Penyakit menular

(Communicable disease)

Daskesmas 2015 Sabtu

(AA)

Reference :
WHO, CDC,
www.watertowncsd.org/webpages/rboyce/
Gulzar Usman Manganhar
 Definition of Communicable diseases

A communicable disease is an illness due to a

specific infectious (biological) agent or its
toxic products capable of being directly or
indirectly transmitted from man to man, from
animal to man, from animal to animal, or from
the environment (through air, water, food,
etc..) to man.
 Another Definition

Communicable disease: a disease that can

be spread to a person from another person,
an animal or object. Ex: common cold,
influenza, tuberculosis, etc.

Non-communicable disease: a disease that

can NOT be spread from person to person.
Ex: cancer, heart disease, cirrhosis, etc.
 In other words, Communicable diseases are :
- Diseases that are spread from one person to the next
- Diseases that are caused by germs or pathogens

Examples of pathogens include: viruses,

bacteria, protozoa, fungi and parasitic worms

Examples of common communicable diseases :

Cold Flu Pneumonia Hepatitis
Mononucleosis STDs HIV/AIDS
 Common Pathogens:
Viruses, Bacteria, Fungi & Protozoa Parasitic worms

Virus: smallest simplest life form. Not alive, and cause upper
respiratory infections and many other type of diseases.

Bacteria: simple one-celled organisms. They are everywhere. Not all

bacteria is bad.

Fungi: more complex than bacteria, but cannot make their own food.
Thrive in warm, moist environments.

Protozoa: one celled, animal like organisms.

Parasitic worms
 How communicable diseases are spread

Direct Contact: Exposure to infected body fluids such as blood or saliva.

Vectors/Reservoirs: Germs are spread by an animal or insect, usually

through a bite

Airborne: Germs are spread through the air, for example when
someone coughs or sneezes.

Food and Water: Food and water can become contaminated

with germs and people can get sick when they eat or drink them.

Indirect contact: Pathogens remain on surfaces that were in contact

with an infected person.
Virus more than 200 types including
rhinoviruses and corona viruses can cause
the cold
sore, scratchy throat, sneezing, and a
runny nose. Other symptoms that may
occur later include headache, stuffy
nose, watering eyes, hacking cough,
chills, and general sick-feeling lasting
from 2 to 7 days. Some cases may last
for two weeks.
Bed rest, drink lots of fluids,
medication to treat the
symptoms. There is NO CURE
 Respiratory illness caused several
different viruses
Fever Tiredness

Aches and chills Cough

Headache Sore throat

Complications of the flu
Bronchitis, pneumonia, can cause death in high risk
groups (people with chronic disease, infants and the
elderly)
Fluids and bed rest
Medication like Tylenol to bring
the fever down and relieve
symptoms
 H1N1 is a new strain of the flu virus
that is a combination of flu viruses that
Symptoms: affect pigs, birds and humans.
Fever Body aches *Some people also have
Cough Headaches vomiting and diarrhea

Sore throat tiredness

If you have any of these symptoms you should seek medical treatment right
away! Your doctor may give you an antiviral medication like tamiflu, which
help to make the symptoms milder.
Treatment: Rest! Did you know that this flu virus affects children and
Drink lots of fluids, especially teens more than other flu viruses do
if you have diarrhea!
Stay home from school if you
Prevention- Get the H1N1 Vaccine
have a fever, and limit your
contact with others
AND.
Cover your nose and mouth with a tissue when you cough or
sneezethrow the tissue away after you use it.
Wash your hands often with soap and water, especially after
you cough or sneeze. If you are not near water, use an alcohol-
based hand cleaner.
Stay away as much as you can from people who are sick.
If you get the flu, stay home from work or school. If you are
sick, do not go near other people so that you don't make them sick
too. Do not return to school until your doctor says you can!
Try not to touch your eyes, nose, or mouth. Germs often
spread this way.
Do not share drinks, food, lip gloss..
Caused by DIFFERENT Viruses (more than 200 for
the cold, only a few for the flu)
The flu comes on more QUICKLY
Some of the symptoms are different.
with the flu there is usually a high fever, aches
and chills
The flu is more serious, and can be deadly
There is a vaccine to prevent the flu
(seasonal and H1N1)
 Hepatitis B is a serious disease caused by a virus that attacks the liver. The
virus, which is called hepatitis B virus (HBV), can cause lifelong infection,
cirrhosis (scarring) of the liver, liver cancer, liver failure, and death

Transmission (how do you get it??)

