Communicable Diseases
sensation in cooler areas
LEPROSY
 Also known as Hansen’s disease
named after the man who
discovered it in 1873
 Caused by Mycobacterium
leprae or M. lepromatosis
bacteria also called “acid fast”
 Rod shaped slow growing
bacillus that only grows inside
of certain human and animal
cells
 Bacteria grow best at 80.9 to 86
degrees F so cooler areas of the
body tend to develop infection
 Mainly affects the skin,
peripheral nerves, mucosal
surfaces of the respiratory tract
and the eyes
Development and Transmission
 Develops slowly (6 months to
40 years) and results in skin
lesions and deformities
 Damages skin and nervous
system
 Secreted through nasal
secretions, droplets or just direct
contact
Signs and Symptoms
 Painless ulcers that occur by
direct action of bacteria on
peripheral nerves, large ulcers
 Skin lesions and eye damage
which infers to the inflammation
of the iris ancillary body that
causes blindness
 Skin nodules and loss of digits
as the bacteria attacks nerves of
the fingers and toes causing
them to go numb
 Facial disfigurement and loss of
DOH Program: National Leprosy Control
Program
 A multi-agency effort to control
leprosy in the country with
private and public partnership in
achieving its goals to lessen the
burden of the disease and its
mission to have a leprosy free
country
 Vision: become a leprosy PH by
the year 2022
 Mission: to ensure the provision
of comprehensive integrated
quality leprosy services
 Objectives:
- To further reduce burden and
sustain provision of high-quality
leprosy services for all affected
communities ensuring that the
principle of equity and social
justice are followed
- To decrease by 50% the
identified hyper endemic cities
and municipalities
 Program Components:
- early diagnosis and treatment
- integration of leprosy services
- referral system
- case detection and diagnosis
- advocacy and IEC focusing on
stigma discrimination and
reduction
- prevention of deformity, elf-
care and rehabilitation
- recording and reporting
- monitoring, supervision and
evaluation
Treatment
  Paucibacillary form: daily
dapsone and rifampicin once
per month
 Multibacillary form – daily
clofazimine is added to
rifampicin and dapsone
 Treatment lasts between 1-2
years
FILARIASIS
 Parasitic disease caused by
microscopic thread-like worm
 Transmitted from person to
person by mosquitoes
 Afflicts Filipinos living in
endemic areas
Infectious Agents
 Caused by nematode parasites
known as Wuchereria bancrofti,
Brugia malayi, and/or Brugia
timoriand they live in lymphatic
vessels
Risks
 People living for a long time in
tropical or sub-tropical areas
where the disease is common
Spread
 When a mosquito bites a person
who has lymphatic filariasis,
microscopic worms and
circulating in the person’s blood
enter and infect mosquito
Stages of Clinical Manifestations
 Incubation period: starts from
the entry of the infective larvae
to the development of clinical
manifestations ranging from 8-
16 months
 Asymptomatic Stage: presence
of Microfilariae in the blood, no
clinical signs and symptoms
 Acute stage: starts when there
are manifestations of
lymphadenitis, lymphangitis,
and in some cases funiculitis,
epididymitis or orchitis in the
male genitalia
 Chronic stage: develop 10-15
years from the onset of first
attack
Signs and Symptoms
 Hydrocele: swelling of the
scrotum
 Lymphadema: temporary
swelling of the upper and lower
extremities
 Elephantiasis: enlargement and
thickening of the skin
Diagnosis
 Physical examination, medical
history and patient education
Laboratory Examinations
 Nocturnal blood examinations:
blood are taken from the patient
at the patient’s residence or in
the hospital after 8
 Immunochromatographic test: it
is a rapid assessment method
and an antigen test that can be
done at anytime
DOH Program: Filariasis Elimination
Program
 Vision: healthy and productive
individuals and families for
Filariasis-free PH
 Mission: elimination of
Filariasis as a public health
problem through comprehensive
 approach and universal access to
quality health services
 Objectives:
- to sustain transmission
interruption
- to intensify interventions
- to strengthen morbidity and
management and disability
prevention (MMDP) activities
and services
- strengthen health system
- secure adequate investment
 Program Components
- interruption transmission
- control and reduce morbidity
- mass annual treatment
Treatment
 Doethylcarbamazine Citrate or
Hetrazan
 Mass treatment: 6 mg/kg single
does
 Surgical treatment
Measures to Control
 Environmental sanitation and
insecticides
Measures to Protect
 Mosquito nets, use of long
sleeve clothing, insect repellent
and health education
MALARIA
 Serious and sometimes fatal
disease caused by a parasite that
commonly infectd a certain type
of mosquito which feeds on
humans
 An infectious disease caused by
protozoan parasites from the
Plasmodium family that can be
transmitted by the bite of the
Anopheles mosquito or by
contaminated needle or
transfusion
 Falciparummalaria: most
deadly type
Signs and Symptoms
 Recurrent chills and fever
 Profuse sweating
 Anemia
 Malaise or the general feeling of
discomfort illness or uneasiness
 Hepatomegaly: enlargement of
the liver
 Spleenomegaly: enlargement of
spleen
Types of Malria
(1) Asymptomatic Malaria
 caused by all Plasmodium
species; the patient has
circulating parasites but no
symptoms
(2) Uncomplicated Malaria
 caused by all Plasmodium
species and symptoms generally
occur 7-10 days after the initial
mosquito bite
 symptoms are non-specific and
can include fever, moderate to
severe shaking chills, profuse
sweating, headache, nausea,
vomiting, diarrhoea, and
anaemia with no clinical or
 laboratory findings of sever human malaria but the exact
organ dysfunction mode of transmission remains
unclear

