Communicable diseases in children and its prevention and
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CHILD HEALTH NURSING; NURSING CARE OF CHILDREN WITH COMMUNICABLE DISEASES
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Communicable diseases in children and its prevention and
- 1. Communicable diseases in children and its prevention and management
- 2. Introduction • Disease • Period of Communicability/ When/How Long Disease Contagious • Clinical Manifestations • Prevention/ Immunization/Immunity • Treatment /Nursing Care/Implementation • Complications
- 3. To discuss………… • Hepatitis B • Diphtheria • Tetanus • Haemophilus influenzae type B • Poliomyelitis • Rubeola (measles) • Parotitis (mumps) • Rubella • Varicella • Hepatitis A • Erythema infectiosum (fifth disease) • Roseola • Lyme disease • Scarlet Fever
- 4. Hepatitis B
- 5. Hepatitis B • Causative agent: • A hepadnavirus; hepatitis B virus • Mode of transmission: • Body fluids, • Transfusion of contaminated blood, • Use of contaminated needle, • To fetus via mother • Incubation period: • Average 60–90 days
- 6. Hepatitis B • Period of communicability/ when/how long disease contagious • End of incubation time and during acute stage • Clinical manifestations • Anorexia, • Abdominal discomfort, • Nausea, • Vomiting, • Jaundice • Prevention/ immunization/immunity • Use of standard precautions • Vaccine for hepatitis B • After exposure— HBIG (hepatitis B immune globulin)
- 7. Hepatitis B • Treatment/nursing care • Rest, • Nutrition with good caloric intake • Complications • Possibly fatal, • Liver problems, • In some cases possibly leading to chronic hepatitis
- 8. Diphtheria
- 9. Diphtheria • Causative agent: • Corynebacterium diphtheriae • Mode of transmission: • Droplet, • Direct contact with infected person, • Carrier, • Contaminated article • Incubation period: • 2–7 days
- 10. Diphtheria • Period of communicability/ when/how long disease contagious • 2–4 weeks in untreated person • 1–2 days with antibiotic therapy • Clinical manifestations • Mucous membranes of nose and throat covered by gray membrane; • Purulent nasal discharge; • Brassy cough; • Toxin from organism passes through bloodstream to heart and nervous system • Prevention/ immunization/immunity • Active immunity from diphtheria toxin in dtap vaccine • Passive immunity with diphtheria antitoxin
- 11. Diphtheria • Treatment/nursing care • Strict droplet precautions; • Intravenous antitoxin and antibiotics; • Bed rest; • Liquid to soft diet; • Analgesics for throat pain; • Immunization for nonimmunized contacts • Complications • Neuritis, • Carditis, • Heart failure, • Respiratory failure
- 13. Tetanus • Causative agent: • Clostridium tetani • Mode of transmission: • Direct or indirect contamination of a closed wound • Incubation period: • 3–21 days
- 14. Tetanus • Period of communicability/ when/how long disease contagious • Non • Clinical manifestations • Stiffness of neck and jaw, • Muscle rigidity of trunk and extremities, • Arched back, • Abdominal muscle stiffness, • Unusual facial appearance, • Pain due to muscle spasms • Prevention/ immunization/immunity • Active immunity from tetanus toxoid in DTaP vaccine
- 15. Tetanus • Treatment/nursing care • Quiet room, • Wound cleaning and débridement, • Penicillin G or erythromycin, • Muscle relaxants • Complications • Serious,Fatal if untreated, • Possible respiratory complications
- 17. Pertussis (whooping cough) • Causative agent: • Bordetella pertussis • Mode of transmission: • Droplet, • Direct contact with respiratory discharges • Incubation period: • 5–21 days
- 18. Pertussis (whooping cough) • Period of communicability/ when/how long disease contagious • About 4–6 weeks, greatest in respiratory stage • Clinical manifestations • Begins with mild upper respiratory symptoms; • In 2nd week progresses to severe paroxysmal cough with inspiratory whoop, • Sometimes followed by vomiting; • Especially dangerous for young infants, may last 4–6 week
- 19. Pertussis (whooping cough) • Prevention/ immunization/immunity • Active immunity from pertussis vaccine in DTaP vaccine; disease gives natural immunity • Treatment/nursing care • Bed rest; • Infants hospitalized; • Oxygen therapy possible, • Observation for airway obstruction; • Provision of high humidity; • Protection from secondary infections, • Increased fluid intake; • Refeeding if vomiting occurs
