1. COMMUNICABLE
DISEASE
INCUBATION
PERIOD
CAUSATIVE AGENT MODE OF
TRANSMISSION
PORTAL OF ENTRY
AND EXIT
TREATMENTS
Central Nervous System
Bacterial
Tetanus
(Lock jaw)
3 days to 3 weeks in
adult
3 to 30 days in
newborn
Clostridium Tetani Through
punctured
wounds
Umbilical stump
of the newborn
Dental extraction
Babies deliver to
mother without
tetanus toxoid.
Unrecognized
wounds (cleaning
of the ears with
sharp materials.
ENTRY: when clostridium
tetani enters the body it
causes local infection and
extensive tissue destruction
and local multiplication of
microorganism more
frequently when the wound
was healed.
EXIT: which an infectious
agent leaves the reservoir.
May be continuous such as
with respiratory droplet or
dependent on the body fluid
exiting the body under
unusual circumstances
1)SPECIFIC
- w/in 72 hours after punctured
wound patient should receive
ATS,TAT
-T.T 5cc IM given on standard
precaution
-pen G Na
2)NON-SPECIFIC
- oxygen inhalation
- NGT feeding
-tracheostomy
- adequate fluid, electrolyte and
caloric intake
- good nursing care
Meningitis
(Cerebrospinal fever)
1 – 10 days Neisseria meningitidis Respiratory droplets
through
nasopharyngeal
mucosa
Direct invasion
through otitis media
Skull fracture and
penetrating wound
ENTRY:
- nasal secretions
- buccal secretions
EXIT:
- direct contact
- droplet spray
- droplet nuclei
IV antibiotics – ampicillin,
cephalosporin (ceftriaxone),
aminoglycosides
Digitalis glycosides
(digoxin) – for arrhythmias
Manitol – to dec. cerebral
edema
Anticonvulsant or sedatives
– to reduce restlessness and
convulsions
Acetaminophen – for
headache and fever
Viral
Encephalitis
(Brain Fever)
Typically 5 to 15
days but may ranges
4-21 days.
Arboviruses -Transmitted to human by
the bite of an infected
mosquito.
--Mosquito becomes
infected by biting an
infected bird.
ENTRY:
Skin mucosa or membrane
EXIT:
Respiratory tract
(nose or mouth)
Promote comfort to the
client
Monitor intake and
output.
Convulsion must be
controlled.

2. Nose and throat
secretions should be
sanitary disposed off.
TSB or alcohol sponge
may be given if
temperature is
excessively high.
Oral care should be
done strictly.
Poliomyelitis
( Infantile
Paralysis/Heine Medin
Disease)
7-21 days for
paralytic case
Polio Virus
3 strains:
1.) Leon
2.) Lansing
3.) Brunhilde
Direct Contact –
through feces,
oropharyngeal
Person to person
through healthy
carrier
Indirectly through
food and water
ENTRY:
Oropharyngeal Mucosa
Intestinal Mucosa
EXIT:
Fecal/ Oral
SUPPORTIVE MEASURES:
Analgesics for
headache
Antibiotics to prevent
infection
Rabies
(Hydrophobia/ Lyssa)
1 week – 7 ½
months in dogs
10 days – 15
years in human
A bullet-shaped
filterable virus called
Rhabdovirus
The most common mode
of rabies virus
transmission is through the
bite and virus-containing
saliva of an infected host.
ENTRY: through open
wounds and mucous
membrane such as eyes, nose,
and mouth contaminated with
saliva containing the virus.
EXIT: salivary glands
secretion
Immediate and thorough
cleaning of the wound with
soap, followed by ethanol
or aqueous iodine.
Postexposure prophylaxis
(PEP) if required:
administration of rabies
immunoglobulin in case of
severe exposure
PEP to be applied as soon
as possible – vaccines with
a potency at least 2.5 IU per
single immunizing
intramuscular dose
Immunize all dogs and cats
owned by an individual or
by the community and
reduce the size of the
ownerless dog population
by reproduction control,
reduction of the carrying
capacity of the environment

3. and law inforcement when
needed
Immunize any person with
proven or probable
exposure to rabies and
administer rabies
immunoglobulin in case of
severe exposure
Humans at high risk (e.g.
laboratory personnel,
professions at high risk)
must receive pre-exposure
immunization: 3 injections
of an intramuscular dose on
days 0, 7, and 28.
Circulatory System
Viral
Dengue Fever
(Breakbone
fever/Hemorrhagic
Fever,Infectious
Thrombocytopenia
Purpura)
3-14 days commonly
7-10 days
-Flavivirus 1,2,3,4 ;a
family of Rogaridae
- Arboviruses group b
-Aedes aegypti, A.
albopictus
Bite of an infected
mosquito principally
the Aedes Aegypti.
Aedes Albopictus
mainly contribute to
the transmission of
the dengue virus in
rural areas.
Other contributory
mosquitoes
a.Aedes Polynensis
b.Scutellaris
ENTRY:
- Deposited in the
skin by the vector.
EXIT:
- An infected person
is bitten by a
mosquito; this is the
portal of exit. The
mosquito now has
the dengue virus in
its system and after
about a week the
infected mosquito is
capable of spreading
the virus to another
person
Analgesics drugs rather than
Aspirin.
Intravenous Infusion
Blood Transfusion
Oxygen Therapy
Sedatives
Malaria  P. falciparum: 12
Days
 P. vivax and P.
ovale: 14 Days
 P. malariae: 30
Days
A. Protozoa of genus
Plasmodia
4 Species of Protozoa:
1. Plasmodium
falciparum
(Malignant
Tertain)
1. Mechanically through
bite of an infected
female Anophales
mosquito
2. Parenterally through
blood transmission
3. Through shared
contaminated needles
ENTRY: The infected cells
will be circulated in the body
through the blood stream or
blood.
EXIT: Skin through female
Anophales mosquito bite.
 Anti malarial drugs:
 Choloroquine (all species
except P. malariae)
 Quinine
 as for resistant of P.
falciparum
 Primaquine for relapses of
P. vivax and ovale