Parasite Cycle

 Stage 1: Common host include

(3) Severe Malaria female Anopheles mosquitoes
and humans
 Caused by infection with
Plasmodium falciparum, though  Stage 2: When an infected
less frequently can also be female anopheles mosquito
caused by Plasmodium vivax or feeds on human blood. It injects
Plasmodium knowlesi. sporozites into the bloodstream
of malarias next victim
 Complications include severe
anaemia, and end-organ damage,  Stage 3: The sporozites are then
including coma, pulmonary rapidly taken by the liver cells
complications, and  Stage 4: these parasites then
hypoglycemia or acute kidney develop into schizonts that will
injury then eventually develop into
 Severe malaria is often several thousand merozoites and
associated with then produce symptomatic
hyperparasitoemia and is infections
associated with increased  Stage 5: some parasites remain
mortality dormant in the liver and become
hypnozoites. These two species
Causative Agents of parasite can initiate a cycle of
asexual reproduction causing
 Plasmodium Falciparum: absence of a new mosquito bite,
responsible for the majority of giving the name relapsing
malaria deaths globally and is malaria
the most prevalent species in
sub-Saharan Africa Sustainable Preventive and Vector Control
 Plasmodium vivax: second most Measures
significant and is prevalent in
- Refer to the adoption of measures for the
Southeast Asia and Latin
prevention and control against malaria
America. Has added
parasite and mosquito vector
complication of a dormant liver
stage which can be reactivated in  Insecticides, house spraying, on
the absence of a mosquito bite, stream seeding and on stream
leading to clinical symptoms clearing
 P.Ovale and Plasmodium
Malariae: represent only a small Other Preventive Measures
percentage of infections
 Plasmodium Knowlesi: a species  Wearing of clothing that covers
that infects primates – has led to arms and legs in the evening
  Avoid outdoor night activities
and use mosquito repellents
 Planting of Neem tree or other
herbal plants which are
(potential mosquito repellent
 Zoo prophylaxis: use of wild or
domestic animals which are not
the reservoir host of human
disease to divert the blood
seeking malaria vectors from
human host
Treatment
 Chemoprophylaxis:
Administration of a medication
for the purpose of preventing
disease or infection
- Chloroquine
o Medication primarily
used to prevent and
treat malaria in areas
where malaria remains
sensitive to its effects
o Must be taken at
weekly intervals
starting from 1-2
weeks before entering
an endemic area
o For pregnant women it
is given throughout
pregnancy
Recommended Anti-Malaria Drugs
 Blood schizonticide: are the first
line of drugs for the treatment of
malaria and must be started as
soon as the diagnosis is made, or
even suspected, in severe
diseases
 Act on asexual forms in the
erythrocytes and interrupt
clinical attacks
Public Health Nursing Responsibilities
1. Participation in the implementation of
the following:
 Treatment policies
 Provision of drugs
 Laboratory confirmation of
diagnosis
 Training of barangau health
workers on the diagnosis
treatment of malaria
 Supervision of malaria control
activities of all health personnel
in the area
 Collection, analysis and
submission of required reports
2. Recognition of early signs and
symptoms for management and further
referrals
3. Education individuals of the importance
of the following:
 Taking chemoprophylaxis
 Wear clothing that covers arms
and legs
 Using mosquito nets, repellents
and insecticides aerosols and
pyrethroid mosquito coils
 Regular cleaning of nearby
streams
4. Availability of anti-malarial drugs and
chemoprophylaxis drugs
Ways to Prevent Malaria Epidemic
1. Should be done in the event of
epidemic:
 Mass blood smear (MBS)
Collection
 Immediate confirmation and
follow-up of cases
 Insecticide-treatment of
mosquito nets
  Focal spraying, stream clearing
and intensive IEC campaign

