This document discusses communicable diseases and central nervous system infections. It defines communicable diseases and outlines the chain of infection, including the infectious agent, reservoir, mode of transmission, portal of entry/exit, and susceptible host. It also classifies diseases based on occurrence and stages of disease. Specific diseases discussed include dengue fever, malaria, filariasis, meningitis, meningococcemia, and rabies. Treatment and nursing considerations are provided for each condition.

1. Communicable Diseases g. Invasiveness- ability to penetrate the cell A. Based on behavior within host
2. Reservoir 1. Infectious disease- caused by invasion
 Communicable Diseases - Natural habitant of the organism that is and multiplication of microorganisms that
- Is defined as an illness caused by an where resides and multiplies. can be transmitted form one person to
infectious agent or its toxins, which can be a. Human another.
transmitted directly or indirectly to a well b. Animal Ex: Dengue fever, malaria, leptospirosis
person. c. Non- animal 2. Contagious disease- easily spreads from
- Caused either by bacteria or virus 3. Portal of Exit/ mode of escape form one person to another.
- Sources of infection consist of man, animal, reservoir: Ex: TB, chicken pox, measles
contaminated food or water, insects and a. Respiratory tract (most common in man)
NOTE: All Communicable Diseases are
environmental factors, such as, dust and b. Gastrointestinal tract
Infectious. But not all infectious diseases are
dirt. c. Genitor- urinary tract
contagious.
 Chain of Infection d. Open lesions
e. Mechanical escape (includes bite of B. Based on occurrence of Disease
insects) a. Sporadic Disease
f. Blood b. Endemic Disease
4. Mode of transmission c. Epidemic Disease
- Indicates the potential of the disease d. Pandemic Disease
4 main routes of transmission e. Herd Immunity- when a large number of
A. Contact transmission people in a population in a particular area
1. Direct contact developed immunity to a particular
2. Indirect contact disease.
1. Causative/Infectious Agent 3. Droplet contact  Stages of Disease
a. Pathogenicity- ability to cause disease B. Vehicle Route 1. Incubation Period
b. Virulence (disease severity) and 1. Food 2. Prodromal Period
invasiveness (ability to enter and move 2. Water 3. Period of Illness
through tissue) 3. Drugs 4. Period of Decline
c. Infective dose- number of organisms needed 4. Blood 5. Period of Convalescence
to initiate infection. C. Airborne Transmission
d. Organisms specificity (Host preference) 5. Portal of Entry/ mode of entry of
antigenic variations Organisms into human VECTOR BORNE INFECTIONS
e. Elaboration of toxin 6. Susceptible host 1. Dengue hemorrhagic Fever (Break Bone
f. Viability- ability to survive outside host  Classification of Communicable Diseases Fever)

2. 2. Malaria e. Manage epistaxis (ice - Other test: CBC, BUN, creatinine,
3. Filariasis compression or nasal pack) SGOT, SGPT
1. Dengue hemorrhagic Fever (Break Bone f. Treatment for shock: PRICES  Management: treatment based on the
Fever) P- rotect species of malaria
 Caused by: Flaviviridae virus R- est a. 1st line anti malarial drugs: Chloroquine,
 Transmitted through: female Aedes i-ce Sulfadoxine, Pyrimethamine and
Egypti mosquito C-ompression Primaquine
 3 clinical stages: E-levation b. 2nd line: Artemeter lumefranthine
1. Febrile/ invasive stage (1st 4 days) S-upport  Nursing Interventions
2. Toxic/ hemorrhagic stage (4th -7th g. Diet: EDCF and drinks a. Advise to avoid outdoor night activities,
day)  WOF: signs of complications like esp. vector’s peak biting hours from 9pm-
3. Convalescent/ Recovery Stage (7th- bleeding and signs of shock 3am
10th day) b. Use mosquito repellents
 S/Sx: - body malaise 2. Malaria c. Using chemophylatic anti- malarial drugs
- saddle- back fever  Caused by: plasmodium with 4 species:  WOF: cerebral malaria (headache, vomiting,
- joint pains P. Falciparum (most serious type), P. changes in LOC, seizure).
- abdominal pain Vivax, P. malaria, P. ovale
- epistaxis  Transmitted through: female anopheles 3. Filariasis- chronic parasistic infection
- gum bleeding mosquitoes  Caused by: Wuchereria bancrofti and
- (+) tourniquet test  s/Sx: fever- 2-3 days interval (hallmark) Brugia malayi
 Dx: a. Torniquet Test (Rumpel leads 3 classic stages:  Transmitted through: Aedes, anopheles,
test) 1. cold stage- 10- 15 mins of chills and mansonia mosquito
b. Labs: platelet count, HCT, PTT, shakes  s/Sx: asymptomatic- early stage
PT 2. hot stage- 4-6 hrs of high grade fever lymphangitis, lymphadenitis,
 Management: Symptomatic and with severe headache, vomiting, elephantiasis and hydrocelle- late S/Sx
supportive therapy abdominal pain and cyanotic face  Dx:nocturnal blood examination- blood
a. Paracetamol- fever 3. diaphoretic stage- excessive taken at 8pm- 4am
b. Omeprazole- inhibits production sweating Immunochromatographic test- rapid
of HCl.  Dx:- clinical history of travel to endemic assessment method at daytime
c. Sucralfate- coats lining of gastric areas  Managemet:
stomach - Malarial blood smear (thick or thin DOC:Diethylcarbamazine or
d. Ranitidine- inhibit secretion of smear) - best time to extract: at the Hetrazan- taken after meals; for 12
gastric acid height of the fever for P. falciparum. days and surgery for chronic cases.

