Respiratory and Intestinal infections

COMMUNICABLE DISEASES
Dr. Ramesh Bhandari
Assistant Professor,
Department of Pharmacy Practice,
KLE College of Pharmacy, Belgaum

Communicable Disease is defined as an
illness of infectious nature which can
spread from one person to another
directly or indirectly through an
infectious agent.
Infected person which does not show
the clinical symptoms of the disease
and act as reservoir of the infectious
agent is called as carrier.

Respiratory Infections
Chickenpox,
Measles,
Rubella,
Mumps,
Diphtheria,
Whooping cough,
 Meningococcal
meningitis,
 Acute respiratory
infections,
 Tuberculosis,
 Ebola
 Influenza (including Avian-Flu, H1N1,
SARS, MERS, COVID-19)

CHICKEN POX
It is also known as Varicella.
It is an acute viral infection.
Mainly it occurs in children below 10
years of age.
One attack generally acquire immunity
for rest of the life.

Causative agent
Mode of Transmission
Varicella – Zooster Virus
It is transmitted by droplet nuclei and
droplet infection.
It can be transmitted by personal
contact with infected person.
It can cross the placental barrier and
infect the foetus

Incubation Period: 14 to 21 days
Sign and
symptoms
Mild Fever
Itching
 Vesicular
rash on trunk,
face and limbs

Prevention and control
Isolation of the patient for 6 days after
the onset of rash.
Disinfect all the articles used by the
patient.
Varicella zooster immunoglobulin 1
gm(1.25-5ml) by intramuscular given
within 72 hours of exposure will acquire
passive immunity against chickenpox.
There is no specific treatment for
chickenpox.

MEASLES
It is one of the commonest infectious
disease of children upto 6 years of
age.
One attack gives high degree of
immunity for the whole life.
Mother who had an attack of measles
imparts immunity to her infants for the
first six months of age.

Causative agent
RNA Paramyxo virus
Direct person to person through
droplet infection i.e. sneezing, talking,
kissing etc.
Infective material is secretion f nose,
throat and respiratory tract.

Incubation Period: 10-14 days
Sign and symptoms
High Fever
Sneezing
Watery and red
eyes
Cough
Koplik’s spot
followed by
maculopapular rash
in face, neck then
whole body.

Prevention: Measles vaccination 0.5ml at the
age of 9 -12 months. If contraindicated then
immunoglobulin can be given.
Isolate the patient for 7 days after the rash
appears.
Protect the eyes of the patient from light.
Disinfect the discharges of nose and throat of
the patient.
Immunise the susceptible children.

DIPHTHERIA
 It is an acute infectious disease affecting most
commonly throat, tonsils, larynx or nose
where it produces a greyish white false
membrane of a soluble exotoxin.
 If that membrane spreads to the air passage,
it may block entry of air and cause difficulty of
breathing.
 It is widely distributed diseases and affects
persons of all ages but children in the age of
3-5 years are more affected.

Causative agent
Corynebacterium diphtheriae
It is spread by droplet infection and
through carriers and patients.
Handling of fomites contaminated by
nasal or throat secretions also transmit the
disease.
It can be spread through sneezing,
coughing, spitting, speaking etc.

Incubation Period: 2-5 days or longer
Sign and
symptoms
 Fever
Toxaemia
Difficulty in
swallowing
Patches of
greyish yellow
membrane over
tonsils & throat.

 Prevention is by immunisation with DPT vaccine
(0.5ml) at the age of 2,4 & 6 month. A booster dose
can be given at 1 and half years and at 5 years of
DT is given.
 Isolation of the patient at home or hospital in a well
ventilated room.
 Article used by patient should be disinfected.
 Good personal hygiene should be maintained.
 Efforts should be made for early detection of
diphtheria carriers.

Treatment:
 Diphtheria antitoxin must be given
immediately.
 Antibiotics like penicillin or erythromycin may
be given.
 Fluid diet should be given to the patient.
 The household or other contacts may be
given prophylactic dose of diphtheria
antitoxin.

WHOOPING COUGH
 It is also known as pertussis.
 It is highly infectious disease of the lower
respiratory tract which affect trachea, bronchi
and bronchioles.
 It occurs in all ages but most common in
children under 5 years of age.
 It is dangerous if it affects infants under six
months of age.
 Females are more affected than males.

