COMMUNICABLE

DISEASE NURSING
JCSPerida
INFECTION
entry and multiplication of an agent to a potential host

• STAGES OF ILLNESS (Spectrum)

-Incubation
-Prodromal
-Illness (Pathognomonic)
-Convalescent vs Defervescent
COMMUNICABLE DISEASE
- illness caused by an infectious agent and/or its toxic substance
that is directly or indirectly transmissible from one person to
another
- transmission (Contagious/ Infectious)

• EPIDEMIOLOGY
1. Sporadic 4. Pandemic
2. Endemic 5. Herd Immunity
3. Epidemic (Outbreak)
CHAIN OF INFECTION
Agent
^ >
Susceptible Host Reservoir
^ >
Portal of Entry ` Portal of Exit
^ <
Mode of Transmission
GENERAL NURSING CARE
I. PREVENTION
- Health Education
- Immunization
-Proper Supervision of Food Handlers
- Environmental Sanitation
II. CONTROL
- Case Findings and Treatment
- Isolation (Strict/ Reverse)
- Quarantine
- Disinfection
- Sterilization
- Disinfestation `
PARADE OF DISEASES
• NERVOUS SYSTEM

• TETANUS (Lockjaw)
- Etiologic Agent (EA): Clostridium tetani (tetanospasmin)
- Incubation Period (IP): 3-30 days
- Mode of Transmission (MOT): Impaired skin/mucous
membrane
- Signs and Symptoms (S/Sxs): Trismus, Risus sardonicus,
Opisthotonos, Laryngospasm, Major muscles involvement
- Diagnostic Test/s (Dx T): Wound culture, Spatula test
• MENINGITIS (Cerebrospinal Fever)
EA: Neisseria meningitidis (and many pulmonary pathogens)
IP: 2-10 days
MOT: Droplet
S/Sxs: Nuchal rigidity, Kernig’s sign, Brudziski’s sign,
Photosensitivity, Increased ICP
Dx T: Lumbar Puncture
• MENINGOCOCCEMIA (Spotted Fever)
-fulminant meningococcal infection
IP: 3-4 days
S/Sxs: Spiking fever (within 24h)
Ecchymotic hemorrhage (acute vasculitis)
Waterhouse- Friderichsen Syndrome
Dx T: Clear Glass Test, Blood Culture
• ENCEPHALITIS (Brain Fever)
EA: Japanese Encephalitis Virus (JEV)
IP: 5-14 days
MOT: Bite of an infected Culex tritaeniorhyncus
S/Sxs: Mild- Fever, Headache
Severe- Sudden onset of high fever, Meningeal irritations,
Increased ICP
Complications: Brain herniation; Serious neurologic,
cognitive and psychiatric sequelae
• RABIES (Hydrophobia, Lyssa, La Rage)
EA: Rhabdovirus
IP: Humans (2-8wks) Dogs (10days) “negri bodies”
MOT: Bite of an infected animal (canine/ sylvatic)
S/Sxs: Invasive/Prodromal
Excitement
Paralytic
Dx T: FRA, Brain biopsy, 10-day observation of the dog
Management: ERIg/HRIg (according to weight)
` PBRV (VeroRab; RabiPur)
• POLIOMYELITIS (Heine-Medin Disease; Infantile Paralysis)
EA: Legio debilitans (I- Brunhilde; II-Lansing; III- Leon)
IP: 7-21 days
MOT: Fecal-Oral Route
S/Sxs:
- Inapparent (Subclinical)
- Abortive
- Major Poliomyelitis
1. Non-paralytic – stiffness of the spine
2. Paralytic- Bulbar, Spinal, Bulbospinal
Dx T: Stool exam, EMG, Lumbar Tap (+ Pandy’s Test)
Management: Iron Lung Machine; Pleconaril
• LEPROSY (Hansen’s Disease; Hansenosis)
EA: Mycobacterium leprae
IP: 6mos- 8yrs or more (20yrs!)