2. All cases should be given drug

treatment and followed-up until clinically
and/or microscopically found negative

3. Continuous surveillance measures

should be implemented for 3 years

4 The LGU in collaboration with the Non-

governmental orgs and with the technical
assistance from the provincial malaria
coordinator should contribute in terms of
IEC campaign and logistics support
DENGUE FEVER
 Severe flu-like illness that
affects infants, young children
and adults but seldom causes
dearh
 Transmitted by female mosquito
mainly by Aedes aeqypti and
less frequent with aedis
albopictus
 Symptoms last for 2-7 days,
after an incubation period 4-10
days after the bite from an
infected mosquito
 Widespread in topical areas
Symptoms
Dengue should be suspected when a high
fever (40 C./104 F) is accompanied by 2 of
the following symptoms during febrile
disease:
 Severe headache
 Pain behind the eyes
 Muscle and joint pains
 Nausea and vomiting
 Swollen hands and rash
Severe Dengue
A patient enters what is called the critical
phase normally about 3-7 days after
illness onset. It Is at this time, when the
fever is dropping (below 38/100) in the
patient, that warning signs associated with
SD manifest
Warning Signs
 Severe abdominal pain,
persistent vomiting and fatigue
 Rapid breathing
 Bleeding gums
 Restlessness and blood in vomit
Mode of Transmission
 Mosquito bite (Aedes Aegypti)
Incubation Period
 Uncertainty probably 5-7 days
Period of Communicability
 Presumed to be on the 1st week
of illness when virus is still
present in the blood
Susceptibility, Resistance and Occurrence
 All are susceptible
Transmission
(1) Mosquito-to-human
 Dengue virus infected person the
virus replicates in the
mosquitoes midgut before it
disseminates to secondary
tissues including salivary glands
 Extrinsic Incubation Period:
the time it takes from ingesting
the virus to actual transmission
to a new host
 EIP: takes about 8-12 days
when the ambient temperature is
between 25-28 C. Also affected
by various genotype, daily
temperature fluctuations, initial
viral concentration
(2) Human-to-mosquito
 Mosquitoes can become infected
from people who are viremic
and this can be someone who
has symptomatic,
presymptomatic and
asymptomatic dengue
Three Stages
1. Febrile Stage
  High fever, abdominal pain,  Goal: to reduce the burden of
headache, vomiting, dengue disease
conjunctival infection and  Objectives: To reduce dengue
epistaxis mortality by 25% by 2022

