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HAND OUTS
COMMUNICABLE DISEASE
Prepared By: Mr. Orlan D. Balanon
NOV 2023 Philippine Nurse Licensure Examination Review
TUBERCULOSIS • Category III
Signs and Symptoms o New smear negative PTB with minimal
• Cough parenchymal lesions on CXR as assessed by the
• Fever TBDC
• Chest or back pains • Category IV
• Hemoptysis o Chronic (still smear positive after supervised re
• Significant weight loss treatment
• Other signs and symptoms such as: sweating, o Treatment regimen
fatigue, body malaise, and shortness of breathe PULMONARY TB
Mode of Transmission Drugs:
• Airborne droplet INTENSIVE: INH, RIF, PYRAZINAMIDE
• Direct invasion CONTINUATION: INH, RIF
Period of communicability: EXTRAPULMONARY PTB:
• depends on the number of bacilli discharged Drugs: INH RIF, PYRAZINAMIDE, ETHAMBUTOL OR
• the virulence STREP
• adequacy of ventilation CONTINUATION: INH, RIF
Methods of Control
• Prompt diagnosis and treatment LEPROSY
• BCG vacccination Signs and symptoms
• Health education EARLY
• Improve social conditions such as overcrowding • Change in skin color
• Make available medical activities • Loss of sensation on the skin lessions
• Provide public health nursing and outreach • Decrease or loss of sweating
services for home supervison. • Thickened and painful nerves
The National TB Control Program • Muscle weakness and paralysis of extremities
Vision: A country where TB is no longer a public health • Pain and redness of the eyes
problem • Nasal obstruction and bleeding
Mission: Ensure that the TB DOTS services are • Ulcers that do not heal
available, accessible, and affordable to the communities Late signs
in collaboration with the LGU and other partners. • Madarosis
Goal: to reduce prevalence and mortality form TB by half • Lagopthalmos
by the year 2015 • Clawing of finger and toes
Targets: • Contractures
• Cure at least 85% of the sputum smear positive • Sinking of the nosebridge
TB patient discovered • Gynecomastia
• Detect at least 70% of the estimated new • Chronic ulcers
sputum smear positive TB cases Method of Transmission:
What is the primary diagnostic tool in NTP case finding? ______________________________________________
______________________________________________ Who are the most susceptible?
What is the only contraindication to direct sputum smear ______________________________________________
microscopy? Prevention
______________________________________________ • Avoidance of prolonged skin to skin contact
_______________________________________ • Bcg vaccination
Who can perform DSSM? • Good personal hygiene
______________________________________________ • Adequate nutrition
What are two formulations of anti TB drugs? • Health education
______________________________________________ WHO leprosy classification
______________________________________________ • Paubacillary (tuberculoid and intermediate)
TB TREATMENT CATEGORY • Multibacillary (lepromaatous and borderline)
• Category 1
o New smear positive PTB SCHISTOSOMIASIS
o New smear negative PTB with extensive Signs and symptoms:
parenchymal lesions on CXR • Diarrhea
o EPTB and • Bloody stool
o Severe concomitant HIV disease • Enlargement of the abdomen
• Category II • Spleenomegaly
o Treatment failure • Weakness
o Relapse • Anemia
o Return after default • Inflamed liver

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Preventive measure • Quinidine gluculate
• Health education Public Health Nursing Responsibilities
• Proper disposal of feces and urine • Participate in the implementation of the
• Improve irrigation and agricultural practices following:
• Treat snail breeding sites with molluscides o Treatment policies
• Prevent exposure to contaminated water o Provision of drugs
• Treat patient in endemic areas to preevent o Laboratory confirmation diagnosis
disease progression o Training of BHW on diagnosis and treatment
What is the treatment? __________________________ o Supervision of malaria control activities
collection, analysis and submission of reports
Filariasis o Recognition of early signs and symptoms
How it is transmitted? o Health education
______________________________________________ o Availability of anti-malarial drugs and
______________ chemoprophylaxis drugs
Asymptomatic stage
• Characterized by the presence of microfilarae in DENGUE HEMORRHAGIC FEVER
the blood Signs and Symptoms
• No clinical signs First 4 days:
• Asymptomatic for years • High fever
• Other progress to acute and chronic stages • Abdominal pain and headache
Acute Stage • Flushing accompanied by vomiting
• Lymphadenitis • Conjunctival infection
• Lymphangitis • Epistaxis
• In some cases, the male genitalia is affected 4th-7th days
leading to orchitis • Lowering of the temperature
Chronic Signs and Symptoms • Severe abdominal pain
• Hydrocele • Vomiting and frequent bleeding
• Lymphedema • Unstable BP and narrow pulse pressure and
• Elephantiasis shock
Diagnosis 7th-10th day
• Physical exam • Generalized flushing with interventing areas of
• History taking flushing
• Observation of signs and symptoms • Appetite regained
Laboratory Examinations • Stable blood pressure
• Nocturnal Blood Examinations (NBE) H-fever classification
• Immunochromatographic Test (ICT) • Severe, frank type
What is the drug of choice? • Moderate
______________________________________________ • Mild
What is the source of infection?