3.  Caused by: rhabdovirus 1. Active
CENTRAL NERVOUS  Types: Ex: purified chick embryo vaccine
SYSTEM INFECTIONS 1. Damp/silent type- asymptomatic (PCEC), RABIPUR,VEROWELL
1. Meningitis 2. Furious 2. Passive- give immediate but
2. Meninggococcemia  3 Stages: temporaryprotection
3. Rabies 1. Prodromal- symptoms with no reason Ex: Equine rabies immunoglobulin
4. Tetanus - earliest sign : paresthesia/numbness (ERIG)- Wt in Kg x 0.2=ml to be
1. Meningitis- inflammation of meninges on the bitten area injected (stock is 5ml/vial),
 Caused by: Neisseria meningitides, H. 2. encephalitic- foaming of the mouth. Human rabies
influenza,M. tuberculosis and S. Hydrophobia, aerophobia immunoglobulin(HRIG)- wt in kg X
Pneumonia 3. paralytic .1333= ml to be injected (stock
 s/Sx: Meningeal irritations- Brudzinski  s/Sx: pathognomic sign: Hydrophobia 2ml/vial).
sign, babinski sign and kernig sign  Dx:history of bite, fluorescent antibody 4. Tetanus
(pathognomonic sign) test (FAT), and microscopic examination  Caused by: clostridium tetani
 Dx:lumbar puncture of negri bodies  s/Sx: trismus, risus sardonicus
 Managemet:Mannitol- to dec. ICP  Management: (sustained contraction of the facial
 WOF: ICP - Patient should be categorized first muscles produces a grimace),
1. Category 1- licking of intact skin, no opisthotonus (sustained contraction of
2. Meninggococcemia abrasion the back muscles produces an arched
 Caused by: Neisseria meningitidis 2. Category 2- lower extremity bite and back), rigid abdomen and local muscle
 s/Sx: high grade fever, pathognomonic biting animal should be observed for 2 spasms
rash (violaceous or purpuric rashes), wks  Dx:wound culture, CBC
Fulminant meningococcemia(enlarging 3. Category 3- upper extremity bite, head,  Management: DOC: Penicillin
violaceous rashes with vasomotor neck bite or any site of bite and the dog Tetanus toxoid prophylaxis (0-1-6-1-
collapse and shock) can’t be observed for 2 wks 1)
 Dx:blood, CSF, skin lesion culture - treatment is based on the category of bite: Control of muscle spasm: diazepam
 Management: Antibiotic of choice: o 1. Category 1- observe the dog for 2  Nursing Interventions: maintain
Penicillin wks airway patency, neutralized the toxin.
 WOF: complications like deterioration of o 2. Category 2- give active vaccine
sensorium, signs of shock and signs of and observe dog for 2 wks
bleeding. o 3. Category 3- give passive and Prepared by: Janica Mae B. Gonzales
active vaccine
 Vaccine BSN- 4B1
3. Rabies aka Lyssa
11/12/12