LEGEND: TOPIC
CPH REVIEWER – RENZO DIZON
Communicable Diseases
Human Body’s Immune System
- a system of biological structures and processes
within an organism that protects against diseases
by identifying and killing pathogens and tumor
cells.
- It detects a whole variety of agents, including
viruses and parasitic worms.
- Detection can be complicated as pathogens can
evolve rapidly and adapt.
- protects organisms from infections.
-Human infection occurs when bacteria, fungi,
parasites, or viruses enter the human body and
start to multiply.
Bacterium
- single-celled microorganisms, which can exist as
either independent (free-living) or parasitic
(dependent on another organism).
Virus
- microorganism smaller than a bacterium, which
cannot grow or reproduce apart from a living
cell.
- Invades living cells and uses them to keep itself
alive or multiply.
Parasite
- organism that lives in or on and takes its
nourishment from another organism
- Parasitic diseases include infections by
protozoa, helminths, and arthropods.
Factors affecting risk of infections:
- age
-heredity
-level of stress
-nutritional status
Current medical therapy
-pre-existing disease
-immunization status
STAGES OF AN INFECTIOUS PROCESS:
I. Incubation Period
- the silent stage and ends when the first signs
and symptoms of disease appear.
II. Prodromal Period
- first onset signs and symptoms occur (malaise,
runny nose, etc.)
III. Illness period/Acute Stage (Pathognomonic
Sign)
-the disease reaches its highest point
IV. Declining Period
-Symptoms starts to subside
V. Convalescence Period
-Symptoms vanished, pathogen eliminated
KEYWORD
-not sick or contagious
Controlling Spread of Infectiion:
The Reactive Approach
Diagnosis is importance – establish the
occurrence of disease based on signs and
symptoms.
- Presumptive vs. Definitive
-Use of physical exam, lab tests
-Case definition
-start treatment of sick person immediately
according to protocol.
(Early Diagnosis and Prompt Treatment)
Identify the source of infection – where did the
sick person get the infection?
Identify the mode of transmission – how did the
sick person get infected?
Controlling the Spread of infections:
Proactive Approach
Identify Risk Groups – people who are
susceptible to acquire communicable diseases
Identify risk -is the community at risk of exposure
to various communicable diseases?
Preventive measures to address:
1. Identified reservoir of infectious diseases
2. Community’s defense against infection
(Herd Immunity, Barriers on routes of
transmission)
3. Screening of presumed healthy population
Communicable Diseases:
Pathognomonic: a sign or symptom that is so
characteristic of disease and can be used to make
a diagnosis.
_______________________________________
Pulmonary Tuberculosis
Causative Agent: Mycobacterium Tuberculosis
Reservoir: humans
Definition: Chronic Infection of lungs
- chronic coughing for two weeks
-weight loss, night sweats, unexplained fever
-blood-stained sputum
Period of communicability:
It depends on the number of bacilli discharges,
the virulence of bacilli, ventilation, exposure to
the sun or UV light, and opportunities for
aerosolization by coughing, sneezing, talking, or
sneezing.
Latent TB infection:
-Person infected with TB bacteria
-bacteria kept dormant in persons immune
system
-10% develop TB disease over life time
-infection detected by TB skin test
TB SKIN TEST (PPD – Purified
Protein Derivative)
Active TB Disease
-Usually involves lung infection
-cough > 3 weeks, fever, weight loss, night sweats
-treatable with antibiotics
-contagious until appropriately treated
Preventing Spread of TB
-Patients with TB should delay court appearance
until appropriate duration of therapy.
-Patients with TB are no longer contagious after
2-3 weeks of appropriate therapy (should be
cleared by doctor).
TB other name: Koch’s Pulmonary
MOT: Airborne droplet
-Direct invasion through mucus
-breaks in skin (rare)
Period of communicability: as long as viable
bacteria are discharged from sputum
Signs/Symptoms (S/S) – early weight loss,
listlessness, vague chest pain, pleurisy anorexia,
fever, night sweats
Prevention- BCG & health education
Diagnosis (Dx): PPD (Purified Protein Derivative)
Tuberculin exposure
-chest x-ray cavitary lesion
-sputum-confirmatory
Management: MDT
r-orange urine (rifampicin)
i-neuritis and hepatitis (Isoniazid)
p-hyperuricemia (Pyrazinamide)
e-impairment of vision (Ethambutol)
s-8th cranial nerve damage (Streptomycin)
DOTS (Direct Observed Treatment Short Course) -
to detect and cure TB patients.