4. 2. Plasmodium vivax
(Benign Tertain)
3. Plasmodium
malariae (Quartan)
4. Plasmodium ovale
B. The primary vector
of malaria is the
female Anopheles
mosquito.
4. Through placental
transmission
 Erythrocyte exchange
transfusion for rapid
production of high levels of
parasites in the blood.
Filariasis
(Elephantiasis)
8 to 16 months Wuchereria a
As& lymph
vessels of the
legs, arms, vulva
& breasts.
Brugia malayi
-with
manifestation of
swelling of
extremities, below
knees & below
elbows.
Brugia timori-
affects genitals.
Loa loa-
another filarial
parasite in
humans
transmitted by
deer fly
1. Person to person by
mosquito bites
2. Persons having
circulating
microfilariae are
outwardly health but
transmit the infection
to others through
mosquito bites
3. Persons with chronic
filarial swellings
4. In India, 99.4% of
cases caused by
Wuchereria bancrofti,
Brugia amalayi
ENTRY: Skin by mosquito
bite
1. Invermectin,
albendazole or
diethylcarbamazine
(DEC)
Treatment act by:
a. Eliminating the
larvae
b. Impairing the adult
worms ability to
reproduce &
c. Actually killing the
adult worm
Integumentary System
Measles
(Rubeolla/Morbili)
Usually 10 to 12
days.
Longest is 20 days
and shortest is 8
days.
Filtrable Virus which
belongs to the genus
Morbilivirus of the
family
paramyxoviridae.
Through direct
contact with
droplets spread
through coughing
or sneezing.
Indirectly through
articles or fomites
freshly
ENTRY:
-Respiratory tract
-Droplets
EXIT:
-Respiratory secretions
-Genitourinary
-Transplacental
Anti-viral Drugs
(Isoprinosine)
Antibiotics if there’s a
complication.
Supportive Therapy
Oxygen inhalation

5. contaminated
with Respiratory
secretions or
infected patients.
IV Fluids
German Measles
(Rubella/Three-day
Measles)
Usually 14-21 days
(from exposure to the
appearance of the
rashes)
Rubella virus
(Family: Togaviradae
Genus: Rubivirus)
•Direct contact with
nasopharyngeal secretions
•Indirect contact
•Transplacental
transmission in congenital
rubella
•Contact in pharyngeal
secretions and urine from
infants with congenital
rubella
ENTRY: Respiratory tract
EXIT: Respiratory tract
a. Treatment is essential
symptomatic.
Chicken Pox 10-21 days or may be
prolonged after
passive immunization
against chicken pox
Varicella 1. Direct contact with a
patient who sheds the
virus from the
vesicles
2. Indirect contact,
through linens or
fomites
3. Airborne, or spread
by aerosolized
droplets from the
nasopharynx of ill
individuals
Portal of EXIT: sneezing
Portal of ENTRY: newly
infected mouth
1. Oral cyclovir 800 mg
3x a day for 5 days
2. Oral antihistamine
3. Calamine lotion
4. Salicylates
5. Antipyretics
6. Antihistamine
Herpes zoster
(Shingles/Acute
Posterior Ganglionitis)
Varicella-zoster Unknown, but is
believed to be 13 to 17
days
Direct contact,
specifically through
droplet infection and
airborne spread
Indirect contact
such as article freshly
soiled by secretions
and discharges from an
infected person
ENTRY
-nasopharyngeal space and
the conjunctiva
Symptomatic
Antiviral drugs
Analgesics to control
pain
Anti-inflammatory
Leprosy
(Hansen’s
disease/Hansenosis)
Mycobacterium
leprae
5 ½ months to 8 years Respiratory
droplets
Inoculation
through the skin
break and
mucous
membranes
EXIT - skin and the nasal
mucosa
ENTRY - skin and the upper
respiratory tract
a therapy
Rehabilitation,
recreational and
occupational therapy
Multiple drug therapy
(MDT)

