Communicable Disease

Nursing
JULIUS CAEZAR S. PERIDA, RN, MAN
INFECTION

Entry &
agent potential host
multiplication
Spectrum of Disease

1. Incubation Period – (+) infection / (-) s/SXs

2. Prodromal – initial s/SXs
3. Illness – all s/SXs, pathognomonic
4. Convalescent - recovery
Communicable Disease

Infectious its toxic in/directly 1 person to

Illness or / and
Agent product transmissible another

Forms:
• Contagious – w/ or w/o contact
• Infectious – requires direct inoculation
Epidemiology

Patterns:
1. Sporadic – on & off Agent

2. Endemic– always present

but w/ low number of
susceptible/s
3. Epidemic – outbreak Host Environment

4. Pandemic – worldwide
 CHAIN OF INFECTION

Agent
- Index / Frank
Susceptible
- Carrier
Reservoir
Host - Suspect
- Contact

- Respi-inhalation
- GIT-ingestion Portal Portal - Body secretions
- GUT-exposure of of - Blood
- Circulatory (Parenteral) Entry Exit
- Placental
Mode of
Transmission
- Contact (direct, indirect)
- Airborne
- Vehicle
- Vector-borne
GENERAL NURSING CARE

I. Prevention II. Control III. Medical Asepsis

• Health Education • Case Findings / • Protective barriers
• Vaccination Treatment • Placarding
• Environmental Sanitation • Isolation • Cohorting
• Quarantine
• Disinfection
• Sterilization
• Disinfestation
GENERAL NURSING CARE
Active
-recovery from
illness
-carrier
Natural
Passive
-Breastmilk (IgA)
IV. Immunity -Placental (IgG)
• 1st Line – mucus membrane,
Immunity
skin
• 2nd Line – NKCs,
Active
Lymphocytes -EPI
PBRV

Artificial
Passive
-Tig (TAT/ATS)
-Dig
-ERIg / HRIg
PARADE OF DISEASES
JULIUS CAEZAR S. PERIDA, RN, MAN
CNS – TETANUS (Lockjaw)

 E.a: Clostridium tetani

 I.P: 3-30 days
 MOT: skin / mucus membrane
 Pathogenesis: produces tetanospasmin & tetanolysin
 s/SXs: Trismus, Risus sardonicus, Opisthotonos, Respiratory spasm & paralysis
 DX Test: spatula test; culture
CNS – MENINGITIS (Cerebrospinal Fever)

 E.a: All pulmonary pathogens Neisseria meningitidis

 I.P: 2-10 days
 MOT: Droplet
 s/SXs: Brudzinskis sign, Kernig’s sign, Opisthotonos, Nuchal rigidity
MENINGOCOCCEMIA (Spotted Fever)

 I.P: 3-4 days

 s/SXs: Spiking Fever, Ecchymotic hemorrhage, waterhouse – Friderichsen
syndrome
 Dx Test: Lumbar puncture, Blood culture, CT scan
 Mnmt: P& C: Rifampicin, Sulfonamides
 N.C: - Meds – Aqueous Pen G, Broad Spectrum Cephalosporin,
Chloramphenicol
CNS – ENCEPHALITIS (Brain Fever)

 E.a: Japanese Encephalitis Virus

 I.P: 5-15 days
 MOT / Pathogenesis

pigs wading birds

culex
tritaenlorhyncus

Humans
CNS – RABIES
(Hydrophobia; Lyssa; La Rage)
 E.a: Rhabdovirus
 I.P: Humans – 2-8 weeks, Dogs – 10-14 days
 MOT: Bite of an infected animal (canine-sylvatic)
 Pathogenesis:
exoplasm of
muscle
peripheral
inoculation
nerves