LEPROSY
CA: Mycobacterium Leprae, Hansen's Bacillus
MOT: prolonged skin-skin contact (common) and
droplets
IP = years to decades
Chronic disease of the skin and peripheral nerves
S/S EARLY
1. change in skin color (either reddish or white)
2. loss of sensation on the skin lesion
3. decrease or loss of sweating and hair growth
on skin lesion
4. thickened and/or painful nerves
5. pain and redness in the eyes
6. nasal obstruction or bleeding
 LEGEND: TOPIC KEYWORD

LATE S/S: quartan-febrile paroxysm: q48H-72H Dx:

1. Lagopthalmos: -inability to close the eyelids ACUTE FEBRILE ILLNESS WITH NO IDENTIFIABLE
completely MOT: Bite from infected anopheles mosquito FOCUS OF INFECTION
2. Madarosis: absence or loss of Blood Transfusion Internal and external sign of bleeding
eyelashes/eyebrows IP (Incubation Period) 5-6 days Torniquet Test or Rumpel Lead Test
3. Clawing of fingers and toes Dx: blood extraction (extract blood at the height Platelet count
4. contractures - permanent shortening of of fever) PT (Prothrombin Time)
muscle or joint Manifestations: APTT (Activated Partial Thromboplastin Time)
5. Saddle nose- sinking of the nosebridge Fever, chills, profuse sweating-convulsion Bleeding time
6. gynecomastia -enlargement of breast in males Anemia, fluid and electrolyte imbalance, Coagulation time
7. Chronic ulcers hepatomegaly, splenomegaly, rigor, headache,
DX: Lepromin Test - ID injection and diarrhea. Notes:
Slit Skin Smear Blackwater Fever - hemolysis and -any condition associated with bleeding is
Prevention: hemoglobinuria enough cause for alarm
-avoid MOT Management: -for fever don't give asa
-BCG vaccination, good personal hygiene, Chloroquine and Primaquine drug of choice -rapid replacements of fluids is the most
adequate nutrition, Health Education Chloroquine for pregnant women important treatment
Management: For resistant plasmodium-use chemo drug -give oresol/hydrite
Multidrug therapy (MDT- two or more drugs -vit c to promote capillary integrity
RA 4073 (home meds) NOTES: -blood transfusion
-Paucibacillary (Tuberculoid and indeterminate) -travelers to malaria endemic area should follow -iv crystalloids (plain lrs, plain 0.9 nss)
Dapsone/ Rifampicin preventive measures (chemoprophylaxis -dextran (colloids)
Non-infectious types -chloroquine may be taken 1 week before -platelets
Duration of tx: 6-9 months entering endemic area) -fresh frozen plasma
-Multibacilary (Lepromatous and borderline) -soaking of mosquito net in an insecticide -cryoprecipitate
Dapsone/ Rifampicin/Clofazimine solution -whole blood
Infectious types -bio ponds for fish -no known immunization (vaccine currently
-Duration of tx: 24–30 months -on stream clearing (to expose the breeding underway)
stream to sunlight)
-vectors peak biting at night 9pm-3am MEASLES
CHICKEN POX -planting of neem tree (repellent effect) AKA: 7 Day Fever, Hard Red Measle
AKA: Varicella -zooprophylaxis (deviate mosquito bites from CA: Rubeola virus
CA: Herpes Zoster Virus; Varicella Zoster Virus man to animals) MOT = droplets and airborne
MOT: direct contact, Droplet spread -infected mother can continue breast feeding PC 4 days before and 5 days after rash
IP: 2-3 weeks commonly 14-21 days HIGHLY CONTAGIOUS
Period of communicability: one day IP 7-14 days
before rash and 6 days after first crop of vesicles Rashes: maculopapular, cephalocaudal (hairline
and behind the ears to trunk and limbs),
