Communicable Diseases
o Environment
TOPIC OUTLINE
Definition of terms in Communicable Disease
Chain of infection
Control and Management of Infectious Disease
Immunization
Protective Precautions / Isolation
Diseases acquired thru GI tract
Diseases acquired thru the skin
Diseases acquired thru the respiratory tract
Diseases acquired thru sexual contact
COMMUNICABLE DISEASE
It is an illness caused by an infectious agent or its toxic
products that are transmitted directly or indirectly to a
well person through an agent, vector or inanimate object
TWO TYPES
INFECTIOUS DISEASE
Not easily transmitted by ordinary contact but require a
direct inoculation through a break in the previously intact
skin or mucous membrane
CONTAGIOUS DISEASE
Easily transmitted from one person to another through
direct or indirect means
TERMINOLOGIES
DISINFECTION destruction of pathogenic microorganism
outside the body by directly applying physical or chemical
means
Concurrent method of disinfection done
immediately after the infected individual
discharges infectious material/secretions. This
method of disinfection is when the patient is still
the source of infection
Terminal applied when the patient is no longer
the source of infection.
Disinfectant -chemical used on non living objects
Antiseptic chemical used on living things.
Bactericidal kills microorganism
Sterilization complete destruction of all microorganism
General Principles
Pathogens move through spaces or air current
Pathogens are transferred from one surface to another
whenever objects touch
Hand washing removes microorganism
Pathogens are released into the air on droplet nuclei when
person speaks, breaths, sneezes
Pathogens are transferred by virtue of gravity
Pathogens move slowly on dry surface but very quickly
through moisture
INFECTION
invasion and multiplication of microorganisms on the
tissues of the host resulting to signs and symptoms as well
as immunologic response
injures the patient either by:
o competing with the hosts metabolism
o cellular damage produced by the microbes
intracellular multiplication
Factors of severity of infection
o disease producing ability
o the number of invading microorganism
o The strength of the hosts defence and some
other factors.
Epidemiological triad:
o Agent
o Host
Classification accdg to incidence:
SPORADIC - disease that occur occasionally and irregularly
with no specific pattern
ENDEMIC those that are present in a population or
community at times.
EPIDEMIC diseases that occur in a greater number than
what is expected in a specific area over a specific time.
PANDEMIC is an epidemic that affects several countries
or continents
Causes of INFECTION
Some bacteria develop resistance to antibiotics
Some microbes have so many strains that a single vaccine
cant protect against all of them ex. Influenza
Most viruses resist antiviral drugs
Opportunistic organisms can cause infection in
immunocompromised patients
Most people have not received vaccinations
Increased air travel can cause the spread of virulent
microorganism to heavily populated area in hours
Use of immunosupressive drugs and invasive procedures
increase the risk of infection
Problems with the bodys lines of defense
Three Lines of Defense
FIRST LINE OF DEFENSE
o MECHANICAL BARRIERS
o CHEMICAL BARRIERS
o BODYS OWN POP. OF MICROORGANISM -
microbial antagonism principle
SECOND inflammatory response
o Phagocytic cells and WBC to destroy invading
microorganism manifesting the cardinal signs
THIRD immune response - Natural/Acquired:
active/passive
RISK FACTORS
Age, sex, and genes
Nutritional status, fitness, environmental factors
General condition, emotional and mental state
Immune system
Underlying disease ( diabetes mellitus, leukemia,
transplant)
Treatment with certain antimicrobials (prone to fungal
infection), steroids, immunosuppresive drugs etc.
CHAIN OF INFECTION
Mode of Transmission
Contact transmission
Direct contact - person to person
Indirect - thru contaminated object
 o Droplet spread - contact with respiratory
secretions thru cough, sneezing, talking.
Microbes can travel up to 3 feet.
Airborne Transmission
Vector Borne Transmission
Vehicle Borne Transmission
Emerging problems in infectious diseases
Developing resistance to antibiotics eg: anti tb drugs,
MRSA, VRE
Increasing numbers of immunosuppressed patients.
Use of indwelling lines and implanted foreign bodies has
increased.
INFECTION CONTROL MEASURES
UNIVERSAL PRECAUTION All blood, blood products and
secretions from patients are considered as infected.
WORK PRACTICE CONTROL
Handwashing
o Before and after using gloves, after hand contact
with patients, patients blood and other
potentially infected materials.
Protective Equipment shall be removed immediately upon
leaving the work area. Like apron, mask, gloves etc.
o Place in designated area.
Used needles and sharps shall not be bent, broken,
recapped. Used needles must not be removed from
disposable syringes.
Eating, drinking, smoking, applying cosmetics or handling
contact lenses are prohibited in work areas.
Foods and drinks shall not be stored in refrigerators,
freezers where blood or other infectious materials are
stored.
All procedures involving blood or other potentially
infectious materials shall be performed in such a manner
as to minimize splashing, or spraying.
Control Measures
Masking Wear mask if needed. Patient with infectious
respiratory diseases should wear mask.
Handwashing Practice it with soap and water.
Gloving Wear gloves for all direct contact with patients.
Change gloves and wash hands every after each patient.
Gowning - Wear gown during procedures which are likely
to generate splashes of blood or sprays of blood and body
fluids, secretions or excretions.
Eye protection (goggles) wear it to prevent splashes.
Environmental disinfection Clean surfaces with
disnfectant 70% alcohol,diluted bleach)
o Ex. Normal clean clean the room post
discharge, final clean- MRSA and infectious pts.
ISOLATION PRECAUTIONS
Separation of patients with communicable diseases from
others so as to reduce or prevent transmission of
infectious agents.
7 Categories Recommended in isolation
Strict isolation prevent spread of infection from patient
to patient/staff.- handwashing, infectous materials must be
discarded, use of single room, use of mask, gloves and
gowns and (-) pressure if possible
Contact isolation prevent spread by close or direct
contact
Respiratory isolation prevent transmission thru air.
TB isolation for (+) TB or CXR suggesting active PTB.
Enteric Isolation direct contact with feces
Drainage/secretion precaution- prevents infection thru
contact with materials or drainage from infected person.
Universal Precaution for handling blood and body fluids.
(Bloods, pleural fluid, peritoneal fluid etc.)
PREVENTION
Health Education educate the family about
Immunization
MOT
Environmental sanitation breeding places of mosquito,
disposal of feces
Importance of seeking medical advice for any health
problem
Preventing contamination of food and water.
Environmental Sanitation
o Water Supply Sanitation Program DOH thru
EHS (Environmental Health Services)
o Policies on Food Sanitation Program
o Policies on Hospital Waste Management
The CHNurse is in the best position to do health education
such as
o > development of materials for environmental
sanitation
o > providing group counselling, holding
community assemblies and conferences.
o > create programs for sanitation
o > be a role model
Immunization introduction of specific antibody to produce
immunity to certain disease.
o Natural passive (from placenta), active (thru
immunization & recovery from diseases)
o Artificial passive (antitoxins), active (vaccine,
toxoid)
Maintain vaccine potency by preventing:
o Heat and sunlight
o Freezing
Antiseptic/ disinfectants/ detergents lessen the potency of
vaccine. Use water only when cleaning fridge/ref.
COLD CHAIN SYSTEM maintenance of correct
temperature of vaccines, starting from the manufacturer,
to regional store, to district hospital, to the health center
to the immunizing staff and to the client.
Diseases Acquired Thru Respiratory
TUBERCULOSIS
Chronic respiratory disease affecting the lungs
characterized by formation of tubercles in the tissues--->
caseation --> necrosis ---> calcification.
AKA: Phthisis, Consumption, Kochs, Immigrants dse
Etiologic agent: Mycobacterium tuberculosis
Incubation period: 2 10 wks.
Period of communicability: all throughout the life if not
treated
MOT: Droplet
Sources of infection sputum, blood, nasal discharge,
saliva
Classification
1. Inactive asymptomatic, sputum is (-), no cavity on chest X ray
2. Active (+) CXR, S/S are present, sputum (+) smear
Classification 0-5
A. Minimal slight lesion confined to small part of the lung
B. Moderately advanced one or both lungs are involved, volume
affected should not extend to one lobe, cavity not more than 4 cm.
C. Far advance more extensive than B
MANIFESTATIONS
Primary Complex: TB in children: non contagious, children
swallow phlegm, fever, cough, anorexia, weight loss, easy
fatigability
Adult TB
o afternoon rise in temperature
o night sweats
o weight loss
o cough dry to productive
o Hemoptysis
o sputum AFB (+)
Milliary TB - very ill, with exogenous TB like Potts disease Diagnostic exams:
Primary Infection o Lumbar tap, CSF - high WBC and CHON, low
o Asymptomatic glucose
o No manifestations even at CXR, Sputum AFB Manifestations:
Primary Complex o Sudden onset of fever x 24h
o Minimal manifestations o Petechiae, Purpuric rashes
o Lymphadenopathy o Meningeal irritation
Stiff neck
Opisthotonus
Kernigs sign
Brudzinski sign
o ALOC
o S/S of Increase ICP
Nursing Mgt:
Administer prophylactic antibiotics: Rifampicin - drug
of choice
Aquaeous Pen
Mannitol
Dexamethasone
DX Priority: AIRWAY, SAFETY
Tuberculin testing Maintain seizure precaution
CXR Respiratory precaution
Sputum AFB Handwashing
Prevention Suction secretions
BCG
Avoid overcrowding DIPTHERIA
Improve nutritional status
Acute contagious disease characterized by generalized toxemia
TX
coming from localized inflammatory process
DOTS
Etiologic agent: Corynebacterium Diptheria (Klebs loffer
6 months of RIPE
bacillus)
Respiratory isolation,
Incubation period: 2-5 days
Take medicines religiously prevent resistance
Period of communicability: variable, ave:2-4 weeks
Stop smoking
MOT Droplet, direct or intimate contact, fomites, discharge
Plenty of rest
from nose, skin, eyes
Nutritious and balance meals, increase CHON, Vit. A, C
Manifestation
PSEUDOMEMBRANE - grayish white, smooth, leathery and
MENINGITIS spider web like structure that bleeds when detached
Inflammation of the meninges usually some
Types of Respiratory Diptheria
combination of headache, fever, stiff neck, and
NASAL
delirium
o serous to serosanginous purulent discharge
Meningococcemia: cerebrospinal fever
o Pseudomebrane on septum
o Etiologic agent: Neisseria meningitidis
o Dryness/ excoriation on the upper lip and nares
o Incubation: 2-10 days
PHARYNGEAL
o MOT: droplet
o pharyngeal pseudomembrane
Acute meningococcemia - with or without meningitis
o bull neck ( cervical adenitis)
o Waterhouse Friederichsen Syndrome
o Difficulty swallowing
LARYNGEAL
o Sorethroat, pseudomemb
o Barking, dry mettallic cough
Complications
o Due to TOXEMIA
 Toxic endocarditis Convulsions (brain damage - asphyxia,
Neuritis hemorrhage)
Toxic nephritis Dx:
o Due to Intercurrent Infection Elevated WBC
Bronchopneumonia Nasopharyngeal swab
Respiratory failure Nursing Management
DX Prevention:
Nose and throat swabs - culture of o DPT
specimen form beneath membrane Parenteral fluids
Virulence test Erythromycin - drug of choice
SHICKs TEST: test for susceptibility to diptheria Prone position during attack
MOLONEYs TEST: test for hypersensitivity to diptheria Abdominal binder
MANAGEMENT Adequate ventilation, avoid dust, smoke
1. Penicillin, Erythromycin Isolation
2. Diptheria Antitoxin after skin test if (+), fractional dose Gentle aspiration of secretions
3. Supportive
O2, if laryngeal obstruction tracheostomy MEASLES
CBR for 2 weeks Acute viral disease with prodromal fever,
Increase fluids, adequate nutrition- soft food, rich in conjunctivitis, coryza, cough and Kopliks spots
Vit C AKA: Rubeola, 7-day measles
Ice collar Etiologic agent: Morbilli Paramyxoviridae virus
4. Isolation till 3 NEGATIVE cultures Incubation period: 10-12 days
Prevention Period of communicability: 3 days before and 5 days
DPT after the appearance of rashes. Most communicable
during the height of rash.
PERTUSIS (whooping cough) MOT: Airborne
Repeated attacks of spasmodic coughing with series of Sources of infection secretions from eyes, nose and
explosive expirations ending in long drawn force inspiration throat
Etiologic agent: Bordetella pertusis or Haemiphilus pertussis Pathognomonic sign:
Incubation period: 7-14 days Kopliks spots
Period of communicability: 7 days post exposure to 3 wks post
disease onset
MOT Droplet

