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Infectious diseases nc
- 1. DISEASES (AKA “COMMUNICABLE DISEASES”) GERMS, COOTIES, AND OTHER SUCH LITERAL CRAP, OH MY!
- 2. • OCCUPATIONAL HEALTH AND SAFETY ADMINISTRATION (OSHA) • CENTERS FOR DISEASE CONTROL AND PREVENTION (CDC) • VACCINATIONS Public Health Agencies are responsible for monitoring and preventing endemic, epidemic and pandemic diseases.
- 4. PROTECTING PUBLIC HEALTH… • ASK ALL PATIENTS THEIR TRAVEL HISTORY • DISINFECT APPROPRIATELY CRITICAL, SEMICRITICAL, AND NONCRITICAL EQUIPMENT PARAMEDICS ARE RESPONSIBLE FOR PROTECTING PATIENTS FROM HEALTH CARE- ASSOCIATED INFECTIONS.
- 5. PROTECTING HEALTH CARE PROVIDERS • DESIGNATED INFECTION CONTROL OFFICER (DICO) • RYAN WHITE CARE ACT • PERSONAL PROTECTIVE EQUIPMENT AND PROTOCOLS • OTHER POTENTIALLY INFECTIOUS MATERIALS (OPIM)
- 6. COMMUNICABLE DISEASE TRANSMISSION • BACTERIA, FUNGI, BACTERIA…PERSON-TO-PERSON • CONTACT TRANSMISSION “FOMITES” • DROPLET TRANSMISSION • AIRBORNE TRANSMISSION • “VECTORS”
- 7. TRANSMISSION-BASED PRECAUTIONS • STANDARD PRECAUTIONS • AIRBORNE PRECAUTIONS • DROPLET PRECAUTIONS • CONTACT PRECAUTIONS • PERSONAL PROTECTIVE EQUIPMENT (PPE) AND PRACTICES
- 8. OPIM • OTHER POTENTIALLY INFECTIOUS MATERIALS
- 9. CHAIN OF INFECTION, EXPOSURE, INFECTION RISK • TYPE OF ORGANISM • DOSE OF THE ORGANISM • VIRULENCE OF THE ORGANISM • MODE OF ENTRY • HOST RESISTANCE • HOST DEFENSE MECHANISMS
- 10. • INCUBATION PERIOD- EXPOSURE TO FIRST SYMPTOMS • COMMUNICABLE PERIOD- CAN BE TRANSMITTED • RESERVOIR
- 11. INFECTION AND SEPSIS • INCREASING AWARENESS OF SEPSIS • SEPSIS: WIDESPREAD INFECTION; BODY’S “OVERREACTION” • QSOFA • SEPTIC SHOCK
- 12. QSOFA SCORE • RESPIRATORY RATE > 22 • AMS (GCS < 15) • SYSTOLIC BP < 100 MMHG • SCORE OF 2 OR MORE IS SEPSIS WITH POOR OUTCOME
- 13. DROPLET-TRANSMITTED DISEASES • MENINGITIS • RESPIRATORY CONDITIONS • SEASONAL INFLUENZA • PERTUSSIS (WHOOPING COUGH) • MUMPS AND RUBELLA (GERMAN MEASLES)
- 14. MENINGITIS • MOST COMMON: MENINGOCOCCAL MENINGITIS • MENINGEAL INFLAMMATION (SURROUND BRAIN AND SPINAL CORD) • TWO TYPES: VIRAL AND BACTERIAL • CLASSIC: STIFF NECK, FEVER, KERNIG SIGN
- 15. KERNIG AND BRUDZINSKI SIGN
- 16. RESPIRATORY CONDITIONS • MULTITUDE; MAY/MAY NOT BE FEBRILE • MAY BE JUST “ANNOYING,” OR DEADLY • SYNCTIAL VIRUS LEADING CAUSE OF LOWER TRACT INFECTIONS
- 17. SEASONAL INFLUENAZA • INFLUENZA AKA “FLU” • ACUTE RESPIRATORY ILLNESSES • GENERALLY WINTER EPIDEMICS • STRAIN VARIES YEAR TO YEAR • DEATHS OCCUR IN ADULTS WITH COMORBIDITIES
