Chicken pox is an acute and highly contagious disease of viral in Herpesvirus varicellae

etiology that is characterized by vesicular eruptions on the skin

and mucous membrane with mild constitutional symptoms.
The incubation period is to 10-21 days or maybe
prolonged after passive immunization against
chickenpox.
Transmitted through direct contact with patients who shed the
virus from the vesicles. It can also be transmitted through indirect
contact, through linens or fomites. It can also be airborne, and 1. Secondary infection of the lesions – furuncles,
spread by droplet infection. cellulitis, skin abscess 2. Meningoencephalitis 3.
Pneumonia 4. Sepsis

Pre- eruptive manifestations are mild fever and malaise. The patient is capable of transmitting the
Eruptive stage. Rash starts from the trunk (unexposed area), disease about a day before the eruption of
then spread to other parts of the body. Initial lesions are the first lesion up to five days after the
distinctively red papules where contents become milky and pus- appearance of the last crap.
like within for days. In adult and bigger children, the lesions are
more widespread and more severe. There is a rapid progression
so that transition is completed in 6 to 8 hours. Vesicular lesions
are very pruritic. All stages are present simultaneously before all Zovirax 500mg/tablet, 1 tab 2x a day for
are covered with scabs known as “Celestial Map” seven days must be administered.
Oral acyclovir 800mg 3x a day for five
days must also be given.
Oral antihistamines can be taken for
Determination of V-Z virus through complement fixation test symptomatic pruritus.
Determination of V-Z virus through electron microscopic Calamine lotion will ease itchiness.
examination of vesicular fluid. Salicylates must not be given.
Antipyretic might be given for fever.
Respiratory isolation is must until all vesicles have crusted.
Prevent secondary infection of the skin lesion through
hygienic care of the patient.
Attention should be given to nasopharyngeal secretions
and discharges. Linens must be disinfected under the
sunlight
or through boiling.
Cut finger nails short and wash hands more often to
minimize bacterial infections that may be introduced by
scratching.
A child must wear mittens
Provide activities to keep child occupied to lessen pruritus.
Mumps is an acute viral disease manifested by swelling
of one or both parotid glands, with occasional The disease is communicable 6 days before and 9 days
involvement of other glandular structures, particularly after the onset of parotid gland swelling; the 48 hours
the testes in males. period immediately preceding the onset of swelling is
considered the time of highest communicability.
The first symptom of mumps may begin with a
sudden headache, earache, loss of appetite, fever, Swollen Parotid Gland
and swelling of the parotid gland which is located
in front and below the ear.
Pain is related to the extent of swelling of the Compliment fixation test shows
gland which usually reaches its peak in about 2 presumptive evidence of infection.
days and continues for 7 days to 10 days. Hemo-agglutination inhibition test is used to
The temperature remains moderately elevated determine immune status.
but may reach 40°C during the acute stage of The neutralization test determines immunity
the disease. to mumps.
One gland may be affected at first, and one to Viral culture or the isolation of the virus
three days later, the other side may become from the pharynx a few days before and at
involved. least five days after parotid swelling is done.
Occasionally, enlargement of the gland may be the Serum amylase determination is the most
only symptom. useful test in making an early presumptive
diagnosis for mumps.
The causative organism is a filterable virus of the
paramyxovirus group usually found in the saliva of an
infected person. Man is the only natural reservoir. The incubation period ranges from 14 to 25
days (average is 18 days)
The mumps virus replicates in the upper respiratory tract and is
transmitted from person to person through direct contact with
saliva or respiratory droplets of a person infected with mumps. The 1. Active immunization (MMR)
risk of spreading the virus increases the longer and the closer the 2. Reporting of cases to health
contact a person has with someone who has mumps. authorities
3. Isolation of patient

