Emerging communicable diseases-WHO blue print

1. A TOPIC PRESENTATION ON
EMERGING COMMUNICABLE
DISEASES

2. INTRODUCTION
EMERGING COMMUNICABLE
DISEASES ARE DISEASES OF
INFECTIOUS ORGIN WHOSE
INCIDENCE IN HUMAN HAS
INCREASED WITHIN THE RECENT PAST
OR THREATENS TO INCREASE IN THE
NEAR FUTURE.

3. EMERGINGCOMMUNICABLEDISEASES
DEFINITION
EMERGING AND REMERGING
COMMUNICABLE DISEASES CAN BE DEFINED AS
THAT ARE RECOGNIZED IN THE HUMAN HOST
FOR THE FIRST TIME AND DISEASES THAT
HISTORICALLY HAVE INFECTED HUMANS BUT
CONTINUE TO APPEAR IN A NEW LOCATION OR
IN DRUG RESISTANCE FORMS OR THAT APPEAR
AFTER APPARENT CONTROL OR ELIMINATION

4. CONTRIBUTION FACTORS
• MICROBIAL ADAPTION
• CHANGING HUMAN SUCEPTIBILITY
• CLIMATE AND WEATHER CHANGES
• CHANGES IN HUMAN DEMOGRAPHICS AND TRADE
• ECONOMIC DEVELOPMENT
• BREAKDOWN OF PUBLIC HEALTH
• POVERTY AND SOCIAL INEQUALITY
• WAR AND FAMINE
• BIOTERRORISM
• DAM AND IRRIGATION SYSTEM CONSTRUCTION

5. WHO BLUE PRINT
• ARENAVIRAL HEMMORHAGIC FEVER(LASSA
FEVER)
• CRIMEAN CONGO HEMMORRAGHIC FEVER
(CCHF)
• FILOVIRAL DISEASES (EBOLA AND MACBURG)
• MIDDLE EAST RESPIRATORY SYSDROME –
CORONA VIRUS
• SEVERE ACUTE RESPIRATORY SYNDROME
(SARS)

6. CONT..
• NIPAH AND RELATED HENIPA VIRAL DISEASES
• RIFT VALLEY FEVER (RVF)
• SEVERE FEVER WITH THROMBOCYTOPENIA
SYNDROME(SFTS)
• ZIKA FEVER
• CHIKUNGUNYA FEVER

7. 1. LASSA FEVER
• ALSO KNOWN AS LASSA HEMMORAGIC
FEVER
• LASSA VIRUS IS A MEMBER OF THE
ARENA VIRIDAE VIRUS FAMILY
• SPREAD THROUGH CONTACT WITH URINE
AND FECES OF AN INFECTED
MULTIMAMAL RAT
• SPREAD BY DIRECT CONTACT
• DIADNOSIS BASED ON SYMPTOMS

8. CONT..
• THERE IS NO VACCINE FOR LASSA FEVER
• PREVENTION MAINLY BY AVIOD CONTACT WITH RATS
• SYMPTOMS;
-FEVER
-WEAKNESS
-HEADACHE
-VOMITING
-MUSCLE PAIN
-BLEEDING FROM GIT
-DEAFNESS
• TREATMENT
-IS SYMPTOMATIC

9. CONT..
-ANTIVIRAL AGENTS (RIBAVIRIN)
-IV INTERFERON THERAPY
- FLUID REPLACEMENT
-BLOOD TRANFUSION
• PROGNOSIS; 15-20% PATIENTS WILL DIE

10. 2.CRIMEAN CONGO
HEMORRHAGIC FEVER
• VIRAL DISEASES, CAUSED BY TICKS
• FIRST DETECTED IN 1940S
• IT OCCURS IN AFRICA,THE BALKONS,THE MIDDLE EAST/ ASIA
• CAUSES;
-TICKS ARE THE RESERVOIR AND VECTOR
-CAUSATIVE ORGANISM IS ‘THE CRIMEAN CONGO
HEMORRAHAGIC FEVER VIRUS (CCHFV)’
-RNA VIRUS(ORTHONAIROVIRUS)

11. CONT.
• MODE OF TRANSMISSION;
-CCHF VIRUS SPREAD BY TICK’S BITE
-CONTACT WITH LIVESTOCKS
-MAINLY AFFECTED IN FARMERS &WORKS IN
SLAUGHTER HOUSES
-SPREAD VIA BODY FLUIDS
• SIGNS AND SYMPTOMS;
-SVERE FORM OF HEMMORRHAGIC FEVER
-MOOD INSTABILITY
-AGITATION
-MENTAL CONFUSION
-THROAT PETECHIAE

