Hepatitis

1. Communicable disease in
toddler
Communicable disease result from infection or
infestation capable of being transmitted directly or
indirectly from man or from animal to man or from
environment to man or animal.
With better knowledge and advancement in their
epidemological studies these disease are now
being efficiently controlled in developed countries
but in developing countries quite a number of
these disease are still a problem .The major pre-
requirment for the spread of this disease are:

2. Cont….
• Presence of infectious agent .
• Presence of susceptable person.
• Favourable environmental factor.
Some communicable disease which are more
common in toddler are
Common viral infection
1.Viral hepatitis A
2.Poliomyelitis
3.Measels
Common bacterial infection
1.Whopping cough
2.Enteric fever
3.Tetanus

3. VIRAL HEPATITIS A
• It is an acute communicable disease caused
by an RNA virus of the enterovirus family .Age
group under 15 yre are at most risk.
RISK FACTOR
• Commonly in early winter
• Infected water,food(waterborn and
foodborne)
• Man,s faeces(mainly)serum,blood or other
fluid.

4. MOOD OF TRANSMISSION
• Fecal-oral route
• Parenteral route
• Sexual transmission
Incubation period
15 to 45 day(usually25 to 30 day)
Clinical feature
• Fever ,anorexia ,followded by progressive
jundice.
• Leathergy ,irritability ,nausea vomiting
abdominal pain
• Pruritis

5. Cont…
• Anemia ,tender hepatomegaly ,spleenomegally.
• Palmar erythemia and gynacomastia
MANAGEMENT
• Prvide adequate rest.
• Encourage to take proper diet.
• Provide psychological support.
• Provide symptomatically treatment.
• Relief of pruritis.
• Antiemetic decrease nausea and vomiting.
• A diet high in carbohydrate and calories with moderat
amount of fat and protein is recommended.

6. PREVENTION
• Control of reservoir .
• Control of transmission by maintain personal
hygiene, prevent contamination of water
,food ,milk.
• Control susceptabl population.

7. Defination
• Typhoid fever is an acute infectious disease caused
by salmonella typhi.
• The term “enteric fever” includes both typhoid and
paratyphoid fevers.
• The disease may occur sporadically , epidemically , or
endemically.
• It is characterized by constitutional symptoms like
prolonged pyrexia ,prostration and involvement of
spleen and lymph nodes.

8. Etiology
• It is caused by Salmonella typhi , Salmonella
paratyphi A, B and C lead to a typhoid like
illlness ,so called paratyphoid fever.

9. Mode of transmission
• Oral ingestion of contaminated food or beverage.
• Unboiled milk and vegetable or water.
• Hand to mouth transmission after using a
contaminated toilet and neglecting hand
hygiene.
• Oral transmission via sewage contaminated water
or shellfish.
• House flies play a significant role by carrying
bacilli from urine or stool of an infected person or
active sufferer or carrier to food and products

10. Incidence
• Common in infant and young children.
• Highest in 5-19 years age group.
• Peak incidence occurs in summer and rainy
season.

11. Incubation period
• 10-14 days with a range of 3days to 3 weeks .

12. Clinical features
• Rapid raise of temperature
• Extreme malaise
• Anoroxia
• Severe headache and coated tongue
• Vomiting and abdominal pain and distension
• Cloudiness of consciousness
• Diarrhea
• A rash (maculared rose spot)is said to be
appear about 5th day on the front &back of

13. • Bacillary dysentry ,respiratory infection or
meningitis.
• Convulsion ,anemia, blood loss or hemolysis
from auto antibodies.
• Seizures ,jaundice,hepatomegaly,anoroxia &
weight loss.

14. Diagnosis
• History collection
• Physical examination
• Blood and bonemarrow culture.
• Routine blood examination
• Widal test is positive.
• Stool& urine culture is positive after 2nd week.

15. Management
1. Specific management of enteric fever is
antibiotic.
• Antibiotics are used for about 10-14 days.
Drugs used are;
• 3rd generation cephalosporins such as
ceftrixone , cefotaxim,cefexime.
• Fluoroquinolone such as ciprofloxacin,
ofloxacin
• chloramphenicol

16. 3. Other supportive management includes;
• Management of fever: antipyretics, rest ,
fluids
• Maintenance of fluid & electrolyte balance.
• General care like oral &general hygiene ,
bowel & bladder care(careful disposal).
• Nutritious diet should be provided.
• Blood transfusion may be needed in intestinal
perforation or hemorrhage.