Manifestations
1.Pre eruptive stage / Prodromal (10-11 days)
o Coryza, Cough, Conjunctivitis
Manifestation o Kopliks Spots, whitish spot at the inner
o rapid cough 5-10x in one inspiration ending cheek
a high pitched whoop. o Fever, photophobia
Catarrhal slight fever in PM, colds, watery nasal 2. Eruptive stage
discharge, teary eyes, nocturnal coughing, 1-2 weeks o Maculopapular rashes
Paroxysmal Spasmodic stage; 5-10 successive o Rash is fully developed by 2nd day
forceful coughing ending with inspiratory whoop, o High grade fever on and off
involuntary micturition and defecation, choking spells, o Anorexia, throat is sore
cyanosis 3. Convalescence (7-10 days)
Convalescent 4th- 6th week; diminish in severity, o Desquamation of the skin
frequency Diagnostics
Complications: Nose and throat swab
Otitis media Treatment
Acute bronchopneumonia 1. Antiviral drugs- Isoprenosine
Atelectasis or emphysema 2. Antibiotics if with complications
Rectal prolapse, umbilical hernia 3. Supportive O2, IVF
 Complications bronchopneumonia, otitis Eruptive: rash starts from trunk
media, encephalitis Lesions - red papules then becomes milky and pus like within 4
days,
Nursing Management Pruritis
Preventive measles vaccine at 9 months, MMR Stages of skin affectations
15 months and then 11-12; defer if with fever, o Macule flat
illness o Papule elevated above the skin diameter about 3 cm
Isolation - contact/respiratory o Vesicle
TSB , Skin care daily cleansing wash o Pustule
Oral and nasal care o Crust scab , drying on the skin
Plenty of fluids Complications
Avoid direct glare of the sun- due to o pneumonia, sepsis
photophobia Treatment
Zovirax 500mg tablet 1 tab BID X 7 days
GERMAN MEASLES Acyclovir
Mild viral illness caused by rubella virus. Oral antihistamine
AKA: Rubella; 3-Day Measles Calamine lotion
Incubation period from exposure to rash 14 -21d Antipyretics
Period of communicability one week before and and 4 NURSING MANAGEMENT
days after onset of rashes. Worst when rash is at its peak. Strict isolation until all vesicles scabs disappear
MOT: Droplet, nasal ceretions, transplacental in congenital Hygiene of patient
Manifestations Cut finger nails short
1. Prodromal low grade fever, headache , malaise, colds, Baking soda - pruritus
lymph node involvement on 3rd to 5th day PREVENTION: Live attenuated varicella vaccine
2. Eruptive FORSCHEIMERS SPOTS: pinkish rash on soft VZIG - effective if given 96h post exposure
palate, rash on face, spreading to the neck, arms and trunk
o lasts1-5 days with no pigmentation or Herpes Zoster
desquamation Acute inflammatory disease known to be caused by herpes
o muscle pain virus varicellae or VZ virus
Treatment Infection of the sensory nerve charac by extremely painful
o symptomatic treatment infection along the sensory nerve pathway
Complications Occurs as reinfection of VZ virus
1. Encephalitis, neuritis MOT
2. Rubella syndrome microcephaly, mental retardation, o Direct
deaf mutism, congenital heart disease o Indirect airborne
Incubation: 1-2 weeks

