Community Health Nursing
Communicable Disease Lecture Notes
Prepared by: Mark Fredderick R. Abejo RN,, MAN
Disease
Tuberculosis
Primary Complex is
less than 3 years old
- any child who does
not return to normal
health after measles or
whooping cough.
Most hazardous
period: first 6-12
months after
infection
Highest in risk of
developing: under 3
years old
COMMUNITY HEALTH NURSING
Communicable Disease
Lecturer: Mark Fredderick R. Abejo RN, MAN
EPI TARGET DISEASES
Causative Agent Mode of Clinical Manifestation Reservoir Diagnostic Exam Treatment Nursing Implication
Transmission
Mycobacterium Droplet Infection General weakness Man Sputum Exam DOTS Pointers for teaching
Loss of weight, cough and 3 sample are taken on Anti-TB drugs:
Tuberculosis ( inhalation of bacilli wheeze which does not And with 24 hrs: - patient is required
from patient who respond to antibiotic to take the Ant-Tb
coughs and sneeze) therapy. Diseased Cattle - spot sample (1st drugs in the
Fever and night sweat visit) presence of a health Rifampicin: taken
Abdominal swelling with a (Bovine TB) befor meals, causes red
care provider to
hard painless mass and free - early morning
ensure compliance urine urine
Degree of fluid
specimen to treatment
Hemoptysis and chest pain
Communicability regimen Isoniazide: causes
Painful firm or soft
- spot sample peripheral neuritis,
swelling in a group of
Depends upon: superficial lymph nodes. given with Vit.B6
Note: (2nd visit)
- num.of bacilli Pyrazinamide: cause
In young children the only Note: at least 2 hyperurucemia
- virulence of bacilli sample are
sign of pulmonary TB may be Anti-TB drugs:
positive Ethambutol: causes
stunted growth or failure to
- environmental
Community Health Nursing
Communicable Disease Lecture Notes
Prepared by: Mark Fredderick R. Abejo RN,, MAN

conditions thrive (RIPES) optic neuritis/ blurring

of vision
Chest Xray Rifampicin
Mantoux Test Isoniazid Streptomycin: cause
- .1 cc injection of Pyrazinamide tinnitus, loss of
PDD and 48-72 Ethambutol hearing balance,
hours reading Streptomycin damage to 8th cranial
nerve
* 10 mm +

5 mm + (HIV pt.)
Note: After 2-4 weeks
of treatment, patient is
no longer contagious
Community Health Nursing
Communicable Disease Lecture Notes
Prepared by: Mark Fredderick R. Abejo RN,, MAN

The National Tuberculosis Control Program Increase and sustain support and financing for TB control activities

Vision: A country where Tb is no longer a public health problem Strategies:

Mission: Ensure that TB DOTS services are available, accessible and
affordable to the communities in collaboration with the LGUs
and other partners
Goal: To reduce prevalence and mortality from TB by half the year
2015 ( Millennium Development Goal )
Facilitate implementation of TB-DOTS Center certification and accreditation
Build TB coalitions among different sectors
Advocate for counterpart input from local government units
Mobilize/extend other resources to address program limitations

Targets: Objective D:
1. Cure at least 85% of the sputum smear- positive TB patient discovered.
2. Detect at least 70% of the estimated new sputum smear-positive TB cases. Strengthen management (technical and operational) of TB control services at
all levels
NTP Objectives and Strategies
Strategies:
Objective A:
Enhance managerial capability of all NTP program managers at all levels
Establish an efficient data management system for both public and private sectors.
Improve access to and quality of services provided to TB patients, TB symptomatics and
Implement a standardized recording and reporting system.
communities by health care institutions and providers
Conduct regular monitoring and evaluation at all levels.
Advocate for political support through effective local governance
Strategies:

Enhance quality of TB diagnosis.

KEY POLICIES
Ensure TN patients treatment compliance.
Ensure public and private health care providers adherence to the implementation of national Case Finding
standards of care for TB patients.
Improve access to services through innovative service delivery mechanisms for patients living in
1. DSSM ( Direct Sputum Smear Microscopy ) shall be the primary diagnostic
challenging areas.
tool in NTP case finding.
Note: No TB diagnosis shall be made based on Xray result alone likewise result
of PDD skin test (Mantoux Test)
Objective B:
2. All TB symptomatic identified shall undergo DSSM for diagnosis before start of
Enhance the health-seeking behavior on TB by communities, especially the TB treatment
symptomatics Note: Only contraindication for sputum collection is hemoptysis

Strategies: 3. After three sputum specimen yielding negative result X-ray and culture are
necessary
Develop effective, appropriate and culturally-responsive IEC/communication materials. Note: Diagnosis based on Xray shall be made by the TB DiagnosticCommittee.
Organize barangay advocacy groups
4. Only trained medical technologist or microscopist shall perform DSSM.

Objective C:
Community Health Nursing
Communicable Disease Lecture Notes
Prepared by: Mark Fredderick R. Abejo RN,, MAN

Patients with the following conditions shall be recommended for hospitalization:

massive hemoptysis RECOMMENDED CATEGORY OF TREATMENT REGIMEN

pleural effusion
military TB ( TB of the Spine Pots Disease)
TB meningitis
TB pneumonia Category Type of TB Patient Treatment Regimen
and those requiring surgical intervention
Intensive Continuation Total
Phase Phase Period
Anti-TB drugs:
New smear positive
(RIPES) PTB
New smear positive
Rifampicin PTB with extensive
Isoniazid I parenchymal lesion 2 RIPE 4 RI 6 mos.
Pyrazinamide EPTB and Severe
Ethambutol concomitant HIV
Streptomycin disease
Treatment Failure
Relapse
Two Formulation of Anti-TB Drugs II Return after default 2 RIPES /1 5 RIE 8 mos.
RIPE
1. Fixed-Dose Combination ( FDCs) two or more first line anti-TB drugs are combined in
one tablet. There are 2,3, or 4 drug fixed dose combinations. New smear-
2. Single Drug Formulation (SDF) each drug is prepared individually. Isoniazid, negative PTB
Pyrazinamide and Ethambuto are in tablet form while Rifampicin is in capsule form and III With minimal 2 RIP 4 RI 6
streptomycin is injectable. parenchymal
lession mos.

