List of Infectious diseases covered by EPI

(Expanded program of immunization

What is EPI?
The Expanded Programme on Immunization (EPI)isadiseasepreventionactivityaimingat
reducingillness,disabilityandmortalityfromchildhooddiseasespreventablebyimmunization.These
diseasesarereferredas9EPItargetdiseasesandcausemillionsofailments,disabilities&deathseachyear.
1) Poliomyelitis
2) NeonatalTetanus
3) Measles
4) Diphtheria
5) Pertussis(WhoopingCough)
6) Hepatitis-B
7) Pneumonia
8) Meningitis
9) Tuberculosis

Disease

Tuberculosis
Primary
Complex is
lessthan3years
old
-anychildwho
does
notreturnto
normal
healthafter
measlesor
whoopingcough.
Mosthazardous
period:first6-12
monthsafter
infection
Highestinriskof
developing:under
3
yearsold

Causative agent

Mycobacterium
Tuberculosis

Mode of
transmission

Clinical
manifestation

Diagnostic
exam

Treatment

DropletInfection
(inhalationof
bacilli
frompatientwho
coughsandsneeze)
Degree of
Communicability
Depends upon:
- num.ofbacilli
-virulenceofbacilli
-environmental

Generalweakness
Lossofweight,cough
andwheezewhich
doesnotrespondto
antibiotictherapy.

SputumExam
3sampleare
taken
with24hrs:
-spotsample(1st
visit)
-earlymorning
specimen
-spotsample
(2ndvisit)
Note: at least 2
sample are
positive

DOTS
-patientis
required
totaketheAntTb
drugsinthe
presenceofa
health
careproviderto
ensure
compliance
totreatment
regimen
Anti-TB drugs:

Feverandnightsweat
Abdominalswelling
withahardpainless
massandfreefluid
Hemoptysisandchest
painPainfulfirmor
softswellingina
groupof
superficiallymph
nodes.

Disease

Causative agent

Mode of
transmission

Clinical manifestation

Diphteria:

Nasal

itisan
acutepharyngitis,
acute
nasopharyngitis
oracutelaryngitis
with
Pseudo
membrane
grayishwhitein
color
withleathery
consistencyinthe
throatandonthe
tonsil

1. drynessoftheupper
lip
2. Serosanguinous
3. secretioninthenose

Corynebacterium
diphtheriae

Respiratory
dropletsand
secretions.

Pharyngeal
4. Bullneck
appearancebecauseof
theenlargecervical
lymphnodes.
Laryngeal
5. sorethroat
6. Hoarseness
7. brassymetalliccough

Diagnostic
exam

chicks Test
-testforthe
susceptibilityto
Diptheria
Moloney Test
-for
hypersensitivity
to
Diptheriatoxin

Treatment

Antibiotics
Pen G
Potassium
Erythromycin

Disease

Pertussis:
-Pertussis,also
knownas"whooping
cough,"isahighly
contagious,acute
respiratoryillness
characterizedbyfitsof
coughingandcaused
bythebacteria
Bordetellapertussis.

Causative
agent

Mode of
transmission

Clinical
manifestation

Diagnostic
exam

Bordetella
Pertussis

Airbornedroplet
Primarilybydirect
contactwithhe
dischargefrom
respiratorymucous
membranesof
infectedperson

Atfirst,theinfected
childmayhavea
commoncoldwith
runnynose,sneezing
andmildcough
Intermittentepisode
ofparoxysmal
cough
followedbya whoop
ending vomiting

BordetGengou
Agar Plate
-usedfor
culture
medium

Treatment

Erythromycin
Ampicillin
-isgiven5-7days

Disease

Causative agent

Poliomyelitis 3TypesofPolio
Infantile
Paralysis
aninfectious
viraldiseasethat
affectsthe
centralnervous
systemandcan
causetemporary
orpermanent
paralysis.

Virus

1. Type I
Brunhilde
2. Type II
Lansing
3. Type III
Leon

Mode of
transmission

1. Fecal-oralroute
2. Oralroute
through
pharyngeal
secretion
3. Contactwith
infectedperson

Clinical manifestation

Diagnostic
exam

Abortive - didnot
progresstosystemic
infection
Non-paralytic slight
involvementoftheCNS
Poker spine or
stiffnessofthespinal
column
Spasms of the
hamstring
With paresis

1. Once
Throat swab
thevirusthat
causespoliohas
Stool exam
infectedaperson,
thereisno
Lumbar
treatmentthatwill
exam
curepolio.
2. Earlydiagnosisand
supportive
treatmentssuchas
bedrest,pain
control,good
nutrition,and
physicaltherapyto
preventdeformities
fromoccurring
overtimecanhelp
reducethelongtermsymptoms
duetomuscleloss.

Paralytic severe
involvementofCNS
Kernigs sign
Brudzinski sign

Treatment

Disease

Causative
agent

Hepatitis B
-itisliver
infection
causedbythe
Btypeof
Hepa B
hep.virus.
Virus
Itattacks
liversthe
liveroften
resultingin
inflammation

Mode of
transmission

3Ps

Clinical
manifestation

Prodromal/preicteric

Persontoperson
Parenteral
Placental

Weightloss
Anorexia
RUQpain
Malaise
Icteric
Jaundice
Acholicstool
bile-coloredurine

Diagnostic
exam

Treatment

Antiviralmedications.Several
antiviralmedicationsincluding:

Liver
Function
Test

1.
2.
3.
4.

lamivudine(Epivir),
adefovir(Hepsera),
telbivudine(Tyzeka)
andentecavir(Baraclude)

canhelpfightthevirusand
slowitsabilitytodamage
yourliver.