multi-organ
brain
involvement
CNS – Poliomyelitis
(Heine-Medin Dse; Infantile Paralysis)
 E.a: Legio debilitans
 I. Brunhilde
 II. Lansing
 III. Leon
 I.P: 7-21 days
 MOT: Fecal oral mouth
 Affection: Spinal, Bulbar, Bulbo-Spinal Paralysis
 Dx Test: Lumbar Puncture – (+) Pandy’s Test, Stool exam
LEPROSY
(Hansen’s Dse; Hansenosis)
 E.a: Mycobacterium Leprae
 I.P: 6 months – 8 years or more
 MOT: Droplet, Prolonged skin to skin contact
 Dx Test: Slit Skin Smear, Lepromin Rxn Test
 Categories:
 1. Tuberculoid
 2. Lepromatous
 3. Borderline
 Indeterminate
CIRCULATORY SYSTEM
JULIUS CAEZAR S. PERIDA, RN, MAN
DENGUE
(Hemorrhagic Fever; Breakbone F. Dandy F; Infectious
Thrombocytopenic Purpura)
 E.a: Flavivirus 1,2,3,4, Arbovirus Grp B, Chikungunya, O nyong nyong
 I.P: 6 days to 1 week
 MOT: Aedes aegypti
 Pathogenesis: viremia – capillary fragility, permeability
 S/Sxs: Herman’s sign
 Dx Test: Torniquet Test, Rumpel – Leads Test
MALARIA
(Ague: Marsh Fever: Periodic Fever, King of Tropical
Diseases)

 E.a: Plasmodium falciparum (malignant tertian malaria)

 I.P: 10-12 days

 p. vivax (benign tertian malaria)

 p. ovale Hypnozoites
 I.P: 14 days

 p. malariae (Quartan Malaria)

 I.P: 30 days
 MOT: Aropheles mosquito
MALARIA
(Ague: Marsh Fever: Periodic Fever, King of Tropical
Diseases)

 Pathogenesis:

microgametocyte
macrogametocyte

sporozoite
MALARIA
(Ague: Marsh Fever: Periodic Fever, King of Tropical
Diseases)

 s/SXs: Cold, Hot, Diaphoretic Stage

 Dx Test: Blood smearing, Quantitative Buffy Coat
 P & C: Biologic Control (Streamseeding, Zooprophylaxis)
 Environmental (Streamclearing)
SCHISTOSOMIASIS
(Snail Fever: Bilharziasis)
 E.a: Schistosoma japonicum, S. mansoni, s. haematobium
 I.P: Average of 2 months
 MOT / Pathogenesis:
feces with eggs

fresh H2O
miracidium

Oncomelania quadrasi

DOC:
cercaria 1. Praziquantel
Oxamniquine
Metrifonate
 Dx Test: Circum-ova precipitin test
PARAGONIMIASIS

 E.a: Paragonimus westermani

 I.P: Unknown
 MOT: crabs; crayfish
 Stage infective to humans – metacercaria
 Dx Test: Sputum exam (brown spots – ova of worms)
 DOC: Praziquantel
EBOLA

 E.a: Ebolavirus  Vector Animals:

 Bundibugyo (cote’d  Chimpanzees
ivoire)  Gorilla
 Zaire  Fruit bat (Pteropodidae)
 Sudan  Monkeys
 Reston  Antelopes
 Tai Forest  Porcupine
 I.P: 2-21 days
 MOT: Human to
Human: body
secretions
ZIKA
 E.a: Zika virus (Flavivirus)
 I.P: a few days
 MOT: Aedes aegypti
 S/Sxs: Flu + measles symptoms but mild complications

M-F microcephaly

Adult males: Guillan-Barre Syndrome

LYMPHATIC SYSTEM
JULIUS CAEZAR S. PERIDA, RN, MAN
FILARIASIS

 E.a: Wuchereria bancrofti

Brugia malayi
B. timori
 I.P: 8-16 months
 MOT: Aedes poecilus
 S/Sxs: Asymptomatic – “microfilariae”
Acute – inflammation
Chronic – Lymphadema, Hydrocoel, Elephantiasis
 Dx Test: Nocturnal Blood Exam
Immunochromatographic Test
 DOC: Diethycarbamazine citrate
RESPIRATORY SYSTEM
JULIUS CAEZAR S. PERIDA, RN, MAN
TUBERCULOSIS
(Koch’s Infection; Phthisis)
Miliary (Extrapulmonary) TB

 E.a: Mycobacterium tuberculosis

m. africanum
Caseation
m. bovis
Necrosis
 I.P: 2 to weeks
 MOT: Droplet / Airborne
 Pathogenesis: Liquefy
Calcify
(spread)
(Ghons tubercle)
“cavity”
TUBERCULOSIS
(Koch’s Infection; Phthisis)
Miliary (Extrapulmonary) TB

 Dx Test: Sputum Exam / DSSM / AFB Staining

-Hemoptysis -contraindication
Purified Protein Derivative
-10 children
-Monday/Tuesday
Chest x-ray
 Categories:
I -New Sputum Smear (+)
III- New Sputum Smear (-) w/ minimal cavitary lesion
II- TB – default, relapsed
IV- Chronic TB
TUBERCULOSIS
(Koch’s Infection; Phthisis)
Miliary (Extrapulmonary) TB

