COMMUNICABLE DISEASES

Course Outline decaying

I. Basic concepts in infection control vegetation)
[Link]-19 2. Mushroom
III. Disease of the respiratory system 3. Yeast - Candidiasis
IV. Disease of the circulatory system
[Link] of the gastrointestinal system 2. Environment - refers to extrinsic factors that
VI. Sexually transmitted infection affect the agent and the opportunity for
VII. Disease of the integumentary system exposure
VIII. Emerging infections - Factors:
a. Physical – geology and climate
EPIDEMIOLOGIC TRIAD b. Biologic
c. Socioeconomic – crowding,
sanitation, and availability of
health services

3. Host - different profiles

A. Patient – positive and symptomatic
B. Carrier – positive and asymptomatic
C. Suspect – need for confirmation
D. Contact – asymptomatic but was
exposed to an infected individual

CHAIN OF INFECTION
- Leavell & Clark
- There is always interaction between this
components

1. Agents - originally referred to an infectious

microorganism or pathogen:

AGENTS
o Self limiting a. COVID-19
o Long-term b. MERS
Viruses
immunity c. SARS-Cov
(vaccines)
o Needs of a. Pneumonia
Bacteria
medication b. Tuberculosis
oMicroscopic, 4 groups:
one-celled 1. Sarcodina - 1. Infectious agent
organisms that ameba - Eradicate before transmission
can be free-living 2. Mastigophora - - Use disinfectant or appropriate
Protozoa or parasitic in flagellates chemicals
nature 3. Ciliophora -
oMOT : fecal oral ciliates 2. Reservoir
route 4. Sporozoa - - Environment of the agent
Balantidium
Fungi oReproduce by 3 major groups: 3. Portal of exit
means of spores 1. Mold – - Anything that comes outside the body
oOmnipresent Aspergillosis - Bodily fluid, waste, or byproducts
(land, decaying (dead leaves,
matter, soil, stored grain, 4. Mode of transmission
moist areas) composites piles, - Weakest link

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- Must know transmission in order to -

Measles
prevent getting infected -
Tuberculosis
-
Varicella
5. Portal of entry -
SARS
- The manner in which a pathogen enters  Protection:
a susceptible host - N95 mask
- Types: - High efficiency particulate air filter
1. Inhalation – respiratory tract (HEPA Filter)
2. Absorption – mucous membrane  Patient room should be negative
3. Ingestion – gastrointestinal (pull)

6. Susceptible host 2. Droplet

- Susceptibility may vary on: -short distance
a. Genetic or constitutional factors -Occurs when bacteria or viruses travel
b. Immunity relatively large respiratory droplets that
c. Nonspecific factors that affects people SNEEZE, COUGH, EXHALE
ability to resist infection or to limit - All other respiratory infection
pathogenicity  Protection:
- Ordinary mask (medical mask)
DISEASE PRECAUTIONS - Goggles (for healthcare providers)

STANDARD PRECAUTION 3. Contact precaution – used for diseases that

- Bare minimum precaution can be transmitted during contact with
- Used to be “universal precaution” patient or patient’s environment
- Done to patient with whatever diagnosis - Gi, skin diseases
1. Use of PPEs or barriers – appropriately  Protection:
to patient diagnosis - Gown
2. Handling sharps – containers that are - Gloves
puncture proof
3. Handwashing – most effective to LEVEL OF PREVENTION
prevent any infections;
 20-30 sections is not visible soiled LEVEL TARGET ACTIVITIES
 40-60 second if soiled - Prevention
 friction is more important than (risk
agents used in handwashing reduction)
 5 moments of handwashing Primary Well person - Promotion
- Ex. Isolation,
quarantine,
vaccination
- Early
Early sick diagnosis
Secondary
- Prompt
treatment
- Rehabilitation
- maximize
Tertiary Late sick and preserve
capacity of
the patient

DISEASE CONTROL
TRANSMISSION BASED PRECAUTION
1. Airborne – transmitted through air

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ISOLATION - Most patient will experience mild to

- Separation of the infected person from the moderate respiratory illness
well people o At risk:
o Strict isolation  Aged 60 year old and over
- primary level of prevention  HTN, CVD
o Protective/Reverse isolation  COPD and asthma
- immune compromised individuals  Diabetes Mellitus
- tertiary level of prevention  Cancer
 Obesity
 High-risk pregnancies
 Immunodeficiency
 Unvaccinated
- Etiology:
o Severe acute respiratory syndrome
coronavirus 2 (Sars-Cov-2 )
- MOT (droplet with airborne precaution:
o Droplet - large respiratory droplet; 3 in 6
ft
o Contact - direct/indirect
o Aerosol - small respiratory particles from
intubation, bronchoscopy
o Environment: indoor, crowded, and
inadequately ventilated spaces (3Cs)
o Potential pre-symptomatic (incubation)
& asymptomatic transmission (carrier)

