Communicable Diseases Communicable Diseases

INFECTIOUS DISEASE NURSING Host IMMUNIZATION

 Man or animal IMMUNITY
COMMUNICABLE DISEASES – diseases that can be transmitted  Consider the susceptibility (degree of resistance) of the  State of being resistant to infection; state of being free Active
through: host from infection.  Weakened microorganism/toxin
 Direct – person-to-person; face-to-face encounter with  Stimulate antibody production
an infected person (e.g. skin contact, kissing); droplet 4 types of Host Two Types:  Effect: 4-7 days
 Continuously produces antibody (long-lasting
Droplet Airborne  Patient – infected with signs and symptoms; isolate  Natural immunity)
Source of Respiratory Droplet Respiratory Droplet and observe precautionary measures; least source of o Inherent in the individual’s body tissues and fluids  EPI: BCG, OPV, MMR, DPT, AMV
Infection (droplet nuclei) (droplet nuclei) infection (born with it and die with it) – rare  Tetanus Toxoid, Anti-rabies, HBV, Pneumovax,
Respiratory Bigger, heavy Smaller,  Carrier – harbors/carries microorganisms but without o Race (lahi) Varivax, Fluvax
Droplet (remains in the carried/suspended in signs and symptoms; also a/potential source of o Genetic abnormality
surface), can be the air, lighter infection. Passive
carried for some  Contact – close contact/exposure to infected person  Acquired  Antibodies
time only  Suspect – medical history and symptoms suggest  Provide high titer of Antibodies (TX)
Distance Within 3ft of the No limitation, more infectious presence of disease. A. Active – actual participation of the  Effect: immediate
patient extensive than droplet individual’s body tissues and fluids in the  Not long-lasting/short-lived immunity
*airborne transmission is not direct transmission Agent production of antibodies.  ATS/TAT, TIg, Equinae, Rabies Ig, HRIg, ADS, PIg, VZIg
 Indirect – from source to other person with intermediary  Microorganism  Active (toxins) and Passive (antibodies) Immunization
object o not all possesses pathogenicity (capacity of 1.) Naturally Acquired – produce antibodies by – do not inject on the same side/site.
o Vehicle-borne – fomites, inanimate objects/non- microorganism to cause an infection) and natural means; unintentionally
living things (e.g. stethoscope, BP cuff, eating virulence (strength and power of microorganism  previous infection CHAIN OF INFECTIOUS PROCESS
utensils) to cause infection)  Subclinical Immunity – developed
o Vector-borne – insects, arthropods, rodents due to constant exposure to a
*opportunistic microorganism certain infection.
 Break in Skin Integrity
o Inoculation (BT, sharps and needles) Virus Bacteria 2.) Artificially Acquired – artificial means; Causative
intentionally done Agent
 Airborne – stands alone, another mode of transmission  only multiply in living things  multiply both in living and  (vaccines – attenuated/weakened
(e.g. Chicken pox, TB, Measles)  can pass through filters in non-living things microorganisms)
*uses N95 mask – airborne droplet can pass through the body  cannot pass through filters in
Susceptible
an ordinary mask. o blood-brain barrier the body (big in size) B. Passive – presence of antibodies in the serum not Reservoir
Host
*doors should always be closed o placental barrier  self-limited/self-limiting coming from the individual himself (get antibodies)
 Rubella/German o Colds – 2-3 days
* ALL THESE FOUR (4) are HORIZONTAL TRANSMISSION Measles (1st trimester) o Influenza – 1 week 1.) Naturally acquired – get antibodies by natural
 self-limited/self-limiting  Treponema pallidum (C.A. means/unintentionally
VERTICAL TRANSMISSION o Colds – 2-3 days of Syphillis) – can pass  placental transfer of maternal
 Mother to unborn child transmission (perinatal o Influenza – 1 week through placental barrier antibodies
transmission/trans-placental transmission)  treated according to after the 16th week of  Baby protected up to 6mos.
symptoms (no specific viral pregnancy (2nd to 3rd (antibodies from mom)
 infection under 6mos. (mom’s fault) Portal of
INFECTIOUS DISEASES – Presence of living organisms in the body agents) trimester) Portal of Exit
 give us permanent immunity o 3rd trimester – highly fatal Entry
which may not be transmitted through ordinary contact.
 management: rest, nutrition  give us temporary immunity  WHO – no immunization must be
CONTAGIOUS DISEASES – easily transmitted given earlier than 2mos. (mom’s
Protozoal Fungal antibodies will fight infection Mode of
*ALL COMMUNICABLE DISEASES are INFECTIOUS but NOT ALL are Transmission
CONTAGIOUS  Amoebiasis  Tinea (ring worm)  Exception to the rule – in a country
 Malaria o capitis (head, scalp) or state where infectious
*ALL CONTAGIOUS DISEASES are INFECTIOUS and at the same  Gardiasis o corporis (body) diseases are constantly present,
time COMMUNICABLE  PCP o pedis (feet) –athlete’s they can give vaccine before two
foot months
IDNAP – Infectious Disease Nurses Association of the Philippines o ugeuna (nails) Vehicle of Transmission – source of infection
o cruris (inguinal) – jock’s  Mother with HIV = baby with
EPIDEMIOLOGIC TRIAD itch antibodies = doesn’t mean baby
*can be cut anywhere but it will be easier if the weakest link
o barbae (beard) – is infected
would be cut
barber’s itch
Environment  Mother’s antibodies stay up to
*portal of exit before portal of entry
18mos.
*Ricketsia – typhus fever (Phonazeki) – bites of lice on head In taking care of an infected person,
(causes falling of hair)  >18mos. = body (+) HIV antibodies
1. Know C.A.
= baby has HIV
2. Know vehicle of transmission
ENVIRONMENT 3. Know mode of transmission
Host Agent  Conducive and favorable to the growth and  Breastfeeding (IgA) – colostrum
multiplication of microorganisms.

General Nursing Care

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Communicable Diseases Communicable Diseases

I. Preventive – no infection yet, not allow infection to set in  PD 856 Revised Isolation Precaution  Anaerobic – w/o oxygen
o Gonorrhea – once a month 1. Standard Precaution  Protected against oxygen because it is in the
A. Health Education o Syphillis – twice a month  Primary strategy for preventing nosocomial infection form of spore
- Knowledge *with certificates  Took the place of universal precaution  Very difficult to destroy - Sterilization
- Attitude  Applies to the following:  Inside the body - vegetative form – not
- Skills  PD 825 – Anti-littering Law o All patients regardless of their diagnosis protected from oxygen
o Php 2000 – 5000 o Blood and all body fluids, excretions and  MOT: Break in skin integrity (wound) – any kind of
 doctor – ultimately responsible for giving health o Imprisonment of 6mos.-1yr secretions except sweat wound
education  Universal precaution – visible blood  Tetanus Neonatorum – poor cord care
 nurse – key person/ provider D. Proper Supervision of Food Handlers o Non-intact skin  IP: 3 days to 4 weeks
 DOH (doctors) o Mucous membrane  The shorter the incubation period is, the poorer is
B. Immunization  FDA –monitor foods, drugs, and cosmetics if the prognosis
EPI – P.D. 996 - ↓8y/o they are safe for consumption  Essential Elements of Standard Precaution  S/Sx:
UN Goal (UCI) – Proc. No. 6 - ↓6 y/o o Use barrier precaution o Initially signs of wound inflammation
Yr. 2000 (NID) Proc. No. 46 - ↓5y/o II. Control (with infection) – limit spread o Prevent inadvertent percutaneous exposure 5 Cardinal Signs of Inflammation
A. Isolation  Needle prick injury  Rubor - redness
7 Childhood Diseases  Infected person during period of  Do not recap – one-hand technique  Callor - warmth
1. TB communicability – scooping, fishing  Dolor - pain
2. Diphtheria o Strict – protect others  Do not bend  Tumor - swelling
3. Pertussis o Protective – protect patient;  Do not break  Function loss
4. Tetanus microorganism away from patient  Do not manipulate o Increased muscle tone near the wound
5. Poliomyelitis o Immediate hand washing and washing of o Tachycardia, profuse sweating
6. Hepatitis B Quarantine other skin surface area o Low grade fever
7. Measles  Limitation of freedom of movement of a o Painful involuntary muscle contraction
well person during longest incubation 2. Transmission Based Precaution
Permanent Contraindications to Immunization period  Communicable Diseases  Tetanolysin – dissolves RBC
 Instituted to patients infected with highly transmissible  Tetanospasmin – causes muscle spasm
1. Allergy B. Disinfection infection o Affects the myoneural junction of the muscles
 MMR – egg and neomycin  Killing of pathogenic microorganism by:  Precautions beyond those set forth in standard and internuncial fibers of the spinal cord and the
– made of chick embryo and neomycin o Physical – washing, boiling precaution brain
 Hepatitis B – baker’s yeast o Chemical – use of chemical agents  Transmission based + standard precaution
– Saccharomyces cerevisiae  sterilization  Muscles affected:
 IPV (salk vaccine) – neomycin (streptomycin)  Airborne Precaution o Masseter muscle – closing of the mouth
 Flu – chicken and chicken products Disinfestation o Use of respiratory protection (particulate  Lockjaw – trimus – rigidity of the jaw
 Killing of small undesirable animal forms respirator) muscle
2. Encephalopathy without known cause or o Arthropods and rodents  HEPA filter – high efficiency particulate air o Facial muscle
convulsion within 7 days after vaccine filter  Risus sardonicus – sardonic smile/ grin
a. If with convulsion Fumigation o Measles, TB, varicella  Smiling with eyebrows raised
 No DPT = DT only  Gaseous agents o SARS, Avian flu – droplet o Extensor muscles of the spine
 May have permanent  Kill arthropods and rodents  Opisthotonus position – arching of the
neurologic disorder (neurologic  Droplet Precaution back
encephalopathy C. Medical Asepsis o Contact to the conjunctiva, nasal or oral o Abdominal muscle
 24o crying inconsolably  Hand washing mucosa  Board-like abdomen
o 10 to 15 secs o PPE: regular mask and goggles
Temporary Contraindications o Length is not considered anymore = o Ex: Meningitis, Hib infections, pneumonia  Dx Exam: Clinical observation + history of wound
1. Pregnancy FRICTION  Med Mgt: Objectives
a. Live vaccines – never given to pregnant o Medical Asepsis  Contact Precaution o Neutralize the toxin
individuals – may affect growth and  Hands are lower than the elbow o Activities that require physical contact  ATS (Anti-tetanus serum) / TAT (Tetanus
development of fetus – congenital o Surgical asepsis o Contact with inanimate objects anti-toxin)
problems  Hands are higher than elbows o PPE: gloves and gown o ATS – from animal products –
o Ex: GI infections, skin infections, STI’s, Ebola perform skin testing
Live Vaccines  Use of barrier precaution (personal protective  TIg (Tetanus Immuniglobulin)
- OPV - MMR equipment) CENTRAL NERVOUS SYSTEM o Kill the microorganism
- BCG - Varivax o Used when in direct contact with  Bacteria  Antibiotic – Penicillin
patient o Tetanus  Daily cleansing of wound - NSS
2. Very severe disease/severe febrile disease o Used as necessary o Meningitis o Thin dressing
3. Immunocompromised situation (receiving o Use only PPEs that needs to be worn  Virus o Prevent and control spasms
corticosteroids) o Wearing: Mask  goggles  bonnet o Encephalitis  Muscle relaxants
4. Recent receipt of blood products, wait for 2-3 gown  gloves o Poliomyelitis o Diazepam – IV push, IV drip
months o Remove: gown  gloves  o Rabies o Methocarbamol (Robaxin,
a. AMV handwashing  bonnet  goggles  Robaxisal)
b. Varivax mask  handwashing o Lionesal (Baclofen)
c. MMR 1. TETANUS o Epirison (Myonal)
 No amount of immunization will give you full protection  AKA: Lockjaw  Osterized feeding (NGT) – patient cannot
(vaccine failure)  Use of Placarding Principle  CA: Clostridium Tetani feed through the mouth
o No smoking  Soil, clothes, dust
o Arm precaution  Intestines of herbivores – manure – soil – pasture  Nursing Care:
C. Environmental Sanitation areas  Maintain adequate airway and ventilation

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 Communicable Diseases Communicable Diseases
o Padded tongue depressor  CA: Virus, fungus, bacteria o Viral -  Protein,  WBC, Normal Sugar  Post-vaccine encephalitis – Anti-rabies
 Maintain an IV line o Cytomegalovirus (CMV) - Virus  Culture & Sensitivity – type of drug vaccine
o Should be patent (for medications)  Opportunistic - low body resistance - AIDS  CIE (Counter immunoelectrophoresis) – virus  Wear mask – previous infection
 Monitor clients for signs of arrhythmia o Cryptococcal Meningitis (C. Neoformans) - Fungus or protozoa  Common in the Philippines
 Prevent client from having spasms  Opportunistic – low body resistance – AIDS  Contraindication - Highly increased ICP –
o Exteroceptive stimuli – external  SOI: Excreta of birds herniation of brain o Toxic Encephalitis
environment o TB Meningitis - Bacterial o Blood Culture  Metal poisoning
 Dim and quiet environment  Common cause of meningitis in the o Lead poisoning
o Interoceptive stimuli – within patient Philippines o Mercurial poisoning
 Stress – limit visitors  Not necessarily secondary to tuberculosis  Med Mgt:
 Flatus and Coughing – turn to sides o Staphyloccocal o Antimicrobial therapy  S/sx:
o Proprioceptive stimuli – participation of o Streptococcal o Corticosteroids – Dexamethasone o Same as meningitis
patient and other person  Secondary to respiratory infection o Osmotic Diuretics – I & O o ALOC
 Touching – gentle handling – inform o Meningococcal Meningitis/ Meningococcemia/ o Anticonvulsant Agents – Dilantin (Phenytoin) o Lethargic – abnormally sleepy, difficult to
before touching Neisseria Meningititis  IV - Sandwich with NSS – crystallization of drug awaken
 Turning – not done frequently – at  Deadliest type  Oral – Gingival hyperplasia – frequent oral  Dx Exam:
least once/shift  Affects vascular system  DIC  prone to care or gum massage o Lumbar puncture – clear
 Jarring the bed intravascular bleeding  vascular collapse o Laboratory exam -  Protein,  WBC, Normal
 Minimal handling of the patient  death – 10%  Nursing Care: Sugar
o Avoid unnecessary disturbing  Waterhouse Friderichsen Syndrome – group o Assess neurologic function o EEG – extend of brain involvement
of the patient of symptoms - death within 6 to 24 hours o Maintain adequate nutrition and elimination
o Organized and cluster nursing  MOT: Direct (droplet) o Ensure client’s comfort  Med Mgt: Symptomatic
care  IP: 2 to 10 days  Diversionary activities
 Protect client from injury  S/sx:  Rest  Nursing Care: Same as meningitis
o Never leave the patient o Nasopharynx – URTI – cough, colds  Massage
alone o Bloodstream o Effleurage – figure of 8 or circular  Prevention:
o Padded side rails  Petechiae – pinpoint red spots on the skin manner o Eradication of source of infection
o Call light is within the reach of o Apply pressure and redness remain – o Petrissage – friction; thumb, index or o Use of insecticide
the client tumbler test (clear glass) middle finger o Use of insect repellants
 Prevention: o Extremities first then body o Tapotement – edge of hand o Screening doors and windows
o Immunization  Ecchymosis – blotchy purpuric lesions o Kneading o 4S
 DPT o Area of bleeding – obstruction – may  Quiet and dim environment  Search and destroy breeding places
o 6 wks after birth become necrotic  Limit visitors  Self-protection
o 3 doses with 4 wks (1 month) interval  Spotted fever o Symptomatic and supportive  Stop indiscriminate fogging – drive away
o 0.5 cc o Meninges  Maintain fluid and electrolyte imbalance only
o IM/ Vastus lateralis  Pathognomonic sign: nuchal rigidity – entire  Safety  Seek early consultation
o Fere – antipyretic neck is rigid
o Observe – signs of convulsion for 7 days  + Kernig sign  Prevention 4. POLIOMYELITIS
o Warm compress (immediately) – o Supine and flex knees towards the o Immunization – 10 years and below
vasodilation and better drug absorption abdomen  BCG  AKA: Infantile Paralysis
o Cold compress 20 mins after – o Pain/ difficulty extending the less after  Hib Vaccine Acute Flaccid Paralysis – soft,
vasoconstriction -  or prevent swelling knee flexion  Meningococcemia vaccine flabby, limp
o If there is swelling already – apply cold o Pain – hamstring – back of the thigh o Proper disposal of nasopharngeal secretions Heine – Medin’s Disease
compress  + Brudzinski sign o Covering of nose and mouth when coughing and
o Warm compress 24 to 36 hours after o Flex neck towards the chest sneezing  CA: Poliovirus (Legio Debilitans)
injury sets in o Involuntary drawing up of extremities or o Type I – Brunhilde – permanent immunity –
 Tetanus Toxoid hips upon flexion of neck 3. ENCEPHALITIS common in the Philippines
o 2nd trimester   ICP – obstruction in the subarachnoid  Inflammation of the encephalon/ brain o Type II – Lansing – temporary immunity
o 2 doses with 1 month interval space - CSF  AKA Brain fever o Type III – Leon – temporary immunity
o 0.5 cc IM/ deltoid – non-dominant hand o Severe headache  CA: Arbovirus (Arthropod borne virus) – carried and
o Projectile vomiting – 2 to 3 ft away transferred by an arthropod  MOT: Early stage – direct (droplet) – 1st 4 days –
1st dose Anytime
o Seizures/ convulsion – inflamed  Classifications: microorganism in the nasopharynx
1 month after 1st
2nd dose meninges – altered pressure in the o Primary Encephalitis Late stage – fecal-oral – Day 5 onwards
dose
cranial cavity  Affects the brain directly  Enterovirus – intestines
3rd dose 6 months
o Altered vital signs -  Temp,  PR,   St. Louise, Japanese B, Australian X, Effects on CNS
4th dose 1 year RR,  Systolic and normal diastolic, Equine (E – W)  Severe muscle pain
5th dose 1 year Widened pulse pressure  MOT: Mosquito bites o Do not turn or hold patient
o Diplopia – choking of optic disk – o Aedes sollicitans o No amount of massage or positioning can
o Low risk – booster dose – every 10 yrs double vision o Culex Tarsalis relieve pain of patient
o High risk – booster dose – every 5 yrs o ALOC  Ticks of horses o Warm compress/ narcotic drugs can relieve
 Proper wound care  Dx Exam:  Migratory birds pain
o Thin dressing – air vent o Lumbar puncture – CSF  No need to wear mask  (x) Morphine and Nubain – may cause
 Avoid wounds  Color  Not common in the Philippines respiratory depression
o Yellowish, turbid, cloudy – bacterial  (/) Codeine
etiology
o Clear – normal or viral o Secondary Encephalitis  Stiffness of hamstring
2. MENINGITIS  Laboratory exam  There was a previous infection  Hoyne’s sign – head drop
 Inflammation of the covering of the brain and spinal o Bacterial -  Protein,  WBC,  Sugar  Complication o if shoulders are lifted, head will drop
cord

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Communicable Diseases Communicable Diseases

 Poker spine – Opisthotonus with head retraction  Low forms of animals – warm blooded - dogs, cats o Hydrophobia  Site: Vastus lateralis
 Tripod position – maintain a sitting position  CA: Rhabdo virus - neurotropic – strong affinity to  Not a phobia – avoided  Given within 7 days – body has not yet
o Lean backward, not forward nerves and neurons because it causes pharyngeal produced antibodies
 MOT: Contact with saliva of a rabid animal spasms
Paralytic Stage (Flaccid) Organ transplantation - rare o Maniacal behavior  Nursing Mgt:
 Bulbar  Benadryl – relax patient o Supportive/ Symptomatic
o Affects Cranial Nerve IX and X  Antipsychotic – Haloperidol  Keep water out of sight


o
Spinal
May cause respiratory paralysis Rhabdo (Haldol)
o Normalizes behavior


Dim and quiet environment
Room should be away from sub utility room
o Anterior Horn Cell Virus  Paralytic Stage  Restrain before maniacal behavior
o Affects the motor function of patient o Spasm stops  Provision of comfort measures
o Extremities, intercostal muscle o Paralysis sets in – rapid and progressive
 BulboSpinal Peripheral Efferent o From toes going up  Prevention:
o Cranial Nerve and Anterior Horn Cell nerves nerves o Be a responsible pet owner
o CN IX and X + Motor function * Rabies is preventable but not curable – dies within o Have the animals immunized
24 to 72 hours – 100% mortality o Keep animals caged or chained
* Not all patients will develop paralysis Central nervous o Preventable but not curable
Salivary gland
* As long as the patient does not develop paralysis/ has system (Negri bodies  Dx Exams:
not reached paralytic stage, patient has good prognosis - pathologic lesions o Done before symptoms are manifested CIRCULATORY SYSTEM
that are formed as (animals)  Virus
 Dx Exam: microorganism o No exams are done on humans o Dengue Hemorrhagic Fever
o Lumbar puncture - result same as Encephalitis multiplies; 10% of (-) Negri bodies – results will be (-) if no s/sx  Protozoa
rabid animals (-)
o Throat washing – 1st 4 days of the pharynx o Brain biopsy o Malaria
negri bodies)
o Stool exam – 5th day onwards o Direct Fluorescent Antibody Test
o Observation of animal (10 days) 6. DENGUE HEMORRHAGIC FEVER
 Medical Management:  Site of the bite  CA: Dengue Virus (Arbovirus) – carried by one to
o Supportive o Waist up – no need to observe, another by arthropod
o Iron lung machine – mech vent used for polio  10% of rabid animals (-) negri bodies vaccine is administered o Dengue Virus 1-4
patients  If bitten by a dog/animal, do not kill them immediately  Extend of the bite o Oinyongnyong
 Principle of negative pressure breathing  Cage the animal for observation o Deep, multiple, big bite - no need to o Chikungunya (less harmful than DHF)
 No problem in the lungs but with o Rabid if dies or have behavioral stages within 10 observe, vaccine is administered o West Nile Virus
nerves/muscles days o Reason for the bite o Flavi Virus
 Life-saving measure  Provoked – no need to worry
 Months and years  S/sx:  Unprovoked – worry!  MOT: Mosquito bites
 Weaning o Animals - 3 to 8 weeks o Aedes Aegypti; Aedes Albopictus
 7 machines in the Philippines  Dumb Stage – complete changes in behavior  Biological Transmitter
o Withdrawn – depressed  8-11 days after the mosquito bit a
 Nursing Care: o Overly affectionate  Medical Mgt: Post-exposure prophylaxis person, it will be able to pass the virus
o Supportive o Hyperactive – Manic o Active immunization  Transfers virus to its offspring
 Turn to sides  PVRV (Purified Vero Cell Vaccine) - ID
 Furious Stage o VERORAB (0.5 mL/vial) o Culex Fatigans
 Prevention: o Easily agitated  PCEV (Purified Chick Embryo Vaccine) - IM  Mechanical transmitter
o Immunization o Easily bites o RABIPUR (1 mL/vial)  After it acquires the virus, only the very
 OPV (Sabin) o Vicious or fierce look  IM with sensitivity test – Deltoid first person it will bite will get the
o 5 weeks after birth o Drooling of saliva disease
o 3 doses with 4 weeks interval o Dies Day 0 2 vials
o 2-3 gtts/orem Day 7 1 vial o Aedes Aegypti (day and night biting)
o Vomiting: Give again o Humans – 10 days to years Day 21 1 vial  Breed on a clear, stagnant water
o Diarrhea: Administer but does not  Invasive Stage  (X) on dirty water – no O2 – larva
count – repeat after 4 weeks – OPV 2 o Site of the bite  ID will not survive
o Continuous stimulation to produce  Itchy  Low-flying – bites on lower extremities
Day 0 0.1 mL on each site
antibodies  Painful (usual)
o Be careful with disposal of feces – virus  Numbness Day 3 0.1 mL on each site  With white stripes on the legs, gray
is excreted in the feces wings, lands parallel on the skin
o Contraindication: If with relatives who Day 7 0.1 mL on each site
o Flu-like symptoms
are immunocompromised – IPV  Sore throat Day 21 0.1 mL on each site  S/Sx:
 IPV (Salk)  Fever o Dengue Grade 1 or Dengue without warning sign
o 0.5 cc/ Intramuscular  Avoid drinking alcohol – interferes with  High grade fever for 3-5 days
 Headache
o Not sensitive to neomycin and antibody production  Pain
 Body malaise
streptomycin  Headache
o Avoid mode of transmission o Passive Immunization  Retroorbital
o Marked insomnia
 Proper disposal of oropharyngeal secretions  ERIg – Equine Rabies Immunoglobulin  Joint and bone
 Restless
 Covering of nose and mouth when o ARS (Anti rabies serum) 0.2 cc/ kg  Abdominal
 Irritable
coughing and sneezing BW * misdiagnosed for influenza
 Apprehensive
 Do not put anything in the mouth o Equirab  Nausea/vomiting
o Slight photosensitivity
 Petechiae/Herman’s sign (generalized
5. RABIES  HRIg – Human Rabies Immunoglobulin flushing/redness of the skin)
 Excitement Stage
 AKA: Hydrophobia, Lyssa, La Rage o Imogam 0.133 cc/ kg BW
o Aerophobia
o Rabuman 0.133 cc/ kg BW

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 Communicable Diseases Communicable Diseases
* Dengue fever only 7. MALARIA  Collect blood when patient is at the  Types:
* Aka Dandy fever, Break bone fever  AKA: peak of fever (microorganism in the o Paucibacillary
 CA: Plasmodium bloodstream) o Multibacillary
o Grade 2 or Dengue with warning signs o Vivax –most common
 With spontaneous bleeding  Falciparum – most common/most o Quantitative Buffy Coat (QBC)  S/Sx
o Epistaxis, gum bleeding fatal  Rapid Malarial Test o Early Manifestations
o Hematemesis, melena (GIT) o Ovale  No fever needed 1. Color changes on skin that does not
 Coffee ground (blood was acted o Malariae disappear even with treatment
upon by the digestive enzymes)  MOT: Mosquito bite (Female) – Anopheles Mosquito  Medical Mgt: 2. Skin lesions that does not heal even with
o Hematochezia (LGI) (Biological Mosquito) o Chloroquine (mainstay), Primaquine, Arabnine treatment
o Night Biting Mosquito o Fansidar, Quinine, Antemethen (1st choice) 3. Pain and redness of the eyes
o Grade 3 or Severe DHF o Breeding sites: clear, slow-flowing water  Quinine – 1st developed; parenteral; not 4. Muscle weakness and paralysis of the
 With signs of circulatory failure o Most common in: regularly used (for severe cases only)( extremities
o Cold, clammy skin  Palawan o Used cautiously in pregnant women – 5. Nasal obstruction and nose bleeding
o Cold extremities  Saranggani abortifacient 6. Area affected – loss of sensation
o Prolonged capillary refill  Davao o If not treated = neonatal malaria = severely  Loss of growth
 Cagayan Valley anemic = death  Anhydrosis
o Severe Shock Syndrome o Doesn’t give permanent immunity
 Anemic (RBC’s are destroyed as the microorganism o Late manifestations
 Dx Exam: reproduces)  Prevention: Eradicate Mosquito (4S) 1. Lagopthalmus – inability to close eyelids
o Rumpel Leede Test  Microorganism in the bloodstream = fever; several 2. Madarosis – loss of eyebrow, eyelashes
 Test for Capillary Fragility RBC’s destroyed INTEGUMENTARY SYSTEM 3. Sinking of the bridge of the nose (Saddle-nose
 Presumptive Test  Bacteria deformity)
 S/Sx: 3 Stages o Leprosy  Absorption of small bones
o Tourniquet test o Cold Stage (15mins.)  Virus  “Natural Amputation”
 BP = (S + D)/ 2 = ? mmHg  Chilling sensation (shaking of the body) o Measles 4. Contractures (clawing of fingers and toes)
 Amount of inflation  Keep patient warm (provide with blanket, o German measles 5. Chronic skin ulcers
 Obscure for Petechial Formation warm drinks, expose to droplight, hot o Chicken pox  Integumentary: may be infected
 Count how many in a square inch water bag as ordered on soles of feet o Herpes Zoster already but remains unnoticed due to
 (+) result = ≥ 20 patches in a square inch o Hot Stage (2-6 hours) patient’s loss of sensation
 High grade fever Macule – flat rashes 6. Gynecomastia (males)
Criteria for Tourniquet Test  Vomiting Papule – elevated rashes
1. Age = 6 mo. or older  Abdominal pain Vesicle – elevated rashes filled with fluid  Dx Test:
2. Fever more than 3 days Pustule – elevated rashes filled with pus o Skin Smear Test
3. No other signs of DHF Nursing Obj: Lower down temperature o Skin Lesion Biopsy
 TSB 1. LEPROSY o Lepromin Test
o Blood Tests  Cold compress over forehead  AKA: Hansen’s Disease; Hansenosis o Wassermann Reaction Test
 Plt count ↓  Light, loose clothing o Lepers – Hansenites
 Hct determination ↑  Provide fluids  CA: Mycobacterium Leprae (closely associated with M.  Medical Mgt: Multiple Drug Therapy
o X ↑OFI – aggravate tuberculosis) o Combination of Drugs to:
 Medical Mgt:  MOT: prolonged intimate skin-to-skin contact 1. Prevent drug resistance (esp. Dapsone –
o Symptomatic o Wet Stage  Research: droplet (highly concentrated in mainstay drug)
o Prevention of bleeding  Profuse sweating respiratory secretions 2. Hasten recovery
 Feeling of weakness
 Nursing Care  Cardinal Signs 3. Lessen period of communicability (1-2
o Prevention and control of bleeding Nursing Obj: make patient comfortable o Peripheral Nerve Enlargement weeks)
 Control of nose bleeding  Keep warm and dry o Lossof sensation o Reportable Side Effects:
o Avoid forceful blowing  Provide fluids to prevent dehydration o (+) skin smear test for M. leprae (discontinue treatment)
o Avoid nose picking  Rifampicin – hepatotoxicity s/sx
 Prevention of gum bleeding o Falciparum
Paucibacillary Multibacillary
o Last resort: soft-bristled toothbrush  Severe Anemia Types Paucibacillary Multibacillary
 Prevent GI Bleeding  Cerebral Hypoxia Tuberculoid Lepromatous
o Avoid irritating foods (spicy, hot, etc.) 1. Restlessness Leprosy Leprosy  Rifampicin – once/month  Rifampicin – once/month
o If with bleeding already – 2. Confusion Previously called - non-infectious - Infectious  Dapsone – OD  Dapsone – OD
 Ice compress on epigastric area 3. Delirium - benign -Malignant  Duration: 6-9 mos.  Lamphen – OD (SE:
 NPO 4. Convulsions hyperpigmentation of
 Comfort measures 5. Loss of Consciousness Severe skin)
 If not relieved, refer to MD 6. Coma Severity Mild Fatal without  Duration: 12-18 mos.
 Avoid dark-colored foods treatment
o Avoid red meat (for occult blood test) o Black Water Fever Leonine Face  Dapsone – generalized itchiness; dryness
Milder with skin and flaking of skin
o No salmon  Black urine/dark red urine (Lagopthalmus,
Unique S/Sx lesions, peripheral
o Increase Oral Fluid intake Madarosis, Saddle-
enlargment Microorganism dies → toxin → Leprae Reaction
o ↑ body resistance nose Deformity) o
o Supportive Care 1-5 patches >5 patches → do not discontinue treatment; go to health
Defined by WHO center
 Dx Exam: associated with associated with
as
 Prevention o Malarial Smear leprosy leprosy
o Eradicate mosquitos (4S)  Timing is IMPORTANT! Possibly – high o Leprae Reaction – manage symptomatically
Is the person concentration on  MILD
No
infectious? respiratory
secretions
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Communicable Diseases Communicable Diseases

 R – reddening in and around the o No diet restriction
nodule  Dx Exam: Clinical observation  Dx Exam: Same as measles o Permanent immunity
 E – edema  Med Mgt: Same as measles o Communicable: Until all the rashes dry
 S – sudden ↑ in the number of lesions  Med Mgt: Symptomatic  Nrsg Care: Same as measles o Not Communicable: all rashes are dry; not
 T – tenderness and pain on nerves o Antibiotics – to prevent secondary bacterial  Prevention: Same as measles necessarily fall or peel off
 SEVERE infection o Communicable during the entire course of the  Prevention:
 I – Iritis o Cause of death – pneumonia disease – includes incubation period o Immunization:
 S – sudden acute paralysis o Permanent immunity  Varivax
 A – acute uveitis  Nrsg Care: Supportive o Fatal – Pregnancy during the 1st to 2nd trimester o 12 to 18 months
o Avoid Draft (acquired or exposure) o 0.5 mL/ SC
 Nursing Mgt: o Adequate rest  Even exposure could cause defect o Deltoid
o Psychological Aspect of Care o Adequate nutrition  If exposed, needs gammaglobulin within 72 o  13 y/o – single dose
 ↓ self-esteem o Communicable hours o  13 y/o – 2 doses with 1 month interval
 Social stigma  4 days before and 5 days after  Congenital defects o May have rash or fever
o Skin Care appearance of rashes o Microcephaly o Same as measles
 Skin injury because of loss of sensation  Hightly communicable: BEFORE rashes o Congenital Heart Defect o Proper disposal of nasopharyngeal secretions
 Chronic skin ulcer appear o Congenital Cataract  Blindness o Covering of mouth and nose when coughing and
o Provide/encourage physical exercise  More respiratory secretions before = o Deafness and Mutism sneezing
o Provide drug information more/highly communicable before 5. HERPES ZOSTER
appearance of rashes  Dormant type/ Inactive type
* does not give permanent immunity o Gives permanent immunity 4. CHICKEN POX  Cannot have herpes zoster without chicken pox first
 Prevention:  AKA Varicella  Adults
 Prevention o Immunization  CA: Varicella-zoster virus  AKA Shingles, Zona, Acute Posterior Ganglionitis –
o Immunization (BCG)  AMV – 9 mos. o Nasopharyngeal secretions ganglion of the posterior nerve roots
o Avoid MOT (contact with patient with Leprosy) o 0.5 mL/ SC o Secretions of rashes  CA: Varicella-zoster virus
o PPE: Contact precaution; Droplet Precaution o Deltoid  Can cause disease if the virus entered  MOT: Direct (droplet)
o May have fever the nasopharynx  S/sx: Same as chicken pox
2. MEASLES (Rubeola) o May experience mild rash reaction –  MOT: Airborne o Vesiculo-pustular rashes
 AKA: Rubeola, Morbilli, Hard Measles, Little Red NORMAL  S/sx:  Painful – up to 2 months
Disease, 7 day measles, 9 day measles, 1st Disease  MMR – 12 to 15 months o Pre-eruptive Stage – 24 to 48 hours  Unilateral distribution – follows the nerve
 1st Measles o Same dosage, route, site and  Presence of absence of low grade fever pathway
2nd Scarlet Fever/Scarletina instructions  Headache, body malaise, muscle pain o Vertical
3rd German measles o Female of child bearing age – no  Appears in cluster
4th Duke’s Disease pregnancy within 3 months o Eruptive Stage  Dx Exam: Clinical observation
5th Erythema Infectiosum / Slapped cheek  Congenital defect  Vesiculo-papular/ pustular rashes  Med Mgt: Symptomatic
disease o Endemic – may be given as early as 6 o Macule  Papule  Vesicle   Nrsg Care: Supportive
6th Roseola Infantum, Exanthem Crotiam, months then revaccination at 15 Vesiculopapular o NO permanent immunity
Exanthem Subitum, Tigdas Hangin months o Common: Vesiculo-pustular  Prevention:
 CA: Paramyxovirus (Rubeola virus) o Proper disposal o Itchy – Pock Marks o Chicken pox and herpes zoster can appear
 MOT: Airborne (Respiratory Droplet)  Take a bath everyday simultaneously
 S/sx: 3. GERMAN MEASLES (Rubella) o Generalized distribution
o Pre-eruptive Stage  AKA: 3 day disease, Rubella, Roteln o Covered part of the body first –
 High grade fever (3 to 4 days)  CA: Pseudoparamyxovirus (Togavirus/Rubella virus) trunk and scalp RESPIRATORY SYSTEM
 3 C’s  MOT: Direct (droplet) o Abundantly found on the  Bacteria
o Cough  S/sx: covered parts o Diptheria
o Colds/ coryza o Pre-eruptive Stage o Unifocular appearance – one at o Pertussis
o Conjunctivitis  Presence or absence of fever (1 to 2 days) a time and never fuses together o Pneumonia
 Eyes are res, excessive lacrimal  Mild cough or mild colds o Different sizes o Tuberculosis
discharges  Hallmark sign : Forschheimer’s Spots  Virus
 Photosensitivity o Fine red spots/ Petechial spots o Post-eruptive Stage o Colds
 Koplick Spots o Soft palate  Rashes start to dry o Influenza
o Fine red spots with bluish or grayish white  Crusts (dry), falls off (peels off)
spot at the center o Eruptive Stage o DO NOT peel it off by yourself 1. DIPTHERIA
o Within the inner cheek  Maculo-papular rashes o Let it fall of by itself  Contagious disease
o Pinkish, discreet – smaller/finer rashes  Leave pock marks  All ages
o Eruptive Stage o Cephalocaudal – starts at the face  On the road to recovery  Generalized toxemia – causes systemic infection and
 Maculo-papular rashes o 24 hrs entire body signs and symptoms
o Reddish, blotchy  Enlargement of lymph nodes – differentiating  Dx Exam: Clinical Observation  CA: Corynebacterium Diphteriae (Klebs-Loeffler
o Cephalocaudal – 1st appears behind the factor between measles and German Bacillus)
ears, face, neck, extremities measles  Med Mgt: Symptomatic  MOT: Direct (droplet)
o Appears 3rd day of illness (2 to 3 days o Suboccipital o Acyclovir (Zovirax)  S/sx:
entire body) o Posterior auricular o Antipruritic Agents o Irritating nasal discharge – sero-sanguinous; foul
o Posterior cervical  Temporary relief of itchiness mousy odor
o Post-eruptive Stage o Permanent relief: take a bath daily o Sore throat
 Fine branny  Tepid water o Dysphagia
 Desquamation o Post-eruptive Stage o Neck edema – bullneck appearance
 If the spots start to peel off – on the road to  Rashes disappears (3rd day of illness)  Nrsg Care: Supportive o Hoarseness of voice, aphonia
recovery  Enlarged lymph node gradually subsides o Increase body resistance  Temporary, larynx is affected