Anti-viral drugs. At the same time, relief of pain from parotid
swelling can be afforded by the application of hot or cold,
whichever is preferred by the patient.
The most notorious complication of mumps is orchitis.
Testicular involvement usually occurs several days after
the onset of parotid swelling. Orchitis is often accompanied
by an elevation of temperature. Pain is often excruciating
and is aggravated by movement. The testes are swollen
and tender in palpation.
In females, oophoritis may occur manifested by pain and
tenderness of the abdomen.
sling between the thighs thus relieving the
Mastitis has also been reported to accompany mumps.
pull of gravity on the testes and blood
Central nervous system involvement has been reported to
complicate mumps as manifested by headaches, the
elevation of cerebrospinal protein concentration, and cell
count changes.
3. Diet
Nuchal rigidity is associated with lethargy, headache,
convulsions, or delirium.
during the acute stage when the patient
Deafness due to the involvement of the auditory nerve.
may find it difficult
Meningoencephalitis common complication of mumps
and painful to chew.
Pancreatitis manifests through epigastric pain, vomiting,
chills, and prostration.
as tolerated
Rare complications of mumps include transverse myelitis,
ataxia, thrombocytopenia, myocarditis, arthritis, nephritis.
1. Medical aseptic protective care
Patients should be cared for in a single-
occupancy room.
Susceptible individuals must use masks and
must wash their hands regularly.
Terminal disinfection is desirable.
Oral care and personal hygiene are a must.
2. General management of the disease
Bedrest is encouraged by some physicians
to avoid complications
Diversional activities are recommended for
the less ill patient
In males, the scrotum is supported by a
properly fitted suspensory, a pillow, or a
vessels and minimizing the danger of
orchitis, edema, and atrophy when orchitis
occurs.
No restriction of food is necessary except
The diet should be Soft and semisolid food
Sour food or fruit juices are disliked
because of the burning or stinging sensation
they elicit
 Tuberculosis (TB) is a chronic, sub-acute or acute The patient is capable of discharging the organism all
respiratory disease commonly affecting the lungs throughout life if he remains untreated. The disease is
characterized by the formation of tubercles in the tissue highly communicable during the active phase.
which tend to undergo cessation, necrosis, and calcification.

Afternoon rise in temperature Quantitative Classification of TB

Night sweating
Body malaise and weight loss
Cough, dry to productive
Dyspnea, hoarseness of voice
Hemoptysis
Occasional chest pain Sputum positive for AFB
Tuberculosis is caused by an organism that is
rod-shaped called Mycobacterium tuberculosis,
Another causative agents are M. africanum from
human and M. bovis from cattle
The incubation period is from 2 to 10 weeks
Minimal - characterized by slight lesion without
demonstrable excavation, confined to a small part
of or both lungs
Moderately advanced - One or both lungs may be
involved or the volume affected should not extend
to one lobe or the total diameter of the cavity
should not exceed four centimeters
Far advanced classification - lesions are more
extensive than moderate
Submit all babies for BCG immunization
Improve nutritional and health status
Advise persons who have been exposed to
infected persons to receive a tuberculin test and if
necessary, chest x-ray and prophylactic isoniazid

Tuberculosis is transmitted by deliberate inoculation of microorganisms or by droplets. It