Chronic ( still Refer to Specialized facility

smear-positive after
IV supervised re- or DOTS Plus Center refer
treatment )
to City Provincial NTP

Coordinator
Community Health Nursing
Communicable Disease Lecture Notes
Prepared by: Mark Fredderick R. Abejo RN,, MAN

Categories II : 2 RIPES / RIPE / 4RIE (FDC)

DOSAGE PER CATEGORY OF TRATMENT REGIMEN

A. Fixed-Dose Combination Formulation Body Intensive Continuation Phase

Weight Phase
The number of tablets of FDCs per patient will depend on the body weight.
First Two (2) Months 3rd Month FDC-B E

( RI ) 400 mg
Categories I and III : 2 RIPE / 4 RI ( FDC)
FDC-A Streptomycin FDC-A

(RIPE) (RIPE)
Body Weight (kg) No.of tablets per day No. of tablets per day
30 37 2 0.75 g 2 2 1
Intensive Phase Continuation Phase
38 54 3 0.75 g 3 3 2
( 2 months ) ( 4 months )
55 70 4 0.75 g 4 4 3
FDC-A ( RIPE) FDC-B (RI)
More 5 0.75 g 5 5 3
30 - 37 2 2
than 70

38 54 3 3

55 70 4 4 B. Single Dose Formulation ( SDF )

More than 70 5 5 Simply add 1 tablet of Isoniazid ( 100mg) , Pyrazinamide (500mg) and
Ethambutol ( 400mg) each for the patient weighing more than 50kg before treatment
initiation. Modify drug dosage within acceptable limits according to patients body weight,
particularly those weighing less than 30 kg at the time of diagnosis.
Community Health Nursing
Communicable Disease Lecture Notes
Prepared by: Mark Fredderick R. Abejo RN,, MAN

Categories I and III: 2 RIPE / 4 RI (SDF)

Anti-TB Drugs No. of tablets per day No. of tablets per day Drug Dosage per Kg. Body Weight

Intensive Phase Continuation Phase

( 2 months ) ( 4 months ) Anti-TB Drugs Dose per Kg Body Weight and Maximum Dose

Rifampicin 1 1

Isoniazid 1 1 Rifampicin 5 ( 4 6 ) mg/kg and not to exceed 400 mg daily

Pyrazinamide 2 Isoniazid 10 ( 8 12 ) mg/kg and not to exceed 600 mg daily

Ethambutol 2 Pyrazinamide 25 ( 20 30 ) mg/kg and not to exceed 2 mg daily

Ethambutol 15 ( 15 20 ) mg/kg and not to exceed 1.2 g daily

Categories II: 2 RIPES / 1 RIPE / 5 RIE Streptomycin 15 ( 12 18 ) mg/kg and not to exceed 1 g daily

Anti-TB Drugs No. of Tablets / Vial per day No.of Tablets per day D.O.T.S ( Directly-Observed Treatment Shortcourse ) TuTok Gamutan

Intensive Phase Continuation Phase

(3months ) ( 5 months ) 5 Elements of D.O.T.S

First 2 months 3rd months Sustained political commitment

Access to quality-assured sputum microscopy
Rifampicin 1 1 1 Standardized short-course chemotherapy for all cases of TB
Uninterrupted supply of essential drugs
Isoniazid 1 1 1 Recording and reporting system enabling outcome assessment of all patients and
assessment of overall program performance.
Pyrazinamide 2 2

Ethambutol 2 2 2

Streptomycin 1 vial per day

Note: 56 vials of Streptomycin for two months

Community Health Nursing
Communicable Disease Lecture Notes
Prepared by: Mark Fredderick R. Abejo RN,, MAN

MANAGEMENT OF CHILDREN WITH TB Management

Prevention For children with exposure to TB

BCG vaccination shall be given to all infants. Should undergo physical examination and PDD testing (Mantoux Test)
BCG vaccine is moderately effective. It has a protective efficacy of: A child with productive cough shall be referred for DSSM, if found positive, treatment
50 % against any TB disease shall be started immediately. PDD testing shall no longer needed.
Children without sign/symptoms of TB but with positive Mantoux Test and those with
64 % against TB meningitis symptoms of TB but negative Mantoux Test shall referred for chest x-ray examination.

74 % against death from TB

Case Finding
Cases of TB in children are reported and identified in two instances:
- The patient sought consultation.
- The patient was reported to have been exposed to an adult with TB
All TB symptomatic children 0-9 years old, except sputum positive child shall subject to PDD
testing
- Only trained nurse and midwife shall do the PDD test and recording
- Testing and reading shall be conducted once a week either on Monday or
Tuesday.
For children with signs and symptoms of TB
A child to have signs and symptoms of TB with either known or unknown exposure
shall be referred for Mantoux test.
For children with known contact but with negative Mantoux and those unknown contact
but with positive Mantoux shall be referred for chest x-ray examination.
For a negative x-ray report, Mantoux test shall be repeated after 3 months.
Chemoprophylaxis of Isoniazid for 3 months shall be given to children less than 5 years
old with negative chest x-ray after which Mantoux test shall be repeated
Treatment

Note: 10 children shall be gathered for testing to avoid wastage. D.O.T.S will still be followed just like in adult
Short course regimen:
A child shall be suspected as having TB and considered symptomatic if with any three (3) of the - at least 3 anti-TB drugs for 2 months ( intensive phase )
following sign and symptoms: - 2 anti-TB drugs for 4 months ( continuation phase )

cough and wheezing for 2 weeks or more
unexplained fever for 2 weeks or more
loss of appetite, loss of weight, failure to gain weight
failure to respond to a 2 weeks of appropriate antibiotic therapy
failure to regain state of health 2 weeks after a viral infection or after having measles.
A child shall be clinically diagnosed or confirmed of having TB if he has any three (3) of the
following condition:
* For Extra Pulmonary TB Cases:
- 4 anti-TB drugs for 2 months ( intensive phase )
- 2 anti-TB drugs for 10 months ( continuation phase )
Domiciliary treatment shall be the preferred mode of care
No treatment shall be initiated unless the patient and health worker has agreed upon a
caseholding mechanism for treatment compliance.

positive history of exposure to an adult/ adolescent TB case

presence of sign and symptoms suggestive of TB
positive Mantoux Test
abnormal chest radiograph suggestive of TB
Community Health Nursing
Communicable Disease Lecture Notes
Prepared by: Mark Fredderick R. Abejo RN,, MAN

Treatment Regimen Continuation Phase

A. Pulmonary TB Rifampicin 10-15 mg/kg body weight 10 months

Isoniazid
Drugs Daily Dose (mg/kg per body weight ) Duration 10-15 mg/kg body weight

Intensive Phase

Rifampicin 10-15 mg/kg body weight 2 months

Isoniazid
Pyrazinamide 10-15 mg/kg body weight Public Health Nurse Responsibilities ( Childhood TB )

20-30 mg/kg body weight

Continuation Phase 1. Interview and open treatment cards for identified TB children.
2. Perform Mantoux testing and reading to eligible children
Rifampicin 10-15 mg/kg body weight 4 months 3. Maintain NTP records
Isoniazid 4. Manage requisition and distribution of drugs
10-15 mg/kg body weight 5. Assist the physician in supervising the other health workers of the RHU in the
proper implementation of the policies and guidelines on TB in children.
6. Assist in the training of other health workers on Mantoux testing and reading.

