INTRODUCTION OF

MICROPARASITORY
COMMUNICABLE DISEASE NURSING

I. REVIEW OF TERMS:
1. COMMUNICABLE DISEASE NURSING:
Refers to the comprehensive nursing are
given to a patient with a communicable
disease.
2. EPIDEMIOLOGY:The science that studies the
patterns of health and disease, its occurence
and distribution for the prevention and control
of diseases.
PATTERNS AND DiSEASE OCCURENCE:

a. SPORADIC: On and off, occasional occurrence of a

disease."sporadic fighting broke out”.
b. ENDEMIC: Continuous or constant occurrence such as
the case as the malaria, which is always present in the
Philippine community.
c. EPIDEMIC:Sudden increase in the number of cases in
the short period of time.
d. EXAMPLE; the rise of dengue, the incidence of
meninggococcemia(baguio)
d.PANDEMIC: world wide epidemic.
EXAMPLE; HIV cases worldwide and the SARS
incident (2014).
3. COMMUNICABLE DESEASE: Disease caused by an
infectious agent which is acquired from an infected.
-individual and transmitted to a susceptible host, either by
direct on indirect contact through direct inoculation into a
broken skin.
examples of diseases:
-enterovirus,ebole,flu, hepatitis A,hepatitis B,
HIV/AIDS, measles, pertusis, sexually
transmitted,tuberculosis,Zika
CLASSIFICATIONS OF COMMUNICABLE DISEASES:

a. INFECTIOUS: a disease which is not easily transmitted

from one person to another.
example; malaria,dengue, tetanus
b. CONTAGIOUS: a disease which can be easily
transmitted from one person to another.
maybe either high or not highly contagious.
examples; 1. by droplet/ direct contact; tuberculosis
2. through sex; HIV, gonorrhea
*ALL COMMUNICABLE DESEASE ARE INFECTIOUS BUT NOT ALL ARE CONTAGIOUS*
d. TRIAD OF DISEASE CAUSATION/ECOLOGIC OR
EPIDEMIOLOGIC TRIAD: all three factors effect the
occurence of a desease ad a communicable disease
will exist every time there's and imbalance of the three
factors.
a. AGENT: Maybe virus bacteria or fungi, its mere
presence only denotes contamination:
1. INFECTABILITY: ability to enter into the hostbody and
move into the tissues of the body.
2. INFECTIVE DOSE: The number of causative organism
present .
3. PHATOGENICITY:ability to cause a disease.
4. ANTIGENICITY: ability to stimulate an antibody
response.
b. ENVIRONMENT:aids in the spread of communicable
desease bec.
1. It provides for a medium for culture or multiplication and
survival og the microarganism.
ex, Ascaris thrives i a moist, humid and dark
environment.
2.Its provide a mode of transmitting and spreading of
causative organism.
c.HOST: A host could either be;
1.RESISTANT: Immune to the pathognic effect of a
causative agent.
2.SUSCEPTABLE: Maybe influenced by the host's
intrinsic and extrinsic characteristics:
extrimes of age:
1. the very young infants are very susceptible because
of their non-fully developed immune system.
2. The very old because they maybe compramised
already with disease or olds ages.
b. SEX: some disease are gender related as as the case of
leprosy which is more common in males( females are more
meticulous with hygiene).
c. DIET/NUTRITION: Poorly nourished people are normaly
less resistant to disease and are infact predisposed to
illnesses.
d. SKIN:an intavt skin is our first line of defense to any
infection.
e. IMMUNE SYSTEM: strong immune system is the BEST
defense to disease.