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 Communicable Diseases Communicable Diseases
o Barking cough – dry metallic cough, dry husky  Shaking chills (rigor) o Tuberculin Test/ PPD Test (Purified Protein
cough o Paroxysmal/ Spasmodic  Productive cough Derivative)
o Pseudomembrane – grayish white membrane  5 – 10 successive forceful coughing,  Sputum production o Screening Test
(pathognomonic sign) which ends in a prolonged inspiratory o Rusty – Strepto o (+) result – exposure to TB
 Nasal septum phase or a whoop o Creamy Yellow – Staph o Consistently (+) – developed sensitivity to
 Larynx  Congested face o Greenish – Pseudomonas microorganism
 Soft palate  Congested tongue (purple) – pressure of o Currant Jelly – Klebsiella o Uses purified protein derivative
 Uvula teeth when coughing o Clear – No infection o Administered intradermally
 Pillars of the tonsils  Teary red eyes w/ eyeball protrusion  Pleuritic/ chest pain – friction between o Interpreted 48 to 72 hours
 Distended face and neck vein the pleural layers of the lungs o (+) result of tuberculin testing > 10 mm
 Dx Exam:  Involuntary micturition and defecation o Splint the chest wall induration
o Nose and throat swab – Definitive Test  Abdominal hernia o Apply chest binder o Immunocompromised > 5 mm
o Schick Test – Immunity/ susceptibility  Chokes on mucous/ vomiting o Turn to sides (affected side) induration
o Moloney Test – Hypersensitivity to diphtheria
antitoxin o Convalescent – No longer communicable o IMCI o Sputum Exam (AFB Stain)
 Signs and symptoms subsides  Fast breathing o Chest X-ray – extent of the disease
 Med Mgt:  On the road to recovery
o Antidiphteria serum (ADS) – neutralize toxin 1 wk to 2 mos. 60 bpm
o Antibiotic – Penicillin – kill the microorganism
2 mos. to 12 mos. 50 bpm
 Dx Exam:
 Nrsg Care: o Nasal swab – Catarrhal stage – plenty of nasal 12 mos. to 5 y/o 40 bpm
o Provide complete bed rest – prevent Myocarditis discharges  Chest indrawing
o Minimal PTB
 Some toxin goes to the heart muscles o Nasopharyngeal culture – Definitive test o Subcostal retraction – use of
o Moderate Advanced PTB
 Waits until the resistance of the heart is  Bordet-gengou accessory muscles
o Far Advanced PTB
decreased and invades  Agar plate  Stridor – harsh breath sound during
 Signs of Myocarditis  Cough plate INSPIRATION
o Marked facial pallor  Wheezing – high pitched sound during
 Med Mgt:
o Very irregular PR  Med Mgt: EXPIRATION
o Antitubercular agents – SCC – Short course
o  BP o Antibiotic
chemotherapy
o Chest pain/ epigastric pain  Erythromycin – drug of choice  Dx Exam:
o Rifampicin
o Maintain patent airway  Penicillin o Chest X-ray – Confirmatory test
o Hepatotoxic
 Independent: o Pertussis Immune globulin  Lung consolidation
o Avoid alcoholic beverages
o Proper positioning o Fluid and electrolyte replacement  Patchy infiltrates
o Monitor liver enzymes
o Increase oral fluid intake o Codeine with mild sedation o Sputum exam
o Remove contact lenses and replace with
o Chest physiotherapy  Specific cause
glasses
o Encourage deep breathing and  Nrsg Care:
o Turn to color orange
coughing exercises o Provide adequate rest – conserve energy and  Med Mgt:
o Isoniazid
o Turn to sides at least every 2 hours decrease O2 consumption o Antibiotic
o Hepatotoxic
 Dependent: o Maintain fluid and electrolyte balance o Inhalation therapy – nebulization
o Avoid alcoholic beverages
o Inhalation therapy o Maintain adequate nutrition with aspiration
o Monitor liver enzymes
o O2 precaution  Nrsg Care:
o Peripheral neuritis
o Nebulization  Feed upright o Maintain patent airway
o Vitamin B6 Pyridoxine
o Steam inhalation  NPO when child starts coughing o Provide adequate rest
o Pyrazinamide
o Suctioning  Bottle feeding – should have a small hole o Provide adequate nutrition
o Hyperuricemia – Gout/ Kidney Stone
o Postural drainage o Apply abdominal binders – prevent abdominal o Provide comfort measures
o Alkaline urine
o Provide adequate nutrition – soft hernia
 Increase OFI
o Provide comfort measures o NOT permanent immunity but second attack is  Prevention:
 Increase milk intake
o TEMPORARY IMMUNITY rare o Immunization
 Increase vegetable intake
o Proper disposal of nasopharyngeal secretions
o Ethambutol
 Prevention:  Prevention: o Covering of the nose and the mouth when
o Optic neuritis
o Immunization o Same as measles sneezing and coughing
o Irreversible
o Proper disposal of nasopharyngeal secretions
o Color blindness
o Covering of the nose and mouth when sneezing 3. PNEUMONIA 4. TUBERCULOSIS
o Difficulty differentiating red and
and coughing  Inflammation of the lung parenchyma  AKA: Koch’s Infection, Phthisis, Galloping
green
o Never kiss the patient  CA: Virus, Protozoa, Bacteria (common) Consumption, PTB
o Streptomycin
o PCP – Pneunocystis Carinii Pneumoniae  CA: Mycobacterium Tuberculosis Hominis (human)
o Nephrotoxicity
(protozoa) o Bovis – Bovine – Cattles
o Monitor I and O
2. PERTUSSIS –  6 y/o o CAP – Streptococcus (bacteria) o Avis – Avium – Birds
o Monitor creatinine level
 AKA: Whooping Cough, Chin Cough o HCAP – Staphylococcus, Gram (-) Bacteria  MOT: Airborne
o Ototoxicity
 CA: Bordetella Pertussis, Hemophilus o ICU - Pseudomonas, Klebsiella  S/sx:
o Monitor for signs of vertigo and
Pertussis o Inhalation of noxious substances o Low grade fever, night sweats
tinnitus
 MOT: Direct (droplet)  Aspiration pneumonia o Anorexia, weight loss, fatigability
 IP: 7-10 days  Lipid pneumonia – use of oil for cleaning o Body malaise, chest/ back pain
 S/sx: the nose or as lubricant o Productive cough, hemoptysis, dyspnea
o Catarrhal stage - highly communicable for 1  MOT: Direct (droplet) o Erosion of lung capillaries – NO CPT
 Nursing Care:
week  S/sx:
o Provide adequate rest
 colds, fever, nocturnal coughing o Cardinal Signs:  Dx Exam:
o Provide adequate nutrition – increase immunity
 tiredness and listlessness  Fever
o Encourage drug compliance

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Communicable Diseases Communicable Diseases

o DOTS – program to encourage drug o Maintain fluid and electrolyte balance  Catarrhal jaundice hepatitis  Tea-colored urine
compliance  Monitor I and O  Epidemic hepatitis  Acholic stool – clay-colored
 Assess for signs of DHN - # 1 sign within 24 hrs  CA: Hepatitis A Virus (RNA)  Some pre-icteric symptoms may persist but
 Prevention – weight loss  Feces and blood a lesser degree
o Same as pneumonia  Fluids per orem  MOT: fecal-oral
o BCG – at birth  Regulate IVF  At risk: Children and food handlers
o 0.05/ ID o Provide adequate nutrition  IP: 2 to 6 weeks Bilirubin
o Deltoid  Small but frequent feeding (unconjugated)
o Abscess formation  heal  scar (within 2  Pedia – NPO 4 to 8 hrs – rest the GI tract o Hepatitis B – Serum Hepatitis
to 3 months)  Clear liquid diet  soft diet  DFA  Homologous Hepatitis
o Indolent Abscess – Koch’s o Provide comfort measures  Viral Hepatitis – most fatal
Phenomenon  Prevention: TEMPORARY IMMUNITY  Blood, sputum and other body fluids
 Wrong technique by the nurse o Immunization – CDT – Cholera, Dysentery, Typhoid  MOT:
Bloodstream Kidneys - 2x
o Child had exposure to a patient with o Avoid the 5 Fs  Parenteral – BT, sharps and needles
active TB – usually asymptomatic  Feces – proper disposal o At risk: Blood recipients, drug
o Bring back child to health center – I &  Fingers – hand washing addicts
D  Food – preparation, handling, storage  Oral – oral
Liver Urine
o Give prophylaxis – INH  Flies – environmental sanitation o Kissing
 Effect:  Fomites – Avoid putting anything to our o 6 to 8 gallons
o Children - 6 mos to 8 mos mouths – ballpen  Sexual contact
 Immunocompromised – 12 mos o Seminal and cervical fluids
o No booster 2. LEPTOSPIROSIS  Vertical Un/conj
 AKA: Mud Fever, Canicola Fever, Swamp Fever, o Mother and child
GASTROINTESTINAL TRACT Pre-tibial Fever, Ictero-hemorrhagica o Childbirth
 Bacteria Disease, Weil’s Disease, Swineherd’s Disease  IP: 6 wks to 6 months
o Typhoid  CA: Leptospira (Spirochete)
o Leptospirosis  Source: Rats o Hepatitis C Intestines
o Bacillary  MOT: Skin penetration  Post Transfusion Hepatitis
o Cholera  IP: 2 days to 4 weeks  CA: Hepatitis C virus
 Protozoa – Amebiasis  Affects striated muscles, Liver, Kidneys  MOT: Parenteral
 Virus – Hepatitis o Cause of death: Kidney failure  IP: 5 to 12 wks
 Helminths – Parasitism  At risk: Paramedical team, drug addicts, BT Stools
 S/sx: recipients
o Fever, headache, vomiting
1. TYPHOID FEVER o Muscle tenderness, pain (calf) o Hepatitis D
 CA: Salmonella typhosa  Patient does not stand up or walk  Dormant type of Hepatitis B
 MOT: Fecal-oral o Jaundice with hemorrhage  CA: Hepatitis D / Delta virus Acholic
o 5 Fs o Orange eyes/ skin  Delta virus cannot multiply by itself – needs
 Food o Oliguria/ Anuria – Kidney failure the help of the B virus
 Fingers  MOT: Same as hepatitis B
 Flies  Dx Exam:  IP: 3 to 13 wks o Post-icteric
 Feces o Microscopic Agglutination Test (MAT)  Jaundice disappears
 Fomites  Med Mgt: o Hepatitis E  Signs and symptoms subsides
 Target organ: Peyer's patches o Antibiotic – Doxycycline  CA: Hepatitis E virus  Energy level increases
 Prophylaxis - 200 mg twice a day for 3 days  Source: Feces  Avoid alcoholic beverages and OTC drugs
 S/sx:  Nrsg Care:  MOT: Same as hepatitis A for at least 1 year
o Fever, dull headache, abdominal pain o Supportive  IP: 3 to 6 wks o Liver recovers
o Vomiting, diarrhea/ constipation o UO – consistency, frequency and amount
o Clinical features:  Refer if with changes o Hepatitis G  Dx Exam:
 Ladderlike fever  CA: Hepatitis G virus o Liver Enzyme Test
 Rose spots – Abdomen  Prevention: TEMPORARY IMMUNITY  MOT: Same as hepatitis C  ALT Alanine Aminotransferase
 Spleenomegaly o Eradicate the source of infection (rats)  IP: Unknown o 1st to shoot up if liver problem is
 Dx Exam: o Use of protective barrier when walking in flood present even if asymptomatic
o Blood culture  S/sx:  AST Aspartate Aminotransferase
o Widal Test – Antigen left by the microorganism 3. DYSENTERY o Pre-incteric o Increases upon onset of jaundice
 AgO – Somatic – Presently infected * see table  Fever, RUQ pain o Not reliable
 AgH – Flagellar – Exposed/ Had an  Fatigability, weight loss, body malaise  ALP Alkaline Phosphatase
immunization 4. HEPATITIS o inability to convert glucose to o Obstructive jaundice
o Thyphidot – Antibody  Inflammation of the liver glycogen – source of energy  GGR Gamma Glutanyl Transferase
 IgM – presently infected  Causes:  Anorexia, nausea and vomiting – o Toxic Hepatitis due to toxic substances
 IgG – some form of immunity/ recovering o Alcoholism deamination of CHON (e.g. alcohol, drugs, substances)
o Drug intoxication  Anemia -  lifespan RBC (60 to 120 days)  LDH Lactic Dehydrogenase
 Med Mgt: o Chemical intoxication – Arsenic o Bilirubin – end product of RBC o Increase = Liver Damage
o Antibiotic o Microorganism destruction - accumulates – jaundice o Serum Antigen Antibody Test
 Chloramphenicol – drug of choice
o Fluid and electrolyte replacement  Viral Hepatitis o Icteric  Med Mgt: Symptomatic
o Hepatitis A  Jaundice, pruritus - accumulation of bile o Hepatic Protection (Liver aid) - ↓ effort of
 Nrsg Care:  Infectious hepatitis salts on the skin metabolism, allow liver to relax

University of Santo Tomas – College of Nursing / JSV University of Santo Tomas – College of Nursing / JSV
 Communicable Diseases Communicable Diseases
 Essentiale, Sillymarin, Jettipar (pedia)  GA: Neisseria Gonorrhea o Opthalmia Neonatorum (effect to child)
o Antiviral – Lamivudine OD for 1 year Taeniasus  MOT: Sexual Contact  Crede’s Prophylaxis
o Immune Stimulant – Chronic Hepatitis B, C, D  AKA Tapeworm  IP: 3 to 21 days
 IM  Taenia Saginata  S/sx: 2. SYPHILIS
 Interferon o Ingestion of insufficiently cooked or raw beef o Male – obvious signs because same opening for  AKA Pox, Lues, Bad Blood Disease
 2-3x/wk. for 6mos.  Taenia Solium reproduction and urination  CA: Treponema Pallidum – crosses placental
o Rest and Nutrition o Pork  Urethritis, dysuria barrier – 2nd to 3rd trimester
 Diphyllobothrium Latum  Redness and edema of urinary meatus  MOT: Sexual contact, blood transfusion (rare)
 Nrsg Care: o Fish  Purulent urethral discharge  IP: 10 – 90 days
o Rest – liver recovery  Hymenolepsis Nana  Frequent gonorrhea - scar in the
o Nutrition o Dwarf tapeworm epididymis – obstruct flow of sperm cell -  S/sx:
  Fats – no enough bile released by the liver o Person to person sterility o Primary
for emulsification of fats; increases tendency o Hand to mouth transmission o Female – shows symptoms if they have PID;  Chancre
for bleeding  Get it as a whole – regenerate urethra is not usually affected o Painless moist ulcer that heals
  CHO every now and then – spare CHON  Urethral discharge spontaneously w/ or w/o treatment
metabolism – ammonia – encephalopathy Paragonimiasis  Frequent gonorrhea - Narrowing of the o Genitals or extragenitally (face, fingers,
 Butterball diet – hard candy (source of  Flatworm, Oriental lung fluke fallopian tube – ectopic pregnancy/ tongue, anal, lips)
energy)  CA: Paragonimus westermani sterility  Regional lymphadenopathy
o Infected Moderate CHON  Source: ingestion of insufficiently cooked crab or o Gonococcal septicemia o Secondary/ Infectious
o Recovery Period High CHON crayfish  Tender papillary skin lesion (pustular,  Highly communicable
o Complications Low CHON  S/sx: productive cough and hemoptysis hemorrhagic or necrotic)  Flu-like symptoms
 Prevention: o Misdiagnosed as TB  Migratory polyarthralgia, polyarthritis,  Fever, headache, body malaise, sore throat
o Immunization tenosynovitis  Skin rashes, condyloma lata/ condylomata
 Hepatitis B vaccine Parasitism through skin of the feet  Dx Exam: lata
o 0.1 mL o Culture and sensitivity o Lesions fused together found under the
o 3 doses Ancylostomiasis  Urethral discharge breast or genitalia
o IM – Vastus Lateralis  Hookworm o Swab/scrape directly on the  Oral mucous patches
o 2 kg: 0-6-14  Only blood-sucking worm anterior urethra  Patchy alopecia
o <2 kg (4 doses): 0-6-10-14  Loss of 50 mL of blood/ day o Cervical smear/ Pap smear  Thinning of pubic hair
o No special instructions  Ancylostoma Duodenale  Generalized lymphadenopathy
o Side effects:  Necatur Americanus  Med Mgt: o Latent Phase
 soreness at injection site o Antibiotic  Asymptomatic (1 to 2 yrs)
 slight increase in ALT Stongyloidiasis  Penicillin – Benzathine Penicillin G  May still spread infection
o Avoid mode of transmission  Threadworm o IM use only o Tertiaty/ Late Stage
 Strongyloide Stercoralis o Large muscle – preferably on the  Gumma – infiltrating tumor (skin, bone, liver)
Parasitism through Ingestion buttocks  Not communicable
Enterobiasis S/sx: o Big gauge needle – Gauge 19  CV changes – aortitis, aneurysms
 AKA Pinworm infection, Seatworm, Oxyuriasis  Voracious appetite o Only penicillin that is NOT given per  CNS degeneration – paresthesia, abnormal
 CA: Enterobius Vermicularis  Weakness, pot belly, anemia IV – death – readily coagulates – reflexes, shooting pains, dementia, psychosis
 MOT: Ingestion  Stunted growth embolus  Dx Exam:
 S/sx: o Given to patients with gonorrhea o Darkfield microscope
o Nocturnal ani – night itchiness Dx: Stool exam and RHD o Serologic test
 Female worm goes out of the intestinal  Cephalosporin – Ceftriaxone, Cefuroxime  FTA-ABS (Flourescent Treponema Antibody
 Well-fitted underwear Med Mgt: Absorption Test) – DEFINITIVE
 Dx Exam:  Antihelminthic – Albendazole o If Gonorrhea does not heal – (+) Chlamydial  VDRL (Venereal Disease Research Laboratory)
o Not diagnosed with stool exam Infection – clear discharge  RPR (Rapid Plasma Reagin)
o Cellophane tape test Nursing Care: Supportive  Tetracycline – Doxycycline  Med Mgt: Antibiotic
 Morning  Nrsg Care: Same as gonorrhea
Prevention:  Nursing Care:  Prevention: Same as gonorrhea
Ascariasis  Personal hygiene o Psychological aspect of care  Pregnancy – fetal death or congenital anomaly
 AKA Giant intestinal roundworms  Cutting long nails o Health education – prevent recurrence and
 CA: Ascaris Lumbricoides  Wearing slippers spread of infection 3. HIV IINFECTION / AIDS
 MOT: Ingestion  Taking a bath  HIV is the early stage of AIDS
 S/sx: Intestinal obstruction  Proper preparation of food  Prevention:  CA: Human Immunodeficiency Virus (Retrovirus)
o Passing out or vomiting of worms o Safe sex practices  Fragile – easily destroyed by:
GENITO-URINARY SYSTEM  No sex o Alcohol 70%
Trichuriasis  Bacterial  Long term mutually monogamous o Chlorine
 AKA Whipworm o Gonorrhea relationship o 56 C
 CA Trichuris Trichiuria o Syphillis  Mutual masturbation without direct o Na Hypochloride – 1: 10 parts of water
 MOT: Ingestion  Virus contact  Survive outside of the body
o HIV o Holding part but no sexual contact o With body fluids – 4 hours
Trichinosis o Education and Counseling o With blood – 12 hours
 Roundworm o Behavior modification  Dead patient – cremated or sealed metal coffin
 Trichiniasis  Stick to one partner o Buried within 24 hrs – not embalmed
 Trichinellosis 1. GONORRHEA o Use of condom – PREVENTIVE measure only, NOT
 CA: Trichinella Spiralis – Helminth  AKA Clap, Strain, Jack, G.C., Gleet, Morning drop, part of safe sex practice  MOT:
 MOT: Ingestion “Tulo”
 Source: Insufficiently cooked or raw meat o Pus draining from the genitalia in the morning  Chlamydial infection Single exposure

University of Santo Tomas – College of Nursing / JSV University of Santo Tomas – College of Nursing / JSV

Communicable Diseases Community Health Nursing

 Children – 2 major, 2 minor
Blood transfusion 90% DYSENTERY
o Opportunistic Infections
Sexual contact 0.1 to 1%  MAC
Exposure to infected blood  CMV Bacillary Violent Amebic
0.1 to 0.5%
products or tissue  PCP Shigellosis Bloody Flux Cholera Eltor Amebiasis
Synonym
Perinatal transmission 30% (without treatment)  CA – Kaposi’s Sarcoma
(Pregnancy) 5% (with treatment) Shigella Vibrio Cholerae Entamoeba Histolytica
o Malignancy of blood vessel wall
 Shiga  Comma
Sharing needles or syringes 0.1 to 5% o Manifested in the skin o Flexneri o Ogawa 2 stages:
 Leopard Look - pink or purple o Boydii o Inaba  Inactive – cyst - harmless
painless pus on the skin Causative Agent o Bonnet o El Tor  Active – trophozoides – becomes active when
 Dx Exam: passes the intestines
Cell Mediated Immunity Humoral Immunity o ELISA Test – Enzyme Linked Immuno Sorbent Assay –
Screening
o Western Blot
Mode of Fecal-oral
 T cells  B cells  Prerequisite: 2 positive ELISA test Transmission
o Synthesis of o Produces  Definitive Mucoid stool Rice watery stool one after the Mucopurulent blood streaked stool with foul smell
secretions of antibodies o HIV Viral Load Blood streak if severe other  Dissolved intestinal tissue
leukotrienes o Stimulated by  Monitors replicating activity of the virus  Vibriolytic substances   Stool has pus
o Backbone of Helper T cells  Low value – T cell count is maintained peristalsis  s/sx
immune system  Monitored in an HIV woman who wants to  Rapid DHN
Signs and
 Killer T cells be pregnant  Washerwoman’s hand
Symptoms
o Dry, wrinkled
o Cytotoxic o CD4 cell count
 Waten bed
o Traces down and kills  1200 cells o Hole and pail for the
infected human cells  Monitors stage of infection stool
 Helper T cells  > or = 200 – HIV infection
o Stimulates B cells  < 200 – AIDS – may develop opportunistic Stool Examination Stool Examination Stool Examination
 Suppresor T cells infections Rectal Swab Rectal Swab Rectal Swab
Time-keeper Diagnostic Exams  Fresh – w/in 30 mins
o o Newborn/ Pedia
 Trophozoides  cyst
o Infection is under  Blood Culture for HIV
control  Immune-complex-dissociated p24 assay
o Tells immune system o Check for antigen Antibiotic (Ciprofloxacin) Antibiotic (Tetracycline) Antibiotic (Metronidazole)
Oral rehydration Therapy IV Therapy *Chloroquine – antiprotozoal
to relax Medical Oral rehydration Therapy
 Med Mgt: Does not kill virus, only prevents viral Management
multiplication
 MO  detected macrophage  alert T cells  o ARV Drugs Nursing Care Same as typhoid
stimulate B cells  antibodies  MO  Cocktail Drugs – 21 tablets/ day Prevention Same as typhoid
 HIV  reverse transcriptase  becomes T cells (allow o Neucloside reverse transcriptase inhibitor (NRTI)
virus to multiply)  damaged T cell  Virus will leave  Blocks or terminates viral multiplication
the T cell  virus will retrovert  AZT (Azidothymidine), zidovudine, retrovir
 Macrophages does not easily detect virus – symptoms  Agranulocytosis
not seen easily  CBC every 2 weeks
o Non-nucleoside reverse transcriptase inhibitor
 S/sx: (NNRTI)
o AIDS Related Complex Symptoms  Blocks DNA activity of virus
 Fever w/ night sweats w/o a cause  Nevirapine (Viramune)
 Enlarged lymph nodes w/o a cause o Protease Inhibitor (PI)
 Fatigability, weight loss, body malaise  Prevents and inhibits viral maturation
 Altered sleeping patterns  Saquinavir (Invirase), Indinavir (Crixivan),
 Temporary memory loss Ritonavir (Novir)
 Altered gait o Fusion inhibitor
 Prevents fusion of the virus to human cell
o AIDS Defining Disease
 Major signs  Nrsg Care:
o Persistent fever 1 month and above o Promote knowledge and understanding
o Chronic diarrhea 1 month and above o Promote quality of life – unpredictable
o 10 % weight loss (stunted growth) o Provide self-care and comfort
 Minor signs
o Persistent cough 1 month and above  Prevention:
o Persistent generalized o Same with other STIs
lymphadenopathy
o Generalized pruritic dermatitis
o Oropharyngeal candidiasis
o Recurrent herpes zoster
o Progressive disseminated herpes
simplex

 Adults – 2 major, 1 minor

University of Santo Tomas – College of Nursing / JSV

University Of Santo Tomas – College Of Nursing Page 20
5 Communicable Disease Nursing 6 Communicable Disease Nursing

I. EPI DISEASES NATIONAL TB CONTROL PROGRAM: s

MANAGEMENT OF CHILDREN WITH TUBERCULOSIS - for TB symptomatic children
Vision: A country where TB is no longer a public health problem *a TB symptomatic child with either known or
MODE OF Mission: Ensure that TB DOTS Services are available, accessible, and
DISEASE CAUSATIVE AGENT PATHOGNOMONIC SIGN MANAGEMENT/TREATMENT PREVENTION Prevention: BCG immunization to all infants (EPI) unknown exposure to a TB case shall be referred
TRANSMISSION affordable to the communities in collaboration with LGUs and others
1. Tuberculosis Mycobacterium tuberculosis Airborne-droplet 1. Usually asymptomatic Diagnostic test: Respiratory precautions for tuberculin testing
Goal: To reduce prevalence and mortality from TB by half by the year 2015
2. Low-grade afternoon fever Sputum examination or the Acid-fast bacilli (AFB) / Cover the mouth and nose Casefinding: * (+) contact but (-) tuberculin test and unknown
Other names: TB bacillus Direct invasion through 3. Night sweating (Millennium Development Goal)
sputum microscopy when sneezing to avoid Targets: 1. Cure at least 85% of the sputum smear (+) patients discovered - cases of TB in children are reported and identified in 2 contact but (+) tuberculin test shall be referred for
Koch’s Disease Koch’s bacillus mucous membranes and 4. Loss of appetite
1. Confirmatory test mode of transmission 2. Detect at least 70% new sputum smear (+) TB cases instances: (a) patient was screened and was found symptomatic CXR examination
Consumption Mycobacterium bovis breaks in the skin (very 5. Weight loss
Phthisis rare) 6. Easy fatigability – due to 2. Early morning sputum about 3-5 cc Give BCG Objectives: 1. Improve access to and quality of services of TB after consultaion (b) patient was reported to have been *(-) CXR, repeat tuberculin test after 3 months
Weak lungs (rod-shaped) increased oxygen demand 3. Maintain NPO before collecting sputum Improve social conditions 2. Enhance stakeholder’s health-seeking behavior exposed to an adult TB patient * INH chemoprophylaxis for three months shall be
Incubation period : 7. Temporary amenorrhea 4. Give oral care after the procedure 3. Increase and sustain support for TB control activities - ALL TB symptomatic children 0-9 y.o, EXCEPT sputum given to children less than 5y.o. with (-) CXR; after
4 – 6 weeks 8. Productive dry cough 5. Label and immediately send to laboratory 4. Strengthen management of TB control activities at all levels positive child shall be subjected to Tuberculin testing (Note: which tuberculin test shall be repeated
Most hazardous period for development of clinical 9. Hemoptysis 6. If unknown when was the sputum collected, Only a trained PHN or main health center midwife shall do
KEY POLICIES:
disease is the first 6-12 months after infection discard *Case finding: tuberculin testing and reading which shall be conducted once a Treatment (Child with TB):
Highest risk of developing disease is children under Chest X-ray is used to: - DSSM shall be the primary diagnostic tool in NTP case finding week either on a Monday or Tuesday. Ten children shall be Short course regimen
3years old 1. Determine the clinical activity of TB, whether it is - No TB Dx shall be made based on CXR results alone gathered for testing to avoid wastage. PULMONARY TB
inactive (in control) or active (ongoing) - All TB symptomatic shall be asked to undergo DSSM before treatment
TREATMENT: SCC/Short Course Chemotherapy, Direct –observed treatment short course/DOTS; 2. To determine the size of the lesion:
Intensive: 3 anti-TB drugs (R.I.P.) for 2 months
- Only contraindication for sputum collection is hemoptysis - Criteria to be TB symptomatic (any three of the following:) Continuation: 2 anti-TB drugs (R&I) for 4 months
Rifampicin (R), Isoniazid (H), Pyrazinamide (Z), Ethambutol (E), Streptomycin (S) a. Minimal – very small - PTB symptomatic shall be asked to undergo other tests (CXR and culture), * cough/wheezing of 2 weeks or more
b. Moderately advance – lesion is < 4 cm only after three sputum specimens yield negative results in DSSM
CATEGORY 1: 6 CATEGORY 2: 8 CATEGORY 3: 6 SIDE EFFECTS: * unexplained fever of 2 weeks or more EXTRA-PULMONARY TB
c. Far advance – lesion is > 4 cm - Only trained med techs / microscopists shall perform DSSM
months SCC months SCC months SCC Rifampicin * loss of appetite/loss of weight/failure to gain weight/weight Intensive: 4 anti-TB drugs (RIP&E/S) for 2 months
Tuberculin Test – purpose is to determine the history SIDE EFFECTS: - Passive case finding shall be implemented in all health stations
Indications: Indications: Indications: body fluid of exposure to tuberculosis
faltering Continuation: 2 anti-TB drugs (R&I) for 10 months
discoloration Ethambutol * failure to respond to 2 weeks of appropriate antibiotic therapy
> new (+) smear > treatment failure > new (-) smear PTB Other names: *Treatment: Domiciliary treatment – preferred mode of care
hepatotoxic Optic neuritis for lower respiratory tract infection
> (-) smear PTB with > relapse with minimal lesions Mantoux Test – used for single screening, result DSSM – basis for treatment of all TB cases
> return after default permanent interpreted after 72 hours
Blurring of vision * failure to regain previous state of health 2 weeks after a viral
extensive on CXR *Hospitalization is recommended: massive hemoptysis, pleural effusion,
discoloration of Tine test – used for mass screening read after 48 hours (Not to be givento infection or exanthem (e.g. measles)
parenchymal lesions Same meds with military TB, TB meningitis, TB pneumonia, & surgery is needed or with
Intensive Phase:3 mos contact lenses Interpretation: children below 5 y.o. due
on CXR Category 1 complications
R&I 1 tab each; P&E 2 0 - 4 mm induration – not significant to inability to complain -Conditions confirming TB diagnosis (any 3 of the following:)
> Extrapulmonary TB Intensive Phase: 2 *All patients undergoing treatment shall be supervised
tabs each Isoniazid 5 mm or more – significant in individuals who are blurring of vision) * (+) history of exposure to an adult/adolescent TB case
*National & LGUs shall ensure provision of drugs to all smear (+) TB cases
> severe concominant Streptomycin – 1 months Peripheral considered at risk; positive for patients who are HIV- Inability to recognize *Quality of fixed-dose combination (FDC) must be ensured * (+) signs and symptoms suggestive of TB
HIV disease vial/day IM for first 2 R&I 1 tab each; P&E neuropathy positive or have HIV risk factors and are of unknown * (+) tuberculin test
green from blue *Treatment shall be based on recommended category of treatment regimen
Intensive Phase: 2 months = 56 vials (if 2 tabs each (Give Vit HIV status, those who are close contacts with an active * abnormal CXR suggestive of TB
Streptomycin
months given for > 2mos can Continuation Phase: B6/Pyridoxine) case, and those who have chest x-ray results consistent DOTS Strategy – internationally-recommended TB control strategy * Lab findings suggestive or indicative of TB
Damage to 8th CN
R&I : 1 tab each; P&E cause nephrotoxicity 4 months with tuberculosis. Five Elements of DOTS: (RUSAS)
2 tabs each R&I 1 tab each Pyrazinamide 10 mm or greater – significant in individuals who Ototoxic
Recording & reporting system enabling outcome assessment of all patients - for children with exposure to TB
Continuation Phase: 5 hyperuricemia /gouty have normal or mildly impaired immunity Tinnitus
Continuation Phase: Uninterrupted supply of quality-assured drugs * a child w/ exposure to a TB registered adult patient shall
months CATEGORY 4: arthritis (increase fluid nephrotoxic Standardized SCC for all TB cases
4 months undergo physical exam and tuberculin testing
R&I : 1 tab each Chronic (*Referral intake) Access to quality-assured sputum microscopy
R&I : 1 tab each * a child with productive cough shall be referred for sputum
E : 2 tabs needed) Sustained political commitment exam, for (+) sputum smear child, start treatment immediately
* TB asymptomatic but (+) tuberculin test and TB symptomatic
but (-) tuberculin test shall be referred for CXR examination

7 Communicable Disease Nursing 8 Communicable Disease Nursing

2. Diphtheria Corynebacterium diphtheria Droplet especially Pseudomembrane – mycelia of Diagnostic test: DPT immunization 6. Measles RNA containing paramyxovirus Droplet secretions from 1. Koplik’s spots – No specific diagnostic test Measles vaccine
secretions from mucous the oral mucosa causing Pasteurization of milk nose and throat whitish/bluish pinpoint patches Disinfection of soiled articles
Types: Klebbs-loffler membranes of the nose formation of white membrane on Nose/throat swab Education of parents Other names: on the buccal cavity Management: Isolation of cased from diagnosis
> nasal and nasopharynx and the oropharynx Moloney’s test – a test for hypersensitivity to diphtheria Morbilli Incubation period: 10 2. cephalocaudal appearance of Supportive and symptomatic until about 5-7 days after onset of
> pharyngeal – most from skin and other toxin Rubeola days – fever maculopapular rashes rash
common lesions Bull neck Schick’s test – determines susceptibility to bacteria 14 days – rashes appear 3. Stimson’s line – bilateral red
> laryngeal – most Dysphagia line on the lower conjunctiva
fatal due to proximity Milk has served as a Dyspnea Drug-of-Choice: Period of
to epiglottis vehicle Erythromycin 20,000 - 100,000 units IM once only Communicability:
4 days before and 5 days
Incubation Period: Complication: MYOCARDITIS (Encourage bed rest) after the appearance of
2 – 5 days rash
3. Pertussis Bordetella pertussis Droplet especially from Catarrhal period: 7 days Diagnostic: DPT immunization
Hemophilus pertussis laryngeal and bronchial paroxysmal cough followed by Booster: 2 years and 4-5 years
Whooping cough Bordet-gengou bacillus secretions continuous nonstop Bordet-gengou agar test Patient should be segregated until
Tusperina Pertussis bacillus accompanied by vomiting after 3 weeks from the
No day cough Incubation Period: 7 – Management: appearance of paroxysmal cough 7. Hepatitis B Hepatitis B virus Blood and body fluids 1. Right-sided Abdominal pain Diagnostic test: -Hepatitis B immunization
10 days but not Complication: abdominal hernia 1. DOC: Erythromycin or Penicillin 20,000 - 100,000 units Placenta 2. Jaundice -Wear protected clothing
exceeding 21 days 2. Complete bed rest Other names: 3. Yellow-colored sclera Hepatitis B surface agglutination (HBSAg) test -Hand washing
3. Avoid pollutants Serum Hepatitis Incubation period: 4. Anorexia -Observe safe-sex
(because if more than 21 4. Abdominal binder to prevent abdominal hernia 45 – 100 days 5. Nausea and vomiting Management: -Sterilize instruments used in
days, the cough can be 6. Joint and Muscle pain > Hepatitis B Immunoglobulin minor surgical-dental procedures
Incidence: highest under 7 years of age related to TB or lung 7. Steatorrhea -Screening of blood products for
Mortality: highest among infants (<6 months) cancer) 8. Dark-colored urine Diet: high in carbohydrates transfusion
4. Tetanus Clostridium tetani – anaerobic Indirect contact – Risus sardonicus (Latin: “devil No specific test, only a history of punctured wound DPT immunization 9. Low grade fever
One attack confers definite and prolonged
spore-forming heat-resistant and inanimate objects, soil, smile”) – facial spasm; sardonic Hepatitis A – infectious hepatitis; oral-fecal
immunity.
Other names:Second attack
livesoccasionally occurs
in soil or intestine street dust, animal and grin Treatment: Tetanus toxoid immunization Hepatitis B – serum hepatitis; blood and body fluids
Lock jaw human feces, punctured Antitoxin among pregnant women Hepatitis C – non-A non-B, post-transfusion hepatitis; blood and body fluids
wound Opisthotonus – arching of back antitetanus serum (ATS) Hepatitis D – Delta hepatitis or dormant hepatitis; blood and body fluids; needs past history of infection to Hepatitis B
Neonate: umbilical cord tetanus immunoglobulin (TIG) Licensing of midwives Hepatitis E – oral-fecal
Children: dental caries For newborn: Pen G
Adult: punctured wound; after 1. Difficulty of sucking Diazepam – for muscle spasms Health education of mothers II. DISEASES TRANSMITTED THROUGH FOOD AND WATER
septic abortion Incubation Period: 2. Excessive crying
Varies from 3 days to 1 3. Stiffness of jaw Note: The nurse can give fluid provided that the patient is able MODE OF
month, falling between 7 4. Body malaise to swallow. There is risk of aspiration. Check first for the gag DISEASE CAUSATIVE AGENT PATHOGNOMONIC SIGN MANAGEMENT/TREATMENT PREVENTION
TRANSMISSION
– 14 days reflex 1. Cholera Vibrio cholera Fecal-oral route Rice watery stool Diagnostic Test: Proper handwashing
5. Poliomyelitis Legio debilitans Fecal – oral route Paralysis Diagnostic test: OPV vaccination Vibrio coma Stool culture Proper food and water sanitation
Polio virus Muscular weakness Frequent hand washing Other names: Ogawa and Inaba bacteria 5 Fs Period of Communicability: Immunization of Chole-vac
Other name: Enterovirus Incubation period: 7 – Uncoordinated body movement CSF analysis / lumbar tap El tor 7-14 days after onset, Treatment:
Infantile paralysis 21 days Hoyne’s sign – head lag after 4 Pandy’s test Incubation Period: occasionally 2-3 months Oral rehydration solution (ORESOL)
Attacks the anterior horn of the months Few hours to 5 days; IVF
neuron, motor is affected Management: usually 3 days Drug-of-Choice: tetracycline (use straw; can cause staining of
Man is the only reservoir (!Safety) Rehabilitation involves ROM exercises teeth)
2. Amoebic Dysentery Entamoeba histolytica Fecal-oral route Abdominal cramping Treatment: Proper handwashing
Bloody mucoid stool Proper food and water sanitation
Protozoan (slipper-shaped body) Tenesmus - feeling of Metronidazole (Flagyl)
incomplete defecation * Avoid alcohol because of its Antabuse effect can cause
9 Communicable Disease Nursing 10 Communicable Disease Nursing

