Pathology

Rubeola Fever, maculopapular rash, cough & coryza or conjunctivitis Complications 1- Diarrhea 2- Respiratory inflammations 3- Otitis media 4- Vitamin A deficiency 5- Encephalitis 6- Subacute sclerosing panencephalitis

Rubella Same + lymphadenopathy Complications 1- Encephalitis 2- TCP 3- Arthritis 4- Congenital rubella syd

Anthrax Cutaneous: localized itch, painless papule turns vesicular & enlarges, ulcerates, blackens & forms eschar. GI: shock & death. Inhalational: like influenza, + N&V, severe resp distress, diaphoresis, cyanosis & shock. Hgic meningitis if H. spread

Brucella Fever > 3days, profuse night sweating, fatigue, myalgia & arthralgia Complications: 1- Chronic ostitis, osteoperiostitis, late cold abscess. 2- Endocarditis. 3- Epidydimo-orchitis. 4- Granulomatous renal & hepatic diseases. 5- Hypersplenism. 6- Meningitis & enc.

Tetanus Generalized spasms, risus sardonicus, trismus. Death of unknown cause 3-28 day old CFR = 90% in neonatal CFR = 30-90% in adults

Rabies Acute fatal encephalomyelitis Headache, fever, malaise Paralysis & hydrophobia CFR = 100%

Confirmation

Virus isolation & Ab detection

same

Isolation, antigen, culture, radio

Isolation, serum titre > 1:160, 4 fold increase titre over 2 weeks WW, areas where reservoir exists Variable acc. When reservoir gives birth General, more in adult males acc. occupation 1-3 weeks, may reach 7 m Contact, common vehicle, vector, air borne in labs General, full protection after recovery NO

Place Time Person IP MOT Susceptibility Period of com

Endemic in many Any esp. winter Any age mainly children Malnutrition 10 days for symptoms Droplet, direct contact, contamination & air General 4 days before & 4 days after, highly infectious

WW endemic Winter & spring

Agricultural areas --------

Clinical Normal ability to suck 3 days, loss of it after that, convulsions WW Summer All 4-21 days, 2 days in neonatal Injury General NO

Clinical

WW Any All especially exposed to animals & lab workers 4 days to 1 year Contact with saliva or lab General NO

Children & young adults Wool sorters, drum makers, travelers 18 days 1-7 days Same + transplacental General 7 days before & 4 after rash, congenital = months Contact, D & Ind General ???

Vaccine

Live attenuated, mono or MMR, single dose SC, MMR is given in 2 doses

Same CI in pregnancy

Cell free vaccine 0,2,4 weeks, 6,12,18 months, annual booster

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Prevention

Basic respiratory, vaccine, immunoglobulin (for immunocompromised)

Basic respiratory, immunization

Vaccination, education, sterilize animal products, deep bury, proper ventilation, disinfection & dust control Notify, treat, disinfect

Eradication, pasteurization, education of both public & exposed persons

Tetanus toxoid DPT (2,4,6,18m, 4prim, booster/10years) Any one at risk at any age On injury TT Health education Licensing midwives

Human cell diploid vaccine (0,3,7,14,28 days) + booster 90 days Antirabies serum (horse antiserum-rabies IG) Postexposure: cleaning, antiseptic, no suture, half dose of IG on injury, penicillin, immunization Preexposure: vaccine + booster/2years Avoid import of dogs from infected areas Report, isolate (for patients sake), supportive & disinfection Gloves & gowns

Control (cases)

Report, isolate, disinfect, no Rx

Report, isolate, no Rx

Report, Ix source, disinfection of animal discharge, treat Nothing

Report, isolate ( for patients sake), treat

Control (contacts)

Surveillance, vaccine or IG for unimmunized

Surveillance, IG for pregnant only

Ix for exposure

NOthing