RISK for congenital malformation

1. 100% when maternal infection happens on first
trimester of pregnancy.
2. 4% - second/third trimester
Nursing Management
1. Isolation. Bed rest
2. Room darkened photophobia
3. Encourage fluid
4. Like measles tx
PREVENTION;
MMR, Pregnant women should avoid exposure to rubella
patients
Administration of Immune serum globulin one week after
exposure to rubella.
Diagnostic procedure
o Hx of chickenpox
CHICKEN POX o Pain and burning sensation over lesions of
Acute and highly contagious viral disease characterized by
vesicles along nerve pathway
vesicular eruptions on the skin
o Smear of vesicle fluid- giant cells
Infectious agent Herpes zoster virus or Varicella zoster
o Viral cultures of vesicle fluid
Incubation period 10 -21 days
o Electron microscopy
Period of communicability: 1 day before eruption up to 5 days
o Giemsa-stained scraping multinucleate giant
after the appearance of the last crop
MOT: airborne, direct, indirect epithelial cells
o Direct contact thru shedding vesicles, S/S
o Burning, itching, pain then erythematous patches followed
o Indirect thru linens or fomites
by crops of vesicles
Manifestations
o Eruptions are unilateral
Pre eruptive: Mild fever and malaise
o Lesions may last 1-2 weeks
 o Fever, regional lymphadenopathy
o Paralysis of cranial nerve, vesicles at external auditory DIAGNOSTIC PROCEDURES
canal 1. Viral culture
o Paralytic ileus, bladder paralysis, encephalitis 2. WBC count

Complications PREVENTION: MMR Vaccine

o Opthalmia herpes blindness because of
damage of gasserian ganglion TREATMENT MODALITIES
o Geniculate herpes deafness because of 1. Antiviral drugs
infection of 7th CN (AKA: Ramsay Hunt Syndrome) 2. NSAIDS - Acetaminophen
Nursing Intervention Nursing Interventions
o Compress of NSS or alluminum acetate over o Symptomatic
lesions o Application of warm/ cold compress
o Analgesics, sedatives weeks to mos o Oral care, warm salt water gargle
o Steroids o Diet semi solid, soft food easy to chew
o Keep blister covered with sterile powder esp Acid foods/fluids fruit juices may increase
after break discomfort
o Prevent bacterial invasion
o Encourage proper disposal of secretions and Diseases Acquired thru GIT
usage of gown and mask Diseases caused by Bacteria
o Typhoid Fever
MUMPS o Cholera
Acute viral disease manifested by swelling of one or both o Dysentery
of the parotid glands, with occasional involvement of other Diseases caused by Virus
glandular structures,particularly testes in male. o Poliomyelitis
Etiologic agent filterable virus of paramyxovirus group o Infectious Hepatitis A
usually found in saliva of infected person. Diseases caused by Parasites
AKA: Epidemic/ infectious parotitis o Amoebiasis
Incubation period: 14 -25 days. o Ascariasis
Period of communicability 6d before and 9d post onset
of parotid gland swelling TYPHOID FEVER
o 48 hrs immediately preceding the onset of Infection of the GIT affecting the lymphoid
swelling is the highest communicability. tissues(ulceration of Peyers patches) of the small intestine
MOT: direct, indirect - droplet, airborne Etiologic Agent: Salmonella typhosa and typhi, Typhoid
bacillus
Incubation period: 1-2 weeks
Period of communicability: as long as the patient is
excreting the microorganism,
MOT: fecal-oral route, contaminated water, milk or other
food
Sources of Infection
o A person who recovered from the disease can be
potential carrier.
o Ingestion of shellfish taken from waters
contaminated by sewage disposal
o Stool and vomitus of infected person are sources
of infection.