can also be transmitted through the inhalation of organisms directly into the lungs from
contaminated air. Additionally, it can also be transmitted through direct or indirect contact
with infected persons, usually by discharges from the respiratory tract by means of
coughing, sneezing, or kissing. The disease can also be transmitted through contact with
contaminated eating or drinking utensils. Rarely, it can be transmitted through skin lesion.
Clinical Classification Maintain respiratory isolation until the patient
Inactive TB - Symptoms of TB are absent, sputum is responds to treatment or until the patient is no longer
absent for tubercle bacilli after repeated examination, contagious
and there is no evidence of cavity on chest x-ray Administer medicines as ordered
Active TB - tuberculin test is positive, X-ray of the Always check sputum for blood or purulent
chest is generally progressive, symptoms due to expectoration
lesions are usually present, sputum and gastric content Teach the patient to cough and sneeze into tissue
is positive for tubercle bacilli paper and dispose of secretions properly
Activity not determined - When the activity has not Advise the patient to have plenty of rest and eat
been determined from a suitable period of observation balanced meals. Be alert for signs of drug reaction
or adequate laboratory and x-ray studies If the patient is receiving ethambutol, watch for optic
neuritis. If it develops, discontinue the drugs
Sputum analysis for AFB-confirmatory If the patient is receiving rifampicin, watch for
Chest X-ray Tuberculin testing hepatitis and purpura.
Mantoux Test (PPD) Emphasize the importance of regular follow-up
examinations and instruct the patient and family about
Short-course chemotherapy may be given through a 6 the signs and symptoms of recurring TB.
months treatment with Isoniazid (INH), Rifampicin,
Pyrazinamide (PZA), and Ethambutol
Patients with drug resistance may be given second-line
drugs such as streptomycin, cycloserine, amikacin, and
quinolone drugs.
WHO recommends “Direct Observed Therapy” (DOT)
to prevent non-compliance. The health worker insures
that the patient takes his/her drugs.
If the medicine is taken incorrectly, the patient
becomes resistant to anti-TB drugs.
Relapsing patients usually become resistant to individual
drugs (INH, Rifampicin, Ethambutol, PZA). They are
given the combination of the above mentioned drugs.
Without treatment, tuberculosis can be fatal. The
untreated active disease typically affects your lungs,
but it can affect other parts of your body, as well.
Tuberculosis complications include:
Spinal pain - Back pain and stiffness are common
complications of tuberculosis.
Joint damage - Arthritis that results from
tuberculosis (tuberculous arthritis) usually affects
the hips and knees.
Swelling of the membranes that cover your brain
(meningitis) - This can cause a lasting or
intermittent headache that occurs for weeks and
possible mental changes.
Liver or kidney problems - The liver and kidneys
help filter waste and impurities from your
bloodstream. Tuberculosis can impair their
functions.
Heart disorders - Rarely, tuberculosis can infect the
tissues that surround your heart, causing
inflammation and fluid collection that might
interfere with your heart's ability to pump
effectively.

Viral shedding persists for 1 to 3 weeks. Infected persons

are most likely to transmit HAV 1 to 2 weeks before the
onset of illness when HAV concentration in stool is
highest. The risk then decreases and is minimal the week
after the onset of symptoms.
 Hepatitis A is a vaccine-preventable liver infection
caused by the hepatitis A virus (HAV). HAV is found in
the stool and blood of people who are infected.
Hepatitis A is very contagious.
Hepatitis A is caused by infection with HAV, an RNA virus
that is classified as a picornavirus. It was first isolated in
1979. Humans are the only natural host, although several
nonhuman primates have been infected in laboratory
conditions. Depending on conditions, HAV can be stable in the
environment for months.
The incubation period of hepatitis A is approximately 28
days (range 15 to 50 days). The clinical course of hepatitis
A is indistinguishable from that of other types of acute
viral hepatitis. The illness typically has an abrupt onset of
fever, malaise, anorexia, nausea, abdominal discomfort,
dark urine, and jaundice
Hepatitis A can be spread from close, personal contact
with an infected person, such as through certain types of
sexual contact (like oral-anal sex), caring for someone
who is ill, or using drugs with others. Hepatitis A is very
contagious, and people can even spread the virus before
they even feel sick.
Jaundice
Flu-like illness with chills and high fever
Diarrhea, fatigue, and abdominal pain
Loss of appetite
Nausea, diarrhea, and fever
Jaundice and dark-colored urine.
The infection in young children is often mild
and asymptomatic.
HAV and HBV – complement fixation rate
Liver function test – to determine the presence
and extent of liver damage and to check the
progress of the liver
Bile examination in stool and urine
SGOT – serum glutamix oxaloacetic transaminase
SGPT – serum glutamic pyruvic transaminase
ALT – serum alanine transaminase
IgM level
There is no specific treatment, although bed rest is
essential.
Diet must be high in carbohydrates, low in fat, and low in
protein.
Patients must take vitamin supplements, especially the B
complex group.
Intravenous therapy is occasionally necessary.
Isoprinosine (methisoprenol) may enhance the cell-
mediated immunity of the T-lymphocytes.
Alkalies, belladonna, and anti-emetics should be
administered to control dyspepsia and malaise.
 Hands should be washed thoroughly after use of
the toilet.
Travelers should avoid water and ice if unsure of
their purity.
Food handlers should carefully be screened.
Safe preparation and serving of food must be
practiced.
The public should be educated on the mode of
transmission of the disease.
1. Progressive encephalopathy is characterized by
drowsiness and cerebral edema
2. GIT bleeding progressing to stupor and later coma.
Bleeding is not responsive to parenteral Vitamin K
administration.
3. Clonus and hyperreflexia are later replaced by loss of
deep tendon reflexes.
4. Edema and ascitis
5. Aplastic anemia.
6. In the late course of the disease, loss of corneal and
papillary reflexes elevated arterial blood, respiratory
failure, to cerebrovascular collapse may be present.
1. 1. The patient must be isolated (enteric isolation).
2. Patients should be encouraged to rest during the
acute or symptomatic phase.
3. Improve nutritional status.
4. Utilize appropriate measures to minimize the spread
of the disease.
5. Observe the patient for melena and check stool for
the presence of blood.
6. Provide optimum skin and oral care.
7. Increase in ability to carry out activities.
a. Encourage the patient to limit activity when
fatigued.
b. Assist the client in planning periods of rest and
activity.
c. Encouraged gradual resumption of activities and
mild exercise during recovery.