Causative agent
Bordetella pertussis
It spread directly by droplet infection or
indirectly through fomites contaminated
with nasal or buccal secretions.
The germs are spread into the air during
talking, sneezing or coughing by the
patient.

Sign and
symptoms
 slight fever
Running nose
Whooping
sound while
cough
Catarrhal,
paroxysmal and
convalescent
stage.

 Prevention is done by immunisation with DPT
Vaccine at 2, 4, 6 month of age. Booster dose is
given at the age of 1 and half years.
 Infants are protected from exposure to this disease.
 Isolate the patient.
 Disinfect the nasal and buccal discharge of the
patient.
 Disinfect the fomites of the patient.
 Cough preparations and antibiotics can be given.
 Affected children should not allowed to go to school
for period of 6 weeks.

TUBERCULOSIS
 Tuberculosis is a chronic infectious disease of
lungs caused by Mycobacterium tuberculosis.
 It is more common in developing countries.
 Primarily it affects lungs and causes pulmonary
tuberculosis.
 It can also affect intestines, meninges of the
brain, bones, joints, lymph glands, skin etc.
 It can occur at any age but more common in old
persons than in young persons.
 More common in malnourished, poor hygienic
conditions and who live in over crowded places.

Causative agent
Mycobacterium tuberculosis
Mycobacterium bovis
Atypical Mycobacterium

It is spread by droplet infection. When the droplets
are expelled by tubercular patient through coughing,
sneezing, talking and inhaled by the healthy persons.
By inhaling fine dust particles containing tubercle
bacilli.
By handling sputum and other discharges of the
tubercular patient.
By direct contact with the patient.
By consuming food and drinks contaminated with
tubercle bacilli.
By consuming milk derived from a cow or buffaloes
suffering from tuberculosis and without proper boiling.
Flies also can transmit the infection by
contaminating the food.

Incubation Period: few months to years.
Sign and
symptoms
 Excessive
fatigue
Evening rise of
temperature.
Chest pain
Loss of weight
Chronic cough
Blood in the
sputum

General measures:
 Keep the patient in well ventilated house.
 Health education should be provided to the people.
 Advice proper balanced diet.
 People should be educated not to spit here and
there.
 Milk should be consumed after proper boiling.
 Maintain personal hygiene.

Specific measures:
 Tuberculosis patient should be detected as early as
possible by doing sputum examination.
 Infected person should be isolated.
 All the detected tuberculosis patient should be treated
with antitubercular drugs.
 Patient should not be allowed to spit here and there.
 While coughing or talking patient should wear a face
mask or keep handkerchief before his mouth while
coughing.
 Prevention: Immunisation by BCG vaccine can be
given to the newborns below 4 years of age.

Rubella
It is also known as German
measles.
It is an acute childhood infection
usually mild lasting for 3 days.
Infection in early pregnancy may
cause abnormalities or even death
to the foetus.

Causative agent
Rubella Virus
It spread directly from person to person
by droplet infection from nose and throat
and droplet nuclei in the form of aerosols.

Incubation Period: 2-3 weeks.
Sign and symptoms
 Low grade fever
 Minute, discrete,
pinkish macular
Rash
Rash starts from
behind the ears,
then head & neck
 Sore throat
 Enlargement of
lymph nodes

 Vaccination with combined vaccine measles,
mumps and rubella (MMR) is the mainstay of
prevention.
 Vaccination of child bearing age (15-39 years)
women to avoid congenital rubella.
 Pharmacists should emphasize to all pregnant
women about possibility of congenital
malformations with rubella infection.

Mumps
It is acute infection caused by virus
which has preference for glandular
and nervous tissue.
The main features of disease is
enlargement and tenderness of one
or both the (salivary) parotid gland.
It may also affects testes,
pancreas, ovaries, prostrate and
CNS.

Causative agent
Myxovirus parotiditis
It spread directly from person to person
by droplet infection.
An infected person coughing or sneezing
and releasing tiny droplets of contaminated
saliva

Incubation Period: 2-3 weeks.
Sign and symptoms
Fever, Headache
Pain and swelling
in either one or both
gland
Ear ache in
childrens
Pain and stiffness
while opening mouth

 Vaccination with combined vaccine measles,
mumps and rubella (MMR) is the mainstay of
prevention. 2 doses in children (1st: 12-15 months,
2nd: 4-6 Years)
 Vaccine should not be administere-d to pregnant
women, patient receiving immunosuppressive
therapy and who is severely ill.
 Isolation till the clinical symptoms subside.
 Disinfect all the articles used by patient.