B. Extra Pulmonary TB

Drugs Daily Dose (mg/kg per body weight ) Duration

Intensive Phase

Rifampicin 10-15 mg/kg body weight

Isoniazid
Pyrazinamide 10-15 mg/kg body weight

20-30 mg/kg body weight 2 months

Plus

Ethambutol
OR 15-25 mg/kg body weight

Streptomycin 20-30 mg/kg body weight

 Community Health Nursin
Communicable Disease Lecture Notes
Prepared by: Mark Fredderick R. Abejo RN,, MAN

EPI TARGET DISEASES

Disease Causative Agent Mode of Clinical Manifestation Reservoir Diagnostic Treatment Nursing Implication
Transmission
Exam

Diphteria it is an Corynebacterium Respiratory Nasal Man Schicks Test Antibiotics Isolate patient until
acute pharyngitis, acute Droplets 2-3 cultures taken at
nasopharyngitis diphtheriae dryness of the upper - test for the least 24hrs apart are
lip susceptibility to negative
or acute laryngitis with serosanguinous Diptheria Pen G Potassium Small frequent
secretion in the nose Erythromycin feeding
Pseudo membrane
Promote absolute
grayish white in color
rest
with leathery Use ice collar to
Pharyngeal Moloney Test
consistency in the relieve pain of sore
throat and on the tonsil Bullneck throat
- for hyper-
appearance because of May put on soft diet
sensitivity to
the enlarge cervical
Diptheria toxin
lymph nodes.

Laryngeal

sore throat
hoarseness
brassy metallic cough
Pertussis Bordetella Pertussis Airborne droplet At first, the infected
child may have a
- 100 days cough Primarily by direct common cold with
contact with he runny nose, sneezing
- Whooping cough discharge from and mild cough Bordet-Gengou Erythromycin Place the patient on
Intermittent episode Agar Plate Ampicillin NPO during
respiratory mucous
- tuspirina of paroxysmal cough Man paroxysmal stage to
membranes of followed by a whoop - used for culture prevent aspiration
infected person ending vomiting
medium - is given 5-7 days Position prone for
infants and upright
for older
 Community Health Nursin
Communicable Disease Lecture Notes
Prepared by: Mark Fredderick R. Abejo RN,, MAN

Neonatal Tetanus Clostridium Tetani Unhygienic cutting Assess the NEWBORN

of umbilical cord for a history of all 3 of
the following: Blood Culture Penicillin Prevention
Erythromycin
- which produces the Tetracycline
exotoxins: Improper handling
of cord stump esp. Normal suck and cry CSF analysis Aseptic handling of
Tetanolysin when treated with for the first 2 days of - administered within the neonatal
Tetanospasmin contaminated life 4 hours of injury umbilical cord
Onset of illness Tetanus Toxiod
substance
between 3 and 28 immunization for
days mothers
Inability to suck Active immunization
followed by stiffness of DPT
of the body and
convulsion
Soil
Intestinal
In OLDER CHILDREN, canal of
the following may be animal
observed: Man

Trismus lockjaw
Opisthotonus
arching of the neck
and back
Ridus Sardonicus
sardonic smile
 Community Health Nursin
Communicable Disease Lecture Notes
Prepared by: Mark Fredderick R. Abejo RN,, MAN

Poliomyelitis 3 Types of Polio Virus Fecal-oral route Abortive - did not Throat swab Strict Isolation
progress to systemic Hot moist compress
Infantile Paralysis Type I Brunhilde infection Man to relieve spasm
Type II Lansing
Type III Leon Oral route through Stool exam
pharyngeal Use protective
secretion Non-paralytic slight devices:
involvement of the CNS - handroll to prevent
Lumbar exam claw hand

Contact with
infected person Poker spine or
stiffness of the spinal Pandys test
column
- for CSF analysis

Spasms of the - trochanter roll, to

hamstring prevent outer rotation
With paresis of femur

- footboard
Paralytic severe
involvement of CNS

Hoynes Sign head

falls back when he is
in supine with
shoulder elevated
Paralysis
Head log/drop
Tripod position
extend his arm behind
for support when he
sits up
Kernigs sign
Brudzinski sign
 Community Health Nursin
Communicable Disease Lecture Notes
Prepared by: Mark Fredderick R. Abejo RN,, MAN

Hepatitis B Prodromal/pre-icteric

- it is liver infection Hepa B Virus 3 Ps Symptoms of URTI Liver Function Increase CHO
caused by the B type of Weight loss Test Moderate fat
hep.virus. Anorexia Man Low CHON
RUQ pain
It attacks livers the Person to person Malaise
liver often resulting in Icteric Observed universal
inflammation Parenteral precaution
Jaundice
Placental Acholic stool
bile-colored urine
3 Cs

Measles Paramyxo Virus Droplet Conjunctivitis Observe respiratory

Coryza isolation
Cough Man Should kept out of
Kopliks spot bluish school for at least 4
gray spot on the buccal days after rash
mucosa. appear
For Photophobic,
darkened room,
Generalized blotch rash
sunglasses
 Community Health Nursin
Communicable Disease Lecture Notes
Prepared by: Mark Fredderick R. Abejo RN,, MAN

DISEASES TRANSMITTED THROUGH FOOD AND WATER

Disease Causative Agent Mode of Transmission Pathognomonic Sign Management and Treatment Prevention

Cholera Vibrio cholera Fecal-oral route Rice watery stool Diagnostic Test: Proper handwashing
Vibrio coma 5 Fs Stool culture Proper food and water
Other names: Ogawa and Inaba Period of sanitation
El tor bacteria Incubation Period: Communicability: Treatment: Immunization of Chole-vac
Few hours to 5 days; 7-14 days after onset, Oral rehydration solution (ORESOL)
Usually 3 days occasionally 2-3 IVF
months Drug-of-Choice: tetracycline (use straw; can
cause staining of teeth).
Oral tetracycline should be
administered with meals or after milk.

Amoebic Entamoeba histolytica Fecal-oral route Abdominal Metronidazole (Flagyl) Proper handwashing
Dysentery Protozoan (slipper- cramping * Avoid alcohol because of its Antabuse effect Proper food and water
shaped Bloody mucoid stool can cause vomiting sanitation
body) Tenesmus - feeling
of
incomplete defecation

Shigellosis Shigella bacillus Fecal-oral route Abdominal Drug-of-Choice: Co-trimoxazole Proper handwashing
Sh-dysenterae most cramping Proper food and water
Other names: infectious 5 Fs: Finger, Foods, Bloody mucoid stool Diet: Low fiber, plenty of fluids, easily sanitation
Bacillary Sh-flesneri common Feces, Flies, Tenesmus - feeling digestible Fly control
dysentery in Fomites of incomplete foods
the Philippines defecation
Sh-connei Incubation Period:
Sh-boydii 1 day, usually less
than 4 days

Typhoid fever Salmonella typhosa Fecal-oral route Rose Spots in the Diagnostic Test: Proper handwashing
(plural, typhi) 5 Fs abdomen due to Proper food and water
bleeding caused by Typhi dot confirmatory test; specimen is feces sanitation
Incubation Period: perforation of the Widals test agglutination of the patients
Usual range 1 to 3 Peyers patches serum
weeks, average 2 Ladderlike fever
weeks Drug-of-Choice: Chloramphenicol
 Community Health Nursin
Communicable Disease Lecture Notes
Prepared by: Mark Fredderick R. Abejo RN,, MAN

Hepatitis A Hepatitis A Virus Fecal-oral route Fever Prophylaxis: IM injection of gamma globulin Proper handwashing
5 Fs Anorexia (early sign) Hepatitis A vaccine Proper food and water
Other names: Headache Hepatitis immunoglobulin sanitation
Hepatitis / Incubation Period: Jaundice (late sign) Avoid alcohol Proper disposal of urine
Epidemic 15-50 days, Clay-colored stool Complete bed rest to reduce the breakdown of and feces
Hepatitis / depending on dose, Lymphadenopathy fats for metabolic needs of liver Separate and proper
Catarrhal Jaundice average 20-30 days Low-fat diet; increase carbohydrates (high in cleaning of articles used by
sugar) patient
In convalescent period, patient may have
difficulty with maintaining a sense of well-being.