CLINICAL MANIFESTATIONS
1. Sudden headache, earache, loss of appetite
2. Swelling of the parotid gland
3. Pain is related to extent of the swelling of the gland
which reaches its peak in 2 days and continues for 7-10
days.
4. Fever may reach 40 C during acute stage,
5. One gland may be affected first and 2 days later the
other side is involved
COMPLICATIONS
1. Orchitis testes are swollen and tender to palpation.
2. Oophoritis- pain and tendeness of the abdomen
3. Mastitis
4. Deafness may happen
5. Meningo-encephalitis -possible
CLINICAL MANIFESTATIONS o Initial stool is brown and contains fecal
ONSET material becomes rice water
Ladderlike fever o Nausea/ Vomiting
Nausea, vomiting and diarrhea o S/s of Dehydration
RR is fast, skin is dry and hot, abdomen is o poor tissue trugor, eyes are sunken
distended o Pulse is low or difficult to obtain, BP is low
Head-ache, aching all over the body and later unobtainable.
Worsening of symptoms on the 4th and 5th day o RR rapid and deep
Rose spots o Cyanosis later
TYPHOID STATE o Voice becomes hoarse speaks in whisper
Tongue protrudes- dry and brown Oliguria or anuria
sordes Conscious, later drowsy
(coma vigil) Deep shock
(subsultus tendinus) Death may occur as short as four hours after onset.
(Carphologia) Usually first or 2nd day if not treated
Always slip down to the foot part of the bed, Principal deficits
Severe case - delirum sets in often ending in 1. Severe dehydration - circulatory collapse
death 2. Metabolic acidosis loss of large volume of bicarbonate
Complications rich stool. RR rapid and deep
o Hemorrhage, Peritonitis, Pneumonia, Heart failure, 3. Hypokalemia massive loss of K. abdominal distention
Sepsis paralytic ileus
DIAGNOSTIC PROCEDURES DIAGNOSTIC EXAMS
1. WBC elevated Fecal microscopy
2. Blood Culture (+) S. typhosa 1. Rectal swab
3. Stool Culture (+) 2. Stool exam
4. Widal test blood serum agglutination test
O antigen active typhoid
H antigen- previously infected or vaccinated Treatment
Vi antigen - carrier 1. IVF- rapid replacement
TREATMENT 2. Oral rehydration
1. Chloramphenicol drug of choice 3. Strict I and O
2.Paracetamol 4. Antibiotics Tetracycline, Cotrimoxazole.
NURSING MANAGEMENT
1. Restore FE balance NURSING MANAGEMENT
2. Bedrest 1. Medical Asepsis
3. Enteric precaution 2. Enteric precaution
4. Prevent falls/ safety prec 3. VS monitoring
5. Oral/personal hygiene 4. I and O
6. WOF intestinal bleeding-bloody stool,sweating, pallor 7. 5. Good personal hygiene
NPO, BT 6. Proper excreta disposal
7. Concurrent disinfection.
CHOLERA 8. Environmental sanitation
An acute bacterial disease of the GIT characterized by PREVENTION
profuse diarrhea, vomiting, loss of fluid. 1. Protection of food and water supply from fecal
Etiologic agent: Vibrio cholerae, V. comma contamination.
Pathognomonic sign: rice watery stool 2. Water should be boiled/ chlorinated.
Incubation period: 2-3 days 3. Milk should be pasteurized.
Period of Communicability: entire illness, 7-14d 4. Sanitary disposal of human excreta
MOT: fecal oral route 5. Environmental sanitation.

DYSENTERY
Acute bacterial infection of the intestine characterized by
diarrhea and fever
Etiologic Agent: Shigella group
o Shigella flesneri - commmon in the Philippines
o Shigella boydii, S. connei,
o S. dysenteria most infectious, habitat
exclusively in man, they develop resistance to
antibiotics
Incubation period 7 hrs. to 7 days
Period of communicability during acute infection until
the feces are (-)
MOT fecal-oral route, contaminated water/ milk/ food.
Clinical manifestations
o Acute, profuse, watery diarrhea.
Clinical manifestations
Fever esp. in children
Nausea, vomiting and headache
Anorexia, body weakness
Cramping abdominal pain (colicky)
Diarrhea bloody and mucoid 3 Types of Paralysis
Tenesmus Spinal Paralytic
Weight loss o Flaccid paralysis
DIAGNOSTICS o Autonomic involvement
Fecalysis o Respiratory difficulty
Rectal Swab/culture Bulbar Form
Bloods WBC elevated o Rapid & serious
Blood culture o Vagus and glossopharyngeal nerves affected
TREATMENT o Cardiac and respiratory reflexes altered
Antibiotics- Ampicillin, Cotrimoxazole, Tetracycline o Pulmo edema
IVF o Hypertension, impaired temp regulation
Anti diarrheal are Contraindicated o Encephalitic s/s
NURSING MANAGEMENT Bulbospinal
1. Maintain fluid and electrolyte balance o Combination
2. Restrict food until nausea and vomiting subsides. Minor Polio
3. Enteric precaution o Inapparent / subclinical
4. Excreta must be disposed properly. o Abortive: recover within 72 hours; flulike;
5. Prevention- food preparation, safe washing facilities, fly backache; vomiting
control Major Polio
o Paralytic: asymmetrical weakness,
POLIOMYELITIS paresthesia, urinary retention, constipation
An acute infectious disease caused by any of the 3 o Non paralytic: slight involvement of the
types of poliomyelitis virus which affects mainly the CNS; stiffness and rigidity of the spine,
anterior born cells of the spinal cord and the medulla, spasms of hamstring muscles, with paresis
cerebellum and the midbrain o Tripod position: extend his arms behind
AKA: Acute anterior poliomyelitis, heinmedin disease, him for support when upright
infantile paralysis o Hoynes sign: head falls back when he is in
Etiologic Agent: Poliovirus (Legio Debilitans) supine position with the shoulder elevated
3 Types of Poliovirus o Meningeal irritation: (+) Brudzinski, Kernigs
Type I - most paralytogenic, most frequent
sign
Type II - next most frequent
Diagnostic tests:
Type III - least frequent associated with paralytic
Throat swab, stool exam, LP
disease
Nursing Interventions
3 Strains
Supportive, Preventive Salk and Sabin Vaccine
o Brunhilde
NO morphine
o Laasing Moist heat application for spasms
o Leon AIRWAY: tracheotomy
MOT: Fecal-Oral Footboard to prevent foot drop
Incubation period: 7-14 days ave (3-21 days) Fluids, NTN, Bedrest
Period of communicability: Enteric and strict precautions
o 7-16 days before and few days after onset of
s/s HEPATITIS A
S/S Inflammation of the liver caused by hepatitis A virus
o Febrile episodes with varying degrees of AKA: infectious hepatitis
muscle weakness Incubation period: 2-6weeks
o Occasionally progressive Flaccid Paralysis MOT: oral-fecal/ enteric transmission
Diagnostic test: liver function (SGOT/SGPT)
 Diarrhea watery and foul smelling stool often containing
blood streaked mucus
Colic and abdominal distention
Intestinal perforation -bleeding
DIAGNOSTIC EXAM
Stool Exam ( cyst, amoeba+++)
WBC elevated
TREATMENT
o Amoebacides Metronidazole(Flagyl) 800mg TID X 7days
o Bismuth gylcoarsenilate combined with Chloroquine
o Antibiotic Ampicillin, Tetracycline, Chloramphenicol
o Fluid replacement IVF, oral
NUSING MANAGEMENT
Enteric precaution
Health education- boil drinking water (20-30 mins),
Clinical manifestations Use mineral water.
Prodromal/ pre icteric Cover leftover food.
S/S of URTI Avoid washing food from open drum/pail.
Weight loss Wash hands after defecating and before eating.
Anorexia Observe good food preparations.
RUQ pain Fly control
Malaise
Icteric ASCARIASIS
Jaundice Helminthic infection of the small intestine caused by
Acholic stool ASCARIS LUMBRECOIDES
Bile-colored urine MOT: fecal-oral
Incubation period: 4-8 weeks
Diagnostic tests: HaV Ag, Ab, SGOT, SGPT Communicability: as long as mature fertilized female
worms live in intestine
Nursing Interventions Diagnostic exams: Microscopic identification of eggs in
o Provide rest periods stool, CBC, Hx of passing out of worms (oral or anal), Xray,
o Increase CHO, mod Fat, low CHON S/S
o Intake of vits/minerals o Stomachache
o Proper food preparation/handling o Vomiting
o Handwashing to prevent transmission o Passing out of worms
o Complications
AMOEBIASIS o Energy / Protein malnutrition, Anemia
Involves the colon in general but may involve the liver or lungs o Intestinal obstruction
as well Treatment:
Etiologic agent: Entamoeba histolytica o Pyrantel Pamoate
Incubation: 3-4 weeks o Piperazine Citrate
Period of communicability: duration of illness o Mebendazole, Tetramizole
MOT: fecal oral route o Dicyclomine Hcl, NSAIDS for abdominal pain
Indirect - Ingestion of food contaminated with E.Histolytica o For intestinal obstruction
cysts, polluted water supply, exposure to flies, unhygienic food Decompression
handlers. Fluid and electrolyte therapy
Direct contact sexual, oral, or anal, proctogenital If persistent, laparotomy
o FF up stool exam 1-2 weeks after treatment
Nursing Intervention
o Isolation- not needed
o Enteric precaution
o Handwashing
o Proper nutrition
o Maintenance of hydration / fluid balance / boil of water
o Improve personal hygiene
o Proper food prep/handling
o Administer meds (NSAIDS, MEBENDAZOLE