RENIN ANGIOTENSINOGEN PROCESS (COVID-19)

QUARANTINE
- Limitation of the freedom of movement
- Target: Well person
- Basis: longest incubation period

STEPS:
1 Renin release
2 Angiotensinogen into Angiotensin I
3 Angiotensin I into Angiotensin II

CORONAVIRUS DISEASE 2019

CARE PATHWAY (COVID-19)

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2. Vital load
1. CONFIRMATORY o High level= increased disease severity and
- ensure prompt diagnosis using molecular transmissibility
(NAAT/RTPCR)
3. Viral shedding
Diagnosis: o expulsion and release of viral materials
1. Reverse transcriptase polymerase chain following successful reproduction in the
reaction (RT-PCR) – host
o Gold standard for diagnosis COVID-19 o Severe covid = longer viral shedding
 Nucleic acid implication test (NAAT)
or molecular testing - Detects the 3. RESPOND
antigen - treatment selection is determined by
2. Rapid Antigen test severity of disease and risk factors
o Best for case finding, contact tracing,
outbreak investigation A. Non severe (mild and moderate) without
o Diagnostic and confirmatory tests for risk factor (covid-19):
close contact, and COVID-19 suspect and o Symptom management and supportive
probable cases care
o Monitoring
2. ASSESS
- provide early clinical assessment and B. Non severe with risk factors:
evaluation to determine if the patient has MEDICATION DESCRIPTION ROUTE
risk factors, emergency signs, or symptoms o Indication: Used
that require treatment, clinical referral or to treat mild to
admission to hospital care; Categorize moderate
severity o Prevent the
growth of the
A. Most common symptoms: virus
- Fever Nimatrelvir o WOF: non-stop
- Loss of tase or smell Oral
& Ritonavir nausea and
- Dry cough
vomiting,
- Tiredness
anorexia,
abdominal pain,
B. Less common:
jaundice, dark
- Body aches
urine, clay
- Sore throat
colored stool
- Diarrhea
o Indication: Mild
- Conjunctivitis
to moderate
- Headache
o Not for pregnant,
- Rash on skin or discoloration
breastfeeding
women, and
C. Serious symptoms:
children due to
- DOB Molnupiravir Oral
lack of evidence
- Chest pain or pressure
o Most used in the
- Loss of speech or movement
Philippines
o WOF: Diarrhea
D. Incubation period
- 5-6 days average; 14 days longest and Allergic
reaction
E. Additional confirmatory tests (COVID-19): Remdesivir o Inhibits viral SQ
1. X-ray: ground glass opacities replication by injection
terminating RNA
transcription

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prematurely PREVENTION
o Target: Omicron - Hand hygiene
o WOF: back pain, o Alcohol
chest tightness, o Antimicrobial soap
dark colored - Mask
urine, flushing, - Physical distancing
headache, - Avoid 3Cs
hives/itching, - Avoid touching surfaces in public setting
light colored - Regular cleaning/disinfection
stools, o 0.5% chlorine
hyperemesis o Bleach 1:10
headache,
hives/itching, HEALTH EDUCATION
light A. Covid and disinfection: not recommended
o Outdoor disinfection
o Spraying of individual with
C. Severe or critical: disinfectant (tunnel, cabinet, or
o Symptomatic and supportive care chamber)
o O2 therapy o Disinfecting food packages
o Corticosteroids (oral or IV)
- serve as immunosuppressant and anti- B. Covid and masks
inflammatory o Prolonged use of masks does not
o Venous thromboembolism (VTE) cause CO2 intoxication nor oxygen
prophylaxis deficiency
- prevent deep vein thrombosis o Do not wear masks when
o Immunomodulator performing vigorous PA
- modifies, or modulates, the immune
system to help your body respond to a COVID 19 AND MASKING
disease or illness A. Non-medical fabric masks for general public
- Interleukin-6 receptor blocker o Wash in soap/detergent and hot
(tocilizumab or sarilumab) water at least OD or wash it room
- Janus kinases - JNK inhibitor (Baricitnib) temperature water, followed by
o Hospitalized pediatric age 2 to less boiling (for reusable mask)
than 18 years of age that requires B. Medical masks for high-risk groups
oxygen, mechanical ventilation or C. Respirators for medical front liners
ECMO
COVID-19: PREGNANCY/BREASTFEEDING
NURSING CARE - Pregnant women at higher risk for severe
- Symptomatic and supportive illness/complication
1. Fluid intake - No evidence to suggest increased risk of
2. DBCT abortion;
3. Management of fever - No evidence of impaired fetal
4. Positioning development,
- reposition in different position - No evidence of intrauterine infection from
o redistributes blood and air flow vertical transmission
more evenly and improving gas - Maintain skin to skin contact after delivery
exchange - Continue breastfeeding
o prone to prevent atelectasis in o Hand hygiene and face mask
order to re-expand the lungs o Express breastmilk
o Wet nursing or donor human milk

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A. Active – produces the immunity

i. Natural – exposed to the
PPE GUIDANCE FOR HCWS disease/infection
- Respirator mask (FFP2=N95; FFP3=N99) ii. Artificial – produced after receiving
o Top strap on crown of head and vaccine promoting formation of
lower strap at base of neck antibodies (weakened organism)
o Perform user seal check
 Positive pressure (exhale > B. Passive – receives the immunity from
pressure) others
 Negative pressure (inhale i. Natural – via placental transfer (IgG) or
> collapse) breastfeeding (IgA)
- Face mask ii. Artificial – acquired to immune serum of
- Gown the body
- Face shield (below the chin) and goggles o Immunoglobulin, Gama globulin,
- Gloves anti-toxin, anti-serum

DOFFING PPE (REMOVAL) ACTIVE VS PASSIVE IMMUNITY

- Glove-in-glove method - Active – slow to come, slow to go/own body
- Bird beak method - Passive – quick to come, quick to go/from
- Steps: others
o Remove gloves
o Remove gown from behind ELIGIBILITY TO COVID-19 VACCINATION
o Hand hygiene A. Not eligible
o Remove face shield/goggles from o Allergy to any vaccine component
behind (e.g. polysorbate, PEG)
o Remove mask o Severe allergic reaction to first
o Hand hygiene dose of the vaccine
o Age less than 18 year of age
COVID-19 VACCINATION (except for Pfizer/Moderna
- Duration of immunity estimated around 6 to vaccine)
8 months
- No vaccine provides 100% protection from B. Need for special clearance from MD
getting COVID-19 o Autoimmune disease
o HIV
4. EVALUATE o Cancer
o Underwent transplant
IMMUNITY o Steroidal therapy
o Bedridden, vegetative state, life
expectancy < 6 months

C. Rescheduling
o Currently diagnosed or with
symptoms of COVID-19
o History of exposure to confirmed
or suspected COVID-19 case in the
past 14 days
o Received convalescent plasma or
monoclonal antibodies for COVID-
19 in the past 90 days
1. Natural – you have it within you o Women in the first 3 months of
2. Acquired – occurs after a person receives pregnancy
antibodies from another source

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o Has received any other vaccine in c. Common in people with chronic

the past 14 days health issues or weakened immune
o Has had attacks, been admitted or system (immunocompromised)
changed medications for co- o Pneumocystis pneumonia
morbidities in the past 3 months (PCP)
o Hypertensive emergency or o Histoplasmosis
BP>180/120 with symptoms or o Cryptococcus
possible organ damage o Coccidioidomycosis (Valley
fever)
D. Priority groups for vaccination in the PH
o Frontline health II. Injury
o Seniors d. Aspiration
o Person with chronic disease
 HTN, CVD, DM, asthma, B. MODE OF TRANSMISSION
kidney failure, cancer a. droplet

DISEASE OF THE RESPIRATORY SYSTEM C. MANIFESTATION

a. Infectious respiratory s/sx
I. PNEUMONIA b. Sputum
- Inflammation of the lungs 1. Bacterial - rusty, yellowish, greenish
- Lung consolidation – restrictive disease 2. Viral - white or clear
- Most common nosocomial infection c. Chest pain - pleuritic pain
d. Lung sound – crackles/rales
A. CAUSATION e. Breath sounds – Dull (secretions)
I. Infection:
A. Viral D. DIAGNOSTIC TEST
1. CMV 1. Chest x-ray
2. Respiratory Syncytial Virus (RSV) a. hazy appearance
3. Corona 2. Sputum Exam
4. Common cold and flu viruses a. For identifying what kind of organism
caused the condition
B. Bacteria
a. CAP - streptococcus pneumoniae E. MANAGEMENT
b. HAP - staphylococcus aureus
Medication Description Drugs
Treat- - Penicillins
Antibiotics bacterial - Cephalosporins
infection
- Induce - Salbutamol
relaxation (beta 2)
lung and - Ipratropium
expansion (anti-
Bronchodilators
airway cholinergic)
passage
- Assess: HR
(tachycardia)
- Promote - Acetylcysteine
easy sputum (dilute in
Mucolytics
expulsion water)
- Carbocisteine
C. Fungal
F. NURSING INTERVENTION

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a. Deep breathing and cough - Components:

practices a. Political support (devolution)
o When in pain - splint b. Regular drug supply
b. Supplement O2 c. Sputum microscopy (GeneXpert)
c. Encourage fluid intake d. Recording system
d. Incentive spirometer e. Intake supervision
e. Semi-Fowlers – promote lung
expansion
II. TUBERCULOSIS
- There is cavitation (chronic) in the lungs of G. PHARMACOLOGY
the patient 1. Rifampicin
o Normal: red orange discoloration of
B. ETIOLOGY secretion
f. mycobacterium tuberculosis o Hepatotoxic