(Wikipedia) vomiting III. SEXUALLY TRANSMITTED DISEASES

3. Shigellosis Shigella bacillus Fecal-oral route
Other names: Sh-dysenterae – most infectious 5 Fs: Finger, Foods,
Bacillary dysentery Sh-flesneri – common in the Feces, Flies, Fomites
Philippines
Sh-connei Incubation Period:
Sh-boydii 1 day, usually less than 4
days
4. Typhoid fever Salmonella typhosa (plural, Fecal-oral route
typhi)
5 Fs
Incubation Period:
Usual range 1 to 3
weeks, average 2 weeks
5. Hepatitis A Hepatitis A Virus Fecal-oral route
Other names: 5 Fs
Infectious Hepatitis /
Epidemic Hepatitis / Incubation Period:
Catarrhal Jaundice 15-50 days, depending
on dose, average 20-30
days
6. Paralytic Shellfish Dinoflagellates Ingestion of raw of
Poisoning (PSP I Red inadequately cooked
tide poisoning) Phytoplankton seafood usually bivalve
mollusks during red tide
season
Incubation Period:
30 minutes to several
hours after ingestion
MODE OF
Abdominal cramping Drug-of-Choice: Co-trimoxazole Proper handwashing DISEASE CAUSATIVE AGENT PATHOGNOMONIC SIGN MANAGEMENT/TREATMENT PREVENTION
TRANSMISSION
Bloody mucoid stool Proper food and water sanitation 1. Syphilis Treponema pallidum Direct contact Primary stage: painless chancre Diagnostic test: Abstinence
Tenesmus - feeling of Diet: Low fiber, plenty of fluids, easily digestible foods Fly control (a spirochete) Transplacental at site of entry Dark field illumination test Be faithful
incomplete defecation Other names: Buboes Fluorescent treponemal antibody absorption test – most Condom
(Wikipedia) Sy Incubation Period: Condylomata reliable and sensitive diagnostic test for Syphilis
Bad Blood 10 days to 3 months Gumma VDRL slide test, CSF analysis, Kalm test,
The pox (average of 21 days) Wasseman test
Lues venereal
Rose Spots in the abdomen – Diagnostic Test: Proper handwashing Morbus gallicus Treatment:
due to bleeding caused by Typhi dot – confirmatory test; specimen is feces Proper food and water sanitation Primary and secondary sores will go even without treatment but the germs continue
Drug of Choice: Penicillin (Tetracycline if resistant to
perforation of the Peyer’s Widal’s test – agglutination of the patient’s serum to spread throughout the body. Latent syphilis may continue 5 to 20+ years with NO Penicillin)
patches 2. Gonorrhea symptoms, but the person is NODirect
Neiserria gonorrheae longer infectious
contact to other
– genitals, people.
Thick A pregnant
purulent yellowish Diagnostic test: Abstinence
Drug-of-Choice: Chloramphenicol mother can transmit the diseaseanus,
to her unborn child (congenital
mouth dischargesyphilis). Culture of urethral and cervical smear Be faithful
Ladderlike fever Other names: Burning sensation upon Gram staining Condom
GC, Clap, Drip, Incubation Period: urination / dysuria
Fever Prophylaxis: “IM” injection of gamma globulin Proper handwashing Stain, Gleet, 2 – 10 days Treatment:
Headache Hepatitis A vaccine Proper food and water sanitation Flores Blancas Drug of Choice: Penicillin
Jaundice Hepatitis immunoglobulin Proper disposal of urine and feces 3. Trichomoniasis Trichomonas vaginalis Direct contact Females: Diagnostic Test: Abstinence
Clay-colored stool Separate and proper cleaning of white or greenish-yellow Culture Be faithful
Lymphadenopathy Complete bed rest – to decrease metabolic needs of liver articles used by patient Other names: Incubation Period: odorous discharge Condom
Anorexia Low-fat diet; increase carbohydrates (high in sugar) Vaginitis 4 – 20 days; average of 7 vaginal itching and soreness Treatment:
Trich days painful urination Drug of Choice: Metronidazole (Flagyl) Personal Hygiene
Males:
Numbness of face especially Treatment: 1. Avoid eating shellfish such as Slight itching of penis
around the mouth 1. No definite treatment tahong, talaba, halaan, Painful urination
Vomiting and dizziness 2. Induce vomiting kabiya, abaniko during red Clear discharge from penis
Headache 3. Drink pure coconut milk – weakens the toxic effect tide season 4. Chlamydia Chlamydia trachomatis Direct contact Females: Diagnostic Test: Abstinence
Tingling sensation/paresthesia 4. Sodium bicarbonate solution (25 grams in ½ glass of 2. Don’t mix vinegar to (a rickettsia) Asymptomatic Culture Be faithful
and eventful paralysis of water) shellfish it will increase toxic Incubation Period: Dyspareunia Condom
hands Advised only in the early stage of illness because effect 15 times greater 2 to 3 weeks for males; Fishy vaginal discharge Treatment:
Floating sensation and paralysis can lead to aspiration usually no symptoms for Drug of Choice: Tetracycline
weakness NOTE: Persons who survived the first 12 hours after ingestion females Males:
Rapid pulse have a greater chance of survival. Burning sensation during
Dysphonia urination
Dysphagia Burning and itching of urethral
Total muscle paralysis leading opening (urethritis)
to respiratory arrest and death 5. Candidiasis Candida albicans Direct contact White, cheese-like vaginal Diagnostic Test: Abstinence
discharges Culture Be faithful
ROBERT C. REÑA, BSN Other names: Curd like secretions Gram staining Condom
Moniliasis
Candidosis Treatment:
Nystatin for oral thrush
Cotrimazole, fluconazole for mucous membrane and vaginal
infection

11 Communicable Disease Nursing 12 Communicable Disease Nursing

Fluconazole or amphotericin for systemic infection Cytomegalovirus

6. Acquired immune Retrovirus (Human Direct contact 1. Window Phase
deficiency syndrome T-cell lymphotrophic virus 3 or Blood and body fluids a. initial infection
(AIDS) HTLV 3) Transplacental b. lasts 4 weeks to 6 months
c. not observed by present
Attacks the T4 cells: T-helper Incubation period: laboratory test (test should be
cells; T-lymphocytes, and CD4 3-6 months to 8-10 years repeated after 6 months)
lymphocytes
Variable. Although the 2. Acute Primary HIV
time from infection to the Infection
development of a. short, symptomatic period
detectable antibodies is b. flu-like symptoms
generally 1-3 months, the c. ideal time to undergo
time from HIV infection screening test (ELISA)
to diagnosis of AIDS has
an observed range of less 3. Asymptomatic HIV
than 1 year to 15 years or Infection
longer. a. with antibodies against HIV
(PHN Book) but not protective
b. lasts for 1-20 years depending
upon factors
4. ARC (AIDS Related
Complex)
a. a group of symptoms
indicating the disease is likely to
progress to AIDS
b. fever of unknown origin
c. night sweats
d. chronic intermittent diarrhea
e. lymphadenopathy
f. 10% body weight loss
5. AIDS
a. manifestation of severe
immunosuppression
b. CD4 Count: <200/dL
c. presence of variety of
infections at one time:
oral candidiasis
leukoplakia
AIDS dementia complex
Acute encephalopathy
Diarrhea, hepatitis
Anorectal disease
Pneumonocystis carinii
pneumonia (fungal)
Diagnostic tests: Abstinence TB
Enzyme-Linked Immuno-Sorbent Assay (ELISA) Be faithful Kaposi’s sarcoma (skin cancer;
- presumptive test Condom bilateral purplish patches)
Western Blot – confirmatory Herpes simplex
Sterilize needles, syringes, and Pseudomonas infection
Treatment: instruments used for cutting Blindness
1. Treatment of opportunistic infection operations Deafness
2. Nutritional rehabilitation
3. AZT (Zidovudine) – retards the replication of Proper screening of blood donors ROBERT C. REÑA, BS
retrovirus IV. ERUPTIVE DISEASES
4. PK 1614 - mutagen Rigid examination of blood and
other blood products MODE OF
DISEASE CAUSATIVE AGENT PATHOGNOMONIC SIGN MANAGEMENT/TREATMENT PREVENTION
TRANSMISSION
Avoid oral, anal contact and
1. Chickenpox Human (alpha) herpes virus 3 Droplet spread Vesiculo-pustular rashes No specific diagnostic exam Case over 15 years of age should
swallowing of semen
(varicella-zoster virus), a be investigated to eliminate
Other names: member of the Herpesvirus Direct contact Centrifugal appearance of rashes Treatment is supportive and symptomatic; infection viral in possibility of smallpox.
Avoid promiscuous sexual
Varicella group origin, and therefore is self-limiting Report to local authority
contact
Indirect through articles Pruritus Isolation
freshly soiled by discharges Drug-of-choice: Concurrent disinfection of throat
HIV/AIDS Prevention and of infected persons Acyclovir (orally to reduce the number of lesions; topically to and nose discharges
Control Program: lessen the pruritus) Exclusion from school for 1
Period of Communicability:
Not more than one day before Incubation Period: week after eruption first appears
Goal: Contain the transmission of
and more than 6 days after 2-3 weeks, commonly 13 to Avoid contact with susceptibles
HIV /AIDS and other
appearance of the first crop of 17 days
reproductive tract infections and
vesicles
mitigate their impact
2. German Measles Rubella virus or RNA- Droplet Forscheimer spots – red Diagnostic Test: MMR vaccine (live attenuated
containing Togavirus pinpoint patches on the oral Rubella Titer (Normal value is 1:10) virus)
Other Names: Incubation Period: cavity - Derived from chick embryo
Rubella German measles is teratogenic Three (3) days Contraindication:
Three-day Measles infection. Maculopapular rashes - Allergy to eggs
Headache - If necessary, given in divided
Low-grade fever Instruct the mother to avoid pregnancy for three months after or fractionated doses and
Sore throat receiving MMR vaccine. epinephrine should be at the
bedside.
3. Herpes Zoster Herpes zoster virus Droplet Painful vesiculo-pustular lesions Treatment is supportive and symptomatic Avoidance of mode of
(dormant varicella zoster virus) Direct contact from secretion on limited portion of the body transmission
Other names: (trunk and shoulder) Acyclovir to lessen the pain
Shingles
Cold sores Low-grade fever
4. Dengue Dengue virus 1, 2, 3, and 4 and Bite of infected mosquito Classification (WHO): Diagnostic Test: 4 o’clock habit
Hemorrhagic Fever Chikungunya virus (Aedes Aegypti)
Grade I: Torniquet test (Rumpel Leads Test / capillary fragility test) – Chemically treated mosquito net
Other names: Period of communicability: Daytime biting a. flu-like symptoms PRESUMPTIVE; positive when 20 or more oetechiae per 2.5 Larva eating fish
H-fever Unknown. Presumed to be on Low flying b. Herman’s sign cm square or 1 inch square are observed Environmental sanitation
13 Communicable Disease Nursing 14 Communicable Disease Nursing

the 1st week of illness up to
when the virus is still present in
the blood
Occurrence is sporadic
throughout the year
Epidemic usually occur during
the rainy seasons (June to
November)
Peak months: September and
October
DISEASE CAUSATIVE AGENT
1. Malaria Plasmodium Parasites:
Vivax
Falciparum (most fatal; most
common in the Philippines)
Ovale
Malariae
Stagnant clear water c. (+) tourniquet sign Antimosquito soap sweating for immediate impact; 200-
Urban Platelet count – CONFIRMATORY; (Normal is 150 - 400 x Neem tree (eucalyptus) - anemia / pallor QBC/quantitative Buffy Coat – fastest 400/ha. for a delayed effect)
Grade II: 103 / mL) - tea-colored urine Malarial Smear – best time to get the specimen is at height of *On Stream Clearing – cutting
Incubation Period: a. manifestations of Grade I plus Eliminate vector - malaise fever because the microorganisms are very active and easily of vegetation overhanging along
Uncertain. Probably 6 days to spontaneous bleeding Treatment: Avoid too many hanging clothes - hepatomegaly identified stream banks
1 week b. e.g. petechiae, ecchymosis Supportive and symptomatic inside the house - splenomegaly
purpura, gum bleeding Paracetamol for fever Residual spraying with - abdominal pain and Chemoprophylaxis *Avoid outdoor night activities
Manifestations: Analgesic for pain insecticide enlargement Only chloroquine should be given (taken at weekly intervals (9pm – 3am)
Grade III: - easy fatigability starting from 1-2 weeks before entering the endemic area). In *Wearing of clothing that covers
First 4 days: a. manifestations of Grade II Rapid replacement of body fluids – most important treatment pregnant women, it is given throughout the duration of arms and legs in the evening
Febrile/Invasive Stage plus beginning of circulatory pregnancy. *Use mosquito repellents
- starts abruptly as fever failure ORESOL NURSING CARE: *Zooprophylaxis – typing of
- abdominal pain b. hypotension, tachycardia, 1. TSB (Hot Stage) Treatment: domestic animals like the
- headache tachypnea Blood tansfusion 2. Keep patent warm (Cold Blood Schizonticides - drugs acting on sexual blood stages of carabao, cow, etc near human
- vomiting Stage) the parasites which are responsible for clinical manifestations dwellings to deviate mosquito
- conjunctival infection Grade IV: Diet: low-fat, low-fiber, non-irritating, non-carbonated. 3. Change wet clothing (Wet 1. QUININE – oldest drug used to treat malaria; from bites from man to these animals
-epistaxis a. manifestations of Grade III Noodle soup may be given. ADCF (Avoid Dark-Colored Stage) the bark of Cinchona tree; ALERT: Cinchonism –
plus shock (Dengue Shock Foods) 4. Encourage fluid intake quinine toxicity Intensive IEC campaign
4th – 7th days: Syndome) 5. Avoid drafts 2. CHLOROQUINE
Toxic/Hemorrhagic Stage ALERT! No Aspirin 3. PRIMAQUINE
- decrease in temperature 4. FANSIDAR – combination of pyrimethamine and
- severe abdominal pain sulfadoxine
- GIT bleeding 2. Filariasis Wuchereria bancrofti Bite of Aedes poecillus Asymptomatic Stage: Diagnosis CLEAN Technique
- unstable BP (narrowed pulse Brugia malayi (primarily) Presence of microfilariae in the Physical examination, history taking, observation of major and
pressure) Other names: Brugia timori Aedes flavivostris blood but no clinical signs and minor signs and symptoms Use of mosquito repellents
- shock Elephantiasis (secondary) symptoms of disease Anytime fumigation
- death may occur – nematode parasites Laboratory examinations Wear a long sleeves, pants and
Endemic in 45 out of Incubation period: Acute Stage: Nocturnal Blood Examination (NBE) – blood are taken from socks
7th – 10th days: 78 provinces 8 – 16 months Lymphadenitis the patient at his residence or in hospital after 8:00 pm
Recovery/Convalescent Lymphangitis Immunochromatographic Test (ICT) – rapid assessment
Stage Highest prevalence Affectation of male genitalia method; an antigen test that can be done at daytime
- appetite regained rates: Regions 5, 8, 11
- BP stable and CARAGA Chronic Stage: (10-15 years Treatment:
from onset of first attack) Drug-of-Choice: Diethylcarbamazine Citrate (DEC) or
ROBERT C. REÑA, BSN Hydrocele Hetrazan
V. VECTOR-BORNE DISEASES Lymphedema
Elephantiasis
MODE OF
PATHOGNOMONIC SIGN MANAGEMENT/TREATMENT PREVENTION 3. Shistosomiasis Schistosoma mansoni Contact with the infected Diarrhea Diagnostic Test: Dispose the feces properly not
TRANSMISSION
Bite of infected anopheles Cold Stage: severe, recurrent Early Diagnosis and Prompt Treatment *CLEAN Technique S. haematobium freshwater with cercaria and Bloody stools COPT or cercum ova precipitin test reaching body of water
mosquito chills (30 minutes to 2 hours) Early diagnosis – identification of a patient with malaria as *Insecticide – treatment of Other Names: S. japonicum (endemic in the penetrates the skin Enlargement of abdomen Use molluscides
soon as he is seen through clinical and/or microscopic method mosquito net Snail Fever Philippines) Splenomegaly Treatment: Prevent exposure to
Night time biting Hot Stage: fever (4-6 hours) Clinical method – based on signs and symptoms of the patient *House Spraying (night time Bikharziasis Vector: Oncomelania Hepatomegalu Drug-of-Choice: PRAZIQUANTEL (Biltracide) contaminated water (e.g. use
High-flying and the history of his having visited a malaria-endemic area fumigation) Quadrasi Anemia rubber boots)
Rural areas Wet Stage: Profuse sweating Microscopic method – based on the examination of the blood *On Stream Seeding – Endemic in 10 regions weakness Oxamniquine for S. mansoni Apply 70% alcohol immediately
Clear running water smear of patient through microscope (done by the medical construction of bio-ponds for and 24 provinces Metrifonate for S. haematobium to skin to kill surface cercariae
- intermittent chills and technologist) fish propagation (2-4 fishes/m2 Allow water to stand 48-72

15 Communicable Disease Nursing 16 Communicable Disease Nursing

High prevalence: hours before use clothing respiratory paralysis.

Regions 5, 8, 11 3. Bubonic Plague Bacteria (Yersinia pestis) Direct contact with the Fever and lyphadenitis Streptomycin, tetracycline, chloramphenicol Environmental Sanitation
infected tissues of rodents
Vector: rat flea
ROBERT C. REÑA, BSN
REFERENCES: VII. DISEASES OF THE SKIN
THE ROYAL PENTAGON REVIEW SPECIALISTS, INC NOTE-TAKING GUIDE FOR COMMUNICABLE DISEASE NURSING by DANIEL JOSEPH E. BERDIDA, RM, RN
CHAPTER VII: COMMUNICABLE DISEASE PREVENTION and CONTROL, PUBLIC HEALTH NURSING IN THE PHILIPPINES, 10th EDITION MODE OF
DEPARTMENT OF HEALTH OFFICIAL WEBSITE: www.doh.gov.ph DISEASE CAUSATIVE AGENT PATHOGNOMONIC SIGN MANAGEMENT/TREATMENT PREVENTION
TRANSMISSION
CENTERS FOR DISEASE CONTROL AND PREVENTION (CDC) OFFICIAL WEBSITE: www.cdc.gov 1. Leprosy Mycobacterium leprae Airborne-droplet Early signs: Diagnostic Test: Avoid prolonged skin-to-skin
Change in skin color – either reddish or Slit Skin Smear - determines the presence of M. leprae; contact
VI. DISEASES TRANSMITTED BY ANIMALS Other names: Prolonged skin-to-skin white optional and done only if clinical diagnosis is doubtful to BCG vaccination – practical
Hansenosis contact Loss of sensation on the skin lesion prevent misclassification and wrong treatment and effective preventive
MODE OF Hansen’s disease Loss of sweating and hair growth Lepromin Test – determines susceptibility to leprosy measure against leprosy
DISEASE CAUSATIVE AGENT PATHOGNOMONIC SIGN MANAGEMENT/TREATMENT PREVENTION
TRANSMISSION Thickened and painful nerves Good personal hygiene
1. Leptospirosis Leptospira interrogans – Through contact of the skin, Leptospiremic Phase Diagnosis Protective clothing, boots and -an ancient disease Muscle weakness or paralysis or Treatment: Adequate nutrition
bacterial spirochete especially open wounds with - leptospires are present in Clinical manifestations gloves and is a leading cause extremities Ambulatory chemotherapy through use of MDT Health education
Other Names: water, moist soil or blood and CSF Culture of organism of permanent physical Pin and redness of the eyes Domiciliary treatment as embodied in RA 4073 which
- Weil’s Disease RAT is the main host. Although vegetation infected with urine - onset of symptoms is abrupt Examination of blood and CSF during the first week of illness Eradication of rats disability among the Nasal obstruction or bleeding advocates home treatment
- Mud Fever pig, cattle, rabbits, hare, skunk, of the infected host - fever and urine after the 10th day communicable Ulcers that do not heal
- Trench Fever and other wild animals can also - headache Leptospira agglutination test Segregation of domestic animals diseases PAUCIBACILLARY (tuberculoid and indeterminate);
- Flood Fever serve as reservoir Incubation Period: - myalgia Late Signs: noninfectious type
- Spirochetal 7-19 days, average of 10 days - nausea Treatment: Awareness and early diagnosis Madarosis Duration of treatment: 6 to 9 months
Jaundice Occupational disease affecting - vomiting Penicillins and other related B-lactam antibiotics Loss of eyebrows Procedure:
- Japanese Seven veterinarians, miners, farmers, - cough Tetracycline (Doxycycline) Improved education of people Inability to close eyelids Supervised: Rifampicin and Dapsone once a month on the
Days fever sewer workers, abattoir workers, - chest pain Erythromycin (lagophthalmos) health center supervised by the rural health midwife
etc Clawing of fingers and toes Self-administered: Dapsone everyday at the client’s house
Immune Phase Contractures
- correlates with the appearance Chronic ulcers MULTIBACILLARY (lepromatous and borderline); infectious
of circulating IgM Sinking of the nosebridge type
2. Rabies Rhabdovirus of the genus Bite or scratch (very rare) of Sense of apprehension Diagnosis: Have pet immunized at 3 Enlargement of the breast Duration of treatment: 24-30 months
lyssavirus rabid animal Headache history of bite of animal months of age and every year (gynecomastia) Procedure:
Other Names: Fever culture of brain of rabid animal thereafter Supervised: Rifampicin, Dapsone, and Lamprene (Clofazimine)
Lyssa Degeneration and necrosis of Non-bite means: leaking, Sensory change near site of demonstration of negri bodies once a month on the health center supervised by the rural health
Hydrophobia brain – formation of negri bodies scratch, organ transplant animal bite Never allow pets to roam the midwife
Le Rage (cornea), inhalation/airborne Spasms of muscles of Management: streets Self-administered: Dapsone and Lamprene everyday at the
Two kinds of Rabies: (bats) deglutition on attempts to *Wash wound with soap immediately. Antiseptics e.g. client’s house
a. Urban or canine – transmitted Source of infection: saliva of swallow povidone iodine or alcohol may be applied Take care of your pet
by dogs infected animal or human Fear of water/hydrophobia *Antibiotics and anti-tetanus immunization
Paralysis *Post exposure treatment: local wound treatment, active National Rabies Prevention
b. Sylvatic – disease of wild Incubation period: Delirium immunization (vaccination) and passive immunization and Control Program
animals and bats which 2 – 8 weeks, can be years Convulsions (administration of rabies immunoglobulin) Goal: Human rabies is
sometimes spread to dogs, cats, depending on severity of *Consult a veterinarian or trained personnel to observe the pet eliminated in the Philippines
and livestock wounds, site of wound as “FATAL once signs and for 14 days and the country is declared
distance from brain, amount symptoms appear” rabies-free
of virus introduced, and *Without medical intervention, the rabies victim would
protection provided by usually last only for 2 to 6 days. Death is often due to
17 Communicable Disease Nursing 18 Communicable Disease Nursing

2. Anthrax Bacillus anthracis
Other names:
Malignant pustule
Malignant edema Incubation period:
Woolsorter disease few hours to 7 days most
Ragpicker disease cases occur within 48 hours
Charbon of exposure
3. Scabies Sarcoptes scabiei
- An itch mite
parasite
4. Pediculosis Pediculosis
Capitis (head lice)
Other name: Corporis (body lice)
Phthipiasis Pubis (crab lice)
Contact with 1. Cutaneous form – most common Treatment: Penicillin Proper handwahing
a. tissues of animals - itchiness on exposed part MODE OF
DISEASE CAUSATIVE AGENT PATHOGNOMONIC SIGN MANAGEMENT/TREATMENT PREVENTION
(cattle, sheep, goats, - papule on inoculation site Immunize with cell-free TRANSMISSION
horses, pigs, etc.) dying - papule to vesicle to eschar vaccine prepared from culture 1. Ascariasis Ascaris lumbricoides Fecal-oral route Pot-bellied Diagnostic Test: Fecalysis Proper handwahing
of the disease - painless lesion filtrate containing the Voracious eater
b. biting flies that had protection antigen Other names: (nematode) 5 Fs: Finger, Foods, Feces, Thin extremities Treatment:
partially fed on such 2. Pulmonary form – contracted from Roundworm Flies, Fomites Antihelminthic: Mebendazole / Pyrantel Pamoate
animals inhalation of B. anthracis spores Control dust and proper Giant worms
c. contaminated hair, - at onset, resembles common URTI ventilation 2. Taeniasis Taenia solium – pork Eating inadequately cooked Muscle soreness Diagnostic Test: Fecalysis Proper handwahing
wool, hides or products - after 3-5 days, symptoms become Taenia saginata – beef pork or beef Scleral hemorrhage
made from them e.g. acute, with fever, shock, and death Other name: Dyphyllobotruim latum – fish Treatment: Cook pork and beef adequately
drums and brushes Tape worm 5 Fs: Finger, Foods, Feces, Antihelminthic: Mebendazole / Pyrantel Pamoate
d. soil associated with 3. Gastrointestinal anthrax – Flies, Fomites
infected animals or contracted from ingestion of meat from
contaminated bone meal infected animal 3. Capillariasis Trichuris trichuria Eating inadequately cooked Abdominal pain Diagnostic Test: Fecalysis Proper handwahing
used in gardening - violent gastroenteritis seafood Diarrhea
- vomiting Other name: Capillararia Philippinensis borborygmi Treatment: Cook seafoods adequately
- bloody stools Whip worm 5 Fs: Finger, Foods, Feces, Antihelminthic: Mebendazole / Pyrantel pamoate
Flies, Fomites
4. Enterobiasis Enterobium vermicularis Inhalation of ova Nocturnal anal itchiness Diagnostic Test: Fecalysis / tape test Proper handwahing
Toilet seat
Other name: Infected bedsheets Treatment: Proper disinfection of beddings
Pinworm Antihelminthic: Mebendazole / Pyrantel pamoate
5 Fs: Finger, Foods, Feces,
Flies, Fomites
5. Ancyloclos- Ancyclostoma duodenal Walking barefooted Dermatitis Diagnostic Test: Fecalysis Proper handwahing
tomiasis
Direct contact with Itching Diagnosis: Personal hygiene Necatur americanus 5 Fs: Finger, Foods, Feces, Anemia Treatment: Avoid walking barefooted
infected individuals Appearance of the lesion Avoid playing with dogs Other name: Flies, Fomites Antihelminthic: Mebendazole / Pyrantel pamoate
When secondarily infected: Intense itching Laundry all clothes and iron Hookworm Black fishy stool
Incubation Period: Skin feels hot and burning Finding of causative mite Maintain the house clean ROBERT C. REÑA, BSN
24 hours Environmental sanitation
When large and severe: fever, headache, Treatment: (limited entirely to the skin) Eat the right kind of food IX. OTHER COMMUNICABLE DISEASES
and malaise Examine the whole family before undertaking treatment Regular changing of clean
Benzyl benzoate emulsion (Burroughs, Welcome) – cleaner to clothing, beddings and towels MODE OF
use and has more rapid effect DISEASE CAUSATIVE AGENT PATHOGNOMONIC SIGN MANAGEMENT/TREATMENT PREVENTION
TRANSMISSION
Kwell ointment 1. Pneumonia Bacteria: Droplet Rusty sputum Diagnosis: Avoid mode of transmission
Pneumococcus, streptococcus Fever and chills Based on signs and symptoms
Types: pneumoniae, staphylococcus Incubation Period: Chest pain Dull percussion on affected lung Build resistance
a. Community aureus, Klebsiella pneumonia 2 – 3 days Chest indrawing Sputum examination – confirmatory
Acquired Pneumonia (Friedlander’s bacilli) Rhinitis/common cold Chest x-ray Turn to sides
Direct contact Itchiness of the scalp Kwell shampoo (twice a week) Proper hygiene (CAP) Productive cough
b. Hospital / Virus: Fast respiration Management: Proper care of influenza cases
Common in school age One tbsp water + one tbsp vinegar Nosocomial Haemophilus influenzae Vomiting at times Bedrest
c. Atypical Convulsions may occur Adequate salt, fluid, calorie, and vitamin intake
Fungi: Pneumonocystis carinii Flushed face Tepid sponge bath for fever
VIII. INTESTINAL PARASITISM pneumonia Dilated pupils Frequent turning from side to side

19 Communicable Disease Nursing 20 Communicable Disease Nursing

Highly colored urine with
reduced chlorides and increased
urates
2. Mumps Mumps virus, a member of Direct contact Painful swelling in front of the
family Paramyxoviridae ear, angle of the jaws and down
Other name: Source of infection: the neck
Epidemic Parotitis Secretions of mouth and nose Fever
Malaise
Incubation Period: Loss of appetite
12 to 26 days, usually 18 days Swelling of one or both testicles
(orchitis) in some boys
Antibiotics based on CARI of the DOH C. Symptoms of menigeal Anti-inflammatory (Dexamethasone) – to relieve cerebral
irritation edema
Oxygen inhalation - nuchal rigidity (stiff neck) – Antimicrobial (Penicillin)
Suctioning earliest sign Anticonvulsany (Diazepam / Valium)
Expectorants / mucolytics - Kernig’s sign – when knees
Bronchodilators are flexed, it cannot be extended
Oral/IV fluids - Brudzinski signs – pain on Complications:
CPT neck flexion with automatoc Hydrocephalus
Supportive and symptomatic MMR vaccine flexion of the knees Deafness (Refer the child for audiology testing) and mutism
- convulsion Blindness
Sedatives – to relieve pain from orchitis Isolate mumps cases - poker soine (poker face / flat
Cortisone – for inflammation affect)
- Increased ICP
Diet: Soft or liquid as tolerated (Cushing’s triad: hypertension,
bradycardia, bradypnea) and
Support the scrotum to avoid orchitis, edema, and atrophy widening pulse pressure

Dark glasses for photophobia IX. KILLER DISEASES OF THE NEW MILLENNIUM
3. Influenza Influenza virus Direct contact Sudden onset Supportive and symptomatic Avoid use of common towels,
A – most common Droplet infection or by Fever with chills glasses, and eating utensils MODE OF
DISEASE CAUSATIVE AGENT PATHOGNOMONIC SIGN MANAGEMENT/TREATMENT PREVENTION
Other name: B – less severe articles freshly soiled with Headache Keep patient warm and free from drafts Cover mouth and nose during TRANSMISSION
La Grippe C – rare nasopharyngeal discharges Myalgia / arthralgia TSB for fever cough and sneeze 1. Meningococcemia Neisseria meningitides Direct contact with High grade fever in the first Respiratory isolation within 24 hours Universal precaution
Airborne Boil soiled clothing for 30 minutes before laundering respiratory droplet from 24 hours Chemoprophylaxis
Period of Communicability: nose and throat of infected Hemorrhagic rash – Drug-of-Choice: Penicillin Proper hand washing
Probably limited to 3 days from Incubation Period:
individuals petechiae
clinical onset Short, usually 24 – 72 hours
4. Streptococcal sore Group A beta hemolytic Droplet Sudden onset Avoid mode of transmission
nuchal rigidity
Diagnosis:
throat streptococcus High grade fever with chills Throat swab and culture Incubation Period: Kernig’s sign
Complication: Enlarged and tender cervical 2 – 10 days Brudzinski sign
Other name: Other diseases: Rheumatic Heart Disease lymph nodes Treatment: erythromycin Shock
Pharyngitis Scarlet fever Inflamed tonsils with Death
Tonsillitis St. Anthony fire mucopurulent exudates Care: 2. Severe Acute Coronavirus Close contact with Prodromal Phase: No specific treatment Utilize personal protective
Puerperal sepsis Headache Bed rest Respiratory Syndrome respiratory droplet Fever (>38 0C) equipment (N95 mask)
Imoetigo dysphagia Oral hygiene with oral antiseptic or with saline gargle (1 glass / SARS secretion from patient Chills PREVENTIVE MEASURES and CONTROL
Acute glumerulonephritis of warm water + 1 tsp rock salt)
Malaise 1. Establishment of triage Handwashing
Rheumatic Heart Disease Ice collar
5. Meningitis Meningococcus Direct (Droplet) A. Sudden Onset Respiratory Isolation
Earliest case: Incubation Period: Myalgia 2. Identification of patient
Diagnostic Test:
Neisseria meningitides - high fever accompanied by Guangdong Province, 2 – 10 days Headache 3. Isolation of suspected probable case Universal Precaution
Other name: Incubation Period: chills Lumbar puncture or Lumbar tap - reveals CSF WBC and China in November Infectivity is none to low 4. Tracing and monitoring of close contact The patient wears mask
Cerebrospinal fever 2 - 10 days - sore throat, headache, protein, low glucose; contraindicated for increased ICP for 2002 5. Barrier nursing technique for suspected and Isolation
prostration (collapse) danger of cranial herniation Respiratory Phase: probable case
Global outbreak: March Within 2-7 days, dry
B. entrance into the bloodstream Hemoculture – to rule out meningococcemia 12, 2003 nonproductive cough
leading to septicemia progressing to respiratory
(meningococcemia) Treatment: First case in the distress
a. rash, petchiae, purpura Osmotic diuretic (Mannitol) – to reduce ICP and relieve
Philippines:
cerebral edema; Alert: fastdrip to prevent crystallization
April 11, 2003
  Refers to infection or disease that occurs regularly at low or
COMMUNICABLE DISEASE moderate frequency.
21 Communicable Disease Nursing  Eg. Malaria
3. Bird Flu Influenza Virus H5N1 Contact with infected birds Fever Control in birds: Isolation technique
Infectious Disease
Body weakness and body 1. Rapid destruction (culling or stamping out of all Vaccination Epidemic Disease
Other Name: Incubation Period: malaise infected or exposed birds) proper disposal of carcasses Proper cooking of poultry  It is a disease caused by a pathogen
Avian Flu 3 days, ranges from 2 – 4 Cough and quarantining and rigorous disinfection of farms
days Sore throat 2. Restriction of movement of live poultry  That requires direct inoculation of the organism through a break  Defined as greater than usual number of cases of a disease in a
Dyspnea
n the skin or mucous membrane. particular region, usually occurring within a relatively short
Sore eyes In humans:
1. Influenza vaccination period.
2. Avoid contact with poultry animals or migratory Communicable Disease  Occurs when there is sudden increase in frequency above
birds
4. Influenza A (H1N1) Influenza Virus A H1N1 Exposure to droplets from - similar to the symptoms of Diagnostic: - Cover your nose and mouth endemic levels.
the cough and sneeze of regular flu such as Nasopharyngeal (throat) swab when coughing and sneezing  If the infectious disease is transmissible from one human to
Other Name: This new virus was first the infected person Fever Immunofluorescent antibody testing – to distinguish - Always wash hands with  Eg. Dengue; SARS
Swine Flu detected in people in influenza A and B soap and water
another.
Headache
April 2009 in the United Influenza A (H1N1) is not Fatigue - Use alcohol- based hand Pandemic Disease
May 21, 2009 – first States. transmitted by eating Lack of appetite sanitizers Contagious Disease
confirmed case in the thoroughly cooked pork. Runny nose Treatment: - Avoid close contact with
Philippines Influenza A (H1N1) is Antiviral medications may reduce the severity and sick people  Disease occurring in epidemic proportions in many countries
fatal to humans The virus is killed by
Sore throat
duration of symptoms in some cases: - Increase your body's  Communicable disease that is easily transmitted from one
June 11, 2009 - The cooking temperatures of
Cough
Oseltamivir (Tamiflu) resistance simultaneously – sometimes worldwide.
- Vomiting or nausea person to another.
WHO raises its 160 F/70 C.
- Diarrhea
or zanamivir - Have at least 8 hours of  The size of outbreaks is dependent upon factors such as the ratio
Pandemic Alert Level to sleep  Eg. Meningococcemia
Phase 6, citing Incubation Period: - Be physically active of susceptible to immune subjects, period of infectivity,
significant transmission 7 to 10 days - Manage your stress
of the virus. - Drink plenty of fluids Zoonotic Disease population density etc.
- Eat nutritious food

ROBERT C. REÑA, BSN  Infectious diseases that human acquire from animal resources. Incidence – Occurrence
 Eg. Foot and mouth disease; Bird’s flu
 It is the number of new cases of that disease in a defined
Sporadic Disease population over a specific period.