Contact with the body fluids of an infected person

*Sexual contact *Blood to Blood contact

Symptoms: Treatment- Bed rest,

medications, do not drink
Jaundice (yellowing of eyes and skin) alcohol
Tiredness and weakness
Weight loss, loss of appetite Prevention: vaccine, do
not share needles, abstinence
Abdominal pain (no sex or drugs!)
 an infection of the lungs, which can be
caused by a variety of microorganisms,
including viruses, bacteria, and parasites.

fever vomiting
chills chest pain
cough abdominal pain
unusually rapid breathing
decreased activity
breathing with grunting or
wheezing sounds
labored breathing

Treatments :
antibiotics(bacterial) Prevention: vaccine
antiviral medications * dont share food or drink, or be
bed rest around sick people
 Infectious mononucleosis is sometimes called "mono"
or "the kissing disease. It is an infection usually
caused by the Epstein-Barr virus (EBV).

constant fatigue
fever
Not everyone who is exposed to EBV sore throat
gets sick loss of appetite
swollen lymph nodes
Once you have it, you will carry the
headaches
virus for the rest of your life,
sore muscles
although you probably will not get
larger-than-normal liver
sick from it again!
or spleen
skin rash
abdominal pain

Kissing someone who has it

Sharing food, drink, utensils, No curebed rest, fever reducing
toothbrushes medications, treat other symptoms,
people usually get better in 3-4 weeks
An itchy rash of spots that look like
blisters can appear all over the body
and may be accompanied by flu-like
symptoms.

Rash of bumpy fluid filled red bumps that can

rupture and scab over. This rash is very itchy.
Other symptoms include a fever, abdominal
pain, sore throat, and headache (last 5-7 days on
average)
No cure/symptoms can be treated .

Varicella Vaccine
Smallpox

CDC, AFIP
 Smallpox
Overview
Two strains: variola major and variola minor
Variola minor milder disease with case fatality
typically 1% or less
Variola major more severe disease with average
30% mortality in unvaccinated

Person-to-person transmission
 Smallpox
Overview

Killed approximately 300,000,000 persons in 20th century

Routine smallpox vaccination in the U.S. stopped in 1972
WHO declared smallpox eradicated in 1980
Vaccine has significant adverse effects
No effective treatment

6
 Smallpox
Transmission

Infectious dose extremely low

Spread primarily by droplet nuclei >aerosols >

direct contact

Maintains infectivity for prolonged periods out of

host
Contaminated clothing and bedding can be infectious
8
 Smallpox
Transmission

Transmission does not usually occur until after

febrile prodrome
Coincident with onset of rash

Slower spread through the population than chickenpox or measles

Large outbreaks in schools were uncommon

Less transmissible than measles, chickenpox,

influenza 9
 Smallpox
Clinical Features
Prodrome (incubation 7-19 days)
Acute onset of fever, malaise, headache,
backache, vomiting, occasional delirium
Transient red rash
Exanthem (2-3 days later)
Preceded by enanthem on
oropharyngeal mucosa
Begins on face, hands, forearms
Spread to lower extremities then trunk over
~ 7 days
CDC
Synchronous progression: flat lesions
vesicles pustules scabs
Lesions most abundant on
face and extremities,
including palms/soles 13
 Smallpox
Clinical Course