INFLUENZA
It is highly communicable disease
of the upper respiratory tract also
known as “Flu”.
It affects people of all ages and
both gender.

Causative agent
Influenza Virus A, B and C.
The influenza virus is present in the
nasal secretions and the sputum of
the patient.
Direct contact
Droplet nuclei and droplet infection
i.e. Coughing, sneezing or talking.

Sign and
symptoms
 Fever last for
1-5 days.
Chills
Headache
Pain in the limb
and back, sore
throat and
cough.

 Isolate the suspected cases.
 During illness avoid meeting people for one week.
 Avoid going to over crowded places.
 Body should be protected from chills by wearing
sufficient warm clothes.
 Face mask should be used while attending a
patient.
 Disinfect the materials used by the patient.
 Sneezing spitting and coughing in public places
should be avoided.

Prevention:
 Vaccination
Prophylactic drug amantadine
can be given.
No specific treatment but
amantadine or simantidine 100 mg
twice a day can be given.

POLIOMYELITIS
It is also known as infantile paralysis.
It is an acute infectious viral disease of
the human alimentary tract but may
affect the central nervous system
resulting in paralysis.
It affects all ages but children below five
years of age are more susceptible.
Male are affected more than females.

Causative agent
Polio virus I, II, and III.
It spreads through fecal-oral route.
Virus is found in the nasopharyngeal
secretions, faeces and urine of patients
and carrier.
Infection can spread directly through
contaminated fingers or indirectly through
contaminated water, milk, food etc.

Sign and
symptoms
 Preparalytic
symptoms (high
fever, headache,
chillness,
diarrhoea, pain)
Paralytic
symptoms(foot
drop, facial
paralysis etc)

 Prevention is done by active immunisation of all
infants and children upto five years of age. Oral
polio vaccine.
 OPV is given in 3 doses at the age of 1 and half
month, 2 and half month, and 3 and half month.1st
booster dose at 18 months and next booster dose at
5 years of age.
 Patient should be isolated.
 Faeces, urine and other discharges of the patient
should be properly disposed.
 Hygienic conditions should be maintained.

Proper for safe and adequate water
supply and sanitary disposal of solid
wastes should be made.
Flies should be destroyed.
Avoid over crowding in schools and
other places of gatherings.

Hepatitis (Viral Hepatitis)
It is a communicable disease caused
by virus and affects liver.
Viral hepatitis includes hepatitis A and
Hepatitis B.
Infectious Hepatitis – Hepatitis A virus
Serum Hepatitis – Hepatitis B Virus
Delta Hepatitis – Hepatitis D Virus

Hepatitis A
It is formerly known as Infectious
Hepatitis.
Childrens are more affected than
adults.
An attack of hepatitis A generally
provides immunity against a
second attack.

Causative agent
Hepatitis A Virus (enterovirus)
It spreads through faecal-oral route.
It can occur by using contaminated food,
water or milk.
May spread from person to person by
direct contact through contaminated hands.
Rarely transmitted through needles,
Blood products.

Sign and symptoms
 Fever with chills
Nausea, vomitting
Headache
Jaundice
Fatigue
Liver enlarged
Generalized weakness

 Isolate the hepatitis cases.
 Disinfect the faeces and fomites of the patient.
 Follow personal and community hygiene.
 Antifly measures should be taken.
 Needles and syringes should be properly sterilized.
It is advisable to use disposable syringes and
needles.
 Human normal immunoglobulin should be
administered to all contacts before or within a week
of exposure.

Hepatitis B
It is also known as serum Hepatitis.
It is an acute systemic infection of liver,
sometimes leading to cancer of liver.
It affects all age group but more
common in adults than in children.

Causative agent
Hepatitis B Virus
Parenteral route: through infected blood,
and blood products, blood transfusion,
dialysis, contaminated needles and
syringes etc
Mother to foetus in uterus.
Transmitted by sexual contact or even
kissing.

Sign and symptoms
 Fever with chills
Nausea, vomiting
Jaundice
Fatigue
Liver enlarged
Generalized weakness
Chronic liver disease which leads to
cancer of the liver.