5.CHAIN OF TRANSMISSION/INFECTIOUS CYCLE:

a.Causative agent:
1. Might be the causative agent itself,or
2. The toxins are produced by these causative agents as their waste
products;
a. ENDOXINS: The toxins are produced inside the body of the
causative agent when they are either dead or disintegrating.
 ex. Typhoid fever psychosis sometimes result
from a succesful treatment of salmonella.
LEPRA REACTION: sometimes result
treatment of lepros.
b. EXTOXINS: The toxins are produced outside the cell
and released by the causative agent while alive.
ex: TETANUS SPASMIN: Produced by
clostridium tetani.
B.RESERVOIR/SOURCE OF INFECTION: The environment, area or
body were the organism can be found and dependent for
survival.
 1.HUMAN RESERVOIRS:
a. Frank case:people eho are infected by the disease it self.
(least dangerous bec they manifest the signs and symtoms)
b.sub-clinically infected: individual which someone signs
ans symptoms but the symotom are mild or slight that they do not bother
the individual.
(lessdangerous)
c.carriers: an individual who is harboring the organism but is
not manifesting the symptoms of the disease. these are apperently
healthy individuals.
(they post the most danger for transmission)
 2.ANIMALS:
a.dogs and cats: rabies
b.rats: leptospirosis. bubonic plaque
c.cow: anthrax< mad cow disease
d.fowls (chicken, birds):avian flu
e.pig: foot and mouth disease
C.portal of exit( from reservoir) usually the causative
organisnm will escape in an opening nearest its breeding place.
1. respiratory truct: through exhalation, coughing or sneezing
2. gastrointestinal tract: through vomiting or defecating (ex :ascaris)
3. wounds/lessions: through which inflammatory exudates come
out (boils, scabies)
4. genito urinary: when voiding or sexual intercourse.
5. mechanical:
a. incision/drainage
b. needle aspiration: as in hipatitis B
c. bites/stings of insects: dengue, malaria

D.MODE OF TRANSMISSION: cutting the chain of transmision

is the best done by interfering in the mode of trans mission.
1.contact transmission:can be direct or indirect
a. DIRECT CONTACT:
a) Direct :skin to skin
b) lips to lips
c) genitalia to genitalia
b. IN DIRECT CONTACT: as in the cases of sore eyes and head lice
contamination .
2.DROPLET: contact with droplet nuclei containing causatyive
organism within the talking, sneezing and coughing
distance og the infected individual.
Within 3ft/ 1m-distance from the infected individual.
3.AIRBORNE CONTACT: Contact with droplet new nuclei
containing the causative organism that has remained
suspended in the air brought to you by air current.
4.VEHICLES OF TRANSIMISSION:
4.a . Intermediary means of transmitting the causative
borganism to man. matters through which the causative
organism can remain alive for a period of time outside of the
body.
 Ex. Body secrations: blood and seme; HIV virus are said
to live for 3-4 hours in blood outside man's body.
5.VECTORS: Insects,rodents and animals that are living in
human habitat and that can transmit disease to man.
6.FOMITES

E.PORTAL OF ENTRY: Corresponds with the portal

exit.( Causative agents usually use the same opening
(portal of exit) when they enter a host body).
1.Respiratory syste: through inhalation
2.Gastrointestinal rest: through ingestion
 3.Genitourinary system: Sex
4.Skin: Through tattoos,ear/ body piercing and needle

prick.
5.Blood entry: Vertical entry: from the mother to the fetus
in utero such as in placental transfer in cases of
measles, HIV syphilis and hepatitis B.

F. SUSCEPTIBLE HOST: Pls see earlier notes on p.1

6.IMMUNIZATION: The process of rendering an individual

resistant to a specific disease.
• ANTIGEN: Protein substances that will stimulate antibody
production when introduced into the body. Examples are vaccines
toxoids.

• ANTIBODY: An immunoglobulin produced by

lymphocytes in response to bacteria, viruses and other
antigenic substances.

