Chapter 6: Dimension of Development: Health Awareness

Learning Objectives

At the end of this chapter, the learners are expected to:

1. name some common communicable and non-communicable diseases;

2. identify the causes and symptoms of these diseases; and
3. enumerate and follow the preventive measures for these diseases.

Overview

This chapter deals with some common communicable and non-communicable diseases
and their causes, symptoms, and prevention.

The triangular model of a disease has three components: agent, host, and environment.
Disease occurs when an external agent meets a susceptible host in an environment that allows the
agent and host to interact.

Communicable Diseases

Here are some common infectious diseases:

Dengue

Hawker et al. (2007) mention in their book that dengue fever is a febrile disease caused
by one of four closely related virus serotypes of the genus Flavivirus, family Flaviviridae. Each
serotype is sufficiently different that there is no cross-protection, and epidemics caused by
multiple serotypes (hyperendemicity) can occur. Dengue is transmitted to humans by the Aedes
aegypti mosquitoes that are found in the tropics.They tend to bite just after dawn and just before
sunset. However, it has been observed that they can bite and spread infection at any time of day.
Incubation period is from 3 to 15 days.

Signs and Symptoms of Dengue

Dengue is manifested by a sudden onset of high fever with severe headache and muscle
and joint pains, myalgia and arthralgia. It is also called breakbone fever or bonecrusher disease.
The patient may develop dengue rashes that are characteristically bright red petechiae. These
usually appear first on the lower limbs and chest and spread to cover most of the body. The
patient may suffer from gastritis, abdominal pain, nausea, vomiting, or diarrhea.

Mild cases of dengue, where no rash is present, can be misdiagnosed as flu or other viral
infection. Patients can pass on the infection through mosquitoes or blood products while they are
still febrile.

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Prevention of Dengue

The best way of prevention is to avoid being bitten by mosquitoes. Take note of the following
tips:

1. Use mosquito nets and insect repellent.

2. Put screens on doors and windows.
3. Refrain from going outdoors during the time of the day when mosquitoes are most active.
4. Remove stagnant water. Cover water containers and change water in flower vases
frequently.

Malaria

Malaria is a vector-borne infectious disease that is widespread in tropical and subtropical

regions, including the Philippines. It is "commonly associated with poverty but is also an effect
of poverty and a major hindrance to economic development" (Engelkirk, 2007).

Malaria, according to Engelkirk (2007) in Burton's Microbiology for the Health Sciences
is "one of the most common infectious diseases and enormous public-health problems." It is
caused by protozoan parasites of the genus Plasmodium. The most serious forms of the disease
are caused by Plasmodium falciparum and Plasmodium vivax, but other related species can also
infect humans. This group of human-pathogenic Plasmodium species is usually referred to as
malaria parasites (Hawker et al., 2007). They are transmitted by female Anopheles mosquitoes.

Signs and symptoms of Malaria

The parasites multiply within the red blood cells and cause anemia, high fever, chills,
nausea, headache, diarrhea, and in severe cases, coma and death.

Prevention of Malaria

Malaria can be prevented by avoiding mosquito bites through the use of mosquito nets
and insect repellent, spraying insecticides, and draining standing water where mosquitoes lay
their eggs.

No vaccine is currently available for malaria. Preventive drugs must be taken

continuously to reduce the risk of infection.

Cholera

Cholera is an acute intestinal infection caused by ingestion of food or water contaminated

with the bacterium Vibrio cholerae. It has a short incubation period lasting from less than one
day to five days. It also produces an enterotoxin that causes copious, painless, and watery
diarrhea that can quickly lead to severe dehydration and death if treatment is not promptly given.
Vomiting also occurs in most patients (Hawker et al., 2007).

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 The incubation period of cholera according to Hawker, et al. (2007) is from six (6) to
forty-eight (48) hours, but there are reported cases of people being infected during the period of
diarrhea and up to seven (7) days after.

Signs and Symptoms of Cholera

Aside from diarrhea, the patient may also experience nausea, vomiting, fever, and muscle
clamps.