MOT: Droplet; Prolonged skin-to-skin contact
S/Sxs:
Early- Anesthesia, Anhidrosis
Late- Leonine appearance; Madarosis; Lagophthalmos
Terminal: Blindness; Amputation
Dx T: Slit Skin Smear; Lepromin Reaction Test
Categories: Tuberculoid, Lepromatous, Borderline, Indeterminate
Management: Paucibacillary and Multibacillary Treatment
CIRCULATORY SYSTEM
• DENGUE (Hemorrhagic Fever; Dandy Fever; Infectious
Thrombocytopenic Purpura)
EA: Dengue Flavivirus 1,2,3,4)
IP: 6days- 1wk
MOT: Bite of an infected Aedes aegypti/ A. albopictus
S/Sxs: Gr I to Gr IV (Nimannitya)
Dx T: Torniquet Test; Rumpel-Leads Test
Management: 4-o’clock Habit
• MALARIA(Ague; Marsh Fever; Periodic Fever; King of Tropical Disease)
EA: Plasmodium falciparum (Malignant Tertian Malaria)
P. vivax (Benign Tertian)
> Hypnozoites
P. ovale
P. malariae (Quartan Malaria)
P. knowlesi
MOT: Anopheles mosquito
Life Cycle: Sporozoite (mosquito) > Human Liver (Schizogony= merozoite > Human RBC (multiple
fission= merozoites, a piece of both microgametocyte [male] and macrogametocyte [female]>
mosquito gut (ookinete)
S/Sxs: Cold, Hot, Diaphoretic Stages
Dx T: Blood smearing (Thick smear)
Management: P/C: Streamseeding; Zooprophylaxis; Streamclearing
Medications: CoArtem; Chloroquine; Fansidar
• EBOLA
EA: Ebola Virus (Bundibugyo; Zaire; Sudan; Reston; Tai Forest)
IP: 2-21days
MOT: Human to human- Exposure to body secretions
Vectors- Primates, Antelopes, Porcupines, Fruit bat
S/Sxs: Bruising and bleeding; Skin blisters (sloughing off)
Vomiting of liquefied organs
Complications: Dehydration; Hypovolemic Shock
Management: Rehydration; Plasma infusion)
• ZIKA
EA: Zika virus (Flavivirus)
IP: 3-14 days
MOT: Bite of an infected A. aegypti; A. albopictus
S/Sxs: mild symptoms of flu and measles symptoms combined
Complications: Microcephaly
GBS
Management: Analgesics; Paracetamol
• SCHISTOSOMIASIS (Snail Fever; Bilharziasis; Swimmer’s Itch
EA: Schistosoma japonicum; S. mansoni (GI blood vessels)
S. haematobium (Urinary bladder)
IP: 2mos
MOT/Pathogenesis: Human feces w/eggs > miracidium
(freshwater) > Oncomelania quadrasi snail (cercaria)
S/Sxs: Diarrhea, Bloody stool; Katayama fever; Clam-digger’s itch
Complications: Portal HPN; Cor pulmonale
Dx T: Circum-Ova Precipitin Test
Management: Praziquantel
• PARAGONIMIASIS
EA: Paragonimus westermani
MOT/Pathogenesis: Sputum w/ eggs > miracidium(freshwater) >
Oncomelania quadrasi (cercaria) > crabs/crayfish
(metacercaria)
S/Sxs: Mostly co-infected w/ TB, abdominal pain and diarrhea
Dx T: Sputum exam (Brown spots)
Management: Praziquantel
LYMPHATIC SYSTEM
• FILARIASIS
EA: Wuchereria bancrofti; Brugia malayi; B. timori
IP: 8-16 mos
MOT: Bite of a microfilariae carrier A. poecelius
S/Sxs: Asymptomatic- circulating microfilariae
Acute- Lymphangitis, lymphadenitis; Orchitis
Chronic- Lymphadema w calabar swelling, Hydrocoel,
Elephantiasis
Dx T; Nocturnal Blood Exam; Immunochromatographic Test
Management: Diethylcarbamazine citrate [DEC] (Hetrazan)
RESPIRATORY SYSTEM
• TUBERCULOSIS (Koch’s Infection; Phthisis; Miliary (EP) TB
EA: Mycobacterium tuberculosis; M. bovis
IP: 2-10wks
MOT: Droplet; Airborne
S/Sxs: Night sweats, night fever, hemoptysis
Anorexia, malaise and significant weight loss
Coughing for more than 2 weeks
Dx T: Sputum exam/ DSSM/AFB staining
(microscopist/medtech)
BHS- BHW
contraindication: Hemoptysis
 -Tuberculin Testing (PPD)- 10 children
Monday or Tuesday
-Chest X-ray
Categories: I – New sputum smear (+)
EPTB; Concomitant HIV infection
New sputum smear (-) w/ extracavitary lesions
III- New sputum smear (-) w/ minimal cavitary lesion
Medications: 2RIPE/ 4RI
 II- TB default; TB relapsed
Medications: 2RIPE + S (56inj) followed by 1 RIPE/5 RI + E
IV- Chronic TB (hospitalization
Treatment Facility: Regional/QI (National)
