ACUTE MORBIDITY

(Preventive Measures)

Risk factors:
● Close Contact: Close contact with small children who frequent group settings, such as school or
daycare, increases the risk of URI, as does the presence of URI in the household or families

● Travel: The incidence of contracting a URI is increased because of exposure to large numbers of
individuals in closed settings
● Smoking and exposure to second-hand smoke: These may alter mucosal resistance to URI
● Immunocompromised that affects cellular or humoral immunity:
● Carrier state: Although some people are chronic carriers of group A streptococci, repeated URIs in such
patients may be viral in origin
● Undernutrition
● Lack of breastfeeding among young children
● Decreased coverage of immunization (not fully immunized)
● Low socioeconomic class
● Overcrowding
● Exposure to indoor air pollution (use of solid fuels)
● Improper housing condition
Nonspecific Infections of URT
Nonspecific URIs are a broadly defined group of disorders that collectively constitute the leading cause of ambulatory
care visits. By definition, nonspecific URIs have no prominent localizing features. They are identified by a variety of
descriptive names, including acute infective rhinitis, acute rhinopharyngitis/ nasopharyngitis, acute coryza, and acute
nasal catarrh, as well as by the inclusive label common cold. They commonly presents as an acute, mild, and self limited
catarrhal syndrome with a median duration of ~1 week (range,2–10 days).

1. Symptoms
The signs and symptoms of nonspecific URI are similar to those of other URIs but lack a pronounced localization
to one particular anatomic location, such as the sinuses, pharynx, or lower airway.
● rhinorrhea (with or without purulence)
● nasal congestion
● cough
● sore throat
● Fever (more common among infants and young children)
● Malaise
● Sneezing
● Lymphadenopathy
● hoarseness

2. Prevention
● Same with flu except for flu shot
Flu
The CDC defines it as a contagious respiratory illness caused by influenza viruses that infect the nose, throat and lungs. It
can cause mild to severe illness, and at times can lead to death.

1. Symptoms
● Fatigue
● Muscle/body ache
● Headache
● Fever or chills
● Sore throat
● Runny or stuffy nose
● Cough

2. Complications
● Bacterial Pneumonia
● Dehydration
● Ear infections
● Sinus infections
● Worsen chronic disease like asthma and diabetes

3. Prevention

The single best way to prevent seasonal flu is to get vaccinated each year, but good health habits like covering
your cough and washing your hands often can help stop the spread of germs and prevent respiratory illnesses
like the flu. There also are flu antiviral drugs that can be used to treat and prevent flu.

● Get a flu shot

● Avoid close contact.
Avoid close contact with people who are sick. When you are sick, keep your distance from others to
protect them from getting sick too.
● Stay home when you are sick.
If possible, stay home from work, school, and errands when you are sick. This will help prevent
spreading your illness to others. CDC recommends that you stay home for at least 24 hours after your
fever is gone except to get medical care or for other necessities.
● Cover your mouth and nose.
Cover your mouth and nose with a tissue when coughing or sneezing. It may prevent those around you
from getting sick. Flu and other serious respiratory illnesses, like respiratory syncytial virus (RSV),
whooping cough, and severe acute respiratory syndrome (SARS), are spread by cough, sneezing, or
unclean hands.
● Clean your hands.
Washing your hands often will help protect you from germs. If soap and water are not available, use an
alcohol-based hand rub.
● Avoid touching your eyes, nose or mouth.
Germs are often spread when a person touches something that is contaminated with germs and then
touches his or her eyes, nose, or mouth.
● Practice other good health habits.
Clean and disinfect frequently touched surfaces at home, work or school, especially when someone is ill.
Get plenty of sleep, be physically active, manage your stress, drink plenty of fluids or water, and eat
nutritious food.
Pneumonia
Get Vaccinated
● Get a flu shot every year to prevent seasonal influenza. The flu is a common cause of pneumonia, so preventing
the flu is a good way to prevent pneumonia.

● Children younger than 5 and adults 65 and older should get vaccinated against pneumococcal pneumonia, a
common form of bacterial pneumonia. The pneumococcal vaccine is also recommended for all children and
adults who are at increased risk of pneumococcal disease due to other health conditions.

Wash Your Hands

Wash your hands frequently, especially after blowing your nose, going to the bathroom, diapering, and before eating or
preparing foods.