C. MODE OF TRANSMISSION 2. Isoniazid

g. Airborne o Peripheral neuritis
o Supplement Vitamin B6
D. MANIFESTATION o Hepatotoxic
- Coughing – lasted for 2 weeks or more;  Before giving - Liver enzyme test
presence of sputum
- Low grade fever 3. Pyrazinamide
- Chest/Back pain o Increase uric acid level (gout and stones)
- Weight loss (anorexia) – consumption of  Increase fluid intake
energy
- Hemoptysis – Blood in the sputum 4. Ethambutol
o Optic neuritis – blurred vision (possible
E. DIAGNOSTIC TEST for blindness)
1. Screening – exposure to TB (Mantoux)  Stop medication if blurred vision is
a. Tuberculin skin test (TST) – skin test reported
b. Purified protein derivative (PPD)
o Positive sign – 10 or more 5. Streptomycin
(adjustment: 5 mm for individual o Ototoxic – tinnitus or imbalance
with HIV)  Supplement with creatinine
o Does not mean you have TB o Nephrotoxic
(exposed pa lang)
o Results - 42 – 72 hours (longer the H. NURSING INTERVENTION
better) - Compliance to medication
- Nutrition – increase calories (carbs and
2. Confirmatory proteins)
a. GeneXpert pMTB/RIF assay - Counseling – address stereotypes and
o Rapid diagnosis and drug resistance health education
- Prevention of spread
3. Others: - BCG immunization
a. Direct Sputum Smear Microscopy
(DSSM) – sputum exam DISEASES OF THE CIRCULATORY SYSTEM
b. Chest x-ray
I. MALARIA
F. TREATMENTS - Common in province of Palawan – forest
II. DOTS
- Directly observed treatment, short A. ETIOLOGY
course a. Plasmodium species

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o Falciparum o Environmental sanitation – stream

o Vivax clearing
o Ovale malariae o Anti-mosquito
o Neem trees
b. Vector o Zooprophylaxis
o Female Anopheles mosquito – a
night biting II. DENGUE HEMORRHAGIC FEVER
o Environment: clear, slow flowing, - Viral infection that spreads from
shaded bodies of water mosquitoes to people
o Time: 9 PM – 3 AM
A. ETIOLOGY
B. MOT - Dengue virus
1. Mosquito bite
2. Blood transfusion B. VECTOR
3. Needle stick injury o Aedes aegypti – day and night biting
4. Pregnancy (vertical transmission) o Environment: stagnant water
o Rural or Urban areas
C. MANIFESTATION
1. Fever C. MOT
Chilling sensation o Mosquito bite
COLD Chattering of lips and
shaking of body D. Pathophysiology
High-grade fever
HOT Ha, abdominal pain,
vomiting
Profuse sweating with
WET
body weakness

2. Others:
o Anemia
o Jaundice
o DENV > continuous capillary injury
D. COMPLICATION (plasma leakage) > platelet activation
o Cerebral Hypoxia – 4-6 minutes (consumption) > bleeding
brain sustain oxygen
o Liver failure E. DIAGNOSTIC TEST
o Kidney failure 1. Dengue N1
2. Dengue blot test
E. DIAGNOSIS 3. Platelet count Hct (increases)
a. History o F: 35-47%
b. Peripheral blood smear – similar to o M: 42-52%
CBG 4. Rumpel Leede test (tourniquet test)

F. TREATMENT F. MANIFESTATION
a. Anti-malaria-lumefantrine 1. Fever 3 days or more
b. Chloroquine o Grades:
c. Primaquine Dengue fever
G1
symptoms
G. PREVENTION G2 G1 + bleeding
o Chemically treated mosquito nets G3 G2 + circulatory
o Larvae eating fishes - streaming failure
*Check for

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narrow pulse f. Salt

pressure g. Alcohol
G3 + shock
G4 (dengue shock ETIOLO VECTOR AFFECTATION
syndrome) - Protozoa - Female - RBCs
2. Petechia (20 or more) - Night biting
3. Bleeding (nose, UGI, skin, small BV) - Clear
4. Muscle pain flowing
shaded
5. Headache Malari bodies of
6. Bone pain a water
7. Joint pain DIAGNOSTIC
MANIFESTATIO
TREATMENT
8. Nausea and Vomiting N
- Peripheral - Fever - Anti-
- blood smear (Cold-Hot- malarials
G. TREATMENT: Wet)
- Supportive - Anemia
o Management of bleeding (epistaxis, ETIOLO VECTOR AFFECTATION
melena) - Virus - Aedes - Platelet
 Home (UGI) – ice compress aegypti
 (UGI) Hospital – lavage; NPO mosquito
DHF - Day and
a. Diet modification
night
o Avoid dark colored food - Stagnant
b. Avoid antipyretic such as NSAID, water
paracetamol, and ASPIRIN – blood thinner DIAGNOSTIC MANIFESTATIO TREATMENT
N
and anti-platelet
- Screening: TT - s/sx bleeding - Symptomatic
c. Vitamin C – treat or avoid scurvy - Confirmatory: and
(spontaneous bleeding) Dengue NS1 supportive
d. IVF - PLT count
e. Blood Transfusion – last resort (platelet
concentrate)
o N: 150k-450k
Diseases of the Gastrointestinal System

