• Complications:

• Encephalitis
German Measles
• Neuritis
• Rubella/three-day Measles • Arthritis
• An acute contagious disease characterized • Arthralgias
by mild constitutional symptoms, and a • Rubella syndrome
rose-colored macular eruptions. • AMB microcephaly, mental
• It causes mild, feverish illness associated w/ retardation, cataracts, deaf-
rashes and aches in joints. mutism, heart diseases
• It has teratogenic effect on the fetus. • German Measles
• The older the person is, the more severe the • Risk of congenital malformation:
symptoms are likely to be. • 100% risk when maternal infection
• German Measles occurs during the first month (or first
• Etiologic agent: trimester of pregnancy).
• Rubella virus (Family – Togaviridae; • 4% risk when maternal infection
Genus – Rubivirus) occurs during the second and third
• Incubation period: trimesters of pregnancy.
• 14 to 21 days • German Measles
• Period of communicability: • Clinical Manifestations:
• One week before and four days after • Classic congenital rubella syndrome
the onset of the rash, worst when the • IUGR; infant has low birth
rash is at its peak. weight
• German Measles • Thrombocytopenic purpura
• Mode of transmission: known as “blueberry muffin”
• Direct contact w/ nasopharyngeal skin
secretions. • Lethargy and hypothermia
• Air droplets • Intrauterine infection:
• Transplacental transmission in • May result in spontaneous
congenital rubella abortion
• Pharyngeal secretions and urine are • Birth of a live child may
highly communicable for infants develop multiple birth
with congenital rubella. anomalies.
• German Measles • Cleft palate, hare lip,
• Clinical manifestations: talipes, and eruption
• Prodromal period: of teeth.
• Low-grade fever • Cardiac defects
• Headache (PDA, ASD)
• Malaise • Eye defects
• Mild coryza (glaucoma,
• Conjunctivitis retinopathy,
• Post-auricular, sub-occipital, microphthalmia
and posterior cervical (unequal-sized
lymphadenopathy w/c occurs eyeball.
rd th • Ear defects (bilateral
on the 3 to the 5 days deafness, abnormally-
after onset shaped ear)
• German Measles • Neurological
• Clinical manifestations: (microcephaly, MR,
• Eruptive period: psychomotor
• A pinkish rash on the soft retardation,
palate (Forcheimer’s spot), an behavioral
exanthematous rash that disturbances,,
appears first on the face, vasomotor instability)
spreading to the neck, the • German Measles
arms, trunk, and legs. • Nursing management:
• German Measles • Isolation
• Eruption appears after the onset of • Best rest until fever subsides
adenopathy • Provide dark room to avoid
• The rash may last for one to five days and photophobia.
leaves no pigmentation nor desquamation • Irrigation of warm normal saline to
• German Measles patient’s eye to relieve irritation
• Testicular pain in young adults. • Encourage increased fluid intake
• Transient polyarthralgia and polyarthritis • German Measles
may occur in adults and occasionally in • Prevention:
children. • MMR
• German Measles • Avoid exposure to persons infected
• Modalities of treatment: w/ rubella during pregnancy
• Treatment is symptomatic
 • Immune serum globulin after • Diagnostic exam:
exposure to rubella • In females = culture of specimen
• Isolation (inoculation of specimen on
• Gonorrhea Thayer_martin medium w/c contains
• Clap/ Flores Blancas/ Gleet antibiotic that inhibits growth of
• A STD caused by bacteria involving the other microorganisms)
mucosal lining of the GUT, the rectum, and • In males = gram stain
pharynx. • Gonorrhea
• Etiologic agent: • Treatment modalities:
• Neisseria gonorrhoeae or • Ceftriaxone 125 – 250 mg IM single
gonococcus. dose
• Incubation period: • Doxycycline 100 mg PO BID x 7
• 3 to 21 days. days
• Gonorrhea • For pregnant: Ceftriaxone 125 – 250
• Mode of transmission: mg IM single dose plus
• Mucus to mucus membrane (sexual erythromycin 500 mg PO x 7 days
transmission) from exudates • Procaine Penicillin 4 million units
• Uterine transmission occurs upon the IM (ANST)
rupture of membranes. • Gonococcal conjunctivitis:
• Bacterial transmission occurs when Ceftriaxone IM and irrigation of
the baby comes out of the infected infected eye w/ normal saline
birth canal. solution.
