n

INTRODUCTION
A disease of infectioU$ nature that can be transmitted from one perso
· host, dire ctly or m
from a reservoir to a susceptible · called as a n to cln.other(
· directIy Is
disease The time period required for the transmission of the infectiouscolltrnUrtiC3b
. to a susceptible host to cause disease
reservoir . . known as communicableagent
Is p . fr 0ll1
period may be short or long, depending. upon the nature of the disease.
. enact ·h t
11

The infectious agents may be virus, bacteria, protozoa, fungi, rickettsia et , .

can affect various systems o~ the body. Sometime~
. the infe~ted p_erson shows noC.clinic
\\ hie
features of the disease and srmply acts as reservoir of that infectious agent, such pe
is known as carrier. This carrier state may be short or long duration. rso
With the improvment of personal and social hygiene and awareness about healt}
communicable diseases are now being effectively controlled. In developed countries th
communicable diseases are much less than the under developed and developing countire:

A. RESPIRATORY DISEASES
I. CHICKEN-POX
Age : Chicken pox primarily occurs in children under 1O years of age. The mo 5
vulnerable age is 1 year onwards. It is uncommon in adults. The disease tends to be mar
severe if it occurs in adults.
C ti
ausa . ve organism
· : Chi ck en pox (varicella) is caused by a h erpes vi·rus callei
Varicella-Zoster virus (v-z virus).
M d f
. .
o e o transmission . transmitted from person to person (a) by drop1et .infectior
: It IS sec
(b) by droplet nuclei (c) through personal contact (d) freshly contaminated foou~;;.,
by the patient can also transmit the disease. (e) The virus can cross the placental
and may infect the foetus.

Incubation period, The period varies from 14-21 days. ,as'

Cilin" al f f er and d
Ic
th : The early signs and symptoms of disease are ev face aJ1
eatures
Rash apperu-g on e trunk on the second day of the illness and then on th~e 1esior'
finally the limbs are involved. Macuies* appear first and within a few hours
@
 ,M#M¥1 . . . ** f!J'\.r
\!i§J
ar.. and then ve~1cular . W1thm 24 hours the lesions become pustular
, i,ecoJlle papul
.th pus)• These dry up m a few days to form scabs.
filled wi . and control :
4 ~.'\ ( preventton. can be done by administering specific V. Zoster immunoglobulin to
"'•I (a) preve~tli:ontacts of varicel.la. Dose is 1.25-5 ml IM or Hyp:rirnrnunogarnma
high r'.s referably from patient recently recovered from the disease.
S globul~
At the firsPt sign of secondary infection a local antiseptic like chlorhexidine can be
(b) plied. 'b• · h uld b ·
ap tena • fection progresses, an anti 1otic s o
. 1m e given.
INTRODUCTION (cl If bac . f ction can also be prevented by isolation of the patient for 5-7 days
(d) spread of m :arance of the rash and sterlization of all articles soiled by the patient.
. f . , ti· nature that can be transmitted from one pers frorn the app
A disease o 111,ec ou5 . d' . on to
;. to a susceptible host, directly or m irectly 1s called as a another
omareservou . h • • f h . co111 111 . or
fr. Th time period reqmred for t e transm1ss10n o t e mfectiou un1cab II. DIPHTHERIA
• k s age t le
reservoir
d1sease. toea susceptible host to cau~e disease IS nown as communicable n. fr°lll i Di htheria : Diphther!a most commonly affects the upper respiratory tract (la
period may be short or long, depending upon the nature of the disease. Period. !his px) and sore throat 1s frequently the presenting feature. rynx,
The infectious agents may be virus, bacteria, protozoa, fungi, rick t . pharyn
Age : Maximum mc1. 'dence occurs m . child ren between 2-5 years of age.
can affect various systems of the body. Sometime~ the infected person s~ tsia etc. Which
features of the disease and simply acts as reservorr of that infectious ag ows no clinic 1 Causative organism : The disease is caused by the exotoxin of Corynebacterium
. . . . b ent su h a diphtheriae, which i~ a. Gram +ve, non-motile bacteria.
1s known as earner. This earner state may e short or long duration. ' c person
With the improvment of personal and social hygiene and aware Mode of transm1ss1on :
communicable diseases are now being effectively controlled. In devel~es~ about health (a) The disease spreads usually by droplet infection from patients.
.countries th;
communicable diseases are much less than the under developed and devrleopmgcounti (b) It also spreads through personal contact.
res
I I (c) Transmission by objects such as cups, thermometers utensils etc. contaminated by
A. RESPIRATORY DISEASES . nasopharyngeal secretions of the patient is possible only for short period.
Incubation period : Average incubation period is two to four days but may be more.
I. CHICKEN-POX
Clinical features : Disease begins suddenly with fever other symptoms are : (1) Sore
Age : Chicken pox primarily occurs in child:en under 10 y.ears of age. The most throat, (ii) Swollen lymph glands, (iii) A gray membrane grows across the throat cavity
vulnerable age is J year onwards. It 1s uncommon m adults. The disease tends to be more and its causes difficulty in breathing, (iv) Swelling in the neck.
severe if it occurs in adults.
Prevention control and treatment :
Causative organism : Chicken pox (varicella) is caused by a herpes virus called (i) Prevention of this disease is done by active immunization with DPT vaccine.
i/ Varicella-Zoster virus (v-z virus).
I This vaccine provides prevention against diphtheria, pertusis and tetanus. It is
Mode of transmission: It is transmitted from person to person (a) by droplet infection given at the age of 2nd, 3rd and 4th month.
(b) by droplet nuclei (c) through personal contact (d) freshly contaminated fomites used
(ii) Patient should not be allowed to mix with other children and all other children
by the patient can also transmit the disease. (e) The virus can cross the placental barrier who have come in contact with the patient should be given diphtheria toxoid.
and may infect the foetus.
(iii) All the articles and clothes used and soiled by the patient should be disinfected.
Incubation period : The period varies from 14-21 days.
Antitoxin of diphtheria is the main part of treatment for mild cases, 4000--8000 units
Ci!inical features : The early signs and symptoms of disease are fever and rash.
~ash appears
th on the_ trunk on the second day of the illness and then on the face and
finally e limbs are involved. Macules* appear first and within a few hours the lesions •Macules - Small flat coloured spot on the skin .
.. Popular - A spot raised above the surface of skin.
•••vasicle - A small circumscribed elevation of the epidermis containing fluid.
@)
 ·
,·rr:1·1
·:CH..
1:@WN¥&¥HH,flrhl9·iulrn - .
11'1 ·ts I'K
,v, and for severe cases dose ~u ¥1¥i-1D o· "
2000 uni . • antitoxin its sensitivit Pto 1 o ,..r,•il
• . 117,
G for rnoderate case~v~~~O~ before eliminate Corynebacte~u~U~t- be 'te; tOOi)
~=:~; can o~cdur at a~~=~~~:~tg;c~;;10y:al after age of 10 years. Mostly it occurs in
units IM can also beg_ ·stered for on_e e thfomycin. IPhthetied. f.'l, ·zed chtl ren u . . ~rs.
·cillin rnust be adlll'.1"il"~ can be given ry ~e. ..... iJ1lll'uJ11. organisJil : Bordetella pertusis 1s the causative organism
eni
Patients . t penic .,..
allergic · .,.. cau sative .
