneous bleeding - Excitation and Apprehension
Grade III: Shock - Nuchal Rigidity, Twitching
Grade IV: Profound Shock, Unmeasurable BP - Aerophobia/Hydrophobia
Complications:  Terminal/Paralytic
- Dengue Encephalopathy -> CNS -> ALOC - Repiratory depression, Paralysis
Medical Management: Medical Management:
o Analgesics except aspirin o Tetanus Toxoid
o Blood transfusion o Anti-rabies serum/vaccine
o Oxygen Therapy Nursing Management:
o Sedatives (Anxiety and Apprehension) o Isolation
Nursing Management: o Darken the room
o Recognize Defervescence period (fever has o No water on site
subsided) -> Critical period -> rapid deterioration o IVF: wrapped securely include IV tubing
(24-48 hours) o Vaccination of all dogs
o Placed in mosquito free environment o Confine dog for 10-14 days
o Monitor V/S, Prevent Bleeding o Cut the head of the dog -> place it on ice container
o Soft & Bland diet (EDCF) > negri bodies(fluorescent test)
Tawa-tawa: Promotes cell production and prevent
platelet destruction PULMONARY TUBERCULOSIS (PTB)
CA: Mycobacterium tuberculosis
SCHISTOSOMIASIS MOT: Airborne, Droplet, Indirect (Fomites)
- A.K.A Bilharziasis/Snail Fever Pathognomonic sign: Hemoptysis
Incubation Period (IP): 14-82 days Manifestations:
CA: Schistosoma Japonicum (Phil)  Asymptomatic Initially
MOT: Ingestion of infected H20, Skin pores
Vector: Oncomelania quadrasi Classifications:
Pathognomonic Sign – Swimmer’s Itch,  Class I – No exposure, No infection
Jaundice  Class II – Exposure, No infection
Sign and Symptoms:  Class III – Infection, No disease
- Swimmer’s itch - (+) PPD but no clinical evidence of active TB
- Bloody mucoid stool  Class IV – Disease, not clinically active
- Liver problems -> Jaundice/Icteric  Class V – Suspected, Diagnosis pending
Diagnostics
 COMMUNICABLE DISEASES
Diagnostics: C Post-Transfusion
o Sputum Exam – 3 consecutive (+) result D Delta Agent
o Chest X-ray – nodules, cavities E Enteric
o Purified Protein Derivative (PPD) – Tuberculin
F Hypothetical
Test/Mantoux Test (Exposure only)
G No Human Illness
Medical Management: Multi-Drug Therapy
o Rifampicin Onset:
o Isoniazid o Acute – Hepatitis A and E
o Pyrazinamide o Chronic – Hepatitis B and C
o Ethambutol Stages:
o Streptomycin  Pre-Icteric Stage
Take on an empty stomach Fatigue Nausea, Vomiting, Anorexia
No longer contagious after 2-3 weeks of MDT and 2  Icteric Stage
(-) sputum result Jaundice, Dark urine, Acholic stool (Lack of bile)
Nursing Management:  Post-Icteric Stage
o Adequate rest
o Proper nutrition – Increase CHON, Vitamin C SEXUALLY TRANSMITTED DISEASE
SYPHYLIS
o Religious intake of medications
C.A. – Treponema Pallidum
o Semi-fowler’s Position
MOT – Intimate contact
o Primary prevention
Sources of infection:
o BCG, Public education about MOT, environmental
– Discharges, Semen, Surface lesions
sanitation
Manifestations:
Prevention of Spread
 Primary Syphilis: Chancres - painless raised lesions
o N95 mask worn by HCP
 Secondary Syphilis: Condylomata lata – pink or
o Face mask worn by patient
grayish white lesions
o Isolation  Latent syphilis: Asymptomatic
o Handwashing  Late syphilis: Gumma – deep, single, painless
o Proper disposal of secretions asymmetrical lesion
Medical Management:
DENGUE AND MALARIA o Penicillin
DENGUE MALARIA o Tetracycline
Flavivirus Plasmodium Nursing Management:
(Chikungunya and ovale, Vivax,
Causative Agent o Stress importance of continuing treatment
Onyongyong virus) Malarae,
Falciparum o Partners should be tested
Aedis Aegypti Aedis Poecilus o Universal precaution
D – ay biting N – ight biting o Keep lesion dry
L – ow flying H – igh flying
Vector GENITAL HERPES
S - tagnant F - lowing
U - rban R – ural C.A. – Herpes simplex virus
Problem Low Platelet Low RBC MOT – intimate contact
Bleeding Bleeding Manifestations:
Manifestations tendencies tendencies and o Genital sores
Anemia
o Painful sores
 Symptomatic  Symptomatic
 Platelet  Transfusion of o Fever
Transfusion RBC o Muscular pain
Management - Fresh frozen - Packed RBC o Burning sensation on urination
plasma
Medical Management: Acyclovir
- Platelet
Nursing Management: Personal hygiene
GONORRHEA
HEPATITIS
C.A. – Neisseria gonorrheae
TYPES AKA MOT
A Infectious Hepa MOT – intimate contact
Manifestations:
B Serum Hepa
Female
 COMMUNICABLE DISEASES
- Burning and frequent urination o Liver, Spleen, Kidney, Brain, Peritoneum,
- Yellow vaginal discharge Testis/ovary, Spinal cord
Males Manifestations:
- Dysuria with pus - diarrhea, abdominal pain, fever, cough, urticaria,
- Rectal infection for homosexuals hepatosplenomegaly, pulmonary abnormalities
- prostatitis Medical Management
Medical Management - Praziquantel
o Ceftriaxone Nursing Management
o Penicillin - avoid eating raw or undercooked freshwater crabs
o Infants born to mother with gonorrhea – give 1% and crayfish from endemic waters
silver nitrate
Nursing Management TAENIA SAGINATA
o All info about patient is confidential Reservoir – cattle
o Isolation MOT – fecal-oral
o Sex education Manifestations:
o Contact Tracing o Asymptomatic
CHLAMYDIA o weight loss, dizziness, abdominal pain
C.A. – Chlamydia trichomatis o Diarrhea
MOT – vaginal and rectal intercourse o Chronic indigestion
Manifestations: Medical Management
o Cervicitis - Praziquantel
o Dyspareunia - Niclosamide
o Dysuria Nursing Management
o Pyuria - avoid eating raw or undercooked cattle
o Scrotal swelling HOOKWORM
o Tenesmus Reservoir – mammales (dogs, cats)
Medical Management MOT – fecal-oral
o Doxycycline x 7 days Manifestations:
o Ground itch
o Azithromycin x 1 dose
o Epigastric pains
Nursing Management
o Universal precaution o Indigestion
o Suggest both partners submit to HIV testing o nausea
TRICHOMONIASIS o Vomiting
C.A. – Trichomonas vaginalis o constipation
MOT – STD o diarrhea
Manifestations: Medical Management
o Cervicitis - Albendazole
o Vaginitis - Iron, folic acid, Vit B12 – for anemia
o Urethritis Nursing Management
o Dyspareunia - sanitation
o Dysuria
Medical Management: Metronidazole
Nursing Management
o Universal precaution
o Practicing safe sex

PARASITISMS
PARAGONIMIASIS
C.A. – Lung fluke – Paragonimus westermani
Reservoir - seafoods
MOT – fecal-oral
o Eggs may circulate to following sites: