Communicable Diseases

Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome (HIV/AIDS)

Causative agent: HIV/ human T-cell lymphotrophic virsu- a retro/lenti virus MOT: - sexual contact -contaminated sharps(needles, syringes, nippers, barber razors, etc.) - Blood Trans. And IV drug use - mother to infant by during pregnancy, at birth or by Breastfeeding - direct contact with infected fluids-blood, semen, vaginal discharges; rare case via saliva Signs and Symptoms: may go unnoticed/asymptomatic for up to 10 years a. Physical: - Maculo-papular rash - Loss of appetite - Fever of unknown origin - Malaise - CHRONIC DIARRHEA (30 days) - Esophageal candidiasis - KAPOSIS SARCOMA most common skin cancer in AIDS; increase Cervical and lymph node cancer risk - PNEUMOCYSTIS carinii PNEUMONIAmost common opportunistic infection - Gaunt-looking, apprehensive b. Mental: forgetfulness, depression c. Early S/Sx: a. Loss of concentration b. Loss of libido c. Apathy d. Psychomotor retardation and withdrawal d.Late stages a. confusion, disorientation b. seizures c. mutism d. loss of memory and DEMENTIA \ e. coma Diagnostic Tests: a. Enzyme Linked Immuno Sorbent Assay (ELISA) presumptive b. Western Blot confirmatory Risk factor: - Homosexuals highest number of cases - Medical practitioners - IV drug users - Commercial Sex workers and multiple partners Prevention: A. Abstinence- best (Philippines) B. Use of condoms best (NCLEX) C. Monogamous relationship- be faithful to one partner D. Avoid promiscuous sexual contact

E. Thorough sterilization of medical equipments F. Proper screening for blood donors and blood products to be infused G. Avoid oral, anal and swallowing of semen H. Protective gear for health workers- avoid needle-stick injuries 4 Cs of DOH for Sexually Transmitted Diseases Compliance to treatment Counseling/education Contact tracing Condoms Treatment: no definite treatment yet a. Anteroviral drugs- treats but does not cure - Reverse transcriptase inhibitors such as Zidovudine, Zalcitabine - Protease inhibitors such as Saquinavir, Ritonavir Overview of Nsg. Management a. HEALTH EDUCATION on risk factors, safe sex, and ways of prevention/treatment. CONVEY ACCEPTANCE, NO JUDGEMENTAL OPINIONS b. Practice universal/standard precautions thorough HANDWASHING, NEVER RECAP SYRINGES, USE PROTECTIVE GEARS, use puncture proof needle container c. Label blood and other specimen with AIDS precaution. d. Promptly clean BLood spills with BLeach. e. Personal items (shave, razors, nippers) should be of patient use ONLY. f. AIDS patients should be isolated. g. PREVENTIVE, CASE-FINDING /CONTACT TRACING, SUPPORTIVE 3 MAJOR NSG. ROLES

Pulmonary Tubercolosis (PTB, Kochs Disease)

AGENT: Mycobacterium (tubercle bacillus) tubercolosis

MOT: airborne-droplet infection, direct invasion via mucous membrane(rare) Incubation Period: 2-10 weeks; hazardous at 6-12 months Dx test: a. Sputum AFB staining (DSSM)- Sputum Smear Microscopy (Best and Most important) b. Mantoux Test (most common) c. Chest x-ray to detect extent of lung involvement. S/Sx:

a. Primary Infection with little or no Sx; patient may be restless, irritable, fatigued with crepitation and rales; PRIMARY COMPLEX in CHILDREN is noncommunicable b. POST PRIMARY TUBERCOLOSIS - S/Sx highly visible due to pyrexia - Distressing cough and breath sounds can be noted c. CHRONIC PTB GENERAL SYMPTOMS: - malaise, anorexia, easy fatigability, apathy, irritability and indigestion - Dyspnea, cyanosis, tachycardia - Late afternoon fever - Night sweats - Weight loss - Hemoptysis-pathognomonic Classification Based on Disease Extent a. Minimal confined lesion in lung/s b. Moderately advanced cavity on one or both lungs 4 cm in diameter c. Advanced more extensive lesions Drug of Choice (with possible S/E): a. Rifampicin Red-orange urine/ body fluids - Instruct client that this is normal - Hepatitis, purpura, hemoptysis may develop b. Isoniazid (INH) causes peripheral neuritis as this drug competes with Vit. B6 (pyridoxine)- expect Vit. B6 supplement. c. Pyrazinamide hyperuricemia - Instruct to increase fluids d. Ethambutol optic neuritis and/or rash (Discontinue immediately) - Not given to child 6 y.o and below (not able to properly report eye changes) e. Streptomycin CN 8/ Vestibulocochlear nerve damage; oto/nephro toxic - Assess CN 8 intactness- Rombergs test - Increase Oral Fluid Intake *Direct Observe Treatment Short Course is recommended to prevent non-compliance *if not taken as orders, resistance develops especially with RIPE; Streptomycin is considered second line Nursing Management: a. Best prevention BCG vaccination b. Educate public MOT, control measures, and prompt diagnosis c. Improve social conditions- e.g overcrowding d. Make available all facilities possiblemedical, lab., X-ray equipments e. Proper disposal of secretions. Advise on covering mouth when sneezing/coughing f. Promote healthy lifestyle especially balanced diet and to stop smoking

Schistosomiasis (Bilhariasis Disease, Snail Fever)

Katayama

Agent: Schistosoma japonicum (endemic/common in Phil), S. mansoni, S. haematobium BLOOD FLUKES Vector: Oncomelania quadrasi (snail) MOT: - ingestion of contaminated water - Entrance via broken skin/pores - Via intermediary host (snail) S/Sx: a. Swimmers itch rash at site of Penetration; pathognomonic b.diarrhea c. bloody stool d. abdominal enlargement e. spleenomegaly f. weakness g. anemia h.inflamed liver Methods of Control/ Health Education a. Public education b. Proper disposal of feces and urine concurrent disinfection c. Improve irrigation and agriculture practices d. Use of molluscicides in breeding grounds e. Prevent exposure to contaminated water ( use of rubber boots) f. Provide clean, safe water g. Treat patients in endemic areas h. Inform risks to travelers i. During epidemic prioritize children; finding source of infection is community effort Treatment: a. PRAZIQUANTEL (Biltricide) drug of choice for all species: Oxamniquine and metrifonate-alternative

LEPTOSPIROSIS (JAPANESE SEVEN DAYS FEVER, FLOOD/MUD FEVER, Weils Disease)

AGENT: Leptospira interrogans, L. macilae SPIROCHETE/BACTERIA Vector/Main Host: RAT; others- dog, mice MOT: ingestion or contact of the skin with water, moist soil, secretions or vegetation infected with urine Dx Tests: Culture of blood 1st week; Culture of CSF 5th to 12th day; Culture of Urine 10th day

S/S based on 3 stages: A. Septic stage- signs of infection with abdominal pain and prostration B. Immune or toxic stage CNS/ brain involvement (meningitis, seizure, headache) - Oliguria and anuria leading to renal failure - Shock and coma; fatal at 9-16th day C. Convalescence recovery Medical Management: A. PENICILLIN and other B-lactam antibiotics B. Tetracycline/Doxycycline C. Erythromycin D. Peritoneal dialysis E. IVF and blood transfusion as appropriate\ Prevention and Control a. Improved education on risks b. Protective clothing, boots, gloves c. Rat eradication program d. Chemoprophylaxis

Grade 3: Grade 2 + circulatory failure Grade 4: Grade 3 + profound shock and undetectable pulse and BP Management Supportive and Symptomatic RAPID REPLACEMENT OF BODY FLUIDS MOST IMPORTANT. Increase OFI and give ORS For fever and muscle pains, give Paracetamol; NO ASPIRIN For hemorrhage: EPISTAXIS FLEX NECKand ice pack on the forehead; gum bleeding-soft toothbrush For low platelet, blood transfusion with whole blood Melena ice bag on abdomen; NO DARK COLORED FLUIDS Avoid unnecessary movement Observe for shock. PREVENTION is the best treatment. Dorsal recumbent position CLOSELY MONITOR TEMP. Diet low fat, low-fiber, non-irritating, non carbonated. Give noodle soup.

a. b. c. d.
-

e. f. g.
h.

Dengue Hemorrhagic Fever ( Dandy/ Breakbone Fever)

AGENT: Dengue Virus Types 1,2,3 and 4(Flavivirus) and Chikungunya virus MOT: mosquito bite of the VECTOR- Aedes aegypti- DAY BITING Dx test: a. Rumpel Leads Test/ Tourniquet test - screening test for capillary fragility - (+) if 20 or more petechiae is present in a 1-inch square box b. Platelet greatly suggest positive infection; may confirm diagnosis c. Occult blood and other blood tests 3 Stages: a. First 4 days febrile or invasive stage b. 4th to 7th day toxic or hemorrhagic stage c. 7th to 10th day convalescent or recovery stage CLASSIFICATION A. SEVERE FRANK TYPE most critical and of sudden onset B. MODERATE less hemorrhage and no shock C. MILD- typical cases of slight fever; no hemorrhage Grades of Dengue Grade 1 : Fever + positive Torniquet test Grade 2 : Grade 1 + spontaneous bleeding

PHN Responsibility during epidemic: A. REPORT TO MHO ASAP B. REFER IMMEDIATELY C. Conduct strong health education on vector control and environmental sanitation. D. Assist in Dx of suspects E. CONDUCT EPIDEMIOLOGIC INVESTIGATION

Malaria (King of Tropical Disease, Marsh Fever, Periodic Fever, Ague)

Agent : Plasmodium falciparum 70% of cases and the most serious type that causes Pernicious Malaria *Others: P. vivax causes benign tertian malaria; P. ovale ; P. malariae Modes of Transmission a. Through vector ( female mosquito)- night biting b. Mother to newborn c. Infected needle and syringes d. Transplacental Signs and Symptoms: a. Recurrent chills b. Fever c. Profuse sweating d. Anemia e. Malaise f. Hepatomegaly g. Spleenomegaly

Anopheles

Stages

* monitor I and O to prevent pulmonary edema

a. Cold stage massive chills b. Hot stage - fever

Diphtheria
Infectious Agent: Corynebacterium (Klebs-Loeffler bacillus) diphtheria

c. Wet stage sweating (fluid replacement needed) Diagnostic Exam: Blood Smear for Malarial Parasite (BSMP) confirms presence of specie and its density; taken at height of fever and repeated 12 hours after an attack Rapid Diagnostic Test for immediate results when outside the laboratory or in the field to detect malarial parasite antigen Early Diagnosis and Treatment a. Early Diagnosis identification of a patient with malaria ASAP by clinical and/or microscopic method b. Microscopic Method based on S/Sx of patient and Hx of visitation in Malariaendemic area c. This will be done by Medical Technologist or Microscopist at Main Health Center d. Medical Technologist will take smear of patients who have: 1. Fever or recent fever within the month 2. Stayed in malaria-endemic areas and clinically diagnosed patients 3. Not responded to treatment PREVENTIVE Chemoprophylaxis - ONLY CHLOROQUINE should be given weekly about 1-2 weeks before entering endemic areas and given throughout pregnancy Insecticide-treatment of mosquito net or curtains House Spraying On stream seeding and clearing Wearing protective clothing in arms and legs during evening Avoid as much as possible night activities Mosquito repellents Planting Neem trees or other potential repellant plants RECOMMENDED ANTI-MALARIAL DRUGS BLOOD SCHIZONTICIDES drugs acting on sexual blood stages of the parasites which are responsible for the clinical manifestations: a. Chloroquine b. Sulfadoxine c. Quinine- neurotoxic d. Tetracycline e. Quinidine *Nursing management is similar to other diseases with fever as main symptom. FLUID BALANCE is the most vital

Mode of Transmission: direct contact with infected patient or carrier; and indirect contact with soiled articles Dx Test: Schicks test (Intradermal) to determine susceptibility - Nose and throat swab Maloneys test determine hypersensitivity to Diphtheria toxoid S/Sx: Sx Pseudomembrane(pathognomonic) and excoriation of nostrils b. Pharyngeal Sx- sore throat , bulls neck (edematous neck), difficulty in swallowing, loss of weight, anorexia c. Laryngeal Sx hoarseness, cough, LARYNGEAL OBSTRUCTION, and respiratory arrest * Pseudomembrane may cause death due to airway obstruction *nasopharyngeal type is the DEADLIEST Prevention: DPT immunization and Isolation of known cases Medical Management: a. Serum therapy Diptheria Antitoxin to neutralize toxin ( assess allergy) b. Antibiotics erythromycin or penicillin to destroy microorganism c. Isolation after 2-3 positive culture with 24 hour interval Nursing Management: a. Enough bed rest for 2-3 weeks b. Fluid balance and adequate nutrition c. Oral hygiene d. ICE COLLAR to relieve pain e. Proper disposal of soiled articles

a. Nasal

Tetanus (Lockjaw)
Agent: Clostridium tetani or tetanus bacillus (Anaerobic) Mode of Transmission: direct and indirect contamination of open wound and umbilical stump Sources of infection: A. Animal or human feces B. Soil and dust containing spores

C. Unsterile instruments
Dx Test- Physical S/Sx evaluation S/Sx: Lockjaw or trismus Muscle rigidity Opisthotonus- arching of the back Tonic-clonic muscle spasms Boardlike abdomen Laryngeal or pharyngeal spasm (most dangerous) g. Photophobia h. Irritability and restlessness In neonates: 1. Poor sucking 2. If sucking is attempted, spasm and cyanosis occurs 3. Mild, short, voiceless cry 4. Flaccidity and exhaustion then death Treatment : a. To neutralize the toxin: - Tetanus immune globulin (TIG) - Anti-tetanus serum (ATS) - Tetanus antitoxin (TAT) or tetanus b. To destroy microorganism erythromycin, tetracycline, penicillin c. Diazepam prevention and control of spasm Nursing Care: *Prevention- DPT/TT immunization; expose stump in the air periodically; proper cord care a. Reduce environmental stimuli b. During convulsion-open airway, no restraints, DONT PUT TONGUE DEPRESSOR c. Adequate fluids and electrolytes d. Strict aseptic technique during cord dressing and cord care e. PHN has responsibility of reporting immediately any case to the physician.

f. Loss of appetite
g. In some boys, swelling of one or two testes or orchitis that may lead to sterility Dx Test: - Compliment fixation presumptive - Viral culture - Serum amylase determination useful in early diagnosis of mumps - Hemo-agglutination inhibition checks immune status Prevention: MMR vaccine (not common) Management: a. Usually no treatment if before puberty b. Comfort measure c. Suspenders, pillow or sling between thighs to minimize danger of orchitis d. Sedatives to relieve pain e. Immediate oral dose of cortisone for adults f. Soft or liquid diet as tolerated; acidic foods increases eating discomforts

a. b. c. d. e. f.

Chicken Pox (Varicella)

Agent: Varicella-zoster virus MOT: direct contact or airborne-droplet spread; indirect via soiled articles. Diagnostic Tests: a. Complement Fixation Test determines presence of virus b. electronic microscopic determination of vesicular fluid Signs and Symptoms: A.MILD FEVER and MALAISE initial B.Eruptions/ rash starts from trunk - maculo-papular rash (pathognomonic) -vesicle and crust -pustule C. Extreme pruritus / fleeting erythema D. Respiratory symptoms E. May leave grabular scabs Medical Treatment: a. Acyclovir - antiviral b. Vedarabine c. Antihistamine d. Calamine lotion/oatmeal bath promote comfort and healing e. Antipyretic no aspirin Nursing Management a. Case over 15 y.o. should be reported to r/o smallpox b. Isolation precaution c. Concurrent disinfection of secretions soiled linens are exposed to sunlight

Mumps (Epidemic Parotitis)

Agent: filterable virus of mumps (RNA virus); Rubivirus Mode of Transmission: contaminated fomite S/Sx: airborne-droplet;

a. Painful chewing and swallowing - earliest b. Painful swelling in front of ear, angle of
jaws, and down the neck c. Fever d. Malaise e. Headache

d. Exclude from school for 1 week after

eruption occurs e. Skin care-regular baths f. Cut fingernails short; mittens for child g. Calm peaceful environment

C. WHO Multi-drug treatment (MDT) use of 2 or more drugs and renders patients noninfectious after a week. It allowed take home medication. a. Paucibacillary (Tubercoloid and indeterminate) b. Multibacillary ( lepromatous and borderline) Common Drugs for MDT a. *DAPSONE common b. Rifampicin c. Ofloxacin d. Minocycline e. Clofazimine * A person who completed the MDT is considered cured Responsibilities of the Nurse a. Prevention health education, health advocacy and immunization b. Casefinding recognize early signs, conduct epidemiological investigation, assist in physical exams c. Management and treatment shift from institutional to domiciliary d. Rehabilitation e. Training, supervision and research

Leprosy ( Hansens Disease)

Agent: Mycobacterium leprae or Hansens bacillus MOT: prolonged skin to skin contact with open lesions and droplet infection

Types:

A. TUBERCOLOID AND INDETERMINATE

( non-infectious) B. LEPROMATOUS AND BORDERLINE ( Infectious) Early Signs and Symptoms: a. Red or white change in color b. Loss of sensation c. Decrease sweating d. Thick painful nerves e. Muscle weakness f. Pain and redness in the eyes g. Nasal obstruction h. Ulcers that dont heal Late

Pertussis (Whooping Cough)

Infectious Agent Bordetella pertussis or Bordet gengou bacillus Mode of transmission direct spread through salivary and respiratory secretions Method of Prevention: DPT immunization Dx Test: Bordet Gengou Agar Plate S/Sx:

a. LOSS OF EYEBROW MADAROSIS b. INABILITY TO CLOSE EYELIDS c. d. e. f.

g. LAGOPTHALMOS Clawing of fingers and toes Contractures SINKING OF NOSEBRIDGE Gynecomastia in males Chronic ulcers

PREVENTION a. Avoidance of prolonged skin to skin contact, especially the children b. BCG VACCINATION- not completely protects c. Good personal hygiene d. Adequate nutrition e. Health education Management/ treatment LEGAL BASIS RA 4073 liberalized the treatment for leprosy A. Ambulatory chemotherapy through use of Multi-drug therapy B. Domiciliary(home) treatment as embodied in RA 4073

a. Catarrhal Stage- most communicable stage

Low grade fever, respiratory secretions, cough and wheezing b. Paroxysmal Stage - Spasmodic cough - Subconjunctival hemorrhage - Abdominal hernia - Convulsion - During attackcyanotic, eye bulging/popping out, tongue protrusion, lacrimation, choking spells, may be with vomiting c. Convalescent stage Prevention: DPT immunization; DOC: erythromycin

Nursing Management: a. Enough rest and supportive care b. Attention to diet if needed due to vomiting c. Teach parent to pick up child during paroxysm and give ABDOMINAL SUPPORT d. AVOID TRIGGERS e. Suctioning and oxygen as needed f. PROPER DISPOSAL OF DISCHARGES

MEASLES (RUBEOLA)
AGENT: Filterable virus of PARAMYXOVIRUS, morbillivirus measles-

MOT: airbornedroplet transmission or direct/indirect contact with infected secretions of throat and nose *Highly Communicable during the Coryza or Catarhhal period

Bacterial Meningitis (CSF fever)

Agent: Neiserria Meningitidis Other: H. influenzae for child; S. pnemonia and S. aureus for adults MOT: droplet Diagnostic Exams: a. LUMBAR PUNCTURE for CSF analysis culture, relieve increased ICP and introduce medicine b. NEUROLOGIC EXAM S/Sx: INITIAL SYMPTOM: high fever, headache and stiff neck (nuchal rigidity) Symptoms resembles to that of flu, meningeal irritation and increased ICP Characteristic Signs/Symptoms: a. KERNIGS SIGN b. BRUDZINKIS SIGN c. Opisthotonus d. Waterhouse-Friedrichsen syndrome vascular *assignment nyo mga meaning nito pra matandaan niyo Medical Treatment a. Cephalosporin b. Vancomycin c. Ampicillin d. Gentamicin e. Dexamethasone - glucorticoid Nursing Interventions: a. Standard precaution b. Reduce environmental stimuli quiet darkened room c. Prevent injury during convulsions d. Periodic assessment of neurologic status but plan assessment to avoid fatigue e. Oral hygiene f. Encourage STRICT adherence to the antibiotic regimen

Signs and symptoms INITIAL: THE 3 Cs of Measles a. cough b. coryza c. conjunctivitis (STIMSONs Line) * KOPLIKs SPOTS phatognomonic sign Other Sx: fever, MACULOPAPULAR eruptions on the skin, anorexia, irritability, pruritus, lethargy, photophobia STAGES*: A. PRE-ERUPTIVE STAGE B. ERUPTIVE STAGE C. POST-ERUPTIVE/CONVALESCENT STAGE *refers to the appearance and eruption of rash DIAGNOSTIC EXAMS: A. NOSE AND THROAT SWABBING common B. u/a C. Blood chemistry D. Complement Fixation or hemagglutination test ( CONFIRMATORY TEST) PREVENTION: MEASLES VACCINE TREATMENT: NONE FOR UNCOMPLICATED CASES PHN RESPONSIBILITIES A. Emphasize need for isolation during catarrhal stage B. Explain serum gamma globulin to family and refer to appropriate facility C. Observe for complication D. Proper disposal of secretions E. Teach concurrent and terminal disinfection

Nursing Interventions A. Protect eyes from glaring lights B. Adequate ventilation but free from drafts and chilling to avoid PNEUMONIA C. Increase OFI and antipyretics for fever D. During eruptive stage, no strong soaps and alcohol

E. Provide hypoallergenic diet F. Strict precautions in handling soiled linens G. Vaseline for eyes
H. Penicillin for secondary infections

History taking

INFLUENZA (A,B,C)
Infectious agent: Influenza virus A, B, C Mode of Transmission: direct contact with droplet secretions from upper airway Prevention: a. Frequent handwashing b. Cover mouth when sneezing or coughing c. Avoid use of common towels and utensils d. Influenza vaccine (not common) assess allergy to egg and chicken S/Sx: - think tinatrankaso a. Fever b. Chills c. Body aches d. Dry cough e. Throat sore f. Headache g. Some abdominal discomfort and N & V Dx Tests: - Throat swab - Viral serology Treatment: Amantadine (Symmetrel) antiviral specific for type A Management: a. Bed rest and isolation precaution b. Adequate hydration and nutrition c. Report cases promptly FILARIASIS (ELEPHANTIASIS) Agent: Wuchereria bancrofti (worm) MOT: vector borne- passed from person to person by bite of mosquito Aedes poecillus S/Sx: - Initial: chills, headache and fever - Redness, swelling, and pain in the arms, legs, scrotum - Lymphadenitis, lymphangitis - Epidydimitis and orchitis - CHRONIChydrocele (swelling of scrotum), lymphedema, and elephantiasis Dx Tests: - Circulating Filarial Antigen - Blood culture- done at night because larvae are active around 10pm to 2am

Medical Treatment: To kill the worms and impede reproduction: - Diethylcarbamazine (DEC) - Ivermectin - Albendazole Surgery drain fluid, remove excess tissue and minimize massive enlargement For Elephantiasis of legs (murag elephant kadako ang tiil) elevate the legs and provide elastic bandages DEC fortified salt is also helpful

Prevention and Control a.sleep under mosquito nets b. use mosquito repellants during dusk till dawn c. take yearly prophylactic drugs to kill worms

MISCELLANEOUS DISEASES

Rabies (hydrophobia, lyssa)

Agent: rhabdovirus strong affinity (Close) to CNS kaya delikado MOT: bite or lick of rabid animal to an open wound S/Sx: a. Headache b. Fever c. Spasm of muscles for eating and swallowing d. Hydrophobia e. Delirium, sensitivity to light and sound and temp f. Convulsions g. Paralysis h. Respiratory paralysis/failurecommon cause of death Dx Tests: - virus isolation from saliva or throat - Fluorescent rabies antibody (FRA) most definitive diagnosis - Presence of NEGRI BODIES in the dogs brain *observe the dog for 14 days, if it dies and shows signs of rabies (nabuang) consult MD. Kill the dog and bring head for negri body exam (buhata lang bisan brutal, hehe). *Submit to immunization if dog is unavailable. Management: a. Symptomatic and supportive b. Proper wound care wash with running water and soap

c. For immediate (passive) immunity- Human immune globulin may be given d. For long term rabies vaccine (active immunity) e. Reduce stimuli avoid loud noises, glaring lights and extreme temp f. DO NOT BATH THE PATIENT unless ayaw mo ng mabuhay. There should be no sound of running water in close distance HYDROPHOBIC!!!!

a. b. c. d. e. f.

Antivirals for influenza are found effective Prevention is by vaccination Precaution standard, droplet, contact Isolation of cases Bed rest and proper nutrition/hydration PROPER FOOD PREP VIRUS CANT SURVIVE IN WELL COOKED MEAT

GONORRHEA (CLAP, BLANCAS,GLEET)

FLORES

SEVERE ACUTE SYNDROME (SARS)

RESPIRATORY

Agent: Neisseria gonorrheae/ gonococcus MOT: sexual contact or mother to baby during birth (natural or CS) S/Sx: a. Males burning urination, pus discharge b. Female most are asymptomatic; may have YELLOW purulent discharge; burning and painful urination, itching, urethritis, cervicitis, Pelvic inflammatory disease c. Sterility may develop in both sexes d. For infants Opthalmia neonatorum Dx Tests: a. In female culture of specimen from cervix and canal on THAYER MARTIN MEDIUM b. In Male- gram staining Medical Management a. Drug of Choice Ceftriaxone; Doxycycline b. For pregnant mother- Ceftriaxon plus Erythromycin c. After negative skin test, Procaine Penicillin is given d. Terramycin or Erythromycin Eye ointment is given to Newborn to prevent eye infection Nursing Management: a. Health education on MOT, signs/symptoms. And prevention b. Condoms may provide protection c. CASE FINDING, CONTACT TRACINGtreat not only patient but partners as well. Consider all information gathered CONFIDENTIAL d. Report incidence to Municipal Health Officer e. Control prostitution encourage sex workers to undergo regular check-up

Agent: coronavirus first in CHINA(2002) MOT: droplet transmission and close person to person contact or contact with soiled articles S/Sx: - Sudden onset of high fever - Headache and overall feeling of discomforts and body aches - Increased cytokine levels - Mild respiratory Sx progressing to dry cough and pneumonia - Respiratory difficulty and lung damage *Diagnosis is based on history of travel to infected regions/countries, contact with positive cases, and signs and symptoms Treatment: a. NO EXACT TREATMENT. Supportive care only b. Early treatment of mild respiratory symptoms is the KEY c. Boost your immunity- proper diet, exercise, and other healthy habits d. Droplet and contact precautions wear mask, cover mouth when coughing/sneezing e. HANDWASHING

Avian/ Bird Flu

Agent: Avian orthomyxoviridae influenza (AI) virus;

MOT: airborne-droplet, contact with manure and other contaminated articles (meat, water), vectorborne (cats) S/Sx: same with influenza (fever, sore throat, cough, etc.) BUT VIRAL STRAINS CAN CAUSE DEATH IN FEW DAYS Dx: Standard Influenza Test Management:

Syphilis (Lues Venereal)

Agent: TREPONEMA PALLIDUM MOT: sexual contact - Contact with soiled articles/linens/diapers - Transplacental

S/Sx: a. Primary painless chancre (pathognomonic) And buboes or enlarged lymph node b. Secondary macula-papular rash, patchy hair loss, Grayish-white lesion on skin folds (condylomata ata), brittle nails, and sore throat c. Latent no symptoms for years until death; serologic test may be reactive d. Late destructive but non-infectious and causes multiple organ damage *may cause deafness in children due to CN 8 damage Dx Test a. Venereal Disease Research Laboratory (VDRL) screening b. Dark Field Illumination Test most effective if lesions are present Medical management: a. Drug of Choice: Benzathine Penicillin G b. If with allergy, Tetracycline or Doxycycline may be given c. No sexual contact until healed Nursing Management: a. Health education on MOT, signs/symptoms. And prevention b. Condoms may provide protection c. CASE FINDING, CONTACT TRACINGtreat not only patient but partners as well. Consider all information gathered CONFIDENTIAL d. Report incidence to Municipal Health Officer e. For neurosyphilis, watch for ataxic gait f. Control prostitution encourage sex workers to undergo regular check-up

S/Sx: Onset: very high morning fever, Rose spots on the abdominal area, nausea, vomiting Typhoid Stage: a. Sordes dirty brown collection of bacteria and dry mucous in mouth; preventable with good nursing care b. Coma vigil staring blankly c. Subsultus tendinum wrist twitching d. Carphologia inability to control finger movements e. Always slips to the foot part of the bed f. Severe delirium g. Hemorrhage and perforation 2 DEADLIEST COMPLICATION Dx Tests: a. Typhidot confirmatory b. Widal c. Rectal Swab Medical Management: a. Chlorampenicol drug of choice Nursing Management: a. Maintain adequate hydration b. Monitor V/S c. Prevent falls and injuries d. Meticulous oral care e. Watch for signs of intestinal bleeding dark stools, bloody/ smelly vomitus, abdominal pain, low BP, thread pulse f. Sanitary disposal of waste g. Enteric isolation h. HANDWASHING!!!!!