MALARIA ______________________________________________
Signs and symptoms Mode of transmission:
• Recurrent chills ______________________________________________
• Fever Diagnostic test
• Profuse sweating Management
• Anemia • Paracetamol, analgesic
• Malaise • Rapid replacement of body fluids
• Hepatomegaly • Includes intensive monitoring and follow up
• spleenomegaly • Give ORS to replace fluid
Mode of transmission: Control Measures
___________________________________ • Eliminate vector by:
• Blood transfusion o Changing water and scrubbing sides of lower
• Sharing IV needles vases once a a week
• Transplacental o Destroy bleeding places of mosquito
• Infectious agents o Proper disposal of rubber tis, empty bottles and
Early diagnosis cans
• Clinical method o Keep water containers covered
• Microscopic method
What drug is given for chemoprophylaxis? MEASLES
___________________________________ Signs and Symptoms
Vector control measures • Fever
• Insecticide treatment of mosquito net • Rashes
• House spraying • Symptoms referrable to upper repiratory tract
• On stream seeding infection
• On stream clearing • Koplik spot
Recommended antimalarial drugs What is the mode of
• Choroquine sulfate transmission:___________________________________
• Sulfadoxine ______
• Quinine sulfate PERIOD OF COMMUNICABILITY
• Quinine hydrochloride • Method of Prevention and Control
• Tetracycline hydrochloride • Avoid exposing children to any person with
• Quinidine sulfate catarhhal symptoms

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• Isolation of cases from diagnosis until 5-7 days Signs and Symptoms
after the onset of rash • Ordinary cold which becomes increasingly
• Disinfection of articles soiled with infected severe
secretions • Paroxysms of cough
• Administration of measles immune globulin to • Vomiting may follow spasm
susceptible infants • Cough may last several weeks and some 2-3
Nursing care: months
• Protect eyes of patient from glare Mode of
• Keep the patient in adequately ventilated room transmission:___________________________________
• Teach, guide, supervise adequate nursing care Period of
as indicated communicability:________________________________
• Check corrections of medication and treatment Methods of prevention and control
prescribed by the physiscian • Routine DPT immunization in all infants
• Booster dose given at 2 years and again at 4 to
CHICKEN POX 5 years
Signs and Symptoms • The patient should be segregated until after 3
• Slight fever weeks from the appearance of paroxysmal
• Maculo-papular rash for a few hours cough
• Vesicular for 3-4 days Nursing care
Period of communicability: • Care should be focused on prevention and
_______________________________________ complication: special attention to diet is needed
Methods of Prevention and Control if patient vomits after cough paroxysms
• Case over 15 years of age should be • Teach parents how to pick up the infant or child
investigated to eliminate the possiblity of the during paroxysmal cough, giving abdominal
small pox support
• Isolation • General care of the nose and throat.