Immunity: The power or ability to resist a specific

disease.
Types of Immunity;
1.Natural Immunity: Innate, inherent and inborn to the
individual.
2.Acquired Immunity: Developed throughout the individual's
lifetime.
Types of Acquired Immunity;
• Natural:
a. Natural Active: Developed to through exposure and
having experienced the disease yourself, effect os longterm,
even for life.
Ex. You will have lifetime immunity to measles and chicken
pox after contacting these diseases.
 B.Natural Passive: Immunity developed after receiving maternal
antibodies through placental transmission (IgH) or through
breastfeeding (IgH); affects are short term only.
Ex. Maternal immunity for tetanus is passed by the mother to the
fetus.
• Artificial
a. Artificial Active: Immunity developed through
introduction of antigens that will stimulate the body produce
antibodies againts them.
b.. Artificial Passive: Developed through are intoduction of
antibodies that comes from the other sources such as human
serum (immunoglobulins) or from animals (antisera or
antitoxins); effect is short term. “Performed antibodies are
introduced into the body in the forms of;
1.Live attenuated (Weakend) antigens: BCG, measles, OPV, MMR
2.Killed antigens: The pertussis portion of DPT vaccine, Typhoid
vaccine, and hepab vaccine (antigens should be killed bec they are
so potent-100x more than HIV virus).

Toxoid: weakend/ attenueated toxins:

-TT1 for adult and pregnant woman
-DpT the D and T portions of DPT vaccines for infants
-DiTe for older children with with no DPT vaccinations.
*Ig's: TIG: Tetanus immunoglobulin
HRIG: Human Rabies Immunoglobulins
HAIG:Hepatitis A Immunoglobulins
ATS: Anti-tetanus serum
ARS:Anti-rabies serum
ADS:Anti-Diphtheria serum
example:
dog bites:
vaccines given: a.Active: for long term protection
1.Lyssavac
2.Imovax: this two antigens
effective up to three years
2.Passive:to give immidiate protection.
1.ARS
2.HGIG
7. STAGES OF DISEASES:
1. INCUBATION: The time interval from the first exposure (to
the disease) to the appearance of the first signs and symptoms
of the disease.
2. PRODROMAL STAGE: The time from the appearance of
the first signs and symptoms of the disease of the
appearance of the characteristics symptoms of the disease
.
3. STAGE OF ILLNESS: Period when the characteristics symptoms
of tghe disease are manifested by the patient and observed by
others.
 4. CONVALESCENCE: The period of revovery: when the signs
and symptoms are gradually disappearing.

8.PREVENTION ADN CONTROL OF COMMUNICABL DISEASE:

A.PREVENTION: is given to a people who are healthy and those who
are at risk.
THREE LEVEL OF PREVENTION:
I.Primary level: Health promotion through health education
which includes yhe fallowing
1. HEALTH TEACHING:
a. Bedside haelth teaching
b. community assemblies
c. use of tri-media
 2.GIVING SPECIFIC PROTECTION:
2.a. Such as the EPI for those below 8 y/o.
a. Tuberculosis e.Hepatitis B
b. Tetanus f. Diphtheria
c. Polio g. Pertusis
d. Measeles

3.ENVIRONMENT SANITATION:
PD 956 : Code of satitions provides for the control of all
factors of man's environment that affect health including the quality
of water, food, milk, control of insects, animal carriers, transmitters
of disease, sanitary and creation facilities,nise, pollution, unpleasant
odors and control of nuisance.
PD 825: ANTI LITTERING LAW: Provides penalty for the improper
disposal of garbage: citizens arrest maybe done.
Also includes the monitoring of commercial sex workers:
1. VD clearance for gonorrhea: every two weeks (incubation is
2-5/7 days)
2.VD clearance for syphilis : every 4-6 weeks (incubationis 10-
90 days;average is 21 days or 3 weeks)
II. SECONDARY LEVEL: is given to those:
1. who are early sick
2.who had been exposed or in contact wth an infected
individual.
*THE FOLLOWING ARE NECESSARY UNDERTAKINGS:
a. Case finding is done
b. Screening
c. Early diagnosis is rendered
d. Early treatment id given
e. Prophylaxis is done (most commonly given is
rifampicin/ cipro for 5 days)