I. DIARRHEAL DISEASE

1. MOT
- fecal oral route
H. PREVENTION - 5Fs:
o Food
o Fingers
o Feces
o Fomites
o Flies

2. TYPES
1. Acute watery
- Lasts several hours or days, and
includes cholera
a. Search and destroy
b. Seek Early consultation – 3 days fever
2. Acute bloody
c. Secure self-protection measures – mosquito
- Dysentery
repellant, pants, long sleeves
d. Support Fogging/spraying in hotspot areas
3. Persistent diarrhea
e. Aceite – efficacent oil

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- Lasts 12 days or longer

B. DIAGNOSIS
3. OTHER CLASSIFICATIONS 1. Fecalysis
1. Osmotic diarrhea
a. Ingestion of poorly absorbed C. MANAGEMENT
substrate 1. F and E replacement
o Mannitol 2. Tetracycline
o Sorbitol o Take with empty stomach as foods
o Epsom Salt (MgSO4) can disrupt absorption
o Antacids
b. Malabsorption – lactose intolerance D. FLUID AND ELECTROLYTE REPLACEMENT
- Commercially available ORS
2. Secretory diarrhea - D5LR – best fluid to administer
- Water secreted in the intestine exceeds - Home-made ORS:
absorption o 8 teaspoons of sugar
o Laxatives o 1 teaspoon of salt
o Hormones secreted by certain o 1L of water
tumors - Fruits
o Various drugs - Buko juice – rich in potassium and other
o Certain metals, organic toxins, and electrolytes
plant products (arsenic, insecticide, - Rice water
mushroom toxins)
III. DYSENTERY
3. Inflammatory or infectious diarrhea - Shigella dysenteriea
- Epithelium’s barrier is disrupted by invading
microbial and viral pathogens A. MANIFESTATION
o Bacteria: Salmonella E. Coli and - Blood in stool
Campylobacter o Risk for anemia
o Viruses: Rotaviruses, corona, parvo - Watery stool
(canina and feline), and nonviruses
o Protozoa: Coccidia species, B. Management
Cryptosporium, and Giardia - Ciprofloxacin
- For pediatrics – sterilized the water bottle
4. Motility-related diarrhea for 2-3 minutes
- Nutrients and water remains in the intestine
for sufficient time (transit time) IV. AMOEBIASIS
- Increase transit time = diarrhea - Entamoeba histolytica

A. MANIFESTATION
II. CHOLERA - pus in the stool
- Vibrio cholerae - Men are asymptomatic and passes it on
- Severe diarrhea and dehydration – severe female
abdominal cramps
o Rice watery stool C. MANAGEMENT
o Poor skin turgor - Metronidazole
o Sunken eyes
Manifestation Management
(aside from complications (aside from
A. COMPLICATION: diarrhea) ORS/IVF)
1. Acid base and electrolyte imbalance: Rice watery Severe Tetracycline
Metabolic Alkalosis Cholera
stool dehydration
o K - cardiac (violent)
AB imbalance
o NA – neuro Dysentery Blood in stool Dehydration Ciprofloxacin

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(Bacillary) Anemia - Vaccination: CDT (cholera, dysentery, and