• Current disinfection of throat and nose Tetanus
discharges Mode of transmission:
• Avoid contact with susceptible Methods of prevention and control
• Pregnant women should be actively immunized
MUMPS in region where tetanus neonatorum is prevalent
Period of communicability: • Licensing of midwives into professional
______________________________________________ supervision and education as to methods of
Signs and Symptoms equipment and techniques of sepsis on
• Painful swelling in front of the ear, angle of jaws childbirth
and down the neck • Health education on mothers relatives and
• Fever attendants in the practice of strict aseptic
• Malaise methods of umbilical care in the newborn
• Loss of appetite INFLUENZA
• Swelling of one or both testicles Signs and Symptoms
Treatment • Abrupt onset of fever
• Prophylactic: vaccine/ immunization againts the • Chilly sensations/ chills
disease • Aches or pains in the back
• Active treatment: the average case before • Respiratory symptoms include: coryza, sore
puberty requires little attention throath and cough
• After the age puberty: immediate oral dose of Period of communicability:
cortisone 300 to 400 mg followed by 100 mg _____________________________________
every 6 hours Methods of Prevention and Control
DIPTHERIA • Education of the public as to sanitary hazard
Mode of from spitting, sneezing and coughing
transmission:___________________________________ • Avoid use of common towels, glasses and eating
Incubation utensils
period:________________________________________ • Active immunization with influenza vaccine
Methods of Prevention and Control provided prevailing strain of virus matches the
• Active immunization on all infants and children antigenic component of vaccine
with 3 doses od DPT toxoid PNEUMONIAS
• Pasteurization of milk Etiology
• Education of parents • Majority of cases due to diploccocus
• Reporting of the case to the health officer for pneumoniae
proper medical care • Occasionaly pneumoccocus of Friedlander
Nursing responsibilities • Viruses
• Follow prescribed dosage in administering anti Predisposing causes
toxin • Fatigue
• Comfort of the patient should always be in mind • Overexposure to inclement weather
• The visiting bag set up should be outside the • Exposure to polluted air
room of the room of the patient or should be far • Malnutirition
from the bedside of the patient and a separate Signs and symptoms:
upon a appear towel as in temperature taking • Rhinitis
may be brought and placed on the bedside by a • Chest indrawing
table or chair. • Rusty sputum
PERTUSSIS • Productive cough

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• Fast respiration Incubation period: _________________________
• Fever Nursing care
• Vomiting • Demonstrate to family how to give bedside care,
• Convulsions may occur such as tepid sponge bath, feeding, changing of
• Flushed face linen bed, use of bed pan and mouth care
• Dilated pupil • Any bleeding from the rectum, blood in the
• Severe chills in young children stools, sudden acute abdominal pain,
• Pain over the affected lung restlessness and falling of temperature should
Diagnosis be reported at once to the physician or the
• Based on history and clinical signs and patient should be brought at once to the
symptoms hospital
• Dull percussion noted on the affected side of the • Take vitals signs and teach family member how
lungs to take and record.
• X ray
Complications: BACILLARY DYSENTERY
• Emphysema or pleural effusion Etiologic agents:
• Endocarditis or pericarditis There are four main group:
• Pneumoccocal meningitis • Shlesneri
• Otitis media in cbhildren • Shboy-dii
• Hypostatic edema and hyperemia of unaffected • Sn- connei
lung in the elderly • Sh-dysenterae
• Jaundice Signs and Symptoms:
• Abortion • Diarrhea
Management • Fever
• Bedrest • Tenesmus
• Adequate salt, fluid, calorie and vitamin intake • Period of communicability
• TSB for fever Methods of Prevention and Control
• Frequent turning from side to side • Sanitary disposal of human feces
• Antibiotic based on Care of the Acute • Sanitary supervision of processing, preparation
Respiratory Infection of the Department of Health and serving of food particularly when eaten raw
• Cholera • Adequate provision for safe washing facilities
Signs and Symptoms • Fly control and screening to protect foods
• Sudden onset of acute and profuse colorless againts fly contamination
diarrhea • Protection of purified water supplies and
• Vomiting construction of safe privy
• Severe dehydration Methods of Prevention and Control
• Muscular cramps • Control of infected individual contacts and
• Cyanosis environment
Mode of transmission: • Reporting to local health officer
___________________________________ • Isolation of patient during acute illness
Methods of Prevention and Control • Rigid personal precautions by attendants
• Report case at once to the health officer SOIL TRANSMITTED HELMINTHIASES
• Bring patient to the hospital for proper isolation • Etiologic agents
and prompt and competent medical care • Ascaris lumbricoides
• Other general preventive measure to control the • Trichuris trichiura and;
spread of the disease • hookworm (ancylostoma doudenale and necator
• All contact of the cases should submit americanus
themselves for stool examination and be treated Signs and Symptoms
accordingly if found or discovered positive. • Anemia
Nursing care • Malnutrition
• Continue and increase the frequency of • Stunted growth in height and body size
breastfeeding • Decreased physical activity
• Give additional fluid , “am” soup, cereals, • Impaired mental development and school
mashed vegetables, performance
• Coconut water is said t be rich in potassium, one • Prevention and Control
of the electrolytes found in choleric stools Health teaching on:
• Make patient comfortable as possible • Good personal hygiene
• Give ORESOL according to the prescribed • Keeping fingernails clean and short
anount according to age • Use of footwear
TYPHOID FEVER • Wash fruits and vegetable very well
Source of infection: • Advocate use of sanitary toilet
___________________________________________ • If water is not safe for drinking, boil properly
Signs and Symptoms • Once sign and symptoms appear consult RHU
• Fever staff
• Anorexia • Early diagnosis and treatment
• Slow pulse • Consult RHU and BHS staff
• Involvement of lymphoid tissues • Laboratory/ stool/ blood exam
• Ulceration if the peyer’s patches • Ensure proper dosage of medication and
• Spleenomegaly completion of treatment
• Rose spots • Referral and follow up as needed.