Amoebiasis protozoal infection of human beings initially

involves the colon but may spread to soft tissues, most
commonly to the liver or lungs, by contiguity or
hematogenous or lymphatic dissemination.
 The disease can be passed from one person to another
through fecal-oral transmission
The disease can be transmitted through direct contact,
through sexual contact by orogenital, oroanal,
and proctogenital sexual activity
Through indirect contact, the disease can infect humans by
ingestion of food especially uncooked leafy vegetables or
foods contaminated with fecal materials containing E.
histolytica cysts
Food or drinks may be contaminated by cysts through
pollution of water supplies, exposure to flies, use of night soil
for fertilizing vegetables, and through unhygienic practices
and food handlers.
The incubation period in severe infection is 3 days. In subacute
and chronic form it lasts for several months. In average cases
the incubation period varies from 3 to 4 weeks.
The microorganism is communicable for the entire
duration of the illness.
Metronidazole (Flagyl) 800 mg TID x 5 days
Tetracycline 250 mg every 6 hours
Ampicillin, quinolones, sulfadiazine
Streptomycin SO4, chloramphenicol
Lost fluid and electrolytes should be replaced
Health education
Sanitary disposal of feces
Protect, chlorinate, and purify drinking water
Observe scrupulous cleanliness in food
preparation and food handling
Detection and treatment of carriers
Fly control (they can serve as vector)
A liver abscess (collection of pus in the liver)
Medicine side effects, including nausea.
Spread of the parasite through the blood
to the liver, lungs, brain, or other organs.
Prevalent in unsanitary areas
Common in a warm climate
Acquired by swallowing
Cyst survives a few days outside the body
Cyst passes to the large intestine and
hatches into trophozoites. It passes into the
mesenteric veins, to the portal vein, to the
liver, thereby forming amoebic liver absces
1. Acute amoebic dysentery Entamoeba histolytica has two developmental stages:
Diarrhea, watery and foul-smelling stool often 1. Trophozoites/vegetative form
containing blood-streaked mucus - Trophozoites and facultative parasites that may invade
Colic and gaseous distension of the lower abdomen the tissues or may be found in the parasitized
Nausea, flatulence, abdominal distension and tissues and liquid colonic contents.
tenderness in the right iliac region over the colon 2. Cyst
2. Chronic amoebic dysentery - Cyst is passed out with formed or semi-formed stools
Attack of dysentery that lasts for several days, and are resistant to environmental conditions
usually succeeded by constipation - This is considered as the infective stage in the life cycle
Tenesmus accompanied by the desire to defecate of E. histolytica.
Anorexia, weight loss, and weaknesses
The liver may be enlarged
The stool at first is semifluid but soon becomes Stool exam (cyst, white and yellow pus
watery, bloody, and mucoid with plenty of amoeba)
Mild toxemia, constant fatigue, and lassitude Blood exam (leukocytosis)
Abdomen loses its elasticity when picked up between Proctoscopy/sigmoidoscopy
fingers
On sigmoidoscopy, scattered ulceration with a Hematochezia
yellowish and erythematous border
The gangrenous type (fetal cases) is characterized
by the appearance of large sloughs of intestinal
tissues in the stool accompanied by hemorrhage.
3. Extraintestinal forms
Pain in the upper right quadrant with a tenderness of
the liver
Jaundice
intermittent fever
Loss of weight or anorexia
An abscess may break through the lungs, the patient
coughs anchovy-sauce sputum
 Filariasis is an infectious tropical disease caused by any one of
several thread-like parasitic round worms. The two species of
worms most often associated with this disease are Wuchereria
bancrofti and Brugia malayi. The larval form of the parasite
transmits the disease to humans by the bite of a mosquito.
The causative agents of lymphatic filariasis (LF) include the
mosquito-borne filarial nematodes Wuchereria bancrofti,
Brugia malayi, B. timori An estimated 90% of LF cases are
caused by W. bancrofti (Bancroftian filariasis).
infective after 10 days of repeated infection in the
endemic region lead to severe manifestation as
Elephantiasis.
The standard method for diagnosing active infection is
the identification of microfilariae in a blood smear by
microscopic examination. Microfilariae can be
detected microscopically on blood smears obtained at
night (10 PM–2 AM) and a thick smear should be made
and stained with Giemsa or hematoxylin and eosin.

