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CHN - communicable diseases.pdf
- 1. RESPIRATOY INFECTIONS CON, EIMS Host Factor All ages Less immunity Introduction: It is an acute infectious disease caused by variola virus. It was one of the greatest killer diseases in 1967. India declared small pox free in 5th July 1975and eradication at April 1977. Globally eradication of small pox in May 1980. Epidemiological determinants: Source of infection Period of communicability Mode of transmission Clinical features Diagnostic evaluation Prevention • Usually the cases of chicken pox • Oropharyngeal infections • Skin leasion • 1 to 2 days before appearance of rash • 4 to 5 days after appearance of rash • Droplet infection • Face to face contact • Fomitus • Sudden onset of fever • Head ache • Vomiting • Rash – starts from face to trunk • stages of rash - macule, papule, vesicle, pustule and scab. Blood serum for antibodies and immunoglobulin • Immunoglobulin • Vaccine Control • Antiviral therapy • Notification • Isolation Incubation period: 14 to 21 days SMALL POX Agent: variolla virus Environmental factor
- 2. RESPIRATOY INFECTIONS CON, EIMS Host Factor Children under 10 years Less immunity Environmental factor Winter and spring season Introduction: Chicken pox or varicella is an acute, highly infectious disease caused by varicella – zoster virus. Epidemiological determinants: Source of infection Period of communicability Mode of transmission Clinical features Diagnostic evaluation Prevention • Usually the cases of chicken pox • Oropharyngeal infections • Skin leasion • 1 to 2 days before appearance of rash • 4 to 5 days after appearance of rash • Droplet infection • Face to face contact • Fomitus Pre eruptive stage (First 24 hours) Sudden onset of fever, malaise, shivering Eruptive stage • Rash appear from trunk to face • Macule, papule, vesicle and scab • Pleomorphism Blood serum for antibodies and immunoglobulin • Vericella – zoster immunoglobulin • Vaccine Control • Antiviral therapy • Notification • Isolation Complications Usually, it is self-limiting disease • Pneumonia • Hemarrhage • Encephalitis • Congenital defects in fetus Incubation period: 14 to 16 days CHICKEN POX Agent:
- 3. RESPIRATOY INFECTIONS CON, EIMS Host Factor 6 months to 3 years of age Less immunity Mal nourished child Environmental factor Any season usually Winter season Introduction: An acute infectious disease of childhood caused by a specific virus of the group of myxovirus. Epidemiological determinants: Source of infection Period of communicability Mode of transmission Clinical features Diagnostic evaluation Prevention • Usually the cases of measles • Oropharyngeal infections 4 days before and 4 days after appearance of rash • Droplet infection • Face to face contact • Fomites Prodromal stage Fever, coryza, cough, redness of eyes, lacrimation, Koplik’s spots Eruptive stage Dusky red macular rash behind the ears spread rapidly over the face, neck, Rash disappear within 3 to 4 days Blood serum for antibodies and immunoglobulin • Immunoglobulin • Vaccine – Age – 9 months Dose – 0.5 ml Route – SC Control •Notification •Isolation •Antiviral therapy Complications Usually, it is self-limiting disease • Pneumonia Otitis • Diarrhoea • Encephalitis • Congenital defects in fetus Incubation period: 10 to 14 days MEASLES Agent: Paramyxo virus
