This document defines communicable diseases and provides information on common viral and bacterial infections in children. It discusses how communicable diseases are transmitted and symptoms, diagnosis, and management of specific diseases like varicella, measles, pertussis, tuberculosis, hepatitis A and B, meningitis, and HIV/AIDS. Prevention strategies like immunizations, hand washing, and protective equipment are also outlined.

2. Definition of communicable diseases
• A communicable disease is an illness due to a
specific infectious (biological) agent or its toxic
products capable of being directly or indirectly
transmitted from man to man, from animal to
man, from animal to animal, or from the
environment (through air, water, food, etc..) to
man.

3. Introduction:
• Communicable diseases are the most
common cause of morbidity and mortality
among the children. With proper hygienic
measures and preventive measures it can
be prevented easily.

4. Communicable Diseases
– An illness that is transmitted by contact with body
fluids
• directly transmitted
• acquired from a person or vector (ticks, mosquitoes, or
other animal)
– indirectly transmitted
• by contact with contaminated objects.

5. Communicable Diseases
of childhood include diseases with high
transmission rates
– Viruses are the leading cause of most pediatric
infections

6. Communicable Diseases
• The poor hygiene behaviors of young children promote the
transmission of infectious diseases
• The fecal-oral and respiratory routes are the most common
sources of transmission in children.
• Young children may not wash their hands after toileting unless
closely supervised.

7. Immunization Schedule
–By 24 Months children should have:
– 4 DTP, Hib, PCV
– 3 Hep B, IPV
– 1 MMR, varicella

8. Immunizations
• Are either inactivated or activated
• Inactivated include Dtap, Hib, Hep
• Activated (live) multiplies for days-weeks in
body MMR, Varicella

9. Reactions
• Vaccines are very safe and have little chance
for side effects
• Side effects are minor and occur with in days
of administration
• Reactions to live vaccines can occur 30-60
days post vaccine (usually in older children)

10. Reaction to Vaccines
local tenderness
erythema
swelling at site
low grade fever (possibly high with
activated)
behavior changes, irritability

11. Adverse Events
• National Law to provide care for those
affected by a vaccine’s adverse event
• Law requires nurses to
– Obtain consent prior to vaccine
– record, manufacturer, exp. date of vaccine
after administration

12. • Unimmunized children are at a greater risk of
getting the disease and of spreading it to
pregnant women and to infants and children
with serious medical conditions.

13. Administration
Nursing Consideration
Proper storage
Reconstitution
Expiration date
Consent
Documentation (immunization record)

14. Nursing Responsibilities
Assessment:
• Identify recent exposure
• Identify prodromal symptoms
–s/s occur early in disease
• Locate immunization history
• Confirm history of having the disease

15. Nursing Responsibilities
Implementation:
1. prevent spread-isolation
2. reduce risk of cross contamination
3. prevent complications
4. provide comfort

16. Viral Infections

17. Varicella (Chicken Pox)
• Varicella Virus
• Vaccine available
• Transmitted by respiratory secretions in contact and droplet,
contaminated objects

18. Varicella
• Begins with slight fever, maliase, anorexia
• In 24 hours highly itchy rash primarily over trunk
• Starts as a macule which progresses into a papule and
then a vesicle surrounded by erythema base
• The fluid becomes cloudy, breaks and crusts over

19. Varicella
• The Key to diagnosis is varying stages of rash
• Rash starts on trunk and progresses to body
including genitalia, mucous membranes
• Also can detect presence of disease after 1 month
through serum antibody testing

20. Management
• Isolation at home until vesicles dry (2-3 weeks) and 1
week after lesions are gone
• Very young and immunocompromised may need
isolation in hospital
• Relief of itching
• Antiviral agents
• Treat secondary complications (bacterial infections
from scratching)

21. Roseola
• Viral infection
• No vaccine available
• Transmitted most likely by contact with saliva
• Disease of younger children, rarely affects children
>3 years
Communicability unknown, but believed NOT to
be communicable once rash appears