6. - Combinations of
rifampicin 600mg
given once a
month, a 50mg
daily for a 12
month duration and
a 100mg daily for a
leprosy
- For a leprosy, give
rifampicin 600mg
once a month, a
once daily;
duration of
treatment 6 months
- Rifampicin is the
most important anti
– leprosy drug
Scabies Usually between 2 to
6 weeks; can be as
little as 1 to 4 days in
people that have been
sensitized by prior
exposure
Sarcoptes scabiei Skin-to-skin
contact with
persons carrying
the scabies mite
Less often,
scabies can be
transmitted by
sharing of clothes
and bedding
ENTRY: Skin
EXIT: Skin
(Limited entirely to the skin)
Examine the whole family
before undertaking
treatment
Benzyl benzoate emulsion
(Burroughs, Welcome) –
cleaner to use and has more
rapid effect
Kwella ointment
Respiratory System
Bacterial
Diphtheria
(Boulogne Sore Throat)
Usually 2 to 5 days,
occasionally longer
Cornybacterium
diphtheriae
(Klebs-Loeffler bacillus)
Contact with a patient or
carrier or with articles
soiled with discharges of
infected persons. Milk has
served as a vehicle
ENTRY:
Spread person to person via
respiratory droplets or skin
contact
EXIT:
Respiratory droplets;
aerosolized secretions of
infected individuals
Antitoxin - it neutralizes
circulating diphtheria toxin
and reduces the progression
of the disease.
Antibiotics – such as
penicillin or erythromycin.
Inserting a breathing tube
(intubation)
Hospitalization
Bed rest
Intravenous fluids
Tracheotomy
Isolation to avoid contagion

7. Pertussis
(Whooping Cough)
The incubation
period of Pertussis is
commonly 7–10
days, with a range of
4–21 days, and rarely
may be as long as
42days.
Bordetella pertussis 1. Transmission most
commonly occurs by the
respiratory route through
contact with respiratory
droplets, or by contact
with airborne droplets of
respiratory secretions.
2. Transmission occurs
less frequently by contact
with freshly contaminated
articles of an infected
person.
ENTRY:
Respiratory tract
EXIT:
Respiratory tract
1.Antibiotic effective against
pertussis (such as azithromycin,
erythromycin or trimethoprim -
sulfamethoxazole) should be
administered to all close
contacts of persons with
Pertussis, regardless of age and
vaccination status.
Pneumonia
Types of pneumonia:
Community-
acquired
pneumonia
Hospital-acquired
pneumonia
Health Care-
Associated
pneumonia
Aspiration
pneumonia
Atypical
Pneumonia
1-3 days Streptococcus
pneumonia
Respiratory droplets from
the nose or mouth of an
infected person
Respiratory Tract -penicillin
-ceftriaxone
-antipseudomonal
fluoroquinolones
-antihistamines
Others:
-Hydration
-Oxygen inhalation
-Chest physiotherapy
-nasal decongenstants
Viral
Bird’s Flu
Avian Influenza
3 days
ranges of 2-4 days
A bird-adapted strain of
H5N1, called HPAI A
(H5N1) for "highly
pathogenic avian
influenza virus of type A
of subtype H5N1", is the
causative agent of H5N1
flu, commonly known as
"avian influenza" or
"bird flu".
People mainly become
infected with avian
influenza through close
contact with infected birds
and poultry (live or dead)
or their
droppings. Human-to-
human transmission is
inefficient.
ENTRY:
Faeco-oral route (amongst
human or birds)
Upper respiratory tract
among humans
EXIT:
Feces, saliva and nasal
secretions of infected birds
Different types of avian flu virus
may cause different symptoms.
Therefore, treatment may vary.
In general, treatment with the
antiviral medication oseltamivir
(Tamiflu) or zanamivir
(Relenza) may make the disease
less severe if you start taking the
medicine within 48 hours after
your symptoms start.

8. Main upper respiratory tract
among humans
Oseltamivir may also be
prescribed for persons who live
in the same house as those
diagnosed with avian flu.
The virus that causes human
avian flu appears to be resistant
to the antiviral medicines
amantadine and rimantadine.
Therefore these medications
should not be used if an H5N1
outbreak occurs.
People with severe infection
may need to be placed on a
breathing machine. Experts
recommend that persons
diagnosed with avian flu be put
in isolation.
Doctors recommend that people
get an influenza (flu) shot to
reduce the chance of an avian flu
virus mixing with a human flu
virus, which would create a new
virus that may easily spread.
The U.S. Food and Drug
Administration have approved a
vaccine to protect humans from
the avian flu. Experts say the
vaccine could be used if the
current H5N1 virus starts
spreading between people.
Influenza
(Commonly known as
Flu)
1-4 days
(average: 2 days)
Influenza virus Direct transmission
(when an infected
person sneezes mucus
directly into the eyes,
nose or mouth of another
person)
EXIT:
Mucous secretions
ENTRY: Respiratory System
(mouth or nose)
Flu Shot (annually)
Bed Rest
Fluids
Acetaminophen
(Tylenol), or Ibuprofen
can relieve head and
muscle aches. Aspirin