Diseases Acquired thru the Skin

Clinical manifestations Diseases caused by Trauma and Inoculation
Intermittent fever o Tetanus
Nausea, vomiting, weakness o Rabies
Later : anorexia, weight loss, jaundice o Malaria
o DHF
 o Leptospirosis o Septicemia
o Schistosomiasis Nosocomial infections
Disease acquired thru Contact o Death
o Leprosy Diagnostic procedure:
entirely clinical
TETANUS CSF normal
An acute, often fatal, disease characterized by WBC- normal or slight elevation
generalized rigidity and convulsive spasms of skeletal Treatment:
muscles caused by the endotoxin released by C. Tetani Wounds should be cleaned
AKA: Lockjaw Necrotic tissue and foreign material should be removed
Etiologic Agent: Clostridium Tetani Tetanic spasms - supportive therapy and maintenance of
o Anerobic an adequate airway
o Spore forming, gram positive rod Tetanus immune globulin (TIG)
Sources: o help remove unbound tetanus toxin
o Animal and human feces o cannot affect toxin bound to nerve endings
o Soil and dust o single intramuscular dose of 3,000 to 5,000 units
o Plaster, unsterile sutures, rusty scissors, o Contains tetanus antitoxin.
nails and pins Oxygen
MOT: NGT feeding
o Direct or indirect contact to wounds Tracheostomy
o Traumatic wounds and burns Adequate fluid, electrolyte, caloric intake
o Umbilical stump of the newborn During convalescence
o Dirty and rusty hair pins o Determine vertebral injury
o GIT- port of entry rare o Attend to residual pulmonary disability
o Circumcision/ ear pearcing o Physiotherapy
Incubation period: 3d-3week (ave:10d) o TT
Nursing Interventions:
Prevention
DPT
o Adverse Reactions
o Local reactions (erythema, induration)
o Fever and systemic symptoms not common
o Exagerated local reactions

Nursing interventions:
Prevention of CV and respiratory complications
o Adequate airway
o ICU ET- MV
Provide cardiac monitoring
KVO
S/s: Wound care (TIG, Debridement, TT)
persistent contraction of muscles in the same Administer antibiotics as ordered
anatomic area as the injury o Penicillin
Local tetanus Care during tetanic spasm/ convulsion
Cephalic tetanus - rare form o Administer Diazepam muscle rigidity/spasm
o otitis media (ear infections) o Administer neuromuscular blocking agents
Generalized tetanus (metocurin iodide) relax spasms and prevent
o trismus or lockjaw seizure
o stiffness of the neck Keep on seizure precaution
o difficulty in swallowing Parenteral nutrition
o rigidity of abdominal muscles Avoid complications of immobility (contractures, pressure
o elevated temperature sores)
o sweating WOF urinary retention, fractures
o elevated blood pressure episodic rapid
heart rate RABIES
Neonatal tetanus - a form of generalized tetanus that A viral zoonotic neuroinvasive disease that causes acute
occurs in newborn infants encephalitis
Complications: Etiologic agent: Rhabdovirus
o Laryngospasm AKA: Hydrophobia, Lyssa
Hypostatic pneumonia Negri bodies in the infected neurons pathognomonic
Hypoxia Incubation period: 4-8 weeks; 10d-1yr
Atelectasis Period of communicability: 3-5 days before the onset of s/s
o Trauma until the entire course of disease
Fractures MOT: contamination of a bite of infected animals
 Diagnostic procedures o Tetanus prophylaxis
o History of exposure o Antibiotics
o PE/ assessment of s/s o Suturing should be avoided
o Microscopic examination of Negri bodies using Antirabies sera
Sellers May-Grunwald and Mann Strains o Heterologous serum obtained by
o Fluorescent Rabies Antibody technique / Direct hyperimmunization of different animal
Immunofluorescent test species i.e. horses
o HRIG Homologous reabies
immunoglobulin human origin
Rabies Vaccine
Active immunization
o Administered 3 years duration
o Used for lower extremity bites
o Lyssavac (purified protein embryo),
Imovax, Anti-rabies vaccine
Passive immunization
o 3 months
o Rabuman, Hyper Rab, Imogam
Nursing Intervention
o Isolation of patient
o Provide comfort for the patient by:
Place padding of bedside or
use restraints
Clean and dress wound with
Clinical Manifestations
the use of gloves
Prodromal Phase / Stage of Invasion
Do not bathe the patient,
Fever, anorexia, malaise, sorethroat, copious
wipe saliva or provide
salivation, lacrimation, perspiration, irritability,
sputum jar
hyperexcitability, restlessness, drowsiness,
o Provide restful environment
mental depression, marked insomia
Quiet, dark environment
Sensitive to light, sound, and changes in temp
Close windows, no faucets or running water should be
Myalgia, numbness, tingling, burning or cold
heard
sensation along nerve pathway; dilation of pupils
IVF should be covered
Stage of Excitement
No sight of water or electric fans
Marked excitation, apprehension
Delirium, nuchal stiffness, involuntary twitching
Painful spasms of muscles of mouth, pharynx, MALARIA
and larynx on attempting to swallow food or Acute and chronic disease transmitted by mosquito bite
water or the mere sight of them hydrophobia confined mainly to tropical areas.
Aerophobia Etiologic agent Protozoa of genus Plasmodia
Precipitated by mild stimuli touch or noise Plasmodium Falciparum (malignant tertian)
Death spasm from or from cardiac / respiratory o most serious, high parasitic densities in RBC with
failure tendency to agglutinate and form into
Terminal Phase or Paralytic Stage microemboli. Most common in the Philippines
Quiet and unconscious P. Vivax - non life threatening except for the very young
Loss of bowel and bladder control and old.
Tachycardia, labored irregular respiration, steady o Manifests chills every 48 hrs on the 3rd day
rising temp onward if not treated,
Spasm, progressively increasing paralysis P. malarie (Quartan) less frequent, non life threatening,
Death due to respiratory paralysis fever and chills occur every 72 hrs on the 4th day of onset
TREATMENT P. ovale - rare
No cure Incubation period:
No specific symptomatic/ supportive directed o 12days P. falciparum, 14 days P vivax and ovale,
toward alleviation of spasm 30 days P. malariae
Employ continuing cardiac and pulmonary Period of communicability
monitoring o If not treated /inadequate more than 3 yrs. P
Assess the extent and location of the bite biting malariae, 1-2 yrs. P. vivax, 1 yr- P. falciparum
incident/ status of the animal Mode of transmission
o Severe exposure o Mosquito bite
o Mild exposure VECTOR female Anopheles mosquito
Wound treatment (local care)
o Cleanse thoroughly with soap and DIAGNOSTICS
water (or ammonium compounds, Malarial smear film of blood is placed on a slide, stained
betadine, or benzalkonium cl) and examined
o Anti rabies serum
 Rapid diagnostic test (RDT) done in field. 10 -15 mins Is an acute febrile disease cause by infection with one of the
result blood test serotypes of dengue virus which is transmitted by mosquito
( Aedes aegypti).