2. Toxic Stage

 Lowering temperature, severe Program Components

abdominal pain, vomiting,
frequent bleeding, unstable  Surveillance: case surveillance
blood pressure, narrow pulse through PH Integrated Disease
pressure, and shock Surveillance and Response
(PIDSR)
3. Convalescent Stage  Case Management and
Diagnosis: Dengue clinical
 Generalized flushing, blanching, management and guidelines
appetite regain, stable blood training for hospitals
pressure  Integrated Vector Management:
Classifications (IVM) Training on Vector
Management, Training on Basic
1. Severe, Frank: flushing, sudden fever, Entomology for Sanitary
haemorrhage, sudden drop of temp, shock, inspector, training on integrated
terminating in recovery and death vector management (IVM) for
health workers
2. Moderate: high fever, less haemorrhage,  Outbreak Response: Continuous
no shock DOH augmentation of
3. Mild: slight fever, w or without insecticides such as adulticides
and larvicides to LGUs for
petechial haemorrhage
outbreak response
Control Measures  Health Promotion and
Advocacy: Celebration of
1. Eliminate vector by: changing water, ASEAN Dengue by June 15
destroy breeding places and keep water  Research
containers covered
Treatment
2. Avoid too many hanging clothes
 There is no specific treatment
3. Residual spraying for dengue fever. Fever reducers
DOH Program: Dengue Prevention and and pain killerd can be taken to
Control Program control the symptoms of muscle
aches and pains, and fever.
 Vision: A dengue free PH  The best options to treat these
 Mission: Ensure healthy lives symptoms are acetaminiophen or
and promote well-being for all at paracetamol
all times  NSAIDS such as ibuprofen and
aspirin should be avoided
Nursing Care
1. For haemorrhage: keep patient at rest
during bleeding episodes
2. For shock: prevention is the best
treatment
 Adequate preparation of patient
 Provision of warmth thru
lightweight cover
3. Diet: low fat, low fiber,
MEASLES
 An acute highly communicable
infections characterized by
fever, rashes, and symptoms
referable to respiratory tract
 Eruption is preceded by about
two days of coryza, during
which stage grayish pecks
(koplik’s spot) may be found on
the inner surface of the cheeks
 A morbilliform rash appears on
the third or fourth day affecting
face, budding and extremities
ending in branny desquamation
 Etiologic Agent: filterable virus
of measles
Infectious agent
 Caused by Rubeola virus
History
 First systematic description of
measles and its distinctive from
other exanthematous diseases
(smallpox and chickenpox)
credited to the Persian physician
Rhazes who published The
Book of: Smallpox and
Measles
 1529, measle outbreak in Cuba
Mode of Transmission
 Direct contact or airborne
 Source of infection: secretion of
nose and throat of infected
person
Signs and Symptoms
 Cough and runny nose
 Red eyes/conjunctivitis
 Fever
 Skin rashes lasting for more than
3 days
Incubation Period
 10 days from exposure to
appearance of fever
 About 14 days until rash appears
Susceptibility, Resistance and occurrence
 All persons
 Babies born of mothers who had
the disease before babu is born
are immune for the first months
of life
 Permanent acquired immunity
Period of Communicability
 Period of coryza or catarrhal
symptoms is about 9 days (from
4 days before and 5 days after
rash appears)
Risk Factors
 Malnutrition, Vitamin A
deficiency
 Underlying immunodeficiency
 Pregnancy
  Anyone who never had measles
and has never been vaccinated
 Babies younger than 12 months
because they are too young to be
vaccinated
 Small percentage of vaccinated
children and adults who may not SCHISTOSOMIASIS
have responded to vaccine
Methods of Prevention and Control
 Avoid exposing children to any
person with fever or with acute
catarrhal symptoms
 Isolation of cases from diagnosis
until 5 to 7 days after onset of
rash
 Disinfection
 Encouragement by health Infectious Agents
department and private
physician of administration of
measles immune globulin to
susceptible infants and children
under 3 years of age in families
or institutions where measles
 Live attenuated and inactivated
measles virus vaccines have
been tested and are available for
use in children with no history, 9
months of agen or soon
Signs and Symptoms
thereafter
 Live attenuated measles vaccine
is recommended for all persons
unless specific contraindications
to live vaccines exist
 Recommended that this vaccine
be given as measles-mupms-
rubella (MMR) at 9-12 months Transmission
of age
 Second dose: 4 years of age
(prior to school entry)
 Second dose is not a booster but
is designed to vaccinate the
approx.. 5% of children who do
not seroconvert to measles after
first dose of vaccine
 also known as Bilharasis or snail
fever
 a tropical disease caused by
blood flukes
 mostly affects farmers and their
families in rural areas
 high prevalence in Region 5
(Bicol), Region 8 (Samar &
Leyte), and Region II (Davao).
 Schistosomiasis is caused by the
blood fluke Schistoma
Japonicum that is transmitted by
a tiny freshwater snail
oncomelania quadrasi
 Schistosoma mansoni. S.
haematobium and S. japonicum
(native in the PH) are major
species causing the disease
 Diarrhoea, bloody stools
 Enlargement of the abdomen,
and splenomegaly
 Weakness, anaemia and
inflamed liver
 Infection occurs when your skin
comes in contact with
contaminated freshwater in
which certain types of snails that
carry schistosomes are living. It
is the free swimming forms
 larval forms of the parasite that
penetrate the skin
Risks
 If you live in or travel to areas
where schistosomiasis occurs
and your skin comes in contact
with freshwater from canals,
rivers, streams, ponds, or lakes,
you are at risk of getting
schistosomiasis.
Diagnosis
 Stool or urine samples can be
examined microscopically for
parasite eggs (stool for S.
mansoni or S. japonicum eggs
and urine for S.
haematobium eggs). The eggs
tend to be passed intermittently
and in small amounts and may
not be detected, so it may be
necessary to perform a blood
(serologic) test.
DOH Program: Schistosomiasis Control
Program
 Vision: Schistosomiasis Free
Philippines
 Mission: Synchronized and
harmonized public and private
stakeholders’ efforts in the
elimination of schistosomiasis in
the Philippines
Objectives
Interruption of transmission of
Schistosomiasis Infection by 2025.
 All high endemic barangays will
reach the target of criteria for
Morbidity/Infection Control
(<5% prevalence of heavy
intensity infection for 5 years).
 All moderate endemic barangays
will reach the target of criteria of
Transmission Control
(Elimination as a Public Health
Problem with <1% prevalence of
heavy intensity infection for 5
years).
 All low endemic barangays will
reach the target criteria of
Transmission Interruption (no
local infection in man and
animals, no infection in snail for
5 years)
Program Components
 Preventive Chemotherapy
 Intensified Case Management
 Water, Sanitation and Hygiene
(WASH)
 Veterinary Public Health and the
Promotion of Animal Health
under One Health Approach.
 Effective Intermediate Host
Control and Surveillance
Strategies
 Preventive Chemotherapy
through Mass Drug
Administration
 Intensified Case Management
 Promotion of Animal Health and
Veterinary Public Health under
One Health Approach
 Effective Intermediate Host
Control and Surveillance
 Water, Sanitation and Hygiene
(WASH)
Methods of Prevention and Control
Treatment: Safe and effective medication
is available for treatment of both urinary
and intestinal schistosomiasis.
Praziquantel, a prescription medication, is
taken for 1-2 days to treat infections
caused by all schistosome species.

