CONTROL OF COMMUNICABLE DISEASES nies p.332 1.

TUBERCULOSIS- Highly infectious chronic disease

TUBERCULOSIS Cause: TUBERCLE BACILLI –

OTHER NAMES  Mycobacterium Tuberculosis &

 M. Africanum
 Phtisis
 M. bovis (from cattle), or M. canettii.
 Consumption disease
 Koch's disease Mode of Transmission:

-is one of the oldest and deadly diseases worldwide 1. Airborne Droplet Method

Statistics about TB A small proportion will progress to disease due to

unsatisfactory body immunity.
As reported by WHO (Global Tuberculosis Report in
2019) Example: newborn babies, immunity defect, HIV
infection, malignancy. diabetes
In 2018:
mellitus,silicosis,malnutrition elderly.alcoholic.
- 10 million of new cases
Incubation Period- 4-6 weeks
- 1.2 million deaths

Take NOTE: 44% of the cases worldwide occur in

Southeast Asia PERIOD OF COMMUNICABILITY

In 2018: the Philippine ranked 9th among 22 countries .As long as VIABLE tubercle bacilli are being discharged
with high TB burden from the sputum

In Western Pacific region: PHILIPPINES -ranked 2nd in

new smear positive TB notification rate -ranked 3rd in
SUSCEPTIBILITY AND RESISTANCE
case density
First 6-12 months after infection
Ranked 8th in the leading causes of mortality about 75
deaths everyday (DOH,2018) Risk of developing is HIGH in children (less than 3 y/o)
High burden among the POOR SECTORS reasons: HIGH Risk among
1. unsanitary conditions 1. Immunosuppresive individuals
2. poor ventilation 2. Underweight persons
3. malnutrition 3. with Diabetes Mellitus
4. overcrowding 4. Persons with Silicosis
5. had done Gastrectomies
6. Substance abusers
Facts about TB in the Philippines
Clinical Manifestations of TB
Demographic Profile shows that:
 Fever: low grade afternoon
Majority are MALES  Loss of appetite
 Easy fatigability
70% are within the economically productive group
 NIGHT SWEATS
Estimated that:  Dry cough
 Later productive cough with Hemoptysis
20-30% of household income is lost for morbidity
 Chest pain
15 years of income is lost for mortality
 Methods of Control PTB Smear (-) would mean ALL Three (3) sputum smear
results as NEGATIVE
Prompt diagnosis and treatment of infectious cases
New Guidelines under Manual of Procedures for the
BCG vaccination of newborn, infants, and grade school
NTP (5th edition)
entrants.
POSITIVE Test would mean at least 1 sputum smear
Educate public in mode of spread and methods of
result is (+)
control and importance of early diagnosis
.NEGATIVE Test would mean BOTH sputum smear are (-)
Improve social conditions
Spot specimen or early morning specimen sputum
Make available medical, laboratory and x-ray facilities
collection
for examination of patients
Ask the patient to breathe in air deeply.
Provide PHN and outreach services for home
supervision of patients At the height of inspiration, ask the patient to cough
strongly and spit the sputum in the container.
A. CASE FINDING
The MIDWIFE shall supervise the patient during the
1. Direct Sputum Smear Microscopy (DSSM) shall be the
procedure and observe contamination precautions.
primary diagnostic tool in NTP case finding.

All TB symptomatics identified shall be asked to

undergo DSSM before start of treatment. However, if 3. Xpert MTB/RIF-Is a RAPID diagnostic assay test for TB
HEMOPTYSIS, NOT to be done and DRUG RESISTANCE