III. Tertiary Level : rendered to those who had recovered

from disease but have some
complications for :
1. Rehabilitation and
2. Limitation of disability
B.CONTROL: the following measures are done :
1. Notifying /reporting of health incidents :
Bgy captain  RHU : to conduct
2. Epidemiological investigation : observe, collect specimen for
laboratory analysis.
3. Respiratory isolation : done in the presence of respiratory
diseases w/c are not highly contagious : to prevent the spread of
microorganisms by droplet
4. Isolation / Quarantine :
a. Isolation : separation of the infected person based on the longest
period of communicability of the disease by :
 1. Strict isolation : those with highly contagious
diseases such as diphtheria where
strict adherence to proper asepsis should
bedone.
a. Move said patient away from the main wards.
b. Use of personal protective equipments (PPE’s) by
the health team such as masks, gloves,goggles etc.
2. Reverse isolation : done by those are immunocompromised
like those afflicted by leukemia, AIDS, burn
patients and those undergoing
chemotherapy : they have to protect themselves bec
of weakened immune system.
.
3. Respiratory isolation : done in the presence of
respiratorydiseases w/c are not
highly contagious : to prevent the spread of
microorganisms by droplet.
.4. Enteric isolation : those with diseases affecting the GIT
like those with typhoid fever,
dysentery : to prevent spread of diseases by
vomitus/ feces.
5. Wound isolation : those with diseases characterized by
wounds or lesions through which
inflammatory exudates are coming out such as in
scabiesthose with diseases characterized by
wounds or lesions through which inflammatory
exudates are coming out such as in
scabies.
6. Blood an secretions : universal precaution or standard
precaution is done.
 b. Quarantine : limitation of freedom of movement of
exposed animals, persons/individuals in
contact with an infected person based on the
longest incubation period of the disease.
5. Disinfection / Disinfestations :
Disinfection : destruction of pathogenic organisms
excluding spores
Sterilization : destruction of pathogenic organisms
including spores.
Two ways to kill pathogenic organisms :
1. Mechanical :
a. by boiling
b. by burning
c. by autoclaving : kills all kinds of infectious
pathogens.
2. Chemical :
a. Antiseptics : used on human beings to
inhibit the growth of pathogenic organisms
*Ex. : betadine, alcohol and Lactacyd
b. Disinfection : used on inanimate objects such
as bed pans, linens etc to kill pathogenic organisms. *
Ex. : Lysol, cidex, purex.
Two disinfection techniques :
a. concurrent :disinfection is ongoing while the patient
is the sole source of infection.
b. terminal : the final, the end; when the patient is no
longer the source of infection bec he is either well already
or has died already.
Disinfestation : destruction of insects, rodents or animals that are
living in human habitat and can transmit diseases to
man. This is done by :
a. Fumigation/fogging
b. Spraying
c. Delousing :
c.1. Nits
c.2. Lice
6. Medical Asepsis : absence of disease-producing microorganisms.
1. Surgical asepsis : to render an area free of pathogenic
organisms. This is done in the OR,
ER, Nursery etc.
2. Medical asepsis / clean technique : to reduce the
number of and prevent the transfer of
microorganisms in the environment. This is achieved
by :
a. Hand washing : CBQ : the single most important
technique of reducing the number of
pathogenic organisms.
CBQ : The quality of hand washing
rather than the length of hand washing is important : at least
10 secs. if not grossly dirty.
1. Apply friction
2. Pay attention to the inter-digital areas (between fingers and
toes)
3. Fingernails : should be cleaned well : underneath may be
pathogens
4. Direction of hand rinsing : from cleanest to dirtiest (elbow to
fingers)
b. Concurrent disinfection
c. Use of PPE’s :1. Caps
2. Goggles
3. Face shields
4. Masks : N95 (95% efficient surgical masks;
brassieres may be used as substitute in its absence)
5. Gloves
5. Gloves
6. Gowns
7. Protective boots/shoes
d. Placard/ Barrier cards : bold notices used as
precautionary measures.