Management:
- Watch out for side effects of drugs
- High calories; High CHON diet
• PNEUMONIA
EA: CAP (Streptococcus; Mycoplasma;Hemophilus; Legionella)
HAP(Staphylococcus; Pseudomonas; Enterobacter)
Atypical (Bronchopneumonia): Viruses, Chlamydia;
Mycoplasma; Legionella
IP: 2-3 days
S/Sxs: Rusty sputum; Fever w/ chills; Hypochloremia
Dx T: Chest X-ray/ Culture
Prevention: Pneumovax
• COVid-19
EA: SARS-CoV-2
IP: 2-14days
MOT: Droplet Vectors: Bats, Pangolins
S/Sxs: Fever, Dry cough, shortness of breath
Sudden onset of anosmia, ageusia and dysgeusia
Complications: Pneumonia. ARDS, Kidney failure;
Worsening of comorbidities
Treatment: Mass vaccination; Symptomatics
• DIPHTHERIA
-pseudomembrane and toxemia
EA: Corynebacterium diphtheriae
IP: 2-5days
MOT: Droplet
S/Sxs and Classifications:
Pharyngeal- High fever; Bullneck
Laryngeal- Brassy coughing; dyspnea; cyanosis
Nasal- Excoriation of the nares
Cutaneous- pseudomembrane resembles impetigo
Dx T: Schick’s Test; Moloney Test; Culture
• PERTUSSIS (Whooping cough)
EA: Bordetella pertussis
IP: 7-10 days
MOT: Droplet
S/Sxs: Catarrhal Stage- Coryza, lacrimation, sneezing
Paroxysmal- “Whooping cough” and its complications
Dx T; Bordet-Gengou Agar
Convalescent: Patient no longer communicable but watch
out for residual paroxysm in the next 6mos
• FLU (The Grippe; Influenza)
EA: Orthomyxoviridae Virus A (zoonotic); B, C
H- Hemagluttinin (H1-H19)
N- Neuraminidase (N1-N10)
Bird Flu (H5N1, H5N6) IP: 2-4days
Influenza A(H1N1) IP: 7-10days
Management: Vaccination (Contraindication: Allergy to eggs)
Treatment: Oseltamivir (Tamiflu); Zanamivir (Relenza)
• ANTHRAX (Ragpicker’s Disease; Woolsorter’s Dse; Malignant Pustule;
Malignant Edema)
EA: Bacillus anthracis
IP: A few hrs to 7 days
MOT: (Classification):
Cutaneous; Pulmonary (inhalation); GI Anthrax
- presence of “black eschar”
Management: Cremation/burning
-Unhydrous CaO2
Treatment: Pen G or Gentamycin
INTEGUMENTARY SYSTEM
• MEASLES (Rubeola)
EA: Paramyxovirus of the Morbillivirus family
IP: 8-20 days
MOT; Droplet; Airborne
S/Sxs; Prodromal- Coryza, coughing, conjunctivitis (stimson line),
Koplik spots
Eruptive- Maculopapular rashes, more pronounced fever
and respiratory symptoms
Convalescent: Branny desquamation
Vaccine: Anti-measles (9mos; MMR)
• GERMAN MEASLES (Rubella)
EA: Rubivirus
IP: 14-21 days
MOT: Droplet, Airborne
S/Sxs: Prodromal- Low grade fever, Forscheimer’s spots
Eruptive- Rashes w/ lymphadenopathy
Vaccine: MMR
• CHICKENPOX (Varicella)
EA: Varicella zoster (Human Alpha- Herpes Virus-3)
IP: 13-17 days
MOT: Droplet; Airborne
S/Sxs: Scattered, pruritic vesicles
• SHINGLES (Herpes zoster)
IP: Reactivation of latent infection
S/Sxs: Unilateral, clustered, and painful vesicles that tend to coalesce
Complications: Gasserian ganglionitis; Ramsay-Hunt Syndrome
Management: Varivax/Zostavax (Vaccine)
DOC: Zovirax
Addenda for Shingles: Analgesics; KMnO4 (A-B-O effects)
GASTRO-INTESTINAL
• TYPHOID FEVER
EA: Salmenella typhi/typhosa
IP: 5-40days
MOT: Fecal-oral route; 5F’s
S/Sxs: Ladder-like fever, Splenomegaly, rose spots
Complications: Typhoid psychosis; Intestinal perforation
and hemorrhage
Dx T: Widal’s Test (screening); Typhidot (Confirmatory)
Management: Chloramphenicol (plus Cotrimoxazole)
High Calorie; low fiber and low residue diet
• BACILLARY DYSENTERI (Shigellosis)
EA: Shigella flexneri. S. boydii, S. sonnei, S. dysenteriae
Management: Ampicillin; Cotrimoxazole
• AMOEBIC DYSENTERI (Amoebiasis)
EA: Entamoeba histolytica (cyst- [infective stage]; trophozoite)
Management: Metronidazole
IP: 1-3 days
S/Sxs: Bloody mucoid stool; Abdominal pain; Tenesmus
• CHOLERA (El Tor)
EA: Vibrio cholerae ( serotypes: Inaba, Hikojima, Ogawa)
-with choleragen that activates cAMP
IP: 1-3 days
S/Sxs: Rice watery stool (24-30l/day!)