 Occurs only occasionally (sporadically) and irregularly within the
population of a particular geographic area without specific
pattern.
Endemic Disease
 Disease that is always present within the population of a
particular geographic area. The number of cases of the disease
may fluctuate over time, but the disease never dies out
completely.
Prevalence – Popularity
 Describes the number of cases in a population at a point in time.
 2 types of prevalence:
1. Period Prevalence – number of cases of the disease
existing in a given population during a specific period.
2. Point Prevalence – number of cases of the disease
existing in a given population at a particular moment in
time.

 CD’s have identifying manifestations – clinical hallmark –

pathognomonic sign
Secular Trend Mortality Rate

 Refers to a change in the prevalence of infection over years.  Ratio of the number of people who died of a particular disease
ASPECTS OF CAUSATION
 This relates to better living conditions, better hygiene, and during a specified period per a specified population.
vaccination.  CD causation is MULTIFACTORIAL
COMMUNICABLE DISEASE
 Eg. The decrease in tuberculosis in the United Kingdom.  Disease causation is due to the summation of all
 Pathological conditions that are caused by biological agents that contributory entities – no single entity can attribute a CD.
Seasonal Trend
are infectious and are easily transferrable from host to host due  Man is an open system.
 Refers to the changes in the prevalence of infection occurring to an effective mode of transmission.  Interplay of both extrinsic and intrinsic factors.
over the year. Disease Triad
Communicable Disease vs Infectious Disease Extrinsic Factors
 Eg. RSV outbreaks; measles
 The reason the seasonality is unclear but changes of  Climate  Responses of the human body is an interplay of all factors
Communicable Disease Infectious Disease
 Topography pertaining to both intrinsic and extrinsic aspects.
temperature, crowding and humidity may play a role.  Biological causative  Biological opportunistic:
agent: specific variable  Geography
Seroprevalence  (+)  No communicability
Period of  Environmental conditions
communicability  Confined  Presence of contacts, epidemics, endemics, etc. (exposure)
 Refers to the number of individuals who have antibodies to a
 High ability to spread  Diffused manifestations
particular pathogen. It shows how common the pathogen is in  (+) Clinical hallmark  Variable clinical course Intrinsic Factors
the population.  Well defined clinical  Agent cannot usually be
course isolated externally  Host conditions
Prevalence vs Incidence  Mandated by Koch’s  Immunity
postulates  Nutrition
 The prevalence of infection describes the number of cases in a
population at a point in time.  Stress
 The incidence refers to the number of cases arising over a Therefore, communicable disease principles…  Activity
defined period of time.  Vices
 Communicable diseases are infectious, but infectious diseases
Morbidity Rate are not communicable. INFECTIVE CYCLE
 CD’s have specific causative agent – drug of choice
 Expressed as the number of new cases of a particular disease  The infective cycle is an intertwining chain of factors, which
 CD’s have a potent mode of transmission
that occurred during a specified period per a specifically defines shows the interplay of aspects that can lead to an infection.
 Causative agents of CD’s can produce the same manifestations
population.
of inoculated into another host.
CHAIN OF INFECTION b) Incubatory Carrier – person who is capable of 3. There must be a PORTAL OF EXIT. c) Vehicle transmission
transmitting pathogen during the incubation period of a  Path or way in which the organism leaves the reservoir. - Transmission of infectious disease through particles or
 There are six components in the infectious process (aka chain of
particular infectious disease.  Common portal of exits are: substances that harbor the organism until it is ingested
infection).
 A person who is incubating the illness a) Respiratory system or inoculated into the host.
b) Genitourinary tract
1. There must first be a PATHOGEN (AGENT).
c) Convalescent Carrier – harbor and can transmit a c) Gastrointestinal tract d) Vector transmission
 Causative Agent – is any microbe capable of producing a
particular pathogen while recovering from an infectious d) Skin and mucous membrane - Occurs when intermediate carriers such as fleas, flies, and
disease.
disease. e) Placenta (transplacental transmission) mosquitoes transfer the microbes to another living
a) Bacteria
 A person who is at the recovery stage of illness but organism.
b) Viruses
continues to shed the pathogenic organism. 4. There must be a PORTAL OF EXIT.
c) Chlamydiae
 Means by which the infectious agent passes through the portal 5. There must be a PORTAL OF ENTRY.
d) Fungi
d) Active Carrier/Chronic/Sustained Carrier – have of exit of the reservoir to the susceptible host.  It is the venue where the organisms gains entrance into the
e) Protozoa
completely recovered from the disease but continue to  Easiest link to break in the chain of infection. susceptible host.
f) Parasites
harbor the pathogen indefinitely.  4 modes of transmission:  The infective microbes use the same venous when they exit from
 A person who always has the infectious organism in a) Contact transmission the reservoir.
2. There must be a source of pathogen (RESERVOIR)
his/her system.  Direct Contact – person to person transfer
 Sources of microorganism that causes infectious diseases.
- Direct skin-to-skin contact 6. There must be a SUSCEPTIBLE HOST.
 Reservoir – it is a site where a pathogen can multiply or merely
e) Intermittent Carrier – a person who occasionally shed - Direct mucous membrane-to-mucous membrane contact  The human body has many defenses against the entry and
survive until it is transferred to a host. Reservoirs may be a living
the pathogenic organism. multiplication of organism.
hosts or inanimate objects or materials.
 Indirect Contact – susceptible person comes in contact with  When the defenses are good, no infection will take place.
Animals
a contaminated object.  However, in weakened host, microbes will launch in infectious
1. Living Reservoir – include humans, pets, farms, animals, wild
 Infectious disease that humans acquire from animal resources - Indirectly via airborne droplets disease.
animals, certain insects. The human and animal reservoir may or
are called zoonotic disease or zoonoses. - Indirectly via contamination of food and water by fecal
may not be experiencing illness due to the pathogens they are Symptomatology
 Many pets and other animals are important reservoirs of material.
harboring.
zoonoses. - Indirectly via arthropods vectors  Body will always respond to any stimuli given until point of
Human Carrier  Zoonoses are acquired by direct contact with the animal, - Indirectly via formites exhaustion is reached.
ingestion of the pathogen or injection of the pathogen by an  Communicable disease symptomatology is fixed due to
 Carrier – a person who is colonized with a particular pathogen, b) Air borne transmission
arthropod. specific action of causative agents.
but the pathogen is not currently causing disease in that person. - Occurs when fine microbial particles or dust particles  Clinical hallmark or pathognomonic sign
 Types of Carrier: containing microbes remain suspended in the air for a
2. Non Living Reservoir - Is the most unique clinical manifestation of a
a) Passive Carrier – carry the pathogen without ever prolonged period.
 A.k.a. inanimate reservoirs of infection communicable disease.
having had the disease. - Infectious disease is spread by air current and is inhaled
 Includes: air, soil, dust, food, milk, water, and formites.
by a susceptible host.

 A clinical hallmark highly suggests a CD and no other means of Isolation - With on/off control  RED/GREEN  Disinfection
diagnostics are usually needed. - After 2 weeks of anti-koch’s, may remove patient from  Supportive/Palliative care
 Separation of the patient during the longest period of
room  Medication administration (drug of choice)
TERMINOLOGIES: (CD TERMS) communicability.
 Promotive/Preventive management
Antigen 7 CATEGORIES RECOMMENDED IN ISOLATION 5. Enteric Precaution – for infections with direct contact with  Case finding and reporting
feces.
 Any protein that can stimulate the immune response. 1. Strict Isolation – to prevent highly contagious or virulent
infectious. 6. Drainage/Secretion Precaution – to prevent infectious that
Period of Communicability
- Wash hands after every contact with the patient or are transmitted by direct/indirect contact with purulent
 Duration in which the patient is discharging the infectious agent potentially contaminated articles and before taking care material or drainage from an infected body site.
of another patient.
Quarantine - Articles contaminated with infectious materials should be 7. Universal Precaution – which is applied when handling
appropriately discarded or bagged and labeled before blood and body fluids.
 Restriction of movement in a place where a CD exist for a period
they are sent for decontamination and processing. - This precaution is applied to patients with HIV/HBC
of time equivalent to the longest incubation period of that
- The health care worker may use a private room. - It is intended to prevent parenteral, mucous membrane
disease.
- Use of gowns, mask, gloves is a must. and non intact skin exposure of health care workers to
Concurrent Disinfection - Negative pressure to surrounding area is desireable. blood borne pathogens.
2. Contact Isolation – to prevent the spread of infection - This isolation is necessary to prevent infections that are
 The destruction of microorganisms as soon they leave the body. primarily by close or direct contact. transmitted by direct contact with infected blood or
Toxoid body fluids.
3. Respiratory Isolation – to prevent transmission of infectious - This is applied to blood, semen, vaginal secretions, and
 Exotoxin that has been detoxified but capable of producing disease over a short distances through the air. other fluids (CSF, synovial fluid, pleural fluid, peritoneal
antibodies. fluid, pericardial fluid, amniotic fluid) and tissues
4. TB Isolation (Negative Pressure Room) – for TB patient containing visible blood.
Antitoxin
with (+) smear test or with CXR which strongly suggests
active TB. DO’S OF CD NURSING MANAGEMENT
 Also called antiserums, neutralizes toxins produced by
pathogens.
N-95 mask desireable  Isolation
- Respiratory
Exanthem  skin eruption
- traps very small particulate matter - Enteric
Enanthem  changes in mucous membrane - Reverse
Negative Pressure Room
 Quarantine
- Exclusive ventilation source with exhaust.  Hand washing
 Sources  Tetanus Immunoglobulin (TIG)  High mortality rate if not treated.
TETANUS  Destruction of C. Tetani spores  Agent: Neisseria Meningitides
 Soil
 Antibiotics  Invades the bloodstream without involving the meninges
 An acute disease induced by toxin of tetanus bacillus growing  Animal manure
 Penicillin, 3rd generation cephalosporins  MOT: Direct contact with respiratory secretions
anaerobically.  Human feces  found in the intestinal canal of herbivores
 Metronidazole –  bacterial count but has no effect  Onset: Acute
 Synonym – Lockjaw  Unsterile sutures, pins; rusty materials
on toxin.  Incubation: 2-10 days with ave. of 3-4 days
 Characterized by generalized sporadic painful spasms of the
Incubation – 3 to 21 days average of 10 days  Supportive  Most common in Infants and Children
skeletal muscles  form of striated muscles used in voluntary
 Wound care – general
movement. Meningococcemia vs Meningitis
Mode of Transmission - direct contact with open wound and unhealed  Diazepam – muscle relaxant
 Cardiac muscle, cannot be tetanized because of its intrinsic
umbilical stump.  Nutrition – NGT/TPN  Even with antibiotics, approximately 1 in 10 victims of
electrical properties
 O2
 Agent: Clostridium Tetani  Infection generally occurs through wound contamination and meningococcal meningitis will die.
 Gram (-), spore forming, obligate anaerobic often involves a cut or deep punctured wound.  The sepsis type of infection is much more deadly, and results in a
Nursing Management
bacterium  Onset - insidious or acute severe blood poisoning that affects the entire body  (septic
 2 Forms  Lockjaw – Trismus  Strict monitoring shock)
1. Vegetative – easily destroyed by heat and chemicals  Risus Sardonicus – 1st sign  Prevent complication
Manifestations
2. Spore Forming – resistant to heat  Severe spastic attacks  Nutrition support
 Isolation  May be asymptomatic
Toxins: Manifestations:  Avoid Stimulation  Restricted to nasopharynx or exhibit URTI
o No TSB  It may cause meningococcal septicemia or meningitis
1. Tetanospasmin  Opisthotonus
o No circulating air  High grade fever (>38o) for 24 hours
 Difficulty in Swallowing
 Neurotoxin inactive inside the bacteria, but when the bacteria o Do not startle  Purpuric rashes – 24 hours
 General muscle weakness
die, the toxin is released and activated by proteases and carried o Avoid bright light and noise  Adrenal medulla hemorrhage extending
 Restless
into the SC and brainstem o Do not leave patient abruptly  WATERHOUSE FRIDERICHSEN SYNDROME
 Impermeability
 Damaged upper motor neurons can no longer inhibit lower  Rapid development of petechiae and purpuric
 Anemia-like manifestations
motor neurons. MENINGOCOCCEMIA ecchymotic spots in associated with shock
 Produce the hallmark muscle rigidity and spasms Medical Management  Runs a short course and is usually fatal.
 Called meningococcal meningitis, meningococcal septicemia,  Meningeal irritation – H/A, N/V, stiff neck
2. Tetanolysin  Prevention – immunization  DPT (for babies) meningococcal bacterimial blood poisoning.  (+) Brudzinski, (+) Kernig’s
 Toxoid – Active  Booster every 10 years  Acute and potentially life threatening infection of the
 Responsible for destruction of RBC; hemolysis
 Antitoxin – Passive bloodstream, leads to vasculitis. Medical Management
 Fatal up to 60% of unimmunized person: fatal within 10 days of
 Anti-Tetanus Serum (ATS)  Maybe asymptomatic, may be restricted to the nasopharynx, or
onset  Strict isolation
 Neutralization of Toxins exhibit URTI.
 When symptoms develop within 3 days  poor prognosis  Pen G, 3rd generation cephalosporin, chloramphenicol
 ATS

 IVF/BT Types:  A. Spinal Paralysis  Poliovirus divide within gastrointestinal cells for about a week,
 O2/Mechanical breathing support  Paralysis occurs in the muscles innervated by the SC from where it spreads to the tonsils, the intestinal lymphoid,
1. Inapparent/Subclinical/Asymptomatic/Silent Type
 Wound care for areas of skin with blood clots  Characterized by asymmetry, scattered paralysis on 1 or tissue including the M cells of Peyer’s patches, and the deep
 Institute management for shock and DIC  Intact immune system – does not develop full blown polio both LE cervical and mesenteric lymph nodes, where it multiplies
 Prophylaxis  Rifampicin, Ceftriaxone (Ciprofloxacin)  Person who are expose to poliomyelitis ward like the nurses and  (+) respiratory difficulty abundantly.
 Patients suffering from meningococcal disease are other members of the health team.  The virus is subsequently absorbed into the bloodstream.
treated with a large doses of antibiotics  B. Bulbar Paralysis  The presence of virus in the bloodstream enables it to be
2. Abortive  Develops rapidly and is a more serious type widely distributed throughout the body.
Nursing Care
 Motor neurons in the brainstem are attacked and affect
 Does not invade CNS Clinical Manifestations
 Avoid Stimulation – Dim light, quiet  A minor illness – flu-like symptoms
the medulla.
 Respiratory support  Weakens the muscle supplied by the CN 9 and 10  Abortive – no evidence of CNS involvement.
 Recovery in 72 hours
 Complication precaution  Paralyzed, facial, ocular and pharyngeal muscle  Preparalytic – with evidence of CNS involvement but without
 Proper monitoring 3. Non-Paralytic Aseptic  (+) respiratory difficulty and cardiac irregulation paralysis.
 Place on respiratory isolation within 24 hours.  Paralytic – with CNS involvement and paralysis.
 Flu-like symptoms with signs of meningeal irritation and  C. Bulbospinal Paralysis
transient paresis.
POLIOMYELITIS  Usually lasts about a week with meningeal irritation persisting for
 Involvement of neurons in the BS and SC.  A blockage of the lumbar anterior spinal cord artery due to polio.
 A photomicrograph of the lumbar spinal cord depicting
about 2 weeks. OUTCOME PROPORTION OF CASE
 Infantile Paralysis, Heine-medin Disease an infarct due to polio type III surrounding the anterior
 (+) Pandy’s test  (+) Globulin in CSF Asymptomatic 90-95%
 Viral caused by ANS of the 3 polio viruses which affects the Minor Illness 4-8% spinal artery.
 indicates inflammation in CNS
anterior horn cells of the spinal cord , medulla, cerebellum and Non-paralytic aseptic meningitis 1-2%  When spinal neurons die, Wallerian degeneration takes
midbrain. 4. Paralytic Poliomyelitis Paralytic poliomyelitis 0-1-0.5% place resulting in muscle weakness of those muscles
 Disease of the lower motor neuron  flaccidity - Spinal polio 79% of paralytic cases once innervated by the now dead neurons.
 90% of polio infections cause no symptoms at all - Progresses to paralytic disease in which the muscles become - Bulbospinal polio 19% of paralytic cases
Manifestations in children include:
 Agent: Polio virus, I – Brunhilde, II – Lansing, III – Leon weak, flappy and poorly controlled, and finally completely - Bulbar polio 2% of paralytic cases
 Was identifies in 1908 by Karl Lansteiner paralyzed; this condition is known as acute flaccid paralysis.
Day 1-3: Fever but resolves immediately
 MOT: Airborne, direct contact with droplet, close association - Classified depending on site of paralysis.
Pathogenesis
with infected people, fecal oral route. - (+) Kernig’s/Brudzinki’s sign Day 3-5: Headache, neck pain, muscle pain, fever
 Incubation: 7-21 days ave of 12 days - (+) Hoyne’s Symptom  way of confirming meningeal irritation  Poliovirus enters the body through the mouth, infecting the first
Day 5-7: Mild paralysis
 POC: 1st 3 days – 3 months - Less DTR cells it comes in contact with – the pharynx (throat) and intestinal
 Most contagious during first day - Paralysis occurs mucosa. After Illness: Permanent paralysis
- Hypersensitivity to touch  The virus then hijacks the host cells own machinery, and begins
to replicate.
 Communicable Diseases
TOPIC OUTLINE
• Definition of terms in Communicable Disease
• Chain of infection
• Control and Management of Infectious Disease
• Immunization
• Protective Precautions / Isolation
• Diseases acquired thru GI tract
• Diseases acquired thru the skin
• Diseases acquired thru the respiratory tract
• Diseases acquired thru sexual contact
COMMUNICABLE DISEASE
• It is an illness caused by an infectious agent or
Diagnostics  Three doses of live-attenuated OPV produce protective antibody its toxic products that are transmitted directly
or indirectly to a well person through an agent,
to all three poliovirus types in more than 95% of recipients.
1. Throat swab vector or inanimate object
 It was licensed in 1962 and rapidly became the only polio
2. Stool C/S TWO TYPES
vaccine used worldwide.
3. Lumbar Puncture with CSF Analysis   WBC  CHON INFECTIOUS DISEASE
 Because OPV is inexpensive, easy to administer, and produces
• Not easily transmitted by ordinary contact but
Pandy Test excellent immunity in the intestine (which helps prevent infection require a direct inoculation through a break in
with wild virus in areas where it is endemic), it has been the the previously intact skin or mucous
 screening test for globulin in the cerebrospinal fluid; a positive result vaccine of choice for controlling poliomyelitis in many countries. membrane
is an indication of inflammation in the central nervous system. CONTAGIOUS DISEASE
IPV vs OPV • Easily transmitted from one person to another
Medical Management: through direct or indirect means
 Until recently OPV was recommended for most children
TERMINOLOGIES
 Symptomatic  OPV helped rid the world of polio, and it is still used in many • DISINFECTION –destruction of pathogenic
parts of the world. microorganism outside the body by directly
Nursing Management: applying physical or chemical means
 Both IPV and OPV gives immunity to polio
  Concurrent – method of disinfection
 CBR But OPV is better at keeping the disease from spreading to other
done immediately after the infected
 Warm compress on affected muscles people.
individual discharges infectious
 Comfort measures  However, for a few people (about one in 2.4 million) material/secretions. This method of
 ROM exercises  OPV actually causes polio disinfection is when the patient is still
 On very rare occasions (about 1 case per 750,000 vaccine the source of infection
Prevention: recipients) the attenuated virus in OPV reverts into a  Terminal – applied when the patient is
form that can paralyze. no longer the source of infection.
 Vaccination • Disinfectant -chemical used on non living
 The polio shot (IPV) does not cause polio.
 Inactivated polio vaccine (IPV) objects
 Salk Vaccine (Jonas Salk, 1952) • Antiseptic – chemical used on living things.
 The Salk vaccine, or inactivated poliovirus vaccine (IPV), is based • Bactericidal – kills microorganism
• Sterilization – complete destruction of all
on poliovirus grown in a type of monkey kidney.
microorganism
 After two doses of IPV (given by IM injection), 90% or more of General Principles
individuals develop protective antibody in all three serotypes of • Pathogens move through spaces or air current
poliovirus, and at least 99% are immune to poliovirus following • Pathogens are transferred from one surface to
three doses. another whenever objects touch
 Oral Polio Vaccine (OPV) (Albert Sabin, 1957) • Hand washing removes microorganism
• Pathogens are released into the air on droplet
 A single dose of Sabin’s oral polio vaccine produces immunity to
nuclei when person speaks, breaths, sneezes
all three poliovirus serotypes in approximately 50% of recipients. • Pathogens are transferred by virtue of gravity
• Pathogens move slowly on dry surface but very
quickly through moisture
INFECTION
• invasion and multiplication of microorganisms
on the tissues of the host resulting to signs and
symptoms as well as immunologic response
• injures the patient either by:
o competing with the host’s metabolism
o cellular damage produced by the
microbes intracellular multiplication
Factors of severity of infection
o disease producing ability
o the number of invading microorganism
o The strength of the host’s defence and
some other factors.
Epidemiological triad:
o Agent
o Host
o Environment
Classification accdg to incidence:
• SPORADIC - disease that occur occasionally
and irregularly with no specific pattern
• ENDEMIC – those that are present in a
population or community at times.
• EPIDEMIC – diseases that occur in a greater
number than what is expected in a specific
area over a specific time.
• PANDEMIC – is an epidemic that affects several
countries or continents
Causes of INFECTION
• Some bacteria develop resistance to antibiotics
• Some microbes have so many strains that a
single vaccine can’t protect against all of them
ex. Influenza
• Most viruses resist antiviral drugs
• Opportunistic organisms can cause infection in
immunocompromised patients
• Most people have not received vaccinations
• Increased air travel can cause the spread of
virulent microorganism to heavily populated
area in hours
• Use of immunosupressive drugs and invasive
procedures increase the risk of infection
• Problems with the body’s lines of defense
Three Lines of Defense
• FIRST LINE OF DEFENSE
o MECHANICAL BARRIERS
o CHEMICAL BARRIERS
o BODY’S OWN POP. OF
MICROORGANISM - “microbial
antagonism principle”
• SECOND – inflammatory response
o Phagocytic cells and WBC to destroy
invading microorganism manifesting
the cardinal signs
• THIRD – immune response - Natural/Acquired:
active/passive
RISK FACTORS
• Age, sex, and genes
• Nutritional status, fitness, environmental
factors
• General condition, emotional and mental state
• Immune system
• Underlying disease ( diabetes mellitus,
leukemia, transplant)
• Treatment with certain antimicrobials (prone to
fungal infection), steroids, immunosuppresive
drugs etc.
CHAIN OF INFECTION

• Gloving – Wear gloves for all direct contact o Natural – passive (from placenta), o Minimal manifestations
with patients. Change gloves and wash hands active (thru immunization & recovery o Lymphadenopathy
every after each patient. from diseases)
• Gowning - Wear gown during procedures which o Artificial – passive (antitoxins),
are likely to generate splashes of blood or active (vaccine, toxoid)
sprays of blood and body fluids, secretions or Maintain vaccine potency by preventing:
excretions. o Heat and sunlight
• Eye protection (goggles) – wear it to prevent o Freezing
splashes. • Antiseptic/ disinfectants/ detergents lessen the
• Environmental disinfection – Clean surfaces potency of vaccine. Use water only when
with disnfectant 70% alcohol,diluted bleach) cleaning fridge/ref.
o Ex. Normal clean – clean the room post
• COLD CHAIN SYSTEM – maintenance of correct
discharge, final clean- MRSA and temperature of vaccines, starting from the
infectious pts. manufacturer, to regional store, to district
Mode of Transmission ISOLATION PRECAUTIONS hospital, to the health center to the
• Separation of patients with communicable DX
Contact transmission immunizing staff and to the client.
diseases from others so as to reduce or • Tuberculin testing
• Direct contact - person to person
prevent transmission of infectious agents. • CXR
• Indirect - thru contaminated object Diseases Acquired Thru Respiratory
7 Categories Recommended in isolation • Sputum AFB
o Droplet spread - contact with
• Strict isolation – prevent spread of infection Prevention
respiratory secretions thru cough, TUBERCULOSIS • BCG
sneezing, talking. Microbes can travel from patient to patient/staff.- handwashing,
infectous materials must be discarded, use of • Chronic respiratory disease affecting the lungs • Avoid overcrowding
up to 3 feet. characterized by formation of tubercles in the
• Airborne Transmission single room, use of mask, gloves and gowns • Improve nutritional status
and (-) pressure if possible tissues---> caseation –--> necrosis ---> TX
• Vector Borne Transmission calcification.
• Vehicle Borne Transmission • Contact isolation – prevent spread by close or • DOTS
Emerging problems in infectious diseases direct contact • AKA: Phthisis, Consumption, Koch’s, • 6 months of RIPE
• Respiratory isolation – prevent transmission Immigrant’s dse • Respiratory isolation,
• Developing resistance to antibiotics eg: anti tb
drugs, MRSA, VRE thru air. • Etiologic agent: – Mycobacterium tuberculosis • Take medicines religiously – prevent
• Increasing numbers of immunosuppressed • TB isolation – for (+) TB or CXR suggesting • Incubation period: 2 – 10 wks. resistance
patients. active PTB. • Stop smoking
• Period of communicability: all throughout the
• Plenty of rest
• Use of indwelling lines and implanted foreign • Enteric Isolation – direct contact with feces life if not treated
bodies has increased. • Drainage/secretion precaution- prevents • Nutritious and balance meals, increase
• MOT: Droplet
CHON, Vit. A, C
INFECTION CONTROL MEASURES infection thru contact with materials or • Sources of infection – sputum, blood, nasal
• UNIVERSAL PRECAUTION – All blood, blood drainage from infected person. discharge, saliva
products and secretions from patients are • Universal Precaution – for handling blood and MENINGITIS
considered as infected. body fluids. (Bloods, pleural fluid, peritoneal • Inflammation of the meninges usually
Classification
WORK PRACTICE CONTROL fluid etc.) some combination of headache, fever, stiff
1. Inactive – asymptomatic, sputum is (-), no cavity on
• Handwashing PREVENTION neck, and delirium
chest X ray
o Before and after using gloves, after Health Education – educate the family about 2. Active – (+) CXR, S/S are present, sputum (+) smear • Meningococcemia: cerebrospinal fever
Immunization Classification 0-5 o Etiologic agent: Neisseria
hand contact with patients, patient’s •
blood and other potentially infected • MOT A. Minimal – slight lesion confined to small part of meningitidis
materials. • Environmental sanitation – breeding places of the lung o Incubation: 2-10 days
mosquito, disposal of feces B. Moderately advanced – one or both lungs are o MOT: droplet
• Protective Equipment shall be removed
• Importance of seeking medical advice for any involved, volume affected should not extend to one • Acute meningococcemia - with or without
immediately upon leaving the work area. Like
health problem lobe, cavity not more than 4 cm. meningitis
apron, mask, gloves etc.
• Preventing contamination of food and water. C. Far advance – more extensive than B o Waterhouse Friederichsen
o Place in designated area.
Environmental Sanitation Syndrome
• Used needles and sharps shall not be bent,
broken, recapped. Used needles must not be o Water Supply Sanitation Program –
removed from disposable syringes. DOH thru EHS (Environmental Health MANIFESTATIONS
• Eating, drinking, smoking, applying cosmetics Services) • Primary Complex: TB in children: non
or handling contact lenses are prohibited in o Policies on Food Sanitation Program contagious, children swallow phlegm, fever,
work areas. o Policies on Hospital Waste cough, anorexia, weight loss, easy fatigability
• Foods and drinks shall not be stored in Management • Adult TB
refrigerators, freezers where blood or other • The CHNurse is in the best position to do health o afternoon rise in temperature
infectious materials are stored. education such as o night sweats
• All procedures involving blood or other o > development of materials for o weight loss
potentially infectious materials shall be environmental sanitation o cough dry to productive
performed in such a manner as to minimize o > providing group counselling, o Hemoptysis
splashing, or spraying. holding community assemblies and o sputum AFB (+)
Control Measures conferences. • Milliary TB - very ill, with exogenous TB like
o > create programs for sanitation Pott’s disease Diagnostic exams:
• Masking – Wear mask if needed. Patient with
o > be a role model • Primary Infection o Lumbar tap, CSF - high WBC and
infectious respiratory diseases should wear
Immunization – introduction of specific antibody to o Asymptomatic CHON, low glucose
mask.
produce immunity to certain disease. o No manifestations even at CXR, Manifestations:
• Handwashing – Practice it with soap and water.
Sputum AFB o Sudden onset of fever x 24h
• Primary Complex o Petechiae, Purpuric rashes
o Meningeal irritation
  Stiff neck 2. Diptheria Antitoxin – after – skin test if (+), fractional • Prone position during attack • TSB , Skin care – daily cleansing wash
 Opisthotonus dose • Abdominal binder • Oral and nasal care
 Kernig’s sign 3. Supportive • Adequate ventilation, avoid dust, smoke • Plenty of fluids
 Brudzinski sign • O2, if laryngeal obstruction – • Isolation • Avoid direct glare of the sun- due to
o ALOC tracheostomy • Gentle aspiration of secretions photophobia
o S/S of Increase ICP • CBR for 2 weeks
Nursing Mgt: • Increase fluids, adequate nutrition- MEASLES GERMAN MEASLES
soft food, rich in Vit C • Acute viral disease with prodromal fever, • Mild viral illness caused by rubella virus.
• Administer prophylactic antibiotics:
• Ice collar conjunctivitis, coryza, cough and Koplik’s • AKA: Rubella; 3-Day Measles
Rifampicin - drug of choice
4. Isolation till 3 NEGATIVE cultures spots
• Aquaeous Pen Prevention
• Incubation period– from exposure to rash 14
• Mannitol • AKA: Rubeola, 7-day measles -21d
 DPT
• Dexamethasone • Etiologic agent: Morbilli Paramyxoviridae • Period of communicability – one week before
• Priority: AIRWAY, SAFETY virus and and 4 days after onset of rashes. Worst
PERTUSIS (whooping cough)
• Maintain seizure precaution • Incubation period: 10-12 days when rash is at it’s peak.
• Repeated attacks of spasmodic coughing with
• Respiratory precaution series of explosive expirations ending in long • Period of communicability: 3 days before • MOT: Droplet, nasal ceretions, transplacental in
• Handwashing drawn force inspiration and 5 days after the appearance of rashes. congenital
• Suction secretions Most communicable during the height of Manifestations
• Etiologic agent: Bordetella pertusis or
Haemiphilus pertussis rash. • 1. Prodromal – low grade fever, headache ,
DIPTHERIA • MOT: Airborne malaise, colds, lymph node involvement on 3rd
• Incubation period: 7-14 days
• Sources of infection – secretions from eyes, to 5th day
• Acute contagious disease characterized by • Period of communicability: 7 days post
generalized toxemia coming from localized nose and throat • 2. Eruptive – FORSCHEIMER’S SPOTS: pinkish
exposure to 3 wks post disease onset rash on soft palate, rash on face, spreading to
inflammatory process Pathognomonic sign:
• MOT – Droplet the neck, arms and trunk
• Etiologic agent: Corynebacterium Diptheria • Koplik’s spots
o lasts1-5 days with no pigmentation or
(Klebs loffer bacillus) desquamation
• Incubation period: 2-5 days o muscle pain
• Period of communicability: variable, ave:2-4 • Treatment
weeks o symptomatic treatment
• MOT – Droplet, direct or intimate contact, Complications
fomites, discharge from nose, skin, eyes • 1. Encephalitis, neuritis
Manifestation • 2. Rubella syndrome – microcephaly, mental
retardation, deaf mutism, congenital heart
 PSEUDOMEMBRANE - grayish white, smooth, disease
leathery and spider web like structure that
bleeds when detached
Types of Respiratory Diptheria RISK for congenital malformation
• NASAL • 1. 100% when maternal infection happens on
o serous to serosanginous purulent first trimester of pregnancy.
discharge Manifestation • 2. 4% - second/third trimester
o Pseudomebrane on septum Manifestations
o rapid cough 5-10x in one Nursing Management
o Dryness/ excoriation on the upper lip • 1.Pre eruptive stage / Prodromal (10-11
inspiration ending a high pitched 1. Isolation. Bed rest
and nares days)
whoop. 2. Room darkened – photophobia
• PHARYNGEAL o Coryza, Cough, Conjunctivitis
• Catarrhal – slight fever in PM, colds, 3. Encourage fluid
o pharyngeal pseudomembrane o Koplik’s Spots, whitish spot at the
watery nasal discharge, teary eyes, 4. Like measles tx
o bull neck ( cervical adenitis) inner cheek PREVENTION;
nocturnal coughing, 1-2 weeks o Fever, photophobia
o Difficulty swallowing • MMR, Pregnant women should
• LARYNGEAL • Paroxysmal – Spasmodic stage; 5-10 • 2. Eruptive stage avoid exposure to rubella patients
o Sorethroat, pseudomemb successive forceful coughing ending with o Maculopapular rashes • Administration of Immune serum
inspiratory whoop, involuntary micturition o Rash is fully developed by 2nd day globulin one week after exposure
o Barking, dry mettallic cough
and defecation, choking spells, cyanosis o High grade fever –on and off to rubella.
Complications
o Due to TOXEMIA • Convalescent – 4th- 6th week; diminish in o Anorexia, throat is sore
severity, frequency • 3. Convalescence (7-10 days) CHICKEN POX
 Toxic endocarditis
Complications: o Desquamation of the skin Acute and highly contagious viral disease
 Neuritis •
• Otitis media Diagnostics characterized by vesicular eruptions on the skin
 Toxic nephritis • Acute bronchopneumonia
o Due to Intercurrent Infection • Nose and throat swab • Infectious agent – Herpes zoster virus or
• Atelectasis or emphysema Treatment
 Bronchopneumonia • Rectal prolapse, umbilical hernia Varicella zoster
• 1. Antiviral drugs- Isoprenosine
 Respiratory failure • Convulsions (brain damage - • Incubation period – 10 -21 days
• 2. Antibiotics – if with complications
DX asphyxia, hemorrhage) • Period of communicability: 1 day before
• 3. Supportive – O2, IVF
• Nose and throat swabs - culture of Dx: eruption up to 5 days after the appearance of the
• Complications – bronchopneumonia,
specimen form beneath membrane • Elevated WBC last crop
otitis media, encephalitis
• Virulence test • Nasopharyngeal swab • MOT: airborne, direct, indirect
• SHICK’s TEST: test for susceptibility to diptheria Nursing Management o Direct contact thru shedding vesicles,
Nursing Management
• MOLONEY’s TEST: test for hypersensitivity to • Prevention: o Indirect thru linens or fomites
• Preventive – measles vaccine at 9
diptheria o DPT months, MMR 15 months and then 11- Manifestations
MANAGEMENT • Parenteral fluids 12; defer if with fever, illness • Pre eruptive: Mild fever and malaise
1. Penicillin, Erythromycin • Erythromycin - drug of choice • Isolation - contact/respiratory