 Meds:

1st Line 2nd Line

• Rifampicin • Streptomycin
• Isoniazid
• Pyrazinamide
• Ethambutol
PNEUMONIA

 Community Acquired  Hospital Acquired

 Streptococcus pneumoniae  Enterobacter spp.
 Mycoplasma pneumoniae  Pseudomonas aeruginosa
 Haemophilus influenza  Staphylococcus aureus
 Legionella pneumophila  MOT: Droplet
 Atypical (Bronchopneumonia)  Dx Test: Chest x-ray
 Virus  Pathogenesis: Lung Engorgement
 Chlamydia Red Hepatization
 Legionella Gray Hepatization
Resolution
 Mycoplasma
DIPHTHERIA • Fever
• Bullneck
Pharyngeal • Toxemia

 E.a: Corynebacterium diphtheriae • Brassy coughing

 I.P: 3-5 days • Dyspnea
Laryngeal • Cyanosis
 MOT: Droplet
 S/Sxs:
 Dx Test: • Excoriation of Nares
Nasal-
 Schick’s Test – Susceptibility to diphtheria septum
 Moloney Test – Hypersensitivity to toxoid
 Culture & Sensitivity Test Nasopharyngeal
• Pseudomembrane resembles impetigo
swabbing Cutaneous-
Burns
PERTUSSIS
(Whopping cough)
 E.a: Bordetella pertussis
 I.P: 7-10 days
 MOT: Droplet
 S/Sxs: Catarrhal Stage
Paroxysmal Stage
 Dx Test: Bordet - Gengou Agar
SARS
(Severe Acute Respiratory System)
 E.a: Coronavirus
 MOT: Droplet
 S/Sxs: Fever, Dry Cough, Dyspnea, Shortness of breath
 Comp.: Pneumonia, ARDS, Kidney Failure

SARS-CoV (2002) MERS-CoV (2012) CoViD-19 (2019)

• 2-10 days • 2-10 days • 2-14 days

SARS
(Severe Acute Respiratory System)
 Classification: Possible, Probable, Positive
 PUI - Person Under Investigation
- should be quarantined
 ICC - Infection Control Committee (per hospital)
- responsible for preliminary investigation
 DOH Regional Surveillance Units (RESU) – the one to
report it to DOH Epidemiological Bureau
FLU
(The Grippe; Influenza)
 E.a: Myxovirus
A. zoonotic
B. exclusive to humans
C.
H – Hemagluttinin (H1-H19)
N – Neuraminidase (N1-N10)

Bird Flu
H5N1
Influenza A
H7N7
(H1N1) MOT: Droplet
H9N2
I.P: 7-10 days
H5N6
I.P: 2-4 days
ANTHRAX
(Ragpicker’s Dse; Woolsorter’s Dse; Malignant Pustule;
Malignant Edema)

E.a: Bacillus anthracis

I.P: a few hours to 7 days
Classification:
1. Cutaneous – black eschar
2. Inhalation / Respiratory
3. Gastro-intestinal
Measles
(Rubeola)
 E.a: Paramyxovirus of the morbillivirus family
 I.P: 8-20 days
 MOT: Droplet; Airborne
 Prodromal: -3Cs and Koplik spots
 Eruptive: Maculopapular rashes + high fever and
respiratory symptoms (1 week)
 Convalescent: Branny desquamation
German Measles
(Rubella)
 E.a: Rubivirus
 I.P: 14-21 days
 MOT: Droplet; Airborne
 S/Sxs:Prodromal – Low grade fever,
Forschheimer’s spots
 Eruptive: Rashes with lymphadenopathy
CHICKENPOX / SHINGLES
E.a: Varicella-zoster Virus
MOT: Droplet / Airborne
Exposure to lesion

Chikenpox Shingles

I.P: Reactivation of
I.P: 3-17 days
latent infection

S/Sxs: Unilateral,
painful and clustered
S/Sxs: Scattered, vesicles that tend to
pruritic vesicles coalesce (along
distribution of
affected nerve)
PEDICULOSIS

E.a:Pediculus humanus capitis

MOT: Contact transmission
DOC: Kwell (Lindane)
SCABIES
(Galis-Aso)
-itchmite infection

E.a:Sarcoptes Scabiei
MOT: Contact transmission
DOC: Benzyl benzoate emulsion
GASTRO-INTESTINAL
JULIUS CAEZAR S. PERIDA, RN, MAN
TYPHOID FEVER