Paralytic Dinoflagellates Ingestion of raw of Numbness of face Treatment: Avoid eating shellfish
Shellfish Phytoplankton inadequately cooked especially around the such as tahong, talaba,
Poisoning (PSP I seafood usually mouth 1. No definite treatment halaan, kabiya, abaniko
Red tide bivalve mollusks Vomiting and 2. Induce vomiting during red tide season
poisoning) during red tide dizziness 3. Drink pure coconut milk weakens the
season Headache toxic effect Dont mix vinegar to
Tingling 4. Sodium bicarbonate solution (25 grams in shellfish it will increase
Incubation Period: sensation/paresthesia glass of water) toxic effect 15 times
30 minutes to and Advised only in the early stage of illness greater
several hours after eventful paralysis of because paralysis can lead to aspiration
ingestion hands
Floating sensation NOTE: Persons who survived the first 12 hours
and after
weakness ingestion have a greater chance of survival.
Rapid pulse
Dysphonia
Dysphagia
Total muscle
paralysis
leading to respiratory
arrest and death
 Community Health Nursin
Communicable Disease Lecture Notes
Prepared by: Mark Fredderick R. Abejo RN,, MAN

DISEASES CAUSED BY VIRUS

Disease Causative Agent Mode of Transmission Pathognomonic Sign Management and Treatment Prevention

Chickenpox Human (alpha) herpes Droplet spread Vesiculo-pustular No specific diagnostic exam Case over 15 years of age
virus 3 (varicella-zoster Direct contact rashes Treatment is supportive. should be investigated to
Other names: virus), a member of the Indirect through articles Centrifugal eliminate possibility of
Varicella Herpesvirus group freshly soiled by appearance of Drug-of-choice: smallpox.
discharges of infected rashes rashes which Acyclovir / Zovirax (orally to reduce the Report to local authority
Period of persons begin on the trunk and number of lesions; topically to lessen the Isolation
Communicability: spread peripherally pruritus) Concurrent disinfection of
From as early as 1 to 2 Incubation Period: and more abundant on throat and nose discharges
days before the rashes 2-3 weeks, commonly covered NEVER give ASPIRIN. Aspirin when given to Exclusion from school for
appear until the lesions 13 to 17 days body parts children with viral infection may lead to 1 week after eruption first
have crusted. Pruritus development of REYES SYNDROME. appears
Avoid contact with
Nursing Diagnoses: susceptibles
Disturbance in body image
Impairment of skin integrity

German Rubella virus or Droplet Forscheimer spots Diagnostic Test: MMR vaccine (live
Measles RNAcontaining red pinpoint patches Rubella Titer (Normal value is 1:10); below 1:10 attenuated virus)
Togavirus Incubation Period: on the oral cavity indicates susceptibility to Rubella. - Derived from chick
Other Names: (Pseudoparamyxovirus) Three (3) days Maculopapular rashes embryo
Rubella Headache Instruct the mother to avoid pregnancy for three Contraindication:
Three-day German measles is Low-grade fever months after receiving MMR vaccine. - Allergy to eggs
Measles teratogenic infection, Sore throat - If necessary, given in
can cause congenital Enlargement of MMR is given at 15 months of age and is given divided or fractionated
heart disease and posterior cervical and intramuscularly. doses and epinephrine
congenital postauricular should be at the bedside.
cataract.

Herpes Zoster Herpes zoster virus Droplet Painful vesiculo- Treatment is supportive and symptomatic Avoidance of mode of
(dormant varicella Direct contact from pustular Acyclovir to lessen the pain transmission
Other names: zoster secretion lesions on limited
Shingles virus) portion of the body
Cold sores (trunk and
shoulder)
Low-grade fever
 Community Health Nursin
Communicable Disease Lecture Notes
Prepared by: Mark Fredderick R. Abejo RN,, MAN

Mumps Mumps virus, a Direct contact Painful swelling in Supportive and symptomatic MMR vaccine
member front of the ear, angle Sedatives to relieve pain from orchitis Isolate mumps cases
Other name: of family Source of infection: of the jaws and down Cortisone for inflammation
Epidemic Parotitis Paramyxoviridae Secretions of mouth and the neck
nose Diet: Soft or liquid as tolerated
Fever Support the scrotum to avoid orchitis, edema,
Incubation Period: Malaise and atrophy
12 to 26 days, usually Loss of appetite
18 days Dark glasses for photophobia
Swelling of one or
both testicles (orchitis)
in some boys

Influenza Influenza virus Direct contact Sudden onset Supportive and symptomatic Avoid use of common
A most common Fever with chills Keep patient warm and free from drafts towels, glasses, and eating
Other name: B less severe wesDroplet infection or by Headache TSB for fever utensils
La Grippe C rare articles freshly soiled Myalgia / arthralgia Boil soiled clothing for 30 minutes before Cover mouth and nose
with nasopharyngeal during cough and sneeze
Period of discharges
Communicability: Immunization:
Probably limited to 3 Airborne Flujob/Flushot effective
days from clinical onset Incubation Period: for 6 months to 1 year
Short, usually 24 72
hours
 Community Health Nursin
Communicable Disease Lecture Notes
Prepared by: Mark Fredderick R. Abejo RN,, MAN

DISEASES CAUSED BY BACTERIA

Disease Causative Agent Mode of Transmission Pathognomonic Sign Management and Treatment Prevention

Pneumonia Bacteria: Droplet Rusty sputum Diagnosis: Avoid mode of

Pneumococcus, Fever and chills Based on signs and symptoms transmission
Types: streptococcus Incubation Period: Chest pain Dull percussion on affected lung Build resistance
a. Community pneumoniae, 2 3 days Chest indrawing Sputum examination confirmatory Turn to sides
Acquired staphylococcus aureus, Rhinitis/common cold Chest x-ray Proper care of influenza
Pneumonia (CAP) Klebsiella pneumonia Productive cough cases
b. Hospital / (Friedlanders bacilli) Fast respiration Management:
Nosocomial Vomiting at times Bedrest
c. Atypical Virus: Convulsions may occur Adequate salt, fluid, calorie, and vitamin intake
Haemophilus Flushed face Tepid sponge bath for fever
influenzae Dilated pupils Frequent turning from side to side
Highly colored urine Antibiotics based on CARI of the DOH
Fungi: Pneumonocystis with reduced chlorides Oxygen inhalation
carinii pneumonia and increased urates Suctioning
Expectorants / mucolytics
Bronchodilators
Oral/IV fluids
CPT