Don't Smoke
Tobacco damages your lung's ability to fight off infection, and smokers have been found to be at higher risk of getting
pneumonia. Smokers are considered one of the high-risk groups that are encouraged to get the pneumococcal vaccine.
Sinusitis
Rhinosinusitis refers to an inflammatory condition involving the nasal sinuses. Although most cases of sinusitis involve
more than one sinus, the maxillary sinus is most commonly involved. Acute rhinosinusitis—defined as sinusitis of <4
weeks’ duration—constitutes the vast majority of sinusitis cases. Most cases are diagnosed in
the ambulatory care setting and occur primarily as a consequence of a preceding viral URI.

1. Symptoms
● Nasal drainage / congestion
● Facial pain or pressure
● Headache
● Cough
● Sneezing
● Fever
● Tooth pain (often upper molars)
● halitosis

2. Prevention
● Bathe your nasal passages daily.
Use a small pot or squeeze bottle to run water into the nasal passages. This helps clear excess mucus
and moisten membranes.
● Drink lots of water.
Good hydration helps keep mucus thin and loose.
● Inhale steam.
Linger in a hot shower. Or bring water to a boil, pour it into a pan, place a towel over your head, and
bend over the pan to inhale the steam.
● Avoid dry environments.
A humidifier by your bed or at your desk can help keep nasal passages from drying out.

● Sleep with your head elevated. Mucus pools when your head is down.
Sore Throat
Most sore throats are caused by viruses, like ones that cause a cold or the flu, and do not need antibiotic treatment.
Some sore throats are caused by bacteria, such as group A Streptococcus. Sore throats caused by these bacteria are
known as strep throat. Other common causes of sore throats include: allergies, dry air, pollution (airborne chemicals or
irritants), and smoking or exposure to secondhand smoke.

1. Symptoms
● It is caused by a viral infection or due to allergies: sneezing, coughing, watery eyes, mild headache or
body aches, runny nose and low fever (less than 101 °F)
● Strep throat: Red and swollen tonsils sometimes with white patches or streaks of pus, tiny red spots
(petechiae) on the soft or hard palate, high fever (101 °F or above), nausea, vomiting, swollen lymph
nodes in the neck, severe headache or body aches and rashes

2. Prevention
● Practice good hand hygiene. Wash your hands frequently, especially after blowing your nose or after
caring for a child with a sore throat.
● Avoid close contact with people who have sore throats, colds or other upper respiratory infections
● If someone in your home has a sore throat, keep his eating utensils and drinking glasses separate from
those of other family members. Wash these objects in hot, soapy water.
● If a toddler with a sore throat has been sucking on toys, wash the toys in soap and water.
● Immediately get rid of used tissues, and then wash your hands.
● Avoid smoking and exposure to secondhand smoke
● Avoid substances that cause allergy
Dengue
Dengue is the fastest spreading vector-borne disease in the world endemic in 100 countries.
Dengue virus has four serotypes (DENV1, DENV2, DENV3 and DENV4). First infection with one of the four serotypes usually is no n-severe or
asymptomatic, while second infection with one of other serotypes may cause severe dengue. It has no treatment but the disease can be early
managed. The five year average cases of dengue is 185,008; five year average deaths is 732; and five year average Case Fatality Rate is 0.39 (2012-
2016 data).

TRANSMISSION : Dengue virus is transmitted by day biting Aedes aegypti and Aedes albopictus mosquitoes.

DENGUE CASE CLASSIFICATION AND LEVEL OF SEVERITY:

1. Dengue without warning signs
● suspect dengue
- a previously well individual with acute febrile illness of 1-7 days duration plus two of the following: headache, body
malaise, retro-orbital pain, myalgia, arthralgia, anorexia, nausea, vomiting, diarrhea, flushed skin, rash (petechial,
Hermann’s sign)

● probable dengue
- a suspect dengue case plus laboratory test: Dengue NS1 antigen test and a tleast CBC (leukopenia with or without
thrombocytopenia) or dengue IgM antibody test (optional)

● confirmed dengue
- a suspect or probable dengue case with positive result of viral culture and/or Polymerase Chain Reaction (PCR)
and/or Nucleic Acid Amplification Test- Loop Mediated Amplification Assay (NAAT-LAMP) and/ or Plaque Reduction
Neutralization Test (PRNT)

2. Dengue with warning signs

• a previously well person with acute febrile illness of 1-7 days plus any of the following: abdominal pain or tenderness, persistent
vomiting, clinical signs of fluid accumulation (ascites), mucosal bleeding, lethargy or restlessness, liver enlargement, increase in
haematocrit and/or decreasing platelet count

3. severe dengue
● severe plasma leakage leading to shock (DSS) and fluid accumulation with respiratory distress
● severe bleeding
● severe organ impairment