• Diarrhea

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PARAGOMNIASIS Mode of transmission:
Endemic areas identified: _______________________________________
• Mindoro Signs and Symptoms
• Camarines sur • Numbness of the face especially around the
• Camarines norte mouth
• Sorsogon • Vomiting and dizziness
• Samar • Headache
• Leyte • Tingling sensation, paresthesia and eventual
• Negsro Island paralysis of the hands and feet
• Cebu • Rapid pulse
• Basilan • Difficulty of speech and difficulty swallowing
• Island of Mindanao including Basilan • Total muscle paralysis with respiratory arrest
Etiologic agents and death in several cases
• Paragominus westermani Management and control Measures
• Paragominus siamenses • Induce vomiting
Known intermediate host in the Philippines • Drinking pure coconut milk
• Antemelania asperata • Shellfish affected by red tide must not be
• Crabs and cooked with vinegar
• Varona litterata • Toxin of red tide is not totally destroyed upon
• Crayfish cooking hence consumers must be educated tp
Mode of transmission: avoid bi-valve mollusks such as tahong, talaba,
______________________________________________ halaan, kabiya, abaniko when the red tide
Signs and Symptoms warning has been issued.
• Cough of long duration LEPTOSPIROSIS
• Hemoptysis or recurrent blood streaked sputum Signs and symptoms
• Chest/ back pain • fever with sudden onset
• PTB like meds • headache
Diagnosis • Chills
• Sputum examination • Severe myalgia (calves and thighs)
• Immunology • Cough and chest pain.
• Cerebral paragonimiasis Mode of transmission:
Treatment _______________________________________
• Praziquantel Diagnosis
• Bithionol • Clinical manifestations
Prevention and Control • Culture of the organism
• Treatment of infected person • Examination of blood and CSF during the first
• Sanitary disposal of excreta week of illness and urine after the 10th day
• Anti-mollusk campaign Treatment
• Education of the population • Penicillin and other related B-lactam antibiotic
• Avoid eating infected foods • Tetracycline
• Avoid bathing in infected water • Erythromycin
Prevention and Control
HEPATITIS A 1. Educate public on the modes of transmission,
Predisposing factors to avoid swimming or wadding in potentially
• Poor sanitation contaminated waters and to use proper
• Contaminated water supply protection when work requires such exposure
• Unsanitary preparation and serving of food 2. Protect workers in hazardous occupations by
• Malnutrition providing boots and gloves.
Signs and symptoms 3. Recognize potentially contaminated waters
• Influenza like such as headache and soil and drain such waters when possible.
• Malaise and easy fatigability 4. Control rodents in human habitations,
• Anorexia and abdominal discomfort especially rural and recreational. Burn cane
• Nausea and vomiting fields before harvest.
• Fever Control of patient, contacts and the immediate
• Lymphadenopathy environment:
• Jaundice accompanied by pruritus and urticaria 1. Report to local health authority.
• Bilirubinimea with clay colored stools 2. Isolation: Blood/body fluid
Management and treatment precautions.
• Prophylaxis 3. Concurrent disinfection: Articles
• Complete bed rest soiled with urine.