- 4. RESPIRATOY INFECTIONS CON, EIMS Host Factor All ages Environmental factor Winter and spring season Over crowding Introduction: An acute respiratory tract infection caused by influenza virus, of which there are 3 types – A, B and C. A – H1N1, H3N2 Commonly in birds H5N1 Can infect pigs and human. Epidemiological determinants: Source of infection Period of communicability Mode of transmission Clinical features Diagnostic evaluation Prevention • Usually, the cases of influenza • Oropharyngeal secretions 1 to 2 days before and 1 to 2 days after appearance of symptoms • droplet infection • Fever • Chills • Ache and pains • Cough • Generalized weakness • fever, cough, sore throat, rhinorrhoea, head ache, muscle pain • Throat swab culture • Immunoglobulin assay • Avoid over crowding • Good ventilation • Cover the face • Hand washing Control • Notification • Isolation • Antiviral therapy • Use of mask, sanitation, hand washing, PPE, isolation. Complications • Asthma, • COPD, • Hepatic failure, • Renal failure. Incubation period: Usually 18 to 72 hours, for H1 N1 is 2 to 3 days Agent: Influenza A, B, C Reservoir of infection Swine, horses, dogs, cats, domestic poultry, wild birds INFLUENZA
- 5. RESPIRATOY INFECTIONS CON, EIMS Host Factor 6 months to 3 years of age Less immunity Malnourished child Environment Factor Winter and spring season Introduction: It is a contagious viral infection best known by its distinctive red rash and lymphadenopathy. Also called as ‘German measles’ or ‘three-day measles’. Epidemiological determinants: Source of infection Period of communicability Mode of transmission Clinical features Diagnostic evaluation Prevention • Usually, the cases of rubella • Oropharyngeal infections One week before and after appearance of symptoms. • Droplet infection • Trans-placental transmission Prodromal symptoms Fever, coryza, cough, redness of eyes, lacrimation Lymphadenopathy post auricular and post cervical lymph nodes Rash Minute, discrete, pinkish macular rash Throat swab culture • Immunoglobulin • Vaccine – ▪ 15 months, along with measles vaccine (MMR) ▪ Booster dose in adolescent girls in 14 – 15 years of age. Control • Notification • Isolation • Antiviral therapy (No specific treatment for rubella) Complications Usually, it is self-limiting disease • Encephalitis • Thrombocytopenic perpura • Congenital malformation in fetus. Incubation period: Average 17 days; usually 12 to 20 days. RUBELLA Agent: RNA virus of the tago virus family
- 6. RESPIRATOY INFECTIONS CON, EIMS Host Factor usually children Environmental factor Over crowding Poor nutrition, LBW Rainy and winter season Introduction: Common cold Acute infectious diseases caused by various microorganisms and usually self-limiting disease. Rarely complications Epidemiological determinants: Source of infection Period of communicability Mode of transmission Clinical features Diagnostic evaluation Prevention • Usually, the cases of influenza • Naso pharyngeal secretions as long as symptoms • droplet infection • Fever • Cough • Malasie • Sneezing • Rhinorrhoea etc. Classification: • Very severe pneumonia • Severe pneumonia • Pneumonia • No pneumonia •Throat swab culture •Immunoglobulin assay • Immunization • Personal hygiene • Mask • PPE Control • Notification • Antiviral therapy • Early identification and treatment • PPE Incubation period: differs based on agent ACTUTE RESPIRATORY INFECTIONS Agent: B. Pertussis C. Diphtheriae H. Influenza Staphylococcus Streptococcus Ademovirus Enterovirus Corana virus M. Pneumoniae
- 7. RESPIRATOY INFECTIONS CON, EIMS Host Factor 5 years of age, less immunity, Malnourished child Environmental factor Winter and spring season Introduction: An acute infectious disease caused by an RNA virus. Epidemiological determinants: Source of infection Period of communicability Mode of transmission Clinical features Diagnostic evaluation Prevention • Usually, the cases of rubella • Oropharyngeal secretions • Also, blood, urine human milk, even in CSF 4 to 6 days before symptoms and one week after symptoms • droplet infection • direct contact •Pain and swelling of the parotid gland •May involve sublingual and submandibular gland •Ear ache •Stiffness in opening of mouth • Throat swab culture • Immunoglobulin assay • Immunoglobulin • Vaccine – 15 months, along with measles vaccine (MMR), booster dose in adolescent girls in 14 – 15 years of age. Control • Notification • Isolation • Antiviral therapy • Disinfection of articles Complications • Orchitis • Ovaritis • Pancreatitits • Meningo encephalitits • Thyroiditis Neuritis • Hepatitis • Myocarditis Incubation period: 2 to 4 weeks MUMPS Agent: Myxovirus paratoditis
