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ALTERATION IN IMMUNE RESPONSE


I. Review of Related Terms
A. Communicable isease caused by an infectious agent which is acquired from an
infected individual and transmitted to a susceptible host either by direct and indirect
contact or through direct inoculation into a broken skin or mucous membrane.
The two persons important for a communicable disease to occur are the infected
individual and the susceptible host.
T!"es of Communicable isease
1. Infectious disease is NT easily transmitted from person to person. It
requires inoculation! e.g. tetanus! malaria! dengue! "lariasis! rabies
Inoculation entrance of microorganism through mechanical means! e.g.
biting! puncturing! laceration! open wound
#. Conta#ious easily transmitted from one person to another through droplet!
direct! or indirect contact! e.g. tuberculosis! diphtheria! measles! chickenpo$!
meningococcemia
%. E"idemiolo#! the science of the patterns of disease! its occurrence! distribution! or
spread and the prevention and control among group of individuals as public health&
backbone of disease prevention
a. Patterns of isease Occurrence
1. S"oradic $ on'and'o( attack of the disease& intermittent or occasional& #)*
susceptible host! +)* immune ,because occurrence is predictable and therefore!
can be prevented-
#. Endemic $ constantly present in a certain locality& .)* immune! .)* susceptible
Three endemic in the /hilippines0 ,1- 1alaria! ,#- 2ilariasis! 3 ,4-
5chistosomiasis ,with high prevalence in 6egions .! +! and 11-
4. E"idemic $ number of cases e$ceeds beyond the normal number of cases for a
short period of time& +)* susceptible host! #)* immune
7. Pandemic $ worldwide epidemic! e.g. AI85! 5A65! %ird 2lu
9. Triad of isease Causation or t%e E"idemiolo#ic Triad ,by :eavell 3 9lark- factors
that interact to cause a disease
Three 2actors0
1. A#ent $ these are bacteria! viruses! proto;oa! and parasites ,biological agents-
9haracteristics of Agent0
Infectivity ability to enter the human body and to move into tissues
&irulence strength! potency! or power of the agent to cause a disease
<the shorter the incubation period! the virulent the agent is
Antigenicity ability to stimulate antibody response ,speci"c response-
Pathogenicity ability to cause infection or disease
#. Environment the medium for survival and multiplication of causative agent
4. 'ost the area where the agent gets its nourishment
a. 'umans
i. Carrier asymptomatic& a person who harbors microorganisms but does
not manifest signs and symptoms& most dangerous
ii. Sub(clinicall! ill manifests mild signs and symptoms& less dangerous
iii.Clinicall! ill manifests A:: the signs and symptoms& least dangerous
b. Animal serves as an intermediate host& secondary or transitional& important
in the completion of the life cycle or the microorganisms! e.g. oncomelania
quadrasi ,snail- in schistosomiasis
c. Plants breeding places of animals
d. Soil) water) air) mil*
e. +omites inanimate ob=ects
Alert0 All these factors are necessary to cause a disease& an absence of one factor will not
cause a disease
<<< If one factor is absent! it will lead to health or wellness
8. C%ain of Infection ,ARPEMPS-
Nonspecific
response:
Calor
Rubor
Dolor
Tumor
Functio laesa
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./ A#ent $ causative agent that releases to$ic products that can be found inside or
outside the cell
T!"e of to0in1
a. E0oto0in to$ic product that can be found outside the cell when the
microorganism is still alive
b. Endoto0in to$ic product inside the cell that is released when the cell is
already dead& more dangerous
2/ Reservoir source of infection& normal area in the body where the organisms can be
found
3/ Portal of E0it from the reservoir to the outside environment
a. 6espiratory system snee;ing and coughing of respiratory secretions ,51I:IN>
is not included-
b. >IT ? Alimentary tract vomitus and feces
c. >@T urine! semen! vaginal discharges