Amoebiasis Pus in stool Dehydration Metronidazole typhoid fever vaccine)
(amoebic) Liver abscess
VI. LEPTOSPIROSIS
V. TYPHOID FEVER - Leptospira pyrogens (screw-like shape)
- Systemic disease - Comes from rodents
- Salmonella typhosa
- Disease course MOT
- Skin penetration
STAGES
- Start MANIFESTATION
- Abdominal pain - Liver s/sx
PRODOMAL - Vomiting o Jaundice
- Diarrhea o Tea colored urine
o Anorexia
- Ladder like fiver - Renal failure (intra-renal)
PYREXIAL OR
- Rose spots - Massive pulmonary edema
FASTIGIAL
- Splenomegaly
- Ulcer formation DIAGNOSTIC TEST
DEFERVESCENCE - Melena or - Leptospira agglutination test (LAT)
hematochezia o Clumping of blood
- Recovery
- May develop MANAGEMENT
relapses - Antibiotics (IV drip and with soluset)
- Reconfirm o Tetracycline
with o Doxycycline (post exposure prophylaxis)
LYSIS OR
diagnostic  Not allowed to pregnant woman (3 rd
CONVALESCENCE
exam since trimester) and 8< year of age
recovered  Do not mix with fluids that contains
individual may metals (antacids, iron, and calcium rich
still be a foods)
carrier  Provide with 1 full glass of water
 WOF: permanent teeth staining
DIAGNOSIS - Penicillin G
- Stool exam
- Blood exam NURSING CARE AND PREVENTION
o TyphiDot test - antibodies - Monitor urine output
- Avoid contact with contaminated sources
MANAGEMENT
- Chloramphenicol VII. SCHISTOSOMIASIS
o WOF: bone marrow suppression - AKA bilharziasis
(pancytopenia) - Schistosoma species (blood fluke)
- Fluid and electrolyte replacement o Japonicum
- Diet modification (focus on carbs and o Haematobium
electrolytes) o Mansoni
o Banana – rich in potassium - Intermediate host: snails
o Rice – carbohydrates (energy) - Common in Visayan regions
o Apple – potassium
o Toast – carbohydrates Manifestation
- AVOID the following: - Diarrhea
o Dark colored foods - Hepatomegaly

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Diagnosis Complication:
- Fecalysis - Intestinal obstruction
- Circumova precipitin test (COPT) o Cluster worms

Management Management
- Anti-parasitic - PURGA
o Praziquantel o Albendazole
o Mebendazole
Prevention o Pyrantel Pamoate
- Snail control  3 days prior – provide patient to take
o Molluscides anti-histamine (target: worms)
o Irrigation
o Snail eating fish Enterobiasis
- Environmental sanitation - Pinworm
o Proper excreta disposal
o Foot bridges MOT
- Direct/indirect contact
- Fecal – oral route
LEPTOSPIROSIS SCHISTOSOMIASIS
Bacteria Parasite (Blood Manifestation
Etiology - Anal pruritus
(Leptospira) flukes)
o Itchy buttocks
Skin Skin penetration
MOT
penetration
Diagnostic test
- Tape test
o Done in the morning (inactive
worm)

Management
- Anti-helminthic
o Family members should be
INTESTINAL PARASITISM
included
PARASITISM
Prevention
- Daily hygiene
MANIFESTATION
- Changing underwear and bed items and
- Voracious appetite
towels
- Weakness
o Bleach and hot water
- Pot belly
o Dry under sunlight
- Anemia
- Avoid nail biting
- Stunted growth
- Hand washing
- Gloves or mittens
Diagnosis
- Fecalysis
Ancylostomiasis
o Purga – high risk for <5 years of age
- Hookworm
(6 months advisable)
o Blood suckers
I. Ascariasis
MOT
- Giant roundworm
- Skin penetration
o Common in soils
MOT
- Fecal – oral route
Manifestation

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- Anemia chronic
- Anorexia
- Fatigue Diagnostic
- Liver enzymes
Diagnostic - Serum Ag- Ab test
- CBC o HbsAg – virus (NR)
- Stool exam o Anti-Hbs – antibodies (NR)

Treatment Management
- Anti-helminthics - Essentiale, Silymarin
- Iron supplements - Chronic HBV: interferon
o Black stool are normal
o Z tract with SQ Nursing Care
- Balance rest and activities
Taeniasis o Rest for liver
- Tapeworm - Nutrition
o Beef o High carbs (simple sugars) and
o Pork protein
o Fish o low fats
- Lifestyle modification
MOT o Remove alcohol consumption
- Ingestion of contaminated meat
SEXUALLY TRANSMITTED INFECTIONS
Management
- Praziquantel GONORRHEA
- Niclosamide - Neisseria gonorrhea
- Related to Chlamydia
HEPATITIS
- Etiology MOT
o A – infectious hepatitis - Various forms of sexual contact
o B – serum hepatitis (DNA – sexually
transmitted) Manifestation
o C – Post transfusion hepatitis - Pyuria
o D – Delta/Dormant HepB o Pus in the urine
o E – Enteric hepatitis - Dysuria

MOT Diagnostic
- A and E = fecal oral route - Gram staining
- B, C, D = blood and body fluids
Complications
stages - Sterility
Pre icteric - Fever, RUQ pain - Pelvic inflammatory disease (PID)
- Weight loss, fatigue - Ectopic pregnancy
- Anorexia, nausea o Women are asymptomatic
and vomiting
Icteric - Jaundice
- Pruritus
- Dark colored urine Management
- Alcoholic or clay - Antibiotic
colored stool o Ceftriaxone
Post icteric - Recovery  IM ‘
- Chances are it is o Treatment for chlamydia (doxycycline)