• Eruptive: rash starts from trunk o Burning, itching, pain then 4. Fever may reach 40 C during acute stage,
• Lesions - red papules then becomes milky and erythematous patches followed by crops of 5. One gland may be affected first and 2 days
pus like within 4 days, vesicles later the other side is involved
• Pruritis o Eruptions are unilateral COMPLICATIONS
Stages of skin affectations o Lesions may last 1-2 weeks 1. Orchitis – testes are swollen and tender to
o Macule – flat o Fever, regional lymphadenopathy palpation.
o Papule – elevated above the skin diameter o Paralysis of cranial nerve, vesicles at 2. Oophoritis- pain and tendeness of the
about 3 cm external auditory canal abdomen
o Vesicle o Paralytic ileus, bladder paralysis, 3. Mastitis
o Pustule encephalitis 4. Deafness may happen
o Crust – scab , drying on the skin 5. Meningo-encephalitis -possible
Complications Complications
o pneumonia, sepsis o Opthalmia herpes – blindness because DIAGNOSTIC PROCEDURES
Treatment of damage of gasserian ganglion 1. Viral culture
• Zovirax 500mg tablet 1 tab BID X 7 2. WBC count
o Geniculate herpes – deafness because
days of infection of 7th CN (AKA: Ramsay
• Acyclovir PREVENTION: MMR Vaccine
Hunt Syndrome)
• Oral antihistamine Nursing Intervention
• Calamine lotion TREATMENT MODALITIES CLINICAL MANIFESTATIONS
o Compress of NSS or alluminum acetate
• Antipyretics 1. Antiviral drugs ONSET
over lesions 2. NSAIDS - Acetaminophen
NURSING MANAGEMENT • Ladderlike fever
o Analgesics, sedatives – weeks to mos Nursing Interventions
• Strict isolation until all vesicles o Steroids • Nausea, vomiting and diarrhea
scabs disappear o Symptomatic • RR is fast, skin is dry and hot, abdomen
o Keep blister covered with sterile o Application of warm/ cold compress
• Hygiene of patient powder esp after break is distended
• Cut finger nails short o Oral care, warm salt water gargle • Head-ache, aching all over the body
o Prevent bacterial invasion o Diet – semi solid, soft food easy to
• Baking soda - pruritus o Encourage proper disposal of • Worsening of symptoms on the 4th and
• PREVENTION: Live attenuated chew 5th day
secretions and usage of gown and Acid foods/fluids – fruit juices may
varicella vaccine • • Rose spots
mask increase discomfort
• VZIG - effective if given 96h post TYPHOID STATE
exposure • Tongue protrudes- dry and brown
MUMPS Diseases Acquired thru GIT
• Acute viral disease manifested by swelling of • Diseases caused by Bacteria
• sordes
Herpes Zoster one or both of the parotid glands, with • (coma vigil)
• Acute inflammatory disease known to be o Typhoid Fever
occasional involvement of other glandular • (subsultus tendinus)
caused by herpes virus varicellae or VZ virus o Cholera
structures,particularly testes in male. • (Carphologia)
• Infection of the sensory nerve charac by o Dysentery • Always slip down to the foot part of the
• Etiologic agent – filterable virus of
extremely painful infection along the sensory • Diseases caused by Virus bed,
paramyxovirus group usually found in saliva of
nerve pathway o Poliomyelitis • Severe case - delirum sets in often
infected person.
• Occurs as reinfection of VZ virus o Infectious Hepatitis A ending in death
• MOT • AKA: Epidemic/ infectious parotitis • Diseases caused by Parasites Complications
o Direct • Incubation period: 14 -25 days. o Amoebiasis o Hemorrhage, Peritonitis, Pneumonia,
o Indirect – airborne • Period of communicability – 6d before and 9d o Ascariasis Heart failure, Sepsis
• Incubation: 1-2 weeks post onset of parotid gland swelling DIAGNOSTIC PROCEDURES
o 48 hrs immediately preceding the TYPHOID FEVER 1. WBC – elevated
onset of swelling is the highest • Infection of the GIT affecting the lymphoid 2. Blood Culture – (+) S. typhosa
communicability. tissues(ulceration of Peyer’s patches) of the 3. Stool Culture (+)
• MOT: direct, indirect - droplet, airborne small intestine 4. Widal test – blood serum agglutination test
• Etiologic Agent: Salmonella typhosa and typhi,  O antigen – active typhoid
Typhoid bacillus  H antigen- previously infected
• Incubation period: 1-2 weeks or vaccinated
 Vi antigen - carrier
• Period of communicability: as long as the
TREATMENT
patient is excreting the microorganism,
1. Chloramphenicol – drug of choice
• MOT: fecal-oral route, contaminated water, 2.Paracetamol
milk or other food NURSING MANAGEMENT
• Sources of Infection 1. Restore FE balance
o A person who recovered from the 2. Bedrest
disease can be potential carrier. 3. Enteric precaution
Diagnostic procedure o Ingestion of shellfish taken from waters 4. Prevent falls/ safety prec
o Hx of chickenpox contaminated by sewage disposal 5. Oral/personal hygiene
o Pain and burning sensation over lesions o Stool and vomitus of infected person 6. WOF intestinal bleeding-bloody
of vesicles along nerve pathway are sources of infection. stool,sweating, pallor 7. NPO, BT
o Smear of vesicle fluid- giant cells
CLINICAL MANIFESTATIONS
o Viral cultures of vesicle fluid CHOLERA
1. Sudden headache, earache, loss of appetite
o Electron microscopy
2. Swelling of the parotid gland • An acute bacterial disease of the GIT
o Giemsa-stained scraping –
3. Pain is related to extent of the swelling of characterized by profuse diarrhea, vomiting, loss
multinucleate giant epithelial cells the gland which reaches its peak in 2 days and of fluid.
S/S continues for 7-10 days.
 • Etiologic agent: Vibrio cholerae, V. comma PREVENTION spinal cord and the medulla, cerebellum o Paralytic: asymmetrical
• Pathognomonic sign: rice watery stool 1. Protection of food and water supply from and the midbrain weakness, paresthesia, urinary
fecal contamination. • AKA: Acute anterior poliomyelitis, retention, constipation
• Incubation period: 2-3 days 2. Water should be boiled/ chlorinated. heinmedin disease, infantile paralysis o Non paralytic: slight involvement
• Period of Communicability: entire illness, 7-14d 3. Milk should be pasteurized. • Etiologic Agent: Poliovirus (Legio of the CNS; stiffness and rigidity of
• MOT: fecal oral route 4. Sanitary disposal of human excreta Debilitans) the spine, spasms of hamstring
5. Environmental sanitation. 3 Types of Poliovirus muscles, with paresis
• Type I - most paralytogenic, most frequent o Tripod position: extend his arms
DYSENTERY • Type II - next most frequent
behind him for support when
• Acute bacterial infection of the intestine • Type III - least frequent associated with
upright
characterized by diarrhea and fever paralytic disease
3 Strains o Hoyne’s sign: head falls back
• Etiologic Agent: Shigella group when he is in supine position with
o Brunhilde
o Shigella flesneri - commmon in the the shoulder elevated
o Laasing
Philippines o Meningeal irritation: (+)
o Shigella boydii, S. connei, o Leon
• MOT: Fecal-Oral Brudzinski, Kernig’s sign
o S. dysenteria – most infectious, • Incubation period: 7-14 days ave (3-21 Diagnostic tests:
habitat exclusively in man, they days) • Throat swab, stool exam, LP
develop resistance to antibiotics • Period of communicability: Nursing Interventions
• Incubation period – 7 hrs. to 7 days o 7-16 days before and few days • Supportive, Preventive – Salk and
• Period of communicability – during acute after onset of s/s Sabin Vaccine
Clinical manifestations infection until the feces are (-) • NO morphine
• S/S
o Acute, profuse, watery diarrhea. Moist heat application for spasms
• MOT – fecal-oral route, contaminated water/ o Febrile episodes with varying •
o Initial stool is brown and contains milk/ food. degrees of muscle weakness • AIRWAY: tracheotomy
fecal material à becomes “rice o Occasionally progressive Flaccid • Footboard to prevent foot drop
water” Paralysis • Fluids, NTN, Bedrest
o Nausea/ Vomiting • Enteric and strict precautions
o S/s of Dehydration
o poor tissue trugor, eyes are sunken HEPATITIS A
o Pulse is low or difficult to obtain, BP • Inflammation of the liver caused by hepatitis A
is low and later unobtainable. virus
o RR – rapid and deep • AKA: infectious hepatitis
o Cyanosis – later
o Voice becomes hoarse– speaks in
• Incubation period: 2-6weeks
whisper • MOT: oral-fecal/ enteric transmission
• Oliguria or anuria Clinical manifestations • Diagnostic test: liver function (SGOT/SGPT)
• Conscious, later drowsy • Fever esp. in children
• Deep shock • Nausea, vomiting and headache
• Death may occur as short as four hours • Anorexia, body weakness
after onset. • Cramping abdominal pain (colicky)
• Usually first or 2nd day if not treated • Diarrhea – bloody and mucoid
Principal deficits • Tenesmus
1. Severe dehydration - circulatory collapse • Weight loss 3 Types of Paralysis
2. Metabolic acidosis – loss of large volume of DIAGNOSTICS • Spinal Paralytic
bicarbonate rich stool. RR rapid and deep • Fecalysis o Flaccid paralysis
3. Hypokalemia – massive loss of K. abdominal • Rectal Swab/culture o Autonomic involvement
distention – paralytic ileus • Bloods – WBC elevated
DIAGNOSTIC EXAMS o Respiratory difficulty
• Blood culture • Bulbar Form
Fecal microscopy TREATMENT
1. Rectal swab o Rapid & serious
• Antibiotics- Ampicillin, o Vagus and glossopharyngeal
2. Stool exam Cotrimoxazole, Tetracycline
nerves affected
• IVF
o Cardiac and respiratory reflexes Clinical manifestations
• Anti diarrheal are
Treatment altered Prodromal/ pre icteric
Contraindicated
1. IVF- rapid replacement o Pulmo edema • S/S of URTI
NURSING MANAGEMENT
2. Oral rehydration o Hypertension, impaired temp • Weight loss
1. Maintain fluid and electrolyte balance
3. Strict I and O 2. Restrict food until nausea and vomiting regulation • Anorexia
4. Antibiotics – Tetracycline, Cotrimoxazole. subsides. o Encephalitic s/s • RUQ pain
3. Enteric precaution • Bulbospinal • Malaise
NURSING MANAGEMENT 4. Excreta must be disposed properly. o Combination Icteric
1. Medical Asepsis 5. Prevention- food preparation, safe washing • Minor Polio • Jaundice
2. Enteric precaution facilities, fly control o Inapparent / subclinical • Acholic stool
3. VS monitoring o Abortive: recover within 72 hours; • Bile-colored urine
4. I and O POLIOMYELITIS flulike; backache; vomiting
5. Good personal hygiene • Major Polio Diagnostic tests: HaV Ag, Ab, SGOT, SGPT
• An acute infectious disease caused by any
6. Proper excreta disposal of the 3 types of poliomyelitis virus which
7. Concurrent disinfection. Nursing Interventions
affects mainly the anterior born cells of the
8. Environmental sanitation o Provide rest periods

o Increase CHO, mod Fat, low CHON • Incubation period: 4-8 weeks o Direct or indirect contact to • Oxygen
o Intake of vits/minerals • Communicability: as long as mature wounds • NGT feeding
o Proper food preparation/handling fertilized female worms live in intestine o Traumatic wounds and burns • Tracheostomy
o Handwashing to prevent transmission o Umbilical stump of the newborn • Adequate fluid, electrolyte, caloric intake
• Diagnostic exams: Microscopic
During convalescence
o Dirty and rusty hair pins •
identification of eggs in stool, CBC, Hx of
AMOEBIASIS o GIT- port of entry – rare o Determine vertebral injury
passing out of worms (oral or anal), Xray,
• Involves the colon in general but may involve o Circumcision/ ear pearcing o Attend to residual pulmonary disability
S/S
the liver or lungs as well • Incubation period: 3d-3week (ave:10d) o Physiotherapy
o Stomachache
o TT
• Etiologic agent: Entamoeba histolytica o Vomiting
Nursing Interventions:
• Incubation: 3-4 weeks o Passing out of worms
• Prevention
• Period of communicability: duration of illness o Complications
• DPT
o Energy / Protein malnutrition,
• MOT: fecal oral route o Adverse Reactions
Anemia
• Indirect - Ingestion of food contaminated with o Local reactions (erythema, induration)
o Intestinal obstruction
E.Histolytica cysts, polluted water supply, exposure o Fever and systemic symptoms not
to flies, unhygienic food handlers. Treatment:
common
o Pyrantel Pamoate
• Direct contact – sexual, oral, or anal, o Exagerated local reactions
proctogenital o Piperazine Citrate
o Mebendazole, Tetramizole
Nursing interventions:
o Dicyclomine Hcl, NSAIDS for abdominal pain • Prevention of CV and respiratory complications
o For intestinal obstruction o Adequate airway
 Decompression o ICU – ET- MV
 Fluid and electrolyte S/s: • Provide cardiac monitoring
therapy • persistent contraction of muscles in the • KVO
 If persistent, same anatomic area as the injury • Wound care (TIG, Debridement, TT)
laparotomy • Local tetanus • Administer antibiotics as ordered
o FF up stool exam 1-2 weeks after treatment • Cephalic tetanus - rare form o Penicillin
Nursing Intervention o otitis media (ear infections) • Care during tetanic spasm/ convulsion
o Isolation- not needed • Generalized tetanus o Administer Diazepam – muscle
o Enteric precaution o trismus or lockjaw rigidity/spasm
o Handwashing o stiffness of the neck o Administer neuromuscular blocking
Clinical manifestations
• Intermittent fever o Proper nutrition o difficulty in swallowing agents (metocurin iodide) – relax
• Nausea, vomiting, weakness o Maintenance of hydration / fluid balance / boil o rigidity of abdominal muscles spasms and prevent seizure
• Later : anorexia, weight loss, of water o elevated temperature • Keep on seizure precaution
jaundice o Improve personal hygiene o sweating • Parenteral nutrition
o Proper food prep/handling o elevated blood pressure episodic • Avoid complications of immobility
• Diarrhea – watery and foul smelling
o Administer meds (NSAIDS, MEBENDAZOLE rapid heart rate (contractures, pressure sores)
stool often containing blood
Neonatal tetanus - a form of generalized • WOF urinary retention, fractures
streaked mucus •
• Colic and abdominal distention Diseases Acquired thru the Skin tetanus that occurs in newborn infants
• Intestinal perforation -bleeding • Diseases caused by Trauma and Complications: RABIES
DIAGNOSTIC EXAM Inoculation o Laryngospasm • A viral zoonotic neuroinvasive disease that
• Stool Exam ( cyst, amoeba+++) o Tetanus  Hypostatic pneumonia causes acute encephalitis
WBC – elevated o Rabies • Etiologic agent: Rhabdovirus
•  Hypoxia
TREATMENT o Malaria AKA: Hydrophobia, Lyssa
 Atelectasis •
o Amoebacides – Metronidazole(Flagyl) o DHF Trauma
o • Negri bodies in the infected neurons –
800mg TID X 7days o Leptospirosis
 Fractures pathognomonic
o Bismuth gylcoarsenilate combined with o Schistosomiasis Incubation period: 4-8 weeks; 10d-1yr
o Septicemia •
Chloroquine • Disease acquired thru Contact • Period of communicability: 3-5 days before the
 Nosocomial infections
o Antibiotic – Ampicillin, Tetracycline, o Leprosy onset of s/s until the entire course of disease
o Death
Chloramphenicol Diagnostic procedure: • MOT: contamination of a bite of infected
o Fluid replacement – IVF, oral TETANUS animals
 entirely clinical
NUSING MANAGEMENT • An acute, often fatal, disease characterized CSF – normal • Diagnostic procedures
• Enteric precaution by generalized rigidity and convulsive WBC- normal or slight elevation o History of exposure
• Health education- boil drinking water (20- spasms of skeletal muscles caused by the Treatment: o PE/ assessment of s/s
30 mins), Use mineral water. endotoxin released by C. Tetani • Wounds should be cleaned o Microscopic examination of Negri
• Cover leftover food. • AKA: Lockjaw • Necrotic tissue and foreign material should be bodies using Seller’s May-Grunwald
• Avoid washing food from open drum/pail. • Etiologic Agent: Clostridium Tetani removed and Mann Strains
• Wash hands after defecating and before o Anerobic • Tetanic spasms - supportive therapy and o Fluorescent Rabies Antibody
eating. o Spore forming, gram positive rod maintenance of an adequate airway technique / Direct Immunofluorescent
• Observe good food preparations. • Sources: • Tetanus immune globulin (TIG) test
• Fly control o Animal and human feces o help remove unbound tetanus toxin
o Soil and dust o cannot affect toxin bound to nerve
ASCARIASIS o Plaster, unsterile sutures, rusty endings
• Helminthic infection of the small intestine scissors, nails and pins o single intramuscular dose of 3,000 to
caused by ASCARIS LUMBRECOIDES • MOT: 5,000 units
• MOT: fecal-oral o Contains tetanus antitoxin.

Clinical Manifestations
Prodromal Phase / Stage of Invasion
• Fever, anorexia, malaise,
sorethroat, copious salivation,
lacrimation, perspiration, irritability,
hyperexcitability, restlessness,
drowsiness, mental depression, marked
insomia
• Sensitive to light, sound, and
changes in temp
• Myalgia, numbness, tingling,
burning or cold sensation along nerve
pathway; dilation of pupils
Stage of Excitement
• Marked excitation, apprehension
• Delirium, nuchal stiffness, involuntary
twitching
• Painful spasms of muscles of mouth,
pharynx, and larynx on attempting to
swallow food or water or the mere sight
of them – hydrophobia
• Aerophobia
• Precipitated by mild stimuli – touch or
noise
• Death – spasm from or from cardiac /
respiratory failure
Terminal Phase or Paralytic Stage
• Quiet and unconscious
• Loss of bowel and bladder control
• Tachycardia, labored irregular
respiration, steady rising temp
• Spasm, progressively increasing
paralysis
• Death due to respiratory paralysis
TREATMENT
• No cure
• No specific – symptomatic/ supportive –
directed toward alleviation of spasm
• Employ continuing cardiac and
pulmonary monitoring
• Assess the extent and location of the
bite – biting incident/ status of the
animal
o Severe exposure
o Mild exposure
• Wound treatment (local care)
o Cleanse thoroughly with soap
and water (or ammonium
compounds, betadine, or
benzalkonium cl)
o Anti rabies serum
o Hemorrhagic manifestations –
epistaxis, gum bleeding
• CIRCULATORY Phase
o Fall of temp on 3rd to 5th day
o Restless, cool clammy skin
o Profound thrombocytopenia
o Bleeding and shock
o Pulse - rapid and weak
o Untreated shock --- coma – death
o Treated – recovery in 2 days
CLASSIFICATION
• Grade 1
• Grade 2
• Grade 3
• Grade 4
Treatment
• No specific antiviral therapy for dengue
• Analgesic – not aspirin for relief of pain
• IV fluid
• BT as necessary
• O2 therapy
NURSING MANAGEMENT
1. Kept in mosquito free environment
2. Keep pt. at rest
3. VS monitoring
4. Ice bag on the bridge of nose and forehead.
5. Observe for signs of shock – VS (BP low), cold
clammy skin
PREVENTION
• Mosquito net
• Eradication of breeding places of mosquito-
o house spraying
o change water of vases
o scrubbing vases once a week
o cleaning the surroundings
o keep water containers covered
o avoid too many hanging clothes inside
the house
LEPTOSPIROSIS
• Infectious bacterial disease carried by animals
whose urine contaminates water or food which
is ingested or inoculated thru the skin.
• Etiologic agent: spirochete Leptospira
interrogans
o found in river, sewerage, floods
• AKA: Weil’s disease, mud fever, Swineherd’s
disease
• Incubation Period: 6 -15 days
• Period of Communicability – found in urine
between 10-20 days
• MOT – contact with skin of infected urine or
feces of wild/domestic animals; ingestion,
inoculation
• Diagnostic tests:
o Clinical manifestations
o Culture
o Tetanus prophylaxis
o Antibiotics
o Suturing should be avoided
• Antirabies sera
o Heterologous serum obtained
by hyperimmunization of
different animal species i.e.
horses
o HRIG – Homologous reabies
immunoglobulin – human origin
• Rabies Vaccine
• Active immunization
o Administered 3 years duration
o Used for lower extremity bites
o Lyssavac (purified protein
embryo), Imovax, Anti-rabies
vaccine
• Passive immunization
o 3 months
o Rabuman, Hyper Rab, Imogam
Nursing Intervention
o Isolation of patient
o Provide comfort for the patient by:
 Place padding of
bedside or use
restraints
 Clean and dress wound
with the use of gloves
 Do not bathe the
patient, wipe saliva or
provide sputum jar
o Provide restful environment
 Quiet, dark environment
 Close windows, no faucets or running
water should be heard
 IVF should be covered
 No sight of water or electric fans
MALARIA
• Acute and chronic disease transmitted by
mosquito bite confined mainly to tropical
areas.
• Etiologic agent – Protozoa of genus
Plasmodia
• Plasmodium Falciparum (malignant tertian)
o most serious, high parasitic densities in
RBC with tendency to agglutinate and
form into microemboli. Most common
in the Philippines
• P. Vivax - non life threatening except for the
very young and old.
o Manifests chills every 48 hrs on the 3rd
day onward if not treated,
• P. malarie (Quartan) – less frequent, non life
threatening, fever and chills occur every 72 hrs
on the 4th day of onset
• P. ovale - rare
• Incubation period:
o 12days P. falciparum, 14 days P vivax
and ovale, 30 days P. malariae
• Period of communicability
o If not treated /inadequate – more than
3 yrs. P malariae, 1-2 yrs. P. vivax, 1
yr- P. falciparum
• Mode of transmission
SOURCE OF INFECTION
o Rats, dogs, mice
MANIFESTATIONS
o Septic Stage
 Early
 Fever (40 ‘C), tachycardia, skin
flushed, warm, petechiae
 Severe
 Multiorgan
 Conjunctival affectation,
jaundice, purpura, ARF,
Hemoptysis, head-ache,
abdominal pain, jaundice
o Toxic stage – with or w/o jaundice,
meningeal irritation, oliguria– shock, coma ,
CHF
o Convalescence – recovery
MANAGEMENT
1. IV antibiotic
Pen G Na
Tetracycline
Doxycycline
2. Dialysis – peritoneal
3. IVF
4. Supportive
5. Symptomatic
Nursing Interventions
o Isolation of patient – urine must
properly disposed
o Care of exposed persons – keep under
close surveillance
o Control measures
 Cleaning of the environment/
stagnant water
 Eradicate rats
 Avoid bathing or wading in
contaminated pool of water
 vaccination of animals
(cattles,dogs,cats,pigs)
SCHISTOSOMIASIS
• Parasitic disease caused by Schistosoma
japonicum, S. mansoni, S. Hematobium
• AKA: Bilharziasis, Snail fever
• Incubation period: 2-6 weeks
• MOT: bathing, swimming, wading in water
• Vector: Oncomelania quadrasi
o Cercariae: most infective stage
• Diagnostic test: ova seen in fecalysis
• Diagnostic procedures
 Fecalysis
• Identification of eggs
o Mosquito bite • TSB, ice cap on head
VECTOR – female Anopheles mosquito • Hot drinks during chilling, lots of fluid
• Monitoring of serum bilirubin
DIAGNOSTICS • Keep clothes dry, watch for signs of
• Malarial smear – film of blood is bleeding
placed on a slide, stained and • PREVENTION
examined o Mosquito breeding places should
• Rapid diagnostic test (RDT) – be destroyed
done in field. 10 -15 mins result o Insecticides, insect repellant
blood test o Blood donor screening
DENGUE FEVER
• Is an acute febrile disease cause by infection
with one of the serotypes of dengue virus which is
transmitted by mosquito ( Aedes aegypti).
• Dengue hemorrhagic fever – fatal
characterized by bleeding and hypovolemic shock
• Etiologic agent – Arbovirus group B –
• AKA: Chikungunya, O’ nyong nyong, west nile
fever
• Mode of Transmission: Bite of infected
mosquito – AEDES AEGYPTI
• Incubation period – 3-14 days
• Period of communicability – mosquito all
throughout life
Sources of infection
Clinical Manifestions • Infected person- virus is present in the
• Rapidly rising fever with severe
blood and will be the reservoir when
headache sucked by mosquitoes
• Shaking chills
• Stagnant water = any
• Diaphoresis, muscular pain
• Splenomegaly, hepatomegaly
• Hypotension
o May lasts for 12 hours daily or every 2
days.
• Complicated Malaria
• GIT
o Bleeding from GUT, N/V, Diarrhea,
abdominal pain, gastric, tyhoid, choleric,
dysenteric
• CNS or Cerebral Malaria
o Changes in sensorium
o Severe headache
o N/V
• Hemolytic Diagnostic Tests
• Blackwater fever • Torniquet test
o Reddish to mahogany colored urine
• Platelet Count
due to hemoglobinuria • Hematocrit
o Anuria – death Manifestations
• Malarial lung disease • PRODROMAL symptoms
MANAGEMENT o malaise and anorexia up to 12 hrs.
• Antimalarial drugs – Chloroquine (all but o Fever and chills, head-ache, muscle
P. Malarie), quinine, Sulfadoxine (resistant pain
P falciparum) Primaquine (relapse P o N &V
vivax/ovale)
• FEBRILE Phase
• RBC replacement/ erythrocyte exchange o Fever persists (39-40 C)
transfusion o Rash - more prominent on the
Nursing management:
extremities and trunk
• Isolation of patient o (+) torniquet test- petechia more than
• Use mosquito nets 10.
• Eradicate mosquitos
• Care of exposed persons – case finding
o Skin appears purple with blanched
I and O areas with varied sizes ( Herman’s
•
BUN & creatinine – dialysis could be life sign)
•
saving o Generalized or abdominal pain
• ABG
 Liver and rectal biosy o Proper sanitation or disposal of feces
 Immunodiagnostic tests / o Creation of a program on snail control –
circumoval precipitin test and chemical or changing snail
cercarial envelope reactions environment
LEPROSY
• Chronic systemic infection characterized by
progressive cutaneous lesions
• Etiologic agent: Mycobacterium leprae
o Acid fast bacilli that attack cutaneous
tissues, peripheral nerves producing
skin lesions, anesthesia, infection and
deformities.
• Incubation period – 5 1/2 mo - eight years.
• MOT – respiratory droplet, inoculation thru
break in skin and mucous membrane.
Diagnosis
• 1. Identification of S/s
• 2. Tissue biopsy
• 3. Tissue smear
• 4. Bloods – inc. ESR
• 5. Lepromin skin test
• 6. Mitsuda reaction
S/s
o Swimmers itch MANIFESTATIONS
 Itchiness • Corneal ulceration, photophobia –blindness
 Redness and pustule formation at site • Lesions are multiple, symmetrical and
of entry of cercariae erythematous– macules and papules
 Diarrhea • Later lesions enlarge and form plaques on
 Abdominal pain nodules on earlobes, nose eyebrows and
forehead
 hepatosplenomegaly
• Foot drop
CLINICAL MANIFESTATIONS:
• Raised large erythemathous plaques appear on
• Abdominal pain
skin with clearly defined borders. – rough
• Cough
hairless and hypopigmented – leaves an
• Diarrhea
anesthetic scar.
• Eosinophilia - extremely high eosinophil
• Loss of eyebrows/eyelashes
granulocyte count.
• Loss of function of sweat and sebaceous glands
• Fever
• Epistaxis
• Fatigue
• Hepatosplenomegaly - the enlargement of both
the liver and the spleen.
• Colonic polyposis with bloody diarrhea
(Schistosoma mansoni mostly)
• Portal hypertension with hematemesis and
splenomegaly (S. mansoni, S. japonicum);
• Cystitis and ureteritis with hematuria àbladder
cancer;
• Pulmonary hypertension (S. mansoni, S.
japonicum, more rarely S. haematobium);
• Glomerulonephritis; and central nervous
system lesions.
• Complications
o Pulmonary hypertension
o Cor pulmonale
o Myocardial damage TREATMENT
o Portal cirrhosis • multiple drug therapy
Treatment:
• sulfone
Trivalent antimony
• • rehab
o Tartar emetic – administered thru vein
• occupational Health
o Stibophen (FUADIN) – given per IM • isolation
• PRAZIQUANTEL – per orem • moral support
• Niridazole PREVENTION
• Nursing Interventions: 1. Report cases and suspects of leprosy
o Administer prescribed drugs as ordered 2. BCG vaccine may be protective if given during
o Prevent contact with cercaria-laden the first 6 months.
waters in endemic areas like streams 3. Nursing Interventions:
 1. Isolation of patient – until causative o Progressive multifocal • A curable infection caused by the bacteria
agent is still present leukoencepalopathy Neisseria gonorrhoea
2. Care of exposed persons o Salmonella septicemia • AKA: Clap, Drip, G. vulvovaginitis
1. Household contact – o Toxoplasmosis • MOT: transmitted during vaginal, anal, and oral
Diaminodiphenylsulfone for 2 o Wasting syndromes sex
years Treatment • Incubation period: 3-10 days initial
2. Observe carefully for • Started in CD4 counts of <200 manifestations
symptoms of the disease • Viral load >10,000 copies • Period of communicability: considered
• All symptomatic regardless of counts infectious from the time of exposure until
Diseases Acquired Thru Sexual Contact • Note: CD4 reflects immune system treatment is successful
destruction. Viral load- degree of viral activity Manifestations:
HIV /AIDS • Nucleoside Reverse Transcriptase Inhibitors • Urethritis – both male and female
• Chronic disease that depresses immune • Blocks reverse transcriptase • S/S: dysuria and purulent discharge
function NRT • Cervicitis
• Characterized by opportunistic infections when • Acts by binding directly to the reverse • Upper Genital Tract – females (PID)
T4/CD4 count drops <200 transcriptase enzyme Endometritis, Salpingitis,
Diagnostic Tests
• MOT – sexual contact with infected – • Not used alone Pelvic Abscess
• ELISA
unprotected, injection of blood/products, • Rapid development of resistance Complications :
• Western Blot •
placental transmission • Acts by binding directly to the reverse PID
• CD4 count •
• Viral load testing transcriptase enzyme • Infertility
• Home test kits • Not used alone Complications:
History of HIV / AIDS Manifestations • Rapid development of resistance • Upper Genital Tract – male
• 1959 - African man o Minor signs – cough for one month, Generic Trade Dose Notes o Epididymitis, Prostatitis, Seminal
• 1981- 5 homosexual men general pruritus, recurrent herpes Vesiculitis
• 1982-Designated as disease by CDC zoster, oral candidiasis, generalized Zidovudine AZT, ZDV, 300 mg. Taken with food • Disseminated Gonococcal Infection (DGI)
• 1983- HIV 1 discovered lymphadenopathy Retrovir Bid o Tenosynovitis or Polyarthritis, skin
• 1987- 1.5 million HIV-infected in USA o Major signs – loss of weight 10% BW, lesions and fever
• 1994- WHO reports 8-10 mil. Worldwide & chronic diarrhea 1month up, prolonged Didanosine ddI, Videx 200 mg Peripheral • Anorectal Infection
protease inhibitors introduced fever one month up. bid neuropathy • Pharyngeal Infection
• 1999-First clinical trials for HIV vaccine • Persistent lymphadenopathy • Gonococcal Conjuctivitis
Zalcitibine ddC,Hivid .75 mg No antacids
The immune system • Cytopenias (low) o Opthalmia Neonatorum
TID
o Macrophages • PCP • Meningitis, Endocarditis
 Humoral response • Kaposis sarcoma Stavudine d4T, Zerit 400 mg Peripheral Diagnosis:
 Cell-mediated response • Localized candida bid neuropathy • Culture & Sensitivity
• Bacterial infections • Blood tests for N. gonorrhoeae antibodies
• TB Lamivudine 3TC, Epivir 150 mg Used as Treatment:
• STD bid resistance • ANTIBIOTICS
 Neurologic symptoms develops • Penicillin
Criteria for Diagnosis of AIDS • Single dose Ceftriaxone IM + doxycycline PO
Lamiduvine/ Combivir 150/300 Bone marrow BID for 1 week
• CD4 counts of 200 or less
Zidovudine mg toxicity • Prophylaxis: Silver nitrate, Tetracycline,
• Evidence of HIV infection and any of
o Thrush Erythromycin
o Bacillary angiomatosis Protease Inhibitors Nursing Interventions:
o Oral hairy leukoplakia • Introduced in 1995 o Case finding
o Peripheral neuropathy • Acts by blocking protease enzyme o Health teaching on importance of
o Vulvovaginal candidiasis • Indinavir (Crixivan) monogamous sexual relationship
o Shingles o Treatment should be both partners to
o Idiopathic thrombocytopenia CDC Guidelines prevent reinfection
o Fatigue, night sweats, weight loss o Combination of 2 NRTI + PI o Instruct possible complications like
o Cervical dysplasia, carcinoma in • Nursing Management infertility
situ o Administer Antiviral meds as ordered o Educate about s/s and importance of
• Evidence of HIV infection and any one of the o Universal precaution taking antibiotic for the entire therapy
following: o Reverse isolation
o Bronchial candidiasis  gloves, needle stick injury SYPHILIS
o Esophageal candidiasis prevention • a curable, bacterial infection, that left
o CMV disease o Assist in early diagnosis and untreated will progress through four stages
o CMV retinitis management of complications with increasingly serious symptoms
o HIV encephalopathy • 4 C’s • Etiologic agent: Treponema pallidum
o Histoplasmosis o Compliance – info, + drugs • AKA: Lues, The pox, Bad blood
o Kaposi’s Sarcoma o Counselling – education • Type of Infection: Bacterial
o Herpes simplex ulcers, bronchitis, o Contact tracing – tracing out and tx for • Modes of transmission :
pneumonia partners o Through sexual contact/ intercourse,
o Primary brain lymphoma o Condoms – safe sex kissing
o Pneumocystis Carinii Pneumonia o abrasions
o Recurrent pneumonia o Can be passed from infected mother to
GONORRHEA
o Mycobacterium infection unborn child (transplacental)

Symptoms • Mutual monogamy o WOF s/s bleeding, edema

o Primary syphilis (10 – 90 days after
infection)
 Chancre – a firm, painless skin
ulceration localized at the point
of initial exposure to the
bacterium appear on the
genitals
• can also appear on the
lips, tongue, and other
body parts
o Secondary syphilis (last 2 – 6 weeks)
 syphilis rash - an infectious
brown skin rash that typically
occurs on the bottom of the
feet and the palms of the hand
 condylomata lata - flat broad
whitish lesions
 Fever, sore throat, swollen
glands, and hair loss can also
be experienced
• Third stage
o Will manifest 1 – 10 years after the
infection
o characterised by gummas - soft, tumor-
like growths
 seen in the skin and mucous
membranes – occurs in bones
o joint and bone damage
o increasing blindness
o Numbness in the extremities, or
difficulty in coordinating movements.
Neurosyphilis
• generalized paresis of the insane
which results in personality
changes, changes in emotional
affect, hyperactive reflexes
• cardiovascular syphilis
• aortitis, aortic aneurysm,
Aneurysm of sinus of valsalva and
aortic regurgitation, - death
Consequences in Infants
• Congenital syphilis
• extremely dangerous
• Deformities
• Seizures
• Blindness
• Damage to the brain, bones, teeth, and
ears.
Test and diagnosis
• Venereal Disease Research Laboratory
(VDRL) test
• Flourescent treponemal antibody
absorption (FTA – Abs)
• Micro hemagglutination test (MHA - TP)
• CSF examination
Treatment
• Syphilis is easily treatable when early
detected
• Penicillin & other antibiotics
Prevention
• Abstinence
• Latex condoms for vaginal and anal sex o Health education on safe sex
• Nursing interventions
o Case finding SEVERE OF ACUTE RESPIRATORY SYNDROME
o Health teaching and guidance along • An acute and highly contagious respiratory
preventive measures disease in humans
o Utilization of community health • Etiologic agent: SARS coronavirus
facilities • November 2002 and July 2003, with 8,096
o Assist in interpretation and diagnosis known infected cases and 774 deaths
o Reinforce ff up treatment • Incubation period: 2-3days
o VD control program participation • MOT: Airborne
o Medical examination of patient’s S/s
contacts o flu like: fever, myalgia, lethargy,
gastrointestinal symptoms, cough, sore
HEPATITIS B throat
• serious disease caused by a virus that attacks o fever above 38 °C (100.4 °F)
the liver o Shortness of breath
Etiologic agent: hepatitis B virus (HBV)
• o Symptoms usually appear 2–10 days
• Source of infections: Blood and body secretions following exposure
Risk factors o require mechanical ventilation
• multiple sex partners or diagnosis of a sexually
Diagnostic Test:
transmitted disease • Chest X-ray (CXR)- abnormal with patchy
• Sex contacts of infected persons infiltrates
• Injection-drug users • WBC and PLT CT. - LOW
• Household contacts of chronically infected • ELISA test detects antibodies to SARS
persons o but only 21 days after the onset of
• Infants born to infected mothers symptoms
• Infants/children of immigrants from areas with • Immunofluorescence assay, can detect
high rates of HBV infection antibodies 10 days after the onset of the
• Health-care and public safety workerr disease
• Hemodialysis patients o labour and time intensive test
Complications:
• Polymerase chain reaction (PCR) test that can
• Lifelong infection
detect genetic material of the SARS virus in
• Liver cirrhosis
specimens ranging from blood, sputum, tissue
• Liver cancer
samples and stools
• Liver failure
• CXR - increased opacity in both lungs,
• Death indicative of pneumonia
S/s:
• Jaundice • SARS may be suspected
• Pruritus • fever of 38 °C (100.4 °F) or more AND
• Fatigue • Either a history of:
• RUQ - Abdominal pain o Contact (sexual or casual) with
• Loss of appetite someone with a diagnosis of SARS
• Nausea, vomiting within the last 10 days OR
• Joint pain o Travel to any of the regions identified
Prevention: by the WHO as areas with recent local
• Hepatitis B vaccine has been available since transmission of SARS (affected regions
1982. as of 10 May 2003 were parts of China,
o Routine vaccination of 0-18 year olds Hong Kong, Singapore and the province
o Vaccination of risk groups of all ages of Ontario, Canada).
• Immune globulin if exposed • probable case of SARS has the above findings
MEDICAL MANAGEMENT plus positive chest x-ray findings of atypical
• Interferon alfa-2b pneumonia or respiratory distress syndrome
• Lamivudine Treatment
• Telbivudine • Supportive with antipyretics, supplemental
• Entecavir oxygen and ventilatory support as needed.
• Adefovir dipivoxil • Suspected cases of SARS must be isolated,
Nursing Interventions: preferably in negative pressure rooms, with full
o Blood and body secretions precautions barrier nursing precautions taken for any
o Prevention- Hepa B vaccine necessary contact with these patients
o Proper rest periods • steroids
o Prevent stress – physio/psychological • antiviral drug
o Proper NTN, increase in CHO, high in • SARS vaccine
CHON, low fats, Vit. K rich foods and
minerals
o Assistance to prevent injury, promote
safety AAT
H EALTH A DVISORY H EALTH A DVISORY
N a t i o n a l C e n t e r f o r H e a l t h Pr
Pr o m o t i o n N a t i o n a l C e n t e r f o r H e al
a l t h Pr
Pr o m o t i o n
N a t i o n a l C e n t e r f o r D i s e a s e Pr
Pr e v e n t i o n a n d C o n t r o l N a t i o n a l C e n t e r f o r D i s e a s e Pr
Pr e v e n t i o n a n d C o n t r o l

H EALTH A DVISORY
Foreword H EALTH A DVISORY
N a t i o n a l C e n t e r f o r H e a l t h Pr
Pr o m o t i o n N a t i o n a l C e n t e r f o r H e al
a l t h Pr
Pr o m o t i o n
N a t i o n a l C e n t e r f o r D i s e a s e Pr
Pr e v e n t i o n a n d C o n t r o l N a t i o n a l C e n t e r f o r D i s e a s e Pr
Pr e v e n t i o n a n d C o n t r o l

Diseases are perennial

perennia l concerns in our country
countr y. They have been the causes of
premature deaths and illnesses. Being a developing country with a tropical environment
environm ent
and alternating weather conditions, the Philippines is constantly seeing the occurrence
of many diseases.