 Avoid blood transfusion and its products which are
contaminated with hepatitis B virus.
 Use disposable needles and syringes and always
use sterilized instruments for piercing ear or nose.
 Give Hepatitis B vaccine by Intramuscular route. 3
doses of 1 ml each. 2nd dose is given one month
after the first dose and the third dose is given 5
months after the 2nd dose.
 Hepatitis B immunoglobulin should be given
immediately to the persons who are exposed to
hepatitis virus within 24 hours.

CHOLERA
Cholera is an acute infectious disease
of the intestinal tract characterised by
sudden onset of severe diarrhoea and
vomiting leading to rapid dehydration
often resulting in death of the patient.
It affects all ages mainly people with
poor personal hygiene and
environmental hygiene.

Causative agent
Vibrio cholerae, EI Tor Vibrios
Fecal-oral route
Spread by ingestion of contaminated
water, food, milk, milk products or drinks
with discharges of the patient.
By careless handling of fomites of
infected persons and not washing hands
properly.
Flies act as mechanical carriers.

Incubation Period: few hours to 5 days
Sign and symptoms
 Diarrhoea (rice water stools)
Vomiting
Cramps in legs and abdomen
Rapid dehydration

 Early detection of suspected cases and
bacteriological examination of stools for
confirmation.
 Notification to the local health authority.
 Isolation in hospital or treatment centre.
 Disinfection of stools, vomitus, clothes, bedding,
room and utensils.
 Quarantine for a period of five days.
 Sanitary measures like water control, fly control
and disposal excreta.

 Treatment which involves rehydration of the
patient with administration of fluid ORS and
antibiotics like tetracyclines. ORS contains;
Sodium chloride 3.5gm
Sodium bicarbonate 2.5gm
Potassium chloride 1.5gm
Glucose (Dextrose) 20gm
 Prevention by cholera vaccine
 Health education stressing the importance of
food, personal hygiene and water hygiene.

TYPHOID
It is also known as enteric fever which
includes both typhoid and paratyphoid.
Typhoid is an acute communicable
disease caused by Salmonella typhi and
paratyphi.
It affects all ages but more common in
10-30 years of age peoples.

Causative agent
Salmonella typhi,
Salmonella paratyphi A, B, C
Sources of infection are faeces and urine
of cases and carriers.
Transmitted by contaminated water and
food.
Also transmitted by contaminated fingers
and flies.
Poor sanitation and poor hygiene

Sign and symptoms:
 Early symptoms include Nausea,
vomiting, diarrhoea, fever, headache etc.
Continuous fever for 2-4 weeks. There
is a step wise increase to the extent of
10C every day. (step ladder fever)
Weakness, tired, weight loss, poor
appetite
Slow pulse rate

 Water must be protected from contamination with
faeces, urine and sewage. Safe drinking water
supply should be made available to the public.
 Water and milk should be consumed only after
boiling.
 Human excreta and urine should be disposed in a
sanitary way.
 Maintain sanitation in and around the home.
 All eatables should be protected from flies. Raw
vegetables and fruits should be washed properly.

 Antifly measure should be taken.
 Public should be educated about sanitation
and personal hygiene.
 All acute cases should be detected, notified
and isolated at the earliest.
 For Prevention people should be immunised
with TAB vaccine which contains S. Typhi, S.
Paratyphi A & S. Paratyphi B. (2 doses each
of 0.5 ml)

Treatment:
Give complete bed rest.
Chloramphenicol 500 mg 4
times a day is the drug of choice.
Give nourishing diet to the
patient.
Disinfect all the articles used by
the patient.

Food Poisoning
 Food poisoning is an acute gastro-enteritis
caused by ingestion of food or drink
contaminated either with bacteria, their toxins,
inorganic substances or poisons derived from
plants and animals.
 Food poisoning can be classified as:
i. Non-Bacterial food poisoning
ii. Bacterial food poisoning

Causative agent:
i. Non – Bacterial food Poisoning: Caused
by chemicals (arsenic, cyanide, copper,
sulphates and fluorides), fertilisers,
pesticides or plants and sea foods.
ii. Bacterial food poisoning: It is caused by
food contaminated with bacteria or their
toxins. The bacteria which can produce food
poisoning are: Staphylococcus (common)
Clostridium botulinum
Clostridium Perfringes
Salmonella