d. 5kin open wound
e. 1echanical bite of an insect or animal
f. %lood broken skin or mucosa
g. Transplacental mother to fetus
h. A$udates or discharges con=unctival secretions! saliva! pus
4/ Mode of Transmission channel or the medium in which the microorganism is
transmitted
Types0
a. irect Contact person to person& needs intimate contact& se$ual
intercourse! droplet ,coughing and snee;ing-! airborne
ro"let less than three feet& less than 4) minutes
Airborne more than three feet& more than 4) minutes
b. Indirect needs vehicle'borne or vector'borne
i. &e%icle matters through which organism can be transmitted
e.g. milk! soil! water
ii. &ector through animals e.g. arthropods or mollusks
5/ Portal of Entr! corresponds to the portal of e$it
6/ Susce"tible 'ost prone individuals
A. Sta#es of iseases
1. Incubation "eriod period from the "rst e$posure to the causative agent to the
appearance of the "rst signs and symptoms
#. Prodromal "eriod ,catarrhal period- period from the appearance of the "rst signs
and symptoms to the appearance of pathognomonic sign ,classical sign-
4. Sta#e of Illness $ manifestation of all signs and symptoms of the disease
7. Convalescence $ stage of recovery& the signs and symptoms gradually disappearing
2. Immunit! power to resist speci"c infection or disease
a. Immuni7ation the process of rendering the individuals immune
b. Anti#en a substance that induces antibody formation
c. Antibod! a protein substance in response to antigen stimulation
T!"es of Immunit!
1. Natural Immunit! inborn! innate! and inherent
a. Active e$posure to certain disease and formation of memory cells
b. Passive maternal antibodies received bu the fetus through placenta and
infant through breastmilk
#. Arti8cial ' attained through the introduction of antigen such as vaccine! to$oid!
or antibody by arti"cial means
a. Active attained by introduction of antigen
e.g. all A/I vaccine e$cept Bepatitis %
b. Passive introduction of antibodies e.g. IgA! gammaglobulins!
immunoglobulins from serum or human
< Active Cslow to come! slow to goD
< Passive Cquick to come! quick to goD & immediate
>. Prevention and Control of Communicable iseases
%ased on RA 3593 :aw on 6eporting 9ommunicable 8isease
1. Prevention
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a. 'ealth Aducation
b. Environmental 5anitation
c. Speci"c /rotection e.g. nutrition! immuni;ation! personal hygiene
#. Control
a. Noti"cation and prompt intervention
b. Isolation and quarantine
c. Case "nding looking for the infected individuals
9ontact tracing looking for the e$posed individuals
d. Epidemiological investigation
4. Outline Plan of E"idemiolo#ical Investi#ation ,EB-
1. Astablish fact of presence of epidemic
a. Ferify the diagnosis initial step
b. 6eporting
c. /revalence of disease ,recording of old and new cases-
< Incidence recording new cases
#. Astablish time and space relationship of the disease
a. Area of concentration of the disease ,space-
b. nset of the "rst known case ,time-
4. 6elations to characteristics of the group of community
a. Age! se$! color! occupation
7. 9orrelation of all data obtained
7. T!"es of Isolation
Isolation $ separation of infected individual from healthy one& used in case
"nding
:uarantine $ limitation of the freedom of movement of e$posed individual or
animal& used in contract tracing
a. Strict isolation indicated for highly contagious diseases like 5A65!
meningococcemia! bird Gu! anthra$
b. Protective or Reverse Isolation $ intended for those with low
resistance or immunocompromised e.g. AI85! burn! cancer! nephritic
syndrome! organ transplant
c. Res"irator! Isolation $ intended for respiratory diseases
d. Enteric Precaution $ intended for >IT diseases e.g. typhoid fever!
cholera! shigellosis
e. ;ound and S*in Precaution $ intended for persons with skin diseases
e.g. leprosy! fungal infection! impetigo
f. <lood and <od! +luids = Standard = Universal Precaution $ "rst line
of precaution& used when the disease is unknown> usage of gloves!