The incubation period averages 10-12 months. Some people with filariasis have no symptoms. Other affected
Symptoms include fever, lymphadenitis, and individuals may have episodes of acute inflammation of lymphatic
swelling of limbs and scrotum vessels (lymphangitis) along with high temperatures, shaking chills,
body aches, and swollen lymph nodes.

Avoiding mosquito bites is the best form of prevention. The

mosquitoes that carry the microscopic worms usually bite between
the hours of dusk and dawn. If you live in or travel to an area with
lymphatic filariasis:
Sleep under a mosquito net.
Wear long sleeves and trousers.
Use mosquito repellent on exposed skin between dusk and dawn.
Medical treatment consists of a cycle of high-dose
mebendazole (40 mg/kg/die) and subsequent cycles
of diethylcarbamazine at a habitual dose (6 The disease spreads from person to person by mosquito
mg/kg/die). In the interval, the elephantiasic right lip bites. When a mosquito bites a person who has lymphatic
was removed surgically. The overall clinical results was filariasis, microscopic worms circulating in the person's
good. blood enter and infect the mosquito.
 Nursing care is primarily aimed at preventing the potential
complications that may develop. If possible, elastic stockings
or bandages are applied to the affected limbs, to assist
venous return and prevent excessive edema. Bedrest may
be required in more severe cases with an elevation of the
involved extremities
When lymphatic filariasis develops into a chronic
condition it leads to lymphedema (tissue swelling) or
elephantiasis (skin/tissue thickening) of limbs and
hydrocele (scrotal swelling). Involvement of breasts
and genital organs is common
This is a slowly progressive disease caused by blood flukes of
class trematoda. It is chronic wasting disease common among
farmers and their families in certain parts of the Philippines.
There are 3 major types of the organism
Schistosoma japonica - infects the intestinal tract
(Katayama dse), it is found to be the only type that is
endemic in the Philippines and also known as "Oriental
Schistosomiasis"
Schistosoma mansoni - also affects intestinal tract, and
common on some parts of the Africa
Schistosoma haematobium - affects urinary tract and
can be found in some parts of the middle east like Iran
and Iraq
The incubation period is at least two months
Feces of the infected person
Dogs, pigs, carabaos, cows, monkeys, and wild rats
have been found to be infected therefore they
also serve as host
The disease is transmitted through ingestion of
contaminated water
The disease is transmitted through skin pores
The disease is transmitted through an intermediary
host, a tiny snail called Oncomelania Quadrasi
Characteristics of Oncomelania Quadrasi
The snail thrives best along river banks, fresh
water, streams, creeks, canals and swamps
It can be found clinging to water hyacinths, grasses
and decaying leaves, pieces of rotting woods,
bamboos and coconut husks
It also loves to stay in areas with sandy loam soil
The adult snail is greenish-brownish and is just as
big as the smallest grain of palay
Schistosoma japonicum.
A pruritic rash develops at the site of penetration,
known as "swimmers itch"
There is a low grade fever, myalgia and cough
There is the presence of abdominal discomfort due to
hepatomegaly, splenomegaly, and lymphadenopathy
There is blood-mucoid stool, "dysentery-like" that comes
on and off for weeks
Patient becomes jaundice and icteric
Later, his belly becomes big because of an inflamed
liver, resulting that eggs accumulate in that organ
After some years of suffering from this chronic
disease, the patient becomes weak, pale and there is
marked muscle wasting
When the parasite reaches the brain, the victim
experiences severe headache, dizziness and
convulsions
 Praziquantel tablet for 6 months; 1 tab BID for 3 months,
then 1 tab OD for another 3 months
Fuadin injection given either IM or IV. The patient should
consume 360 mg for the entire treatment
If the patient continues to live in the endemic area, he
frequently gets reinjected and has to be retreated
To prevent Schistosomiasis, one must have a thorough
knowledge of how the disease is spread. The basic principle of
