Communicable Disease Nursing

SEMI FINAL TRANS

2. Emerging strains of some microbes that cannot
be protected by a single vaccine
TERMINOLOGIES
3. Resistance of virus to some antiviral meds
• INFECTION 4. Occasionally arising infectious agents (e.g. HIV,
- the implantation and successful replication of anthrax, Ebola)
an organism in host tissue resulting to signs and 5. Localization of some microbes in areas of the
symptoms as well as immunologic response. body difficult to treat
• CARRIER 6. Opportunistic organisms causing infection in
- an individual who harbors the organism and is immuno-compromised patients
capable of transmitting it to susceptible host 7. Most people have not received immunization
without showing manifestations of the disease. 8. Increased air travel can cause spread of virulent
• CONTACT organisms to a heavily populated area in hours.
- Is a person or animal who is in close association 9. Use of biologic warfare and bioterrorism
with an infected person, animal, or freshly 10. The expanded use of immunosuppressive drugs
soiled materials. and invasive procedures increases the risk of
• ISOLATION infection.
- separation from other persons of an individual
suffering from a communicable disease. Chain of Infection
• HABITAT
- Is a place where an organism lives or where the Infectious/ Causative Agent
organism is usually found.  Any microbe capable of producing a disease
• HOST 1. Bacteria
- Is a person, animal, or plant on which a 2. Spirochete
parasite depends for its survival 3. Viruses
• RESERVOIR 4. Rickettsiae
- composed of one or more species of animal or 5. Chalmydiae
plant in which an infectious agent lives and 6. Fungi
multiplies for survival and reproduces itself in 7. Protozoa
such a manner that it can be transmitted to 8. Parasites
man.
• SURVEILLANCE Reservoir
- the act of watching 1. Human reservoir
• COMMUNICABLE DISEASE a. Frank Cases or the very ill
- an illness caused by an infectious agent or its b. Sub-clinical or ambulatory
toxic products that are transmitted directly or c. Carrier
indirectly to a well person through an agency, a • Incubatory carrier: a person incubating
vector or an inanimate object. the illness
• INFECTIOUS DISEASE • Convalescent carrier: a person at the
- transmitted not only by ordinary contact but recovery stage of illness but continues
requires direct inoculation of the organism to shed the pathogenic organism
through a break in the skin or mucous • Intermittent carrier: occasionally sheds
membrane. the pathogenic organism
• Chronic or sustained carrier: always has
WHY INFECTION OCCURS? the infectious organisms in his or her
1. Resistance developed by bacteria to some system.
antibiotics 2. Animals
3. Nonliving things
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SEMI FINAL TRANS
Susceptible Host
– not possessing immunity to a particular
The Portal of Exit pathogen
- path or way in which the organisms leave the
reservoir
1. Respiratory system
2. Genitourinary system
3. Gastrointestinal tract
4. Skin and mucous membrane
5. Placenta

Mode of Transmission means by which the infectious

agent passes through the portal of exit of the reservoir
to the susceptible host.
 the easiest link to break the chain of infection.
1. Contact Transmission
a. Direct – person-to-person transfer ILLNESS FOLLOWING AN ENTRANCE OF PATHOGEN
b. Indirect – susceptible person comes in contact INTO THE BODY DEPENDS ON THE HOST:
with contaminated object 1. Age, sex, genes, and constitution;
c. Droplet spread – contact with respiratory 2. Nutritional status, fitness, environmental
secretions when the infected person coughs, factors;
sneezes, or talks 3. General condition, physical, emotional, and
2. Air-borne transmission – Spread by air current mental state;
and is inhaled by susceptible host. 4. Absence of or abnormal immunoglobulins;
3. Vehicle transmission – through articles or 5. Co-morbid states
substances that harbor the organism until it is 6. Treatment with certain antimicrobials,
ingested or inoculated into the host. corticosteroids, radiation, or
4. Vector-borne transmission – occurs when immunosuppressive drugs.
intermediate carriers transfer the microbes to
another living organism.
COURSE OF INFECTIOUS DISEASE
1. INCUBATION PERIOD
- time of infection to appearance of signs and
symptoms