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 COMMUNICABLE DISEASES

- Health education: PREVENTION (ABCD) Treatment

o Abstinence - Penicillin M
o Be faithful (monogamous)
o Consistent condom usage HIV/AIDS
o Do not use drug - Etiology: Retrovirus
o Some of it cannot be recognized
GENITAL HERPES MOT
- Herpes simplex type 2 - Body fluids
- Chronic o Blood (BT, pricks, transplant)
o Remission – no vesicles o Semen
o Exacerbation – with vesicles o Vaginal discharge
o Breastmilk
MANIFESTATION
- Painful fluid-filled vesicles in the genitals Course
- HIV infection
TREATMENT - AIDS-related complex
- Antiviral - AIDS
o Acyclovir (7 days)
AFFECTATION
SYPHILIS
- Treponema pallidum

MOT
- Sexual contact
- Blood transfusion
- Needle pricks
- Vertical transmission (mother to baby)

STAGES
- Painless ulcer
- Heals
spontaneously - CD4 lymphocytes
Primary: Chancre o N: 500-1500 mm/3
with or
without o AIDS: <200 mm/3
treatment
- Flu like sx Manifestation
- Dermatitis* - immunosuppression
Secondary: o Opportunistic infection
- Patchy alopecia
Condylomata  The more vulnerable =
- Generalized
lymphadenopathy easy to compromise
- Infiltrating lesions  Pneumonia cystis carinii
- CV changes  Cytomegalovirus retinitis
Tertiary: Gumma - CNS degeneration  Candidiasis (T: Nystatin –
- No longer spit or swallow*)
communicable o Persistent fever
o Chronic diarrhea
Diagnosis o Weight loss
- Blood exam or culture o Lymphadenopathy
- Venereal Disease Research Laboratory
(VDRL) Diagnosis
- Rapid plasma reagin (RPR) - Window period: 2 weeks to 6 months: avg is
3 months (looking for the antibodies)

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 COMMUNICABLE DISEASES

- Enzyme-linked immunosorbent assay (EIA) - Vesicle

- Western blot test (WB) o Fluid filled lesion
- Pustule
Management o Pus filled lesion
- Highly Active Anti-Retroviral (HAART) – - Crust/Scab
combination in one tablet TLD or LTE o Dried lesion
o Lamivudine
o Tenofovir MEASLES (RUBEOLA-RED)
o Dolutegravir - Tigdas
o Efavirenz
- Regular lab monitoring MOT
o CD4 lymphocyte count - Airborne
o Viral load
 Goal: UNDETECTABLE Diagnosis
 U = U (undetectable and - Clinical observation
untransmittable) - CBC

Prevention STAGES
- Standard precaution - cough
- Safe sex practices (ABCD) - Cold
- Prophylaxis - Conjunctivitis
o Pre-exposure - Photosensitivity
PRE-ERUPTIVE
 2 hours before act- 1 after - Enanthem (kolpik
-1 day after daily spots – bluish
o Post-exposure white spots at
 After exposure to high buccal cavity)
risk/confirmed contacts - Exanthem
 1 month - Maculopapular
ERUPTIVE
- Reddish
Opportunistic infections - Cephalocaudal
POST- ERUPTIVE - Brownish staining
Kaposi’s Sarcoma
- Vascular endothelium Management
- Purplish lesions (non painful or pruritic) that - Isolation
are flat or indurated o Strict isolation
- AIDS defining disease - Oral care
o Kolpiks spot
Treatment o Gurgle with salt water
- Radiation - Skin care
- Chemotherapy o Calamine lotion
o Anti-histamine
Integumentary Infections o Oatmeal
- Vitamin A administration SQ
Eruptive fevers o 6-11 months (100,000 IU – blue)
- Exanthem o 12 months or above (200,000 IU -
o Outside red)
- Enanthem o Protects the RESPI and GI mucosa
o Inside
- Macule Duration of immunity
o Flat lesion - Lifetime
- Papule
o Raised lesion Prevention

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 COMMUNICABLE DISEASES

- MMR – 0.5/SC CHICKEN POX

- Varicella zoster
- Last for 2 weeks
Measles GM VZ HZ
MOT Lesions
- Vesiculopustular
Age of
- Centrifugal distribution
susceptible
- Itchy
Period of
o WOF secondary bacterial infection
Enanthem due to scratching
Exanthem
Direction Management
of spread - Clinical observation
- History taking