Preventive Measures

 public teaching
 proper waste (feces and urine)
disposal
 improve irrigation and
agriculture practices
 prevent exposure to
contaminated water and apply
70% alcohol
 provide clean water
 mass treatment

Control Measures

 Reducing the number of

infections in people
 Eliminating the snails that are
required to maintain the
parasite’s life cycle..

CHICKENPOX

Etiologic Agent

 Human (alpha) herpesvirus 3

(varicella-zoster virus), a
member of herpesvirus group

Source of Infection
  Secretion of respiratory tract of
infected persons
 Lesions of skin are of little
consequence
 Scabs themselves are not
infective
Definition
 A disease that causes an itchy
rash of blisters and a fever. A
person with chickenpox may
have as many as 500 blisters.
The rash can spread over the
whole body
 Acute infectious disease of a
sudden onset with slight fever,
mild constitutional symptoms
and eruptions which are maculo-
papular for a few hours,
vesicular for 3-4 days and leaves
granular scabs
 Lesions are more on covered
than exposed parts of body and
may appear on scalp and mucous
membrane on upper respiratory
tract
Mode of Transmission
 Direct contact or droplet spread
 Indirect through articles of
freshly soiled by discharges of
infected persons
 One of the most readily
communicable diseases
especially in the early stages of
eruption
 Airborne: Infected person
sneezes, tiny droplets are
released into air, non-immune
person inhales it
 Direct contact: non-immune
person touches blister fluid, and
when they are touching their
eyes, nose and mouth
Incubation Period
 The average incubation period
for varicella is 14 to 16 days
after exposure to a varicella or a
herpes zoster rash, with a range
of 10-21 days
 A mild prodrome of fever and
malaise may occur 1-2 days
before rash onset, particularly in
adults. In children rash is often
first sign of disease
Susceptibility, Resistance and Occurrence
 Universal among those not
previously attacked
 Severe in adults and an attack
confers long immunity
 Second attacks are rare and
probably 70% have the disease
by the time they are 15 years of
age
 Not common in early infancy
Period of Communicability
 Not more than one day before
and more than 6 days after
appearance of the first crop of
vesicles
Signs and Symptoms
 The itchy blister rash caused by
chickenpox infection appears
10-21 days after exposure to the
virus and usually lasts about 5-
10 days
 Other signs and symptoms
which may appear 1-2 days
before rash includes:
- Fever
 - Loss of appetite
- Headache
- Tiredness
 3 phases once rash appears
1. Raised pink or red bumps
(papules) which break out
over several days
2. Small fluid filled blisters
(vesicles) which form in
about one day and then
break and leak
3. Crusts and scabs which
cover the broken blisters
and take several all more
days to health
Methods of Prevention and Control
 The virus can be spread to others
until all lesions have crushed,
thus, the child should not return
to school or day care until they
are no longer contagious, even if
they feel better
 Varicella vaccine may be given
3-5 days after exposure (before
symptoms begin) to prevent or
lessen the severity of the disease
 All children over 12 months of
age should be vaccinated
 Good hygiene can prevent the
spread
 Case over 15 years old should be
investigated to eliminate
possibility of smallpox
DOH EPI
 The EPI was established in 1976
to ensure that infants and
mothers have access to routinely
recommended infant/childhood
vaccines. The MMRV includes
varicella (Chicken pox) vaccine
 Overall goal: To reduce
morbidity and mortality among
children against common
vaccine preventable diseases
Strategies
 Conduct of routine
immunization of
infants/children/women through
reaching every barangay strategy
 Supplemental immunization
activity (SIA)
 Strengthening vaccine
preventable diseases
surveillance
INFLUENZA
Definition
 Acute highly communicable
disease characterized by abrupt
onset with fever which last 1-6
days, chilly sensation or chills,
aches or pain in the back and
limbs with prostrations
 Respiratory symptoms: sore
throat and cough
Etiologic Agent
 Influenza is caused by infection
of the respiratory tract with
influenza viruses
 Influenza Virus A: cause
seasonal epidemics (like flu) and
are the only influenza viruses
known to cause flu pandemics
i.e. global epidemics of flu
disease. Wherein a new and very
different influenza A virus
emerges that both infects people
 and has the ability to spread
efficiently between people
 Influenza Virus B: cause
seasonal epidemics of disease
(flu season)
 Influenza Virus C: cause mild
illness and are not thought to
cause human flu epidemics