- 8. RESPIRATOY INFECTIONS CON, EIMS Host Factor 1 to 5 years of age Both sex Introduction: It is an acute infectious disease caused by cornybacterium diphtheriae. Epidemiological determinants: Source of infection Period of communicability Mode of transmission Clinical features Diagnostic evaluation Prevention and control • Usually the cases & carriers • Oropharyngeal secretions • Discharges from lesions • Contaminated fomitus • Infectious dust 14 to 28 days after appearance of symptoms • droplet infection • Infectious cutaneous lesion • Contaminated objects Pharyngo-tonsillar diphtheria •Sore throat, •difficulty in swallowing, •low grade fever Laryngotracheal diphtheria •Fever, •hoarseness of voice, •crouphy cough Nasal diphtheria •Fever, •righnorrhoea, •erythema • Throat swab culture • Immunoglobulin assay • Avoid over crowding • Good ventilation • Cover the face • Hand washing • Immunization - DPT Age – 6, 10, 14 weeks of age 0.5 ml – IM • Notification • Early detection • Isolation • Antiviral therapy o diphtheria antitoxin o erythromycin Incubation period: 2 to 6 days DIPTHERIA Agent: Cornybacterium diphtheriae Environmental factor All seasons
- 9. RESPIRATOY INFECTIONS CON, EIMS Agent: Bodetella pertussis Host Factor Infant and preschool children Environmental factor Winter and spring season Over crowding Introduction: An acute respiratory tract infection usually affecting young children otherwise known as whooping cough. Epidemiological determinants: Source of infection Period of communicability Mode of transmission Clinical features Diagnostic evaluation Prevention • Usually, the cases of pertussis • Naso pharyngeal secretions one week before and 3 weeks after catarrhal stage • droplet infection • Direct contact Catarrhal stage: 10 days Insidious onset, lacrimation, sneezing, corzya, anorexia and malasie. Paroxymal stage: 2 to 4 weeks bursts of rapid, consecutive coughs followed by deep and high-pitched inspiration Convalesent stage: 1 to 2 weeks • Throat swab culture • Immunoglobulin assay • Avoid over crowding • Good ventilation • Cover the face • Hand washing • Immunization Control • Notification • Early detection • Isolation • Antiviral therapy – erythromicin Complications Usually in infants. • Bronchitis • Brochopneumonia • Epitaxsis Incubation period: 7 to 14 days PERTUSIS
- 10. RESPIRATOY INFECTIONS CON, EIMS Host Factor Children and young adults Environmental factor December to June Over crowding Poor housing Introduction: Otherwise called as cerebro-spial fever. It is an acute infectious disease, if not treated can go for coma in few hours. Epidemiological determinants: Source of infection Period of communicability Mode of transmission Clinical features Diagnostic evaluation Prevention • Usually the cases & carriers • Naso pharyngeal secretions until no longer pathogen in nose and throat • droplet infection • Sudden onset of intense headache • Fever • Nausea and vomiting • Photophobia • Stiff neck • Throat swab culture • Immunoglobulin assay • Avoid over crowding • Cover the face • Vaccination • Mass chemoprophylaxis Control • Notification • Early detection • Isolation Antiviral therapy – penicillin Complications Usually, it is self-limiting disease • Encephalitis • Thrombocytopenic perpura • Congenital malformation in fetus. • Incubation period: 3 to 4 days Agent: Neisseria meningitidis MENINGOCOCCAL MENINGITIS