Dengue hemorrhagic fever fatal characterized by bleeding and

hypovolemic shock
Etiologic agent Arbovirus group B
AKA: Chikungunya, O nyong nyong, west nile fever
Mode of Transmission: Bite of infected mosquito AEDES
AEGYPTI
Incubation period 3-14 days
Period of communicability mosquito all throughout life
Sources of infection
Infected person- virus is present in the blood and will
be the reservoir when sucked by mosquitoes
Stagnant water = any

Clinical Manifestions
Rapidly rising fever with severe headache
Shaking chills
Diaphoresis, muscular pain
Splenomegaly, hepatomegaly
Hypotension
o May lasts for 12 hours daily or every 2 days.
Complicated Malaria
GIT
o Bleeding from GUT, N/V, Diarrhea, abdominal pain, gastric,
tyhoid, choleric, dysenteric
CNS or Cerebral Malaria
o Changes in sensorium Diagnostic Tests
o Severe headache Torniquet test
Platelet Count
o N/V
Hematocrit
Hemolytic
Manifestations
Blackwater fever
PRODROMAL symptoms
o Reddish to mahogany colored urine due to
o malaise and anorexia up to 12 hrs.
hemoglobinuria
o Fever and chills, head-ache, muscle pain
o Anuria death
o N &V
Malarial lung disease
FEBRILE Phase
MANAGEMENT
o Fever persists (39-40 C)
Antimalarial drugs Chloroquine (all but P. Malarie),
quinine, Sulfadoxine (resistant P falciparum) o Rash - more prominent on the extremities and
Primaquine (relapse P vivax/ovale) trunk
RBC replacement/ erythrocyte exchange transfusion o (+) torniquet test- petechia more than 10.
Nursing management: o Skin appears purple with blanched areas with
Isolation of patient varied sizes ( Hermans sign)
Use mosquito nets o Generalized or abdominal pain
Eradicate mosquitos o Hemorrhagic manifestations epistaxis, gum
Care of exposed persons case finding bleeding
I and O CIRCULATORY Phase
BUN & creatinine dialysis could be life saving o Fall of temp on 3rd to 5th day
ABG o Restless, cool clammy skin
TSB, ice cap on head o Profound thrombocytopenia
Hot drinks during chilling, lots of fluid o Bleeding and shock
Monitoring of serum bilirubin o Pulse - rapid and weak
Keep clothes dry, watch for signs of bleeding o Untreated shock --- coma death
PREVENTION o Treated recovery in 2 days
o Mosquito breeding places should be CLASSIFICATION
destroyed Grade 1
o Insecticides, insect repellant Grade 2
o Blood donor screening Grade 3
Grade 4
DENGUE FEVER Treatment
No specific antiviral therapy for dengue
Analgesic not aspirin for relief of pain
 IV fluid o Convalescence recovery
BT as necessary MANAGEMENT
O2 therapy 1. IV antibiotic
Pen G Na
NURSING MANAGEMENT Tetracycline
1. Kept in mosquito free environment Doxycycline
2. Keep pt. at rest 2. Dialysis peritoneal
3. VS monitoring 3. IVF
4. Ice bag on the bridge of nose and forehead. 4. Supportive
5. Observe for signs of shock VS (BP low), cold clammy skin 5. Symptomatic
PREVENTION Nursing Interventions
Mosquito net o Isolation of patient urine must properly
Eradication of breeding places of mosquito- disposed
o house spraying o Care of exposed persons keep under close
o change water of vases surveillance
o scrubbing vases once a week o Control measures
o cleaning the surroundings Cleaning of the environment/ stagnant
o keep water containers covered water
o avoid too many hanging clothes inside the house Eradicate rats
Avoid bathing or wading in
contaminated pool of water
vaccination of animals
LEPTOSPIROSIS (cattles,dogs,cats,pigs)
Infectious bacterial disease carried by animals whose urine
contaminates water or food which is ingested or SCHISTOSOMIASIS
inoculated thru the skin. Parasitic disease caused by Schistosoma japonicum, S.
Etiologic agent: spirochete Leptospira interrogans mansoni, S. Hematobium
o found in river, sewerage, floods AKA: Bilharziasis, Snail fever
AKA: Weils disease, mud fever, Swineherds disease Incubation period: 2-6 weeks
Incubation Period: 6 -15 days MOT: bathing, swimming, wading in water
Period of Communicability found in urine between 10-20 Vector: Oncomelania quadrasi
days o Cercariae: most infective stage
MOT contact with skin of infected urine or feces of Diagnostic test: ova seen in fecalysis
wild/domestic animals; ingestion, inoculation Diagnostic procedures
Diagnostic tests: Fecalysis
o Clinical manifestations Identification of eggs
o Culture Liver and rectal biosy
Immunodiagnostic tests / circumoval
precipitin test and cercarial envelope
reactions