22. Symptoms
• Persistent high fever for 3-4 days in a child who appears well
• Then drop in fever to normal => rash appears
• rose-pink macules first on trunk, spread to neck, face, extremities, not
itchy, lasts 1-2 days

23. Diagnosis and Management
• Diagnosis is made based on classis rash and symptoms, serum
testing available
• antipyretics, analgesics, isolation not necessary
• May result in fetal death if woman is infected
during pregnancy.
• Since fever is very high can have febrile
seizures

24. Rubeola (measles)
• Viral infection
• Vaccine available “M” in MMR
• Transmitted by respiratory secretions, blood and
urine of infected person
Communicable just before the rash appears to 4-5
days after rash appears=highly contagious

25. Symptoms
• First 24 hours
– Fever, malaise, cough, coryza, conjunctivitis
• In 48 hours
– “Koplik spots” (small, irregular, red spots with minute bluish-white center)
first seen on buccal mucosa
• Raised erythema rash rash on face that spreads downward
• Discrete, then turns confluent on the third day
• Other symptoms persist

26. Diagnosis and Management
Diagnosis made on symptoms, serology 1 month later
Management:
• Isolation until rash disappears
• Bed rest
• Antipyretics
• Fluids and vaporizer for cough
• Skin care (itchy rash)
• Decrease lighting-photophobia may cause eye
rubbing and corneal abrasion

27. Mumps
• Viral infection
• Vaccine available 2nd “M” in MMR
• Transmitted by direct contact of saliva and
respiratory droplet
• Communicable immediately before swelling
begins

28. Symptoms
• Fever, HA, M, Anorexia, x 24 hours, earache aggravated by
chewing
• On 3rd day: parotitis (enlarged parotid gland), unilateral or
bilateral, pain, tenderness

29. Diagnosis and Management
Diagnosis by classic presentation, serum antibody testing 1
month after infection
Treatment:
• analgesics for pain
• antipyretics
• Isolation
• Bed rest
• Soft diet
• Cold compress to neck

30. Rubella
(German measles)
• Viral Infection
• Vaccine Available “R” in MMR
• Transmitted by direct contact of nasopharyngeal
secretions, feces, urine, or articles freshly
contaminated
• Communicable 7 days before to 5 days after rash

31. Symptoms
• Rash on face which rapidly spreads downward to neck, arms, trunk and
legs
• by end of first day body is covered with pinkish-red maculopapules
• Rash disappears in same order as it appeared
• Rash gone by 3rd day
• also low grade fever, HA, Malise, cough, sore throat

32. Diagnosis and Management
• Diagnosis by symptoms, serology
available 1 month after infection
• Treatment
– Antipyretics
– Comfort measures
**Pregnant people must avoid infected
child=fetal death

33. Bacterial Infections

34. Diphteria
• Bacterial infection
• Vaccine available “D” in Dtap
• Transmitted by direct contact with respiratory
secretions,droplet, contaminated objects
Communicable 2-4 weeks=highly
contagious

35. Symptoms
• yellow nasal discharge
• may have epitaxis
• sore throat
• hoarseness with cough
• enlarged lymph nodes
• low grade fever
• increase pulse
• malaise
• laryngeal involvement: potential airway
obstruction=serious for the very young

36. Diagnosis and Management
• Diagnosed by culture of discharge
• strict isolation
• abx (PCN)
• complete BR
• trach if obstructed airway
• suctioning

37. Pertussis
(whooping cough)
• Bacterial infection
• Vaccine available “P” in Dtap
• Transmitted by direct contact, droplet
• Communicable for up to 4 weeks

38. Symptoms
• Begins with URI symptoms:
– dry, hacking cough that becomes severe,
worse at night
**short, rapid coughs followed by sudden
inspiration and whooping**
– Cheeks flush, eyes bulge, tongue
protrudes
– Thick secretions, often vomits
– Sick for 4-6 weeks
– www.whoopingcough.net for sound and video