GERMAN MEASLES (RUBELLA) Management

- Tigdas hangin - Anti-viral
- 24 hours measles o Acyclovir (5 days)
- Susceptible to pregnant woman - Antipruritic
o Calamine
MOT o Anti-histamine
- droplet o Oatmeal
o Faster drying – baking soda
STAGES compress
- Fever, mild - Skin care
coughing, colds o Gloves or mittens
- Enanthem - Nutrition
PRE-ERUPTIVE o Avoid fishy and seafood
(Forscheimer’s
spots – reddish o Lessen eggs
buccal cavity) o Avoid protein rich foods
- Lesions: Similar to
measles Immunity
ERUPTIVE - Characteristics - Lifetime
signs:
- Lymphadenopathy SHINGLES
POST- ERUPTIVE - Rashes disappears - Herpes zoster
- Dormant
Diagnosis - Target: adults
- Clinical observation
- Rubella titer test (pregnant woman) MOT
o Result to infant malformation - After previous varicella
- Caution: pregnancy
o Gamma globulin within 72 hours Lesions
after exposure - Localized
- Duration of immunity - Painful
o Infant recovered – lifetime
immunity Management
o MMR - 9 mos and 12 mos (2 doses) - Pain relief (GABA- inhibitory)
o Gabapentin
Prevention o Pregabalin
- Vaccination o Carbamazepine – anti-convulsant
- Anti-viral

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 COMMUNICABLE DISEASES

o Acyclovir o Promote non-stimulating

environment
Recurrence - Protect from injury
- o Padded side
o Raise hand rails
- Cluster your nursing intervention
DISEASES OF THE NERVOUS SYSTEM
Prevention
TETANUS - Vaccination – 5 years
- Lockjaw
- Clostridium tetani (anaerobic bacteria) MENINGITIS
o Spore forming bacteria Etiology
- Children
MOT o Haemophilus influenzae type B
- Break in skin integrity - Adult
o NB - cord o S. pneumonia
o School children – dental caries o S. aureus
o Adult – any type of would (deep o N. meningtidis
punctured wounds)
Mot
S/sx - Droplet
- Painful involuntary contractions
o Masseter Manifestation
o Facial - Increased ICP
o Opisthotonos o Decreased level of LOC
o Tetanus neonatorum - Projectile vomiting
o Trunk - Stiff neck
o Extremities - Nuchal rigidity
o Laryngeal and respiratory muscles - Abnormal reflex
o Brudzinski’s neck
Diagnosis o Kernig’s
- Clinical observation
Diagnosis
Clinical management - CSF analysis
- Immunization o Lumbar
o Active immunity: TT o Spinal tap
o Passive: ATS, TAT  Fetal position
- Antibiotic
o Penicillin G Management
- Muscle relaxants: - Antibiotic
o Diazepam drip o Ceftriaxone
o PO: methocarbamol - Steroid
o Lioresal o Dexamethasone
o Eperisone - Diuretics
o Mannitol
Nursing management o Check BP before administering
- Maintain airway o Withhold if BP is 90/60
- Prevent spasms - Anticonvulsants
o Dim lights o Diazepam
o Lessen noise o Phenytoin
o Limit visitors o Phenobarbital

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 COMMUNICABLE DISEASES

Measures to decrease ICP

- Avoid the following: MOT
o Coughing - Vertical/sexual
o Sneezing
o Suctioning Complication
o Straining - Fetal anomalies/complication
o Bending
o Heavy lifting MERS-COV
- Position
o Straight MOT
o NEVER high fowlers - Animal to human; human to human
- Environmental manipulation
Manifestation
LEPROSY - Respiratory s/sx
- Hansen’s disease/ Hansenosis - No vaccine or specific treatment

Etiology
- Mycobacterium leprae EBOLA VIRUS DISEASE

MOT MOT
- Prolonged, intimate skin to skin - Contact with body fluids of fruit bats,
- contact chimpanzees, gorillas, monkeys
- Human to human transmission
Diagnosis
- Skin slit smear Complication
- Skin lesion biopsy - Hemorrhage
- Peripheral nerve enlargement o High fatality rate
- Loss of sensation
Management
Manifestation - No medication nor vaccine BUT was
- Skin lesion that does not heal controlled due to known source
- Skin lesions spread throughout the body
- Conjunctivitis MONKEYPOX
- Nosebleed - Viral zoonotic disease
- Disfigured face o Squirrels
o Nostril deformed o Rats
o Loss of eyebrows o Primates
o Earl lobe thick and lumpy
- Incomplete eyelid closure (lagophthalmos) MOT
- Deformities in the hands and feet - Close contact
- Paralysis o Lesions
o contractures o Respiratory droplets
- Fingers are amputated due to necrosis o Beddings
- Vertical transmission
Leprosy mgt - Related to smallpox, less contagious and
severe s/sx
OTHER EMERGING INFECTIONS
Manifestation
ZIKA VIRUS - Fever
- Mosquito borne disease; similar vector with - Lymphadenopathy
dengue - Rashes

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 COMMUNICABLE DISEASES

o Face, extremities (shingles like)

o Maculopapular, vesiculopustular

Diagnosis
- PCR (skin lesion)
- Self-limiting disease (2-4 weeks)
- Complications (severe
immunocompromised)
o Pneumonia
o Sepsis
o Encephalitis
o Corneal infection may lead to
blindness

Medication
- Tecovirimat

Vaccination
- Attenuated vaccina virus (Ankara strain)

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