1 02/15/2022

TROPICAL AND
COMMUNICABLE DISEASES
2

GROUP 3
NC FIZA IMTIAZ
JSC NO:17172
ASSIGNED BY: LT CDR SAIRA

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 OBJECTIVES………….
3

At the end of this chapter the learners will be able to:
 understand?
Diarrheal disease
Cholera
Dysentery
Food poisoning
Enteric fever
Polio myelitis

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 FOOD BORNE DISEASES
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 Foodborne illness (also foodborne disease referred to as

food poisoning) is any illness resulting from the food
spoilage of contaminated food, pathogenic bacteria, viruses,
or parasites that contaminate food, as well as chemical or
natural toxins such as poisonous mushrooms and various
species of beans that have not been boiled for at least 10
minutes.
 For example:
 Food poisoning.

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 WATER BORNE DISEASES
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 Waterborne diseases are caused by drinking contaminated

or dirty water.
 And cause other serious illnesses such as Guinea worm
disease.
 diarrhea
 Cholera
 Typhoid
 Dysentery.

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 1. DIARRHEA………….
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 Diarrhea is defined by the World Health Organization as

having three or more loose or liquid stools per day, or as
having more stools than is normal for that person.
 CLASSIFICATION:
 May be classified as acute or chronic diarrhea.
 Acute: lasting less than 21 days.
 Chronic: lasting beyond 21 days.
 MAGNITUDE:
 Small studies conducted in india assumed as 100 million
children suffer from the 300 million episodes of diarrhoea
per year.

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 EPIDEMIOLOGICAL FEATURES:
 Agents:
 bacteria (e.coli, shigella, salmonella, vibrio cholera, staphylococcus)
 virus: (rota virus, adeno virus, astro virus, calcivirus)
 Parasites: entameoba hystolica, giardia lamblin, stronglyoids,
trichuris)
 MODE OF TRANSMSSION:
 Enteric pathogens are transmitted by the
 fecal oral route
 Contaminated water
 Contaminated food
 Direct route

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 PATHO PHYSIOLOGY:
 Viruses, shigella, salmonella pathogens cause an
inflammatory reaction in the epithelial layers of intestines
and cause destructions of intestinal cells lead to diarrhoea.
 E.coli and vibrio cholera produce E toxin and H toxin.
 CLINICAL MANIFESTATION:
 Depends upon the severity of the disease.
 1.DEHYDRATION:
 Little or extreme loss of subcutaneos fat.
 Urinary out put decreases.
 Poor skin turgor and dry mouth.

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 Sunken eyes.
 Low B.P. and high pulse.
 2.BEHAVIORAL CHANGES:
 Irritability.
 Restlessness.
 Weakness.
 Pallor.
 Convulsions.
 3.RESPIRATION:
 Rapid, Tachypnic.

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 4.STOOLS:
 Loose and fluid in consistency.
 Greenish or yellow green in colour.
 May contain mucus or blood.
 5.VOMITING:
 6.FEVER:low grade to 100F
 7.ANOREXIA.
 DIAGONISTIC TOOLS:
 Ask and collect the history and information from the
patient and his relatives regarding to,

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 Diarrhoea, vomiting, thirst and urine output.

 Look and examine the patient for any sign of dehydration.
 Collect the specimen of stool for laboratory diagnosis.
 TREATMENT:
 Increase fluid intake.
 Give ORS therapy.
 Ampicillin, genticin, and tetracyclin are used for bacterial
infections.
 For protozoal infection give metronidazole.
 For fluid replacement, give IV fluids such as ringer’s
solution.

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 PREVENTION:
 access to safe drinking-water.
 use of improved sanitation.
 hand washing with soap.
 exclusive breastfeeding for the first six months of life.
 good personal and food hygiene.
 health education about how infections spread.
 rotavirus vaccination.

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 NURSING MANAGEMENT:
 Replace fluid and electrolyte losses .
 Provide good perianal care. Diarrheal stool is oftentimes highly
acidic. This causes anal soreness and irritation in the perianal
area.
 Promote rest. To reduce peristalsis.
 Diet Small amounts of bland foods
 Low fiber diet
 BRAT Diet (banana, rice, apple, toast)
 Avoid excessively hot or cold fluids. These are stimulants.
 Potassium-rich foods and fluid (e.g. banana, khichdi,milk)
 Antidiarrheal medications as ordered

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 2.CHOLERA
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 Cholera is an infectious disease that causes severe watery

diarrhea, which can lead to dehydration and even death if
untreated.
 The disease is most common in places with poor sanitation,
crowding, war, and famine.
 Common locations include parts of Africa, south Asia, and Latin
America.
 MAGNITUDE:
 Cholera was prevalent in the U.S. in the 1800s, before modern
water and sewage treatment systems eliminated its spread by
contaminated water. Only about 10 cases of cholera are reported
each year in the U.S. and half of these are acquired abroad.