HIGHLY CONTAGIOUS desquamation, pruritus
-An acute infectious disease of sudden onset PS koplik's spot
with slight fever, mild constitutional Characteristic: photophobia (typical complaint)
symptoms and eruption, which are maculo- Fever: high fever
papular for a few hours, vesicular for 3-4 days
and leaves granular scabs. GERMAN MEASLES
- Lesions are more on covered than on exposed AKA: Rotheln Disease, 3 Day Measles
parts of the body and may appear on scalp and CA: Rubella
mucous membrane of URT Rashes: Maculopapular, Diffuse/not confluent,
No desquamation, spreads from the face
Susceptibility/Resistance/ Occurrence DENGUE FEVER downwards
-Universal among those not previously -mosquito-borne infection that causes a severe PS forschheimer's
attacked, severe in adults flu-like illness, and sometimes a potentially lethal Characteristic: cervical lymphadenopathy
-second attacks : rare, 70% have the disease by complication called dengue called dengue Fever: low grade fever
the time they are 15 y/o hemorrhagic fever. CX rare; CX to pregnant women:
Rashes: Maculopapulovesicular (covered areas), -about two fifths of the world’s population are Ist tri-congenital anomalies
Centrifugal, starts on face and trunk now at risk. 2nd tri-abortion
and spreads to entire body 3rd tri-pre mature delivery
Leaves a pitted scar (pockmark) AKA H-Fever, Dandy Fever, Breakbone Disease
DX: Tzanck smear (scraping of ulcer for staining) Acute Febrile Disease
DIPHTHERIA
CA: DENGUE VIRUS TYPE 1,2,3,4, and
CA; Corynebacterium diphtheriae
MALARIA Chikungunya virus
Klebsloeffler's bacillus (bacteria)
King of Tropical Diseases MOT: Bite of Aedes aegypti, Aedes albopictus
MOT = droplets and airborne
CA: Protozoan plasmodium Culex fatigans (day biting, stagnant water)
HIGHLY CONTAGIOUS
plasmodium ovale - dormant (liver) IP (Incubation Period) 1 week
IP 2-5 days
plasmodium vivax - benign S/S
Dx: throat swab, (Schick test - susceptibility to
plasmodium malariae - mild but resistant Hyperpyrexia without focal of infection
diphtheria toxin & Moloney - sensitivity to
plasmodium falciparum - malignant (cerebral TRIAD: fever, rashes and muscle pain (myalgia)
diphtheria toxoid)
malaria) Bleeding to hypovolemic shock
S/sx:
P.VIVAX AND OVALE MAY HAVE RECCURENCE ASA (Aspirin) is contraindicated
sore throat, fever, "Bull-neck"
OF SYMPTOMS Watchout for bleeding
(Pseudomembrane-gray exudate, foul breath,
tertian-febrile paroxysm: q24H-48H PLATELET is being attacked
massive swelling of tonsils and uvula, thick
speech, cervical lymphadenopathy, swelling of
submandibular and anterior neck)
obstruction of respiratory tract
Resp Acidosis with hypoxemia
Management: Diphtheria antitoxin (Skin test),
Penicillin, erythromycin, rifampicin, clindamycin

Notes:
-observe cns, cardiac and kidney complications
-pseudomembranous may lead to resp.
obstruction
-isolation until 2 negative culture at 24 hour
interval
-f&e resuscitation
-parents or siblings who have never immunized
should receive a dose of diph.anti-toxin
-attention to nasopharyngeal discharge
-antibiotics-penicillin, erythromycin if allergic to
penicillin

MUMPS
CA: Mumps virus/filtrable virus
AKA: Parotitis
MOT = droplets and airborne (secretion of the
mouth and nose)
HIGHLY CONTAGIOUS
IP 12-16 days
Unilateral or bilateral parotitis
-ice collar
Stimulating foods cause severe pain
Bilateral orchitis and oophoritis
-Active spermatogenesis
-Sterility
Steroids
Supporter