its prevention and control is to interrupt the life cycle of the
worm and protect people from infection. This can be done
through the following measures:
Have stool examination
Reduce snail density by
a. Clearing vegetation thus exposing the snail to sunshine
b. Constructing drainage (canals) to dry the land surface
where the snails thrive; and
c. Improve farming by proper irrigation and drainage, crop
rotation, and removal of weeks, thus disturbing the living
condition of the snail
Diminish infection rate by
1. Proper waste disposal
2. Control of stray animals
3. Preventing people, especially children from bathing in
infested streams;
4. Building footbridges over snail-infested streams and;
5. Providing adequate water supply for bathing and laundering
and safe water for drinking
Providing health education on the disease process, mode of
transmission and prevention
Herpes simplex is a disease that causes sores and
blisters to form anywhere on the skin. Usually, these
sores develop on the lips, nose, mouth, buttocks, and
genitalia. Herpes Simplex is related to the Epstein-
Barr virus, which causes infectious mononucleosis,
shingles, and chicken pox.
HSV testing is usually done as a swab test, blood
test, or lumbar puncture. The type of test you
get will depend on your symptoms and health
history.
For a swab test, a healthcare provider will
use a swab to collect fluid and cells from a
herpes sore.
For a blood test, a healthcare professional
will take a blood sample from a vein in your
arm, using a small needle. After the needle is
inserted, a small amount of blood will be
collected into a test tube or vial.
A lumbar puncture also called a spinal tap, is
only done if your provider thinks you may
have an infection of the brain or spinal cord.
Sores appear on the affected area. There may be
one or more uncomfortable, fluid-filled blisters.
Before healing, blisters pop open, oozing fluid and
developing a crust.
 Type 1 Virus
HSV type 1 (HSV-1) can cause cold sores that usually
infect during infancy and childhood.
The sore is characterized by tiny, clear fluid-filled
blisters. The sore most commonly affects the lips,
mouth, nose, chin, or cheeks and occurs shortly after
exposure. This may also develop in wounds on the skin.
The sores of primary infection appear 2 to 20 days
after contact with an infected person and usually last
from 7 to 10 days.
The disease can be transmitted by kissing, sharing
kitchen utensils or sharing towels. Patients usually catch
the infection from family members or friends who carry
the virus.
Patients may barely notice the symptoms or need
medical attention for the relief of pain. When herpes
lesions do develop, they often take the form of one or
more vesicles, or tiny blisters, on or near the mouth,
genitals, or rectum.
Herpes simplex virus (HSV)
Type 2 Virus
Type 2 virus (HSV-2) causes genital sores, affecting
the buttocks, the penis, the vagina, or the cervix, for 2
to 20 days. The virus affects about 20% of sexually
active individuals.
Most people get the infection from sexual contact with
an infected person. The virus can also be spread by
touching an unaffected part of the body after touching
the herpes lesions.
Manifestations include minor rash, or itching and
painful sores, fever, muscular pain, and burning
sensation on urination.
HSV-2 infection increases the risk of acquiring HIV
infection by approximately three-fold. Rare
complications of HSV-2 include meningoencephalitis
(brain infection) and disseminated infection.
Rarely, HSV-1 infection can lead to more severe
complications such as encephalitis (brain infection) or
keratitis (eye infection).
Neonatal herpes can occur when an infant is exposed
to HSV during delivery. Neonatal herpes is rare,
occurring in an estimated 10 out of every 100 000
births globally.
Experts have yet to find a cure for herpes. However, the
following are recommended:
Antiviral medications – such as acyclovir, famciclovir, and
valacyclovir – are the most effective medications for
people infected with HSV. These can help to reduce the
severity and frequency of symptoms but cannot cure
the infection.
In addition, daily suppressive therapy (i.e., daily use of
antiviral medication) for herpes can reduce the
likelihood of transmission to partners.