Streptococcal Group A beta hemolytic Droplet Sudden onset Diagnosis: Avoid mode of
sore throat streptococcus High grade fever with Throat swab and culture transmission
Complication: chills
Other name: Other diseases: Rheumatic Heart Enlarged and tender Treatment: erythromycin
Pharyngitis Scarlet fever Disease cervical lymph nodes
Tonsillitis St. Anthony fire Inflamed tonsils with Care:
Puerperal sepsis mucopurulent exudates Bed rest
Imoetigo Headache Oral hygiene with oral antiseptic or with saline
Acute Dysphagia gargle (1 glass of warm water + 1 tsp rock salt)
glomerulonephritis Ice collar
Rheumatic Heart
Disease
 Community Health Nursin
Communicable Disease Lecture Notes
Prepared by: Mark Fredderick R. Abejo RN,, MAN

Meningitis Meningococcus Direct (Droplet) A. Sudden Onset Diagnostic Test: Respiratory Isolation
Neisseria meningitides - high fever Lumbar puncture or Lumbar tap - reveals CSF
Other name: Incubation Period: accompanied WBC and protein, low glucose; contraindicated
Cerebrospinal 2 - 10 days by chills for increased ICP for danger of cranial
fever - sore throat, headache, herniation
prostration (collapse) Hemoculture to rule out meningococcemia

B. entrance into the Treatment:

bloodstream leading to Osmotic diuretic (Mannitol) to reduce ICP and
septicemia relieve cerebral edema; Alert: fastdrip to prevent
(meningococcemia) crystallization
a. rash, petchiae, Anti-inflammatory (Dexamethasone) to
purpura relieve
cerebral edema
C. Symptoms of Antimicrobial (Penicillin)
menigeal Anticonvulsany (Diazepam / Valium)
irritation
- nuchal rigidity (stiff Complications:
neck) earliest sign Hydrocephalus
- Kernigs sign when Deafness (Refer the child for audiology testing)
knees are flexed, it and mutism
cannot Blindness
be extended
- Brudzinski signs
pain on neck flexion
withautomatoc flexion
of the knees
- convulsion
- poker soine (poker
face /
flat affect)
- Increased ICP
(Cushings triad:
hypertension,
bradycardia,
bradypnea)
and widening pulse
pressure
 Community Health Nursin
Communicable Disease Lecture Notes
Prepared by: Mark Fredderick R. Abejo RN,, MAN

VECTOR-BORNE DISEASES
Disease Causative Agent Mode of Transmission Pathognomonic Sign Management and Treatment Prevention

Malaria Plasmodium Parasites: Bite of infected Cold Stage: severe, Early diagnosis identification of a patient *CLEAN Technique
Vivax anopheles mosquito recurrent chills (30 with malaria as soon as he is seen through *Insecticide treatment of
Falciparum (most fatal; Night time biting minutes to 2 hours) clinical and/or microscopic method mosquito net
most common in the High-flying Clinical method based on signs and *House Spraying (night
Philippines) Rural areas Hot Stage: fever (4-6 symptoms of the patient and the history of his time fumigation)
Ovale Clear running water hours) having visited a malaria-endemic area *On Stream Seeding
Malariae Microscopic method based on the construction of bio-ponds
Wet Stage: Profuse examination of the blood smear of patient for fish propagation (2-4
sweating through microscope fishes/m2 for immediate
Episodes of chills, (done by the medical technologist) impact; 200-400/ha. for a
fevers, and profuse QBC/quantitative Buffy Coat fastest delayed effect)
sweating are Malarial Smear best time to get the *On Stream Clearing
associated with rupture specimen is at height of fever because the cutting of vegetation
of the red blood cells. microorganisms are very active and easily overhanging along stream
identified banks
- intermittent chills *Avoid outdoor night
and Chemoprophylaxis activities (9pm 3am)
sweating Only chloroquine should be given (taken at *Wearing of clothing that
- anemia / pallor weekly intervals starting from 1-2 weeks before covers arms and legs in the
- tea-colored urine entering the endemic area). In pregnant women, evening
- malaise it is given throughout the duration of *Use mosquito repellents
- hepatomegaly pregnancy. *Zooprophylaxis typing
- splenomegaly of domestic animals like
- abdominal pain and Treatment: the carabao, cow, etc near
enlargement Blood Schizonticides - drugs acting on sexual human dwellings to
- easy fatigability blood stages of the parasites which are deviate mosquito bites
responsible from man to these animals
for clinical manifestations Intensive IEC campaign
1. QUININE oldest drug used to treat
malaria; from the bark of Cinchona tree; NURSING CARE:
ALERT: Cinchonism quinine toxicity 1. TSB (Hot Stage)
2. CHLOROQUINE 2. Keep patent warm
3. PRIMAQUINE sometimes can also be (Cold Stage)
given as chemoprophylaxis 3. Change wet clothing
4. FANSIDAR combination of (Wet Stage)
pyrimethamine and sulfadoxine 4. Encourage fluid intake
5. Avoid drafts
 Community Health Nursin
Communicable Disease Lecture Notes
Prepared by: Mark Fredderick R. Abejo RN,, MAN

Filariasis Wuchereria bancrofti Bite of Aedes poecillus Asymptomatic Stage: Diagnosis CLEAN Technique
Brugia malayi (primarily) Presence of Physical examination, history taking, Use of mosquito repellents
Other names: Brugia timori Aedes flavivostris microfilariae observation of major and minor signs and Anytime fumigation
Elephantiasis nematode parasites (secondary) in the blood but no symptoms Wear a long sleeves, pants
Endemic in 45 out clinical signs and and socks
of 78 provinces Incubation period: symptoms of disease Laboratory examinations
Highest 8 16 months Nocturnal Blood Examination (NBE) blood
prevalence rates: Acute Stage: are taken from the patient at his residence or in
Regions 5, 8, 11 Lymphadenitis hospital after 8:00 pm
and CARAGA Lymphangitis Immunochromatographic Test (ICT) rapid
Affectation of male assessment method; an antigen test that can be
Genitalia. done at daytime

Chronic Stage: (10-15 Treatment:

years from onset of Drug-of-Choice: Diethylcarbamazine Citrate
first (DEC) or Hetrazan
attack)
Hydrocele
Lymphedema
Elephantiasis

Shistosomiasis Schistosoma mansoni Contact with the Diarrhea Diagnostic Test: Dispose the feces properly
S. haematobium infected freshwater with Bloody stools (on and COPT or cercum ova precipitin test (stool not reaching body of water
Other Names: S. japonicum (endemic cercaria and penetrates off dysentery) exam) Use molluscides
Snail Fever in the Philippines) the skin Enlargement of Prevent exposure to
Bilharziasis abdomen Treatment: contaminated water (e.g.
Endemic in 10 Vector: Oncomelania Splenomegaly Drug-of-Choice: PRAZIQUANTEL use rubber boots)
regions and 24 Quadrasi Hepatomegaly (Biltracide) Apply 70% alcohol
provinces Anemia / pallor Oxamniquine for S. mansoni immediately to skin to kill
High prevalence: weakness Metrifonate for S. haematobium surface cercariae
Regions 5, 8, 11 *Death is often due to hepatic complication Allow water to stand 48-72
hours before use