• Sexual contact (orogenital, • Gonorrhea
anogenital) • Nursing management:
• Fomites • Assess sensitivities to drugs before
• Gonorrhea initiating antibiotic treatment.
• Clinical manifestations: • Explain to the patient that until
• Females: cultures prove negative, he/ she is
• Burning sensation and still infectious and can transmit
frequent urination and gonococcal infection.
dysuria • Standard precautions.
• Yellowish purulent vaginal • Keep the patient’s condition
discharge confidential.
• Redness and swelling of the • Require isolation
genitals • Apply heat to relieve pain in
• Vaginal itchiness gonococcal arthritis
• Urethritis and cervicitis • Silver nitrates ophthalmic
• Endometritis, salpingitis or prophylaxis onto both eyes of infants
pelvic peritonitis w/c may born to mothers positive for
lead to infertility. gonorrhea.
• Pregnant women may infect • Advice patient to refrain from sexual
the eye of her baby during the intercourse.
passage through the birth • Gonorrhea
canal. • Signs of Gonococcal Ophthalmia
• Gonorrhea Neonatorum:
• Clinical manifestations: • Lid edema
• Males: • Bilateral conjunctival edema
• Dysuria w/ purulent • Abundant purulent discharge 2 – 3
discharge (gleet) from the days after birth
urethra two to 7 days after • Corneal ulcerations and blindness if
exposure. left untreated.
• Rectal infection for • Hepatitis
homosexuals • Is defined as an inflammation of the liver
• Urethritis can cause strictures that may be caused by virus or lifestyle.
w/c can prevent the passage • Hepatitis A (infectious Hepatitis/
of urine. Catarrhal jaundice)
• Prostatitis • Inflammation of the liver caused by
• Pelvic pain and fever hepatitis A virus.
• Gonorrhea • It is known as infectious hepatitis
• Complications: because it spreads relatively easy to
• Sterility and PID in women individuals who have closer contact
• Epididymitis w/ the infected person.
• Arthritis • Incubation period:
• Endocarditis • A week before until a week
• Conjunctivitis after the appearance of
• Meningitis symptoms.
• Gonorrhea • Hepatitis a
• Mode of transmission:
• Fecal-oral pathway:
• Ingestion of contaminated
water or ice, uncooked fruits
and vegetables,
• Contaminated food/drinks by
infected food handlers.
• Hepatitis a
• Groups at risk:
• Children in day care center
• Troops living in crowded conditions
• Homosexual men
• People who live in areas w/ a
breakdown of sanitary conditions
• Hepatitis a
• Clinical manifestations:
• Flu-like symptoms w/ chills and high
fever
• Diarrhea, fatigue and abdominal pain
• Anorexia and nausea
• Jaundice and dark-colored urine
• Does not cause permanent liver
damage.
• Prevention: Hepatitis A vaccine
• The disease confers long term
immunity because of the production
of antibodies by the body’s immune
system.
• Hepatitis a
• Complications:
• Progressive encephalopathy
characterized by drowsiness and
cerebral edema
• GI bleeding progressing to stupor
and later coma. Bleeding is not
responsive to parenteral vit. K
administration
• Clonus and hyperreflexia are later
replaced by loss of DTR.
• Edema and ascites
• Aplastic anemia
• Loss of corneal and papillary
reflexes, respiratory failure,
cerebrovascular collapse.
• Hepatitis a
• Diagnostic test:
• HAV – complement fixation rate
• Liver function test = to determine the
presence and extent of liver damage
• SGOT
• SGPT
• Hepatitis a
• Treatment modalities:
• No specific treatment
• Bed rest is essential
• High carbohydrates, low in fat and
low in protein diet.
• Vitamin supplements (B complex
groups)
• IVT
• Isoprinosine (Methisoprenol) may
enhance the cell-mediated immunity
of the T-lymphocytes
• Hepatitis a
• Nursing management:
• Enteric isolation must be employed.
• Rest during acute or symptomatic
phase.
• Nutritional status must be improved
• Observe for melena
• Optimum skin and oral care
• Limit activity when fatigued
• Gradual resumption of activities and
mild exercise during recovery.