Passive case finding shall be implemented in all health -Simultaneously detects mycobacterium tuberculosis
stations complex and RESISTANCE to Rifampicin in less than 2
hours.
Only trained MEDICAL TECHNOLOGISTS or
MICROSCOPIST shall perform DSSM -Uses disposable cartridge with GeneXpert instrument
system
(+) TB under using the DSSM
Xpert MTB/RIF Interpretation
• Demonstration of mycobacterium tuberculosis using
2. Fluorescence Acid Fast Microscopy Staining (FAFMS)- T-MTB detected, Rifampicin resistance NOT detected
Has specificity and efficiency in detecting AFB count in
RR-MTB detected, Rifampicin resistance DETECTED
the sputum (Mendoza, 1987)
TI-MTB detected, Rifampicin resistance Indeterminate
WHO guidelines for AFB quantification
N- MTB not detected
NEGATIVE (-) No AFB seen in 100 fields
I- Invalid results/Error
POSITIVE (+) 1-9 AFB seen in 100 fields

1+ 10-99 AFB seen in 100 fields

2+ 10 AFB seen in at least 50 fields

3+ More than 10 AFB seen in at least 20 fields

PTB

4. TB Skin Testing (TST)- A basic screening tool for TB

Smear (+) would mean at least two (2) POSITIVE sputum
infection among CHILDREN using purified derivative
smear results out of three (3) sputum smear results
(PPD) TUBERCULIN solution that can stimulate
hypersensitivity reaction for those who had previously
been infected
-Test is Read 48-72 hours from time of administration
-Induration of 10 mm or more on the site = (+) result
5. CHEST X-RAY is another method in diagnosing TB but
on SECONDARY role based on NTP
REASONS:
1. Difficulty to determine TB infectivity
2. NO radiographic picture that is absolutely typical of
TB
3. Many other diseases can IMITATE the pattern of PTB
4. Level of disagreement on the interpretation of chest
radiography is HIGH
National Tuberculosis Program-The DOH FLAGSHIP
PROGRAM
GOAL of NTP:
To REDUCE prevalence and mortality from TB by half
year 2015 through its targets:
1. cure at least 85% of the new sputum smear-positive
cases discovered new
2. Detection at least 70% of estimated sputum smear
positive cases
Adoption of Comprehensive Unified Policy on TB control
-It puts all TB Control Protocols under one UMBRELLA
and enjoined other key government agencies and
private organizations in TB control
Example: Establishment of BMSA - Bulacan Multi-
Sectoral Alliance
Direct Observed Treatment Short-course/ DOTS
-Locally known as "Tutok Gamutan"
-An activity wherein a trained health worker or
treatment partner personally OBSERVES the patient to
take anti-TB medicines every day during the whole
course of the treatment of smear positive case.
-???
5 elements of DOTS
1. Sustained Political commitment
2. Access to quality assured sputum microscopy
3. Standardized short-course chemotherapy for all cases
4. Uninterrupted supply of quality-assured drugs
5. Recording and reporting system
Identification of TB symptomatic = Sputum microscopy
= + Result = DOTS
B. Treatment
Treatment shall be based on a realiable diagnostic
technique, namely DSSM
Domiciliary treatment shall be the preferred mode of
care
C. Conditions that needs Hospitalization
 Massive hemoptysis
 Pleural Effusion
 Miliary TB
 TB Meningitis
 TB Pneumonia
 Those that requires surgical interventions
Types Of Cases PTB
New- A patient who haS NEVER had treatment for TB or
who has taken anti tuberculosis drugs for less than one
month.
Relapse- A patient Previously TREATED for tuberculosis -Available in blister packs good for 1 week
who has been declared CURED or treatment completed,
DOSAGE depends on patients BODY WIGHT in KG
and is diagnosed with bacteriologically positive
tuberculosis

Failure- A patient who, while on treatment, is sputum
smear Positive at 5 months or later during the course of
treatment.
Return After Default (RAD) - A patient who RETURNS to
treatment with positive bacteriology (smear or culture),
following interruption of treatment for two months or
more.
Advantages of FDC over SDF
 FDC is administered MORE EASILY than SDF
 Less chances of drug resistance
 Decrease in medication errors
 Useful when DOT is NOT possible
 Improves health workers & patient adherence

Transfer-In A patient who has been TRANSFERRED from

another facility with proper referral slip to continue TB Treatment regimen for CHILDREN
treatment.  Intensive phase
 Maintenance phase

Two Formulation of Anti-TB Drugs Pulmonary TB = 2HRZ (IP) = 4HR (MP)

1. Fixed Dose Combination Extra Pulmonary TB = 2HRZS (IP) = 10HR (MP)

2. Single Drug Formulation

RECOMMENDED CATEGORY, DOSAGE and DOSE OF

TREATMENT REGIMEN in PAGE 244-246

 H-ISONIAZID (300mg) B
 R-RIFAMPICIN (450mg),
 Z-PYRAZINAMIDE (1g).
 S-STREPTOMYCIN (1g)
 E-ETHAMBUTOL (800MG),

Regimen I: Intensive Phase, 1st 2 months

 RIPE

Regimen II: Intensive Phase, 1st 2 months

 Streptomycin

Regimen III: 2HRZE/4HR

HRZE for 2 months during Intensive phase

HR for 4 months during Maintenance phase

Regimen IV - Second-line generation antibiotics based Public Health Nursing responsibilities

on the culture & results of sensitivity test
Nurse as ADMINISTRATOR

Manage the procedure for case finding activities with

Fixed Dose Combination (FDC)- in which 2 or 3 anti TB other NTP staff/workers
drugs are COMBINED in one tablet.
Assign and supervise treatment partner for patient who
will undergo DOTS
Supervise RHM to ensure proper implementation of
DOTS
Maintain and update Treatment regimen
Serves as moral support to TB patients
Refer individual with cough for 2 weeks or more to
nearest DOTS center for proper management
Conducts health education activities on how TB is
acquired & developed

Facilitate requisition and distribution of drugs and other Promotes the DOTS services for TB partners
NTP supplies
Advocates DOTS as strategy for curing TB
Provide continuous health education to all TB patients
Participates during NTP activities
placed under treatment and encourage family to
participate Encourages other people from different sectors to
support TB-DOTS advocates
Conduct training of health workers in coordination with
MHO

Prepare, analyze and submit quarterly reports to the

PHO. Analyze the data together with MHO for future
planning activity

Health Education is very important in the INTENSIVE

phase of the treatment and need to be sustain
throughout the duration of treatment period.

Nurse as CASE MANAGER & COORDINATOR

Managing services for the individually diagnosed or

suspected of having TB from initiation to completion of
treatment and a change in the diagnosis or death

Immediately schedule another date if patient is unable

to keep appointment

Nurse as COMMUNITY ORGANIZER

To ensure that ALL activities related to TB control

program are done in such a way that the patients and
people in general will BENEFIT

1. Generate data on incidence of TB

2. Conduct home visitation
3. Determine resources for treatment regimen
4. Build the team
5. Conduct networking and linkaging with LGUs
and NGOs

Nurse as TB ADVOCATE SCHISTOSOMIASIS nies p.351

Shares experiences and accomplishments in terms of -Also known as Bilharziasis/SNAIL Fever
cure and referral to TB network
Next to malaria, SECOND most prevalent disease caused
Disseminates correct information on TB by a parasite
Infects as many as 200 million people each year. Of
these, 20 million are severely infected.

-Death is usually due to LIVER CIRRHOSIS or BLADDER

CANCER.

 Oncomelania Quadrasi-vector

Infectious Agents

 Schistosoma Mansoni
 S. Haematobium and 51
 S. Japonicum- endemic in Phil

Signs and Symptoms

 Rash at the site of Inoculation

 Diarrhea
 Bloody Stools
 Enlargement of Abdomen
 Splenomegaly
 Body Weakness
 Anemia
 Inflamed liver

Diagnosis

Stool Examination: schistosoma eggs

 COPT- Cercum Ova Precipetin Test

 KATO KATZ technique

Prevention and Control:

1. Proper disposal of feces and urine

2. Proper irrigation of all bodies of water one

3. Prevent exposure to contaminated water (wearing of

rubber boots)

4. Eradication of breeding places of snails.

5. Use of molluscides.

Snail Control- most effective but a very expensive way

to break the life cycle of schistosomiasis worm.

LEPROSY nies p.344

Treatment
World Leprosy Day- Last Sunday In January
Praziquantel (Biltricide) -drug of choice
In order, the ten countries with the most leprosy cases:
Oxamniquine for S. Mansoni/ S. Haematobium
1. India
 2. Brazil  Non-infectious
3. Myanmar (Burma)  Duration of Treatment-6-9 months
4. Indonesia
2. Multibacillary (MB): (+) Skin slit test and more than 5
5. Nepal
lesions
6. Madagascar
7. Ethiopia  Infectious type
8. Mozambique  Duration of treatment is 24-30 months
9. Democratic Republic of the Congo
10. Tanzania.

►Other Names: Hansenosis, Hansen's disease, Drugs and Dosages for PAUCIBACILLARY (PB) Cases
Leontiasis DAY 1- Rifampicin, Dapsone
►Causative Agent: Mycobacterium Leprae/Hansen's Days 2-28- Dapsone
bacillus
Drugs and Dosages for MULTIBACILLARY (MB) Cases
►Mode of Transmission: Prolonged skin contact,
droplet infection DAY 1-Rifampicin, Clofazimine, Dapsone

►Incubation period: 5 months-5 years Days 2-28-Clofazimine, Dapsone

Diagnosis of leprosy is most commonly based on the Domiciliary Treatment in RA 4073- Liberalized
clinical signs and symptoms. Treatment of LEPROSY

early signs: 3 main strategies to leprosy control:

1. Early signs • Early detection of patients

 -REDDISH or WHITE change in Skin Color, loss of • Adequate treatment with multiple drug therapy
sensation on the skin lesion. (MDT)
 the decrease/loss of sweating and hair growth • Prevention of disabilities and rehabilitation for leprosy
MI over the lesion, patients.
 thickened and/or painful nerves,
 muscle weakness, PREVENTION AND CONTROL
 pain or Redness of the eye, nasal
Treat all leprosy cases to prevent spread of infection.
obstruction/bleeding, ulcers that do not heal.
BCG vaccination
2. Late signs
Young children should avoid direct contact with
 loss of eyebrow (Madarosis). untreated patients.
 inability to close eyelids (Lagophthalmos),
 clawing of fingers and toes,  Practice personal hygiene.
 contractures,  Maintain body resistance by healthful living.
 sinking of the nose bridge,  Good nutrition
 enlargement of the breast  Enough rest and exercise
 Clean environment

MEASLES
Patient Classification of Leprosy:
-it isn't just a little rash
SLIT SKIN SMEAR
Measles can be dangerous, especially for babies and
1. Paucibacillary (PB): (-) Skin slit test or 5 or less lesions young children.
An Acute Highly Communicable Infection characterized ISOLATION of cases from diagnosis until about 5-7 days
by: after the onset of rash

 Fever Disinfection of ALL articles soiled with secretion of nose

 Rashes and throat
 Symptoms referable to URTI

Koplik Spots may be found on the inner surface of the

cheeks -pathognomonic sign

Morbiliform Rash appears on the 3rd or 4th day

►ETIOLOGIC AGENT: Filterable virus of measles

►SOURCE: Secretion of NOSE and THROAT of infected

person

►MODE of TRANSMISSION: Droplet infection or direct

contact with infected person or indirectly through
articles freshly soiled with secretions

►INCUBATION period: 10 days from exposure to

appearance of fever. An about 14 days until rash
appears

►PERIOD of COMMUNICABILITY: during the period of

coryza or Catarrhal Symptoms- 9 days (From 4 days
BEFORE and 5 days AFTER Rash appears)

SUSCEPTIBILITY, RESISTANCE and OCCURENCES

ALL persons are Susceptible.

PERMANENT immunity is acquired usually after the

attack of measles

Nursing Care

► Protect eyes from glare of strong lights

►Keep the client in an Adequately Ventilated Room but

free from drafts

Teach, guide and supervise correct technique of giving

sponge bath for comfort of patient

Check for correction of medications and treatment

prescribed by physicians

CHICKEN POX/ Varicella Zoster

Prevention and control
An ACUTE Infectious Disease of sudden onset with:
MMR vaccine -9 months, 1 year
slight fever
Avoid exposing children to any person with fever or
with acute catarrhal symptoms mild constitutional symptoms; eruptions which are
  MACULO-PAPULAR for few hours,
 VESICULAR for 3-4 days and leaves
 GRANULAR scabs

►ETIOLOGIC AGENT: Human (alpha) herpesvirus 3

(Varicella Zoster Virus)

►SOURCE of INFECTION: Secretion of Respiratory Tract

of infected persons.

►MODE of TRANSMISSION: Direct contact or droplet

spread.

INCUBATION PERIOD: 2-3 weeks, commonly 13-17 days

► PERIOD OF COMMUNICABILITY: Not more than one

day before and more than 6 days after appearance of
the first crop of vesicles.

MUMPS

-an ACUTE CONTAGIOUS DISEASE, characterized by

swelling of one or both of the PAROTID GLANDS, usually
occurring in epidemic form

▷ETIOLOGIC AGENT: Mumps virus

►SOURCE of INFECTION: Secretion of MOUTH and  delirium
NOSE  double vision
Signs and Symptoms of MUMPS ALL materials contaminated by secretions should
cleansed by BOILING.
 Painful swelling in front of ear, angle of jaws
and down neck Paper handkerchief should be BURNED.
 Fever
► Ensure clean environment, the room should be
 Malaise
AIRED for 6-8 hours.
 Loss of appetite
 Swelling of one or both testicles in some boys ►Encouraged BED REST to prevent complications
(orchitis)
Daily bath and frequent antiseptic mouthwash should
Treatment of MUMPS be given.

ACTIVE treatment ► Rarely, Conjunctivitis may occur thus COLD

COMPRESS and eye protection from light, dark glasses
3. Diet should be SOFT or LIQUID as tolerated, SOUR
maybe used
foods or fruit juices are DISLIKED
> DAT according to age, SOFT BLAND are necessary as
4. Encourage control of scratching to prevent local
long as jaws are sore
infection and scars

5. Fever can be relieved by ASPIRIN, alcohol rub or TSB

6. ORCHITIS is the common complication After puberty,

in ALL males with mumps, the Scrotum should be
supported by suspensory from the start.

Sedative/ analgesic maybe ordered to control severe

pain

PROPHYLACTIC

1. Use of properly fitted suspensory pillow or sling

between thighs, relieving the pull of gravity on the
testes thus minimizing orchitis to occur

2. If Orchitis occurs, Give 300-400 mg of Cortisone

7. ENCEPHALITIS may complicate mumps

DIPTHERIA- an ACUTE FEBRILE infection of tonsil, throat,
 sudden rise in temperature nose, larynx or a wound marked by PATCH or PATCHES
 stiff neck of grayish membrane from which the diphtheria bacillus
 headache is readily cultured.
 malaise
►ETIOLOGIC AGENT: Corynebacterium Diptheria (Kleb
 nausea and vomiting
Loeffler bacillus)
► SOURCE of INFECTION: Discharges & secretions from
mucus surface of nose and nasopharynx and from skin
and other lesion
►PERIOD OF COMMUNICABILITY: 2 weeks
►SUSCEPTIBLE GROUPS: under 10 years of age
DPT vaccine
►SOURCE of INFECTION: immediate source of infection
is soil, street dust, animal and human feces.
►INCUBATION PERIOD: 3 days-1 month
Methods of Prevention and Control Tetanus
Tetanus Toxoid Immunization for pregnant women
Health education among mothers, relatives, in the
practice of strict aseptic methods of umbilical care

WHOOPING COUGH- an ACUTE infection of Respiratory

Tract. It start as an ordinary cold which became severe
and after second week with paroxysms of cough ending
in a characteristic WHOOP.

►ETIOLOGIC AGENT: Hemophilus Pertussis or Bordet

Gengou Bacillus or Bordetella Pertussis/ Pertussis
bacillus

SOURCE of INFECTION: Discharges from laryngeal and

bronchial mucous membrane of infected persons

Incubation Period:7-10 days

SUSCEPTIBLE GROUPS: under 7 years of age

mortality in INFANTS

Methods of Prevention

Routine DPT immunization of ALL infants

ISOLATION of patients until after 3 weeks from

appearance of paroxysmal cough

Teach on how to PICK UP infant during Paroxysmal

Cough, giving abdominal support

General care of nose and throat discharges

TETANUS- an ACUTE disease induced by toxin of

TETANUS BACILLUS growing anaerobically in wounds at
the site of umbilicus among INFANTS.
►ETIOLOGIC AGENT: Tetanus bacillus/clostridium
tetani
WATER BORNE DISEASES
CHOLERA- an ACUTE serious illness characterized by
sudden onset of acute and PROFUSE COLORLESS
DIARRHEA, severe dehydration, vomiting, muscular
cramps, cyanosis and severe collapse.
►ETIOLOGIC AGENT: Vibrio cholerae - El Tor
► SOURCE of INFECTION: Vomitus an feces of infected
persons and feces of convalescent or healthy carriers
►SUSCEPTIBILITY: ALL
►INCUBATION PERIOD: few hours after exposure
►Oral Fecal Route
diagnosis
 stool examination
Methods of Prevention and Control
Report case once to MHO
Bring patient to hospital for proper ISOLATION and
prompt treatment
ALL contacts of cases should submit themselves to Stool
examination and be treated accordingly
Continue and INCREASE frequency of Breastfeeding
Give additional fluids such as "am", soup, cereals,
mashed potato
►ETIOLOGIC AGENT: twenty seven zero-types of germs
Shigella (dysentery bacillus) 4 types; Shflesneri, Shboy-
dii, Sn-connei, Sh-dysenterea
►SOURCE of INFECTION: feces of infected persons
CHILDREN are Susceptible Group
► INCUBATION: 1 DAY; usually less than 4 days
MODE OF TRANSMISSION: eating contaminated foods
or drinking contaminated water or milk; hand to mouth
transfer of contaminated materials; by flies; by objects
soiled with feces of patient or carrier.
►PERIOD of COMMUNICABILITY: during acute infection
and until organism is ABSENT from feces
Methods and Prevention
Sanitary disposal of human feces
Sanitary supervision of processing, preparation and
serving of food especially those eaten as raw
Adequate provision of safe washing facilities
Fly control and screening of houses to

May administer coconut water-rich in potassium

Make patient as comfortable as possible

Give ORESOL according to required amount based on

Age

BACILLARY DYSENTERY - an ACUTE bacterial infection of

the intestine characterized by diarrhea, fever,
tenesmus, abd in severe cases BLOODY and MUCOID
STOOLS.
TYPHOID FEVER- a SYSTEMIC infection characterized by
continued fever, anorexia, slow pulse, involvement of
Lymphoid Tissue esp. ulceration of the PAYER'S
PATCHES, ROSE SPOT on the trunk and diarrhea.
►ETIOLOGIC AGENT: Salmonella Typhosa, thypoid ►ETIOLOGIC AGENT: Ascaris lumbricoides, Trichuris
bacillus trichuira and hookworm (Ancylostoma duodenale,
Necator Americanus)
►SOURCE of INFECTION: Feces and Urine of infected
persons ►SOURCE of INFECTION: feces and urine of infected
persons
symptoms
►SUSCEPTIBILITY, RESISTANCE & OCCURENCES: -
 WHITE COATING on the tongue
children belonging to 2-5 years old are easily infected
 enlarged liver and spleen.
 rash body - children ages 6-14 HARBORS the greatest local
 ULCERS in the intestine infection and are significant source of transmission

►INCUBATION PERIOD: VARIABLE, average 2 weeks Facts about STH ▷ 3rd most prevalent infection
usual range is 1-3 weeks worldwide, Second to diarrheal disease and tuberculosis