- 18. PERTUSSIS • AKA “WHOOPING COUGH” • CAUSED BY BORDETELLA PERTUSSIS • CURRENT US LARGEST DISEASE CASE NUMBER • HIGHLY CONTAGIOUS • CHILDREN DEVELOP BLACK EYES FROM COUGHING
- 19. MUMPS • AKA “INFECTIOUS PAROTITIS” • PRE-VACCINE, MANY CHILDREN LEFT DISABLED • COMPLICATIONS NOW MORE COMMON IN ADULTS • SWELLING OF SALIVARY GLANDS UNDER EARS
- 20. RUBELLA • AKA “GERMAN MEASLES” • VIRAL, BUT NOT SAME AS MEASLES • BIRTH DEFECTS AKIN TO ZIKA VIRUS • CONTAGIOUS PRIOR TO RASH APPEARING
- 21. AIRBORNE-TRANSMITTED DISEASEAS • TUBERCULOSIS (TB) • VARICELLA ZOSTER (CHICKEN POX) • MEASLES
- 22. TUBERCULOSIS (TB) • NOT HIGHLY COMMUNICABLE • INFECTION (EXPOSED) VS DISEASE (ACTIVE INFECTION) • THREE TYPES: TYPICAL (COMMUNICABLE), ATYPICAL AND EXTRAPULMONARY (NOT COMMUNICABLE)
- 23. VARICELLA ZOSTER (CHICKEN POX) • HIGHLY CONTAGIOUS • HERPES VIRUS FAMILY • ONCE AFFECTED, LIFELONG IMMUNITY • UNVAXXED OR UNAFFECTED? RISK SHINGLES
- 25. MEASLES • AKA “RUBEOLA” • BLOTCHY, RED RASH • VIRAL • EASILY COMMUNICABLE • PREVALENCE DECREASED THANKS TO VACCINE
- 26. OTHER RESPIRATORY TRACT INFECTIONS • MONONUCLEOSIS AKA “MONO” AKA “KISSING DISEASE” CAUSED BY EPSTEIN-BARRE VIRUS (EBV) SUSPECTED CAUSE OF CHRONIC FATIGUE SYNDROME
- 27. SEXUALLY TRANSMITTED DISEASES (STDS) • GONORRHEA • SYPHILIS • GENITAL HERPES • CHLAMYDIA • SCABIES AND LICE
- 28. STDS: GONORRHEA, SYPHILIS, GENITAL HERPES, CHLAMYDIA • MAY OR MAY NOT BE TREATABLE • ALWAYS PROTECT PATIENT MODESTY AND PRIVACY • SIGNS AND SYMPTOMS MAY DIFFER BETWEEN MALES AND FEMALES
- 29. MORE STDS: SCABIES AND LICE • SCABIES • MITES WHICH BURROW INTO HUMAN SKIN • LICE • INSECTS LIVING IN HUMAN HAIR • HEAD, BODY, PUBIC OR “CRAB” LICE
- 30. OTHER STDS AND RELATED CONDITIONS • GENITAL WARTS AND HUMAN PAPILLOMAVIRUS (HPV) • CHANCROID • TRICHOMONIASIS • BACTERIAL VAGINOSIS • CANDIDIASIS (AKA “THRUSH”)
- 31. DERMATOPHYTE INFECTIONS • FUNGAL SKIN INFECTIONS • TYPICALLY SUPERFICIAL • NAME = “TINEA” + LOCATION • EX. TINEA CAPITIS (ON HEAD, SCALP) • EX. TINEA MANUUM (ON HANDS)
- 32. HELMINTHS (WORMS WHICH LIVE INSIDE HUMANS!) • PENETRATE SKIN OR DIRECTLY INGESTED • LIVE IN GI TRACT • HOOKWORMS • PINWORMS
- 33. PARASITIC INSECTS • BEDBUGS • FEED ON BLOOD OF HUMANS • HIDE IN BEDS, LUGGAGE, ETC • BITE HUMANS DURING SLEEP • LOW RISK OF DISEASE TRANSMISSION
- 34. COMMON BLOODBORNE DISEASES • HEPATITIS B • HEPATITIS C • HEPATITIS D • HUMAN IMMUNODEFICIENCY VIRUS INFECTION (HIV) • ACQUIRED IMMUNODEFICIENCY SYNDROME (AIDS)
- 35. VIRAL HEPATITIS (INFLAMMATION OF THE LIVER) • HEPATITIS B (HBV) “SERUM HEPATITIS” • HEPATITIS C (HCV) • HEPATITIS D (HDV) “DELTA HEPATITIS”