Prevention of Cholera

Follow these precautions to reduce the risk of contracting cholera:

1. Wash hands with soap and water frequently and throughly.
2. Drink safe water only.
3. Eat food that is completely cooked.
4. Avoid raw food, street food, and any food from suspicious sources.
5. Observe proper hygiene and sanitation at all times.

Avian Influenza (Bird Flu)

Avian influenza is an infection caused by avian influenza A viruses found chiefly in

birds, but infections can occur in humans. The risk is generally low to most people because the
viruses do not usually infect humans. However, confirmed cases of human infection have been
reported since 1997. Most cases of avian influenza infection in humans could have resulted from
direct contact with infected poultry or contaminated surfaces. H5N1 is a particularly deadly
strain of bird flu that can infect humans and other mammals.

Signs and Symptoms of Avian Influenza

Symptoms of avian flu in humans include fever, cough, sore throat, and muscle aches.
Some people may also experience nausea, vomiting, pneumonia, diarrhea, and others severe and
life-threatening complications, depending on which virus has caused the infection.

Prevention of Avian Influenza

Consider these precautionary measures to prevent infection:

1. Wash hands or use alcohol-based hand sanitizer to avoid infection of all kinds.
2. Stay away from farms and live animal markets.
3. Cover mouth and nose when coughing or sneezing.
4. Cook chicken throughly. Do not eat raw eggs.
5. Avoid cross-contamination. Do not use the same utensils for both raw meat and other
kinds of food.

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H1N1

H1N1 is a flu virus that is also known as the swine flu. Scientists call the H1N1 virus a
"quadruple reassortant" virus because it contains two genes found in flu viruses which circulate
among pigs and two genes found in flu viruses which circulate among birds. The H1N1 virus is
passed from person to person just like other flu strains. But not by eating pork.

What sets the H1N1 virus apart from other seasonal flu viruses is that studies have shown
it to cause more severe symptoms in people younger than people over 60 years old have some
immunity against it.

Most cases of flu caused by H1N1 are mild. However, there have been cases of severe
complications in people with other medical conditions such as pregnancy, diabetes, heart disease,
kidney disease, and asthma.

H1N1 is a subtype of the influenza A virus and is the most common form that infects
people. Certain strains of H1N1 are endemic in the human population and cause periodic flu
outbreaks. It was an H1N1 flu virus that was responsible for the 1918 flu pandemic which killed
50 to 100 million people at the end of World War I and into 1919.

Here are important facts about swine flu

1. Swine flu is a respiratory disease caused by influenza viruses that infect the respiratory
tract of pigs and result in nasal secretions, barking cough, decreased appetite, and listless
behavior.
2. Swine flu viruses may mutate (change), so that they are easily transmissible among
humans.
3. The 2009 swine flu outbreak was due to the H1N1 virus and was first observed in
Mexico.
4. Two antiviral agents, zanamivir (Relenza) and oseltamivir (Tamiflu), have been reported
to help prevent or reduce the effects of swine flu if taken within 48 hours at the onset of
symptoms.

Signs and Symptoms of Swine Flu

Symptoms of swine flu to humans are similar to those of ordinary flu: fever, cough, sore
throat, runny or stuffy nose, body aches, headache, chills, and fatigue. Some people may
experience vomiting and diarrhea.

Prevention of H1N1

The best way to avoid influenza infections is through vaccination.

Almost all vaccines have some side effects. Common side effects of H1N1 vaccines

are typical of flu vaccines. They are as follows:

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 1. Flu shot: Soreness, redness, minor swelling at the shot site, muscle aches, low-grade
fever, and nausea. These do not usually last for more than 24 hours
2. Nasal spray: runny nose, low-grade fever, vomiting, headache, wheezing, cough, and sore
throat.