►MODE OF TRANSMISSION: direct or indirect contact -Ranked 10th among the World's Top Ten Infectious
with patient or carrier. Food and water is the principal diseases killer in 1996 by WHO
vehicle; FLIES are vectors
Signs and Symptoms
►PERIOD of COMMUNICABILITY: as long as bacilli
 Anemia
appear in excreta; usually from appearance of
 Malnutrition
prodromal symptoms from 1st week throughout
 Stunted growth in height and body size
convalescent
 Decreased physical activity
Methods of Prevention and Control  Impaired mental development and school
performance
Education of food handlers in proper hygiene
Pevention and Control
Immunization with a vaccine of high antigenicity
▸ Emphasize health education on:
Same as in Dysentery
1. Good personal hygiene - hand washing
TREATMENT: Chlorampenicol
2. Keeping fingernails clean and short
Demonstrate of how to give TSB, feeding, hanging
linens, use of bedpan, mouth care 3. Use of footwear

Report any bleeding from rectum, blood in the stools, 4. Washing fruits and vegetables very well
sudden acute abdominal pain, restlessness, falling of
5. Use of sanitary toilets
temperature
6. Sanitary disposal of refuge and garbage
Emphasize the importance of taking vital signs

Paralytic Shellfish Poisoning- a syndrome of

Soil Transmitted Helminthiases- are the intestinal
characteristic symptoms predominantly neurologic
WORMS infecting humans that are transmitted through
which occur within minutes or several hours after
contaminated soil ("helminth" means parasitic worm)
ingestion of POISONOUS SHELLFISH
►ETIOLOGIC AGENT: Dinoflagellates
►SOURCE of INFECTION: contaminated shellfish
INCUBATION PERIOD: Varies from 30 minutes to several
hours after ingestion
►MODE OF TRANSMISSION: ingestion of raw or
inadequately cooked seafood usually bi-valve shellfish
or mollusc during red tide season
Signs and Symptoms
 Numbness of the face especially around the
mouth
 Vomiting and dizziness
 Headache
 Tingling sensation; paresthesia and eventually
paralysis
 Floating sensation and weakness
 Rapid pulse
 Difficulty of speech (Ataxia)
 Difficulty in swallowing (Dysphagia)
 Total muscle paralysis with respiratory arrest
 Death
Management and Control Measures
Induce vomiting
Encourage to drink pure coconut milk and Sodium
Bicarbonate during the early stage only
Toxin of red tide is NOT totally destroyed upon cooking
Avoid Bi-Valve Mollusks when red tide warning is given
RABIES/ Hydrophobia, Lyssa- an ACUTE VIRAL
encephalomyelitis caused by RABIES virus.
ZOONOSIS - a disease that is transmitted from animals
to humans
►ETIOLOGIC AGENT: rhabdovirus of the genus
lyssavirus
► SOURCE of INFECTION: rabid dog and other canine
►INCUBATION PERIOD: 2-8 weeks; or be in years
depending on the severity of the wounds, site of the
wound as distance from the brain, amount of virus
introduced and protection provided by clothing
►MODE OF TRANSMISSION: bites of a rabid animal
through saliva; or through scratch or in fresh breaks in
the skins (very rare)
►PERIOD OF COMMUNICABILITY: In dogs or cats, for
3-10 days before onset of clinical signs and throughout
the duration of disease
► SUSCEPTIBILITY & RESISTANCE: ALL WARM-blooded
animals are susceptible Natural immunity in man is
UNKNOWN
Signs and Symptoms
 Sense of apprehension
 ▸Headache
 Fever
 Sensory change near at site of animal bite
 Spasms of muscle or deglutition on attempts to
swallow (hydrophobia)
 Paralysis
 Delirium and convulsions
NOTE: Without Medical Intervention, the Rabies victim
usually LAST ONLY 2-6 days due to RESPIRATORY
PARALYSIS
Management and Prevention
Wound must be cleansed immediately with water and
soap; antiseptic maybe applied
Patient must be given anti-tetanus and antibiotics
Give active immunizations and passive immunization
Be a responsible pet owner