4 P O . 0 period : It lies between 7 to 14 days.
III. I FLUENZA JxtC11t,attf ntransIJ1.ission : It spreads by (1) droplets produced when infe t d
N'Flu'. It is an acute and highly infecti )\,fode O ezes. (2) Articles freshly soiled by the discharges. c e person.
nl J<nown as d b h ous <l' 311 d sne
nza: It is cornrno Y ffects people of all ages an ot sexes. Ise~se coughs . control and tratment :
In ue tract I t a f . Th
of theflupper respira~ory . It i~ caused by a group o myxovrrus. ere are three preve11tton,
. dre11 in their earlf age i.e. 2nd, ~rd and 4th month of life should get immunized
Causative rga111sJI1 · d C Epidernics are caused by A type, small out-bre tykPes of 1. C~ t the disease with D .P.T. vaccme (0-5 ml 1/M) containing diphtheria p tu .
. 0 . A B an • a sb agams , er sis
influenza C lfU'1.IS is occas1ona
type,.e. ' . I· . d . to 48 hours i e t Y8 d t taI1US vaccine
. altogather. Later, 1st booster at age of 1- 2I year and Ilnd boo t
type an d . . d . The incubation peno ts 24 · · 1 o 2 days. an e . . . s er
Incubation peno. ·. . It is transrnitted (1) by droplets generated by co t 5 ear of age. Pertus1s ':accme 1s not recommended over 6 years of age, because
Mode of tra11srn1ssion ·. t ontact (3) through recently contaminated f u_ghing af y re reactions to vaccine.
sneezing
. and sp eaking (2) direc c
f '-"uenza is sudden with. fever upto 102op orn11e. s. . oTh mohild (patient) should be put to bed ma . .
well ventilated room for 3 weeks as far
. . I f h•-s . Onset o uu• d . .h With ch·1 2 ec
Cluuca ea,~~ . I . •• Joss of appetite an sometimes wit nausea and I ls . ossible.
headache'. b ckache h d ' rna
d there
ruse ,rnay be dry cough present. The £:ve~ usually corne vorn·rIJ\g.' as
ThP discharges from nose and throat of patient should be collected in a paper or
5 0
The face dis usif e ap:r care is taken. In neglected cases, complications like pneu wn 3. 1 eth and then properly disinfected.
!, I
after 4-6 ays
bronchitis and ear .
proinfections may deve10 P· rnonia•' o
_cErythroJilycin dose of 50_ m~/kg(day m_4. . .
d1v1ded doses may reduce the severity
Prevention and control : 4 f infection. It 1s of value, 1f given m the first stage. In the second stage antibiotics
'i/
1 . ti' by polyvalent influenza virus vaccine 1 ml subcutaneous or
. rnlaccma on . O 1 to 02
°houldn't be used unless secondary infections occurs. A cough suppressant such
1V ~tradennally given 1-2 weeks apart gives mod erate protection against ·curre~t sas noscapine may b e h e 1p ful m
· contro Iiing t h e seventy
· o f attacks.
/1
I V. TUBERCULOSIS
strams.
'Ii 2. Isolation of suspected cases. Tuberculosis is a major problem in the developing countries. As per WHO (World
3. Spitting in public places should be avoided. Health Organisation) report 'Tuberculosis is the most important specific communicable
4. People must be educated about healthy habits. disease in the world'. It can involve lungs, larynx, intestines, peritoneum, kidney, bladder,
Treatment : its treatment includes bed rest until the fever has subsided. Anal esi brain, eyes, skin, bones and joints, fallopian tubes and lymph nodes etc.
(paracetamol) for the backache and headache may be given. g cs Predisposing factors : Factors those lower resistance like (a) malnutrition, (b) over
Dry cough suppressant like noscapine are given to relieve dry cough. Anti v· I d crowded houses, (c) poverty, (d) alcoholism, (e) drug addiction, (f) corticosteroid therapy
may be tried. Mostly used drug is amantadine hydrochloride 100 mg twice ~a ~gs and (g) certain occupations, (h) lilV infection, (i) use of immunosu pressants.
treatment of complications such as bronchitis and pneumonia is dealt with lat ay. he
a er. Causative organism : Three types of Mycobacteria are responsible for the disease -
(i) Mycobacterium tuberculosis human type, (ii) Mycobacterium bovis, (iii) Atypical or

rv. WHOOPING COUGH opportunistic mycobacteria.

Whooping cough (Pertusis): Whooping cough or Pertusis is a highly infectious disease
of yo=g children causing inflammation of the respiratory tract with severe attacks of
cough, that end in a whooping SOlffid when persons breathe in.
••Malaise - Feeling of discornfon.
•o-...
;-.,,.,umonia • Inflammation of Jung parenchyma.
Mode of transmission : In majority of cases, infection is acquired by inhalation of
air-borne infected droplet nuclei generated by sputum +ve patients (cavitatory tuberculosis
or active tuberculosis). To transmit infection the particles must be fresh enough to carry
a viable organism. It is not transmitted by fomites and other articles used by the patient.
Incubation period : It varies from weeks, months to years depending upon the dose
of infection.
Symptoms : (a) tiredness, (b) loss of appetite, (c) loss of weight, (d) anaemia, (e) evening
 · ·iU®iiiUirttflM !IUl\'i#·,ww !DM#MD
- . during sleep. Other symptoms d ~ - •~ VI. MEASLES (RUBEOLA)
6) sweating especi:fth expectoration and sputum isef~~d llpo
erature, (f) . cough t etc lick n tl" c .ldren suffer from this. disease between age of 3- 5 years an d those h0
rise of temp Jvement i.e.
the Jocal invodyspnoea in Jungs
·
jnvolvernen . and
tvfoS 1 dhl-ay be attacked even m the later life. Infants during fir t 6
ave es
cape '" f .
froill measles because o transferred passive immunity fr
• w
s months of lif
h e
mucopuru Jent'. . tieat is tested for presence of AFB h ,~r .
Jnvestigattons . of suspected pa (Acid f do!l . e organism : Paramyxov1rus
sat1V' Th . ,commonly
. .
called as Rub eo1a virus 1s
. the
. utuJil : sputum .. . . as1 ca·ve11 organisxn of measles. b e virus can t survive outside the human body but retam .
(,) Sp. ') . it 'ties cavities, calc1ficahon m the u
bacilli Ul . esence of opac1 . ' PPer or . catlsa_tl . when restored at su -zero temperature.
'i Chest X-Ray : Pr tuberculosis. . . . . In1ct 1n · · : It 1s
· fecllvtlY f transmission · h'1ghly m. fec ti'ous di sease. It spreads (1) by dire t t
(I ) shows puJmonarY f tuberculin solution is miected intrad ., de o . b d 1t . f . c con act
zone mJ o .. elllaU iv, 0 to person mam1y y rop e m ectton or the droplet nuclei prod d b
... M toux (Mx) test : O·1 (' exposure to T.B). A positive test is indicat '/. l'he erson . f . uce y
{rofll P. and sneezing. The porta1 o entry 1s respiratory tract.
(,u) a~ read at 48--72 hour~ ,.)e.l s than 5 rnm in diameter. ect by an
test 1s . ( welling es coughiilgJ, t'on period : Varies from 8-14 days.
area of induration s bl d tests which are also of significance. 1ncu at
(iv) Hb, nc, DLC, ESR are oo
. CLINICAL FEATURES
preventton · and Control: tb i·mproved e.g. good nutr·itious d'iet, (b) well
f ctors mus e ventiJ
1. Environmental .a f ho! and smoking, (d) unhealthy occupatio atect (i) Catarrhal Stage : (a) fever, (b) running nose, (c) hoarseness of voice, (d) watering
I
houses, (c) av01dancthe o a ~;ential area. ns shouJct cough, (f) appearance of red spots in mouth called koplik's spot help in making
not be located near e res1 . of eyes, (e)
. uirnonary tubercular patients.
2. Isolation of the active P . . . diagnosis.
(. ') Stage or eruption . stage, red macular rash first seen
. : After 3 to 4 days of the first
. . . This is carried out by the admirustration of freeze dried .
3 Bc GVaccination• . d vaccm / back of ears and forehead along hair line, within a few hours, they spread all over
· · · . d t th time of use by the mtra erma I route (0.1 ml). It is e,
reconstitute a e . b • rnostJy :ody. The face is ordinarily the mo~t densely covered area. Rash fades from the face
. . ted . the first month of life but 1t can e given up to age of 15 years It h
miec m l • •• • . · as down wards, in the same sequence as its appearance.
reduced considerably the incidence of tubercu ar merungitis m chJ!dren. Periodical
health check up should be done. Prevention : Prevention of measles is divided in two parts :
_ Treatment: Chemothera~y of_tub~rculosis in?udes the ~ost commonly used five (i) Active immunization, (ii) Passive immunization.
4
drugs. These drugs are given m differeat regimen according to the requirement. (i) Active immunization : One injection of live attenuated measles virus should be
(i) 6 months regimen : Rifampicin, isoniazid, pyrazinamide and streptomycin given subcutaneously in children over one year of age.
ethambutol for first 2 months and rifampicin and Isonex for last 4 months. or (ii) Passive immunization : It is done by human normal immunoglobulin, given
(ii) 9 months regimen : Rifampicin, isoniazid and ethambutol or streptomycin for intramuscularly, for the prevention or attenuation of measles. The dose is 250 mg for
first 2 months and later rifampicin and isonex for last 7 months. children under one year and 500 mg for those over this age.
Dosage: Control measures : The following control measures should be adopted :
Rifampicin - 10-20 mg/kg/ day
(i) Isolation of patient for 7 days after onset of rashes.
Isoniazid - 3-5 mg/kg/ day
(ii) Immunization of contacts within 2 days of exposure.
Streptomycin - children-30 mg/ kg/ day (iii) The articles soiled with discharges should be properly disinfected.
Adults under 40 kg- 0.75 g/day
More than 45 kg - 1 g/day
Ethambutol - B. INTESTINAL INFECTIONS
15-25 mg/kg/ day
Pyrazinamide - 30-35 mg/kg/ day I. POLIOMYELITIS OR INFANTILE PARALYSIS
_Poliomyelitis is an acute systemic disease caused by an RNA virus, which replicates
mainly in the gastro-intestinal tract. In a very small percentage (1 %) of cases, virus may
th
reach the CNS and damage the anterior horn cells of spinal cord and occasionally e
 ---,

@i·ll:®1!m;;m,,.,,1,;nra·mlu•ililim F,\
pi'fl . degrees of paralysis and ra~ J · · II. CHOLERA
. t variou5 . eyd
suiting in
° 11
rteX re . sma
a RNA virus and with three seroty e<lth.
• is is a severe acute gastro-intestinal infection. It is a communic .
15
edulla an d motor co . . po1·ovirus
J Pe i.e.
Chole:der epidemic as well as endemic diseases. able d ease and
i rn live organJsJJI . . I human disease.
I causa d 3 . an exclusJve y it coJtles rive organism : It is caused by Vibrio cholerae. The biotype of V
Typ e 11 2 an . sJJIJSSJ . ·on . It JS I oral route. causa ·ble for pandemic has replaced the classical vibrio .cholerae, El
· h feca - .
Mode of tran 1
J·tted throug d plets (through sneezing etc.) du . respons1 . . .
,_ transrn h rynx ro f h . ring
1 It is rnauuY fr rn nasop a nun·ated fingers o t e patient. <lcute for, f rransn11ss1on :
· read O h conta ~ode o ·sease . transmitted . .
through the food and dnnking
2. But it rnay s~isease or thfoug . bation period lies between 7 to 14 days b ') e dl 15 . water, e1c. contaminated
stage of the . . Usually its mcu Ut in (1 Th by flies, insects a~d improper stora~e.
. penod · , . also transmitted by contact
Incubatio~ 4--35 days. . '') It 1s . with the. contaminated hands of persons wh0
e cases JI is 1 . Ii (11 carelessly handle excreta, vom1tus of patients and contaminated fomites.
sorn . n and contrO : . measure of preventing po omyelitis. Both . ·on period : Its incubation period lies between few hours to 5 days
Preventio . lion is the safe ~ffecnve available and both are safe and effective k11Iect Jncub ati . . .
(i) Irnrn~WZ:ttenuated vaccines are unize all infants by 6 months of age to ;hen . . al features : It suddenly starts with diarrhoea, including effortless rice w t
di.JllC d d . . I d' a ery
and live tly It is essential to J~ es are of two types e.g. p oteci ools with pain in ab omen an vom1tmg ea mg to dehydration. Further it causes
used correc · . The polio vaccm . . st cramps sunken eyes, sub-normal temperature, hollow cheeks and urine out put
thern against polio. m·e . It is inactivated pol10 vaccine administ rnusc1e ·on due to fluid and electrolyte imbalance.
. d) olio vacc · erect
(a) Sall< (inactivate P days it is not use d . suppress1
. •ection. But now a .
by parenteral IDJ li ccine: OPV was descnbed by Sabin in 1 Prevention and control :
. r oral po o va . h d' I . 957. t (i) Personal prevention means strict personal hygiene.
(b) Sabin vacone O • (Type 1 2 3) grown in uman 1p 01d cell cu]tu 1
1
. ted virus ' • res.
contains live attenua M Cl to remain potent for a year. It 1s to be stored in (ii) Water for drinking should come from a clean piped supply or be boiled.
It is stabilized by molar g 2 a
40 (iii) Early detection of suspected c_ ases, confirmation by stool examination and
refrigerator at ~· t an interval of two months, It is first given whe notification to the health authonty must be done as early as possible.
It is given orally m 3 doses, a I n
(iv) Dis-infection of infective discharges and clothing must be done.
baby is 1 -I to 2 rnonths OId, At the age of 1 -2 years a 4th dose or 1st booster dose (v) The sanitation should be maintained properly so that flies don't breed and don't
2
. fS ears Ilnd booster dose is given. It induces both humora] spread the disease by contaminating the food.
ise>iven.Whileatageo Y ' f db b f 2h
. .
. al !IllIDUill
ando· mtestin ·ty, It is advised not to breast ee a Y or ours before (vi) Cholera vaccine is a suspension of killed vibrios preserved in phenol. For
and after giving drops. The drops taste sweet. prevention, 0•5 ml/subcutanequsly is injected to every individual.
(ii) Isolation of the patient. (vii) Treatment of cholera includes :
(ii!)Supply of safe drinking water. (a) Maintain the circulation.
(iv) Proper disposal of urine and fecal matter and It can be done through oral rehydration either alone or supplemented by
(v) Improvemeut in personal hygiene. intravenous fluids as long as diarrhora and vomiting continue. Two types of
Caution : OPV shouldn't be given to any child suffering from diarrhoea, vomiting oral rehydration solutions (ORS) are available :
and fever. (i) ORS bicarbonate, (ii) ORS citrate.
j Treatment : There is no specific treatment for polio. If paralysis does occur the chief (i) ORS - bicarbonate includes the following contents :
treatment is rest. Drugs are given to relieve pain and to ensure rest. After the muscle
Sodium chloride 3·5 gm
~ain has diminished, all the important joints of the body should be passively moved 2-3
times a day, to prevent stiffness of joints, shortening of muscles and deformity. Sodium bicarbonate 2·5 gm
Potassium chloride 1•5 gm
Glucose 20 gm
I 1 litre
Boiled water
I·
)IU,4..,.
 #!M!BH,ii:H+i:,i,,i, . "ftl 7TITC . I d
'[tl!'il - prev entive measures inc u e :
1
. z. G••"'detec n·O n ' notification and isolation of patients. Proper disinfection of urine
.. oitS·Cittate 3-5 gJJ1 () Early
1
Gf <11 15odiuJl1 '--''
.hJ0 ride dihydrate z-9 gJJ1
11!1
d s..tools- . .
d inking water supply andbfood hygiene
· t · d(i.e. cut fruits and vegetables exposed
rrisoditJJll citrat_e 1-5 gJJ1
,,j/I .
p tass1tJill
c111oride
zo gJJ1
(11) safe
dtJst rn
ustr not b e eaten raw) must e mam ame .
.
0
/11 ,/ GJocose 1 litre to 'freatxnent · uld be given complete bed rest and good nourshing diet.
Boiled w_ate~ tibiotics tlsed to to cure cholera are : tt
.
1 pa ·ent1 sho·re ·
drugs such as c1pro fl. oxac1n,
· o fl oxac1n,
. c hl oramp h en1co
. l, P efloxacm ·
· m
11/i (b) J\Jltibiollcs ·. M_ t<JO mg J/V 6 hourly for first 24 hours an 0 . 2 _5pec1 . dosage and duration.
(i) retracycJiJle f. days for adults. d then apPropnte
or 3 . ran
ms 6 hootlY
. . , " ,,,en as ,;u,gl• dose of 400 mg/ d ' So,
e days
,}/ If (Ill''"""'''"'. 1 ay fo, Un, Iv. FOOD POISONING
Ill- tyPHOID FEVER . acute inflammation of lining of stomach and intestines caused b
. ·nness that affects gastro-intestinal tra t . It isi;n food or drink co_ntaminated by toxins of bacteria or inorganic chernicJ
{I ,, cot1suII1 g nd poisons denved from plants or animals.
'd. •n acote infe~uoosd1eveloped. Clinically, the paratyphoidc in ll1an" t,stances, a . . . . .
rypho1 p • ·
. here
15 sanitation 1s un h .d fever. The term entenc · fever mcludes b thsho w no' su t ms : Food po1son1ng usually begins within 2-6 hours of eating the food
11 countrI: ~erence frorn the typ 01 o typhoid _ S~iei:g of nausea and abdominal crapmps, followed by vomiting, diarrhoea (ma;
rernarka aratyphoid
e . fever. ll typhi is the causative. .
organism of typh . with d ) fevers, chills and weakness. The symptoms may start even upto 48 hours
I If an d P . . SaJrnone a .A d S 01d f be bloo y~ g the food or drink.
ausative organ1slll · , typhi s. paratyphi an . paratyphi B ever. after cons
C al host ,or 5· ' ·
Man is the only natur . • . It sprea ds through fecal-oral route.
. . S. typhi is pr esent · Types: . . _
Mode of transnussi~n · d . g acute illness. Contamination of drinkin in the 1 _Non-bacteri:11 : It 1s ca~sed by cons~mmg p01~~nous m~~hrooms or fruits and
stools and urine of patien~ f::: frorn flies are the main reasons. g Water by t bles contaminated by high concentration of pesticrdes, fertilizers, arsenic, mercury
t 1, sewage or contarnmatiOn vegeC~eap
etc. packing materials may also result in the contamination of food with metallic
. . d . Itolies between 5--20 d ays.
Incubation per10 · poisons.
I /1 Prevention and treatlllent : . . . 2 • Bacterial .: It is caused by the ingestion of food contaminated by living bacteria or
'f' rophylactic measures include active 1mmun1sation by vac . their toxins. The bacterial food poisoning may be of the following types :
1. pec1 1c p c1nes
,I S
Vaccines available for typhoid are : · A. Salmonella food poisoning :
i) Monovalent anti-typhoid vaccine : It is an agar grown heat killed and ph
( · · · fS hi l enol (a) Causative Agent : (i) S. typhi mariurn, (ii) S. cholera-sis.
I preserved vaccine containing 1000 million o • typ per m .
(b) Mode of transmission : By eating raw or under cooked, contaminated eggs,
(ii) Bivalent Vaccine: The bivalent vaccine contains S. typhi and S. paratyphi A.
'I I meat, or milk. Symptoms appear with in 6-48 hours.
the proportion of 1000 million and 500 millon organisms respectively. m
Ii J B. Staphylococcal food poisoning:
(iii) TAB: The traditional TAB vaccine contains S.typhi (1000 million), S. paratyphi
'/h I A (500-750 million), S. paratyphi B (500-750 million) organisms per ml. (a) Causative Agent : Toxins of Staphylococus aureus. Atleast 5 entero toxins
b have been identified.
' p
,, ti (b) Mode of transmission : By consuming contaminated salads, custards, milk
DOSAGE AND MODE OF ADMINISTRATION and milk products, pastries, poultry, eggs etc. In most cases symptoms clear up
/·
I
(a) Primary Immunization : It should consist of 2 doses each of 0·5 ml of vaccine, within 24 hours. In some areas this is the most common type of food poisoning
givens/cat an interval of 4-6 weeks. Children between 1-10 years are to be and seems to arise from skin infections on the hands of those who handle
I given smaller doeses (0-25 ml). Immunity develops 10-21 days after inoculation food. Onset of symptoms is 1-8 hours.
I and the protection is maintained for atleast 3 years. (c) Botulism :
(b) Booster doses are recommended only after 3 years. (i) Caustaive Agent It is the most dangerous type of food poisoning. It is caused
 .. , .. -.-- . .... ... -

f d """"ig ,eurntodos prnducoa b . . ~-j,jiz-lWIMU

0 st
th
b ingestion ~f of its victirllS, Y C:J · • • _
,:.,....... ft "1• . ·o, . Th• o,g,o>m is wid,fy dist .b "''• d ""'"""' ,n • «g= of u,., '" ------
jl 1\ Q ..)Mode of uansIJllststf a)tlJllals and enters the food as n Utect ih '11 l!J1 causative organisms : Till date fi g~nerally prese t Q~
II • al uac o f d h . spore ·• so· . . , ve vi n. ,,. .·
,nd "" • - • P""'rred 00 ,.g. omrnnn,a '· ft O ,1. 0 t a,p,tlti• A V=• fHAV) . ft . ha,. b
°"" ,,s
I (-"""""" ol "'~:::,,,, "'"" and ,imil., I= acid ,,;::•••bf~¾;,, .,,,;., befoW 18 y,arn of age •~d : • RNA sfrus. fn ~, fum,d to Q"" 0
or pickled fish, ho at picnics, school cafeterias and 1 s. , s1no~~, cJIJlf uiniting disease. responsible for India HAV is hepatitis e.g.
i/1/ . ds to occur tr· arge . eq ,e .. , acute h . . more c
d poisoi\lilg
. . ten01 w • h e food Jllay be left unre 1gerated too soc1a1 ...
,,, _ 2· JiepatiliS
· B Virus
hi h (HBV) . It .
. . . • • DNA · epatitis mo' tiY Pdtnmon in
1on
n,,.i "' •""f \~• corulfti"'· g " '""' " ,..,,,,_. .,,th •. .• morl>,d,ty aod mort,li '""'· •• >"'1!o, . ro "°"'
'""'""
Foo
Prevention
,.,.and " contrOf •, • ~at ;b<>Ut
are 40 null,oo
capable of lnd!aM = .
transmitting th rrymf g the ft
ty. virus"°"'
wh of fu e preventable
' " ""'" Iobal health
J-
,/ I · · t" •m~u ootf,, . ...,.,
t.f.,i ,..i••"". ye"· •otoofuera wh· :;""' ""Y •pp, .
I: lI 1,1 r••"" bygi'"' '. from ;,fect,d wounds boils . ,. lkPfflti• CVim, fHCV), ft fs • RN . " ct.m 2"" u:.':"1
(i) Persons suhf~~:fe
;,fe<o,msS excluded from food handling'. d1arrhaea and lh 4, }Iepa~tis Of Virus
f <' fundiOO o HBV fra ;o (HDV) : It is
li . a defe Ati_ virus.
' " RNA · ry
'//1 c.11y wash your hands and clean dishes and utens·1<s. toa1 tl
I o,)
.. C_,~ Jie p5. n'1"' ti'li'• E v·
=• (HEV)rep
· ft catmn.
· virus and it coinf"" •o<l • ·
(ff!) 0<m't pf,ceth-'"°"" foOd t,,ck on th, s=e plat, that h,fd th P"'°"'.,.._. 15 y,,ra ofofd .;,a;:' •RNA siru, o,d ;, fruI . S"'"'
iv) Do not use food that have an unusual odour or spoiled last e raw.fr,,.,., Incubation period : From 2 w kgenerally results in mai·or ~a,tb1t is more commo .
. als b . ,. re s to 6 m h " ™"' om
II I at Inspection : The food anJJ1l mu e examined by veter· Mode of Transmission : ont s. n communities
. ( 5t mory st . .
slaughter. . aff before thef
1, HAV : It 1s transmitted through1115
,,, 2 Me
Rehfgerafum, -ptty re ,.,,re
oo whihc • ootto b, ron, · . P"'°"'' hygi= md os~wd! . =• =•
'after preparation. Refrigerator f be
. fri should d set around 4°C (40oF~ed 1mmediat"t ntilk, raw food like salads and ~gt.' ""hedtransmitted
moraf thro~gfths =tominold
spread increases by POO<
I I
3·Foods samples from restaurants,
. messes, canteens, etc. should be take f 2, HBV : Transmission of HBV akes pla hr
contaminated water. e food, water,
'""e 1· • rough ·f owmg r t
to time for laboratory analysIS.
r-wt' n rom "' Parenteral route
(i) =tamfMtOO
..) N pf~ci,g
· e th inst m ected
ce blood/serum/
ruments ough the foll contammat
. ou es:d
4
(
I/ I t. K,ep th, """t fn b,d and ~,e,othlng by -th as fong ., n such " on p=t,ral tfuoo h ·
! =• · ·sa va (kis' · ,eedfo/
persists. As the vomiting subsides, give sips of some warm drinkausea and vomitin (sexual contact). g exchange of body fluids eg Ii .
(iii) From infected mothers to their new horns. It has been recognised that the major
ri• mO<. ""'••• •mg),•meo
route of HBV transmission is percutaneous, that is why it known as serum
hepatitis.
2. In case vomiting is severe and presistent the patient
. should be shifted tol/V h
3. HCV : It is transmitted through percutaneous and non-percutaneous route (e.g.
3. Codeine phosphate and loperamide may be used to control diarr t erapr. blood transfusion, hemodialysis etc.)
• .b•'Jik
1otics e amp1'cilli'n ciprofloxacin, erythromycin etc. may be used· to contr0,, 4. HDV : Its infection is endemic among those with hepatitis B and the disease is
4Anti
infection. transmitted predominantly by non-percutaneous route.
5. HEV : It is transmitted through contaminated food and water.
V. HEPATITIS Incubation Period : It varies from 4 weeks to 6 weeks.
Clinical features :
Hepatitis is a systemic infection of the liver cells with different viruses. Hepatitis (m
jaundice) is the disease that means the necrosis of liver cells. In this disease the bile jui~ 1. Prejaundice phase : Anorexia, nausea and vomiting, fatigue, malaise, arthralgias,
prepared by the liver cells travels back into the blood and througout the body instead ~ myalgias, headache, photophobia, cough and low grade fever and sometimes pain in
going into the small intestine through the bile duct. This leads to the yellow colouration abdomen may precede the onset of jaundice by 1-2 weeks.
of the body, the eyes and the urine. The colour of the stools becomes pale yellow or whi'.1 Jaundice phase : The objective sign of the disease is presence of dark urine. Yellow
due to the absence of bile. Nausea, vomiting, Joss of appetite, flatulence, constipatioi
 .aJlil and inflammation of liver. Ii ~ ..,,,,,, Q"l, 2f,:
a1e stools o\\>e,.
•er ' p so ·il
an d P . 01 daJll · ion and life c cle · F
. 1ouration of the eyes the treatment of viral hepatitis is sympto1n" . h,1 l"jt~ode of ;;a;:;:~ch are passed in th~ st::~'.~:~~~ :i;:::i;:!~c~ _from 500~-
discot JJlSreduce. !JJlent : AS vention e.g. lie hen (JOO egg7 P•• ,arm weather) the eggs hatch to give larval form wh'1 h d_1ti~ns (e.g., m
s,rrnp o d trea pre c, 10, JdS 1n ., . Th . c w1thm a we k
r ntion an b jven a5 . ·on: fie tages infective to man. e tiny worms penetrate the b f e,
rre; stress is to e ~e of transJJ\1ss1 'th hepatitis to single room is rarel th:,hes t~ a;e fields and pass into the blood stream. Now they are c:s~~d f:e~:f those
the Illa 1 eking the rou _ of patients w1fnence for HAV and HEV or u y necess reorking Jll the air passage and then down into the small intestine and fin ; lungs
1. Bo ical isola11on f fecal inco~ _1 Band blood borne HCV. ncon1r Ii~ I" d pass up a y evelop
(a) phys . cases o hepatitlS oled an dult worm, .. , .
except 1n bleeding for h bed pans or fecal material of . into a hose living cond1hons don t mclude proper latrine facilities b
vol11Illin°11s b worn when t e Patients,.. people w gh the feet but also through the arms and legs may ecome
0
houid e . . . . ·111 d throu . ·
(b) Gloves_s A are handled. ·ral hepatitis 1s hm1ted therefore iJ!leCte ·x weeks from the time the larva penetrates the skin and the eggs a .
hepatillS,.. herapYfor vi_ e111Ph, . It takes s1 ppear m
. ation : The t . unizaoon. . . sis~ . . .
2. 111111111n1.Z . n through irnrn . afe and effective. It 1s effective f stool, . al features : Patients with hook worm disease appear pale and are often w k
event!O cine !S S Or lo crn1c
I d' , ea ,
placed on pr vriJC) : This vac . . Two doses are recommended for ng leriii ff from ringing of ears, 1zzmess, headacke and are easily fatigued. In more
(a) HAV (fla f type A hepatltlS. s of age to provide prolonged pr atdu1t ,nd TheY su ers heart is enlarged, and there may be swelling in all the tissues of body Shortness
noon o d 18 year o ecti 1 e case . h • .. ·
preve children un er .ti C on. sever th . noticeable even on s11g t exertion. Nausea and VOffilting are frequent. Mental
doses for cine for hepatI s · of brea is · 1 retarted
V . There is no vac d protection but 3 shots ov h eloprnent is a so ·
(b) HC · . Bl It gives prolonge er alf Ye,r deV . sis . It is made by finding the hook worm eggs in the stools.
( ) HBV : (EnergIX · ar, v,agno ·
c usually required. . . health care workers, dentists, male ho prevention : . . .
.n a high nsk are · rtners ll\osexu,1 ( ') Prevention of hook worm 1s best done by prov1dmg sewerage system and sanitary
A dull51 u111·1e sex pa · 1 · · df ·
. di •duals with Ill P b d t d t
m VI sures should e a op e o supp 1y safe Water 1atrlnes to av01d open a!f e ecation. .
W ter supply : Mea . chi . e The HA V can be inactiv t d • T n, (") Human wastes and excreta should not be used on the fields.
3. Sa fe a e treated WJth onn .' .a e by bolii 11
tammated water may b . f hlorine 1.e. more than 1 PPM residual hi . ni ("') Shoes should be worn by all workers.
con . a hi h concentratton o c . . .. c onne. Ill
and also with g . ecific treatment for typical V!fal hepatitis. Managem . Treatment :
Treat111ent: There is no _sp the patient comfortable and maintaning the ad/ nt1 Drugs used to treat hook worm infestation are :
.1 ortive at keep mg f d• · • h quate 1·
mam Ysupp d tr te balance. Intravenous ee ~g '.s neces_sary m t e acute st,tei (a) Mebendazole, (b) Albendazole, (c) Piperazine, (d) Pyrantel.
nutnttonal an e1ec OIY .. d annot mamtam oral mtake. . . .
t ient has persistent vom1tmg an c .. . 2 . Anaemia is mostly treated by givmg Jron tablets.
the pa e f fl 'd tntions low fat high c I · ct·
Self care measures : Rest, plenty o w s, nu ' a one iet. 3. The patient should receive well balanced diet with plenty of protiens.
c. Arthropod Borne Diseases
VI. HOOK WORM INFECTION
Hook woT!!I infection (Ancylostomiasis) : Hook worms a:e small worms and thev I. MALARIA
II attach themselves to the walls of the intestines and cause senous bleedmg and poisoi Malaria occurs throughout most of the tropical regions of the world. It is a protozoa!
the patient as well. disease transmitted by the bite of Anopheles mosquitoes. It is the most important of the
Causative organism : Human infection is caused by : parasitic diseases of human beings, affecting approximately 200 million people and
(i) Ancylostoma duodenale, (ii) Nectar americanus. causing over 1 million deaths each year. Malaria today is a major burden on tropical
Both of these worms complete life cycle in man. These are whitish in colour, thiTI communities and a danger to travellers.
worms and can be seen by naked eye. Causative organism : Four species of the genus Plasmodium infect humans. These
Males measure S-10 mm and females measure 10-13 mm in length. Transmission are:
of hookworm infection may occur in area where feces are allowed to remain in contact 1. P. vivax (It causes benign tertian malaria).
 .,, , . =pr;J'Il!Mil!Nf PiM,tlOOCS·i IU. . ,., - IS!J•wu,- r,
- ·•-~ohri~)
. d tertian malaria). ,. . .
the mil , . t transmission: Malana may be transmitted directly by ini·ections of. f .
'ble for . . which fever repeats every 72 I ,_... .,., IOil'ec 1 ma. m ected
0 ns1 [aria 1n
(, 1 (It is resP artan 111a lo.,srs I (bl Od or p as · · ·
i P. ova e auses qu . It t1 i,Jo ent·ta! .· Congenital mfechon
. of the new-born
. from an m
• fected mother m
. 1riae (It c [aria). tian malana). . coflg r but is comparatively rare. ay
a of rna . nant ter . (c ) .
3·p. 111a ilder forJJl ses rnahg ....,aJaria parasite undergoes t 0 0 ccu ,
a rn (JI cau . e . The '" wo c a1s . period : It usually vanes from 9-30 days, being shortest in p f 1 •
falciparUJJl ·al paras1t . Yclis 1.anofl . • f t' . a aparum
4.P• aJar1 IJt'II" . p rnalanae m ec 10ns.
01 est 1n · . .
·fe cycle of 111 (") tvfosquito cycle (Sexual cycle) Jong f tures : A typical attack compnses three successive stages .
Li . de), II . d . . ~Jld . jcal ea . . ·
ve!opn1ent · (Asexual cy hen an mfecte mosqmto bites a cJ1J1 id stage : This stage 1s charactenzed. by sud~en onset of fever with rigors and
de
(,.) f-lul1lan cyde ". It begins . with wh following . 4 phases. Person
(a) Co sation of extreme cold. The patient desires to be covered with blank t
I cycle . through t e a,i dsen . t lh es.
(i)Asexua. s which pass oites disappear within 60 minutes Iron, ·JJs an t for 15 mmutes o our.
injeets sporozo1te. hase: 'fhe sporo\re destroyed by phagocytes, but son,/eriPher c)ll e Jass .
1 fJliS stag t stage : The temperature nses upto 106°F. There is intense headache. This
(a) Hepabc P Many of theJ11 t they beoome hepatic schizonts Whi h reach t"
. u!anon. 1 pmen c Ulti 1,,, (b) fio from 2 to 6 hours.
circ Us p./ter deve o f merozoites. illat,1 stage Jasts ...: g stage : Fever decreases wit. h pro fuse sweating. . This stage lasts for 2-4
liver ce · shower o . . i
/I b st 10 release a of the merozo1tes are quickly dest (cl 5wea .. n
I /\hrocytic phase : ~:~[specific receptor sites on the RBCs. Th;~ed bu1, hours- .c malarial paroxysms in which fever spikes, chills and rigors occur at regular
(b) .~;ficant nu111ber attaC nd pass through the stages of troph erozoi1. . me
. gular at fi rst with
. an appropriate tachycardia.
s15,~· the RB s a 'th h lib . ozoite ,, Th e c1ass1less in number. The fever 1s
t e eration of meroz0 . s anq jJlterVa]sare nausea, vomiting · · an dd e1mum
· · • are common. Mil d anaemia and a palpable
then penetrate rythfocyb·c phase ends WI . d Ites h·
schizonts. The e d !Is The cycle 1s repeate over and over . Iv 1ch Jtle cases, f' d'
;~/!/ infect fresh red bloo . ce h~se is constant for each species of malariagain. The JJl so ther common m mgs.
1 n are o
· f erythfocybC P a Paras·1 sp ee ...: n . Preventive measures include :
durabon° ·es of malaria some erythrocytic forms do te. preven .. o · . . . .
. Jn al1speo not ct·1 . tection against mosqmto bite : Mosqmto bite can be prevented by using
(c) Garnetoga111y · d female gametocytes. These are sexual fo V1rj,
111ale an . rnis of (a) ::;ellants, protective clothin~s, bed n~ts and screening of houses.
but become . h . fective to mosqwto. th,
arasites whic are m A ti larval measures : Intermittent drymg of water contamers and using larvicides
11 .. P . e mos uito cycle begins when gametocytes are ingested b
(11) Sexual cycle · 1;1 d' qon an infected person. In the stomach of mosq . Yth, (b) ]i:e kerosene and gambusia fish. (It eats mosquito larvae).
·t when ,ee mg u1to Ill
vector mosqw O lo into microgametes and the female gametocytes develo . a1e (c) Anti adult (Mosquito) : By spraying insecticides like D.D.T., B.H.C., Dieldrin and
gametocytes deMive p etes are attracted towards the female and one of Which p Into flit etc.
macrogarnetes. crogam ul . t · t fir t . causes
I rtiliz ti n of the female gamete. The res ting zygo e is a . s motionless body b (d) Control of human reservoir : It includes chemoprophylaxis or chemotherapy.
ii ;itl,in a!;24 hours, it becomes motile. This is known as ookinete, which penetrate; th: Mass drug administration has been recommended in highly endemic areas.
I stomach wall of the mosquito and develop mto an oocyst on the outer surface of the Chloroquine 5 mg base/kg/week remains the drug of choice for prophylaxis.
stomach. The oocyst grows rapidly and produces numerou~ sporozoites. When matur Treatment : Treatment of uncomplicated malaria includes chloroquine 10 mg base/
I the oocyst bursts and Jiberates-sporozoites into the bo~y caVIty of mosquito. Many of the, kg stat followed by 5 mg base/kg at 6, 24 and 48 hours. Or 10 mg base/kg daily for three
sporozoites migrate to the salivary glands of the mosqU1to and the mosquito now beco e days. Other drugs used c~loroquine intoleranc~ case are primaquine, pyrimethamine
'I infective to man. Depending upon favourable conditions of temperature and humidmes
and sulphadoxine combination etc. to treat malana.
it takes 10-20 days for the development of parasite from gametocyte to sporozoites. J'
period is also referred to as extrinsic incubation period.
i
I
Mode of transmission : II. PLAGUE
(a) Vector transmission: M~aria is transmitted by the bite of certain species of infected Plague is primarily a zoonotic disease or zoonosis i.e. infection is transmitted to man
1/: female Anopheles mosqwtoes. The mosquito is not infective unless the sporozoites by infected rat fleas. Plague has been a recurrent scourge of man from ancient times and
are present m its salivary glands.
earned the name of the 'black death'.
'I *Delirium-A metal disn1,·
-·~--.bance of short dura1ion marked by illusions, delusions Causative organisms : The causative organism is Yersinia pestis which is a small
'1' nauucimation etc.
gram negative bacillus formerly called as Pasteurella pestis.
1: I
) I
ii
 a;) .. . The fleas feed on rats. The infected . Q
Mode of 1rans1111ss1onh. lthY rats run .away and the fleas starv rats die~
'"' " '· ' .
"" - -. - - ' . 111. FILARIASIS
Ii n,,, J,a,e •• "" W The badili whoch "' e,creted in th, I So, they d1 ··
tn • f d1.fferent nematodes of the family filariadae affect man. The ct·
beings and infect theJ!ld: ,,,.tJy through cuts or abrasions. But pn eces of fb te I\
. d "'"' ,._ le ''O ' urnbero • •
tode is calledfil anas1s. 1sease
l1
A n this nerna . . . . .
- • • • ::' "'1'1et ;,r,crion- . .
1s transnu~ Y . d . l1" ;,osi,,tion penod s, >-6 days but J.,.,. .
-o . n,c lyp, ,, O\,
0
of pf,,,, caus
ed bY
. e Agen
t : In India, lymphatic filanas1s 1s common and it is caused by tw
. b ft' ( ") B . o
Ca usati'V . ( ') Wucherena ancro 1, 11 rug1a malayi, (iii) Brugia timri. Th
In""'""' P'n° and · clinical features : There are three type mpneuni . •~ i tOdes . t f I Th 1· , e
. nerna ong. ey 1ve m the lymphatic system and
Types. or plagueJ!lic plague (iii) Pneumonic plague. s of plague n1cPl,. ..,aiJl
,,. ·'t ,worm s are s 1ender and a ew ems · ht · f fil · I · ·
. vessels. There are e1g species o ana parasite mvolvmg different·
p><" fol s,ptte•• ' f,) h 1 adlll lymphatic
1'l ; 1oonk pl"'' , n,;, a most '?mmon type of the disease ~, t,loCI< the the human body. . . .
'I ""ally "" 0
tl< - - • ~ and mocuL,te the bacilli. Th, b; Tl,• iof, Sterns of . d life cycle of filanal parasite : Adult female worms situated in
. l lyJ!lphatic
1 glands where they proliferate. Typical! cdh ar cteq • sY · s1on an b ·
t e regiona 00 . d . Y the e c •1e rran~rnis in the human host pro~uce em ~omc _(about .0.2 mm long) microfilariae
udden fever' chills, headache, dprostration
d I anh . painful
d (b lymphade nitis• u·
.. Patient dalt&ht t'I ,0 us tissues d by cu.lex mosqmtoes or biting flies dunng a blood meal (in about
h . th ·t f b evelop vafl.ch are sucke up ·
a few days greatly enlarged an ten er ymp no es ubos) d ,. Usu aUyeve1o,.Y
1 wh 1
)Micro. filan· · IarvaI stage m
ae develop to th. elf •
· the msect vector and are passed
S
oft@ ITT ., .a,, "',.,k, deJ""d,ng upon • • • o it, by the fl m th >( 0 ll...20 days · h st in which the fmal maturation to adult worms takes place. Adult
..
takes place it is considered a favourable
. sign. Bubonic plague can;a.
t s When seupgroin ,n
,~ lv- w hurnan ° .
onto a ne don't multiply m man.
mI"""'., ., b,cilli ., Jocked up m bubo, and don't find a pne,d fro
w, '""< larial worms
fi . n peno . d .• Mostly the incubation period of lymphatic filariasis is not less
fiil s,pti"'"'i' y Jncuba ti o
. f , pl"''
Th ., 1'inW1'
'd d s,pticaonk
t . . plague 1,; rare exc °' "'Y ,,_•ti ""-'nI ... e rnonths. . .
li j a oratory in ectton. ere 1s rap1 e enoration in the pati , ept fo · than 11 " e . d treatment : Preventiqn and treatment of this dISease can be done as
bubonic 0
0 s conditio: accident pre'Ventton an
/, I b ... plague JJ1ay
.
develop into septicaemic plague in cas.• enft"~ · . ·Bo •
J,,a "'""""" pSgo" Io th• p~umoak plague onset · . ""' mf, r ' , follow: .
(i)
Measure to reduce mosqmtoes :
and copious a "Mth COUgh' d' ,,, .
o,t,riorntioo • in ot) stained
ooctd,f""" (a) Eliminate breeding place, (b) Kill larvae by using larvicides, e.g. kerosene, (c)
'"'™"""' which Sto dwelop•also ""'""'
-'°"""'· ,apid this "". a,g, amou bi°
Kill adult mosquitoes by insecticides e.g. D.D.T.
(ii) Me.isures to provide personal protection : (a) wear protective clothing, (b) use
I PREVENTION AND CONTROL of insect repellants where the vector is a night biting mosquito, (c) wire-screening
I of the house, (d) use of mosquito nets. Early chemotherapy prevents later
(a) General preventive measures : . .
elephantiasis.
(i) Prophylaxis against bubonic and septicaerruc ,riague largely depends on
(iii) In endemic areas treatment of the whole population with diethyl carbamazine
I . b'tin'
preventing -·r· plague bactena.
1 g by fleas c,rnring . Rats
. should be control!eu.,
citrate (DEC), 100 mg for adults and 50 mg for children three times a day for 7
Powders containing 1.5% dieldrin or 2% aldnn applied to floors and blown days, has reduced but not eliminated the infection. Children are given such a
into rat holes kill all the fleas and remain active for 9 to 12 weeks.
course on starting and just before leaving school.
(ii) Early diagnosis, notification, isolation and dis-infection of the excretions like
1//I Note : Once the swelling appears, there is no other treatment except surgical
sputum and discharges help in prevention and control of plague.
operation to reconstruct the affected part, if possible.
(iii) Attendants must wear gowns, masks and gloves.
D. Surface Infection :
(b) Chemoprophylaxis : Contacts and others should be protected by tetracycline 2
I
gm daily and sulphonamide such as sulphadimidine 3 to 6 gm daily for a week.
(c) Vaccination : For personal protection there are two vaccines. The killed vaccine
I. RABIES (HYDROPHOBIA)
1/1
and attenuated vaccine, Killed vaccine is given in two or three doses but latter is in single Rabies is caused by Rhabdovirus which infects central nervous tissue and salivary
dose. Booster doses are required after 3 to 6 months. But both these vaccines don't protect glands.
against pneumonic plague.
Causative agent : The causative agent (Lyssa virus Type-I) is a bullet shaped
neurotropic (affinity for nervous tissue) RNA containing virus. The virus is excreted in
••Lymphadeni1is • Inflammation of lymph glands, the saliva of affected animals. e.g. dog, cat, monkey etc.
!/
 ~--- - . zoonosis. It spreads by aw·
-~ · ·•
- . . 'W
sJilission :.It is
r:~:;~~/ (brok~n skin). After introducu: t~ange Of I 'ds, direct cohn::ie~'.t~aeJJk;~~~:t!/~~;!~:;~o;;:e~f infected persons. 2. Indirect
M de of tran . r ]lei< on the brrun. e Vi 1iafl thfOUg
, When they bite o d fjnallY reaches ti" nt It is shorter in child ¾ colltact . n period : Its incubation period is about 4 to 10 days.
anuna s. the nerves an tient to pa e . ren It cubatto
passes along . d, It varies froJII pa hands 40 days and legs about 60 d dePenq 111 tion and treatment :
Incubation ~eno face about 30 days, hole the minimum time is 9 days ays, It ,1- s rreven . n of trachoma cases.
on site
. of infectionverity,.e. of wound·On the w anct aVerag<so (1") Jsolatto . . .
h ols and other institutions, careful examination
. . of every new inmate sh uld
depend k sonthese . . 'd d into two parts : e ")'~seo . fh d"
(ii u• d·' e for active signs o t e 1sease.
o
. 4to8wee ti ns.and ueatJilent : 1t1sdiv1
. e I be on and handkerchiefs of the patient should not be used by other members of
15 I
preven o h Jax1s : . . . . (iii) Towe s
(a) Pre-exposure prop y . rabies virUS m labs and those livmg m encten,· . . .
/, Persons working ~th upation (e.g., Zoo keepers, animal contr ic areas I jntain personal hygiene i.e. washing of hands and face regularly in high risk
. :MtarnilY•
1
0' and those in high nsk_ oedcc with human rabies virus. o Officers (iv) a s
:1, d be iJIIJIIU1llZ area •
i. etc.) shoul . . of pets and stray dogs. Avoid over crowding.
u1 ry vacci!lation (v)
(ii) Comp so h xis : Prompt and proper treatment can nnent :
(b) Post-exposure prop YIarsons Take following measures : Prevent Trea h ma organism is moderately sensitive both to sulphonamides and broad
·
development O ra ie5f b" in bitten pe ·
f bi"te using plenty of soap and w t (')1 Trac....,,"'
o antibiotics. .
. Full doses of sulphonarrudes, .
especially sulphathiazole or
(i) Thoroug y wash the area o a er fo r about specu ......
ul hadimidine .
for 10 days relieve the symptoms of patient
. and patient becomes
hi
five minutes. . ~o!-infective. Any broad spectrum a~tibiotic such as soframycin or terramycin
(ii) Excise the damaged tissue. . . h0 uld be used locally in the form of omtment. The treatment should be continued
(iii) Apply antiseptics like tincture iodine, dettol_ etc. I : two m.onths to achieve complete cure. Recently, penicillin is found to be
1,1 (iv) Vaccination : Inject one ml of vaccine (Rab1pur) on days 0, 3, 7, 14, 30 and e:ective controlling condition.
in
90.
Ill. TETANUS
Control of spread :
1 (i) Educate the public to increase awareness about rabies. Tetanus (Lock-Jaw) : Tetanus is a fatal infectious disease, characterized by increased
(ii) Yearly vaccination of dogs and pets. muscle tone and spasms.
1 (iii) Importation of all animals into uninfected countries should be strictly Causative organism : Tetanus is caused by toxin produced by Clostridium tetani,
1r , with isolation for six months. controlled which is a G +ve anaerobic spore bearing organism and lives in soil and in the intestines
of humans and animals.
I II. TRACHOMA (GRANULAR CONJUNCTIVITIS) Incubation period : The mediun onset after injury is 7 days however it may vary 3-
'II 14 days
Trachoma is a serious and contagious eye disease affecting the conjunctiva and the
cornea. It is more prevalent in those who live in unsanitary surroundings. Mode of transmission :
(i) Mostly tetanus occurs after an acute injury such as a puncture wound or
1, Age and environment : It is common in children. Adults are also affected. Females
lacerations and is often acquired at home either in doors or outdoors.
are more frequently affected than males. The disease is associated with dry and dusty
weather. Poorer classes of people living in over-crowded conditions are the common (ii) Tetanus may also occur after bums, frost bite, ear infection, surgery, abortion
victims. and child birth etc.
_Causative agent : Trachoma is caused by Chlamydia trachomatis which occupies Pre;vention and ,control :
1
an _nterrnediate position between virus and bacteria. The organisms are small, non- (i) ·Active immuniz/ltion : Active immunization is the best protection against tetanus.
motile, weekly gram negative obligate intracellular cells. All partially immunized and unimmunized adults should recieve vaccine. Purified
Mode of It · · I · tetanus toxoid (adsorbed) is superior·for the purpose of which two doses each of
. . ansmission : t 1s common in poor hot and dry countries having poor
sanitation and limited wate J I ' .
r supp Y· t spreads : 1. Through personal contact e.g. shaking