Stages of Infectious Disease

Professor Antonietta Rosemelinda C. Edra

Infectious diseases follow certain stages during

which communicability or severity of the illness
can be predicted.

Incubation Period –the time between the

invasion of an organism and the onset of
symptoms of infection . During this time
,microorganism grow and multiply.
ProdromalD period- is the time between the
beginning of non specific symptoms such as
malaise, low grade fever ,fatigue and arthralgia
to the onset of disease,specific symptoms such
as a rash, diarrhea and vomiting .
• Depending on the organism, children may be
infectious (capable of spreading the
microorganisms to others) during the prodromal
period. During the prodromal period, therefore,
• infectious diseases spread readily through
communities from a person with the
disease to any susceptible individual.
Fortunately, prodromal stages are generally
short, ranging from hours to a few days.
• Illness is the stage during which specific symptoms
occur. It is important to keep
in mind that the body’s response to infectious agents
causes a variety of
symptoms including fever, myalgia (muscle aches),
arthralgia (joint pain without
swelling), malaise, increased need for sleep, and
headache, which is usually
secondary to fever. There is also a site-specific reaction
such as coughing, runnynose, and sore throat when a
respiratory virus like rhinovirus or respiratory
syncytial virus infects the respiratory tract or diarrhea
and/or vomiting when rotavirus infects the
gastrointestinal
tract.
• Some childhood infections will manifest with a specific
rash on the skin
(exanthem) or mucous membrane (enanthem) (Box
43.2).
The convalescent period is the interval between
when symptoms first begin to
fade and when the child returns to a healthy
baseline. The return to baseline will
vary from child to child depending on the host,
other underlying illnesses, and
the type and severity of infection.
Assessing a Child for Common Signs and
Symptoms of Infectious Disorders
History : Child Concern; Does the child have a
fever, generalized malaise,vomiting or
diarrhea? Was the child recently exposed
to someone with infection?
Past Medical History: Are the child’s
immunizations current?
Physical Examination:
1.Mouth lesions on mucous membrane
2. White plaques on mucous (thrusts)
3. Linear abrasions on scalp;sandlike pastules
on hair shafts (pediculosis).
4. Nose:watery discharged (prodromal
symptoms of measles)
5. Reddened swollen pharynx (infectious
mononucleosis pharyngitis).
6.Gray membrane in pharynx (diptheria).
7. Swollen parotid glands (mumps).
8. Pinpoint papules on a erythematous base
(herpes simplex).
9. Crusty lesions between fingers( scabies).
10. Oozing honey colored, crusty lesions of
face and hands (impetigo).
CHAIN OF INFECTION
The chain of infection is the method by which organisms
are spread and enter a new individual to cause disease.
Breaking the chain at one of its susceptible points is the
most efficient way to prevent infection from spreading
(Chusid & Rotar, 2016).

Nurses are instrumental in doing this by teaching parents

the importance of infection control measures such as
good hand washing and asking them to monitor that
every person that touches their child also washes their
hands. In practicing hand washing and teaching parents to
act as advocates for their child, nurses can prevent
nosocomial infections
(infections transmitted in healthcare facilities)
Reservoir
The reservoir is the container or place in which
an organism grows and reproduces.
The reservoir would be another person with the
disease, a contaminated object such as a
kitchen counter, or an animal or insect. Not all
infectious agents can live on fomites.
Fomites are inanimate objects that can also
transmit infections from one person to another
without direct contact with a human vector.
Portal of Exit
The portal of exit is the route by which an organism leaves
an infected child’s body to be spread to others. Organisms
can be carried out of the body by upper respiratory
excretions, feces, vomitus, saliva, urine, vaginal secretions,
blood, or lesion secretions

Depending on the way an organism is spread, it may be

necessary to wear gowns, gloves, or mask and/or face shield
to care for the child. In some cases, nothing more than
standard precautions are needed even though the child has
an infectious disease. Washing after contact with any body
secretions and covering a cough and/or sneeze with tissue
can limit droplet or airborne spread. Hand washing is the
most effective way to prevent the spread of infection.
Means of Transmission
The mode of transmission refers to whether the
infection is spread by direct or indirect
contact. Sexually transmitted infections, for
example, are spread by mucous membrane
to mucous membrane or direct contact. Other
infections are spread indirectly by fomites
—inanimate objects such as soil, food, water,
bedding, towels, combs, nonrefrigerated
food, or drinking glasses. Infections can also be
spread by vectors such as insects, rats,
or other vermin—who may not be ill but are
carriers of a human disease.
The most common means of indirect contact is the
spread of mouth and nose
secretions (droplet infection) through talking,
sneezing, coughing, breathing, kissing,
and sharing drinking glasses or straws.Some
droplets containing pathogenic organisms
are spread immediately to another individual in
this way. Some droplets fall to the
ground, where the organisms dry and then are
spread by dust. If small, the organisms
become suspended in the air (airborne
transmission) and can move with the wind to
infect people at a distance.
A common respiratory tract infection is an
example of anillness spread by indirect contact.

To break a chain of infection at this point, use

transmission-based precautions as
appropriate and wash hands before, between,
and after patient care. Household
measures such as using paper bathroom cups,
separating toothbrushes, and using
different towels for different people can help
prevent house reinfection.
Portal of Entry
The portal of entry refers to the opening through which a
pathogen can enter a child’s body such as by inhalation,
ingestion, or breaks in the skin from bites, abrasions, or
burns.
To break a chain of infection at this point, teach children
to wash their hands after sneezing or coughing, before
eating, and after using the bathroom. It is important to
teach girls to wipe their perineum from front to back after
defecating or voiding to prevent organisms from
spreading from the rectum to the urethra. Parents need
to wash dirt from cuts with soap and water and avoid
hydrogen peroxide as a cleaning agent as this interferes
with fibroblast production, delaying wound healing
Susceptible Host
For infection to occur, one more step must be present: The child
must be susceptible to the infection (susceptible host). Certain
characteristics make some individuals more prone to infection than
others, including:
• Age: Infection occurs most readily in the very young and the very
old.
• Gender: Girls, for example, have more urinary tract infections
than boys.
• Virulence: Some organisms are stronger than others or cause
disease more
readily.
• Body defenses: Physical, chemical, and immune responses all
protect against foreign invaders. Children with immunosuppression
are more susceptible than others. Infants who are breastfed are
less susceptible to infection than formula-
fed infants.
the end