masks! caps! mask! and goggles
.. isinfection $ destruction of pathogenic microorganisms e$cluding the spores
Sterili7ation $ destruction of microorganisms including spores
elousin# $ killing of lice or louse
+umi#ation $ destruction of microorganisms by the use of gases or fumes
Two #eneral means of *illin# microor#anisms1
a. Mec%anical $ boiling autoclaving! and burning
b. C%emical $ use of
i. isinfectant used in inanimate ob=ects ,e.g. chloro$-
ii. Antise"tic used in live human tissues that inhibits the growth of
microorganisms ,e.g. hydrogen pero$ide! betadine! Normal 5aline
5olution-
< N55 most e(ective antiseptic because as isotonic solution!
keeps the wound moisten which facilitates cell regeneration
< /ovidone Iodine ,%etadine- inhibits growth of hair
Two tec%ni?ues of disinfection
a. Concurrent $ ongoing disinfection! the client is still the source of
infection
b. Terminal $ "nal disinfection! the patient is no longer the source of
infection performed upon discharge of the client ,e.g. fumigation-
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H. Ase"sis $ absence of pathogen or disease'causing microorganisms
1. Two types of Asepsis0
a. Medical = Clean tec%ni?ue ( in handwashing! hands are held lower than
the elbow
Pur"ose1
1. To prevent transfer of pathogens to others
#. To reduce the number of microorganisms
b. Sur#ical = Sterile tec%ni?ue to render area free from microorganisms. In
handwashing! hands are held higher than the elbow
Tec%ni?ues0
1. Bandwashing single most e(ective way of preventing transmission of
microorganisms.
< The most important factor in handwashing is friction.
#. >owning
4. 1asking
7. 8isinfection
.. /lacarding ' barrier cards& CUnsterile / Unauthorized Persons Keep OutD
II. Classi8cation of Communicable iseases Accordin# to Causative A#ents
A. &iral
a. 1easles ? 6ubeola
b. >erman measles ? 6ubella
c. 9hickenpo$
d. /oliomyelitis
e. B'fever ,8engue-
f. 6abies
g. Bepatitis
h. AI85
i. 1umps
=. InGuen;a
%. <acterial
a. Tuberculosis
b. :eprosy
c. 8iphtheria
d. /ertussis
e. Tetanus
f. 9holera
g. Typhoid fever
h. /neumonia
i. 5yphilis
=. >onorrhea
k. %ubonic plague
l. %otulism
9. Proto7oan Parasites
a. 1alaria
b. Amoebiasis
c. Trichomoniasis
8. +un#al
a. 6ingworm
b. 1oniliasis
A. Ric*ettsia
a. 9hlamydia
2. Intestinal Parasites
a. Ascariasis
b. Anterobiasis
c. Taeniasis
d. 9apillariasis
e. Ancyclostosomiasis
f. 5chistosomiasis
>. E0ternal Parasites
a. /ediculosis
b. 5cabies
E@PANE PROARAM ON IMMUNIBATION
&accine Content +orm osa#e C of oses Route
<CA :ive attenuated
bacteria
2ree;e dried
and
reconstituted in
special diluent
infant'
).).ml
/reschool'
).1ml
1 I8
PT 8T' weakened
to$in
/'killed bacteria
:iquid ).. ml 4 I1
OP& weakened virus :iquid # drops 4 ral
'e"atitis /lasma :iquid ).. ml 4 I1
5
< derivative
Measles Eeakened virus 2ree;e dried
and
reconstituted in
special diluent
).. ml 1 5ubcutaneo
us

Sc%edule of &accines
&accine
A#e at .
st
dose
Interval between
dose
Protection
<CA (Bacille of
Calmette and Guerin)
At birth or
anytime after
birth
T%
PT (Diphtheria,
Pertussis, Tetanus)
H weeks 7 weeks
8iphtheria!
/ertussis! and
Tetanus
OP& (Oral Polio
accine)
Hweeks 7weeks /oliomyelitis
'e"a < At birth
5chedule0 At birth! H
th

week!17
th
week
Bepatitis %
Measles I months 1easles

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