STRATEGIES:

Mag4S Laban sa Dengue

● Search and Destroy

Para di maipunan ng tubig at pamugaran ng kiti-kiti:
➢ Palitan ang tubig at linisin ang flower vase minsan sa isang linggo
➢ Takpan ng lupa o buhangin ang mga butas sa paligid ng inyong bahay
➢ Takpan ang mga timba, drum o iba pang imbakan ng tubig
➢ Tanggalin at butasan ang mga gulong sa ibabaw ng inyong bubong o mga gulong sa inyong paligid
➢ Itaob ang mga bote, lata at iba pang maaaring pag-ipunan ng tubig at pangitlugan ng lamok
➢ Linisin at alisin ang tubig sa paminggalan

● Seek Early Consultation

➢ Kung may lagnat ng 2 araw at may rashessa balat, pumunta at komunsulta agad sa pinakamalapit na health center o
ospital
● Self Protection Measures
➢ Iwasan ang maiikling kasuotan upang di madaling makagat ng lamok
➢ Maaari ding gumamit ng mosquito repellant sa araw

● Say yes to fogging only during outbreaks

➢ Yes to fogging only during outbreaks
Diarrhea
Diarrheal diseases account for 1 in 9 child deaths worldwide, making diarrhea the second leading cause of death among
children under the age of 5. It is acute if it occurs <2 weeks duration.

1. What we know
● It causes death by depleting body fluids resulting in profound dehydration.
● Often accompanied by vomiting, fever, and abdominal pain
● Diarrhea can have a detrimental impact on childhood growth and cognitive development.
● About 88% of diarrhea-associated deaths are attributable to unsafe water, inadequate sanitation, and
insufficient hygiene.
● Rotavirus is the leading cause of acute diarrhea and causes about 40% of hospitalizations for diarrhea in
children under 5.
● Most diarrheal germs are spread from the stool of one person to the mouth of another. These germs are
usually spread through contaminated water, food, or objects.
● Water, food, and objects become contaminated with stool in many ways:

◊ People and animals defecate in or near water sources that people drink.
◊ Contaminated water is used to irrigate crops.
◊ Food preparers do not wash their hands before cooking.
◊ People with contaminated hands touch objects, such as doorknobs, tools, or cooking utensils.

2. Prevention

The most important way to avoid diarrhea is to avoid coming into contact with infectious agents that can cause
it. This means that good hand washing and hygiene are very important.

• Vaccinate for rotavirus

• Provide
◊ Safe water
◊ Adequate sanitation and human waste disposal (discourage open defecation)
• Promote
◊ Handwashing with soap
◊ Breastfeeding to reduce exposure to contaminated water
• Treat appropriately with oral rehydration therapy and antibiotics
• Train health care providers and community health workers on diarrhea treatment
• Educate mothers and caretakers about caring for ill children and when to seek medical assistance:

-severe abdominal pain

-Bloody or black feces
-profuse diarrhea with dehydration
-Fever >38.5 cel
-duration >48 hrs without improvement
-recent antibiotic use
-new community outbreak
COVERING YOUR COUGH
Why should I cover my cough?

Serious respiratory illnesses like influenza, respiratory syncytial virus (RSV), and Severe Acute Respiratory

Syndrome (SARS) are spread by coughing or sneezing. These viruses can be spread to others when the ill person coughs

or sneezes into their hands and then contaminates surfaces and objects. These illnesses spread easily in crowded

places where people are in close contact.

How do I stop the spread of germs if I am sick?

Cover your nose and mouth with a tissue every time you cough or sneeze. Throw the used tissue in a waste

basket. Sneeze or cough into your sleeve or the crook of your elbow if you do not have a tissue. Clean your hands with

soap and water or an alcohol-based hand rub immediately after coughing or sneezing. Stay home when you are sick.

Do not share eating utensils, drinking glasses, towels, or other personal items. Clean and disinfect surfaces and objects

that could be contaminated by the ill person.

How can I stay healthy?

Clean your hands often with soap and water or an alcohol-based hand rub. Avoid touching your eyes, nose, or

mouth. Avoid close contact with people who are sick, if possible. Get vaccinated! Influenza (flu), pneumococcal

(pneumonia), and pertussis (whooping cough) vaccines can prevent some serious respiratory illnesses.

When you are at the clinic or hospital:

Cover your cough or sneeze with a tissue and dispose of the used tissue in the waste basket. Clean your hands

with soap and water or an alcohol-based hand rub. Wear a mask to protect others if you are asked.