- 36. HIV AND AIDS • HUMAN IMMUNODEFICIENCY VIRUS INFECTION (HIV) BLOODBORNE; TRANSMISSION TO NEWBORN FROM MOTHER • ACQUIRED IMMUNODEFICIENCY SYNDROME (AIDS) END-STAGE OF HIV DISEASE PROCESS VULNERABLE TO OPPORTUNISTIC INFECTIONS
- 37. EBOLA (EBV) • CONTACT AND DROPLET PRECAUTIONS • WEST AFRICA • INFECTED FRUIT BATS OR PRIMATES • LIMIT INVASIVE PROCEDURES • NEW VACCINATION AVAILABLE
- 38. ENTERIC (INTESTINAL) DISEASES • NOROVIRUS INFECTION FORMERLY “NORWALK AGENT” 90% OF NON-BACTERIAL GASTROENTERITIS WORLDWIDE PATIENTS SELDOM NEED HOSPITALIZATION WASH HANDS! ALCOHOL-BASED CLEANERS INEFFECTIVE
- 39. NON-BLOODBORNE HEPATITIS VIRUSES • FECAL-ORAL ROUTE • HEPATITIS A (HAV) “INFECTIOUS HEPATITIS” • HEPATITIS E (HEV) “ENTERICALLY TRANSMITTED NON-A, NON-B HEPATITIS”
- 40. VECTOR-BORNE AND ZOONOTIC DISEASES • MOSQUITO- AND TICK-BORNE DISEASES • HANTAVIRUS INFECTION • RABIES • MIDDLE EAST RESPIRATORY SYNDROME • TETANUS
- 41. MOSQUITO-BORNE DISEASES • WEST NILE VIRUS • DENGUE FEVER • CHIKUNGUNYA FEVER • ZIKA VIRUS
- 42. TICKBORNE DISEASES • LYME • ROCKY MOUNTAIN SPOTTED FEVER
- 43. HANTAVIRUS • RATS AND MICE • INITIAL FLU-LIKE SYMPTOMS • WORSEN TO LIFE-THREATENING BREATHING PROBLEMS
- 44. RABIES • AKA “HYDROPHOBIA” • SALIVA OF INFECTED ANIMAL, VIA BITE • GENERALLY FATAL
- 45. MIDDLE EAST RESPIRATORY SYNDROME (MERS) • VIRAL • US CASES ORIGINATED IN SAUDI ARABIA • CONTACT WITH CAMELS • TYPE OF CORONAVIRUS • REDUCED LEVEL OF LYMPHOCYTES
- 46. TETANUS • Vaccine-preventable • Tetany: muscle contracture • Abdominal rigidity = key sign • Transmitted via contaminated street drugs OR contaminated puncture wound
- 47. ANTIBIOTIC-RESISTANT ORGANISMS • OVERUSE/MISUSE OF ANTIBIOTICS • METHICILLIN-RESISTANT STAPHYLOCOCCUS AUREUS (MRSA) • VANCOMYCIN-RESISTANT STAPHYLOCOCCUS AUREUS (VRSA) • VANCOMYCIN-RESISTANT ENTEROCOCCI (VRE)
- 48. MRSA AND VRSA • Both cause skin conditions (pimples, boils…) • Vancomycin-Resistant Staphylococcus aureus (VRSA) • Methicillin- Resistant Staphylococcus aureus (MRSA) • Community-acquired • “Colonized”
- 49. VRE • VANCOMYCIN-RESISTANT ENTEROCOCCI (VRE) • CAUSES URINARY TRACT INFECTIONS • MAY ALSO INFECT SURGICAL WOUNDS • NOW TREATED WITH LINEZOLID • TYPICALLY ONLY EFFECTS THOSE IMMUNOCOMPROMISED
- 50. CLOSTRIDIUM DIFFICILE (C DIFF) • BONUS: SCRATCH’N’SNIFF SLIDE! • Watery, foul-smelling, green diarrhea • Resolves after discontinuing antibiotics • WASH HANDS. Alcohol-based cleaners insufficient.
- 51. NEWLY RECOGNIZED DISEASES • “JUMP” FROM ANIMALS HUMANS INCREASINGLY FREQUENT • SEVERE ACUTE RESPIRATORY SYNDROME • AVIAN FLU
- 52. IF YOU’VE LEARNED NOTHING ELSE… never forget your PPE!