• Low fat diet but high in sugar 4. Quarantine: None
• Prevention and Control 5. Immunization of contacts: None
• Ensure safe water for drinking RABIES
• Sanitary method in preparing and handling food Mode of Transmission:
• Proper disposal of feces and urine __________________________
• Washing hands very well before eating and after Signs and symptoms
using the toilet • Sense of apprehension
• Proper cleaning of articles used by patients • Headache
• Fever
PARALYTIC SHELLFISH POISONING • Sensory change near bite of animal
• Spasm of muscle

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• Paralysis Signs and Symptoms
• Delirium and convulsions Males:
Management and prevention • Burning urination and pus discharges from
• The wound must be immediately and thoroughly infection of urethra
washed with soap and water Females:
• Pt. may be given antibiotic or anti tetanus • vaginal discharge
• Post exposure treatment is given to patient who • Infection of the eyes is rare in adults
have been exposed to rabies. It consist of local Diagnosis
wound treatment, active and passive • Gram staining
immunization • Culture of cervical and urethral smear
• Consult a veterenarian or trained personnel to SYPHILLIS
observe pet for 14 days Signs and symptoms
• Be a Responsible Pet Owner Primary stage:
• Have pet immunized at 3 months of age and • Painless chancre at the site of entry and swollen
every year thereafter glands
• Never allow pets to roam the streets Secondary stage:
• Take care of your pet; bathe, feed them • rash
regularly with adequate food, provide them with • patchy hair loss
clean sleeping quarters • sore throat
SCABIES • swollen glands
Signs and Symptoms Late syphilis:
• Itching • varies form no symptoms to indication of
• When secondarily infected, the skin may feel hot damage to other organs such as the brain, heart and
and burning with minor discomfort liver.
• When large areas are involved and secondary Diagnosis
infection is severe, there will be fever, • Dark field illumination test
headache, and malaise • Kalm test
Diagnosis
• Appearance of the lesion, and the intense CHLAMYDIA
itching Signs and symptoms
• Scraping from its burrow with a hypodermic Females:
need or curette and examined under the • Sometimes a slight vaginal discharge, itching
microscope and burning of the vagina, dyspareunia,
Treatment abdominal pain, fever in late stages
• Benzyl Benzoate emulsions Males:
• Kwell ointment • discharge from penis, burning and itching of
Prevention and Control urethral opening, burning sensation upon
• Good personal hygiene urination
• Regular changing of clean clothing and beddings
and towels GARDIANELLA VAGINITIS
• Eating the right kind of food, green leafy Signs and Symptoms
vegetables and plenty of fluids • Slight grayish or yellow odorous vaginal
• Keeping the house clean discharge
• Improving sanitation in the sorrounding • Mild itching
• Burning sensation
ANTHRAX Diagnosis
Signs and Symptoms • Microscopic slide
• Cutaneous form • Chemical analysis of vaginal material and culture
o Exposed part of the skin begins to itch and the test from infection site
papule appears in the inoculation site .
o This papule becomes vesicle and then evolve TRICHOMONIASIS
into depressed eschars Signs and Symptoms
• Pulmonary form Female:
o The onset resembles as that upper respiratory • Yellow or greenish odorous discharges
tract infection • Vaginal itching and soreness
o After 3-5 days the infection becomes acute , • Painful urination
with fever, shock and death Males:
• Gastrointestinal Anthrax • slight itching of penis
o Violent gastrointeritis with vomiting and bloody • painful urination
stools. • clear discharge from penis
Methods of control DIAGNOSIS
• Immunize the high risk person with cell free • Microscopic slide of discharge
vaccine • Culture test
• Educate employees handling potentially • examination
contaminated articles about mode of
transmission HEPATITIS B
• Control dusts and proper ventilation in Signs and symptoms
hazardous industries especially those that • Loss of appetite
handle raw animal materials • Easy fatigability
SEXUALLY TRANSMITTED INFECTIONS • Malaise
GONORRHEA • Joint and muscle pain

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• Low grade fever o Disorientation
• Nausea and vomiting o seizure
• Right sided abdominal pain o Mutism
• Jaundice o Loss of memory, coma
• Dark colored urine Diagnosis
Mode of transmission • ELISA
• From person to person • WESTERN BLOT
• Parenteral Prevention
• Perinatal • Maintain monogamous relationship
High risk group • Avoid promiscuous sexual contact