Mode of transmission

 Direct Contact: through droplet

infection or by articles freshly
soiled with discharge of nose
and throat of infected person
 Source of infection: discharges
from the mouth and nose of
infected persons
 Incubation Period: Short, usually
24-72 hours
 Period of communicability:
limited to 3 days from clinical
onset

Susceptibility, Resistance and Occurrence

 Universal but of varying degrees

as shown by frequent unapparent
typical infection during
epidemics
 Occurrence is variable in
pandemics, local pandemics and
PNEUMONIA
as sporadic cases often
unrecognized by reason if Definition
indefinite clinical symptoms
 Infection produces immunity of  An acute infectious disease of
unknown duration to the type lungs usually caused by
and subtype of infecting virus pneumococcus resulting in the
consolidation of one or more
lobes of either one or both lungs

Etiology

 Disease of respiratory system

caused by many bacterial or
viral infections of the lungs;
  Diploccocus pneumonia:  X-ray
majority of cases are due to this
 Pneumococcus of Friedlander/ Complications
Klabsiella pneumoniae: a type
 Emphysema or pleural effusion
of gram negative bacteria and is
 Endocarditis or pericarditis with
now known to be resistant to
effusion
antibiotics
 Pneumococcal meningitis
 Viruses or RSVs: common and
 Otitis media in children
causes cold like symptoms
(Adenovirus, coronavirus)  Hypostatic edema and
hyperemia of unaffected lung in
Predisposing Causes the body
 Jaundice and abortion
 Pneumonia is also associated by
the following predisposing Program of DOH – National Immunization
causes: fatigue overexposure to Program
inclement weather (extreme heat
or cold), exposure to polluted  Pneumococcal conjugate
air, malnutrition vaccine or PCV13 is given to the
public for free
Incubation Period  PVC protects children, pregnant
women, and the elderly against
 2-3 days diseases caused by
Streptococcus pneumoniae
Signs and Symptoms
such as pneumonia, meningitis,
 Convulsions, flushed face, and sepsis
dilated pupils, severe chill in  DOH advises following means
young children, pain over of prevention: exclusive
affected lung, highly coloured breastfeeding from birth to 6
urine with reduced chlorides and months up to 2 years, frequent
increased urates handwashing, feeding children
 Rhinitis/common cold, chest ages 6 months and beyond
indrawing, rusty sputum, nutritious food to help fight
productive cough, fast infection
respiration, high fever, vomiting
Treatment Management

 Bed rest
 Adequate salt, fluid, calorie and
vitamin intake
Diagnosis  Tepid sponge for fever
 Thoracentesis
 Based on history and clinical
 Frequent turning from side to
signs and symptoms
side
 Dull percussion note on affected
side (lung)
  Antibiotics based on care of
acute respiratory infection
(CARI) of the DOH
 Chest physiotherapy

What are the reasons for making a patient

with pneumonia turn from side to side?