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 AGENT:
 It is caused by vibrio cholera which is motile , comma
shaped, gram negative rods like bacteria.
 INCUBATION PERIOD:
 Incubation period is from few hours to the 5 days.
 HOST FACTORS:
 Effects both sexes.
 Occurs in the poor environmental sanitation.

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 MODE OF TRANSMISSION:
 Spread through the contaminated food, water and drinks.
 By eating or drinking in the contaminated utensils.
 Municipal water supplies
 Ice made from municipal water
 Foods and drinks sold by street vendors
 Vegetables grown with water containing human wastes.
 PATHOPHYSIOLOGY:
 The enterotoxin of vibrio is capable to produce the hyper
secretion of electrolyte balance.

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 CLINICAL FEATURES:
 Rapid heart rate.
 Loss of skin elasticity (the ability to return to original
position quickly if pinched).
 Dry mucous membranes, including the inside of the mouth,
throat, nose, and eyelids.
 Low blood pressure.
 Thirst.
 Muscle cramps
 Abrupt onset of vomiting.

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 DIAGNOSIS:
 Examination of stool specimen by
 Rectal swab method.
 Catheter method.
 Blotting paper method.
 TREATMENT:
 Rehydration with the proper replacement of electrolyte, such
as RINGER LACTATE,ORS.
 ANTIBIOTICS: tetracyclin or ceptaradine 250 to 5oomg.
 ANTIDIARRHOES: pectin kaolin suspension.
 Give creals, banana, butter and milk.

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 PREVENTION:
 Drink only water that you have boiled or treated with
chlorine or iodine.
 Other safe beverages include tea and coffee made with
boiled water and carbonated, bottled beverages with no ice.
 Eat only foods that have been thoroughly cooked and are
still hot, or fruit that you have peeled yourself.
 Avoid undercooked or raw fish or shellfish.
 Make sure all vegetables are cooked.
 Avoid salads.
 Avoid foods and beverages from street vendors.

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 NURSING INTERVENTIONS:
 Encourage the mother to give frequent small sips of clean
water or ORS from a cup; the child vomits, tell to wait for at
least 10 minutes and continue slowly
 Rehydration is the main goal to compensate for the fluid
loss from diarrhea and vomiting.
 Clients are encouraged to take more fluids as much as
possible or are given with ORS to replace electrolyte losses.
 If moderate to severe dehydration ensues, intravenous
infusion with normal saline or Lactate ringer’s solution is
main priority.

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 3.DYSENTERY
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 Dysentery is a type of gastroenteritis that results in diarrhea

with blood. Other symptoms may include fever, abdominal
pain, and a feeling of incomplete defecation.
 TYPES OF DYSENTRY:
 Amoebic dysentery:
 Dysentery caused by amoebiasis, an infection by the amoeba
Entamoeba histolytica, which is found mainly in tropical
areas, is known as amoebic dysentery.
 Bacillary dysentery:
 Dysentery may also be caused by shigellosis, an infection by
bacteria of the genus Shigella, and is then known as bacillary
dysentery (or Marlow syndrome).

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MAGNITUDE:
Insufficient data exists, but Shigella is estimated to have
caused the death of 34,000 children under the age of
five in 2013, and 40,000 deaths in people over five years
of age. Amebiasis infects over 50 million people each
year, of whom 50,000 die.
AGENT:
It is caused by several types of infections such as
bacteria, viruses, parasitic worms, or protozoa. The
mechanism is an inflammatory disorder of the intestine,
especially of the colon.

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 PATHO PHYSIOLOGY:
 Each specific pathogen has its own mechanism or
pathogenesis, but in general, the result is damage to the
intestinal lining, leading to the inflammatory immune
response.
 The result can be impaired nutrient absorption, excessive
water and mineral loss through the stools due to
breakdown of the control mechanisms in the intestinal
tissue that normally remove water from the stools, and in
severe cases, the entry of pathogenic organisms into the
bloodstream.