39. Diagnosis and Management
• Diagnosed by classic presentation
• Treatment:
– hospitalization for infants or children who are dehydrated
– BR
– increase fluids
– abx
– Suctioning
– Humidifier
– Observe for airway obstruction (restlessness, retractions,
cyanosis)

40. Scarlet fever
• Bacterial infection (strep), often
sequela to strep throat
• No vaccine available
• Transmission by direct contact,
droplet
• Communicable for 10 days to 2
weeks

41. Symptoms
• Abrupt high fever
• Very high pulse,
• Vomit, HA, Maliase, chills,
• abd. Pain
• tonsils enlarged: (edematous, red, covered with patches of
white exudate).
• First 1-2 days tongue is coated with papules, is also red &
swollen = “white strawberry tongue”

42. • By 4th or 5th day white coat sloughs off leaving
prominent papillae = “red strawberry tongue”
• Rash: red, pin head sized lesions, rash is intense in
folds and joints, flushed cheeks

43. Diagnosis and Management
• Diagnosis + TC, ASO titer
• Management:
–respiratory isolation x 24 hours
– full course of PCN/EES
– analgesics for sore throat

44. Tuberculosis

45. Tuberculosis
• Bacterial infection (Mycobacterium
tuberculosis)
• Transmitted by droplets
• Pulmonary TB - cough, infected sputum,
hemoptysis, pleuritic pain)

46. Tuberculosis
• Pulmonary TB Signs/Symptoms
–Cough
–Infected sputum
–Hemoptysis
–Pleuritic pain

47. Tuberculosis
• Very low communicability, requires repeated
exposure
• Mask patients with active TB
• Routine skin tests; follow-up on positive
reactors

48. Viral Hepatitis

49. Hepatitis A
• Fecal-oral contact
• Children, young adults
• Most infections subclinical or very mild
• Does not cause chronic liver disease or carrier
state

50. Hepatitis B
• Parenteral transmission (blood, dirty needles)
• Sexual transmission
• Can cause liver failure, necrotic cirrhosis
• Can cause carrier state

51. Viral Hepatitis
• Signs/Symptoms
–Anorexia
–Malaise
–Nausea, vomiting
–Fever
–Joint pain
–Dark urine, jaundice

52. Viral Hepatitis
• Vaccine, immune serum globulin available for
both A and B

53. Meningitis

54. Meningitis
• Inflammation of membranes covering
brain, spinal cord
• Bacteria, viruses, fungi
• Bacterial forms most serious

55. Bacterial Meningitis
• Signs/Symptoms
–Headache
–Nausea
–Fever
–Stiff neck
–Rapid progression to delirium, coma,
seizures

56. Bacterial Meningitis
• Neissera meningitidis
– Petechiae
– Ecchymosis
– Septic shock

57. Bacterial Meningitis
• Avoid contact with oral secretions
• Not transmissible by breathing same air
as patient
• If close contact occurs, Rifampin 600mg

58. HIV/AIDS

59. Acquired Immunodeficiency Syndrome (AIDS)
• Viral infection  Human
immunodeficiency virus (HIV)
• Damage to helper T cells suppresses
immune system

60. AIDS
• Recurring opportunistic infections
–Pneumocystis carini pneumonia
–Kaposi’s sarcoma
–Candida albicans

61. HIV/AIDS
• Transmitted by blood, semen, vaginal
secretions
• Contact with tears, saliva, sweat will not cause
infection
• Cannot be transmitted by casual contact
• Wash hands, wear gloves, needle precautions

62. Prevention
• Maintain good personal health status
• Regular physical exams

63. Prevention
• Immunizations for:
–Tetanus/diphtheria
–Hepatitis B
–Measles, mumps, rubella
• TB skin test at least annually

64. Prevention
• Consider immunizations for:
– Influenza
– Hepatitis A
– Chicken pox

65. Prevention
• Wash hands following patient contacts
• Wear gloves when contact with human
body fluids is anticipated
• Wear face mask if patient has
productive cough (or put mask on
patient)

66. Prevention
• Avoid needle stick (Do NOT recap needles)
• Clean up blood spills quickly using bleach
solution
• Use disposable equipment