Disease

Causative agent

Mode of
transmission

Clinical manifestation

Measles:
Anacute
infectious
disease
occurring
mostlyin
children,
characterized
bycatarrhal
andfebrile
symptomsand
aneruptionof
smallredspots

Dropletbornroute
oftransmission.
Paramyxo Virus

1. 3 Cs
Conjunctivitis
Coryza
Cough
2. Kopliks spot bluish
grayspotonthebuccal
mucosa.
3. Generalized blotch
rash

Diagnostic
exam

Treatment

Measlesare
examineby
skinrashand
checkingfor
symptomsthat
are
characteristic
ofthedisease,
suchaswhite
spotsinthe
mouth,fever,
cough,and
sorethroat.

Thereisno
prescription
medicationtotreat
measles.
Thevirusand
symptomstypically
disappearwithin
twotothreeweeks.
However,doctor
may
recommend:aceta
minophento
relievefeverand
muscleaches.

Disease

Causative agent

Mode of transmission

Clinical manifestation

Mumps

Other name:
EpidemicParotitis
Mumpsisarelativelym
ildshortterm
viralinfectionofthe
salivaryglandsthat
usuallyoccursduring
childhood.
Typically,mumpsis
characterizedbya
painfulswellingofboth
cheekareas,although
thepersoncouldhave
swellingononeside
ornoperceivable
swellingatall.

Mumpsvirus,a
member
offamily
Paramyxoviridae

Directcontact
Source of infection:
Secretionsofmouthand
nose
Incubation Period:
12to26days,usually
18days

1. Painfulswellingin
frontoftheear,angle
ofthejawsanddown
theneck
2. Fever
3. Malaise
4. Lossofappetite
5. Swellingofoneor
bothtesticles(orchitis)
insomeboys

Management and
treatment

Supportiveandsymptomatic
Sedativestorelievepain
fromorchitis
Cortisonefor
inflammation
Diet:Softorliquidas
tolerated
Supportthescrotumto
avoidorchitis,edema,
andatrophy
Darkglassesfor
photophobia

Disease

Causative
agent

Pneumonia

Bacteria:
Pneumococcus
streptococcus
pneumoniae,
staphylococcus
aureus,
Klebsiella
pneumonia

Itisdefinedas
lung
inflammation
causedby
bacterialor
viralinfection,
inwhichtheair
sacsfillwith
pusandmay
becomesolid.
Inflammation
mayaffectboth
lungs

Virus:
Haemophilus
influenzae
Fungi:
Pneumonocystis
carinii
pneumonia

Mode of
transmission

Droplet
Incubation
Period:
23days

Clinical
manifestation

Rusty sputum
Feverandchills
Chestpain
Chestindrawing
Rhinitis/commoncold
Productivecough
Fastrespiration
Vomitingattimes
Convulsionsmayoccur
Flushedface
Dilatedpupils
Highlycoloredurine
withreducedchlorides
andincreasedurates

Diagnostic exam

Treatment

Basedonsignsand
symptoms
Dullpercussionon
affectedlung
Sputumexamination
confirmatory
Chestx-ray

1. Bedrest
2. Adequatesalt,fluid,
calorie,andvitamin
intake
3. Tepidspongebath
forfever
4. Oxygeninhalation
5. Suctioning
Expectorants/
mucolytics
Bronchodilators
Oral/IVfluids
CPT

Disease

Meningitis
Other name:
Cerebrospinal
fever

Causative
agent

Meningococcus
Neisseria
meningitides

Mode of
transmission

Direct
(Droplet)
Incubation
Period:
2-10days

Clinical
manifestation

Diagnostic exam

Treatment

A.SuddenOnset
-highfever
accompanied
bychills
-sorethroat,headache,
prostration(collapse)
B.entranceintothe
bloodstreamleadingto
septicemia
(meningococcemia)
a.rash,petchiae,
purpura
C.Symptomsof
menigeal
irritation
-nuchal rigidity (stiff
neck)earliestsign
-Kernigs sign when
kneesareflexed,it
cannot
beextended

1. Lumbarpunctureor
Lumbartap-reveals
CSF
2. WBCandprotein,
lowglucose;
contraindicated
forincreasedICPfor
dangerofcranial
herniation
3. Hemocultureto
ruleout
meningococcemia

1. Osmoticdiuretic
(Mannitol)to
reduceICPand
relievecerebral
edema;Alert:
fastdriptoprevent
2. Crystallization
3. Anti-inflammatory
(Dexamethasone)
torelieve
cerebraledema
4. Antimicrobial
(Penicillin)
5. Anticonvulsany
(Diazepam/
Valium)

Disease

Neonatal Tetanus
Itisaformoftetanus
thatoccursin
newborns.Infantswho
havenotacquired
passiveimmunityfrom
themotherhaving
beenimmunisedareat
risk.
Itusuallyoccurs
throughinfectionof
theunhealedumbilical
stump,particularly
whenthestumpiscut
withanon-sterile
instrument.

Causative
agent

Clostridium
Tetani
-which
producesthe
exotoxins:
1. Tetanolysin
2. Tetanospas
min

Mode of
transmission

Clinical
manifestation
Assess the NEWBORN
for a history of all 3
of the following:

1. Unhygienic
cutting
ofumbilicalcord
1. Normal suck and
2. Improper
cry for the first 2
handling
days of life
ofcordstumpesp. 2. Onset of illness
Whentreated
between 3 and 28
with
days
contaminated
3. Inability to suck
substance
followed by
stiffness
of the body and
convulsion

Diagnostic
exam

Treatment

1. Blood
2. Culture
CSF
analysis

1. Penicillin
2. Erythromycin
3. Tetracycline
-administered
within
4hoursofinjury

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