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SIGN AND SYMPTOMS:

 mild stomach pains and frequent passage of stool or diarrhea.
 severe abdominal pain, fever, shock, and delirium can all be
symptoms.
 dysentery patients may pass over one liter of fluid per hour.
 nausea, abdominal pain, and frequent watery and usually
foul-smelling diarrhea, accompanied by mucus and blood,
rectal pain and fever.
 Vomiting, rapid weight-loss, and generalized muscle aches .
 In such cases, it may more seriously infect other organs such
as the brain, lungs, and the liver

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 DIAGNOSIS:
 A clinical diagnosis may be made by taking a history and doing a
brief examination.
 Cultures of stool samples are examined to identify the organism
causing dysentery.
 TREATMENT:
 Dysentery is managed by maintaining fluids by using oral
rehydration therapy.
 admission may be required for intravenous fluid replacement.
 When laboratory services are not available, it may be necessary to
administer a combination of drugs, including an amoebicidal drug to
kill the parasite, and an antibiotic to treat any associated bacterial
infection.

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 If shigellosis is suspected and antibiotics such as ciprofloxacin

may be useful.
 Amoebic dysentery is often treated with two antimicrobial drug
such as metronidazole and paromomycin or iodoquinol.
 PREVENTION:
 Pre Wash hands with hot soap and water, especially before
eating.
 Eat fruits and vegetables that are washed thoroughly, boiled, or
peeled.
 Drink treated water or boil it.
 Eat food that is served hot and preferably, food that you can see
being prepared.

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   NURSING MANAGEMENT
 Observe isolation and enteric precautions.
 Provide health education.
 Boil water for drinking or use purified water
 Avoid washing food from open drum.
 Cover leftover food
 Wash hands after defecation or before eating;
 Avoid ground vegetables (lettuce, carrots)
 Proper collection of stool specimen.

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 4.FOOD POISONING
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 Foodborne illness, more commonly referred to as food poisoning,

is the result of eating contaminated, spoiled, or toxic food.
 SIGN AND SYMPTOMS:
 Common cases of food poisoning will typically include at least
three of the following symptoms:
 abdominal cramps
 diarrhea
 vomiting
 loss of appetite
 mild fever, weakness
 nausea
 headaches

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 Symptoms of potentially life-threatening food poisoning

include:
 diarrhea persisting for more than three days
 a fever higher than 101.5°F
 difficulty seeing or speaking
 symptoms of severe dehydration, which may include dry
mouth, passing little to no urine, and difficulty keeping
fluids down
 AGENTS:
 Bacteria: E.coli, salmonella, listeria.
 Viruses: norovirus, sapovirus, astrovirus.

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 DIAGNOSIS:
 Blood tests.
 Stool tests.
 TREARTMENT:
 Food poisoning can usually be treated at home, and most
cases will resolve within three to five days.
 peppermint, and dandelion may calm upset stomach.
 Avoid caffeine, which may irritate the digestive tract.
Decaffeinated teas with soothing herbs like
 In severe cases of food poisoning, individuals may require
hydration with intravenous (IV) fluids at a hospital.

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 5.TYPHOID FEVER
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 Typhoid fever is an acute illness associated with fever caused

by the Salmonella typhi bacteria. It can also be caused by
Salmonella paratyphi, a related bacterium that usually
causes a less severe illness.
 MAGNITUDE
 Worldwide, typhoid fever affects more than 21 million
people annually, with about 200,000 people dying .The
incidence of typhoid fever in the United States has markedly
decreased since the early 1900s, when tens of thousands of
cases were reported in the U.S. Today, less than 400 cases
are reported annually in the United States, mostly in people
who have recently traveled to Mexico and South America.

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 AGENT:
 Salmonella typhi.
 Salmonella paratyphi.
 CAUSES:
 Contaminated food .
 contains a high concentration of the bacteria.
Contamination of the water.
 People with acute illness can contaminate the surrounding
water supply through stool.
 Typhoid fever is contracted by drinking or eating the
bacteria in contaminated food or water.

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 SIGN AND SYMOTOMS:
 Symptoms include:
 Poor appetite
 Headaches
 Generalized aches and pains
 high fever as 104 F.
 Lethargy
 Diarrhea
 Chest congestion.
 abdominal pain and discomfort.