Portal of Entry
- a venue where the organism gains entrance into
the susceptible host
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SEMI FINAL TRANS
2. PERIOD OF PRODROMAL SYMPTOMS/ PRODROMAL
PERIOD
- early symptoms that may mark the onset of a
disease
3. PERIOD OF INVASION
- the disease reaches its full development and
maximum intensity
- also referred to as Fastigium or Acme
4. COMMUNICABLE PERIOD
- period after infection when an infectious
agent can be transmitted to another host.
5. LATENT PERIOD
- period after infection when an infectious
agent cannot be transmitted to another
6. DEFERVESCENCE OR DECLINE
- The stage during which the manifestations
subside.
OCCURRENCE
1. SPORADIC DISEASE
- occasional and irregular (e.g., Tetanus, herpes,
skin diseases, leprosy in Manila)
2. EPIDEMIC DISEASES
- disease attacks a large number of people in a
community at the same time, or during the same
season, and in which disease tends to spread rapidly to
others (e.g. cholera, dengue)
3. ENDEMIC
- those that are present in a population or
community at times; usually involves few people during
specific periods (typhoid fever in Manila, dysentery)
4. PANDEMIC
- an epidemic that affects several countries or
continents (e.g., HIV/AIDS, SARS)
INFECTION CONTROL & work practice control
MEASURES
1. Employees shall wash their hands as soon as
possible after the removal of gloves or other
protective equipment and after hand contact
with blood or other potentially infectious
materials.
2. All personal protective equipment shall be
removed immediately upon leaving the work
area.
3. Used needles and other sharps shall not be
sheared, bent, broken, recapped, or re-
sheathed by hand.
4. Eating, drinking, smoking, applying cosmetics or
lip balm, or handling contact lenses are
prohibited in work areas where there is
potential occupational exposure.
5. Food and drinks shall not be stored in
refrigerators, freezers, or cabinets where blood
or other potentially infectious materials are
stored.
6. All procedures involving blood or other
potentially infectious materials shall be
performed in such a manner as to minimize
splashing, spraying, and aerosolization.
7. Mouth pipetting/suctioning is prohibited.
THE USE OF BARRIER APPARELS
1. MASKING
 All staff should wear mask.
 Patients with respiratory problems
should be asked to wear mask
2. HANDWASHING
 Practice proper hand washing with the
use of soap and water.
 Wash hands before and after patient
contact and after removing the gloves.
3. GLOVING
 Wear gloves for all direct contact with
patients.
 Change gloves and wash hands after
every contact with each patient.
4. GOWNING
 Wear gown during procedures which
are likely to generate splashes or sprays
of blood and body fluids, secretions, or
excretions.
5. EYE PROTECTION (goggles)
 Wear goggles for aerosol/splash-
generating procedures.
 Avoid aerosols
6. ENVIRONMENTAL DISINFECTION
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SEMI FINAL TRANS
 Clean surfaces daily with disinfectant Types of Antigen/vaccines
(diluted household bleach, 70 percent
1. Inactivated (killed organism)
alcohol) 
a. Not long lasting
PREVENTIVE ASPECT OR CARE OF PATIENTS WITH b. Multiple doses needed
COMMUNICABLE DISEASE c. Booster dose needed
2. Attenuated (live organism)
Health education
a. Single dose needed
 Educate the family and the client with
b. Long lasting immunity
respect to:
 the availability and importance of
Environmental Sanitation
prophylactic immunization
• Water Supply Sanitation
 the manner in which infectious illness is • Proper Excreta and sewage disposal
spread and the methods of avoiding the • Food Sanitation
spread • Waste Management
 the importance of seeking medical
advice for any sign of health problem WHAT DAMAGES VACCINES?
 the importance of environmental
cleanliness and personal hygiene • Heat and sunlight (especially live vaccines)
 the means of preventing contamination • Freezing damages the killed vaccines and
of food and water supply toxoids.
• Use water only in cleaning the
Immunization refrigerator/freezer. Antiseptics, disinfectants,