Dengue Dengue virus 1, 2, 3, Bite of infected Classification (WHO): Diagnostic Test: 4 oclock habit
Hemorrhagic and 4 and Chikungunya mosquito (Aedes Torniquet test (Rumpel Leads Test / capillary Chemically treated
Fever virus Aegypti) - characterized Grade I: fragility test) PRESUMPTIVE; positive when mosquito net
Types 1 and 2 are by black and white a. flu-like symptoms 20 or more oetechiae per 2.5 cm square or 1 Larva eating fish
Other names: common in the stripes b. Hermans sign inch square are observed Environmental sanitation
H-fever Philippines Daytime biting c. (+) tourniquet sign Platelet count CONFIRMATORY; (Normal Antimosquito soap
Low flying is Neem tree (eucalyptus)
Stagnant clear water 150 - 400 x 103 / mL)
Urban
Community Health Nursin
Communicable Disease Lecture Notes
Prepared by: Mark Fredderick R. Abejo RN,, MAN

Period of Incubation Period: Grade II: Treatment: Eliminate vector

communicability: Uncertain. Probably 6 a. manifestations of Supportive and symptomatic Avoid too many hanging
Unknown. Presumed to days to 1 week Grade Paracetamol for fever clothes inside the house
be on the 1st week of Manifestations: I plus spontaneous Analgesic for pain Residual spraying with
illness up to when the First 4 days: bleeding Rapid replacement of body fluids most insecticide
virus is still present in Febrile/Invasive Stage b. e.g. petechiae, important Daytime fumigation
the - starts abruptly as fever ecchymosis purpura, treatment Use of mosquito repellants
blood - abdominal pain gum ORESOL Wear long sleeves, pants,
Occurrence is sporadic - headache bleeding, Blood tansfusion and socks
throughout the year - vomiting hematemesis, Diet: low-fat, low-fiber, non-irritating, For the control of H-fever,
Epidemic usually occur - conjunctival infection melena noncarbonated. knowledge of the natural
during the rainy seasons -epistaxis Grade III: Noodle soup may be given. ADCF history of the disease is
(June to November) 4th 7th days: a. manifestations of (Avoid Dark-Colored Foods) important.
Peak months: Toxic/Hemorrhagic Grade ALERT! No Aspirin Environmental control is
September Stage II plus beginning of the most appropriate
and October - decrease in circulatory failure primary prevention
temperature b. hypotension, approach and control of
- severe abdominal pain tachycardia, tachypnea Hfever.
- GIT bleeding Grade IV:
- unstable BP (narrowed a. manifestations of
pulse pressure) Grade
- shock III plus shock (Dengue
- death may occur Shock Syndome)
7th 10th days:
Recovery/Convalescent
Stage
- appetite regained
- BP stable
 Community Health Nursin
Communicable Disease Lecture Notes
Prepared by: Mark Fredderick R. Abejo RN,, MAN

DISEASES TRANSMITTED BY ANIMALS

Disease Causative Agent Mode of Transmission Pathognomonic Sign Management and Treatment Prevention
Leptospirosis Leptospira interrogans Through contact of the Leptospiremic Phase Diagnosis Protective clothing,
bacterial spirochete skin, especially open - leptospires are present Clinical manifestations boots and gloves
Other Names: RAT is the main host. wounds with water, in blood and CSF Culture of organism Eradication of rats
- Weils Disease moist soil or vegetation - onset of symptoms is Examination of blood and CSF during the first Segregation of domestic
- Mud Fever Although pig, cattle, infected with urine of abrupt week of illness and urine after the 10th day animals
- Trench Fever rabbits, hare, skunk, the infected host - fever Leptospira agglutination test Awareness and early
- Flood Fever and other wild animals - headache diagnosis
- Spirochetal can also serve as Incubation Period: - myalgia Treatment: Improved education of
Jaundice reservoir 7-19 days, average of - nausea Penicillins and other related B-lactam antibiotics people
- Japanese 10 days - vomiting Tetracycline (Doxycycline) Avoid wading or
Seven Days Occupational disease - cough Erythromycin swimming in water
fever affecting veterinarians, - chest pain contaminated with urine
miners, farmers, sewer Most common complication: kidney failure of infected animals.
workers, abattoir Immune Phase Concurrent disinfection
workers, - correlates with the of articles soiled with
etc appearance of circulating urine.
IgM

Rabies Rhabdovirus of the Bite or scratch (very Sense of apprehension Diagnosis: Have pet immunized at 3
genus rare) of rabid animal Headache history of bite of animal months of age and every
Other Names: lyssavirus Non-bite means: Fever culture of brain of rabid animal year thereafter
Lyssa Degeneration and leaking, scratch, organ Sensory change near site demonstration of negri bodies Never allow pets to roam
Hydrophobia necrosis transplant (cornea), of animal bite the streets
Le Rage of brain formation of inhalation/airborne Spasms of muscles of Management: Take care of your pet
negri bodies (bats) deglutition on attempts to *Wash wound with soap immediately.
swallow Antiseptics National Rabies
Two kinds of Rabies: Source of infection: Fear of e.g. povidone iodine or alcohol may be applied Prevention and Control
a. Urban or canine saliva of infected water/hydrophobia *Antibiotics and anti-tetanus immunization Program
transmitted by dogs animal or human Paralysis *Post exposure treatment: local wound Goal: Human rabies is
b. Sylvatic disease of Delirium treatment, active immunization (vaccination) and liminated in the
wild animals and bats Incubation period: Convulsions passive immunization (administration of rabies Philippines and the
which sometimes 2 8 weeks, can be FATAL once signs and immunoglobulin) country is declared
spread years depending on symptoms appear *Consult a veterinarian or trained personnel to rabiesfree
to dogs, cats, and severity of wounds, site observe the pet for 14 days
livestock of wound as distance *Without medical intervention, the rabies victim
from brain, amount of would usually last only for 2 to 6 days. Death is
virus introduced, and often due to respiratory paralysis.
protection provided by
clothing
 Community Health Nursin
Communicable Disease Lecture Notes
Prepared by: Mark Fredderick R. Abejo RN,, MAN