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INCUBATION PERIOD:
 The incubation period is usually 1-2 weeks, and the duration
of the illness is about 3-4 weeks.
 DIAGNOSIS:
 Blood CS
 StoolCS
 Urine CS
 TREATMENT:
 Treated with antibiotics.
 Chloramphenicol (Chloromycetin)
 Amoxicillin (Trimox, Amoxil, Biomox)

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 Trimethoprim and sulfamethoxazole (Bactrim DS, Septra)

 Ciprofloxacin (Cipro)
 Azithromycin (Zithromax)
 NURSING INTERVENTIONS:
 1. Assess client's nutritional patterns.
2. Assess eating likes and dislikes.
3. Encourage bed rest / activity restrictions during the acute
phase:
4. Measure weight every day
5. Encourage clients to eat little but often
6. Collaboration with a dietitian for a diet providing

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 6.POLIOMYELITIS
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 Polio (also known as poliomyelitis) is a highly contagious disease

caused by a virus that attacks the nervous system. Children younger
than 5 years old are more likely to contract the virus than any other
group.
 MAGNITUDE:
 According to the WHO, 1 in 200 polio infections will result in
permanent paralysis. However, thanks to the global polio eradication
initiative in 1988, the following regions are now certified polio-free:
 Americas
 Europe
 Western Pacific
 Southeast Asia.

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 AGENT:
 POLIO VIRUS TYPE 1
 POLIO VIRUS TYPE 2
 POLIO VIRUS TYPE 3
 SIGN AND SYMPTOMS:
 SIGNS:
 fever
 sore throat
 headache
 vomiting
 fatigue
 meningitis

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These symptoms include:

 loss of reflexes
 severe spasms and muscle pain
 loose and floppy limbs, sometimes on just one side of the
body
 sudden paralysis, temporary or permanent
 deformed limbs, especially the hips, ankles, and feet
 DIAGNOSIS:
 BY a physical examination and look for impaired reflexes,
back and neck stiffness, or difficulty lifting your head while
lying flat.

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 TREATMENT:
 The most common supportive treatments include:
 bed rest
 Pain killers
 antispasmodic drugs to relax muscles
 antibiotics for urinary tract infections
 portable ventilators to help with breathing
 physical therapy or corrective braces to help with walking
 heating pads or warm towels to ease muscle aches and spasms
 physical therapy to treat pain in the affected muscles
 physical therapy to address breathing and pulmonary problems
 pulmonary rehabilitation to increase lung endurance.

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NURSING CARE:
• Maintain a patent airway, and keep a tracheostomy tray at the
patient’s bed side.
• Encourage a return to mild activity as soon as possible.
• Prevent fecal impaction by giving enough fluids to ensure an
adequate daily urine output of low specific gravity.
• Provide tube feedings when needed.
• Provide good skin care, reposition the patient often, and keep
bed linens dry.
• To alleviate discomforts, use foam rubber pads and sandbags or
light splints as ordered.
• Assess bladder retention that cause muscle paralysis.

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 CHN 2 B.T. BASAVANTHAPA.

 WHO ORGANIZATION
 WIKIPEDIA.

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 TOPIC: COMMUNICABLE DISEASE GROUP 03
NC FIZA IMTIAZ DATE 09/05/2017
S.NO. DISEASE CAUSATIVE SIGN ANSD COMPLICATION TREATMENT NURSING PREVENTION REMARKS/
AGENTS/ SYMPTOMS INTERVENTI ADVANCEM
INCUBATION
43 ON ENT
PERIOD
TRANSMISSION

01. DIARRO Bacteria: E. coli

Dehydration. Fatigue. Increase fluid Replace fluid Safe drinking-  
HEA o Virus: Rota virus
o Urinary o Electrolyte intake. and electrolyte water.
o Parasites: E. o Give ORS . losses . o improved
having output imbalance.
o Promote rest.
three or hystolytica. decreases.   o Ampicillin, o Low fiber sanitation.
more loose o 02 to 04 days.
o Poor skin genticin, diet o Hand washing
or liquid o By fecal oralo dry mouth tetracyclin. o BRAT Diet with soap.
stools per route. o Sunken metronidazol o personal and
day. o Direct route. eyes. e. food hygiene.
o Loose
motion.
o Vomiting.
02. Loss of skin  
CHOLER Vibrio cholera. elasticity Fatigue. Rehydration Rehydration is boiled water.
A o few hours to 05 o Dry mucous o Electrolyte with RINGER the main goal. o Avoid
o ORS to
Is caused days. membrane imbalance. LACTATE, ORS. undercooked
replace
by watery o Contaminated o Low Tetracycline or raw fish or
electrolyte
diarrhea. food, water and pressure. or pectin losses. shellfish.
drinks. o Low Thirst. suspension. o Health o Proper
o Contaminated o Muscle Give creals, education. vegetables are
utensils. cramps banana, butter cooked.
o Abrupt and milk.  o Avoid foods
onset of and beverages
vomiting. from street
vendors.