WHO
 Smallpox
Clinical Progression

WHO
15
 Smallpox
Clinical Progression

Day 10 Day 14 Day 21

Thomas, D.
 Smallpox Vaccine
Administration

Vaccine admin instructions

JAMA 1999;281:1735-45 WHO 29
Smallpox Vaccine
Take

WHO

30
 Smallpox Vaccine Complications
More common in children and primary vaccinees
Most common: secondary inoculation
Skin, eye, nose, genitalia
50% of all complications
529/million (30% in one study were contacts)

Severe reactions less common

Primary vaccination ~ 1 death/million
Revaccination ~ 0.2 deaths/million
 Smallpox
Complication Rates for Primary
Less common Vaccination
Post-vaccination encephalopathy (7-42.3/million)*
Post-vaccination encephalitis (12.3/million)
25% fatal; 23% neurological sequelae
Progressive vaccinia/vaccinia necrosum (1.5/million)
Generalized vaccinia (241.5/million): severe in 10%
Eczema vaccinatum (38.5/million)
Fetal vaccinia - rare
Sourced: MMWR June 22, 2001 / 50(RR10);1-25. Vaccinia (Smallpox) Vaccine
Recommendations of the Advisory Committee on Immunization Practices
(ACIP), 2001
*Vaccines 3rd Ed. Plotkin SA, Orenstein WA. W.B. Saunders, Phila. 1999 32
 Distinguishing Smallpox from
Chickenpox:
Similar Epidemiologic Features
Incubation period 14 (10-21) days

Person-to-person transmission

Seasonal transmission of disease highest during winter

and early spring
 Distinguishing Smallpox from
Chickenpox:
Epi Features that Differ
Chickenpox (varicella) Smallpox (variola)

Most cases occur in Most of the population

children expected to be susceptible

Expected case fatality rate Expected case fatality rate

2-3/100,000 averages 30%

Secondary attack rate of Secondary attack rate

80% among susceptible ~60% in unvaccinated
household contacts family contacts
Distinguishing Smallpox from Chickenpox:
Clinical Features that Differ

Chickenpox (varicella) Smallpox (variola)

Lesions superficial
Rash concentrated on
trunk
Lesions rarely on palms
or soles
Lesions in different
stages of development
Rash progresses more
quickly
Lesions deep
Rash concentrated on
face & extremities
Lesions on palms &
soles
Lesions in same stage of
evolution on any one
area of body
Rash progresses slowly
CDC
 Smallpox
Summary of Key Points

Smallpox is transmitted person to person;

standard and airborne precautions should be
initiated in all suspected cases until smallpox is
ruled out.

Smallpox cases should be considered infectious

from the onset of fever until all scabs have
separated.
 Smallpox
Summary of Key Points
Vaccine-induced immunity wanes with time; therefore
most people today are considered susceptible to smallpox
infection.

In a smallpox outbreak, vaccination is indicated for all

case contacts, including health care workers and case
investigators.

Smallpox surveillance includes pre-event rash

surveillance, post-event surveillance for active cases, and
follow-up of cases, contacts, and vaccine recipients.
 Smallpox
Summary of Key Points

Epidemiologic features that differentiate

smallpox from chickenpox include a higher case
fatality and a lower attack rate.

Clinical features differentiating smallpox from

varicella include differences in lesion progression
and distribution, illness course and presence of a
febrile prodrome.
 Resources
Centers for Disease Control & Prevention
http://www.bt.cdc.gov/
Bioterrorism Web page:
CDC Office of Health and Safety Information System
(personal protective equipment)
http://www.cdc.gov/od/ohs/

USAMRIID -- includes link to on-line version

of Medical Management of Biological Casualties
Handbook http://www.usamriid.army.mil/
 Resources
Office of the Surgeon General: Medical
Nuclear, Biological and Chemical Information
http://www.nbc-med.org

St. Louis University Center for the Study of

Bioterrorism and Emerging Infections
http://bioterrorism.slu.edu