• Hepatitis a
• Prevention and Control:
• Hand washing after using the toilet
• Travelers should avoid water and ice
if unsure of their purity
• Screening of food handlers
• Safe preparation and serving of food
must be practiced.
• Hepatitis B
• Serum Hepatitis
• Inflammation of the liver caused by
hepatitis B virus.
• Considered to be more serious than
hep A due to the possibility of severe
complications such as massive
damage and hepatocarcinoma.
• Etiologic agent:
• Hepatitis B virus
• HBsAg appears in the blood 30 to 60
days after exposure and persists for
variable periods of time.
• Hepatitis B
• Incubation period:
• 50 to 189 days (2 to 5 months)
• Period of communicability:
• The infected person is capable of
transmitting the virus during the
latter part of the incubation period
and during the acute phase. It may
persist in the blood for many years.
• Hepatitis B
• Mode of transmission:
• Direct transmission through infected
body fluids.
• Contaminated needles and syringes.
• Infected blood or body fluids at birth
• Sexual contact
• It does not occur via:
• Fecal-oral route
• Foodborne ort waterborne
transmission
• Arthropod (mosquito)
transmission
• Hepatitis B
• Clinical manifestations:
• Prodromal period:
• Fever, malaise, and anorexia
• Nausea, vomiting, abdominal
discomfort, fever, and chills
• Jaundice, dark urine and pale
stools
• Recovery is indicated by a
decline of fever and
improved appetite.
• Fulminant hepatitis = may be fatal
AMB severe symptoms like ascites
and bleeding
• Hepatitis B
• Diagnostic procedures:
 • Compliment fixation test photophobia and nausea and
• Radio-immunoassay-hemaglutinin vomiting.
test • Changes in smell and taste.
• Liver function test O
• Moderate fever (37.8 – 38.9 C)
• Bile exam in the blood and urine
• Dark-colored urine and clay-colored
• Blood count
stools.
• SGOT, SGPT, ALT
• Signs and Symptoms
• HBsAg
• Clinical jaundice stage:
• Hepatitis B
• Pruritus, abdominal pain or
• Prevention:
tenderness and indigestion
• Screening of blood donors
• Icteric sclerae (yellowish
• Handwashing immediately after
discoloration of the sclerae), and
contact w/ body fluids
jaundice
• Avoid injury w/ sharp objects or
• skin rashes, erythematous patches
instruments.
and urticaria
• Use disposable needles and syringes
• Pain, tenderness of the RUQ,
only once and discard properly.
hepatomegaly, splenomegaly and
• Avoid sharing toothbrushes, razors,
cervical adenopathy
and other instruments that may be
• Recovery stage:
contaminated w/ blood.
• Most of the symptoms decrease or
• Practice safe sex
subside
• Hepatitis B vaccine for pre-exposure
• Lasts for 2 to 12 weeks
• HBIg w/in 72 hours to those exposed
• Hepatitis
directly to HBV
• Diagnosis:
• Hepatitis C
• Hepatitis A = detection of antibodies
• A bloodborne infectious disease caused by
to hepatitis A
hepatitis C virus, originally known as “non-
• Hepatitis B = HBsAg and hepatitis B
A, non-B hepatitis”.
antibodies
• Can lead to liver cirrhosis (fibrosis or
• Hepatitis C = specific antibody
advanced scarring)
• Hepatitis D = detection of delta virus
• Increased risk for the development of
or IgM
hepatocellular carcinoma
• Hepatitis E = hep E antigen
• No vaccine is available for Hep C.
• Hepatitis
• Hepatitis D
• Diagnosis:
• Delta virus, is a small, circular RNA virus
• ALT and AST are increased in
• Is replication-defective and therefore cannot
prodromal stage
propagate in the absence of another virus.
• Serum alkaline phosphatase levels
• It could be transmitted through blood and
are slightly increased
blood products (similar w/ hep B virus)
• Serum bilirubin levels are elevated
• Co-infection = occurs when the patient
• Prolonged PT = more than 3 seconds
acquires hepatitis D virus infection at the
indicates severe liver damage
same time that he/ she is infected w/ the
• WBC = neutropenia and
hepatitis B virus.
lymphopenia followed by
• Superinfection = a patient can also be
lymphocytosis
infected w/ hepatitis B virus at any time
• Liver biopsy is performed if
during acute hepatitis B virus infection.
diagnosis is questionable.