- 20. Pertussis (whooping cough) • Complications • Pneumonia (can cause death of infant); • Otitis media; • Hemorrhage; • Convulsions
- 22. Haemophilus influenzae type B • Causative agent: • Coccobacilli H. Influenzae bacteria • Mode of transmission: • Droplet, • Discharge from nose and throat • Incubation period: • 2–4 days
- 23. Haemophilus influenzae type B • Period of communicability/ when/how long disease contagious • As long as organisms are present; • Noncommunicable after antibiotic therapy for 24–48 hours • Clinical manifestations • Fever, • Vomiting, • Lethargy, • Meningeal irritation with bulging fontanel or stiff neck and back, • Stupor, • Coma
- 24. Haemophilus influenzae type B • Prevention/ immunization/immunity • Vaccine haemophilus influenzae type b (HIB) • Treatment/nursing care • Antibiotics • Complications • Meningitis, • Epiglottitis, • Pneumonia
- 26. Poliomyelitis (infantile paralysis) • Causative agent: • Poliovirus • Mode of transmission: • Direct and indirect contact, fecal-oral route • Incubation period: • 7–14 days
- 27. Poliomyelitis (infantile paralysis) • Period of communicability/ when/how long disease contagious • Greatest just before onset and just after onset of symptoms, • When virus is present in throat and feces, • 1–6 weeks • Clinical manifestations • Fever, • Headache, • Nausea, • Vomiting, • Abdominal pain; • Stiff neck, • Pain, and • Tenderness in lower extremities that proceeds to paralysis
- 28. Poliomyelitis (infantile paralysis) • Prevention/ immunization/immunity • Inactivated polio vaccine (IPV) disease causes active immunity against specific strain • Treatment/nursing care • Bed rest; • Moist hot packs to extremities; • Range-of motion exercises; • Supportive care; • Long-term ventilation if respiratory muscles involved • Complications • Permanent paralysis; • Respiratory arrest
- 30. Rubeola (measles) • Causative agent: • measles virus • Mode of transmission: • Direct or indirect contact with droplets, nasal, and throat secretions • Incubation period: 10–12 days
- 31. Rubeola (measles) • Period of communicability/ when/how long disease contagious • 5th incubation day through first few days after rash erupts • Clinical manifestations • High fever, • Sore throat, • Coryza (runny nose), • Cough, • Enlarged lymph nodes (head and neck), • Koplik spots (small red spots with bluewhite centers on oral mucosa, specific to rubeola), • Conjunctivitis, • Photophobia, • Maculopapular rash starts at hairline and spreads to entire body
- 33. Rubeola (measles) • Prevention/ immunization/immunity • Attenuated live vaccine (part of MMR vaccine) • Disease gives lasting natural immunity • Treatment/nursing care • Antipyretics, • Comfort measures for rash including • Tepid baths, soothing lotion, • Maintenance of dry skin; • Dimly lighted room for comfort, • Fluids
- 34. Rubeola (measles) • Complications • Otitis media, • Pneumonia, • Encephalitis, • Airway obstruction
- 36. Parotitis (mumps) • Causative agent: • Paramyxovirus • Mode of transmission: • Airborne, • Droplet, • Direct contact with saliva of infected person • Incubation period: • 14–21 days
- 37. Parotitis (mumps) • Period of communicability/ when/how long disease contagious • Shortly before swelling appears until after it disappears • Clinical manifestations • Parotid glands swollen, unilaterally or bilaterally; • May have fever, • Headache, • Malaise, and • Complain of earache before swelling appears; • Angle of jaw obliterated on affected side
- 38. Parotitis (mumps) • Prevention/ immunization/immunity • Attenuated live mumps vaccine (part of MMR vaccine) • Disease gives natural immunity • Treatment/nursing care • Liquids and soft foods because chewing is painful; • Avoidance of sour foods, which cause discomfort; • Analgesics for pain; • Antipyretics for fever; • Local compresses of heat or cold
- 39. Parotitis (mumps) • Complications • In males past puberty orchitis (inflammation of the testes); • Meninoencephalitis; • Possible severe hearing impairment (rare).