The nasal spray vaccine contains live virus that has been altered to hinder its ability to
replicate in human tissue. People with a suppressed immune system should not get vaccinated
with the nasal spray. Also most vaccines that contain flu viral particles are cultivated in eggs, so
individuals with an allergy to eggs should not get the vaccine unless tested and advised by their
doctor that they are cleared to obtain it.

Typhoid Fever

Typhoid fever, also known as typhoid, is an acute illness most often caused by the
Salmonella typhi bacteria or the Salmonella paratyphi, a related bacterium that usually leads to a
less severe infection. The bacteria are deposited in water or food by a human carrier and are then
spread to other people in the area (Hawker et al., 2007).

Typhoid is common worldwide and has received various names such as gastric fever,
abdominal typhus, infantile remittent fever, slow fever, nervous fever, or pythogenic fever. The
name typhoid means "resembling typhus" and comes from the neuropsychiatric symptoms
common to typhoid and typhus. Despite this similarity of their names, typhoid fever and typhus
are distinct diseases and are caused by different species of bacteria.

Diagnosis of typhoid fever is made when the salmonella bacteria is detected with a stool
culture. Typhoid fever is treated with antibiotics. Approximately 3 to 5 percent of patients
become carriers of the bacteria once infection becomes an acute illness.

Patients with acute illness can contaminate the surrounding water supply through stool,
which contains a high concentration of the bacteria. Contamination of the water supply can, in
turn, taint the food supply. Some patients suffer a very mild illness that goes unrecognized.
These patients can become long-term carriers of the bacteria. The bacterium multiplies in the
gallbladder, bile ducts, or liver and passes into the bowel The bacteria can survive for weeks in
water or dried sewage (Hawker et al., 2007).

Signs and Symptoms of Typhoid Fever

People with typhoid fever usually have a sustained high fever. Chest congestion develops
in many patients, and abdominal pain and discomfort are common. The fever becomes constant.
Other symptoms include poor appetite, headache, body aches, and lethargy. Improvement occurs
in the third and fourth weeks for those who do not experience complications. About 10 percent
of patients have recurrent symptoms (relapse) after feeling better for one to two weeks. Relapses
are actually more common in individuals treated with antibiotics.

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Prevention and Treatment of Typhoid Fever

Typhoid fever can be prevented by drinking safe water only, improving sanitation, and
eating well-cooked food while it is still hot. Washing the hands often and keeping the
surroundings clean will help stop the spread of infection.

Two vaccines, one injected and the other given orally, are available. These are
recommended especially to people in high-risk areas. Typhoid fever is treated with antibiotics
that kill the salmonella bacteria. Prior to the use of antibiotics, the fatality rate was 20 percent.
Death occurred from overwhelming infection, pneumonia, intestinal bleeding, or intestinal
perforation. With antibiotics and supportive care, mortality has been reduced to 1 to 2 percent.
With appropriate antibiotic therapy, there is usually improvement within one to two days and
recovery within seven to ten days.

The carrier state, which occurs in 3 to 5 percent of those infected, can be treated with
prolonged antibiotics. Often, removal of the gallbladder, the site of chronic infection, will cure
the carrier state.

Non-communicable Diseases

Here are some non-communicable but dreaded diseases:

Hypertension

Blood pressure refers to the force exerted by the circulating blood on the walls of blood
vessels. It is one of the body's vital signs. The pressure of the circulating blood decreases as
blood moves through arteries, arterioles, capillaries, and veins. Blood pressure generally refers to
arterial pressure, i.e., the pressure in the larger arteries, the arteries being the blood vessels which
take blood away from the heart.

Blood pressure consists of two numbers: the systolic pressure (when the heart beats) and
the diastolic pressure (when the heart relaxes). The systolic pressure is the number above the
diastolic pressure.

1. Normal Blood Pressure

Blood pressure reading 120/80 or lower is considered normal.

2. High Blood Pressure

Blood pressure reading 140/90 or higher is considered high. If one or both numbers are
usually high, you have high blood pressure or hypertension.

3. Low Blood Pressure

Blood pressure that is too low is known as hypotension.