• Hepatitis E
• Hepatitis
• Transmitted through fecal-oral routes and
• Nursing management:
waterborne.
• Take juices to maintain hydration.
• Inconsistently shed in stools; therefore,
• Monitor the patient’s weight daily.
detection is difficult.
Record I and O.
• Spread is most often by drinking
• Observe stools for color, consistency
contaminated water.
and amount. Record the frequency of
• Hepatitis E never becomes a chronic (long
bowel movement.
lasting) illness, but on rare occasions the
• Before the patient is discharged,
acute illness damages and destroys so many
discuss restrictions and how to
liver cells that the liver can no longer
prevent recurrence of hepatitis.
function – fulminant liver failure
• Non-viral hepatitis
• Hepatitis E
• Toxic or drug induced (idiosyncratic)
• Persons who recover from hep E infection
hepatitis
do not continue to carry the virus and cannot
• Cause:
pass the infection to others.
• Alcohol overuse
• Signs and Symptoms
• Direct hepatotoxicity = damage and
• Prodromal stage:
necrosis caused by toxins and drug
• Easy fatigability, anorexia, body
overdose (acetaminophen)
malaise, arthralgia, myalgia,
• Idiosyncratic hepatotoxicity =
hypersensitivity to medications,
 INH, methyldopa, lovastatin and • Clinical manifestations:
halothane • Mild to moderate:
• Cholestatic reaction = caused by lack • Erythema multiforme
of bile excretion • Allergic reaction,
• Metabolic and autoimmune disorders complication of HSV
= acute exacerbations of sub-clinical infections.
liver damage • Lesions appear as a
zosteriform
distribution that
mimics herpes zoster.
• Herpes Simplex • Genital herpes
• Is a viral disease characterized by the • Herpes Simplex
appearance of sores and blisters anywhere • Clinical manifestations:
on the skin. These sores usually occur • Severe to fatal diseases:
around the mouth and nose, or on the • Newborns
genitals and buttocks (“virus of love”) • Neonatal herpetic
• Is related to the viruses that cause infectious infection is usually
mononucleosis (Epstein Barr virus), acquired from
chickenpox and shingles. maternal infection at
• Etiologic agent: the time of delivery
• Herpes simplex virus (HSV) • Eczema varicellaform
• Herpes Simplex eruption
• Herpes Simplex • Occurs commonly
• Clinical manifestations: w/atopic dermatitis,
• Mild to moderate: seborrheic dermatitis,
• Oral herpes: and diaper rash
• Gingivostomatitis • Death is due to
• Vesicular and disseminated viremia
ulcerative lesions to the brain and
occur in the buccal visceral organs
mucosa • Encephalitis
• Gingivitis, cervical • Non-epidemic forms
adenopathy and fever of herpes infection
• Excessive salivation • Herpes Simplex
results in pain • Treatment modalities:
• Feeding is painful and • Antiviral drugs (Acyclovir,
fluid intake is poor Famciclovir, Valacyclovir)
• Labial herpes: • Restore F&E balance
• Cold sores or fever • Personal hygiene
blisters = sores • Isolation
commonly affecting • Universal precautions
the lips • Herpes Zoster
• The lesions then • Shingles/Acute Posterior Ganglionitis
crusts and heal. • Caused by the same virus responsible for
• Herpes Simplex chickenpox, the varicella-zoster virus. After
• Clinical manifestations: the initial exposure, herpes zoster lies
• Mild to moderate: dormant in certain nerve fibers. It becomes
• Ocular herpes: active with aging, stress, suppression of the
• Herpetic keratitis immune system, and certain medications.
leads to vision loss • Herpes Zoster
• Conjunctivitis and • Period of communicability:
preauricular • Communicable a day before the
lymphadenopathy appearance of the first rash until 5 to
• Cutaneous herpes: 6 days after the last crust disappears.
• Affecting the skin on • Mode of transmission:
any part of the body. • Direct contact
• “Deep burning” pain, • Indirect contact (droplet, airborne,
fever, skin edema, vehicle)
ascending • Herpes Zoster
lymphangitis and • Clinical manifestations:
regional • Thoracic segment is commonly
lymphadenopathy. affected.
• Above the waistline th
• Extremities and branches of the 5
cutaneous herpes is th
type 1, below the and 7 cranial nerves.
waistline is type 2.