For this reason, the Department of Health (DOH) has identified various
diseases in its effort to prevent its spread and improve the health condition of the
people. This situation spawned a need for information about these diseases. As a
response, the Department of Health produced one-page advisories in language easily
understood.

This compilation of health advisories were put together for easier reference
for those who want precise information. These were crafted in a way that even
individuals with non-medical background can easily read and understand. The
advisories have been grouped according to the nature of the disease or health
condition.

The Department of Health is grateful to the World Health Organization and

other DOH offices for assisting in the development of this project. We thank them for
their unwavering support.

Mabuhay kayong lahat! 

Francisco T.
T. Duque III,
III , M.D., MSc.
Secretary of Health

i
H EALTH A DVISORY
 Acknowledgment H EALTH A DVISORY
N a t i o n a l C e n t e r f o r H e a l t h Pr
Pr o m o t i o n N a t i o n a l C e n t e r f o r H e al
a l t h Pr
Pr o m o t i o n
N a t i o n a l C e n t e r f o r D i s e a s e Pr
Pr e v e n t i o n a n d C o n t r o l N a t i o n a l C e n t e r f o r D i s e a s e Pr
Pr e v e n t i o n a n d C o n t r o l

Editors: Angelina K. Sebial

Rosemarie G. Aguirre

Project Coordinators: Maria Victoria C. Madura

Ma. Arlene S. Arbas

Layout and Design: Adell R. Azuelo

Diosdado G. Angeles Jr.

Technical Assistance: National Center for Disease Prevention

and Control (NCDPC)
National Epidemiology Center (NEC)

Contributor: Edgar S. Hilario

Printed by: World Health Organization (WHO)

ii

H EALTH A DVISORY
Table of Contents H EALTH A DVISORY
N a t i o n a l C e n t e r f o r H e a l t h Pr
Pr o m o t i o n N a t i o n a l C e n t e r f o r H e al
a l t h Pr
Pr o m o t i o n
N a t i o n a l C e n t e r f o r D i s e a s e Pr
Pr e v e n t i o n a n d C o n t r o l N a t i o n a l C e n t e r f o r D i s e a s e Pr
Pr e v e n t i o n a n d C o n t r o l

Page
Fo re w o rd i 39. Measles ...................................................................... 42
Ac k n o wl e d gm e nt ii 40. Menin
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41. Men
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A. Diseas
Diseases/
es/ Disor
Disorders
ders// Health
Health Condit
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43 Para
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44. Paralytic Shellfish Poisonin
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46 Poli
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3. Cancer ..................................................................... 4 47. Rabies ...................................................................... 50
• Bone
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• Breast
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• Colon
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• Live
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• Ovaria
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• Rectum
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• Stoma
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• Thyroi
Thy roidd Can
Cancer
cer ....
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• Uterine
Uteri ne Cervix Cancer
Cancer........
................
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................
................
................
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.... 16
4. Capi
Capillllia
iari
ria
asis
sis ..................................................................... 17 B. Weat
Weathe
herr & Se
Seas
ason
on-re
-rela
late
ted
d Advis
Advisor
orie
ies
s ......
.. ......
......
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..... 60
5. Chi
hic
cken Pox ..................................................................... 18
6. Cholera ..................................................................... 19 • It’s Sum
Summermer tim
timee ....
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7. De
Dengue ..................................................................... 20 • Health for
for the holiday
holiday season.
season.................
...............................
...............................
...............................
............... 62
8. Depressive
Depressive disor disorders
ders ....
.. ....
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.... 21 • During the typhoon
typhoon season..................
season..............................
.........................
..........................
........................
........... 63
9. Diarrhea ..................................................................... 22 • El Nino phenomenon ......
.........
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10. Diphtheria ..................................................................... 23 • La Nina phenomenon ... ......
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..... 65
11. Epilepsy ..................................................................... 24 • Haze ...................................................................... 66
12. Fila
larriasis ..................................................................... 25 • Foo
oodd Safafet
ety
y ...................................................................... 67- 7-68
68
13. Foot and Mouth Diseas Diseasee ...................
........................................
...........................................
............................ 26 • Sun Burn ...................................................................... 69
14. Hep
epa atititi
tis
sA ..................................................................... 27 • Hea
He at Str
tro
oke ...................................................................... 70
15. Hep
epat atit
itis
is B ..................................................................... 28 • Boil ...........................................
.................................................................. .... 71
...........................
16. Hep
epat atit
itis
is C ..................................................................... 29 • Pri
ric
ckly Hea
eatt ...................................................................... 72
17. High blood
blood pressure
pressure ....
.. ....
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28. Influenza ..................................................................... 31 C. Blo
Blood
od Don
Donatio
ation
n ....
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.. 73
29. Iodine Defic
Deficiency
iency Disord
Disorder
er.............
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............. 32
30. Iron Deficien
Deficiency cy Anemia .........
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Share yourr blo
blood
od ....
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.. 74
31. Japanese Encephalitis ... ......
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32. Kaw
Kawasaasaki ki Disea
Diseasese ....
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..... 76
33. Leprosy ..................................................................... 36 • Are you qualifi
qualified
ed to share your blood? ..... ..........
..........
.........
.........
..........
..........
..........
..........
.......
.. 77
34.. Lept
34 Leptosospi piro
rosi
sis
s ..................................................................... 37 • Are you afraid to donate
donat e blood? ...............
.........
.........
..........
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.........
.........
..........
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....... 78
35. Leukemia ..................................................................... 38 • What happens after you give blood? ... ......
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..... 79
36. Lymphomas ..................................................................... 39 • Conditions that prevent
prevent you
you from sharing blood................................. 80
37. Mad
Madcowcow Dis Diseas
easee ....
.. ....
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38. Malaria ..................................................................... 41
 H EALTH A DVISORY H EALTH A DVISORY
N a t i o n a l C e n t e r f o r H e a l t h Pr
Pr o m o t i o n N a t i o n a l C e n t e r f o r H e al
a l t h Pr
Pr o m o t i o n
N a t i o n a l C e n t e r f o r D i s e a s e Pr
Pr e v e n t i o n a n d C o n t r o l N a t i o n a l C e n t e r f o r D i s e a s e Pr
Pr e v e n t i o n a n d C o n t r o l

 ALZHEIMER’S
DISEASE
• Is a form of dementia that is characterized by the progressive degenerative
brain syndrome that affects memory, thinking, behavior and emotion.
• Constitutes 50-60% of all cases of dementia

Causes

• There is destruction of brain cells disrupting the transmitters that carry the messages in
the brain, particularly those responsible for storing memories.

Diseases/ Disorders/ • The cause for the destruction of the brain cells remains unknown.

• Studies show that genetic factors play a part in the development of the disorder.

Health Conditions • The neurotransmitters acetylcholine and norepinephrine are hypothesiz

in Alzheimer’s disease.
hypothesized
ed to be hypoactive

Symptoms

• Loss of memory characterized by inability to recall past as well as new persons, events,
situations and information

• Difficulty in finding the right words

• Difficult
Difficultyy in understanding what people are saying

• Difficult
Difficultyy in performing previously routine tasks

• Personality and mood changes

Prevention and Control

• Currently there is no cure for Alzheimer’s Disease.

• General treatment approach to patient is to provide supportive medical care,

pharmacological
pharmacologi cal treatment for specific symptoms, including disrupti
disruptive
ve behavior, and
emotional support for patients and their families.

1 2

H EALTH A DVISORY H EALTH A DVISORY

N a t i o n a l C e n t e r f o r H e a l t h Pr
Pr o m o t i o n N a t i o n a l C e n t e r f o r H e al
a l t h Pr
Pr o m o t i o n
N a t i o n a l C e n t e r f o r D i s e a s e Pr
Pr e v e n t i o n a n d C o n t r o l N a t i o n a l C e n t e r f o r D i s e a s e Pr
Pr e v e n t i o n a n d C o n t r o l

BIRD FLU (Avian

(Avian Influenza)
I nfluenza)
CANCER
About Cancer

Cancer is a group of many related diseases that begins in cells. Normally, cells grow and divide to
• Bird flu or Avian Influenza is a contagious disease of birds produce more cells only when the body needs them. This orderly process helps keep the body healthy.
ranging from mild to severe form of illness. Sometimes, however, cells keep dividing even if new cells are not needed. These extra cells form a mass
• The outbreaks affecting some Asian countries caused by of tissue, usually called a lump, swelling or tumor.
influenza A/H5N1 virus may also cause severe infection
infection Tumors can be classified as: BENIGN TUMORS which are not cancerous. They often can be removed,
in humans. and in most cases, do not come back; and MALIGNANT TUMORS which are cancerous. Cells in these
tumors are abnormal and they divide without control and they can invade and damage nearby tissues and
• Bird Flu is transmitted to humans through inhalation or contamination with infected
organs.
discharges or feces of sick chicken.
Risk Factors
Signs and Symptoms Cancer is a result of complex mix of factors related to heredity, diet, physical inactivity and prolonged,
continuous exposure to certain chemicals and other substances.
• Fever
A number of factors that increase a person’s chance of developing cancer has been identified and are
• Body weakness or muscle pain called “risk factors”.
• Cough
Cigarette Smoking
• Sore throat Smoking accounts for more than 85% of lung cancer deaths. Smokers are more
m ore likely to develop lung
• Some persons with H5N1 have sore eyes and/or diarrhea cancer compared to non-smokers. Overall, smoking has been linked to cancers of the mouth, larynx,
• Difficulty of breathing in a week’s time from onset in severe cases pharynx, esophagus, pancreas and bladder.
• Case fatality ratio is around 35% Excessive Alcohol Intake
Heavy drinkers have an increased risk of cancers of the mouth, throat, esophagus, larynx and liver.
Treatment Some studies suggest that even moderate drinking may slightly increase the r isk of breast cancer.

Unhealthy Diet
Treatment of Bird Flu in humans is the same as for other influenza viruses. Antiviral Antiviral Diet plays an important role in the development of many cancers, particularly in the digestive and
drugs, such as Osetalmivir halts the progress
progr ess of the illness if given within the first 2 days from reproductive organs. Long-term habit of not eating a healthy diet has been linked that increases incidence
of cancer. Likewise, being seriously overweight has been linked to breast cancer.
the onset of fever.
Chemicals and Other Substances
Exposure to substances such as chemicals, metals or pesticides can increase the risk of cancer.
Prevention Asbestos, nickel, cadmium, uranium, radon, vinyl chloride and benzene are well-known cancer-causing
agents (carcinogens). These may act alone or together with other carcinogens, like cigarette smoke, to
• Wash hands thoroughly with soap and water before and after handling live and dressed increase the risk of cancer.
chicken. Prevention
• Cook chicken thoroughly
thorough ly..
• Do not sell live chicken, ducks, and pigs together in one cage or pen area. There is no 100% guarantee that cancer can ever be prevented. However, being aware of the cancer
risk factors will help in reducing the
t he possibility of cancer. Early detection and proper treatment
treat ment plays a big
• Do not catch, get near or keep in captivity wild birds. role in controlling cancer.
• Do not handle sick or dead birds with bare hands. Use gloves or plastic material for
To lessen the risk of
o f developing cancer:
cance r:
the hands, facial masks and goggles. Quit Smoking
• Report to the nearest agricultural/veterinary
agricultural/veterinary office any unusual death or illness of Limit Drinking Alcoholic Beverages
chicken and other birds. Watch Your Diet
Consult Your Doctor Regularly
• Report to the nearest local health centers any case of respiratory illness with history of Do Regular Physical Activity
exposure to sick chickens and other birds.
Contents are contributed by Philippine Cancer Society
3 4
 H EALTH A DVISORY H EALTH A DVISORY
N a t i o n a l C e n t e r f o r H e a l t h Pr
Pr o m o t i o n N a t i o n a l C e n t e r f o r H e al
a l t h Pr
Pr o m o t i o n
N a t i o n a l C e n t e r f o r D i s e a s e Pr
Pr e v e n t i o n a n d C o n t r o l N a t i o n a l C e n t e r f o r D i s e a s e Pr
Pr e v e n t i o n a n d C o n t r o l

BONE CANCER BREAST CANCER

Breast Cancer is the leading cancer site among Filipino women. It also ranks 2nd as leading cancer site in
both female and male population. An estimated 14,043 new cases of, and 6,357 deaths due to breast
cancer are expected to occur every year.
Incidence
Causes
Bone cancer is the 24th leading site overall, 18th in males and 21st among Genetic factor or the hereditary susceptibility of the person
females. In 1998, an estimated 769 new cases will be seen, 479 cases
Environmental factors which include:
among males and 290 among females. Osteosarcoma is the most
common of all malignant bone tumors. Incidence increases at age 60. - a constant diet that is high in fat, salt and sugar;
- being overweight; and
- woman’s age (above 30 years old) during first pregnancy or those who never had any children
Risk factors Symptoms
Areas of rapid bone growth, such as long bones in children and • Lump, thickening or swelling of the breast.
• Unusual change in the size or shape of the breast.
adolescents, as well as prolonged growth or overstimulated metabolism, • One breast unusually lower than the other.
ot her.
such as chronic osteomyelitis and hyperparathyroidism. External radiation • Puckering/dimpling
Puckering/dimpl ing of the skin of the breast.
• Retraction on the nipple.
and bone-seeking isotopes have also been implicated. • A sore in the nipple.

Early Detection
  Warning signals
Breast cancers when detected early, and given prompt treatment, have excellent chances of being
Pain that is worse at night. cured. Mammography
Mammograph y and Breast Self-Examination (BSE) are important in the early detection of breast
cancer.

Early detection
Early detection is extremely difficult in asymptomatic patients. Patients
with persistent and progressive bone pain should have an x-ray study of
the bone.
Treatment
Although amputation has been the standard treatment of most bone cancer,
limb-sparing surgery has been developed for both malignant and
aggressive begin tumors. Advances in orthopedics, bioengineering,
radiographic imaging, radiotherapy, and chemotherapy have contributed
to safer, more reliable surgical procedures. Paralleling these advances,
adjuvant chemotherapy has dramatically increased overall survival.
Women without personal or family history of breast cancer should undertake mammography starting
age 40 every two years. On the other hand, women at the age of 35 with personal or family history of
breast cancer especially immediate relatives (i.e., grandmother, mother, aunt, sister) must have
mammography every year.
BSE, though practical and economical, has its limitations. While a mammography can detect breast
lumps even on its earliest stage, in BSE a lump would have to grow
gr ow into a considerable size to be noticed
and felt . But since not all Filipino women can afford to have mammography, BSE becomes the best
alternative in breast exam.
BSE is done once a month, a week after a woman’s monthly period. Through BSE, a woman becomes
familiar with the usual appearance
appeara nce and feel of her breast. So she can easily tell any change on it.
Prevention
Generally, breast cancer cannot be prevented from happening, particularly if a woman has a family
history of breast cancer. However, certain measures can be done to minimize the contributing risk factors
a woman may have:
• Eat a healthy diet consisting of high-fiber foods (cruciferous vegetables, foods rich in vitamins A and C)
• Get enough exercise. Be active
act ive to maintain body muscle’s flexibility.
flexib ility.
• Maintain ideal body weight

(turn to next page for instructions on Breast Self-Examination-BSE)

Contents are contributed by Philippine Cancer Society Contents are contributed by Philippine Cancer Society
5 6

H EALTH A DVISORY H EALTH A DVISORY

N a t i o n a l C e n t e r f o r H e a l t h Pr
Pr o m o t i o n N a t i o n a l C e n t e r f o r H e al
a l t h Pr
Pr o m o t i o n
N a t i o n a l C e n t e r f o r D i s e a s e Pr
Pr e v e n t i o n a n d C o n t r o l N a t i o n a l C e n t e r f o r D i s e a s e Pr
Pr e v e n t i o n a n d C o n t r o l

Breast Self-Examination CANCER in CHILDREN

Incidence
Breast Self-Examination
Self-Examinatio n (BSE) is important in the early detection of breast cancer. It is done once a month, In 1998, cancer among children will compromise 3.7% of all cancer among males and 2.6% of all female cancer.
There will be around 2,707 new cases, 1,536 cases in boys and 1,171 among girls. Leukemias are the most
a week after a woman’s monthly period. Through BSE, a woman becomes familiar with the usual appearance
common, compromising 47.8% of cancers among boys and 48.0% among girls. There will be around 735 new
and feel of her breast. So she can easily tell any change on it and can consult a doctor immediately.
leukemia cases among boys and 563 new cases among girls. Other sites include brain and nervous system,
retina, lymph nodes, kidney, bone and soft tissues, gonadal and germ cell sites.
Before A Mirror
1. Stand before a mirror with your arms at your side. Inspect your breast for any Early detection
changes in the size, shape and contour. Check for swelling, dimpling or puckering Malignancies in children are difficult to detect because they may present similarly as other common childhood
of the skin. Gently squeeze each nipple and check
che ck for any discharge. diseases. Parent should have their children undergo regular medical check-up and be alerted to the following
symptoms which may be associated with cancer in children: prolonged, unexplained fever or illness; unexplained
2. Put your hands on your hips and press down firmly, elbows out. Repeat the
pallor; increased tendency to bruise, unexplained localized pain or limping; unusual masses or swelling; frequent
inspection.
headaches, often with vomiting; sudden eye or visual changes; sudden or progressive weight loss.
3. Raise your arms over your head and repeat the inspection.
Normally, your left and right breast will not be exactly the same. It is very often Some of the main childhood cancers are: 
that a woman’s breast are totally the same. Through regular inspection, you will Leukemias: The most common, compromising 47.8% of all childhood cancers. Leukemias may either be acute
know what is normal for you. (with uncontrolled proliferation of immature or “ blastic” cells) or chronic (proliferation of the more mature or
differentiated cells). Leukemias may vary in presentation. Some are detected on routine physical examinations.
In The Shower Some, however, present with pallor, easy bruisability, malaise, anorexia, intermittent fever, bone pains, abdominal
pain or bleeding.
Your hands will move easier over
ove r wet skin. It is therefore easier for
fo r you to examine
your breast during a bath
bat h or shower. Brain and spinal cancer: These rank 2nd, compromising 9.7% of all cancers. In the early stages of brain tumors
Use your right hand to examine your left breast, and your left hand for your right these may cause headaches, dizziness, (often with nausea or vomiting), blurring
blurring of vision, double vision, difficulty
breast. in walking or handling of objects.
Keep your fingers flat. Move them gently in circular motions over every part of each
breast. Check for any lump, hard knot or thickening. Lymphomas (Hodgkin’s Disease or non-hodgin Lymphoma): These rank 3rd, compromising 9.0% of all cancers.
These usually involve the lymph nodes but may at times arise from other organs rich in lymphoid tissue. They
cause swelling of lymph nodes in the neck, chest axilla and groin. They may also present as generalized
Lying Down
weakness and fever.
Lie flat on your back. Place a pillow or folded towel under your left shoulder. Put
your left arm under your head. Retinoblastoma: This ranks 4th, compromising 7.5% of all cancers. This is an eye cancer which usually occurs in
Press gently but firmly your flatten fingers to breast and move in circular motions. children below four years old. The more common presenting signs include the cat’s eye reflex (a whitish
Check for any lump, hard knot or thickening. appearance of the pupil) or squint. A red and painful eye, limitation of vision or proptosis are noted in the late
stages.
Breast Clock Examination
Wilm’s tumor: This is a cancer of the kidney occurring in very young children. Usual presentation is an abdominal
The Breast Clock Examination is a methodical way of checking your
you r breast for any
or flank mass. It compromises 3.4% of all childhood cancers.
lump, hard knot or thickening.
Step 1 sarcoma : A type of bone cancer which usually presents with pain, with or without swelling or a mass
Osteogenic sarcoma:
Imagine your breast as a clock. Start at the outermost part of your breast or 12:00 overlying the involved bone. It compromises 2.3% of all cancers in children.
position. Then move on to 1:00 position and so on around the imaginary
imaginar y clock face
until you are back to 12:00 position. Rhabdomyosarcoma: This is the most common soft tissue cancer in children, often presenting as a mass
which may be painful. It usually occurs in the following sites: head and neck, genito-urinary tract, trunk, and
Step 2 extremities. It compromises 2.2% of all childhood cancers.
Examine every part of your breast. You will need to make at least three circles to
complete the examination on one breast. Gonadal and germ cell sites: These usually present as a testicular mass, or a pelvic mass among girls. They are
Step 3 9th most common diagnostic group, compromising 3.6% of all cancers in children.
Move hand over breast in downward and upward motion. Check for any irregularity.
Treatment
Step 4 Management of childhood cancers is usually by a combination of the different modalities of treatment (surgery,
Squeeze the nipple of each breast between thumb and first finger. Any discharge radiotherapy, chemotherapy), coordinated by a team of experts including pediatric oncologists, surgeons, nurses,
should be reported to a doctor
docto r right away. social workers, psychologists and others who assist children and their families.

Survival
5-years survival rates markedly vary according to the sites of origin of the tumor.
7 8 Contents are contributed by Philippine Cancer Society
H EALTH A DVISORY H EALTH A DVISORY
N a t i o n a l C e n t e r f o r H e a l t h Pr
Pr o m o t i o n N a t i o n a l C e n t e r f o r H e al
a l t h Pr
Pr o m o t i o n
N a t i o n a l C e n t e r f o r D i s e a s e Pr
Pr e v e n t i o n a n d C o n t r o l N a t i o n a l C e n t e r f o r D i s e a s e Pr
Pr e v e n t i o n a n d C o n t r o l

COLON CANCER LIVER CANCER

Incidence & mortality
Incidence & morality Liver cancer is the 3rd leading sites for both sexes. It rank 2nd among males and 9th among
Colon cancer ranks 6th overall, 5th among males and 7th among females. An estimated females. In 1998, an estimated
estimate d 5,249 new cases, 3,906 cases in males and 1,343 cases
2,963 new cases, 1,548 in males 1,415 in females, together with 1,567 deaths will be
in females, and about 4,403 deaths are expected to occur every year. The incidence in
seen in 1998. Colon cancer increases markedly after age 50.
males is practically 2 ½ that of females. Incidence increases at age 40.
Risk factors & prevprevention
ention
Risk factors & prevention
Personal or family history of colon cancer; personal or family history polyps in the colon;
inflammatory bowel disease. Studies
Studies point to a causal relationship between Hepattits B virus carrier state and liver
cancer.. Primary Liver Cancer is much more common in countries where HBV carriers are
cancer
Evidence suggest that colon cancer may be linked to a diet high in fat and deficient in prevalent, such as the Philippines and other Southeast Asian countries, as compared to
whole grains, fruit and vegetables. most developed countries where Hepatitis B is less prevalent.

  Warning signals Hepatitis C infection, though less prevalent, can also lead to liver cancer.
A change in bowel habits such as recurrent diarrhea and constipation, particularly with the
presence of abdominal discomfort, weight loss, unexplained anemia, and blood in the Other factors implicated are heavy alcohol consumption, prolonged heavy intake of aflatoxin
stool. and other chemical carcinogens.

Early detection Emphasis should be towards prevention, by lowering

lower ing the prevalence of Hepatitis B
Unfortunately,, early colon cancer is asymptomic, and there is still no efficient screening
Unfortunately through infant vaccination and improving sanitation nationwide.
method for early detection. The aim should be earlier diagnosis of symptomatic patients
who complain of changes in bowel habits, vague abdominal pains, and unexplained weight   Warning signals
loss and anemia, particularly
particularl y among patients 50 years old and above, by means of barium Abdominal pain, constitutional symptoms such as weight loss, weakness, and loss of
enema or colonoscopy
colonoscopy.. appetite. An
An abdominal mass or an enlarged liver are noted.

The mistaken obsession of our physician with amoebiasis and other forms of inflammatory Early detection
bowel disease had for decades been a major factor that had delayed diagnosis of colon Unfortunately,, there is no efficient early detection method for liver cancer.
Unfortunately
cancer.. The wider availability of antidiarrheals, antibiotics and amoebecides may have
cancer
worsened the situation. Too
Too many physicians still insist in giving vitamin preparations and
Treatment
hematinics for chronic unexplained weight loss and anemia without carefully looking for
For the occasional patient seen in an early stage, surgery can be curative. For the majority
majorit y
the cause.
of cases, who are usually seen in an incurable stage, judicious and cost-effective
cost-eff ective palliative
palliati ve
care can provide an acceptable quality of life.
Treatment
Early colon cancer is curable, and surgery is the most effective method of treatment.

Contents are contributed by Philippine Cancer Society Contents are contributed by Philippine Cancer Society
9 10

H EALTH A DVISORY H EALTH A DVISORY

N a t i o n a l C e n t e r f o r H e a l t h Pr
Pr o m o t i o n N a t i o n a l C e n t e r f o r H e al
a l t h Pr
Pr o m o t i o n
N a t i o n a l C e n t e r f o r D i s e a s e Pr
Pr e v e n t i o n a n d C o n t r o l N a t i o n a l C e n t e r f o r D i s e a s e Pr
Pr e v e n t i o n a n d C o n t r o l

LUNG CANCER OVARIAN CANCER

In the Philippines, Lung Cancer is one of the leading cancer deaths among men and women. The
steady increase in rates of people developing and dying from lung cancer is the delayed effe
effects
cts of increased
smoking by the Filipinos. An estimated 17,238 new cases of, and 15,881 deaths due to lung cance r are Incidence
expected to occur every year.
Cancer of the ovary is 12th overall, and ranks 5 th among females. An
Lung Cancer Facts estimated 2,032 cases will occur in 1998. Incidence increase starting at
• Almost 100% of all lung cancer cases are caused by smoking.
• Smokers reach the “cancer age” at least 15 years earlier than non-smokers. age 40.
• Non-smokers who are continuously
continuous ly exposed to tobacco smoke in enclosed spaces
also run the risk of getting
gettin g lung cancer. Risk factors
• Tobacco smoking before and during pregnancy may cause birth defects.
• Tobacco smoking reduces life expectancy. Few specific risk factors have been defined – nulliparity, history of breast
or endometrial cancer and of menstrual difficulties. Increased familial
Causes
incidence has also been reported. Pregnancy and oral contraceptives are
• Cigarette Smoking possibly protective. The role of exogenous hormones as a protective factor
Smoking causes 75% to 90% of lung cancer. Risk of developing lung cancer increases with the
number of cigarettes smoked each day and the tar and nicotine contents. Smoking even one-half pack a
is still being studied.
day of low-tar and nicotine cigarette is risky. There is no such thing as safe cigarette.

• Involuntary Smoking
  Warning signals
Also called “passive smoking”, it is breathing in of harmful
harm ful substances contained in tobacco smoke by Ovarian cancers are usually asymptomatic at the outset and many case
non-smokers. are detected late. It is usually detected because of an abdominal mass,
• Pollution or mass felt during pelvic examination.
This includes air pollutants such as combustion of diesel and other fossil fuels.

Symptoms Early detection

Thorough annual pelvic examinations may detect early ovary cancer. This
• Persistent dry cough that gets worse over time
• Constant chest pain is recommended to start at age 40.
• Blood-stained sputum (phlegm)
• Extreme shortness of breath, wheezing or hoarseness Treatment
• Repeated pneumonia or bronchitis
• Swelling of the neck and face
For early cancer of the ovary, surgery is curative. In some cases of
• Weight loss advanced cancer, surgery followed by chemotherapy may increase
• Fatigue survival. Advanced cancer requires judicious and cost effective palliative
• Difficulty in swallowing
care.
Prevention
Unfortunately, there is no effective way of detecting lung cancer on its early stages. That is why the
best approach to lung cancer prevention is to STOP SMOKING!

The youth should be discouraged from starting the

th e habit of smoking. BE SMART, DON’T EVER START.
START.

Contents are contributed by Philippine Cancer Society Contents are contributed by Philippine Cancer Society
11 12
H EALTH A DVISORY H EALTH A DVISORY
N a t i o n a l C e n t e r f o r H e a l t h Pr
Pr o m o t i o n N a t i o n a l C e n t e r f o r H e al
a l t h Pr
Pr o m o t i o n
N a t i o n a l C e n t e r f o r D i s e a s e Pr
Pr e v e n t i o n a n d C o n t r o l N a t i o n a l C e n t e r f o r D i s e a s e Pr
Pr e v e n t i o n a n d C o n t r o l

RECTUM CANCER STOMACH

Incidence & mortality
CANCER
Rectum cancer 11th overall, 9th among males and
canc er ranks 11 a nd 11th among females.
An estimated 2,085 new cases, 1,142 cases in males and 943 cases in
females, and 551 deaths will be seen in 1998. Rectum cancer increases Incidence & mortality
markedly at age 50. Cancer of the stomach is the 8th leading site overall. 6th among males and
10th among females. In 1998, an estimated 2,563 new cases 1,511 among
Risk factors males and 1,052 among females, will be seen. About 1,484 deaths will
Personal or family history of rectal cancer, personal or family history of occur. The incidence begins to rise starting at age 50.
polyps in the rectum.
Risk factors
While a diet high in fat and fiber deficient is also implicated, the evidence Pernicious anemia, atrophic gastritis. Evidence suggest that gastric cancer
is not yet strong as that for colon cancer. may be linked to diet, such as salty food, smoked fish, pickled vegetables.
The incidence that had changed to a healthier diet.
  Warning signals
Change in bowel habits, transanal bleeding, unexplained weight loss and   Warning signals
anemia, blood in the stool. Gastric cancer progresses silently to an advanced stage before symptoms
alert the physician or the patient. Early symptoms include indigestion,
Early detection dyspepsia, loss of appetite, and anemia. Weight loss, difficulty in
There is insufficient evidence that a specific screening method had swallowing, vomiting, abdominal mass suggest an advanced stage.
reduced mortality.
Early detection
Earlier diagnosis of symptomatic patients should also be aimed for. Males Unfortunately, there is neither an effective method primary prevention nor
and females 50 years and above who complain of blood in the stool, early detection of stomach cancer. In order to increase survival, earlier
change in bowel habits, unexplained weight loss and anemia should all diagnosis of symptomic patients should be the goal.
undergo a rectal examination and proctoscopy.
Patients over age 50 with vague epigastric symptoms, unexplained anemia,
Treatment and weight loss should undergo upper
uppe r gastrointestinal series or endoscopic
Early rectum cancer is curable by surgery. For advanced cases, judicious studies.
and cost-effective palliative care can offer an acceptable quality of life.
Treatment
Surgery remains the most effective method of treating gastric cancer.

Contents are contributed by Philippine Cancer Society Contents are contributed by Philippine Cancer Society
13 14

H EALTH A DVISORY H EALTH A DVISORY

N a t i o n a l C e n t e r f o r H e a l t h Pr
Pr o m o t i o n N a t i o n a l C e n t e r f o r H e al
a l t h Pr
Pr o m o t i o n
N a t i o n a l C e n t e r f o r D i s e a s e Pr
Pr e v e n t i o n a n d C o n t r o l N a t i o n a l C e n t e r f o r D i s e a s e Pr
Pr e v e n t i o n a n d C o n t r o l

THYROID CANCER UTERINE CERVIX 

CANCER
Incidence
Cervical Cancer
Thyroid cancer ranks 7th overall, 4th in females and 17th in males. An The cervix is part of the female reproductive system located at the junction of the vagina and the uterus
estimated 2,584 new cases, 2,068 in females and 516 in males, will occur (womb). It is often called the neck of
o f the womb.
in 1998. The incidence is three times more in females than that in males. In the Philippines, Cervical Cancer is the 2nd leading cancer site among women. An estimated 7,277
Thyroid cancer is the most common cancer of women at age 15-24. new cases of, and 3,807 death
deathss due to, cervical cancer are expe
expected
cted to occur every year.

Generally, all women who have had sexual intercourse are

ar e at risk of cervix cancer. However, rare types
Risk factors of cervical cancer can occur even in women who never had any sexual intercourse in their life.
History of neck radiation during childhood. Cause
In recent studies, there had been overwhelming evidence that an infectious agent particularly human
  Warning signals papiloma virus (HPV) that is transmitted through sexual intercourse causes cancer of the cervix.
A hard mass in the anterior neck; nodules of the thyroid in men; rapid
The following had been established as possible causes of cervix cancer:
enlargement of a long-standing goiter in older patients; cervical lymph • have had multiple sexual partners
node enlargement; hoarseness, difficulty of swallowing, and difficulty of • have had sexual partners (regular or casual) who themselves had several sexual partners
• have had sexual partner who is infected with human papilloma virus
breathing associated with goiter. • had first sexual intercourse at a very early age, possibly 15 or 16 years old

Symptoms
Early detection
Fine needle aspiration biopsy of solitary nodules,
nodule s, or of unusually prominent, Generally, cervix cancer do not have symptoms. Often, the disease is detected during its advance
stage. However, the following impressions often lead to cervix cancer:
hard or rapidly growing nodules in multinodular goiter.
• Unusual bleeding from the vagina at any
an y time
• Unpleasant vaginal discharge
Treatment
Almost 95% of thyroid cancer in the Philippines are well differentiated Early Detection
carcinoma, and are highly curable by appropriate surgery alone. Radioactive Cervical cancer when detected early is curable. At present, the most reliable and practical way to
diagnose early cervical cancer is through Pap smear.
iodine is the main mode of treatment for metastatic lesions.
A woman’s first Pap smear should be done 3 years after the first vaginal intercourse. After that, it
should be done every year for 3 years.
ye ars. If the Pap smear test is negative for the consecutive 3 years, then
it can be done every two or three years. In unmarried women who never had sexual activity in their life,
Pap smear should be done at age 35.

Early Detection
Since there is almost universal acceptance that cervical cancer is primarily transmitted through sexual
intercourse, the following preventive measures should be followed:

• a one-partner sexual relationship between partners should be observed

• a delay on the first sexual intercourse
• use of barrier contraceptives like condoms during sexual intercou rse

Contents are contributed by Philippine Cancer Society

15 16 Contents are contributed by Philippine Cancer Society
H EALTH A DVISORY H EALTH A DVISORY
N a t i o n a l C e n t e r f o r H e a l t h Pr
Pr o m o t i o n N a t i o n a l C e n t e r f o r H e al
a l t h Pr
Pr o m o t i o n
N a t i o n a l C e n t e r f o r D i s e a s e Pr
Pr e v e n t i o n a n d C o n t r o l N a t i o n a l C e n t e r f o r D i s e a s e Pr
Pr e v e n t i o n a n d C o n t r o l

CAPILLARIASIS CHICKENPOX 
Is an intestinal parasitism caused by smallest
nematodes that infect humans called Capillaria Cause
Philippinesis.. The worms can be seen in the
Philippinesis “varicella” virus
small intestine of humans.
Mode of transmission
Mode of Transmission: • person to person by direct contact, droplet or air borne spread
The disease can be acquired through consumption of infected raw or of fluid or secretions from persons with chickenpox
improperly cooked small freshwater fish. • contagious 5 days before and 5 days after the appearance of
blisters
Incubation Period:
After eating infected fish, it takes at least about 2 weeks for the eggs to Signs and symptoms
mature. • appearance of reddish skin lesions which later become blisters
on the 3rd - 4th day of fever
Signs and Symptoms: • weakness
• abdominal pain • weight lost • muscle and joint pains
• chronic diarrhea for • vomiting • sudden onset of fever
more than 2 weeks • swelling of the body
• loss of appetite • muscle wasting Immediate treatment
• chickenpox rashes will disappear in 1-2 weeks time even without
Treatment: treatment
• Mebendazole 400 mg/day given in divided doses for 20 days for new
cases and for 30 days for relapses of cases. Prevention and control
• Avoid crowded areas during epidemics
• Eggs and parasites disappear from feces within 4 days and symptoms • Isolate known cases
within a week. • Vaccine is available as precautionary measure and as per
doctor’s advise.
• Albendazole has also been found effective in treating intestinal
capillariasis using the same dosage as Mebendazole.