Educate the patient about the purpose of the

medications. How it's not a cure but reduces the
severity and frequency of the outbreak, and reduces
the risk of transmission.
Administer medications as indicated.
Teach the client how to manage sores by keeping the
area clean and avoid contact with partner with HIV.

Practice safe sex

Avoid oral contact with others (including oral sex) and
sharing objects that touched saliva.
Individuals with symptoms of genital herpes should
abstain from sexual activity while experiencing
symptoms.
Pregnant women with symptoms of genital herpes
should inform their healthcare providers to prevent
further complications.
 Herpes

Simplex

Virus

Direct contact

with the

infected person

Infection


Rabies is a specific, acute, viral infection communicated Rabies virus is transmitted through direct contact
to man by the saliva of in infected animal. From the site (such as through broken skin or mucous membranes in
of the bite, the organism proceeds to the CNS the eyes, nose, or mouth) with saliva or brain/nervous
through the exoplasm of the peripheral nerves. system tissue from an infected animal.

In dogs and cats, rabies is usually communicable 3–7

days before onset of clinical signs and throughout the
Paresthesia, pain, or intense itching at the course of the illness. Viral excretion up to 14 days
inoculation site before the appearance of clinical signs has been
observed in some animal species.
The etiologic agent of rabies is rhabdovirus, a bullet-
shaped filtrable virus with a strong affinity to the
CNS. It is sensitive to sunlight, ultraviolet light, formalin,
mercury, and nitric acid. The organism is resistant to
phenol and common antibacterial agents.

The incubation period includes:

One week to seven and a half months in dogs.
10 days to 15 years in human
Incubation period depends upon the following:
o Distance of the bite to the brain
o Extensiveness of the bite
o Specie of the animal
o Richness of the nerve supply in the area of the bite
o Resistance to the host