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High Blood Pressure Range
Systolic pressure Diastolic pressure (mmHg) Stages of High Blood Pressure
(mmHg)
210 120 Stage 4
180 110 Stage 3
160 100 Stage 2
140 90 Stage 1

Normal Blood Pressure Range

Systolic pressure Diastolic pressure (mmHg) Stages of High Blood Pressure
(mmHg)
130 85 High Normal
120 80 Normal
110 75 Low Normal

Low Blood Pressure

Systolic pressure Diastolic pressure (mmHg) Stages of High Blood Pressure
(mmHg)
90 60 Borderline Low
60 40 Too Low
50 33 Dangerously Low

For most people who are suffering from hypertension, there is no obvious cause why
their blood pressure is high. This condition is called essential hypertension and it is especially
important that their blood pressure is kept under control.

Prevention of Hypertension

Changing your diet and lifestyle can do much in managing blood pressure:
1. Quit smoking.
2. Limit the intake of alcoholic beverages.
3. Lose weight if you are overweight.
4. Exercise and eat well-balanced, nutritious meals that are low in fat, salt, and cholesterol
but high in fiber.

Signs and Symptoms of Hypertension

General signs of high blood pressure include headache, dizziness, pounding in ears, and
nosebleed. These symptoms typically do not occur until high blood pressure has reached an
advanced and even a possibly life-threatening stage.

Cardiovascular Disease

High blood pressure increases the risk of coronary artery disease, also called
atherosclerosis, High blood pressure puts added force against the artery wall. Over time, this

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extra pressure can damage the arteries. These injured arteries tend to become narrow and
hardened by fatty deposits. They block the flow of blood to the heart and cannot deliver enough
oxygen to the other parts of the body.

Other causes of cardiovascular disease are as follows:

1. Smoking-Cigarette smokers are at a greater risk than pipe and cigar smokers, but all
forms of tobacco are proven to be detrimental to the heart's health.
2. Diabetes
3. Overweight - Persons who have an excess body fat are at a higher risk than persons of
normal weight.
4. Diet high in saturated fat and salt
5. Family history - Children of parents who developed heart disease before the age of 55
have a higher risk of developing heart disease.
6. Lack of exercise
7. Age-Risk of heart disease increases over the age of 45 in males and over 55 in females.
8. Too much drinking - People who take two alcoholic drinks per day are at risk.
9. High blood pressure
10. Having high cholesterol level

Heart Attack

A heart attack causes permanent damage to the heart muscle due to loss of blood flow to
the heart.

Some heart attacks are sudden and intense; however, most heart attacks start slowly with
mild pain and discomfort. Generally, heart attacks involve discomfort in the center of the chest
that lasts more than a few minutes or that goes away and comes back. It can feel like
uncomfortable pressure, squeezing, fullness, or pain. Shortness of breath may occur, as well as
nausea or lightheadedness. It is vital to get help immediately if any of these symptoms occurs.

Stroke

The brain requires unobstructed blood flow to function. Very high, sustained blood
pressure will eventually cause blood vessels to weaken. Over time, these weakened vessels could
break, and blood could leak into the brain. The area of the brain that is being fed by these broken
vessels start to die, and this will cause a stroke. In addition, if a clot blocks a narrowed artery,
blood ceases to flow and a stroke will occur.

Symptoms of a stroke include sudden numbness or weakness of the face, arm, or leg,
especially on one side of the body, confusion, trouble in speaking, poor vision and sudden severe
headache.

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Prevention of Cardiovascular Diseases

Here are some tips on how to keep your heart healthy:

1. Quit smoking
2. Control diabetes, blood pressure, and cholesterol level.
3. Exercise regularly.
4. Eat a diet that is rich in fiber and low in salt and saturated fat.
5. Maintain a healthy weight.
6. Manage stress.

Diabetes

Diabetes, also referred to as diabetes mellitus, describes a group of metabolic diseases in

which the person has high blood glucose or blood sugar, either because insulin production is
inadequate, or the cells in his/her body do not respond properly to insulin. or both. Patients with
high blood sugar will typically experience frequent urination (polyuria), excessive thirst
(polydipsia), and increased appetite (polyphagia).