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 TOPIC: COMMUNICABLE DISEASE GROUP 03
NC FIZA IMTIAZ DATE 09/05/2017
S.N DISEASE CAUSATIVE SIGN AND COMPLICATION TREATMENT NURSING PREVENTION REMARKS/
O. AGENTS/ SYMPTOM INTERVENTIO ADVANCE
INCUBATION NS MENT
PERIOD 44
TRANSMISSION

03  
DYSEN Bacteria, viruses. Mild Delirium Oral Provide health Pre Wash hands
.
o few hours to 07 stomach o Convulsions rehydration education. with hot soap and
TRY o Boil water .
Diarrhea days. pains . o Coma. therapy. water.
o Avoid
o contaminated o diarrhea. o Ciprofloxaci o Eat fruits and
with washing food
articles. o Severe n from open vegetables that
blood. o Metronidaz
abdomin drum. are washed
al pain ole and thoroughly
o fever paromomyc o Drink treated
o Vomiting in or water or boil it.
, iodoquinol
o nausea.
04
FOOD o Bacteria: o Abdomin o  Lactose o treated at o Health o  wash hands
.
al intolerance. home. education. properly.
POISIO o E.coli o Anemia
o Viruses: cramps o Avoid o Bed rest. o Use the boiled
NING o Irritable bowel
o diarrhea caffeine, o Monitor the water.
Also norovirus syndrome
o vomiting o Kidney failure which may vitals. o Avoid
known o 08 to 22 hours.
o loss of o Hemolytic irritate the uncooked food.
as food o By the means
appetite Uremic . GIT. o Improve
borne of o Reactive
o mild o Hydration sanitation.
illness. contaminated arthritis
fever with (IV)
food with flies, o GBS
o weakness fluids .
dust. o Pericarditis.
o nausea
o Prepare not
o headache
safely.
s.
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 TOPIC: COMMUNICABLE DISEASE GROUP 03
S.N DISEASE CAUSATIVE SIGNNC
ANDFIZA IMTIAZ DATE
COMPLICATION 09/05/2017
TREATMENT NURSING PREVENTION REMARKS/
O. AGENTS/ SYMPTOMS INTERVENT ADVANCEMENT
INCUBATION 45 ION
PERIOD
TRANSMISSION
05  
TYPHOI o Salmonella o Poor o  internal o Treated o Assess o Wash your
D appetite bleeding of with client's hands.
typhi, o Avoid
FEVER o Headache GIT. antibiotics. nutritional
paratyphi. drinking
acute o Generalize o Internal o Chloramph patterns.
o 1-2 weeks. untreated
illness. d aches perforation of enicol o Assess water.
o Spread by
caused by and pains. GIT. Amoxicillin eating o Avoid raw
the contaminated o High o Ciprofloxaci likes and fruits and
Salmonell food . fever as n dislikes. vegetables.
a typhi 104 F. o Azithromyc o Encourage o Choose hot
o Lethargy foods.
bacteria. in bed rest. o Vaccination
o Diarrhea  .

06  
POLIOM o POLIO VIRUS o fever o   club foot o supportive o  Maintain o Can only
YELITIS o headache o Muscle paresi treatment. a patent prevented
TYPE 1, 2, 3. s  airway. by polio
is a o 07 to 21 days. o vomiting o bed rest
o  scoliosis. o Provide vaccination.
contagiou o loss of o compression o antispasmo
o  spread by the tube At different
s disease reflexes. neuropathy. dic drugs. feedings. ages.
fecal oral or o sudden o Antibiotic.
caused by o  bone o Provide
a virus oral route. paralysis. fractures. o physical good skin
that o deformed therapy . care.
attacks limbs, o pulmonary o Assist for
physiother
the feet, hip. rehabilitati
apy.
nervous on.
system.
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