 the introduction of specific protective and detergents or alcohol may lessen the
antibodies or the production of cellular potency of vaccines.
immunity in a susceptible person or NOTE: KEEP ALL VACCINES AT THE CORRECT COLD
animal TEMPERATURE (0-8 degrees Celsius)
Immunity
 a condition of being secure against any
The Cold Chain System
particular disease
Types of Immunity Maintenance of correct temperature for vaccines starts
from the manufacturer
1. Natural
↓
 Passive – acquired through placental Airport
transfer (Maternal) ↓
 Active – acquired through recovery Central Vaccine Store
from a certain disease (Infection) ↓
Regional Store
2. Artificial ↓
 Passive – acquired through the District Hosp.
administration of antitoxin, antiserum, ↓
convalescent serum, and Health Centers or Outreach Service → Dispensary →
gammaglobulins (Antibody transfer) Immunizing Staff → Client
 Active – acquired through the
administration of vaccine and
toxoid (Immunization)
PATIENT ISOLATION PRECAUTIONS (Veenema, 2007).
Communicable Disease Nursing
SEMI FINAL TRANS
STANDARD PRECAUTIONS
• Wash hands after patient contact.
• Wear gloves when touching blood, body fluids,
secretions, excretions, and contaminated items.
• Wear a mask and eye protection, or a face
shield, during procedures likely to generate
splashes or sprays of blood, body fluids,
secretions, or excretions.
• Handle used patient-care equipment and linen
in a manner that prevents the transfer of
microorganisms to people or equipment.
• Use care when handling sharps and use a
mouthpiece or other ventilation device as an
alternative to mouth-to-mouth resuscitation
when practical.
Standard precautions are employed in the care of ALL
patients.
AIRBORNE PRECAUTIONS
• Standard precautions plus:
• Place the patient in a private room that has
monitored negative air pressure, a minimum six
air exchanges per hour, and appropriate
filtration of air before it is discharged from the
room.
• Wear respiratory protection when entering the
room.
• Limit movement and transport of the patient.
Place a mask on the patient if he or she needs
to be moved.
• Conventional diseases requiring airborne
precautions: measles, varicella, pulmonary
tuberculosis
• Biothreat diseases requiring airborne
precautions: smallpox
DROPLET PRECAUTIONS
• Standard precautions plus:
• Place the patient in a private room or cohort
them with someone with the same infection. If
not feasible, maintain at least 3 feet between
patients.
• Wear a mask when working within 3 feet of the
patient.
• Limit movement and transport of the patient.
Place a mask on the patient if they need to be
moved.
• Conventional diseases requiring droplet
precautions: invasive haemophilus influenza
and meningococcal disease, drug-resistant
pneumococcal disease, diphtheria, pertussis,
mycoplasma, GABHS, influenza, mumps,
rubella, parvovirus.
• Biothreat diseases requiring droplet
precautions: pneumonic plague
CONTACT PRECAUTIONS
• Standard precautions plus:
• Place the patient in a private room or cohort
them with someone with the same infection if
possible.
• Wear gloves when entering the room. Change
gloves after contact with infective material.
• Wear a gown when entering the room if contact
with patient is anticipated or if the patient has
diarrhea, a colostomy, or wound drainage not
covered by a dressing.
• Limit the movement or transport of the patient
from the room.
CONTACT PRECAUTIONS
• Dedicate use of noncritical patient-care
equipment (such as stethoscopes) to a single
patient, or cohort of patients with the same
pathogen. If not feasible, adequate disinfection
between patients is necessary.
• Conventional diseases requiring contact
precautions: MRSA, Clostridium difficile, RSV,
parainfluenza, enteroviruses, enteric infections
in the incontinent host, skin infections (HSV,
impetigo, lice, scabies), hemorrhagic
conjunctivitis
• Biothreat diseases requiring contact
precautions: viral hemorrhagic fevers
• Methicillin-Resistant Staphylococcus aureus
• Respiratory Syncytial Virus
Communicable Disease Nursing
SEMI FINAL TRANS