Washerwoman’s hand skin wrinkling (severe dehydration)
Vomiting occurs when diarrhea is established
Hypokalemia
Vox cholerica
Management: F/E Replacements; KCl; Tetracycline, Ampicillin. Cotrimoxazole)
• RED TIDE (Paralytic Shellfish Poisoning)
EA: Pyrodinium bahamense; Gonyaulax catanella, G. tamarenis
IP: 30mins
MOT: ingestion of contaminated shellfish (“saxitoxin”)
S/Sxs: Neuromuscular paralysis
Management:
Antidote: Coconut milk; Sodium bicarbonate in water
Activated Charcoal Filter (gastric lavage)
• MUMPS (Parotitis)
EA: Paramyxovirus of the Myxovirus family
IP: 12-26 days
MOT: Droplet
S/Sxs: Parotid gland swelling
Complications: Orchitis; Oophoritis
Management: MMR Vaccine
Ice collar, cold compress
- Liquid, soft, bland and cool food
- Corticosteroids (for inflammation)
• LEPTOSPIROSIS (Weil’s Dse; Mud Fever; Flood Fever; Spirochaetal
jaundice; Swineherd Disease; Canicola Disease; 7-Day Japanese Fever)
EA: Leptospira interrogans
IP: 7-19 days
MOT: Exposure to rat urine (wading in floodwaters)
S/Sxs: Fever, Myalgia, Liver and Kidney involvement, Orange-
colored sclera of the eyes
Dx Test: Leptospira Agglutination (Antigen-Antibody) Test
Management: Doxycycline (prophylaxis)
DOC: Pennicilin and other Beta-lactam antibiotics
• HELMINTHICS
• ASCARIASIS- roundworm infection (Ascaris lumbricoides)
S/Sxs: Pneumonitis; Obstruction; vomit-out viable worms
Dx T: Kato- Thick (Katz) smear
• UNCINIASIS/EGYPTIAN CHLOROSIS- hookworm infection
EA: Ancyclostoma duodenale; Necator americanus
MOT: Skin penetration
S/Sxs: Pneumonitis, Iron deficiency Anemia
• ENTEROBIASIS- pinworm infection (Enterobius vermicularis)
S/Sxs: Perianal itching (night)
Dx T: Scotch-tape test
DOC: Mebendazole/ Albendazole
REPRODUCTIVE SYSTEM
• GONORREA (Clap; Gleet; Flores Blancas; Tulo)
EA: Neisseria gonorrhea
IP: 3-5 days
MOT: Sexual contact; Perinatal transmission (conjunctivitis)
S/Sxs: Thick yellowish pruritic discharge; Dysuria
-Usually co-infected with Chlamydia trachomatis
S/Sxs; Mild urethritis; Trachoma blindness(newborn)
Management: VDRL; Thayer-Martin Agar
-Keep genitalia clean and dry; Crede’s prophylaxis
-DOC: Pennicilin and other 3rd generation antibiotics
• SYPHILIS (Lues Veneria; The Pox; Bad Blood Disease)
EA: Treponema pallidum
IP: 10-90 days (ave of 3weeks)
S/Sxs: Primary Syphilis- chancre
Secondary syphilis- mucus patches, syphilides, condylomata lata
Latent- Asymptomatic for years
Tertiary- Gumma- sticky agglomeration of necrotic tissue (Cardiosyphilis; Neurosyphilis)
Management: Screening: Rapid Plasma Reagin
Confirmatory: Fluorescent Treponemal Antigen Absorption
Test (FTAAbs)
\ Nursing Care: Keep lesions clean and dry; Watch out for signs of cardio- and neurosyphilis
DOC: Benzathine Pen G
• AIDS
EA: Retrovirus (Lentivirus)
IP: 2mos- 20 yrs or more
MOT: Person to person (sexual)
Parenteral-percutaneous
Placental/perinatal
S/Sxs: Prone to many infections; Kaposi’s sarcoma; Pneumocystis jiroveci
pneumonia
Dx Test: ELISA Test; Western Blot
Management: Nucleoside Reverse Transcriptase Inhibitor (Abacavir,
Didanosine, Lamivudine. Retrovir, Zidovudine)
- Protease Inhibitor- Ritonavir; Indinavir