9. Airborne route (when
someone inhales the
aerosols produced by an
infected person
coughing, sneezing or
spitting)
Hand-to-eye, hand-to-
nose, or hand-to-mouth
transmission, either from
contaminated surfaces or
from direct personal
contact such as a hand-
shake.
should be avoided for
children because it can
cause Reye's Syndrome
Antiviral drugs:
Relenza and Tamiflu
SARS (Severe acute
respiratory syndrome)
OTHER NAME:
 SARS
coronavirus
SARS is usually
from 2-7 days, but
up to 10 days. A
3-5 day incubation
period is most
common
 Coronavirus The mode of
transmission is still
believed to be by droplet
spread through close
person to person contact.
These droplets travel a
distance of about 3 feet
from the mouth or nose
of an infected person
during talking, coughing
or sneezing.
SARS is spread by close
person-to-person
contact. Close contact
includes having lived
with or cared for an
individual with SARS
or having had direct
contact with the body
fluids or respiratory
secretions of an
individual infected with
SARS.
ENTRY:
 The portal of entry is
thought to be
inhalation or contact
with mucous
membranes and/or
conjunctiva.
EXIT:
 Respiratory route:
Respiratory droplet
SARS Treatment
 Generally speaking,
treatment for SARS
focuses on providing relief
of symptoms and
complications while the
patient's body fights the
SARS virus. Since there is
currently no cure that can
kill the virus, treatment
may require
hospitalization for
intensive supportive care,
including providing
patients with IV fluids,
medications, and breathing
support.
An Overview of Treating
SARS
 About 2 to 10 days after
the SARS virus has

10. Examples of close
contact:
Kissing
Hugging
Sharing drinking
or eating utensils
Directly touching
a SARS patient
Talking to a
SARS patient
within three feet
infected a person, the
person may begin
developing SARS
symptoms. There is
currently no treatment that
can kill the SARS virus.
Therefore, treatment for
SARS is focused on
providing relief of
symptoms and
complications as the body
fights the SARS virus.
Supportive Care
SARS treatment requires
hospitalization for intensive
supportive care. This supportive
care can include:
Intravenous (IV) fluids
Medications, including
antibiotics, steroids, and/or
antivirals
Breathing support from a
ventilator
Prevention of secondary
infections
Good nursing care.
Gastrointestinal System
Typhoid fever Salmonellae typhi Average 10–14-day Through the ingestion of
food or drink
contaminated by the faeces
or urine of infected people.
EXIT:
>Respiratory secretion
> Feces
>Lesion, exudates
Fluids and electrolytes may be
given through a vein
(intravenously)
Appropriate antibiotics are given
to kill the bacteria

11. 5 basic methods of
transmission:
Flies.
-Feces.
-Food.
-Fingers
-Fornication.
ENTRY:
> Respiratory tract
>Alimentary tract
>Skin, genital membranes
Broken skin
Botulism
There are three forms of
botulism :
Classical botulism
Intestinal botulism
Wound botulism
- Classical botulism
occurs within 12–36
hours (sometimes
several days) after
eating contaminated
food. The incubation
period for infant
botulism is unknown
due to difficulty in
determining the
precise time of
ingestion. Shorter
incubation periods
are associated with
more severe disease
and higher case-
fatality rates
Clostridium botulinum
infection (Group A
disease
Classical botulism is
acquired by ingestion of
inadequately cooked food
or processed or
refrigerated foods in which
toxin has formed,
particularly canned and
alkaline foods.
-wound botulism are due
to ground-in soil or gravel
-Infant botulism arises
from ingestion of spores
rather than pre-formed
toxin. Sources of spores
include foods such as
honey and dust.
Portal of Exit
• Released through
MOUTH
(vomiting), ANUS
(feces) and
sometimes even
through our
SWEAT.
Portal of Entry:
1. Mucus Membranes
2. Skin
3. Parentarela
It is only food borne,
airborne (ONLY when you
inhale the toxin –
bioterrorism) and infectious
in open wounds.
-Trivalent botulinum antitoxin
(types A, B, E) administered as
soon as possible.
Antitoxin is not used in infant
botulism due to the risk of
anaphylaxis. Antibiotics do not
affect the course of the disease.
For wound botulism, in
addition to antitoxin the wound
should be debrided or drained,
and appropriate antibiotic
prophylaxis against other
potential infections should be
administered.
Ascariasis
(Roundworm Infection)
The lifecycle requires
four to eight weeks to
complete. Ascaris
eggs are
unsegmented when
passed and require a
period of two or three
weeks outside the
host to develop to the
infective stage.
Mature female
worms have been
estimated to produce
an average of 200
000 eggs per day.
(Ascaris lumbricoides) 1. Ascaris lumbricoides
is transmitted through
contaminated fingers
put into the mouth.
2. Ingestion of food and
drinks contaminated
with embryonated
eggs can transmit
Ascariasis.
ENTRY:
Ingestion of
contaminated water
or with eating raw
vegetables,
especially if “nigh
soil” is used as the
fertilizer.
Soil contaminated
with human excreta
Contaminated food,
water, and other
object.
Ingested to
intestine
1. Albendazole or
mebendazole-15 cc as a
single dose.
2. Piperazine citrate- 75mg/kg
twice daily, orally
3. Pyrantel pamoate- 1mg/kg
as a single dose, orally.