Diabetes is classed as a metabolism disorder. Metabolism refers to the way the body uses
digested food for energy and growth. Most of what is eaten is broken down into glucose. Glucose
is a form of sugar in the blood. It is the principal source of fuel for the body.

When food is digested, glucose makes its way into the bloodstream. The cells use glucose
for energy and growth. However, glucose cannot enter the cells without insulin.

Insulin makes it possible for the cells to take in the glucose. Insulin is a hormone that is
produced by the pancreas. After eating, the pancreas automatically releases an adequate quantity
of insulin to move the glucose present in the blood into the cells. As soon as glucose enters the
cells, blood glucose levels drop.

In a person with diabetes, the quantity of glucose in the blood is too elevated
(hyperglycemia) because the body does not produce enough insulin, produces no insulin, or has
cells that do not respond properly to the insulin that the pancreas produces. This results in too
much glucose building up in the blood. This excess blood glucose eventually passes out of the
body through the urine. So, even though the blood has plenty of glucose, the cells are not getting
it for their essential energy and growth.

Three Types of Diabetes

Type 1 Diabetes

The body does not produce insulin. This type is also referred to as insulin-dependent
diabetes, juvenile diabetes, or early-onset diabetes. People usually develop type 1 diabetes before
their 40th year, often in early adulthood or teenage years.

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Type 1 diabetes is nowhere near as common as type 2 diabetes. Approximately 10
percent of all diabetes cases are type 1.

Patients with type 1 diabetes will need to take insulin injections for the rest of their life.
They must also ensure proper blood-glucose levels by carrying out regular blood tests and
following a special diet.

Type 2 Diabetes

The body does not produce enough insulin for proper function, or the cells in the body do
not react properly to insulin (insulin resistance). Approximately 90 percent of all cases of
diabetes worldwide are of this type.

Some people may be able to control their type 2 diabetes by losing weight, following a
healthy diet, doing plenty of exercise, and monitoring their blood glucose levels. However, type
2 diabetes is typically a progressive disease. It gradually gets worse and the patient will probably
end up having to take insulin, usually in tablet form.

Overweight and obese people have a much higher risk of developing type 2 diabetes
compared to those with a healthy body weight. People with a high level of visceral fat, also
known as central obesity, belly fat, or abdominal obesity, Being overweight or obese causes the
body to release chemicals that can destabilize the body's cardiovascular and metabolic systems.
are especially at risk.

The risk of developing type 2 diabetes increases with age, particularly when aging people
put on weight and become less physically active. Those with a close relative who has type 2
diabetes and those of Middle Eastern, African, and South Asian descents are at a higher risk of
developing the disease, including men whose testosterone levels are low.

Cancer

Cancer is a class of diseases characterized by out-of-control cell growth. There are over
100 different types of cancer, and each is classified by the type of cell that is initially affected.
Cancer harms the body when damaged cells divide uncontrollably to form lumps or masses of
tissue called tumors (except in the case of leukemia where cancer prohibits normal blood
function by abnormal cell division in the bloodstream). Tumors can grow and interfere with the
digestive, nervous, and circulatory systems and they can release hormones that alter body
functions. Tumors that stay in one spot and demonstrate limited growth are generally considered
to be benign.

More dangerous or malignant tumors form when two things occur:

1. A cancerous cell manages to move throughout the body using the blood or lymph
systems, destroying healthy tissue in a process called invasion.

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 2. A cancerous cell manages to divide and grow, making new blood vessels to feed itself in
a process called angiogenesis.

When a tumor successfully spreads to other parts of the body and grows, invading and
destroying other healthy tissues, it is said to have metastasized. This process itself is called
metastasis, and the result is a serious condition that is very difficult to treat. Physicians and
researchers who specialize in the study, diagnosis, treatment, and prevention of cancer are called
oncologists.