• Newborns, infant, children of an infected mother • Sterilize needles, syringes and instruments use
• Sexual and household contacts of acute cases for cutting operations
and carriers • Proper screening of blood donors
• Health workers handling blood products • Rigid examination of blood and other products
• Persons requiring/ undergoing frequent BT of transfusion
• Sexually promiscuous heterosexuals and • Avoid oral, anal contact and swallowing of
homosexuals semen
• Commercial sex workers • Use of condoms and other protective device
• Drug addicts using IV drugs
Preventive measures MENINGOCOCCEMIA
• Immunization with Hep B vaccine Mode of transmission
• Universal precaution when dealing with body Signs and Symptoms
fluids • High grade fever 24 hours
• Avoid injury with sharp instruments • Weakness
• Use disposable needles and syringes and discard • Joint and muscle pain
properly • Hemorrhagic rash
• Sterilize instrument use for circumcision, ear • Progressing from few petechiae to widespread
holing, tattoing, acupuncture and those use for purpura and ecchymosis
surgical dental procedures • Meningeal irritation like headache, nausea and
• Avoid sharing toothbrush, razor and other vomiting, stiff neck, bulging of fontanels, seizure
instrument that can become contaminated with or convulsion
blood Methods of Prevention and Control
• Observe safe sex • Respiratory isolation for the first 24 hours upon
• Make sure that blood and blood products for admission to prevent exposure to hospital staff
transfusion have been properly screened for • Hospital personnel upon entry to
hepatitis B meningococcemia room are required to wear
• Have adequate sleep, rest, exercise and eat mask, gloves, googles, gown especially when
adequate nutritious foods to build and maintain doing endotracheal intubation
body resistance • Chemoprophylaxis should be given
• Public should be educated to avoid overcrowded
HIV/AIDS places
Mode of transmission • Those with intimate exposure to nasopharyngeal
• Sexual contact secretions of patients also need to be
• Blood transfusion given chemoprophylaxis
• Contaminated syringes, needles, nipper, razor BIRD FLU
blades Signs and Symptoms
• Direct contact of open wound/ mucus • Fever
membrane with contaminated blood and body fluids • Body weakness or muscle pain
Signs and symptoms • Cough
Physical • Sore throat
• Maculo-papular rash • May have difficulty of breathing in severe cases
• Loss of appetite • Sore eyes
• Weight loss Nursing care
• Fever of unknown origin • Patients will be isolated is designated hospital
• Malaise using hospital referral network
• Persistent diarrhea • Same principles of infection control applied for
• TB(localized and disseminated) SARS will be observed
• Esophageal candidiasis • early recognition of cases of highly pathogenic
• Kaposi’s sarcoma avian influenza (HPAI) during outbreak among
• Pneumocystis carinii pneumonia poultry
• Apprehensive SARS
Signs and Symptoms Signs and Symptos
Mental (early stage) Prodromal phase:
• Forgetfulness • Fever
• Loss of concentration • Chills
• Loss of libido • Malaise
• Apathy • Myalgia
• Psychomotor- retardation • Headache
• Withrawal Signs and Symptoms
Later stage: Respiratory
o Confusion

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• Dry, non productive cough with or without
respiratory distress
• Crackles, rales
• Dullness on percussion and decreased breath
sounds
• Preventive measures and control
• Establishment of Triage
• Assign a specific area of traige of patients who
may have SARS
• Patient wears mask
• Screen patients for travel history, symptoms and
close contact with cases
• Admit if they meet the case definition
• Identification of patient
• Isolation of suspected probable case
• Tracing and monitoring of close contact
• Barrier nursing technique for suspected and
probable cases
Nursing Care
The infection control goals should be which of the
following:
• Detect early suspect cases
• Implement appropriate isolation measures
• Protect health personnel
• Protect other patients
• Protect family and community members
Nursing Care
• Establishing a separate isolation facility ibcluding
the following:
• Hand washing facility
• Dedicated bathroom facilities
• Capacity for waste and laundry
• Control and monitor elevator traffic
• Sufficient number of staff
• Good ventilation
• Turn off conditioning if isolation room cannot be
isolated
Nursing care
• Utilize Personal Protective Equipment which
include the wearing N 95 respirator mask,
goggles, disposable gown and gloves cap and
shoe cover
• Apply the principle of handwashing

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