12. EXIT:
After 10 days, in the
pulmonary
capillaries and
alveoli, the larva
migrates to the
bronchioles, trachea
and epiglottis.
GIT
Penetrates the wall
of the intestine
(duodenum)
Carried to the
bloodstream
Some are carried to
the biliary tract.
Amoebiasis
(Amoebic Dysentery)
The incubation
period in severe
infection is three
days.
In subacute and
chronic form it lasts
for several months.
In average cases the
incubation period
varies from three to
four weeks
Entamoeba Histolytica
1. Trophozoites/vegetat
ive form
 Trophozoites are
facultative
parasites that
may invade the
tissues or may be
found in the
parasitized
tissues and liquid
colonic contents.
2. Cyst
 Cyst is passed
out with formed
or semi-formed
stools and are
resistant to
environmental
conditions.
 infective stage in
the cycle of E.
1. The disease can be
passed from one
person to another
through fecal-oral
transmission.
2. The disease can be
transmitted through
direct contact, through
sexual contact by
orogenital, oroanal,
and proctogenital
sexual activity.
3. Through indirect
contact, the disease
can infect humans by
ingestion of food
especially uncooked
leafy vegetables or
foods contaminated
with fecal materials
containing E.
histolytica cysts.
ENTRY:
Oral Route
EXIT:
Fecal Route
1. Metronidazole (Flagyl)
800mg TID X 5 days
2. Tetracyline 250 mg every 6
hours
3. Ampicillin, quinolones
sulfadiazine
4. Streptomycin SO4,
Chloramphenicol
5. Lost fluid and electrolytes
should be replaced

13. histolytica
Dysentery, Bacillary
(Shigellosis)
-is an infectious disease
of the intestinal tract
caused by bacteria of
the genus
Shigella
,whichiscommonlyafood-
bornedisease
It has a 1-4 day
incubation period and
can vary from 12
hours to 6 days.
-It is a contagious
infection, occurs in
epidemics and occurs
more frequently in
the summer and fall.
Shigella bacteria
1. Shigella
dysenteriae
2. Shigella
flexneri
3. Shigella
sonnei:
4. Shigella boydii
fecal material of a
patient/carrier
-indirectly through
contaminated food and
water.
-Hand-to mouth transfer of
contaminated material
-via personal contact with
sick persons and carriers
- Transmission can also
occur
From person to person
through certain types of
sexual contact (e.g., oral-
anal contact).
ENTRY:
- Gastrointestinal-tract
mucous membranes
EXIT:
- feces
Nursing Management:
-Observe isolation
and enteric precaution
-Provide health education
and instruct patient to
-Boil water for drinking or
use purified water
-Avoidwashingfoodfromopendrum
orpail
-Cover leftover food
-Wash hands after defecations
and before eating
-Avoid ground vegetables
(lettuce, carrots, and the like
-Treatment includes replacement
of fluids and salts, low-residue
diet and medications (if
indicated).
-Increase fluid intake.
-Use of a heating pad or hot-
water bottle on the abdomen
may relieve pain
-Hospitalization of persons
(especially small children with
dehydration) who are seriously
ill. Hospital care will include
isolation and intravenous fluid
supplements

14. Medical Management:
- Antibiotics may be
prescribed. The current
antibiotics of choice are
.Triimethoprim-
sulfamethoxazole, ciprofloxacin
and norfloxacin.
-Antibiotics are indicated when
the patient is very young, when
the disease is very severe or
when the spread of infection to
other people is likely.
-The severity of symptoms and
the length of time the stool
contains Shigella can be reduced
with antibiotics.
-Don't use paregoric
preparations or other anti-
diarrhea drugs unless they are
prescribed. Antispasmodics such
as tincture of belladonna are
helpful when cramps are severe.
Drugs that inhibit intestinal
peristalsis e.g. paregoric, may
ameliorate symptoms but
prolong fever, diarrhea and
excretion of Shigella in feces.
Cholera One (1) – Five (5)
days after ingestion
of bacteria.
Vibrio cholerae Indirect contact,
transmitted by either
contaminated food or
water.
ENTRY:
Indirect contact, transmitted
by either contaminated food
or water.
EXIT:
Mouth, ingestion of
contaminated food and water.
Anus, feces affects
waterways, ground and
Oral Rehydration Therapy
Antibiotics: Doxycycline,
cotrimoxazole, erythromycin,
tetracycline, chloramphenicol,
and furazolidone.
Electrolyte Replacements:
Potassium Levels

15. drinking water.
Leptospirosis
(Well’s
Disease/Canicola
Fever/Hemorrhagic
Jaundice/ Mud
Fever/Swine Herd
Disease)
The incubation
period varies from
six to fifteen days (6-
15 days)
A spirochete of the
genus Leptospira
(Leptospira
interrogans)
1. Leptospirosis is
transmitted
through ingestion
or contact with
the skin or
mucous
membranes of the
infected urine or
carcasses of
either wild or
domestic animals.
2. The disease can
be transmitted
through the
mucous
membranes of the
eyes, nose and
mouth, and
through the
breaks in the
skin.
3. Leptospira enters
the blood to cause
damage, and
thereafter in the
kidneys, the liver
and the
conjunctivae.
4. Leptospirosis can
also be
transmitted by the
semen of infected
animals.
5. Leptospirosis is
common among
waters port
enthusiasts in
certain areas as
prolonged
immersion in
water is known to
promote the entry
ENTRY:
Contact with
contaminated water
and soil
Entry through
mouth and eyes.
Broken skin
EXIT:
After the organism
gains entrance into
the body, it
multiplies in the
bloods, invades the
liver that can result
to the presence of
jaundice.
In kidneys, the
presence of
organism causes
inflammation of the
nephrons and
tubular necrosis,
resulting in renal
failure.
Leptospira may
affect the muscle,
resulting in pain and
sometimes edema.
It also invades the
eye, resulting in
conjunctivitis.
MEDICAL:
A. Suppressing the
causative agents
B. Fighting possible
complications
-Aetiotropic drugs-
penicillin, doxycycline,
ampicillin, amoxicillin.
For prophylaxis,
doxycycline 100 mg
PO every 12 hours for
one week
-Peritoneal dialysis
-Administration of fluid
and electrolytes and
blood as indicated
NURSING:
A. Isolate the patient
B. Urine should be exposed
properly
C. Darken the patient’s room
to decrease eye irritation.
D. Observe meticulous skin
care to ease pruritus.
E. Keep client under close
surveillance.
F. Keep homes clean
G. Eradicate cats and rodents
H. Provide health education on
the modes of transmission
I. Encourage to increase oral
intake.