SOURCE OF INFECTION
o Rats, dogs, mice
MANIFESTATIONS
o Septic Stage
Early
Fever (40 C), tachycardia, skin flushed,
warm, petechiae
Severe
Multiorgan S/s
Conjunctival affectation, jaundice, o Swimmers itch
purpura, ARF, Hemoptysis, head-ache, Itchiness
abdominal pain, jaundice Redness and pustule formation at site of entry of
o Toxic stage with or w/o jaundice, meningeal irritation, cercariae
oliguria shock, coma , CHF Diarrhea
 Abdominal pain Raised large erythemathous plaques appear on skin with
hepatosplenomegaly clearly defined borders. rough hairless and
CLINICAL MANIFESTATIONS: hypopigmented leaves an anesthetic scar.
Abdominal pain Loss of eyebrows/eyelashes
Cough Loss of function of sweat and sebaceous glands
Diarrhea Epistaxis
Eosinophilia - extremely high eosinophil granulocyte count.
Fever
Fatigue
Hepatosplenomegaly - the enlargement of both the liver
and the spleen.
Colonic polyposis with bloody diarrhea (Schistosoma
mansoni mostly)
Portal hypertension with hematemesis and splenomegaly
(S. mansoni, S. japonicum);
Cystitis and ureteritis with hematuria bladder cancer;
Pulmonary hypertension (S. mansoni, S. japonicum, more
rarely S. haematobium);
Glomerulonephritis; and central nervous system lesions.
Complications
o Pulmonary hypertension
o Cor pulmonale
o Myocardial damage TREATMENT
o Portal cirrhosis multiple drug therapy
Treatment: sulfone
Trivalent antimony rehab
o Tartar emetic administered thru vein occupational Health
o Stibophen (FUADIN) given per IM isolation
PRAZIQUANTEL per orem moral support
Niridazole PREVENTION
Nursing Interventions: 1. Report cases and suspects of leprosy
o Administer prescribed drugs as ordered 2. BCG vaccine may be protective if given during the first 6
o Prevent contact with cercaria-laden waters in months.
3. Nursing Interventions:
endemic areas like streams
1. Isolation of patient until causative agent is still
o Proper sanitation or disposal of feces
present
o Creation of a program on snail control chemical
2. Care of exposed persons
or changing snail environment
1. Household contact
Diaminodiphenylsulfone for 2 years
LEPROSY 2. Observe carefully for symptoms of the
Chronic systemic infection characterized by progressive disease
cutaneous lesions
Etiologic agent: Mycobacterium leprae Diseases Acquired Thru Sexual Contact
o Acid fast bacilli that attack cutaneous tissues,
peripheral nerves producing skin lesions,
HIV /AIDS
anesthesia, infection and deformities.
Chronic disease that depresses immune function
Incubation period 5 1/2 mo - eight years.
Characterized by opportunistic infections when T4/CD4
MOT respiratory droplet, inoculation thru break in skin
count drops <200
and mucous membrane.
MOT sexual contact with infected unprotected,
Diagnosis
injection of blood/products, placental transmission
1. Identification of S/s
2. Tissue biopsy
3. Tissue smear
4. Bloods inc. ESR History of HIV / AIDS
5. Lepromin skin test 1959 - African man
6. Mitsuda reaction 1981- 5 homosexual men
1982-Designated as disease by CDC
MANIFESTATIONS 1983- HIV 1 discovered
Corneal ulceration, photophobia blindness 1987- 1.5 million HIV-infected in USA
Lesions are multiple, symmetrical and erythematous 1994- WHO reports 8-10 mil. Worldwide & protease
macules and papules inhibitors introduced
Later lesions enlarge and form plaques on nodules on 1999-First clinical trials for HIV vaccine
earlobes, nose eyebrows and forehead The immune system
Foot drop o Macrophages
Humoral response
 Cell-mediated response o Shingles
o Idiopathic thrombocytopenia
o Fatigue, night sweats, weight loss
o Cervical dysplasia, carcinoma in situ
Evidence of HIV infection and any one of the following:
o Bronchial candidiasis
o Esophageal candidiasis
o CMV disease
o CMV retinitis
o HIV encephalopathy
o Histoplasmosis
o Kaposis Sarcoma
o Herpes simplex ulcers, bronchitis, pneumonia
o Primary brain lymphoma
o Pneumocystis Carinii Pneumonia
o Recurrent pneumonia
o Mycobacterium infection
o Progressive multifocal leukoencepalopathy
o Salmonella septicemia
o Toxoplasmosis
o Wasting syndromes
Treatment
Started in CD4 counts of <200
Viral load >10,000 copies
All symptomatic regardless of counts
Note: CD4 reflects immune system destruction. Viral load-
degree of viral activity
Nucleoside Reverse Transcriptase Inhibitors
Blocks reverse transcriptase
NRT
Acts by binding directly to the reverse transcriptase
enzyme
Not used alone
Rapid development of resistance
Diagnostic Tests Acts by binding directly to the reverse transcriptase
ELISA enzyme
Western Blot Not used alone
CD4 count Rapid development of resistance
Viral load testing
Home test kits Generic Trade Dose Notes
Manifestations Zidovudine AZT, ZDV, 300 mg. Bid Taken with food
o Minor signs cough for one month, general Retrovir
pruritus, recurrent herpes zoster, oral
candidiasis, generalized lymphadenopathy Didanosine ddI, Videx 200 mg bid Peripheral
o Major signs loss of weight 10% BW, chronic neuropathy
diarrhea 1month up, prolonged fever one month
up. Zalcitibine ddC,Hivid .75 mg TID No antacids
Persistent lymphadenopathy
Cytopenias (low) Stavudine d4T, Zerit 400 mg bid Peripheral
PCP neuropathy
Kaposis sarcoma
Lamivudine 3TC, Epivir 150 mg bid Used as resistance
Localized candida
develops
Bacterial infections
TB
STD Lamiduvine/Zido Combivir 150/300 Bone marrow
Neurologic symptoms vudine mg toxicity
Criteria for Diagnosis of AIDS
CD4 counts of 200 or less
Protease Inhibitors
Evidence of HIV infection and any of
Introduced in 1995
o Thrush
Acts by blocking protease enzyme
o Bacillary angiomatosis Indinavir (Crixivan)
o Oral hairy leukoplakia
o Peripheral neuropathy CDC Guidelines
o Vulvovaginal candidiasis
 o Combination of 2 NRTI + PI Etiologic agent: Treponema pallidum
Nursing Management AKA: Lues, The pox, Bad blood
o Administer Antiviral meds as ordered Type of Infection: Bacterial
o Universal precaution Modes of transmission :
o Reverse isolation o Through sexual contact/ intercourse, kissing
gloves, needle stick injury prevention o abrasions
o Assist in early diagnosis and management of o Can be passed from infected mother to unborn
complications child (transplacental)
4 Cs Symptoms
o Compliance info, + drugs o Primary syphilis (10 90 days after infection)
o Counselling education Chancre a firm, painless skin
o Contact tracing tracing out and tx for partners ulceration localized at the point of