Anthrax
Agent: bacillus anthracis MOT: ingestion, inhalation or cutaneous contact with spore- AIRBORNE *common cause of death is meningitis, septic shock and respiratory difficulty DOC: IV Pen G; if with allergy-tetra., erythro., and chloramphenicol *Nsg. Mgt: Supportive

BULLETS:
A. Proper Handwashing is the BEST PRACTICE to prevent spread of diseases B. Surveillance activity of nurse in epidemiologic investigation C. Researcher ROLE of the nurse in epid. Invest. D. Tinea pedis fungal infection in the foot E. Tinea capitis head F. Tinea curis thigh to the groin G. Meningococcemias agent is same with meningitis neisseria meningitides H. Paralytic Shellfish Poisoning (red tide) is caused by dinoflagellates by ingesting raw seafood meat I. Paragonimiasis is a parasitic infection of the the lungs of which the S/Sx are similar to that of PTB J. German Measles is Rubella

Typhoid fever
Agent: Salmonella typhosa/typhii (bacteria) MOT: oro-fecal route; Feces, Flies, Food, Fingers and Fomites are also mode of transmission

K. Methods of Vector Control-applicable to dengue, malaria, and filariasis - Fumigation- avoid indiscriminate fogging - Stream clearing cutting of vegetation to expose area to sunlight so that mosquito will not be able to breed - Stream seeding fish propagation that feed on larvae - Insecticide treatment of nets most practical way to prevent vector-borne diseases - 4 oclock habit burning biodegradable materials (dried leaves, etc) at 4pm where mosquitoes are weakest

Community Organizing -a process by which the people, health services, and agencies of the community are brought together to LEARN ABOUT THEIR COMMON PROBLEMS Goal

Motivate, enhance, seek wider community participation through organizing and mobilizing people for change self-reliance 1. Preparation Phase activities: a. Area selection b. Community Profiling c. Entry in the community d. Integration 2. Organizational Phase Goal: formation of a peoples organization

a. b. c. d.

Social Preparation Spotting and developing potential leaders Core group formation Setting up the CO

E. Coordination and dialogue with other

community organization F. SALT Guidelines for Entry - Recognize the role of local authorities by paying them visits to inform their presence and activities. - Appearance, speech, behavior and lifestyle should be in accordance with those of the community - Adopt a low-key profile. 3. Organization Building Phase 1. preparation of legal requirements 2. guidelines in the organization of the CHO by the core group 3. election of officers Research Team Committee Planning Committee Health Committee Organization Formation of by-laws by the CHO *Leader spotting Key persons - approached by most people Opinion leader - approach by key persons Isolates - never or hardly consulted 4. SUSTENANCE AND STRENGTHENING PHASE A. Training of CHO for monitoring and implementing of community health program. B. Identification of secondary leaders C. Linkaging and networking. D. Conduct of mobilization on health and development concerns. E. Implementation of livelihood projects

3. Education and Training Phase a. Conducting community diagnosis b. Training of CHW c. Health services and mobilization d. Leadership-formation activities 4. Intersectoral Collaboration Phase 5. Phase Out Community OrganizingParticipatory Action Research (COPAR) Definition: a type of research which is a social development APPROACH that aims to transform the APATHETIC, INDIVIDUALISTIC AND VOICELESS POOR into dynamic, participatory, and politically responsive community. Phases of COPAR 1. Pre-entry Phase SIMPLEST PHASE - Conduct preliminary social investigation - Eg. check records, health center data, NSO - Make long/short list of potential communities - Do ocular survey of listed communities - SITE SELECTION/CHOOSING BARANGAY. Criteria are: o Must have a population of 100-200 families o Economically depressed o No strong resistance from the community o No serious peace and order problem o No similar group or organization holding the same program d. Conduct informal interviews with community residents and Pay courtesy call to key informant e. Determine the need of the program in the community. f. Take note of political development g.Develop community profiles for secondary data h. Develop survey tools i. Unite leaders 2. Entry Phase (Social Preparation) MOST CRUCIAL PHASE A. Integration with the community B. Sensitization of the community/ information campaigns C. Continuing/ Deepening social investigation D. Core group formation