• Herpes Simplex
 • Erythematous base of the • Mode of transmission:
skin – appearance of the • Airborne spread
vesicles w/ 24 hours. • Droplet spread
• Dermatomes are involved. • Direct contact
• Vesicles become pustular, • Influenza
break down, and form crusts. • Clinical manifestations:
• Fever, malaise, anorexia, • Chilly sensation, hyperpyrexia,
headache. malaise, sore throat, coryza,
• Gasserian ganglionitis = rhinorrhea, myalgia and headache.
cornneal anesthesia due to • severe back pain, w/ severe
th sweating.
ophthalmic branch (5 • GI symptoms and vomiting
cranial nerve) is affected. • Influenza
• Herpes Zoster • Complications:
• Ramsay-Hunt Syndrome = paralysis • Directly r/t primary viral infection:
of the facial nerve and vesicles in the • Hemorrhagic pneumonia
external auditory canal affects the • Encephalitis and other
th
7 cranial nerve. neurologic syndrome
• Diagnostic test: • Reye’s syndrome, an acute
• Tissue culture technique encephalopathy and fatty
• Smear of vesicle fluid degeneration of the liver
• Microscopy associated w/ epidemic
• Herpes Zoster influenza B infection.
• Complications: • Myocarditis, w/c an lead to
• Encephalitis cardiac failure
• Paralytic ileus, bladder paralysis • SIDS
• Ophthalmic herpes, w/c may lead to • Myoglobinuria
blindness • Influenza
• Herpes Zoster • Complications:
• Treatment modalities: • Superimposed bacterial infections
• Symptomatic due to Streptococcus pneumoniae,
• Antiviral drugs (Acyclovir) Haemophilus influenzae,
• Analgesics Streptococcus pyogenes, and
• Anti-inflammatory Staphylococcus aureus.
• Herpes Zoster • Otitis media
• Nursing management: • Sinusitis
• Strict isolation • Pneumonia
• Apply cool, wet dressings w/ NSS to • Influenza
pruritic lesions. • Diagnostic procedures:
• Prevent secondary infection. • Leukopenia
• Assess the degree of pain and do not • oropharyngeal swab
delay administration of pain • Viral serology
relievers. • complement- fixation test
• Sufficient bed rest and provide • Hemo-agglutination test
supportive care. • Influenza
• Provide diversionary activity. • Management:
• Herpes Zoster • Stay at home
• Prevention: • Drink plenty of fluids
• Immunization against chickenpox • Paracetamol, aspirin, or ibuprofen
• Avoid exposure to a patient with • TSB
varicella or herpes zoster • Respiratory isolation
• Increase immune resistance • Limit strenuous activity
• Influenza • Watch out for complications
• Influenza • Influenza
• La Grippe • Preventive measure:
• Is an acute viral infectious disease • Immunization
affecting respiratory system. • The elderly
• Etiologic agent: • People who have poor
• RNA-containing myxovirus, types A, immunity
A-prime, B, and C • Those w/ diabetes and lung,
• Incubation period: kidney, heart, or liver disease
• 24 to 48 hours • Avoidance of crowded places
• Influenza • Educate the public regarding basic
• Period of communicability: personal hygiene
th • Avian Influenza
• Communicable until 5 day of • Bird Flu
th
illness (up to 7 day in children)
 • Is a type of “influenza” that was first
identified in Italy in the early 1900s
and is now known to exist
worldwide.
• Etiologic agent:
• Avian influenza (A1) virus.
• All A1 viruses belong to
Influenzavirus A, a genus of the
Orthomyxoviridae family.
• Avian Influenza
• Mode of transmission:
• It spreads in the air and in manure.
• Cats are possible vectors for H5N1
strains of avian flu.
• H5, H7, and H1 are known to be capable of
crossing the species barrier.
• Avian Influenza
• Incubation period:
• 3 to 5 days after exposure to manure
or infected birds.
• Signs and symptoms:
• Similar with human influenza (fever,
sore throat, cough, and pneumonia)
• Avian Influenza
• Prevention:
• Rapid destruction (culling or
stamping out of all infected or
exposed birds) proper disposal of
carcasses and quarantining and
rigorous disinfection of farms
• Restriction of movement of live
poultry
• Antiviral drugs [Oseltamivir
(Tamiflu) or Zanamivir]