17. POLIOMYELITIS
INTRODUCTION
Acute viral infection
Caused by RNA enterovirus, called polio
virus.

18. CAUSES
RNA virus
Infectious materials
Droplet infections
Transmitted through faeco-oral route.

19. CLINICAL TYPES
Asymptomatic poliomyelitis
Abortive poliomyelitis
Non-paralytic poliomyeliti
Paralytic poliomyelits

20. CLINICAL MANIFESTATION
Asymptomatic:
Sub clinical infections
silent or in apparent
Abortive:
Fever, sore throat
Headache
Nausea and vomiting
Anorexia
Abdominal pain

21. Non-paralytic:
Meningeal irritation as:
neck rigidity, headache, backache, pain in legs,
neck pain, nausea and vomiting, back stiffness.
Paralytic:
- spinal form: fever, muscle pain, hyperasthesiatremors, deep
tendon reflexes, flaccid paralysis, urinary retention and
constipation.

22. -Bulbar form: dysphagia, nasal speech, dyspnea, facial
and vagus nerve paralysis.
-Bulbospinal: features of both spinal n bulbar.
-Encephalitic form: irritability, tremors, drowsiness,
convulsion, unconsciousness and may be paralysis.

23. MANAGEMENT
No specific treatment.
Supportive treatment:
 Hospitalization
 Strict bed rest
 Positioning and suctioning
 Maintain neutral position of limbs
 Avoid over stretching of paralytic limb
 Analgesic and hot formentation
 Anti-hypertensive drugs and tranquilizer
 Maintainence of fluid and electrolye balance
 Nutritious diet and personal hygiene
 Physiotherapy
 Emotional support and rehabilitation
 Surgical management

24. PREVENTION
Active immunization with OPV.

25. TETANUS INFECTION

26. Clostridium Tetani

27. Clostridium tetani is a gram
positive, anaerobic, spore
bearing organism.
The spores are highly
resistant to injurious agent,
boiling, phenol, cresol etc.

28. etiology
Lack of handwashing or lack of good hygiene.
Contaminated cut or deep puncture injury eg- stepping on a nail.
Injuries that involve dead skin such burn, frost bite,gangrene etc.
Wound contaminated with soil,saliva or feces.
Skin puncture with unsterile needle.
In neonate
Unhygenic delivery practices- delivery by untrainedperson, traditional
birth customs.
Lack of intrest in immunization among antenatal mothers or lack of
education.
Lack of handwashing or hygiene.
Lack of health care centers in remote areas.
Unbilical cord stump contaminated.
Use of cow dunk or soil in the wound or in umbilical cord to prevent
bleeding.

33. Clinical manifestation
Localized tetanus manifest withpain, constant rigidity and muscles
spasm in the region of injury.
Generalized tetanus- rapid progression in muscle spasm and cramps.
Locked jaw or trismus due to stiffness of the masseters.
Difficult in opening mouth and difficult in swallowing.
Restlessness, irritability, headache, neck rigidity.
Rigidity of muscles of back and neck make body arch like bow
(opisthotonus position).
Constant spasm of the muscles of extermities and abdomen.
Other presentation – convulsion, tetanic spasm with clencing of jaws,
hands.
 spasm of laryngeal muscles with respiratory distress, cyanosis and
overexhaustion.

37. management
Specific management should aims
at neutralizing of the toxin and
removal of the clostridium tetani.
Human tetanus immunoglobulin 500-
3000 IU should be given IM immediate
on admission.
Antitetani serum can be
administered after skin test with
30,ooo-1,000,000 IU IM or IV.
Antibiotics administration penicillin
or cephalosporine.

38. IV therapy and oxygen therapy are
essential.
Mechanical ventilationmay be
needed in respiratory paralysis.
Tracheostomy may required in
persistent laryngeal spasm.
Isolate the patient with complete
rest and close observation.
Suctioning oforopharyngeal
secretion, comfortable

39. IMMUNIZATION & VACCINATION

40. THANK YOU