Complications of rabies include the following: seizures, fasciculations,

psychosis, aphasia, autonomic instability, paralysis, coma, and death
1. Prodromal / Invasion Phase
a. The phase is characterized by fever, anorexia,
malaise, sore throat, copious salivation, lacrimation,
perspiration, irritability, hyperexcitability,
apprehensiveness, restlessness, sometimes drowsy,
mental depression, melancholia, and marked insomnia.
b. There is pain at the original site of the bite.
Headache and nausea may be present.
c. The patient becomes sensitive to light, sound, and
temperature.
d. There is pain and aches in different parts of the
body.
e. Anesthesia, numbness, tingling, burning, and cold
sensation may be felt along the peripheral nerves
involved and the site of the bite.
f. Mild difficulty in swallowing.
3. Terminal/Paralytic Phase
a. The patient becomes quiet and unconscious.
b. There is loss of bowel and urinary control.
c. Spasm ceases with progressive paralysis.
d. There is tachycardia, labored, or irregular respiration.
e. Death occurs due to respiratory paralysis, circulatory
collapse, or heart failure.
Virus isolation from the patient’s saliva or throat.
Fluorescent rabies anti-body (FRA) provides the most
definitive diagnosis.
Presence of negri bodies in the dog’s brain.
2. Excitement or Neurological Phase
a. This phase is characterized by marked excitation and
apprehension. Terror may even occur.
b. There is delirium associated with nuchal rigidity,
involuntary twitching, or generalized convulsions.
c. The patient may exhibit maniacal behavior, eyes are
fixed and glossy, and the skin is cold and clammy.
d. There is a severe painful spasm of the muscles of the
mouth, pharynx, and larynx, on the attempt to swallow
water or food or even the mere sight of them.
e. There is aerophobia.
f. There is profuse drooling of saliva.
g. There is tonic and clonic contraction of the muscles.
h. Death may occur during the episode of spasm or
from cardiac/respiratory failure
i. If the patient survives during this phase, the patient
deteriorates rapidly and enters the terminal phase.
The eradication of rabies should be on global scale
and should include measures to prevent and control
the disease in animals and wildlife.
Vaccination of all dogs.
Enforcement of regulations for pickup and
destruction of stray dogs.
Confinement of any dogs that has bitten a
person for 10 to 14 days.
Availability of laboratory facilities for
observation and diagnosis
Providing public education, especially among
children, in avoiding and reporting all animals that
appear sick.
Thoroughly wash the wounds from the bite and
scratches of the dog with soap and running water
for at least 3 mins.
Check the patient’s immunization status. Give TT if
needed.
Give Tetanus antiserum infiltrated around the wound
or give IM after a negative skin test.
Give anti-rabies vaccine, both passive and active,
depending upon the site and extensiveness of the
bite as well as the health condition of the biting
animal.
Isolate the patient
Give emotional and spiritual support.
Provide optimum comfort.
Darken room and provide a quiet environment.
Patient should not be bathed and there should not be any
running water in the room or within the hearing distance
of the patient.
If IV fluid has to be given it should be wrapped and needle
should be securely anchored in the vein to avoid dislodging
in time of restlessness.
Concurrent and terminal disinfection should be carried out.
schistosomiasis
 Acquired immunodeficiency syndrome (AIDS) is a chronic,
potentially life-threatening condition caused by the human
immunodeficiency virus (HIV). By damaging your immune
system, HIV interferes with your body's ability to fight
infection and disease.
Paresthesia, pain, or intense itching at the
inoculation site
Human immunodeficiency virus (HIV), a retrovirus is the
causative agent for Acquired Immunodeficiency
syndrome (AIDS).
sex), never sharing needles, and using condoms the right
The interval from HIV infection to the diagnosis of AIDS
ranges from about 9 months to 20 years or longer, with a
median of 12 years.
Diagnostic procedures include antibody tests,
antigen/antibody tests, and NAT.
The treatment for HIV is called antiretroviral therapy
(ART). ART involves taking a combination of HIV
medicines (called an HIV treatment regimen) every
day. ART is recommended for everyone who has HIV.
ART cannot cure HIV, but HIV medicines help people
with HIV live longer, healthier lives
Different strategies can be applied in order to prevent
acquiring this disease such as abstinence (not having
way during every sexual intercourse. HIV prevention
medicines may also be opted such as pre-exposure
prophylaxis (PrEP) and post-exposure prophylaxis
(PEP).

Generally 1 to 3 months from the time of infection.

Infectious period: Not known precisely; begins early
after the onset of HIV infections and presumably
extends throughout life. Infectivity during the first
months is considered to be high.

Can be transmitted through blood, semen (cum) and pre-seminal

fluid (pre-cum), rectal fluids, vaginal fluids, and breast milk.
Infections common to HIV/AIDS
Pneumocystis pneumonia (PCP)
Candidiasis (thrush)
Tuberculosis (TB)
Cytomegalovirus
Cryptococcal meningitis
Toxoplasmosis
Cancers common to HIV/AIDS
Lymphoma
Kaposi's sarcoma
HPV-related cancers
Other complications
Wasting syndrome
Neurological complications
Kidney disease
Liver disease Promote skin integrity: Avoid scratching, use nonabrasive non-
drying soaps, and apply moisturizers
Promote regular oral care. Promote regular bowel patterns
Prevent infection: Monitor for signs of infection and laboratory
test results that indicate infection.
Improve activity: Assist in planning daily routines that maintain
activity
Maintain thought processes: Encourage ongoing family and
friend interaction
Maintain airway clearance: Deep breathing, coughing, postural
drainage, percussion, and vibration every 2 hours
Relieve pain: Use soft cushions and foam pads; administer pain
medications as prescribed
Maintain nutritional status: Eat foods that are easy to swallow
while avoiding rough, sticky, and spicy foods