Prevention and Control:

• Cook fish thoroughly before eating. Those who had the disease before are already immune
• Avoid eating raw fish.
and will not have the disease again.
• Use sanitary toilet for disposal of human waste.

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H EALTH A DVISORY H EALTH A DVISORY

N a t i o n a l C e n t e r f o r H e a l t h Pr
Pr o m o t i o n N a t i o n a l C e n t e r f o r H e al
a l t h Pr
Pr o m o t i o n
N a t i o n a l C e n t e r f o r D i s e a s e Pr
Pr e v e n t i o n a n d C o n t r o l N a t i o n a l C e n t e r f o r D i s e a s e Pr
Pr e v e n t i o n a n d C o n t r o l

CHOLERA  DENGUE
DENGUE HEMORRHAGIC FEVER
Cause is an acute infectious disease manifested initially
with fever.
• Vibrio cholerae bacteria
Transmission

Aedes aegypti , the transmitter of the disease, is a day-

Mode of Transmission Prevention and Control biting mosquito which lays eggs in clear and stag-
• eating of food or drinking of • Drink only safe and clean water. If nant water found in flower vases, cans, rain barrels,
water contaminated with old rubber tires, etc. The adult mosquitoes rest in dark
unsure, boil drinking water places of the house.
human waste (Upon reaching boiling point,
extend boiling for two or more Signs and Symptoms
Signs & Symptoms
minutes) or
• Do water chlorination • Sudden onset of high fever which may last 2 to 7 days.
• sudden onset of frequent • Joint & muscle pain and pain behind the eyes.
• Keep food away from insects
painless watery stools • Weakness
and rats by covering it.
• vomitting • Skin rashes - maculopapular 
maculopapular rash
rash or red tiny spots on the skin called petechiae 
• Wash and cook food properly. • Nosebleeding when fever starts to subside
• rapid dehydration (e.g. sunken
• Sanitary disposal of human waste. • Abdominal pain
eyeballs, wrinkled and dry skin)
• Use toilet properly and clean • Vomiting of coffee-colored matter
ImmediateTreatment toilet everyday. • Dark-colored stools
• Wash hands with soap after using
• Replace lost body fluid by Prevention and Control
toilet and before eating.
giving Oral Rehydration
• Keep surroundings clean to • Cover water drums and water pails at all times to prevent mosquitoes from breeding.
Solution (ORESOL) or a
prevent flies and other insects • Replace water in flower vases once a week.
homemade solution com- and rodents from breeding. • Clean all water containers once a week. Scrub the sides well to remove eggs of
posed of 1 teaspoon of salt, mosquitoes sticking to the sides.
4 teaspoons of sugar mix to • Clean gutters of leaves and debris so that rain water will not collect as breeding places
1liter of water. I n extreme cases, cholera  of mosquitoes.
• If diarrhea persists, consult is a rapidly fatal disease. A • Old tires used as roof support should be punctured or cut to avoid accumulation of
healthy individual may die  water.
your health workers or bring
• Collect and dispose all unusable tin cans, jars, bottles and other items that can collect
the patient
patient to the nearest
nearest within 2-3 hours if no 
and hold water.
hospital. treatment is provided.

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H EALTH A DVISORY H EALTH A DVISORY
N a t i o n a l C e n t e r f o r H e a l t h Pr
Pr o m o t i o n N a t i o n a l C e n t e r f o r H e al
a l t h Pr
Pr o m o t i o n
N a t i o n a l C e n t e r f o r D i s e a s e Pr
Pr e v e n t i o n a n d C o n t r o l N a t i o n a l C e n t e r f o r D i s e a s e Pr
Pr e v e n t i o n a n d C o n t r o l

DEPRESSIVE DIARRHEA 
DISORDERS
Mode of Transmi
ransmissio
ssionn
• Ingestion of contaminated food and water.
Mental disorders characterized by either depressed mood or markedly diminished interest
int erest
or pleasure in most activiti
a ctivities
es of the day.
day. Signs and Symptoms
• Passage of watery stools at least 3x a day.
Causes • Excessive thirst.
• Sunken eyeballs and fontanel.
The causes vary;
• The research data are most consistent with the hypothesis with disregulation Immediate Treatment:
of the biologic amines specifically norepinephrine and serotonin, • Give Oral Rehydration Solution (ORESOL), rice soup (am) to replace

• Family studies reported that first degree relatives

relatives of depressed disorders have 2-
lost body fluid.
10 times more likely to have the disorder, • Continue feeding.

• Twin studies show that the concordance rate for monozygotic twins is about 50%, Prevention and Control:
• Drink water only from safe sources. If unsure, boil water for 3
• Stressful life events play the primary or principal role in depression, generally,
minutes or do water chlorination.
it is the loss of significant person.
• Eat only foods that are well cooked and properly prepared.
Symptoms Avoid eating “street vended food”.
• Keep the food away from insects and rats by covering them using
• Significant weight loss or weight gain food cover.
• Difficulty in sleeping or oversleeping • Wash fruits and vegetables with clean water before
be fore eating or cooking.
• Fatigue or loss of energy • Use toilet when defecating.
• Psychomotor agitation and slowness
• Wash your hands before eating and after using the toilet.
• Excessive guilt or feeling of worthlessness
• Diminished ability to think or concentrate or indecisiveness
- recurrent thoughts of deaths
- recurrent suicidal ideations

Prevention and Control If diarrhea does not stop,

There are clear guidelines for the treatment
tr eatment of depressive disorders. This include both consult the nearest health center 
antidepressant medications and psychological interventions like cognitive therapy,
behavior therapy,
therapy, interpersonal therapy and family therapy
therapy..

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H EALTH A DVISORY H EALTH A DVISORY

N a t i o n a l C e n t e r f o r H e a l t h Pr
Pr o m o t i o n N a t i o n a l C e n t e r f o r H e al
a l t h Pr
Pr o m o t i o n
N a t i o n a l C e n t e r f o r D i s e a s e Pr
Pr e v e n t i o n a n d C o n t r o l N a t i o n a l C e n t e r f o r D i s e a s e Pr
Pr e v e n t i o n a n d C o n t r o l

DIPHTHERIA  EPILEPSY 
It is a brain disorder characterized by repeated seizures (“fits”) which
A BACTERIAL (Toxin-Related) DISEASE
may take many forms, ranging from the shortest lapse of attention to
It is an acute pharyngitis, acute naso pharyngitis or acute laryngitis with a severe and frequent convulsions.
pseudomembrane formation in the throat.
Signs and Symptoms

Infectious Agent: Corynebacterium diphtheria • loss of awareness/consciousness

• disturbances of movement
Reservoir: Man
Man
• sensation including vision, hearing and taste
Incubation Period: 2 to 5 days or may be longer • automatic function, mood and mental function

Mode of Transmiss
Transmission:
ion: * attacks may vary in frequency from less than one per year to
several per day
• By droplets spread through sneezing, coughing and close personal contact.

Period of Communicability: Causes

• May last for 2 to 3 weeks • excessive electrical discharges in a group of brain cells
• May be shortened in patients with antibiotic treatment • any kind of brain disease can cause seizures (e.g. infection, injury,
• Diphtheria transmission is increased in schools, hospitals, households and in vascular, tumor, congenital and degenerative)
crowded areas.
• imbalance of the chemical neurotransmitter
neurotransmitter in the brain
Prevention: • some provocative factors in some patients for epilepsy like photic
stimulation (disco lights, television, computers, etc.)
• Immunization of infants with 3 doses
doses of DPT (at ages 6 weeks old, 10 weeks
weeks old • over breathing
and 14 weeks old). • over hydration
• loss of sleep
• emotional and physical stress

Treatment

• Available anti-epileptic medications are effective and cost efficient.

• About 70% of newly diagnosed cases can be succesfully treated with
an anti-epileptic medication that is taken without interruption.

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H EALTH A DVISORY H EALTH A DVISORY
N a t i o n a l C e n t e r f o r H e a l t h Pr
Pr o m o t i o n N a t i o n a l C e n t e r f o r H e al
a l t h Pr
Pr o m o t i o n
N a t i o n a l C e n t e r f o r D i s e a s e Pr
Pr e v e n t i o n a n d C o n t r o l N a t i o n a l C e n t e r f o r D i s e a s e Pr
Pr e v e n t i o n a n d C o n t r o l

FILARIASIS FOOT AND MOUTH

commonly known as “elephantiasis” is a disease caused by a
DISEASE
parasite transmitted by mosquito

Signs and Symptoms Cause

A virus of the family Picornaviridee, genus Aphthovirus.

• Pain and swelling of the breast,
vagina, scrotum, legs and arms
• Fever EPIDEMIOLOGY
• Cough
• Chills • One of the most contagious animal diseases, with important
• Wheezing economic losses

• Low mortality rate in adult animals, but often high mortality

mortalit y in young due to myocarditis.
Prevention
Hosts:
• Wear long sleeve shirt and long pants when working in farms
or areas endemic of filariasis. • Bovidae (catel, zebus, domestic buffaloes, yaks), sheep, goats, swine, all wild
• Sleep under a mosquito net. ruminants and suidae. Camelidae (camels, dromedaries,
dromedaries, llamas, vicunas)
vicunas) have low
susceptibility.
• Direct or indirect contact (droplets)
Treatment • Animal vectors (human, etc.)
• Inanimate vectors (vehicles)
• Selective treatment with DEC (Diethylcarbamazine Citrate) • Airborne, especially temperate zones (up to 60 km overland and 300 km by sea)
is given to people with clinical manifestations of the disease.
DIAGNOSIS
• Mass treament of the people living in established endemic
Incubation period is 2-14 days
areas.
Prevention and Control
• Medicines (DEC and albendazole) are given once a year for 5 years.
• Protection of free zones by border animal movement control
contr ol and surveillance
• Slaughter of infected, recovered,
r ecovered, and FMD-susceptible contact animals
• Disinfection of premises and all infected material (implements, cards, clothes, etc.)
Filariasis sugpuin, Gamot
Gamot ay inumin . . . •
•
Destruction of cadavers, litter, and susceptible animal products in the infected area
Quarantine measures
“Sang beses isang taon sa loob ng 5 taon”
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H EALTH A DVISORY H EALTH A DVISORY

N a t i o n a l C e n t e r f o r H e a l t h Pr
Pr o m o t i o n N a t i o n a l C e n t e r f o r H e al
a l t h Pr
Pr o m o t i o n
N a t i o n a l C e n t e r f o r D i s e a s e Pr
Pr e v e n t i o n a n d C o n t r o l N a t i o n a l C e n t e r f o r D i s e a s e Pr
Pr e v e n t i o n a n d C o n t r o l

HEPATITIS A  HEPATITIS B
A VIRAL DISEASE
It is caused by the
t he Hepatitis
Hepatiti s A virus (HAV).
Hepatitis B is liver infection caused by the B type of Hepatitis virus. It attacks the liver
Mode of Tr
Transmi
ansmission
ssion
often resulting in inflammation.
• ingestion of food contaminated
contami nated with human waste and urine of persons
pers ons who are sick of
Signs and Symptoms:
Hepatitis A
• weakness
Signs and Symptoms
• stomach upset
• dark urine or very pale stools
• fever
•  jaundice
• flu-like symptoms: weakness, muscle and joint aches, loss of appetite, dizziness
• with or without vomiting
Mode of transmission
• abdominal discomfort
• after few days, jaundice may follow
Hepatitis B spreads through the following:
Immediate Treatment
• from child to child
• from mother to child during birth
• No specific medicine to cure the patient or shorten the course of illness.
• through blood transfusion
• Sick persons should be isolated, advised to rest, take plenty of fluids and avoid fatty
• through sharing of unsterilized needles, knives or razors
foods.
• through sexual intercourse
• Patient who fail to take fluids or are too weak to eat are sometimes brought for
intravaneous
intravaneous administration of fluids and vitamins.
Complications
Prevention
Prevention and Control
• chronic hepatitis
• cirrhosis
• Wash hands after using the toilet, before preparing food and before eating
• liver failure
• Dispose human waste properly.
• liver cancer
• Thoroughly cook oysters, clams, other shellfish for 4 minutes or steamed for 1 minute
& 30 seconds.
Prevention
• Practice safe handling
handl ing and storage of food and water.
• Immunization of infants with 3 doses of Hepatitis B vaccine at ages 6 weeks old,
10 weeks old and 14 weeks old.
The disease is self-limiting • use of safe/clean injection and equipments/sup
equipments/supplies
plies
a n d m a y l as as t f o r 1 t o 2 w e e k s .
P a t i e n t o f t e n r e c o ve
v e r s e ve
ve n w i t h o u t t r e a t m e n t Treatment: NONE

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 H EALTH A DVISORY H EALTH A DVISORY
N a t i o n a l C e n t e r f o r H e a l t h Pr
Pr o m o t i o n N a t i o n a l C e n t e r f o r H e al
a l t h Pr
Pr o m o t i o n
N a t i o n a l C e n t e r f o r D i s e a s e Pr
Pr e v e n t i o n a n d C o n t r o l N a t i o n a l C e n t e r f o r D i s e a s e Pr
Pr e v e n t i o n a n d C o n t r o l

HEPATITIS C HIGH BLOOD

• Hepatitis C is usually spread through contact with blood products, like accidentally
PRESSURE
being stuck with a dirty (used) needle, using IV drugs and sharing needles, or getting
blood before 1992. " A SILENT KILLER
• Most people who are infected with hepatitis C don’t have any symptoms for years. " Most common among the diseases of the heart
The virus stays in the liver and causes chronic liver inflammation, cirrhosis or liver " Most common cause of stroke
cancer. " Highly preventable

Signs and Symptoms

• Headache, nausea and vomiting, abdominal pain, jaundice (the skin turns yellow),
MOSTLY AFFECTED
AFFECTED BY HI GH BLOOD Facts
PRESSURE...
weakness and fatigue. " CVD- no. 1 killer in the
• Some people have dark yellow urine, light-colored
light-color ed stools and yellowish eyes. " Smokers country
" Overweight
Treatment " Older age group: above 40 years old for " Every hour, 9 Filipinos
males; menopausal age for female die of CVD
Medicines such as interferon and ribavirin don’t cure hepatitis C, but they do make people " With family history like, heart diseases,
feel better and may prevent future liver problems. " 1 out of 4 deaths in
diabetes and kidney disease the country
country is due to
" Under chronic stress
Prevention CVD
CV D
" Heavy alcohol drinker
" With high serum cholesterol level " 1 out of 10 Filipinos
• There is no vaccine
vaccine for hepatitis
hepatitis C.
aged 15 years old and
• Use condom during sexual activity to protect yourself and your partner from hepatitis C. Prevention
Prevention ...
.. .
• Don’t share needles with anyone.
above has
• Wear gloves if you have to touch anyone’s blood. hypertension/high
" Don’t smoke blood pressure
• Don’t use an infected person’s toothbrush,
toothbr ush, razor, or anything else that could have blood
" Maintain ideal body weight
on it. " 80%-85% of all
" Exercise regularly (at least 20 minutes,
• Make sure any tattooing or body piercing is done with clean tools.
continuous & 3x a week) primary high blood
" Avoid fatty and salty foods pressure are mild and
" Have adequate relaxation thus can be managed
" Drink moderately by lifestyle
" Have a regular blood pressure check-up modification

Take good care of your heart,

have a healthy lifestyle! 
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N a t i o n a l C e n t e r f o r H e a l t h Pr
Pr o m o t i o n N a t i o n a l C e n t e r f o r H e al
a l t h Pr
Pr o m o t i o n
N a t i o n a l C e n t e r f o r D i s e a s e Pr
Pr e v e n t i o n a n d C o n t r o l N a t i o n a l C e n t e r f o r D i s e a s e Pr
Pr e v e n t i o n a n d C o n t r o l

INFLUENZA  IODINE
DEFICIENCY DISORDER
• Caused by Influenza virus (A, B or C)

Incubation Period 1-3 days

Mode of TraTransmis
nsmissionsion
Entry of the virus into the respiratory tract: Causes

• via droplets from an infected person through coughing, talking and sneezing. • lack of iodine-rich foods in the diet
• through contact with the surfaces, material and clothing contaminated with • presence of goitrogens
goitrogens in food (i.e. cassava and cabbage)
cabbage)
discharges of an infected person. and water which interfere with the absorption of iodine
by the body
Signs and Symptoms • increase requirement of iodine during adolescence
adolescence,, pregnancy and lactation
• Fever of at least 38 C
• Headache Signs
• Runny nose, sore throat, cough or other respiratory manifestations
manifestati ons
• May or may not have muscle or joint pains • goiter

Treatment Prevention
• Use of antiviral agents within the first two days may halt the course of
influenza illness. Consult your physician regarding antiviral agents.
• Use iodized salt.
• Paracetamol for fever. Aspirin should not be given to children.
• Eat foods rich in iodine, like dilis, pusit, kuhol, lato (seaweeds), WHEN THERE
• Antibiotics to be given
given only to complications
complications of influenza such
such as pneumonia
IS NO RED TIDE BAN: talaba,talaba, tahong, alamang, shrimps, crab.
or otitis media.
• In endemic areas, (with more than 30% of the population has goiter), take
• Adequate rest.
iodine supplement as prescribed by a physician.
• Increase intake of oral
oral fluids and eat nutritious
nutritious foods.

Prevention Why is IODINE important?

• Influenza vaccination preferably to be given anytime from February to June.
• Provide separate room to a person sick with influenza. Iodine is needed to produce thyroid hormone, which prevents:
pr events:
• Cover mouth and nose when sneezing or coughing
cough ing to prevent spread of the
virus. • mental retardation
• Avoid crowded places. Distance yourself from at least 1 meter from people • growth retardation
who are coughing or are sick with influenza. • physical deformities
• Wash hands frequently with soap
so ap and water. • miscarriage and stillbirths

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H EALTH A DVISORY H EALTH A DVISORY
N a t i o n a l C e n t e r f o r H e a l t h Pr
Pr o m o t i o n N a t i o n a l C e n t e r f o r H e al
a l t h Pr
Pr o m o t i o n
N a t i o n a l C e n t e r f o r D i s e a s e Pr
Pr e v e n t i o n a n d C o n t r o l N a t i o n a l C e n t e r f o r D i s e a s e Pr
Pr e v e n t i o n a n d C o n t r o l

IRON JAPANESE
DEFICIENCY ANEMIA  ENCEPHALITIS
• A disease caused by an arbovirus, a large group of viruses that are spread by certain
invertebrate animals (anthropods), most commonly blood-sucking insects.
• It affects the central nervous system and cause severe complications and even death.
• It spreads to human by infected mosquitoes in Asia, the Culex tritaeniorhynchus, that
Causes lives in rural rice-growing and pig-farming regions.
• The virus can infect humans, most domestic animals, birds, bats, snakes and frogs.
• lack of iron-rich foods in the diet After infection, the virus invades the central nervous system, including the brain and the
• lack of vitamin C in the diet
diet which helps
helps in the
the absorption of spinal cord.
iron by the body
Signs and Symptoms
• chronic blood loss due to parasitism or menstruation
• increased demand of the body during pregnancy and lactation • Symptoms usually appear 6-8 days after the bite of an infected mosquito.
• low absorption of iron from foods • Most infected persons develop mild symptoms or no symptoms at all.
• high requirement of infants, adolescent girls, pregnant and lactating women • In people who develop a more severe disease, Japanese encephalitis usually starts as
flu-like illness, with fever, chills, tiredness, headache, nausea and vomiting. Confusion
Signs and agitation can occur in the early stage.
• The illness can progress to a serious infection of the brain (encephalitis) and can be
• weakness fatal in 30% of cases. Among the survivors, another 30% will have serious brain
damage, including paralysis.
• insomnia
• easily becomes tired
Treatment
• lack of appetite
• lack of concentration • Diagnosis is based on tests of blood or spinal fluid.
• paleness • There is no specific treatment for Japanese encephalitis
encephalitis.. Antibiotics are not effective
against viruses, and no effective anti-viral drugs have been discovered.
Prevention • Care of patient’s centers on treatment of symptoms and complications.

• Eat foods rich in iron, such as meat, dark green leafy vegetables ( i.e. malunggay
malunggay,, Prevention
kamote tops, gabi leaves, petchay, saluyot, alugbati, kangkong), liver, internal
• A vaccine is recommended only for persons who plan to travel in affected areas for 4
organs.
weeks or more, except in special circumstances such as an ongoing outbreak of
• Take iron tablets daily as prescribed
pres cribed especially
especi ally during pregnancy.
pre gnancy. disease.
• Eliminate intestinal parasites/deworming. • Because of the potential for other mosquito-borne diseases in Asia, all travelers should
• Breastfeed infants up to 6 months and continue breastfeeding up to 2 years. take steps to avoid mosquito bites. The mosquito that transmit Japanese encephalitis
• Increase vitamin C intake. feed mainly outside during the cooler hours at dusk and dawn. Travelers should
minimize outdoor activities at these times, use mosquito repellent on exposed skin,
and stay in airconditioned or well-screeened rooms.
• Travelers to rural areas should use bednets and aerosol room insecticides.

33 34

H EALTH A DVISORY H EALTH A DVISORY

N a t i o n a l C e n t e r f o r H e a l t h Pr
Pr o m o t i o n N a t i o n a l C e n t e r f o r H e al
a l t h Pr
Pr o m o t i o n
N a t i o n a l C e n t e r f o r D i s e a s e Pr
Pr e v e n t i o n a n d C o n t r o l N a t i o n a l C e n t e r f o r D i s e a s e Pr
Pr e v e n t i o n a n d C o n t r o l

KAWASAKI LEPROSY 
DISEASE
• Is non-specific disease that affects the mucus membranes, lymph nodes, walls of
the blood vessels and the heart. Cause
• Predominantly among
among young children,
children, with 80% of patients below 5 years of age.
• No definite cause of Kawasaki
Kawasaki disease has
has been identified. It appears that the Mycobacterium leprae
vasculis is brought about by an exaggerated immune response.
Mode of
of Trans
Transmission
mission
• Kawasaki disease can cause inflammation of blood vessels (vasculitis) in the
coronary arteries and subsequent coronary artery aneurysms, that can lead to Airborne: inhalation of droplet/spray from coughing
myocardial infarction and
and irregular heart beat (arrhythmias). About 20 - 40% of and sneezing
sneezing of untreated leprosy patient
children with Kawasaki
Kawasaki disease will have evidence of of vasculitis with heart
involvement. Signs and Symptoms
• There is no test to affirm the disease.
disease. A doctor
doctor make diagnosis from the
symptoms and a few characteristic laboratory findings, such as high platelet # long standing skin lesions that do not disappear with ordinary
counts (cells that help blood clot) in the blood. treatment
# loss of feeling/numbness on the skin
Signs and Symptoms # loss of sweating and hair growth over the
th e skin lesions
# thickened and/or painful nerves in the neck, forearm, near elbow
• high persistent fever  joint and the back of knees
• red eyes
• red mucus membranes of the mouth Prevention
Prevention and Control
• red cracked lips
• a “strawberry tongue” # Treat all leprosy cases to prevent spread of infection.
• swollen lymph nodes # We should avoid direct contact with untreated patients.
• skin rashes # Practice personal hygiene.
# Maintain body resistance by healthful living.
Treatment # Good nutrition.
# Enough rest and exercises.
Intravenous gamma globulin in high doses. Marked improvements is usually noted # Clean environment.
within 24 hours of treatment with IV gamma globulin. # Immediate treatment.

Advise

If high grade fever persists, is unresponsive to acetaminophen or ibuprofen and lasts

Go to the nearest health center for free 
more than >24 hours, seek consultation.
consultati on. Treatment should be started as soon as the
diagnosis is made to prevent damage to heart and its arteries. Multi-Drug Therapy (MDT) 

35 36
H EALTH A DVISORY H EALTH A DVISORY
N a t i o n a l C e n t e r f o r H e a l t h Pr
Pr o m o t i o n N a t i o n a l C e n t e r f o r H e al
a l t h Pr
Pr o m o t i o n
N a t i o n a l C e n t e r f o r D i s e a s e Pr
Pr e v e n t i o n a n d C o n t r o l N a t i o n a l C e n t e r f o r D i s e a s e Pr
Pr e v e n t i o n a n d C o n t r o l

LEPTOSPIROSIS LEUKEMIA 
Cause leptospira bacteria
Incidence & mortality
Incubation Period 7 - 10 days
The leukemia’s rank 5th overall, 4th among males and 6th among females.
Mode of Transmi
ransmissio
ssion
n Estimated number of new cases in 1998 are 1,659 in males and 1,488 in
females, giving a total of 3,147 cases, of these 735 cases will occur in
• Entry of the leptospira bacteria through wounds when in contact with boys and 563 cases will be among girls.
flood waters, vegetation, moist soil contaminated with the urine of
infected animals, especially rats. Risk factors & prevention
Exposure to high doses of radiation; and continuous and prolonged
exposure to certain chemicals have been blamed for increasing the risk
Signs and Symptoms of getting leukemia.
• Fever
• Non-specific symptoms of muscle pain, headache   Warning & signals
• Calf-muscle pain and reddish eyes for some cases Easy fatiguability, pallor, weight loss, easy bruising, frequent nosebleed,
or repeated infections, especially among children. Symptoms of acute
• Severe cases result to liver involvement, kidney failure or brain
leukemia appear suddenly. Chronic leukemia may progress slowly with
involvement. Thus some cases may have yellowish body few symptoms.
discolorization,
discolorization, dark-colored urine and light stools, low urine output,
severe headache. Early detection
There is no practical screening method for leukemia. Early detection of
Treatment symptomatic patients, particularly children, should be aimed
a imed for. Peripheral
blood smears and bone marrow examination confirm the diagnosis in
• Antibiotics duly prescribed by a physician. suspicious cases.
• Early recognition and treatment within two days of illness to prevent
Treatment
complications of leptospirosis, so early consultation is advised. Some forms of leukemia, particularly Acute Lymphocytes Leukemia in
children, are highly curable by chemotherapy.
Prevention and Control
• Avoid swimming or wading in potentially contaminated water or flood
water.
• Use of proper protection like boots and gloves when work requires
exposure to contaminated water.
• Drain potentially contaminated water when possible.
• Control rats in the household by using rat traps or rat poison,
maintaining cleanliness in the house.

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H EALTH A DVISORY H EALTH A DVISORY

N a t i o n a l C e n t e r f o r H e a l t h Pr
Pr o m o t i o n N a t i o n a l C e n t e r f o r H e al
a l t h Pr
Pr o m o t i o n
N a t i o n a l C e n t e r f o r D i s e a s e Pr
Pr e v e n t i o n a n d C o n t r o l N a t i o n a l C e n t e r f o r D i s e a s e Pr
Pr e v e n t i o n a n d C o n t r o l

LYMPHOMAS MAD COW

( Hodgkin’s disease and non-hodgkin lymphoma )
Variant Creutzfeldt-Jakob Disease - disease 
in humans 
Incidence
Cause
Lymphomas are the 10th overall, 8th in males and 14th in females. An
A proteinaceous particle called “prion”
estimated 2,088 new cases, 1,253 cases among males and 875 among
females, will be seen in 1998. Incidence increases at age 55. Mode of Transmiss
Transmission ion
A person can be infected by eating meat/meat products from a cow with Bovine
Risk factors Spongiform
Spo ngiform Encephalopathy (BSE) or Mad Cow Disease.
Cause is still unknown but a viral factor is considered since certain
Incubation Period
lymphomas have been shown by epidemiologic, electron microscopy, cell
It takes 10-30 years after exposure (eating contaminated
contamina ted meat) before signs and
culture and immunologic studies to have features implicating viral etiologies. symptoms appear.

  Warning signals Signs and Symptoms

Usual presentation is painless, enlarged lymph nodes which may be affects the brain and the nervous system
associated with fever, night sweats, itching and weight loss. Other organs
Initial Stage Stage of Progression
like the oropharynx, skin, gastrointestinal tract and bone may be involved.
• Insomia • Rapid & progressive dementia
• Depression • Involuntary & irregular jerky movements
Early detection • Confusion • Worsening sight
Recognition of lymphadenopathy and careful histologic evaluation of a • Personality changes • Muscular weakness
lymph node biopsy. • Problem with memory, • Problems with speech
coordination
• Forgetfulness
Treatment THERE IS NO CURE
A multidisciplinary approach offers the most cure rates. Chemotherapy is
the primary treatment, with adjunct radiotherapy in some instances.
Final Stage FOR MAD COW
A patient:
Loses all mental & physical fuctions DISEASE!
Becomes paralyzed, comatose
Dies from other causes Fresh Beef sold 
in the markets are Safe 
Prevention
DO NOT EAT
EAT meat/meat products from countries
countr ies with reported cases of Bovine
Spongiform Encephalopathy (BSE).

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N a t i o n a l C e n t e r f o r H e a l t h Pr
Pr o m o t i o n N a t i o n a l C e n t e r f o r H e al
a l t h Pr
Pr o m o t i o n
N a t i o n a l C e n t e r f o r D i s e a s e Pr
Pr e v e n t i o n a n d C o n t r o l N a t i o n a l C e n t e r f o r D i s e a s e Pr
Pr e v e n t i o n a n d C o n t r o l

MALARIA  MEASLES
Malaria is a disease transmitted through a bite of an infected
female Anopheles mosquito. It usually bites during nighttime. A VIRAL DISEASE

Signs and Symptoms A highly communicable disease with the history of the following:
fol lowing:
• Chills
• High fever grade • Generalized blotchy rash, lasting for 3 or more days
• Sweating • Fever (above
(abov e 38°C or “hot” to touch) and
• Severe headache • Any of the following:
- Cough
Prevention and Control - Runny nose
• Use mosquito nets. It is more effective if the mosquito net is treated with insecticide. - Red eyes/conjunctivi
eyes/conjunctivitis
tis
• Use long sleeves and pants.
• Use repellants/coils and screens on doors and windows. Mode of Tra
Transmis
nsmission
sion::
• Clear hanging branches of trees along the streams.
• Have your blood examined if you have the signs and symptoms
sympt oms of malaria. • By droplets spread from person to person caused by sneezing, coughing, and close
• Follow the advice of health workers on how to take anti-malaria drugs. personal contact.

Complications:
ENDEMIC AREAS with Malaria
1. Palawan 14. Sulu • diarrhea
2. Davao del Norte 15. Agusan
Agusan del Norte • atitis media
3. Compostela Valley 16. Cagayan • pneumonia
4. Agusan del Sur 17. Zamboanga del Sur • encephalitis
5. Mindoro Occidental 18. Bukidnon • malnutrition
6. Kalinga 19. Misamis Oriental • blindness
7. Apayao 20. Quirino
8. Isabela 21. Mt. Province Prevention::
Prevention
9. Quezon 22. Basilan
10. Ifugao 23. Zambales • Immunization with measles vaccine at 9 months old.
11. Davao del
de l Sur 24. Sarangani • Vitamin A supplementat
supplementation
ion during routine measles vaccination
12. Davao Oriental 25. Sibugay
13. Tawi-tawi 26. Surigao del Sur Treatment :
Treatment:
• Nutritional support and oral rehydration to increase body resistance and replace lost
If symptoms persists, go to the nearest health center body fluids caused by coughing, diarrhea and persperation.
• Antibiotics as prescribed by physician to treat body infections.
• Giving of supplementation among infants and children diagnosed with measles.
Malaria Kills, Help eradicate it!

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N a t i o n a l C e n t e r f o r H e a l t h Pr
Pr o m o t i o n N a t i o n a l C e n t e r f o r H e al
a l t h Pr
Pr o m o t i o n
N a t i o n a l C e n t e r f o r D i s e a s e Pr
Pr e v e n t i o n a n d C o n t r o l N a t i o n a l C e n t e r f o r D i s e a s e Pr
Pr e v e n t i o n a n d C o n t r o l

MENINGOCOCCEMIA  MENTAL
Is a disease brought about by spread of the bacteria (Neisseria Meningitides) to blood
stream causing severe signs and symptoms that may lead to death.
RETARDATION
Transmission
• A condition of incomplete or halted development of the mind, which is characterized
• Direct contact with discharges
discharges from the nose and throat of an infected person.
person.
by the impairment of skills
skills as manifested
manifested during the developmental
developmental period that
• It can be spread through coughing, sneezing, kissing, sharing of foods, drinks and utensils.
contributes to the overall level of intelligence (WHO)
Signs and Symptoms
• Significantly below average intellectual functioning (IQ<70) with accompanying
• Fever impairment in the person’s effectiveness
effecti veness in meeting the standards expected of one’s
• Cough, sore throat, other respiratory symptoms
symptoms age, as is expected
expected by social and cultural influences in the following areas:
• Pinpoint rashes which become wider and appear like brushes starting from the legs and communication, self-care, home living, social/interpersonal skills, use of community
arms. (Large maplike bruise-like patches) resources, self-direction,
self-direct ion, functional academic skills, work, leisure, health
healt h and safety.
safety.
• Severe skin lesions may lead to gangrene.
• Unstable vital signs. • Mental retardation is classified by the degree of intellectual functioning as mild,
• May or may not have signs of meningitis such as:
moderate, severe and profound.
- stiff neck
- convulsion (in some cases)
- delirium • There are other physical defects associated with the mental retardation.
- altered mental status
- vomiting
Causes
Prevention and Control
Causative factors are genetic (chromosomal
(chromosomal and inherited) conditions,
conditions, prenatal
• Avoid crowded places. exposure to infections and toxins, perinatal trauma (example prematurity), acquired
• Avoid close contacts with meningococcemia patients. conditions and social factors.
• Increased resistance by having healthy diet, regular exercise, adequate rest sleep, no
alcohol and cigarette smoking.
• Maintain clean environment/
environment/surroundings.
surroundings.
Prevention
Prevention and Control
• Don’t share utensils
utensils or anything else
else that has been in the mouth of
of an infected person.
• Wash hands frequently with soap and water.
water.
• In general, people with mild and moderate mental retardation have the most
Treatment flexibility to adopt to
t o environmental conditions.
Early recognition of meningococcal infection and prompt treatment with penicillin greatly
improves chances of survival. • In most cases, the underlying intellectual impairment
impair ment does not improve, yet the
affected person’s level of adaptation can be positively influenced by an enriched
If you are in areas where there meningococcemia cases or and supportive environment.
have been to these places for the past 10 days, and manifest
• The best treatment of mental retardation
retardat ion is primary, secondary and tertiary
tertiar y.
fever, and other signs and symptoms mentioned above
immediately consult the doctor.