12. CONT..
-NOSE BLEEDING
-VOMITING
-BLACK COLOURED STOOL
-LIVER ENLARGEMENT &KIDNEY FAILURE
-DIC
-SHOCK
-ARDS

13. CONT..
• DIADNOSIS;
-CLINICAL EVALUATION
-CULTURE AND SENSITIVITY
-ANTIGEN ANTIBODY ANALYSIS
• PREVENTION;
-DE-TICKING OF FARM ANIMALS
-PERSONAL TICK AVOIDANCE MEASURES
-BODY SURFACE ISOLATION PREVCAUTIONS
• COMPLICATIONS;
-LIVER FAILURE
-KIDNEY FAILURE & ARDS
-DEATH

14. CONT..
• TREATMENT;
-SUPPORTIVE TREATMENT
-RIBAVIRIN
-IMMUNOGLOBULINS PREPARATUIONS
-MONOCLONAL ANTIBODY THERAPY(IG
PREPARTIONS)

15. 3.EBOLA (FILO VIRUS DISEASES)
• VIRAL HEMORRHAGIC FEVER
• INFECTED BY DIRECT CONTACT AND FRUIT BAT
• CAUSES;
-EBOLA VIRUS (FILOVIRUS)
-SPRED BY DIRECT CONTACT

16. CONT..
• MODE OF TRANSMISSION;
-DIRECT CONTACTWITH BODY FLUIDS
-BODY FLIUDS ;SALIVA,VOMITUS,MUCUS,FECES,
TEARS,SWEAT,BREAST MILK, URINE AND SEMEN.
• SIGNS AND SYMPTOMS;
→ONSET:
-INCUBATION PERIOD IS 2-21 DAYS
-FEVER AND WEAKNESS
-DICREASED APPETITE
-MUSCULAR AND JOINT PAIN
-HEADACHE AND THROAT ACHE
-VOMITING AND DIARRHOEA

17. CONT…
- ABDOMINAL AND CHEST PAIN
-CONFUSION
→BLEEDING
-VOMITING BLOOD
-COUGHING UP OF BLOOD
-BLOOD IN STOOL
-PETECHIAE
-PURPURA
-ECHYMMOSES & HEMATOMAS
-BLEEDING IN GIT

18. CONT..
→RECOVERY
-MUSCULAR AND JOINT PAIN
-LIVER INFLAMMATION
-DECREASED HEARING
-TIERDNESS,WEAKNESS,DECREASED APPETITTE
-VISION PROBLEMS
• DIAGNOSIS
-HISTORY COLLECTION
-PHYSICAL EXAMINATION
-LAB INVESTIGATIONS
*↓ PLATLET COUNT
*↓WBC

19. CONT..
*↑ ALT
*↑ AST
*↑ PT AND PPT
-ELECTRON MICROSCOPY
-PCR
-ELISA
-CULTURE AND SENSITIVITY
• PREVENTION
-PERSONS INFECTED WITH EBOLA SHOULD WEAR
PROTECTIVE CLOTHINGS
-BARRIER ISOLATION
-EDUCATION
-EBOLA CAN BE ELIMINATED BY HEAT

20. CONT..
• TREATMENT
-SUPPORTIVE TREATMENT
-HYDRATION AND SYPTOMATIC TREATMENT
-BLOOD TRANSFUSION
-DIALYSIS
-EXTRACORPREAL MEMBRANE OXYGENATION
• COMPLICTIONS
-RENAL AND LUNG FAILURE
-LIVER FAILURE AND DEATH
• PROGNOSIS
-HIGH RISK OF DEATH (25-90%)
-RECOVERY MAY BE QUICK AND COMPLETE

21. 4.MIDDLEEASTRESPIRATORYSYNDROME–
CORONAVIRUS(MERS-COV)
• KNOWN AS CAMEL FLU
• VIRAL RESPIRATORY DISEASE CAUSED BY MERS –COV
• MERS-COV ;BETA CORONA VIRUS DERIVED FROM BATS
• SPREAD BY CONTACT WITH INFECTED PERSON
• MODE OF TRANSMISSION
-CAMEL TO HUMAN TRANSMISSION OF VIRUS IS
UNCLEAR
-CONTACT TRANSMISSION
-NO EVIDENCE OF TRANSMISSION FROM
ASYMPTOMATIC CASES

22. CONT..
• SIGNS AND SYMPTOMS
-FEVER AND COUGH
-SHORTNESS OF BREATH
-DIARHOEA AND VOMITING
-MYALGIA AND ABDOMINAL PAIN
-PNEUMONIA
• DIAGNOSIS
-HISTORY COLLECTION AND PYSICAL EXAMINATION
-CHEST X-RAY
-BLOOD ANALYSIS
-PCR
-IMMUNOFLURESCENT ASSAY
-NASOPHARYNGEAL SWAB –C&C
-SPUTUM AND TRACHEL ASPIRATIONS