16. of bacteria.
6. Occupations at
risk include
veterinarians,
slaughter house
workers, farmers
and sewer
worker.
7. Human to human
transmission is
rare.
Schistosomiasis or
(Bilharzia disease)
Incubation period is
typically 14–84
days for acute
schistosomiasis
Five species of
trematodes:
1. Schistosoma
mansoni,
2. S. japonicum
3. S.
haematobium
4. S. intercalatum
5. S. mekongi
Occurs in freshwater
when intermediate snail
hosts release infective
forms of the parasite.
People are infected by
contact with water where
infected snails live.
ENTRY
penetration of intact skin by
cercariae stage
EXIT
The host exit by penetrating
the gut or bladder wall and
being passed with host faeces
or urine.
-Drug treatment is the only
way to reduce disease
symptoms and improve the
situation of the patients. Drugs
available are:
-praziquantel: effective in a
single dose against all species
-oxamniquine: effective in a
single dose, but only against S.
mansoni
Hookworm Disease
(Anyclostomiasis /
Miner’s Disease /
Egyptian Chlorosis)
- a soil transmitted
helminthes infection
- It is a parasitic
roundworm that
burrows through the
skin, moves through the
bloodstream to the
lungs, and finally
moves into the
intestinal tract.
2 - 8 weeks
- Hookworm ova
appear in the stool
about 4-6 weeks after
larvae penetrate the
skin.
- Necator
americanus
- Ancylostoma
duodenale
- Ancylostoma
ceylanicum
- Ancylostoma
braziliense
- Necator can only be
transmitted through
penetration of the skin
whereas Anclyostoma can
be transmitted
percutaneously, orally and
probably transplacental.
- Accomplished directly
through the skin of foot
(ground itch).
- Walking barefoot over
contaminated soil.
- Through ingestion of
contaminated drinking
ENTRY:
- skin
- mucous membrane
- blood
EXIT:
- feces
Nursing Management:
- Personal hygiene should be
maintained.
- Diet should be high in calories,
high protein, vitamins and
minerals.
- Proper handling and disposal
of patient excretions.
- Health teaching for the client
about the importance of good
hygiene, drinking of purified or
well-boiled drinking water.

17. water or food.
- Do not walk barefoot on the
soil or sand.
- Do not touch the soil or sand
with your bare hands.
- Improvement in sanitation
measures, proper excreta
disposal
Medical Management:
- Cure the infestation; treat the
complications of anemia, and to
improve nutrition.
- Parasite-killing medications
(Mebendazole, Albendazole)
- Pyrantel Pamoate - orally, 1 - 3
days
- Iron supplement - to correct
anemia
Red Tide
(Parasitic shellfish
poisoning)
30 minutes to several
hours after ingestion
Dinoflagellates  Ingestion of raw
of inadequate
cooked seafood
usually bivalve
mollusks during
red tide season
ENTRY:
 Oral
 Respiratory droplets
EXIT:
vomitus
No definite treatment
Induce vomiting
Drink pure coconut
milk- weakens the toxic
effect
Sodium bicarbonate
solution(25 grams in ½
glass of water)
Mumps/ Infectious Diseases
Mumps
(Epidemic Parotitis)
From 12-26 days,
usually 18 days
Mumps virus, a member
of the family
Paramyxomviridae
 spread by direct
contact with a
person who has
the disease
 by contact with
the articles in
his/her immediate
ENTRY:
 Respiratory tract
EXIT:
 Nasopharyngeal
secretions
Prophylactic:active
immunization of patient
against mumps
Active treatment: cases
before the age of puberty
requires little attention
After the age of puberty:

18. environment
which have
become freshly
soiled with
secretion from
nasopharynx
-should remain in bed rest
until all fever and swelling
have been absent for at least
4 days because of the danger
of glandular complications
In males:
-scrotum should be supported
by a properly fitted
suspensory, pillow, or a
sling between the thighs to
minimize danger of orchitis
-Sedatives to relieve pain if
orchitis occurs
Immediate oral dose of
Cortisone
Soft or liquid diet as
tolerated. Sour food or fruit
juices are disliked because
of the burning or stinging
sensation they elicit.
Sexually Transmitted Diseases
Vaginal Infection
Bacterial Vaginosis
(Non-specific Vaginitis)
There is no
incubation period for
bacterial vaginosis.
The bacterium that
causes it is always
present in the vagina
in small amounts.
Gardnerella vaginalis Sexual contact to Multiple
partners
ENTRY:
Genitals
EXIT:
Genitals
1. Metronidazole
2. Clindamycin
Candidiasis
(Moniliasis, yeast
infection )
Typically 7 to 10
days
Candida albicans Sexual contact ENTRY: mucous membrane
EXIT: mucous membrane
- Miconazole nitrate
vaginally
- Other antifungal drugs
Trichomoniasis also
called "trich"
If symptoms appear,
it usually takes from
3 to 28 days for them
to develop.
Trichomonas vaginalis  Spread through
sexual contact
 Transmission can
occur even if a
person does not
have symptoms
of infection.
 Women contract
trichomoniasis
from infected
PORTAL OF ENTRY:
 Urethra and vagina
PORTAL OF EXIT:
 vagina ,vulva
,urethra
 Antibiotics -
Metronidazole 500mg
2-3 times a day for 7-10
days.
 It is important that
both partners are
treated at the same time
because an infected
man, even a man who
has never had