Mode of Transmission:
 Ingestion of food or water contaminated with
bacteria or their toxins or chemicals.
Incubation period:
 Salmonella: 12-24 hours
 Staphylococcal: 2-4 hours
 Botulism: 12-20 hours

Sign and symptoms
 Nausea, vomiting
 Headache
 Sweating
 Diarrhoea
 Pain in the abdomen
 Severe dehydration
 Dryness of mouth

 Food prepared from animals and meat should
be inspected.
 Personal hygiene and food sanitation should
be ensured by food handlers.
 Stored food should be protected from
cockroaches, flies, rats, dust etc.
 Protection and covering of food during
processing and storage.
 Refrigeration for overnight storage of food.

 Food should be freshly prepared and eaten at
same time.
 If suspicion that the food is developed bacterial
growth, it must be discarded.
Treatment:
Fluid and electrolytes in dehydration
ORS can be given to restore the body
fluids.
Antitoxin must be given in case of Botulism.

Hookworm Infestations
Hookworm infestation/infection is a
intestinal infection caused by two types
of hookworms i.e. Ancylostoma
duodenale and Necator americanus.
The anterior end of these worms is bent
dorsally so it is known as hookworm

Causative agent:
Ancylostoma duodenale and
Necator americanus.

Hookworm infection occurs through
pollution of soil with faecal matter.
The worm enters through the skin
of legs. After penetration it enters
into the lymphatic system. Then
later it enters into the lung through
small blood vesel. From there it
enters into the alimentary tract
through trachea and throat.

Sign and symptoms
 Iron deficiency anemia
 Joints pain
 Abdominal pain
 Oedema
 Generalized weakness
 Loss of appetite

 Defecation in the open should be discouraged.
 Night soil should be properly disposed in rural
and slum areas.
 Sanitary latrines use should be promoted in
rural and slum areas.
 While working in fields wear shoes and gloves
for prevention
 Habit of walking bare foot should be avoided

Source of water supply should be
protected from contamination of
excreta.
Public should be educated for proper
use of sanitary latrines as well as
personal hygiene.
Treatment: Albendazole, mebendazole
can be given. And for anemia iron and
folic acid can be given.

Amoebiasis
Also known as amoebic dysentery
It is an infection caused by
Entamoebagenus infected by the
parasite Entamoeba histolytica.
It is more common in tropical areas with
poor sanitary conditions.

Causative agent:
Entamoeba histolytica, Entamoeba Coli
Usually transmitted by fecal-oral route
Indirectly transmitted through contact
with contaminated hands or objects,
food, water, etc.
Ingestion of the cysts form of the
parasite

Sign and symptoms
 Lethargy,
 Loos of weight,
 Colonic ulcerations,
 Abdominal pain,
 Diarrhoea (Blood)
 Complications: Peritonitis, colitis,
dehydration, anemia

 Prevent the spread of amoebiasis:
 Wash hands thoroughly with soap and water for at least 10 seconds
after using the toilet and before handling food.
 Clean bathrooms and toilets often.
 Avoid sharing towels or face washers.
 Prevent infection:
 Avoid raw vegetables when in endemic areas
 Boil water and avoid eating street foods.
 Treatment of amoebiasis:
 Amoebicidal tissue active agent, Luminal Cysticidal agents

Acute Diarrhoeal Diseases
It is a sudden onset of frequent loose or
watery stools, often accompanied by
vomiting and fever.
Usually mild with spontaneous recovery

Causative agent:
Bacteria: Salmonella, Vibrio parahemolticus
Virus: Norovirus, Rotavirus, Sapovirus and Astrovirus
Transmitted by fecal-oral route
Contaminated hands or ingestion of
contaminated food, water, etc.
Ingestion of the cysts form of the
parasite

Sign and symptoms
 Frequent loose watery stools,
 Abdominal cramps,
 Abdominal pain,
 Fever,
 Bleeding,
 Headache,
 Complications: Dehydration

Hand washing with soap and water.
Access to safe drinking water
Use of improved sanitation
Good personal and food hygiene
Health education about spread of infections
Rotavirus vaccination
 Treatment of amoebiasis:
Plenty of ORS/Fluid
Anti-diarrhoeal drugs like loperamide
Antibiotics

Respiratory and Intestinal infections

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