23. CONT..
• PREVENTION
-WEAR PPE
-AVOID CONTACT WITH CAMEL
-AVIOD CONTACT WITH MEAT AND MILK
-ISOLATION
• TREATMENT
-COMBINATION OF ANTIVIRAL AND INTERFERON /
CORTICOSTEROIDS (RIBAFLAVIN +INTERFERON alfa- 2a)
-CHLOROQUINE, CHLOROPROMAZINE, IOPINIVIR
-MYCOCEPHANOLIC ACID AND CEMOSTSAT
• COMPLICATIONS
-KIDNEY FAILURE /DIC /PERTICARDITIS

24. 5.SARS
• VIRAL ZOONOTIC RESPIRATORY DISEASES
• CAUSED BY SARS CORONA VIRUS
• AN OUTBREAK OF SARS IN SOUTHERN CHINA IN NOV 2002-
JULY 2003
• TOTALY 774 DEATH CASES REPORTED IN WORLD

25. CONT..
• MODE OF TRANSMISSION
-MASKED PALM CIVET OR GEM-FACED CIVET IS
THE PRIMARY SOURCE OF INFECTION
-DROPLET INFECTION
• SIGNS AND SYMPTOMS
-FEVER AND MYALGIA
-COUGH AND SORE THROT INITIALY
-HYPERTERMIA
-SHORTNESS OF BREATH
PNEUMOINA

26. CONT..
• DIAGNOSIS
-HISTORY COLLECTION AND PHYSICAL
EXAMINATION
-CHEST X-RAY
-ELISA
-PCR
-IMMUNOFLURESCENCE
• PREVENTION
-ISOLATION
-HAND WASHING AND DISINFECTION
-WEARING MASK
-AVOID CONTACT WITH BODY FLUIDS
-AVIOD USE OF MASKED PALM CIVET

27. CONT..
• TREATMENT
-ANTIBODIES AND ANTIVIRALS ARE
INEFFECTIVE
-ANTIPYRETICS
-OXYGEN SUPPLEMENTATION
-ISOLATION IN NEGATIVE PRESSURE ROOM
- COMPLETE BARRIER NURSING PRECAUTIONS
• PROGNOSIS
-NOT GOOD
-IN POST SARS PATIENTS SHOWS POST
TRAUMATIC STRESS DISORDER AND MAJOR DEPRESSIVE
DISORDER

28. 6.NIPAH AND RELATED
HENIPAH VIRAL DISEASES
• ZOONOTIC DISEASES
• CAUSED BY NIPAH VIRUS OF PARAMYXOVIRIDAE FAMILY
• SIMILAR TO ANOTHER EMERGING ZOONOSES (HENDRA
VIRUS)
• RESERVOIRS –PIGS &HUMANS
• HUMANS ARE INFECTED BY CONTACT WITH PIGS

29. CONT
• SIGNS AND SYMPTOMS
-SUDDEN DEATH
-ACUTE FEBRILE ILLNES
-INCREASED SALIVATION
-SEROUS MUCOPURULENT OR BLOOD TINGED NASAL
DISCHARGE
-AGITATION
-TETANUS LIKE SPASMS /SEIZURES
-NYSTAGMUS
-PHARYNGEAL MUSCLE PARALYSIS
CHAMPING OF MOUTH

30. CONT..
• DIAGNOSIS
-SEROLOGY/ HISTOPATHOLOGY
-IMMUNOHISTOCHEMISTRY
-ELECTRON MICROSCOPY
-PCR
-CULTURE AND SENSITIVITY
• PREVENTION
-CONTACT ISOLATION
-AVOID CONTACT WITH PIGS, HORSES ETC
-HUMAN MONOCLONAL ANTYBODY IMMUNIZATION
-USE OF PERSONAL PROTECTIVE EQUIPMENTS

31. CONT..
• TREATMENT
-SUPPORTIVE CARE
-RIBAVIRIN IS EFFECTIVE
-INFECTION CONTROL MEASURES
-BARRIER NURSING TECHNIQUES
-PREVENTION OF NOSOCOMIAL INFECTION

32. 7.RIFT VALLEY FEVER
• VIRAL DISEASES THAT CAUSE MILD TO SEVERE SYMPTOMS
• OUT BREAKS OCCURS ACROSS SUB SAHARAN AFRICA
• CAUSED BY RIFT VALLEY FEVER VIRUS (BUMYA VIRIDAE
FAMILY) ,A NEGATIVE SINGLE STRANDED RNA VIRUS
• MODE OF TRANSMISSION;
-TRANSMITTED THROUGH MOSQUITO VECTORS
-CONTACT WITH THE TISSUE OF INFECTED ANIMALS
-CONTACT WITH INFECTED HUMANS