- 11. RESPIRATOY INFECTIONS CON, EIMS Host Factor Mostly Children Mostly Men Malnutrition Environmental factor Over crowding Introduction: It is a specific infectious disease caused by Mycobacterium tuberculosis. It is primarily affecting lungs and causes pulmonary tuberculosis It can also affect intestine, meninges, bones and joints, lymph glands, skin and other tissues of the body. Bovine tuberculosis – affects animals Epidemiological determinants: Source of infection Period of communicability Mode of transmission Clinical features Diagnostic evaluation Prevention • Usually the cases • Naso pharyngeal secretions as long as remain untreated • Droplet infection • Direct contact • Prolonged cough • Weight loss • Fever (usually in evening) • Night sweats • Sputum examination • Sputum culture • Chest x-ray • Tuberculin test – Montoux test • 1 TU of PPD in 0.1 ml in ID • Avoid over crowding • Good ventilation • Cover the face • Hand washing • Immunization: BCG Control • Case finding • Mass screening • DOTS therapy Incubation period: 3 to 6 weeks TUBERCULOSIS Agent: Mycobacterium tuberculosis
- 12. RESPIRATOY INFECTIONS CON, EIMS Host Factor All ages Environmental factor All season Over crowding Introduction: It is an communicable viral disease caused by a new strain of corona virus. Epidemiological determinants: Source of infection Period of communicability Mode of transmission Clinical features Diagnostic evaluation Prevention • Usually the cases of influenza • Naso pharyngeal secretions as long as symptoms • droplet infection • Fever • Cough • Difficulty in breathing • Throat swab culture • Immunoglobulin assay • Avoid over crowding • Cover the face • Hand washing • Isolation • International screening of port • PPE Control • Notification • Isolation • Early detection • Treatment – antiviral therapy Incubation period: 3 to 5 days SARS Agent: Corona virus
- 13. RESPIRATOY INFECTIONS CON, EIMS Host Factor Both sex, old age, immuno depressant Environmental factor Crowded place, poor ventilation Introduction: It is an illness caused by the corona virus SARS COV – 2, that was first identified in December, 2019 in China, then it declared as pandemic. Epidemiological determinants: Source of infection Period of communicability Mode of transmission Clinical features Diagnostic evaluation Prevention • Usually the cases of corona • Naso pharyngeal secretions 2 to 3 days before symptoms and can be contagious after 1 to 2 days after negative report. • droplet infection • contact infection • arousal spreading • Community spreading. • Fever • Cough • Tiredness • Loss of taste or smell • Sore throat • Head ache • Red or irritated eye • PCR test • RT-PCR test through throat swab • RAT • CT scan • Mask • use of sanitizer • physical distensing (6 feet) • hand hygiene • PPE • Vaccine Control • Symptomatic management • Supportive treatment • Zink supplementation • steam inhalation • nutritional support Complications • Respiratory failure • Multiple organ failure Incubation period: 2 to 7 days CORONA Agent: Corona Virus
- 14. RESPIRATOY INFECTIONS CON, EIMS Host Factor Animal whisperer, veterinarian Environmental factor over crowding Introduction: It is a viral zoonotic disease with symptoms similar to small pox. Epidemiological determinants: Source of infection Period of communicability Mode of transmission Clinical features Diagnostic evaluation Prevention • Usually the cases • Naso pharyngeal secretions • Urine • skin lesions • fomitus As long as symptoms completely disappear • Human to human o Respiratory droplet, o Body fluids, o Lesions, o Contaminated clothing and linen • Animal to human o Bite and scratch of infected animals Prodrome stage (0 – 5 days) • Fever, chills, • head ache, • lymphadenopathy, • muscle ache, • sore throat. Skin involvement - Rash • Lasting for 2 to 4 days, • deep seated, • well circumscribed, • umbilication, • Painful and itchy in healing phase. • PCR • RT-PCR • Avoid contact with infected person and objects • Hand hygiene • PPE Control • Isolation • Protection of compromised skin and mucus membrane • Rehydration therapy • Symptom alleviation • Nutritional support • Continuous monitoring • Treatment of complications Incubation period: 5 to 21 days MONKEY POX Agent: Monkeypox virus