19. male or female
partners while
men usually
contract it only
from female
partners
 Using condoms
and/or dental
dams provide
some protection.
Their use is
strongly
encouraged, but
is not 100%
safe.
 Trichomoniasis
can also survive
on infected
objects like
sheets, towels,
and underwear
and could be
transmitted by
sharing them.
symptoms or whose
symptoms have
stopped, can continue
to infect a female
partner until he has
been treated.
 Should avoid sex until
they and their sex
partners have
completed the
treatment.
Infection of the External Genitalia
Genital Herpes
(Herpes Genitalis)
6-8 days
In some cases, it can
be as short as 1 day-
26 days.
HSV-1 (Herpes
simplex virus
1)
HSV-2
(Herpes
simplex virus
2)
Direct contact
Sexual intercourse
 Oral sex
 Anal sex
 Vaginal sex
ENTRY:
Skin (genital area)
EXIT:
Skin (genital area)
Genital herpes cannot be cured.
However, some drugs that can
shorten outbreaks and make
them less severe or even stop
them from happening. These are:
acyclovir,
valacyclovir
famciclovir.
Genital Warts
(Condyloma
acuminatum or venereal
warts)
6 weeks – 3 months
Human papillomavirus
(HPV)
-Sexually transmitted
-direct skin-to-skin contact
during oral, genital, or
anal sex with an infected
partner.
ENTRY:
Skin
EXIT:
Skin
-Topical agents include
podofillox or podophyllin,
which have serious side effects
and are contraindicated during
pregnancy.
-Cryotherapy destroys genital
warts by freezing them with
liquid nitrogen.
-Electrocautery removes genital
warts on the penis, vulva, or
around the anus by burning them

20. with a low-voltage electrified
probe.
-Laser Treatment
-Photodynamic Therapy
-Cantharidin effective against
some warts those are resistant to
other treatments.
Urogenital Infections
Clamydiaa
( Silent Epidemic)
1-3weeks Chlamydia
Trachomatis
The transmission of
chlamydia occurs during
vaginal, anal, or oral sex.
Transmission can also
occur from an infected
mother to her baby during
vaginal childbirth.
ENTRY:
Enters the body through
abrasions or lacerations
and infects cells of the
conjunctiva or cells
lining various mucous
membranes
-Culture of tissue from:
Female endocervix and
urethra
Male urethra
Test for antibodies to
Chlamydia
Polymerase chain reaction
(PCR) or Ligase Chain
reaction (LCR)
Antibiotics:
tetracyclin
erthyromicin
azithromycin
-Avoid having any sexual
activity during chlamydia
treatment.
-Tell your sexual partners so
that they can receive
treatment for chlamydia,
too.
-See your doctor if your
symptoms do not disappear
within one to two weeks
after finishing the medicine.
-See your doctor within
three to four months for
chlamydia testing,
especially if your sex
partner was not treated or if
you have a new sex partner.
Gonnorhea
(The clap)
2 – 5 days
Range: 2 – 14 days
Neisseria gonorrhoeae Contact with exudates
(inflammatory fluid -a.
pus) from infected person
usually as a result of
sexual activity through
EXIT: Genitourinary
ENTRY: Mucous
membranes of genitalia
1. Injectable ceftriaxone
- Typically give in
combination with:
either azithromycin or doxy
cycline.

21. vaginal, oral, or anal sex. 2. Quinolones
Syphilis
(Great imitator)
The average
incubation period of
is 21 days
The causative agent
spirochete bacterium
Treponema palladium
1. Contact with open
lesion of infected
person: common mode
of infection is venereal
infection by sexual
contact and kissing
(Atentiona! the
infection in the
secondary stage reach
the mucous of the
mouth).
2. Exposure to infected
blood by:
-using blood
contaminated syringes
and needles for
inoculation of
medicines or taking
blood sample or by
intravenous drug
abuse.
-blood transfusion
without precaution.
Professional exposure
of medical and
paramedical and
laboratory workers t
infected blood.
3. Congenital Infection
"inutero infection":
transplacental infection
from the 4th month of
pregnancy to the end of
delivery.
4. Contaminated
articles and
fomites::towels,
clothing, drinking, cups
ENTRY: the organism entry
transmissible by kissing near
a lesion, as well as oral,
vaginal, and anal sex.
EXIT: the organisms exit in
exudates of skin and mucous
membrane lesions, blood
and body fluids.
Primary and secondary
syphilis: penicillin G
benzathine, intramuscular single
dose.
Doxycycline is use if the patient
is allergy to penicillin.