Cancer is ultimately the result of cells that grow uncontrollably and do not die Normal cells
in the body follow an orderly path of growth, division, and death. Programmed cell death is
called apoptosis, and when this process breaks down, cancer begins to form. Unlike regular cells,
cancer cells do not experience programmatic death and instead continue to grow and divide. This
leads to a mass of abnormal cells that grow out of control.

Classification of Cancer

There are five broad groups of cancer, namely:

1. Carcinomas are characterized by cells that cover internal and external parts. of the body
such as lung, breast, and colon.
2. Sarcomas are characterized by cells that are located in the bone, cartilage, fat, connective
tissue, muscle, and other supportive tissues.
3. Lymphomas are cancers that begin in the lymph nodes and immune system tissues.
4. Leukemias are cancers that begin in the bone marrow and often accumulate in the
bloodstream.
5. Adenomas are cancers that arise in the thyroid, pituitary gland, adrenal gland, and other
glandular tissues.

Signs and Symptoms of Cancer

Cancer symptoms are quite varied and depend on where the cancer is located, where it
has spread, and how big the tumor is. Some cancers can be felt or seen through the skin. For
instance, a lump on the breast or testicle can be an indicator of cancer in those locations. Skin
cancer (melanoma) is often marked by a change in a wart or mole on the skin. Some oral cancers
present white patches inside the mouth or white spots on the tongue.

Other cancers have symptoms that are less physically apparent. Some brain tumors tend
to manifest early as they affect important cognitive functions. Pancreas cancers are usually too
small to produce symptoms until they induce pain by pushing against nearby nerves or interfere
with liver function to bring about a yellowing of the skin and eyes called jaundice. Symptoms
can also appear as a tumor grows and pushes against organs and blood vessels. For example,
colon cancers lead to constipation, diarrhea, and changes in stool size. Bladder or prostate
cancers affect bladder functions such as more frequent or infrequent urination.

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 As cancer cells use the body's energy and interfere with normal hormone function, it is
possible to cause fever, fatigue, excessive sweating, anemia, and unexplained weight loss.
However, these symptoms are common in several other maladies as well. For example, coughing
and hoarseness can point to lung or throat cancer as well as several other conditions.

When cancer spreads or metastasizes, additional symptoms can be noted in the newly
affected area. Swollen or enlarged lymph nodes are common and likely. When cancer spreads to
the brain, patients may experience vertigo, headaches, or seizures. In the lungs cancer may cause
coughing and shortness of breath. The liver may become enlarged and cause jaundice; bones
become painful and brittle or break easily.

Prevention of Cancer

The following are essential measures to help prevent cancer:

1. Quit smoking and drinking to significantly lower the risk of several types of cancer, most
notably in the lung, throat, mouth, and liver. The earlier you quit, the better.
2. Stay in the shade and protect yourself with a hat, shirt, and sunscreen when under the sun,
to prevent skin cancer.
3. Diet is an important part of cancer prevention since what we eat has been linked to the
disease. Follow recommended diets that are low in fat and rich in fresh fruits and
vegetables and whole grains.

A systematic screening will help detect small irregularities or tumors as early as possible
even when there are no clear symptoms yet. Breast self-examination, mammograms, testicular
self-examination, and Pap smears are common screening methods for various cancers.

Conclusion

A person can only take proper precautions regarding communicable and non
communicable diseases if he/she is aware about them. His/Her familiarity with the said diseases
will enable him/her to adopt certain lifestyle modifications, like avoidance of alcoholic
beverages, to avoid diseases and stay healthy as he/she performs his/her various functions in life.

Health is wealth and a person's good health is crucial to his/her being a successful person
who has the opportunity to maximize his/her potentials in order to achieve all his/her goals in
life.

REFERENCE:
Villasoto, H.S & Villasoto, N. S. (2018). Human person gearing towards social development: NSTP-
CWTS 1 worktext for college students. 2nd Edition. C & E Publishing, Inc. pp. 61 – 74

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