DISEASES OF THE SKIN

Disease Causative Agent Mode of Transmission Pathognomonic Sign Management and Treatment Prevention
Leprosy Mycobacterium leprae Airborne-droplet Early signs: Diagnostic Test: Avoid prolonged skin-to skin
Prolonged skin-toskin Change in skin color Slit Skin Smear - determines the presence of M. contact
Other names: contact either leprae; optional and done only if clinical BCG vaccination
Hansenosis reddish or white diagnosis practical and effective
Hansens disease Loss of sensation on is doubtful to prevent misclassification and preventive measure
-an ancient the skin wrong against leprosy
disease and is a lesion treatment Good personal hygiene
leading cause of Loss of sweating and Lepromin Test determines susceptibility to Adequate nutrition
permanent hair growth leprosy Health education
physical disability Thickened and painful Major activity of leprosy
among the nerves Treatment: control program:
communicable Muscle weakness or Ambulatory chemotherapy through use of MDT casefinding and treatment
diseases paralysis or Domiciliary treatment as embodied in RA 4073 with effective drugs
extremities which advocates home treatment Prevent deformities by
Pin and redness of the self-care, exercise, and
eyes PAUCIBACILLARY (tuberculoid and physical therapy.
Nasal obstruction or indeterminate); noninfectious type
bleeding Duration of treatment: 6 to 9 months
Ulcers that do not heal Procedure: MDT Facts:
Supervised: Rifampicin and Dapsone once a It reduces communicability period
Late Signs: month on the health center supervised by the of leprosy in 4-6 weeks time.
Madarosis rural health midwife It prevents development of
Loss of eyebrows Self-administered: Dapsone (side effect: resistance to drugs.
Inability to close itchiness of the skin) everyday at the clients It shortens the duration of
eyelids house treatment.
(lagophthalmos)
Clawing of fingers and MULTIBACILLARY (lepromatous and
toes borderline); infectious type
Contractures Duration of treatment: 24-30 months
Chronic ulcers Procedure:
Sinking of the Supervised: Rifampicin, Dapsone, and Lamprene
nosebridge Clofazimine; side effect: dryness or flaking of
Enlargement of the the skin) once a month on the health center
breast supervised by the rural health midwife
(gynecomastia) Self-administered: Dapsone and Lamprene
everyday at the clients house
 Community Health Nursin
Communicable Disease Lecture Notes
Prepared by: Mark Fredderick R. Abejo RN,, MAN

Anthrax Bacillus anthracis Contact with Cutaneous form most Treatment: Penicillin Proper handwahing
a. tissues of animals common Immunize with cell-free
Other names: Incubation period: (cattle, sheep, goats, - itchiness on exposed vaccine prepared from
Malignant pustule few hours to 7 days horses, pigs, etc.) part culture filtrate containing
Malignant edema most cases occur within dying of the disease - papule on inoculation the protection antigen
Woolsorter 48 hours of exposure b. biting flies that site Control dust and proper
disease had partially fed on such - papule to vesicle to ventilation
Ragpicker disease animals eschar
Charbon c. contaminated hair, - painless lesion
wool, hides or products
made from them e.g. Pulmonary form
drums and brushes contracted from
d. soil associated inhalation of B.
with infected animals or anthracis spores
contaminated bone - at onset, resembles
meal used in common URTI
gardening - after 3-5 days,
symptoms become
acute, with fever,
shock,
and death

Gastrointestinal
anthrax
contracted from
ingestion of meat from
infected animal
- violent gastroenteritis
- vomiting
- bloody stools
3. Scabies Sarcoptes scabiei Direct contact with Itching Diagnosis: Personal hygiene
- An itch mite infected individuals When secondarily Appearance of the lesion Avoid playing with dogs
parasite infected: Intense itching Laundry all clothes and
Incubation Skin feels hot and Finding of causative mite iron
Period: burning Maintain the house clean
24 hours When large and Treatment: (limited entirely to the skin) Environmental sanitation
severe: fever, Examine the whole family before undertaking Eat the right kind of food
headache, and malaise treatment Regular changing of clean
Benzyl benzoate emulsion (Burroughs, clothing, beddings and
Welcome) towels
cleaner to use and has more rapid effect
Kwell ointment
 Community Health Nursin
Communicable Disease Lecture Notes
Prepared by: Mark Fredderick R. Abejo RN,, MAN

SEXUALLY TRANSMITTED DISEASES

Disease Causative Agent Mode of Transmission Pathognomonic Sign Management and Treatment Prevention
Syphilis Treponema pallidum Direct contact Primary stage (4-6 Diagnostic test: Abstinence
(a spirochete) Transplacental (after weeks): painless Dark field illumination test Be faithful
Other names: 16th week AOG) chancre at site of entry Fluorescent treponemal antibody absorption Condom
Sy Incubation Period: Through blood of germ test, most reliable and sensitive diagnostic test
Bad Blood 10 to 90 days (3 transfusion with serous exudates for Syphilis; serologic test for syphilis which
The pox months); Indirect contact with involves antibody detection by microscopic
Lues venereal average of 21 days Contaminated articles Tertiary stage (one to flocculation of the antigen suspension
Morbus gallicus 35 years) : Gumma, VDRL slide test, CSF analysis, Kalm test,
syphilitic endocarditis Wasseman test
and meningitis
Treatment:
Primary and secondary Drug of Choice: Penicillin (Tetracycline if
sores will go even resistant
without treatment but to Penicillin)
the germs continue
to spread throughout
the body.
Latent syphilis may
continue 5 to 20+
years with NO
symptoms, but the
person is NO longer
infectious to other
people.
A pregnant
mother can transmit
the disease to her
unborn child
(congenital syphilis).
Gonorrhea Neiserria gonorrheae Direct contact Thick purulent Diagnostic test: Abstinence, Be faithful
genitals, anus, yellowish discharge Culture of urethral and cervical smear Condom
Other names: mouth Burning sensation Gram staining Prevention of gonococcal
GC, Clap, Drip, upon ophthalmia is done through
Stain, Gleet, Incubation Period: urination / dysuria Treatment: the prophylactic use of
Flores Blancas 2 10 days Drug of Choice: Penicillin ophthalmic preparations
with erythromycin or
tetracycline
 Community Health Nursin
Communicable Disease Lecture Notes
Prepared by: Mark Fredderick R. Abejo RN,, MAN

Trichomoniasis Trichomonas vaginalis Direct contact Females: Diagnostic Test: Abstinence

white or greenish- Culture Be faithful
Other names: Incubation Period: yellow odorous Condom
Vaginitis 4 20 days; average discharge vaginal Treatment: Personal Hygiene
Trich of 7 days itching and soreness Drug of Choice: Metronidazole (Flagyl)
painful urination

Males:
Slight itching of penis
Painful urination
Clear discharge from
penis

Chlamydia Chlamydia trachomatis Direct contact Females: Diagnostic Test: Abstinence

(a rickettsia) Asymptomatic Culture Be faithful
Incubation Period: Dyspareunia Condom
2 to 3 weeks for Fishy vaginal Treatment:
males; usually no discharge Drug of Choice: Tetracycline
symptoms for
females Males:
Burning sensation
during
urination
Burning and itching of
urethral opening
(urethritis)

Candidiasis Candida albicans Direct contact White, cheese-like Diagnostic Test: Abstinence
vaginal Culture Be faithful
Other names: discharges Gram staining Condom
Moniliasis Curd like secretions
Candidosis Treatment:
Nystatin for oral thrush
Cotrimazole, fluconazole for mucous
membrane and vaginal infection
Fluconazole or amphotericin for systemic
infection
 Community Health Nursin
Communicable Disease Lecture Notes
Prepared by: Mark Fredderick R. Abejo RN,, MAN