- 41. Rubella (German measles) • Causative agent: • Rubella virus • Mode of transmission: • Direct or indirect contact with droplets, nasopharyngeal secretions • Incubation period: • 14–21 days
- 42. Rubella (German measles) • Period of communicability/ when/how long disease contagious • 5–7 days before until about 5 days after rash appears • Clinical manifestations • Low-grade fever; • Headache, • Malaise, • Anorexia, • Sore throat, • Lymph glands of neck and head enlarged; • Pink-red rash begins on face, • Spreads downward, disappears in 3 days, • May have joint pain
- 43. Rubella (German measles) • Prevention/ immunization/immunity • Attenuated live vaccine (part of MMR vaccine) • Disease gives lasting natural immunity • Immune serum globulin may be given to pregnant women • Treatment/nursing care • Comfort measures for rash, • Antipyretics for fever and joint pain • Complications • Severe birth defects if mother is exposed and nonimmunized (especially in 1st trimester)
- 45. Varicella(chickenpox) • Causative agent: • Varicella zoster virus • Mode of transmission: • airborne, direct or indirect contact with saliva or uncrusted vesicles • Incubation period: • 10–21 days • Period of communicability • 1 day before rash appears to about 5–6 days after it appears (until all vesicles crusted)
- 46. Varicella(chickenpox) • Clinical manifestations • Prodromal stage: • Slight fever, • Malaise, and anorexia for first 24 hours; • Rash highly pruritic; begins as macule, rapidly progresses to papule and then vesicle (surrounded by erythematous base; becomes umbilicated and cloudy; breaks easily and forms crusts); • All three stages (papule, vesicle, crust) present in varying degrees at one time
- 47. • Clinical manifestations • Distribution: Centripetal, spreading to face and proximal extremities but sparse on distal limbs and less on areas not exposed to heat (i.e., from clothing or sun) • Constitutional signs and symptoms: Elevated temperature from lymphadenopathy, irritability from pruritus
- 49. Varicella(chickenpox) • Prevention/ immunization/immunity • Attenuated live varicella virus vaccine gives active immunity • Disease causes lasting natural immunity; may reactivate in adult as herpes zoster • Treatment/nursing care • Antihistamines, soothing baths and lotions to reduce itching; • Prevention of scratching with short fingernails or use of mittens; • Acyclovir to shorten the course of the disease; no aspirin should be given • Complications • Reye syndrome possible if child has had aspirin during illness; • Secondary infection of lesions if scratched; • Pneumonia, Encephalitis
- 50. Hepatitis A • Causative agent: • A picornavirus; hepatitis A virus • Mode of transmission: • Ingestion of fecal contaminated food or water or contaminated surfaces • Incubation period: • Average 25–30 days • Period of communicability • Highest during 2 weeks before onset of symptoms
- 51. Hepatitis A • Clinical manifestations • Fever, • Malaise, • Anorexia, • Nausea, • Abdominal discomfort, • Jaundice
- 52. Hepatitis A • Prevention/ immunization/immunity • Good handwashing, sanitary disposal of feces • Vaccine for hepatitis A • After exposure— immune globulin • Treatment/nursing care • Enteric precautions, rest, nutritious diet
- 53. Erythema infectiosum (fifth disease)
- 54. Erythema infectiosum (fifth disease) • Causative agent: • Human parvovirus B19 • Mode of transmission: • droplet, contact with respiratory secretions • Incubation period: • 6–14 days • Period of communicability • Uncertain, child may return to school when rash appears, no longer infectious at that point
- 55. Erythema infectiosum • Clinical manifestations • Fever, • Headache, • Malaise; • A week later, red rash appears on face, called a “slapped face” rash; • Rash appears on extremities, then on trunk; • Rash can reappear with heat, sunlight, cold
- 56. Erythema infectiosum • Prevention/ immunization/immunity • No immunity • Treatment/nursing care • Supportive treatment with antipyretics, analgesics, • Droplet precautions (when hospitalized) • Complications • Arthritis possible; • dangerous for fetus (keep infected child away from pregnant women)
- 58. Roseola (exanthema subitum) • Causative agent: • Human herpesvirus type 6 • Mode of transmission: • Unknown • Incubation period: • About 10 days • Period of communicability • During febrile period
- 59. Roseola (exanthema subitum) • Clinical manifestations • High fever; • irritability; • anorexia; • lymph nodes enlarged; • decreased WBC; • rash appears just after sharp decline in temperature; • rash is rose-pink, mostly on trunk, lasts 1–2 days
- 60. Roseola (exanthema subitum) • Prevention/ immunization/immunity • Contracting disease gives lasting immunity • Treatment/nursing care • Symptomatic for rash and fever; • Standard precautions (if hospitalized)
- 61. Lyme disease
- 62. Lyme disease • Causative agent: • Borrelia burgdorferi • Mode of transmission: • deer tick bite • Incubation period: • 3–30 days • Period of communicability • Not communicable from one person to another
- 63. Lyme disease • Clinical manifestations • Starts as a red papule that spreads and becomes a large, round red ring; • Fever; • Malaise; • Headache; • Mild neck stiffness with rash; • Leads to systemic symptoms and chronic problems
- 64. Lyme disease • Prevention/ immunization/immunity • Avoid tick infected areas; • inspect skin after being in wooded areas • Active immunity from Lyme disease vaccine • Treatment/nursing care • Antibiotics • Complications • Cardiac, musculoskeletal, and neurologic involvement
- 65. Scarlet Fever
- 66. Scarlet Fever • Causative agent: • Beta-hemolytic streptococci group A • Mode of transmission: • direct contact, droplet • Incubation period: • 2–5 days • Period of communicability • During acute respiratory phase, 1–7 days
- 67. Scarlet Fever • Clinical manifestations • Begins abruptly; • Fever; sore throat; headache; chills; malaise; • Red rash on skin and mucous membranes; • Tonsils inflamed; enlarged; white exudate; • Tongue—differentiates from other rashes, by day 4–5 “red strawberry” appearance
- 68. Scarlet Fever • Prevention/ immunization/immunity • Lasting immunity after having disease • Treatment/nursing care • Soft or liquid diet, antipyretics, analgesics, • Comfort measures for itching rash; • Penicillin for streptococcal Infection • Complications • Glomerulonephritis or rheumatic fever if untreated
- 69. • Any doubts ?