 E.a: Salmonella typhi  Pathogenesis:

 I.P: 5-40 days intestine

 MOT: 5 F’s
bone
gallbladder liver spleen
 S/Sxs: Ladder-like fever marrow

Splenomegaly
2⁰ Bacteremia
Rose spots
DYSENTERI
Shigella
flexneri

S. boydii
Bacillary S. sonnei
S. Dysenteriae

endotoxin
Dysenteri intestine

Entamoeba
histolytica
Amoebic
 S/Sxs: Bloody mucoid stool
trophozoite
Abdominal pain
CHOLERA
(Violent Dysenteri; El Tor)
E.a:Vibrio Cholerae
S/Sxs: Rice-watery stool (24-30 L/day)

Washerwoman’s hand skin

Vox cholerica
HEPATITIS
 A – Catarrhal jaundice; Infectious Hepatitis
I.P: 2-6 weeks
 E – Enteric Hepatitis
I.P: 2-8 weeks
 B – Serum Hepatitis
I.P: 6 weeks – 6 months
 C – Post Transfusion Hepatitis
I.P: 2 weeks – 6 months
 D – Delta Hepatitis; Fulminant Hepa
I.P: 2-10 weeks
LEPTOSPIROSIS
(Weil’s Dse; Mud F; Flood F; Spirochaetal jaundice;
Swineherd Dse; 7-Day Japanese Fever)

 E.a: Leptospira interogans  Dx Test: Leptospira Agglutination Test (LAT)

 I.P: 7-19 days
 MOT:
skin mucus membrane

liver bacteria kidney

bleeding
PAROTITIS

E.a: Paramyxovirus of the

myxovirus family
I.P: 12-26 days
MOT: Droplet
HELMINTHIC INFECTION
JULIUS CAEZAR S. PERIDA, RN, MAN
ASCARIASIS
(Round Worm Infection)

E.a:Ascaris lumbricoides
MOT: Ingestion of viable ova
Dx Test: Kato-Thick Smear
ENTEROBIASIS
(Pinworm Infection)

E.a:Enterobius vermicularis
MOT: Ingestion of viable ova
Dx Test: Scotch-Tape Test
THRICHURIASIS
(Whipworm Infection)

E.a:Trichuris trichiura
MOT: Ingestion of viable ova
Dx Test: FECT Method
UNCINIASIS / EGYPTIAN CHLOROSIS
(Hookworm Infection)

E.a:
Ancyclostoma duodenale
Necator americanus
MOT: Skin penetration
CAPILLARIASIS

E.a: Capillaria Philippinensis

MOT: vector – uncooked / raw fish
(“kilawin”)
FOOD TAPEWORMS

 Taenia saginata – beef tapeworms

 Taenia solium – pork tapeworms
 Diphyllobothrium latum – fish tapeworm
 Hymenolepis nana – dwarf tapeworm
 STI’s
JULIUS CAEZAR S. PERIDA, RN, MAN
GONORRHEA
(Clap; Gleet; Flores blancas)
 E.a: Neisseria gonorrhea
 I.P: 3-5 days
 MOT: sexual contact, perinatal transmission
 Dx Test: Thayer-Martin Agar
SYPHILIS
(Lues veneria; The Pox; Bad Blood Dse)
 E.a: Treponema pallidium  Dx Test: Rapid Plasma Reagin
 I.P: 10-90 days (average of 3 weeks) Fluorescent Treponemal Antigen
 MOT: Sexual contact Absorption Test (FTAAbs)
 Stages: Primary Syphilis – “chancre”
Secondary Syphilis – syphilides
condylomata lata
mucus patches
Latent Syphilis – Asymptomatic for years
Tertiary – “gumma”
Neurosyphilis
Cardiosyphilis
AIDS

 E.a: Retrovirus
 I.P: 2 months to 20 years or more
 MOT: Multiple Ps
 S/Sxs: Fever > 1 month
Diarrhea > 1 month
Significant weight loss
AIDS
- Associated Infection
L – Lymphadenopathy
C – Chronic coughing
G – Generalized Pruritic Dermatitis
O – Oral / Genital / Systemic Fungal Infection
R – Recurrent Varicella Virus Infection
P – Progressive Disseminated Herpes Simplex
AIDS

Opportunistic infection:
Pneumocystis jiroveci pneumonia
Cancer: Kaposi’s Sarcoma
Dx Test: ELISA

Western Blood