o Condoms safe sex initial exposure to the bacterium
appear on the genitals
GONORRHEA can also appear on the lips,
A curable infection caused by the bacteria Neisseria gonorrhoea tongue, and other body parts
AKA: Clap, Drip, G. vulvovaginitis o Secondary syphilis (last 2 6 weeks)
MOT: transmitted during vaginal, anal, and oral sex syphilis rash - an infectious brown skin
Incubation period: 3-10 days initial manifestations rash that typically occurs on the
Period of communicability: considered infectious from the time bottom of the feet and the palms of
of exposure until treatment is successful the hand
Manifestations: condylomata lata - flat broad whitish
Urethritis both male and female lesions
S/S: dysuria and purulent discharge Fever, sore throat, swollen glands, and
Cervicitis hair loss can also be experienced
Upper Genital Tract females (PID) Third stage
Endometritis, Salpingitis, o Will manifest 1 10 years after the infection
Pelvic Abscess o characterised by gummas - soft, tumor-like
Complications : growths
PID seen in the skin and mucous
Infertility membranes occurs in bones
Complications: o joint and bone damage
Upper Genital Tract male o increasing blindness
o Epididymitis, Prostatitis, Seminal Vesiculitis o Numbness in the extremities, or difficulty in
Disseminated Gonococcal Infection (DGI) coordinating movements.
o Tenosynovitis or Polyarthritis, skin lesions and
fever Neurosyphilis
Anorectal Infection generalized paresis of the insane which
Pharyngeal Infection results in personality changes, changes in
Gonococcal Conjuctivitis emotional affect, hyperactive reflexes
o Opthalmia Neonatorum cardiovascular syphilis
Meningitis, Endocarditis aortitis, aortic aneurysm, Aneurysm of sinus
Diagnosis: of valsalva and aortic regurgitation, - death
Culture & Sensitivity Consequences in Infants
Blood tests for N. gonorrhoeae antibodies Congenital syphilis
Treatment: extremely dangerous
ANTIBIOTICS Deformities
Penicillin Seizures
Single dose Ceftriaxone IM + doxycycline PO BID for 1 week Blindness
Prophylaxis: Silver nitrate, Tetracycline, Erythromycin Damage to the brain, bones, teeth, and ears.
Nursing Interventions: Test and diagnosis
o Case finding Venereal Disease Research Laboratory (VDRL)
o Health teaching on importance of monogamous test
sexual relationship Flourescent treponemal antibody absorption
o Treatment should be both partners to prevent (FTA Abs)
reinfection Micro hemagglutination test (MHA - TP)
o Instruct possible complications like infertility CSF examination
o Educate about s/s and importance of taking Treatment
antibiotic for the entire therapy Syphilis is easily treatable when early detected
Penicillin & other antibiotics
SYPHILIS
a curable, bacterial infection, that left untreated will
Prevention
progress through four stages with increasingly serious
Abstinence
symptoms
Mutual monogamy
 Latex condoms for vaginal and anal sex An acute and highly contagious respiratory disease in
Nursing interventions humans
o Case finding Etiologic agent: SARS coronavirus
o Health teaching and guidance along preventive November 2002 and July 2003, with 8,096 known infected
measures cases and 774 deaths
o Utilization of community health facilities Incubation period: 2-3days
o Assist in interpretation and diagnosis MOT: Airborne
o Reinforce ff up treatment S/s
o VD control program participation o flu like: fever, myalgia, lethargy, gastrointestinal
o Medical examination of patients contacts symptoms, cough, sore throat
o fever above 38 C (100.4 F)
HEPATITIS B o Shortness of breath
serious disease caused by a virus that attacks the liver o Symptoms usually appear 210 days following
Etiologic agent: hepatitis B virus (HBV) exposure
Source of infections: Blood and body secretions o require mechanical ventilation
Risk factors Diagnostic Test:
multiple sex partners or diagnosis of a sexually transmitted Chest X-ray (CXR)- abnormal with patchy infiltrates
disease WBC and PLT CT. - LOW
Sex contacts of infected persons ELISA test detects antibodies to SARS
Injection-drug users o but only 21 days after the onset of symptoms
Household contacts of chronically infected persons Immunofluorescence assay, can detect antibodies 10 days
Infants born to infected mothers after the onset of the disease
Infants/children of immigrants from areas with high rates o labour and time intensive test
of HBV infection Polymerase chain reaction (PCR) test that can detect
Health-care and public safety workerr genetic material of the SARS virus in specimens ranging
Hemodialysis patients from blood, sputum, tissue samples and stools
Complications: CXR - increased opacity in both lungs, indicative of
Lifelong infection pneumonia
Liver cirrhosis SARS may be suspected
Liver cancer fever of 38 C (100.4 F) or more AND
Liver failure Either a history of:
Death o Contact (sexual or casual) with someone with a
S/s: diagnosis of SARS within the last 10 days OR
Jaundice o Travel to any of the regions identified by the
Pruritus WHO as areas with recent local transmission of
Fatigue SARS (affected regions as of 10 May 2003 were
RUQ - Abdominal pain parts of China, Hong Kong, Singapore and the
Loss of appetite province of Ontario, Canada).
Nausea, vomiting probable case of SARS has the above findings plus positive
Joint pain chest x-ray findings of atypical pneumonia or respiratory
Prevention: distress syndrome
Hepatitis B vaccine has been available since 1982. Treatment
o Routine vaccination of 0-18 year olds Supportive with antipyretics, supplemental oxygen and
o Vaccination of risk groups of all ages ventilatory support as needed.
Immune globulin if exposed Suspected cases of SARS must be isolated, preferably in
MEDICAL MANAGEMENT negative pressure rooms, with full barrier nursing
Interferon alfa-2b precautions taken for any necessary contact with these
Lamivudine patients
Telbivudine steroids
Entecavir antiviral drug
Adefovir dipivoxil SARS vaccine
Nursing Interventions:
o Blood and body secretions precautions
o Prevention- Hepa B vaccine
o Proper rest periods
o Prevent stress physio/psychological
o Proper NTN, increase in CHO, high in CHON, low
fats, Vit. K rich foods and minerals
o Assistance to prevent injury, promote safety AAT
o WOF s/s bleeding, edema
o Health education on safe sex

SEVERE OF ACUTE RESPIRATORY SYNDROME