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H EALTH A DVISORY H EALTH A DVISORY
N a t i o n a l C e n t e r f o r H e a l t h Pr
Pr o m o t i o n N a t i o n a l C e n t e r f o r H e al
a l t h Pr
Pr o m o t i o n
N a t i o n a l C e n t e r f o r D i s e a s e Pr
Pr e v e n t i o n a n d C o n t r o l N a t i o n a l C e n t e r f o r D i s e a s e Pr
Pr e v e n t i o n a n d C o n t r o l

NEONATAL PARAGONIMIASIS
Tetanus
- is a food borne parasitic disease of man and known
as lung fluke disease
A BACTERIAL TOXIN DISEASE

A newborn with a history of all three of the

t he following: Cause:
• Normal suck and cry for the first two days of life
• the parasite, Paragonimus Westermani (PW) which can be found in
• Onset of illness between 3 and 28 days
• Inability to suck followed by stiffness of the body and/or convulsions freshwater or mountain crab

Signs and Symptoms Ways of getting the disease:

• lockjaw
• stiffness of the neck • Eating of raw or inadequately cooked fresh water or mountain crabs
• difficulty of swallowing
• Use of contaminated utensils.
• muscle spasm
• fever
• inability to suck Signs and Symptoms:

Mode of
of Transmiss
Transmission ion • early stages of the infection are usually asymptomatic
• Unhygienic cutting of umbilical cords • heavy infections, patients may suffer dry cough
• Improper handling of cord stump, especially when treated or applied
applied with
• blood stained or rust colored sputum with foul fish odor
contaminated substance
• chest/backpain.
Complications • PTB like signs not responding to anti-TB medications
• fracture of spine or other bones
bones as a result of muscles
muscles spasms
spasms and convulsions
• pneumonia Preventive Measures
• abnormal heartbeats
1. Thoroughly cook crabs.
Prevention
• Immunization of women
women of child bearing
bearing age (15-49
(15-49 years
years old)
old) with tetanus toxoid 2. Proper disposal of sputum and human waste.
• Clean delivery practices 3. Control snails which serve as hosts to the parasite.
• Immunization of infants with 3 doses of
of DPT (at ages 6 weeks
weeks old, 10 weeks
weeks old 4. Treat cases.
and 14 weeks old)
Treatment:
• Praziquantel

45 46

H EALTH A DVISORY H EALTH A DVISORY

N a t i o n a l C e n t e r f o r H e a l t h Pr
Pr o m o t i o n N a t i o n a l C e n t e r f o r H e al
a l t h Pr
Pr o m o t i o n
N a t i o n a l C e n t e r f o r D i s e a s e Pr
Pr e v e n t i o n a n d C o n t r o l N a t i o n a l C e n t e r f o r D i s e a s e Pr
Pr e v e n t i o n a n d C o n t r o l

Paraly tic Shellfish Poisoning

Paralytic
(REDTIDE)
PERTUSSIS
A BACTERIAL (Toxin-Related) Disease
Cause: SHELLFISH (tahong, talaba, halaan)
contaminated with red tide microorganisms History of severe cough and history of any of the following
followin g : Cough persisting 2 or more
weeks; fits of coughing, and cough followed by vomiting.
Mode of Transmis
Transmission:
sion: Eating of contaminated
Occurrence:
shellfish
• Worldwide
Signs and Symptoms: • Morbidity higher in developing countries
Neurological Infectious Agent: Bordetella pertussis
♦ sense of numbness around the mouth or the face

♦ dizziness Reservoir: Man

Man
♦ pricking sensation and/or paralysis of hands and feet
Mode of Transmission:
♦ body weakness

♦ rapid pulse beat

• Primarily by direct contact with discharges from respiratory mucus membranes
♦ difficulty of talking, swallowing, breathing of infected persons
♦ headache • Airborne route probably by droplets
• Indirect contact with articles freshly soiled with the discharges of infected persons
Gastrointestinal
♦ abdominal pain, vomiting and diarrhea
Incubation Period:

• Usually 7 days but ranges from 5 to 15 days

Period of Communicability:
Preventive Measures
♦ Do not eat shellfish when there is a redtide warning.
• Highly communicable in early catarrhal stage, before paroxysmal cough
♦ Avoid eating alamang and small fishes.
f ishes. • Antibiotics may shorten the period of communicability from 7 days after exposure
♦ Wash thoroughly and remove gills and intestines of fish,
fi sh, squids to 3 weeks after onset of typical paroxysms to only 5 to 7 days after onset therapy
and crabs.
♦ Remove heads of shrimps. Susceptibility/Resistance:

• Susceptibility is general.
• One attack confers a prolonged immunity although exposed adults may have
another attack.
• Three doses of DPT confers immunity to pertussis.
These symptoms will be felt within 12 hours
after eating redtide contaminated shellfish
BRING PATIENT IMMEDIATELY
IMMEDIATELY TO THE NEAREST
N EAREST HOSPITAL
HOS PITAL

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H EALTH A DVISORY H EALTH A DVISORY
N a t i o n a l C e n t e r f o r H e a l t h Pr
Pr o m o t i o n N a t i o n a l C e n t e r f o r H e al
a l t h Pr
Pr o m o t i o n
N a t i o n a l C e n t e r f o r D i s e a s e Pr
Pr e v e n t i o n a n d C o n t r o l N a t i o n a l C e n t e r f o r D i s e a s e Pr
Pr e v e n t i o n a n d C o n t r o l

POLIOMYELITIS RABIES
Cause
A VIRAL DISEASE
Rabies Virus

A suspect case of polio is defined as any patient below 15 years of age Mode of Transm
ransmissio
ission
n
with acute flaccid paralysis including those diagnosed to have Guillain-
Barre Syndrome for which no other cause can be immediately identified. Through bite of a rabid animal or contamination of
any wound/scratch with saliva containing rabies virus
Rabid Dog
Signs and Symptoms:
Symptoms:
Signs and Symptoms
• fever
♦ Headache and fever
• severe muscle pain and paralysis ♦ Pain or numbness of bite site
• difficulty of breathing ♦ Delirium and paralysis
• inability to move affectes arm/leg ♦ Muscle spasms
♦ Hydrophobia and aerophobia
Mode of
of Transmission:
Prevention and Control
• Fecal-oral route
Be a Responsible Pet Owner
• Oral route through pharyngeal secretion
• Contact with infected persons ♦ Have your pet dog immunized against rabies at 3 months old and
every year thereafter.
Complications: ♦ Never allow your pet dog to roam the streets.
♦ Take care of your pet dog:
dog : bathe, give clean
cle an food, and provide
provi de
clean sleeping quarters.
• death may occur if respiratory muscles are affected
• paralyzed limb When Bitten by a Dog

Treatment: ♦ Wash the wound immediately with soap and running water.
♦ Observe the dog for 14 days and consult your physician
physici an if any of
the following occurs:
• there is no treatment for polio but support treatment based on the
• dog becomes wild and runs aimlessly
symptoms presented/manifested by the patient • drooling of saliva
• bites any moving or non-moving object
• does not eat or drink
• the dog dies within observation period
♦ If dog cannot be observed (stray dog), or if suspected to be rabid, consult
your physician immediately or go to the nearest Animal Bite Treatment
Treatment Center in
your area.
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N a t i o n a l C e n t e r f o r H e a l t h Pr
Pr o m o t i o n N a t i o n a l C e n t e r f o r H e al
a l t h Pr
Pr o m o t i o n
N a t i o n a l C e n t e r f o r D i s e a s e Pr
Pr e v e n t i o n a n d C o n t r o l N a t i o n a l C e n t e r f o r D i s e a s e Pr
Pr e v e n t i o n a n d C o n t r o l

SARS
Severe Acute Respiratory Syndrome
SCHISTOSOMIASIS
• Severe Acute Respiratory Syndrome The Disease:
• A newly identified respiratory illness
il lness characterized by fever and • It is caused by a blood fluke (parasite) called Schistosoma
pneumonia which rapidly becomes severe and in some cases japonicum, transmitted
transmi tted through a tiny fresh water snail
may lead to death. (Oncomelania quadrasi).
• It is transmitted to man or animal through skin penetration
Signs and Symptoms when they get in contact with schisto infested waters.
If one has visited a country
countr y or area which is affected
affecte d by SARS • It is closely related to personal habits and livelihood
and/or had close contact with a SARS patient and within 14 days requiring contact with water.
show the following signs and symptoms:
Signs and Symptoms:
• High fever (38.0oC)
• Headache a. Early Stage b. Late Advance Stage
• Overall feeling of discomfort • Abdominal pain • Inflammation of the liver
• Body aches • Low grade fever • Bulging of the Abdomen
• Dry cough • Loose bowel movement • Enlargement of the Spleen
• Difficulty of breathing after 2 to 7 days • Bloody stool • Sometimes the brain is affected
Cause that caused epilepsy
SARS is caused by a new coronavirus
coronavirus associated
associated with common cold virus.
Diagnostic Method: Stoo
Stooll examination through Kato Katz method
How does SARS spread?
Prognosis: Curable at the early stage but fatal in the advanced stage
• SARS sprea
spreads
ds throu
through
gh coughin
coughing g or sneezi
sneezing
ng of drople
droplets
ts into the air
air and someo
someonene
else breathes them in. Drug of Choice: Praziquantel tablets
• SARS spread
spreadss by close
close person-to-
person-to-pers
person
on contact.
contact. Most
Most cases
cases of SARS havehave involved
involved:: (available at SCT or Health Centers for free)
a. people who cared for or lived
lived with someone with SARS.
b. had direct contact with infectious material
material (for example, respiratory secretions)
secretions) from Prevention and Control:
Prevention
a person who have SARS. ♦ Submit stool for examination to the Schistosomiasis Control Team Team (SCT) or
c. touching the skin of other people or objects that are contaminated with infectious Health Centers.
droplets and then touching one’s eye(s), nose, or mouth.
mout h. ♦ Construct and use sanitary toilets.
 What is the treatment for SARS? ♦ Avoid contact or exposing oneself to schisto infested waters.
♦ Fencing or tying of stray animals.
No specific cure or treatment for SARS. SARS patients should
should be referred to the nearest ♦ Keep environment clean and participate in community efforts
effort s of controlling the
DOH SARS Referral Hospital for clinical management. disease.
♦ Consult SCT or Health Centers for
f or additional information.
Prevention
• Health screening in airports and seaports of passengers from SARS affected countries
during outbreaks.
• Quarantine of contacts of SARS patients and of new arrivals during outbreaks.
S a m a -s
-s a m a n g S u g p u i n a n g S I ST
S T O!
O!
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N a t i o n a l C e n t e r f o r H e a l t h Pr
Pr o m o t i o n N a t i o n a l C e n t e r f o r H e al
a l t h Pr
Pr o m o t i o n
N a t i o n a l C e n t e r f o r D i s e a s e Pr
Pr e v e n t i o n a n d C o n t r o l N a t i o n a l C e n t e r f o r D i s e a s e Pr
Pr e v e n t i o n a n d C o n t r o l

SORE EYES SUBST ANCE ABUSE:

• term often used for viral conjunctivitis   A LCOHOL
 AL
Incubation period or time from exposure
exposur e to onset
of symptoms: 5 -12 days

Mode of Transmi
ransmission
ssion Symptoms

• Direct contact by one’s eyes with hands contaminated with eye secretions of an Mental disorder recognizable through the following symptoms:
infected person. a. strong and persistent desire to drink alcohol despite harmful
• Touching of eyes with hands getting contact with surfaces, instruments, eye
solutions, make-ups contaminated
contami nated with the virus from an infected person. consequences
• Entry of the virus through the eyes by swimming in poorly
poor ly chlorinated pools. b. inability to control drinking
c. higher priority given to alcohol consumption than other obligations
Signs and Symptoms d. tolerance to alcohol, and a physical withdrawal reaction when alcohol is
• Begins in one eye and later affects both eyes. abruptly discontinued
• Watery to pus-like discharge.
• Redness of the eye with pain and/or itching sensation. Causes
• Eyelids that are stuck together on awakening.
• In severe cases, pain of the eyes on exposure to sunlight and foreign-body solution.
• First degree relatives affected with alcohol related disorders are 3-4x
Treatment likely to have the disorder.

• There is no specific treatment during the acute phase (1-2 weeks). • Psychoanalytic theory points to people with harsh superego, who are
• If eye discharge is profuse and pus-like or patient develops blurring of vision or
severe pain, consultation with an opthalmologist is advised.
self-punitive turn to alcohol to diminish unconscious stress.
self-punitive stress.

Prevention • Conduct disorders and other childhood disorders increases risk of

• Wash hands frequently and thoroughly with soap and water.
alcohol related disorder in adult.
• Minimize hand-to-eye contact.
• Use only own towels, eye drops, make-ups and applicators,
applicator s, sunglasses or eye Treatment
glasses.
• Wear eye/sunglasses on a windy day to protect one’s eyes from foreign particles • Treatment can be done in community settings.
• Avoid crowded places.
• Prognosis is good if a person is pressured into treatment.
• Disinfect surfaces, doorknobs, counters, elevator buttons and hand rails with dilute
bleach solution. • Patients who come for voluntary treatment have the best prognosis.
• Clothes, towels, pillow
pill ow cases and anything else which may have come in contact with • Voluntary mutual help organizations play a large role in the treatment.
an infected person should be washed. • Effective alcohol control policies are also needed.

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N a t i o n a l C e n t e r f o r H e a l t h Pr
Pr o m o t i o n N a t i o n a l C e n t e r f o r H e al
a l t h Pr
Pr o m o t i o n
N a t i o n a l C e n t e r f o r D i s e a s e Pr
Pr e v e n t i o n a n d C o n t r o l N a t i o n a l C e n t e r f o r D i s e a s e Pr
Pr e v e n t i o n a n d C o n t r o l

SUBST ANCE ABUSE:
SUBST ANCE TUBERCULOSIS
ECST ACY  A BACTERIAL DISEASE
a prohibited drug that belongs to the addictive 
An ill child with:
amphetamine group and has been abused as stimulant 
• A history of contact with a suspect or confirmed case pulmonary tuberculosis
• Any child does not return to normal health after measles or whooping cough
SCIENTIFIC NA ME • Losses weight, cough and wheeze which does not respond to antibiotic therapy
3,4 Methylenedioxyamphetamine for acute respiratory disease
• Abdominal swelling with a hard painless mass and free fluid
STREET NAMES • Painful firm or soft swelling in a group of superficial lymph nodes
• Any bone or joint lesion of slow onset
• Signs suggesting meningitis or disease in the central nervous system
• “Love Drug”
• X-tacy Occurrence:
• XTC • Worldwide
• MDMA • Morbidity and mortality rates are higher in developing countries
• ADAM
• Rave Infectious Agent: Myobacterium tuberculosis
• Flying Saucer
Reservoir:
• LBD “Libido”
• Man
• Diseased cattle
Effects
Mode of transmission:
• Hallucinations • By droplets infection, that is through inhalation of bacilli from patients
• Euphoria • By dust inhalation of bacilli which have dried on the surface of the ground or floor
• Nausea and become suspended in the air
• Anorexia Incubation Period:
• About 4 to 12 weeks from infection
• Anxiety
• A year or two after infection of pulmonary or extrapulmonary tuberculosis
• Insomnia
• Death to some extent due to cardiac arrhythmias and seizures Period of Communicability:
• A person who excretes tubercle bacilli is communicable.
• Degree of communicability depends upon:
The onset of effect occurs 20 minutes to one hour after intake * The number
number of excreted bacilli
bacilli in the air
and lasts for six hours. * Virulence of the bacilli
* Environmental conditions like overcrowding

DO NOT USE ECSTACY: Susceptibility/Resistance:

• Susceptibility to infection is general.
• The risk of developing the disease is highest in the children under 3 years.
IT COULD KILL YOU!
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Pr o m o t i o n N a t i o n a l C e n t e r f o r H e al
a l t h Pr
Pr o m o t i o n
N a t i o n a l C e n t e r f o r D i s e a s e Pr
Pr e v e n t i o n a n d C o n t r o l N a t i o n a l C e n t e r f o r D i s e a s e Pr
Pr e v e n t i o n a n d C o n t r o l

TYPHOID  VITAMIN A 
 VITAMIN
Fever DEFICIENCY 
Cause: salmonella typhi bacteria

Mode of
of Transmiss
ransmission:
ion: Causes
• ingestion of food and water
contaminated with human waste • not eating enough foods rich in Vit Vitamin
amin A
• lack of fat or oil in the diet which help the body
Signs and Symptoms: absorb Vitamin A
• sustained high fever • poor absorption or rapid utilization of Vitamin A due to illness
• headache
• malaise (weakness)
• anorexia (loss of appetite) Signs
• diarrhea or constipation and abdominal discomfort

Prevention and Control: • nightblindness (if child refuses to play in the dark or
• Boil water for drinking. (Upon reaching boiling point, extend has difficulty seeing in the dark)
boiling for two or more minutes) or • bitot’s spot (foamy soapsud-like spots on white part
• Do water chlorination of the eye)
• Cook food well and always use food cover to prevent flies • dry, hazy and rough-appearing cornea
and other insects from contaminating them. • crater-like
crater-like defect on cornea
• Wash thoroughly all vegetables and fruits • softened cornea; sometimes bulging
especially those that are eaten raw.
• Avoid eating street vended foods. Prevention
• Wash hands with soap and water after using the toilet and
before eating. • exclusively breastfeed infants up to 6 months and continue
• Keep surrounding clean to prevent breeding of flies. breastfeeding up to 2 years.
• eat food rich in Vitamin A such as liver, eggs, milk, crab fat,
cheese, malunggay, gabi leaves, kamote tops, kangkong,
Bring suspected cases immediate
immediatelyly alugbati, saluyot, carrots, squash, ripe mango
• take correct dose of Vitamin A capsules as prescribed
to the nearest health center or hospital.
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Pr o m o t i o n N a t i o n a l C e n t e r f o r H e al
a l t h Pr
Pr o m o t i o n
N a t i o n a l C e n t e r f o r D i s e a s e Pr
Pr e v e n t i o n a n d C o n t r o l N a t i o n a l C e n t e r f o r D i s e a s e Pr
Pr e v e n t i o n a n d C o n t r o l

WATUSI
Poisoning

It is a condition due to ingestion of watusi which is made up

of an extremely poisonous and toxic chemicals.

Signs and Symptoms of Watusi Poisoning

• Burns
• Burning pain in the throat and garlic odor from breath
•
•
Nausea, vomiting diarrhea, abdominal
Shock
abdomina l pain and vomitus and excreta
Weather and
Season-related Advisories
Immediate Treatment

• If ingested, DO NOT INDUCE VOMITING

• Give 6-8 egg whites to children, 8-12 egg whites for adults
• If there is a dermal exposure, bathe the patient using alkaline soap like Perla or Ivory

Bring the child immediately to the nearest hospital even if the child
seems to be well, ill-effects may not be seen at once.

WATUSI
WATUSI is extremely a dangerous
d angerous firecracker!
firecr acker!
Do not let your child play with it.

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a l t h Pr
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N a t i o n a l C e n t e r f o r D i s e a s e Pr
Pr e v e n t i o n a n d C o n t r o l N a t i o n a l C e n t e r f o r D i s e a s e Pr
Pr e v e n t i o n a n d C o n t r o l

HEALTH
HEAL TH FOR
FOR THE
THE
It’s SUMMER time! HOLIDA
HOL IDAY
Y SEAS
SEASON
ON
March to May is vacation time and fiesta season in the 
country. To avoid food poisoning, diarrhea, heat- 
associated ailments and recreation-associated injuries,
injuries,
the public is advised to take the following precautions.
Here are some health tips
for the Christmas Season:

1. Plan Christmas activities

activities for yourself and your family to prevent
prevent tension and stress.
stress.
Food and drinks
2. Take care of yourself
yourself and your family against changes in temperature. Children and
and adults
may become susceptible to cough, colds and fever. If your cough, colds and fever is is
• Cook food properly
properl y.
more than five days, consult your nearest health station.
• Preferably, foods must be eaten immediately after cooking (while still hot).
• left-over food should be refrigerated and reheated before being eaten.
3. Prepare a well-balanced Noche Buena and and Media Noche meals. Make sure that that
• Food handlers should wash their hands before and after food preparation.
preparati on.
vegetable and fruits are on the table together with your traditional ham and queso de
• If sick, you should avoid preparing food for others.
bola.
• Avoid drinking water and iced beverages
bever ages of doubtful quality.
• If water quality is doubtful, boil your drinking water for at least 2 minutes.
4. Be kind to your
your heart. Eat a moderate amount of nutritious foods to sustain your
your daily
• Peel and wash fruits / vegetables before eating.
activities.
• Wash hands before and after eating.
5. Drink plenty of liquids.
liquids. Drink plenty of water
water and fruit juices to facilitate
facilitate excretion.
At the beach
6. Have enough sleep.
sleep. Give yourself enough
enough sleep so that the mind
mind and body can rest.
rest.

• Do not allow children to swim without the company of an adult who can swim 7. Avoid crowded
crowded areas because
because bacteria
bacteria that cause diseases
diseases multiply and spread
spread
and is not drunk. easily. Airy and well- ventilated
ventil ated areas are essential to healthy
healt hy living.
• Avoid staying under
under the sun with scanty clothes for more than 3 hours as this
predisposes to sunburn, heat exhaustion and and the worst, heat stroke. 8. Use environment-friendly
environment-friendly Christmas decors
decors that cost less
less and are not fire hazards.
• Should you want a tan, drink plenty of fluids so as not to dehydrate yourself. Save decors for next year and store them in a safe place.

9. Buy toys with no pointed

pointed or sharp edges; nor too small
small toys that can cause choking.
choking.
 While on the road
10. Do not use fireworks and firecrackers during the Holidays. Make some noise even
• Check your vehicle very well before going on a trip. without fireworks and firecrackers.
• Bring your repair kit with you.
• When drunk, never attempt to drive.

Stay alive and whole for the coming year.

year.
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Pr o m o t i o n N a t i o n a l C e n t e r f o r H e al
a l t h Pr
Pr o m o t i o n
N a t i o n a l C e n t e r f o r D i s e a s e Pr
Pr e v e n t i o n a n d C o n t r o l N a t i o n a l C e n t e r f o r D i s e a s e Pr
Pr e v e n t i o n a n d C o n t r o l

HEALTH ADVISORY 
EL NIÑO
DURING TYPHOON Phenomenon
 Water:
• Make sure drinking water is from a safe source.
characterized by extreme climatic conditions; 
• When in doubt, do not drink. Boil it for 3 minutes
extreme temperature rise with a little rainfall,
or chlorinate drinking water to make it safe. and at the opposite extreme, there is unusually 
heavy rainfall 
Food:
• Food should be well-cooked.
• Left-overs should be covered and kept away from household
pests.
Health Effects
• Food waste should be disposed properly. • Diseases related to water scarcity or shortage such as
diarrhea and skin diseases
Clothing: • Red Tide Blooms : Paralytic shellfish poisoning
Keep yourself dry and warm. • Disorders associated with high temperatures: heat cramps,
heat exhaustion, exertional heat injury and heat stroke
strok e
Others:
• Consult a doctor at once if you, or any member of your household,
have any sign or symptom to prevent the spread of infection in the
evacuation area.
 What to do?
• Common infections or diseases that may spread in an evacuation
• Conserve water and use it wisely.
area include: coughs and colds, acute gastroenteritis, skin and eye • Protect water sources from contamination.
infections, measles, dengue, leptospirosis, hepatitis A. • Drink more fluids.
• Do not allow children wade in floodwaters to avoid diseases such as • Listen to the updates on shellfish ban.
leptospirosis. • Wear light clothing.
• Dispose all waste properly.
• Avoid strenuous physical activity.
• Maintain personal hygiene, always wash your hands before and
after eating and using the toilet.
• Put safety first. Avoid hanging wires and unstable structures.

Be prepared
prepared for the coming
coming of
El Niño phenomenon!
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Pr o m o t i o n N a t i o n a l C e n t e r f o r H e al
a l t h Pr
Pr o m o t i o n
N a t i o n a l C e n t e r f o r D i s e a s e Pr
Pr e v e n t i o n a n d C o n t r o l N a t i o n a l C e n t e r f o r D i s e a s e Pr
Pr e v e n t i o n a n d C o n t r o l

LA NIÑA  HAZE
is a weather phenomena characterized by unusually cold 
ocean temperature in the Equatorial Pacific which causes  HAZE due to forest fire can cause air pollution which 
increased numbers of tropical storms in the Pacific Ocean. can bring about increased risks for Respiratory 
Tract Infections and Cardiac Ailments.

Health Effects  What to do?

• Disease related to contaminated water due to flooding, such as acute Elderly, children and those with respiratory (Asthma ,COPD) and cardiovascular
gastroenteritis, typhoid fever, cholera and hepatitis A.
diseases:
• Disease related to wading in floodwaters
floodwaters contaminated
contaminated with urine
urine of
infected animals, such as leptospirosis.
• Stay indoors with good ventilation.
• Disease brought by mosquitoes, such as dengue and malaria.
• Wear appropriate
appropriat e dust masks when going outside the house.
• Accidents and injuries such as contusions, lacerations, fractures, electrocution.
• Refrain from physical activities (exercise, etc) in heavily polluted areas.

Prevention Motorists should exercise extreme caution whenever on the road to prevent
accidents.
• Boil your drinking water (Upon reaching boiling point, extend boiling for
two or more minutes) or • Use headlights/foglights.
• Do water chlorination • Follow the required minimum speed level and extreme
ext reme caution in low.
• Wash hands before preparing food and after using the toilet.
toil et. visibility driving.
• Avoid wading in floodwater.
floodwater. If you must, wear rubber boots. • Ensure that vehicle is in good running condition.
• Clean-up all possible mosquito breeding sites, such as vases, empty
coconut shells, old tires and tin cans. Stay away from low-lying areas where smoke and suspended particles may settle.
settl e.

Consult a doctor if there is:

  What to Do In Case of Flood
• difficulty in breathing
• Stay inside a house or building during heavy rains.
Stay r ains.
• cough
• Avoid wading and taking baths in floodwaters.
• chest pain
• When a flood advisory is issued, residents in low lying areas should seek for
• increased tearing of the eyes
higher grounds.
• nose or throat irritation
• Avoid crossing low-lying areas and bridges during evacuation.
Tune in to your radio or television for more health advisories.

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Pr o m o t i o n N a t i o n a l C e n t e r f o r H e al
a l t h Pr
Pr o m o t i o n
N a t i o n a l C e n t e r f o r D i s e a s e Pr
Pr e v e n t i o n a n d C o n t r o l N a t i o n a l C e n t e r f o r D i s e a s e Pr
Pr e v e n t i o n a n d C o n t r o l

FOOD SAFE
SAFETT Y  WATER SANITATION
Is the assurance/guarantee that food will not cause
harm to the consumers when it is prepared and/or
eaten according to its intended use.
Water sanitation deals with the promotion
Food and Water-borne Diseases and provision of safe drinking water.

Is a group of illness caused by any infectious (bacteria,

(bacteri a, viruses and parasites)
and non-infectious agents (chemical, animal and plant toxins)
  Ways of protecting water from contamination
during handling, transport and storage
Common Causes of Food and Water Borne Diseases
• always use clean water containers provided with cover
♦ unsafe sources of drinkng water
• wash containers after every use
♦ improper disposal of human waste
• clean and disinfect storage tanks at least every quarter
♦ unhygienic practices like spitting anywhere, blowing or picking the nose
• avoid hand contact with water during transport
♦ unsafe food handling and preparation practices i.e. street vended foods

Methods of water treatment

Five Keys to Safer Food (Source: WHO)

1. Keep Clean. • boiling - water should be brought to a rolling boil for at least
2. Separate raw and cooked foods. two (2) minutes
3. Cook foods thoroughly. • disinfection - by using chlorine
4. Keep food at sa
safe te
temperatures. 1. Prepare a stock solution by dissolving 1 level of powder
5. Use safe wate
terr and ra
raw
w materials. Chlorine compounds (65 to 75 % available chlorine) to 1
liter of water
wate r.
2. Add 2 teaspoons of stock solution to 5 gallons (20 liters) of
In case of Suspected Foodborne
Foodborne Illnesses water. Mix thoroughly and let it stand for atleast 30 minutes
1. Preserve the evidence. before using.
If a portion of the suspected food is available, wrap it securely “danger”
and freeze it.
2. Seek treatment as necessary.
If symptoms persists or are severe (i.e. bloody diarrhea, excessive nausea
and vomiting or high temperature), immediately
imm ediately consult a doctor.
“    
“    Drink Safe and Clean Water”
3. Report the incidence to the local health department.

(Turn to next page for additional information)

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Pr e v e n t i o n a n d C o n t r o l

SUNBURN HEAT STROKE

Most severe form of heat illness when the body overheats
overheats and can’t cool down. The body
Skin burned by exposure to the sun or other ultraviolet light. cannot take off the excessive heat from the body by sweating because of dehydration and/ 
or humid environment.
Cause Causes
• the risk of heat stroke goes way up in hot and humid weather
Amount of exposure to the sun or other ultraviolet light source exceeds the ability of • vigorous exercise in hot weather
the body’s protective pigment, melanin, to
t o protect the skin. • if you’re dehydrated
• if you’ve had too much direct exposure to the sun
Signs
Signs
• Skin starts to become painful and red. May start with the following signs of heat exhaustion:
• The pain is worst between 6 and 48 hours after sun exposure.
exposu re. In severe sunburns, • warm, flushed skin
blistering of the skin may occur. • faintness
• Swelling (Edema) of the skin, especially in the legs, is common. • dizziness
• Skin peeling usually begins between three and eight days after exposure. • weakness
• May or may have no fever. • headache
• Seek medical help if there is fever
fever.. H e at
at s t r o k e i s a m e d i c a l
May progress to an emergency condition of
heat stroke: emergency! Bring the
Treatment patient immediately
• very high fever of 41 C
• Take a cool shower or bath or place wet, cold wash rags on the burn. (Aspirin
( Aspirin • rapid heartbeat
t o t h e h o sp sp i t a l
should be avoided in children who are running a fever). Avoid products that contain • convulsion a f t e r i n st
st i t u t i n g
benzocaine, lidocaine or petroleum (like vaseline). • delirium emergency measures.
• If blisters are present, dry bandages may help prevent infection. • unconscious
• Ibuprofen may help to alleviate the pain from sunburn. Prevention
• If the skin is not blistering, apply moisturizing
moisturizing cream to relieve discomfort. • Limit the amount of time you spend outdoors.
• Drink plenty of water.
water. Avoid tea, coffee, soda and
and alcohol.
Prevention • Wear a wide-brimmed hat and long-sleeved clothing when outdoors.
• Schedule heavy-duty activities for the beginning or end of the day, when it’s cooler.
• Sunscreen, protective clothing, and ultraviolet-protected
ultraviolet -protected sunglasses are all
Treatment
recommended to prevent excessive sun exposure.
Emergency measures:
• SPF level of 30 or greater is recommended for sunscreen of application into
• Move the person to a shady spot or indoors and have them lie down with their legs
exposed skin.
elevated. If they’re conscious, have them sip cool water.
water.
• Wear a hat and other protective clothing if exposed in the sun. • Remove clothing, apply cool water to the skin and fan them.
• Apply ice packs to the armpits, wrists, ankles and groin.

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Pr o m o t i o n
N a t i o n a l C e n t e r f o r D i s e a s e Pr
Pr e v e n t i o n a n d C o n t r o l N a t i o n a l C e n t e r f o r D i s e a s e Pr
Pr e v e n t i o n a n d C o n t r o l

BOIL PRICKLY HEAT

A boil is a pus filled infection of the skin. It usually starts as an infection in a hair follicle
and spreads in the surrounding area.
A type of heat rash characterized by tiny bumps or even water blisters.
blist ers.

Causes Causes

• Usually caused by Staphylococcus

Staphylococcus bacteria through direct skin contact with infected • Brought about by clogging of sweat glands, resulting into tiny bumps.
persons or surfaces. • The forehead (under caps or visors), body folds, the upper back and chest, and
• Bacteria called Staphylococcus
Staphylococcus aureus are the usual cause. the arms are the most common locations.
• More common in kids with diabetes, malnutrition, or other reason to have their • Most common when it is hot and humid.
immune system not working at full strength.
Signs
Signs
• ‘Prickly’ sensation.
• The rash can look quite similar to one caused by infected hair follicles
fol licles (folliculitis),
• Begins with swelling or redness of the skin.
there are no hair follicles in prickly heat bumps.
• The center of the infection liquefies as pus collects.
• Boils are 1-5 cm in size, and are painful.
Prevention
Prevention
• Take a bath everyday.
• Wash hands frequently and thoroughly with soap and water. • Limit exposure to the sun.
• Take a bath at least once a day. • Always dries up sweat from the skin.
• Wear light, loose clothing.
Treatment
Treatment
• Do not touch the boil with dirty or bare hands.
• Never squeeze a boil, as this could well spread the infection. • Cleanse the skin
ski n gently.
• Apply warm compress to relieve pain. • Apply corn starch or baking soda powder.
• Cover the boil temporarily if it is in danger of getting dirty. • If there is excessive itching or if the rash is infected, consult a physician.
• Some boils may need to be opened and drained and may need antibiotics.
• Consult a physician if the boil does not drain itself.

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N a t i o n a l C e n t e r f o r D i s e a s e Pr
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Pr e v e n t i o n a n d C o n t r o l

Shar e
YOU R
Blood
D i d yo
y o u k n ow
o w t h at
a t ...
Blood Donation $ At present,
present, an average
average of 4 cases
cases need
need blo
transfusion every month in any hospital.
blood
od

$ 3 out of 10 cases who need blood do not get it

because there is not enough supply.
$ Blood from a paid donor is three times more
more likely to
have any four blood transmiss
transmissible
ible diseases, such
such as
malaria, syphilis, hepatitis B, or AIDS.

All commercial blood banks have been closed.

Those who need blood will have to rely on
government blood banks.

Sh a r e y o u r b l o o d .
Go to the nearest government hospital 
to donate blood.

Contents are contributed by National Blood Voluntary Program

73 74

H EALTH A DVISORY H EALTH A DVISORY

N a t i o n a l C e n t e r f o r H e a l t h Pr
Pr o m o t i o n N a t i o n a l C e n t e r f o r H e al
a l t h Pr
Pr o m o t i o n
N a t i o n a l C e n t e r f o r D i s e a s e Pr
Pr e v e n t i o n a n d C o n t r o l N a t i o n a l C e n t e r f o r D i s e a s e Pr
Pr e v e n t i o n a n d C o n t r o l

Shar e Shar e
YOU R YOU R
Blood Blood
How? D o Yo u K n o w Yo u r 
$ Go to the nearest BLOOD COLLECTION Blood Type?
UNIT (BCU) located in a government hospital.
Knowing your blood type can be important, espe-
$ Register as potential
potenti al blood donor.
cially during emergencies. If you will need a blood
transfusion, finding the right type for you will be
$ Your health history
history will be taken. faster.
What are your blood types?

$ A physical examination follows

follow s to check on
your weight, temperature, pulse and blood
pressure.

$ A blood test will be done to know your

you r blood
group or type

Sharing or donating blood is easy and

rewarding. You
You will not feel
fee l any ill effects
eff ects after
donating and you can save the life of someone KNOW YOUR BLOOD TYPE.
who needs your kind of blood.
SHARE YOUR BLOOD.
Go to the nearest government hospital  Go to the nearest government hospital 
to donate blood. to donate blood.
Contents are contributed by National Blood Voluntary Program Contents are contributed by National Blood Voluntary Program
75 76
H EALTH A DVISORY H EALTH A DVISORY
N a t i o n a l C e n t e r f o r H e a l t h Pr
Pr o m o t i o n N a t i o n a l C e n t e r f o r H e al
a l t h Pr
Pr o m o t i o n
N a t i o n a l C e n t e r f o r D i s e a s e Pr
Pr e v e n t i o n a n d C o n t r o l N a t i o n a l C e n t e r f o r D i s e a s e Pr
Pr e v e n t i o n a n d C o n t r o l

Shar e Shar e
YOU R YOU R
Blood Blood
Are you Qualified to share your Blood? A r e Yo u A f r a i d T o D o n a t e
Sharing or Donating blood is easy as ABC. If you are:
• 16 to 65 years old; and,
Blood?
• Weighs at least 45 kilograms or 100 pounds, then you can be a donor Sharing your blood is easy. It takes only 5 to 10 minutes and 250
to 450 ml. (millilite
(milliliters)
rs) of your blood. This amount is replenished by the
If you decide to share your blood , you can go to the nearest
BLOOD COLLECTION UNIT in a government hospital.
body within 3 to 5 hours. No special food is required except the increase
in fluid intake.
The doctors will take your:
• temperature (must not be more than 37 degrees Centigrade), After donating blood, a few minutes’ rest before getting up is
• pulse at regular rhythm (must be between 50 to 100 per minute), recommended, after which snacks can be taken.
• blood pressure (must be between 90 to 160mm Hg. for systolic and 60 to
100 mm Hg. for diastolic), and You can resume your usual activities immediately, unless your
• hemoglobin level (must be 125 grams per liter to 170 grams per liter).  job requires you to be fully alert, such as in operating heavy equipment
• If you meet all these physical requirements
requirem ents and pass the medical
and driving. If this is your kind of job, you may resume your activities
examinations,
examination s, you can share your blood.
bl ood. You
You don’t pay any fee.
after at least 6 hours.
After donating blood,
bloo d, you will be asked to rest for a few minutes and , if you
become hungry or thirsty, take a light snack. You can now go home. A normal and healthy person can give blood every three months
without harmful effects to the body.
So, share your blood. It is rewarding when you know that someone
SHARE YOUR BLOOD. out there needs your kind of blood.
Go to the nearest government hospital 
to donate blood. Go to the nearest government hospital 
to donate blood.

Contents are contributed by National Blood Voluntary Program Contents are contributed by National Blood Voluntary Program
77 78

H EALTH A DVISORY H EALTH A DVISORY

N a t i o n a l C e n t e r f o r H e a l t h Pr
Pr o m o t i o n N a t i o n a l C e n t e r f o r H e al
a l t h Pr
Pr o m o t i o n
N a t i o n a l C e n t e r f o r D i s e a s e Pr
Pr e v e n t i o n a n d C o n t r o l N a t i o n a l C e n t e r f o r D i s e a s e Pr
Pr e v e n t i o n a n d C o n t r o l

Shar e Conditions
YOU R
Blood ...tha t p r eve n t yo u
r e
f r om sharing blood
r o
 What Happens After You Give Blood?
• Diabetes
• Cancer
Giving blood takes only 5 to 10 minutes.
minut es. About 250 to 450
• Hyperthyroidism
ml. of blood is extracted from you and this amount is easily
replaced by the body within 3 to 5 hours. No special food is • Cardiovascular diseases

required, just drink more

mor e water.
water. • Severe psychiatric disorder
• Epilepsy/ convulsions
After giving blood, rest for a few minutes and then may take • Severe bronchitis & other lung disorders, such
your snacks. You
You may resume your usual activities
activiti es afterwards, as TB
unless your job requires you to be awake and alert (such as • AIDS, Syphilis & other sexually transmitted
diseases (past or present)
machine operator,
operator, driver, etc.). If you are, you may resume your
Malaria If you do not have any
usual activities after at least 6 hours. •

of these conditions and

• Kidney & liver diseases, such as Hepatitis
you are physically fit,
Keep the dressing on the needle mark (where blood was • Prolonged bleeding you can share your
drawn) on your arm dry for 24 hours. The skin around the mark • Use of prohibited drugs blood.
may become discolored. It is not dangerous and will disappear
dis appear
after several days.
Go to the nearest 
SHARE YOUR BLOOD. government hospital 
Go to the nearest government hospital  to donate blood.
to donate blood.

Contents are contributed by National Blood Voluntary Program Contents are contributed by National Blood Voluntary Progra m
79 80
H EALTH A DVISORY
N a t i o n a l C e n t e r f o r H e a l t h Pr
Pr o m o t i o n
N a t i o n a l C e n t e r f o r D i s e a s e Pr
Pr e v e n t i o n a n d C o n t r o l