Acquired Retrovirus Blood and body Window Phase Enzyme-Linked Immuno-Sorbent Assay Abstinence
immune (Human T-cell fluids a. initial infection (ELISA) Be faithful
deficiency lymphotrophic virus 3 Transplacental b. lasts 4 weeks to 6 - presumptive test Condom
syndrome (AIDS) or HTLV 3) months Western Blot confirmatory
Attacks the T4 cells: Incubation period: c. not observed by Sterilize needles, syringes,
Thelper 3-6 months to 8-10 present Treatment: and instruments used for
cells; Tlymphocytes, years laboratory test (test 1. Treatment of opportunistic infection cutting operations
and CD4 should 2. Nutritional rehabilitation Proper screening of blood
lymphocytes Variable. Although be repeated after 6 3. AZT (Zidovudine) retards the replication donors
the time from months) of retrovirus; must be taken exactly as Rigid examination of blood
The major route of HIV infection to the ordered and other blood products
transmission to development of Acute Primary HIV 4. PK 1614 mutagen Avoid oral, anal contact
adolescent detectable antibodies Infection Major signs of Pediatric AIDS: and swallowing of semen
is SEXUAL is generally 1-3 a. short, symptomatic Chronic diarrhea > 1 month Avoid promiscuous sexual
TRANSMISSION. months, the time period Prolonged fever > 1 month contact
French kissing brings from HIV infection b. flu-like symptoms Weight loss or abnormally slow growth Avoid sharing of
low to diagnosis of c. ideal time to Breastmilk is important in preventing toothbrushes.
risk of HIV AIDS has an undergo intercurrent infection in HIV infected infants and
transmission. observed range of screening test (ELISA) children. HIV/AIDS Prevention
less than 1 year to 15 and Control Program:
years or longer. Asymptomatic HIV The care of HIV patients is similar to the routine Goal: Contain the
(PHN Book) Infection care given to cases of other diseases. transmission of HIV /AIDS
a. with antibodies Not everybody is in danger of becoming infected and other reproductive tract
against HIV but not with HIV through sex. infections and mitigate
protective Never give live attenuated (weakened) vaccines their impact
b. lasts for 1-20 years e.g. oral polio vaccine.
depending upon LECTURE DISCUSSION
factors HIV positive pregnant women and their partner best method to use in
must be informed of the potential risk to the teaching about safe sex
ARC (AIDS Related fetus. Priority intervention when
Complex) caring for AIDS patient:
a. a group of Use disposable gloves
symptoms indicating when in contact with non intact
the disease is likely to skin.
progress to AIDS
b. fever of unknown
origin
c. night sweats
d. chronic intermittent
diarrhea
e. lymphadenopathy
f. 10% body weight
loss
Community Health Nursin
Communicable Disease Lecture Notes
Prepared by: Mark Fredderick R. Abejo RN,, MAN

AIDS
a. manifestation of
severe
immunosuppression
b. CD4 Count:
<200/dL
c. presence of variety
of
infections at one time:
oral candidiasis
leukoplakia
AIDS dementia
complex
Acute encephalopathy
Diarrhea, hepatitis
Anorectal disease
Cytomegalovirus
Pneumonocystis
carinii
pneumonia (fungal)
TB
Kaposis sarcoma
(skin
cancer; bilateral
purplish
patches)
Herpes simplex
Pseudomonas
infection
Blindness
Deafness
 Community Health Nursin
Communicable Disease Lecture Notes
Prepared by: Mark Fredderick R. Abejo RN,, MAN

DISEASES OF THE NEW MILLENIUM

Disease Causative Agent Mode of Transmission Pathognomonic Sign Management and Treatment Prevention

Meningococcemia Neisseria meningitides Direct contact with High grade fever in the Respiratory isolation within 24 hours Universal precaution
respiratory droplet from first 24 hours Chemoprophylaxis with
nose and throat of Hemorrhagic rash Drug-of-Choice: Penicillin Rifampicin to protect
infected individuals petechiae exposed individual from
nuchal rigidity developing the infection
Incubation Period: Kernigs sign Proper hand washing
2 10 days Brudzinski sign
Shock
Death

Severe Acute Coronavirus Close contact with Prodromal Phase: No specific treatment Utilize personal protective
Respiratory respiratory droplet Fever (>38 0C) PREVENTIVE MEASURES and CONTROL equipment (N95 mask)
Syndrome / SARS secretion from patient Chills 1. Establishment of triage Handwashing
Malaise 2. Identification of patient Universal Precaution
Earliest case: Incubation Period: Myalgia 3. Isolation of suspected probable case The patient wears mask
Guangdong 2 10 days Headache 4. Tracing and monitoring of close contact Isolation
Province, Infectivity is none to 5. Barrier nursing technique for suspected
China in November low and probable case
2002
Respiratory Phase:
Global outbreak: Within 2-7 days, dry
March 12, 2003 nonproductive cough
progressing to
First case in the respiratory
Philippines: distress
April 11, 2003

Bird Flu Influenza Virus H5N1 Contact with infected Fever Control in birds: Isolation technique
Other Name: birds Body weakness and 1. Rapid destruction (culling or stamping out of Vaccination
Avian Flu body all infected or exposed birds) proper disposal of Proper cooking of poultry
Incubation Period: malaise carcasses and quarantining and rigorous
3 days, ranges from 2 Cough disinfection of farms
4 days Sore throat 2. Restriction of movement of live poultry
Dyspnea In humans:
Sore eyes 1. Influenza vaccination
2. Avoid contact with poultry animals or
migratory
birds
 Community Health Nursin
Communicable Disease Lecture Notes
Prepared by: Mark Fredderick R. Abejo RN,, MAN

Influenza A Influenza Virus A Exposure to droplets - similar to the Diagnostic: Cover your nose and
(H1N1) H1N1 from the cough and symptoms Nasopharyngeal (throat) swab mouth when coughing and
This new virus was sneeze of the infected of regular flu such as Immunofluorescent antibody testing to sneezing
Other Name: first detected in people person Fever distinguish influenza A and B Always wash hands with
Swine Flu in April 2009 in the Influenza A (H1N1) is Headache soap and water
United States. not transmitted by Fatigue Treatment: Use alcohol- based hand
May 21, 2009 Influenza A (H1N1) is eating thoroughly Lack of appetite Antiviral medications may reduce the severity sanitizers
first confirmed fatal to humans cooked pork. Runny nose and Avoid close contact with
case in the The virus is killed by Sore throat duration of symptoms in some cases: sick people
Philippines cooking temperatures of Cough Oseltamivir (Tamiflu) Increase your body's
160 F/70 C. - Vomiting or nausea or zanamivir resistance
June 11, 2009 - Diarrhea Have at least 8 hours of
The WHO raises Incubation Period: sleep
its Pandemic Alert 7 to 10 days Be physically active
Level to Phase 6, Manage your stress
citing significant Drink plenty of fluids
transmission of the Eat nutritious food
virus.