22. and others are
potentially
infectious but their role
is minor.
Period of Infectivity:
Untreated cases are
infectious during the
primary and secondary
stages of disease of
varied period, usually
2-4 years.
Pelvic Inflammatory
Disease (PID)
This varies. It can be
months, even years
after the infection of
an STD.
Sexually transmitted
diseases bacteria such as
chlamydia and
gonorrhea.
Transmitted through
sexual contact and other
bodily secretions.
Exit: Genitourinary
Entrance: Mucous
membranes of genitalia
1. Antibiotic therapy
2. Treat the person including
the partners to prevent the
spread of infection.
3. Pain medication and IV
fluids if needed.
Human
immunodeficiency
virus
infection / acquired
immunodeficiency
syndrome
(HIV/AIDS)
Human
immunodeficiency
virus (HIV)
Retrovirus (
Lentivirus)“Slow
Viruses”
The period between
infection and the
appearance of AIDS can
take from 7 to 12 years.
HIV infection can last
from about three years to
over 20 years (on
average, about eight
years).
1. Sexual transmission. It
can happen when there is
contact with infected
sexual secretions (rectal,
genital or oral mucous
membranes). This can
happen while having
unprotected sex, including
vaginal, oral and anal sex
or sharing sex toys with
someone infected with
HIV.
2. Blood Transfusion and
sharing of infected
syringes and needles
among Intravenous drug
users. The risk of
transmitting HIV through
blood transfusion is
nowadays extremely low
in developed countries,
thanks to meticulous
screening and precautions.
Among drug users, sharing
and reusing syringes
Entry:
Needle Sticks
a. Although unintentional
needle sticks are usually
limited to health-care
workers, anyone can get
injured with a sharp,
contaminated object.
B.If you are considering
getting a tattoo or piercing,
or another voluntary needle
stick, consider the
environment first, as needle
sticks can be deadly if
contaminated wars osha.gov.
Intravenous drug users who
share dirty needles are
sharing a portal of entry for
blood borne pathogens. Once
used, the dirty needle can
transmit disease through the
skin directly into the
bloodstream.
2. Gestational Portals
A fetus is directly connected
to its mother by umbilical
Treatments Modalities:
1. Reverse Transcriptase
inhibitors-They Inhibit the
enzyme called reverse
transcriptase, which is needed to
“copy” information for the virus
to replicate. These drugs are
a.Zedovudine(ZDV)- Retrivir
b.Zalcitabine- Havid
c.Stavudine- Zerit
d. Lamivudine- Epivir
e.Nevirapine-
2. Protease Transcriptase
inhibiting the enzyme a needed
for the assembly of viral
particles. These drugs are.
a. a- a
b. a- a
c. Indinavir- a.
Nursing Management:
1. An Education. The
Health Care worker
must:

23. contaminated with HIV-
infected blood is
extremely hazardous.
3. Vertical or perinatal
transmission (from a
pregnant woman to the
fetus during pregnancy,
child delivery, or
breastfeeding.
There are Several ways
of receiving infected
blood.
1.Blood Transfusion
2. Sharing of unsterilized
syringes and needles used
for intravenous injections.
3. Transmission during
pregnancy.
a.) may be
transplacental.
B.)There is greater risk
of transmission when the
Mother has developed
advanced AIDS.
4. Organ donation.
5. Accidental exposure in
hospitals or clinics.
HIV is transmitted by
1.three main routes:
sexual contact,
2.exposure to infected
body fluids or tissues,
3. From mother to child
during pregnancy,
delivery, or breastfeeding
(known as vertical
transmission.
.
arteries that facilitate
transmission of the mother's
blood and nutrients to baby.
3. Open Wounds
Open wounds, including
superficial and deep cuts,
should be covered with an
adhesive bandage or clean
dressing at all times.
Uncovered wounds are
vulnerable portals of entry
for potential contact with
blood-borne pathogens.
4. Mucous Membranes
Mucous membranes line the
soft tissues of your mouth,
eyes, nose, and lining of the
reproductive organs and
anus. Designed to absorb
liquids and contain moisture,
these membranes are easily
permeable upon contact with
a blood borne pathogen.
HIV, a blood borne
pathogen, is transmitted
through mucous membranes
during unprotected
intercourse due to the
potential for contact with
blood and body fluids.
a. Give practical advice
b. Inform the client of
the disease process and
the mode of
transmission.
c. Emphasize the
“AIDS” awareness
program.
d. Avoid judgmental
and moralistic
messages.
E. Be consistent and
concise in giving
instructions, especially
those for proper
management.
f. Use positive
statement: and
G. encourage client to
trace or identify
previous contacts for
proper management.
2. Practice universal
/standard precaution.
a. There is a need for
a thorough medical
hand washing after
every contact with
each patient and
after removing the
gown and gloves,
and before leaving
the room of an
AIDS suspect or
known AIDS
patient.
b. Use of Universal
barriers or personal
protective
equipment( PPE)
3. Prevention
a. Care should be taken to

24. .
avoid accidental pricks
from sharp instruments
contaminated with
potentially infectious
materials from an AIDS
patient.
b. Gloves should be worn
when handling blood
specimens and other
body secretions, as well
as surfaces, materials
and objects exposed to
them.