33. CONT…
• SIGNS AND SYMPTOMS
-A MILD ILLNES WITH FEVER
- HEADACHE
-MUSCLE PAIN
-LIVER DYSFUNCTION
-GENERALISED WEAKNESS
-BACK PAIN
-DIZZINESS
-WEIGHT LOSS

34. CONT..
• DIAGNOSIS
-HISTORY COLLECTION AND PHYSICAL
EXAMINATON
-ELISA
-NUCLEIC ACID TESTING (NAT)
-CELL CULTURE
-IGM ANTIBODY ASSAY
• PREVENTION
-CONTACT ISOLATION
-MOSQUITO AVOIDANCE
-VACCINATING OF ANIMALS
• TREATMENT ; SUPPORTIVE

35. CONT..
• COMPLICATIONS
- HEMORRHAGIC FEVER SYNDROME
-MENINGOENCEPHALITIS
-EYE INFECTION

36. 8.SEVEREFEVERWITH
THROMBOCYTOPENIASYNDROME(SFTS)
• FIRST DESCRIBED IN NORTH EAST AND CENTRAL CHINA
• SFTS VIRUS IS A TICK BORNE PHLEBOVIRUS (BUMYAVIRDIAE)
• IT IS RELATED TO UNKUNEIMI VIRUS
• SYMPTOMS;
-FEVER & THROMBOCYTOPENIA
-VOMITING AND DIARRHOEA
-MULTIPLE ORGAN FAILURE
-LEUCOPENIA
-ELIVATED LIVER ENZYME LEVEL
• TRANMISSION;
-UNKNOWN
-DETECTED IN HAEMOPHYSALIS LONGICORNIS TICKS

37. CONT..
• DIAGNOSIS;
-HISTORY COLLECTION AND PHYSICAL EXAMINATION
-CULTURE AND SENSITIVITY
-PCR
-ELISA
• PREVENTION
-AVOID CONTACT WITH ANIMALS AND BIRDS
-HANDWASHING
-USING INSECT REPELLING MEASURES
• TREATMENT
-SYMPTOMATIC TREATMENT
-BLOOD TRANSFUSION ,IF NECESSARY

38. 9.ZIKA FEVER
• ZIKA VIRUS IS A MEMBER OF FLAVIRIDAE FAMILY
• SPREAD BY DAYTIME ACTIVE AEDES MOSQUITOES
• RELATED TO DENGUE FEVER,YELLOW FEVER ETC
• TRANSMISSION;
-PRIMARY HOST IS MOKEY SO IS CALLED
ENZOOTIC-MONKEY-MOSQUITO CYCLE
-TRANSMITTED PRIMARLY BY AEDES EGYPTI
MOSQUITOES
-SEXUAL CONTACT
-BLOOD TRANSFUSION

39. CONT..
• SYMPTOMS
-MOST CASES ARE ASYMPTOMATIC
-FEVER
-RED EYES
-JOINT PAIN
-HEADACHE
-MACULOPAPULAR RASH
*IN PREGNANCY
-MICROCEPHALY
-BRAIN MALFORMATIONS IN BABIES

40. CONT..
• DIAGNOSIS;
-HISTORY COLLECTION
-PYSICAL EXAMINATION
-BLOOD /SALIVA/SALIVA ANALYSIS
-CULTURE AND SENSITIVITY
• PREVENTION
-MOSQUITO AVOIDANCE
-USE OF CONDOMS
- NO VACCINATION
• TREATMENT
-NO SPECIFIC TREATMENT
-PARACETAMOL IS USED FOR FEVER

41. 10.CHICKUNGUNYA FEVER
• CAUSED BY CHICKUNGUNYA VIRUS (CHIK V)
• SYMPTOMS ARE USUALLY OCCUR AFTER 2-12 DAYS OF
EXPOSURE
• CHIK V –MEMBER OF ALPHA VIRUS GENOUS AND
TOGOVIRIDIAE FAMILY
• MODE OF TRANSMISSION;
-BY ARTHOPODES, MOSQUITOES
-MAINLY BY AEDES EGYPTI AND A.ALBOPICTIS
- LESS CHANCE TO MOTHER TO CHILD
TRANSMISSION OR AT BIRTH
-BLOOD TRANSFUSION AND ORGAN
DONATION, TRANSMISSION IS POSSIBLE

42. CONT..
• SIGNS AND SYMPTOMS
-SUDDEN ONSET OF FEVER
-JOINT PAIN
-HEADEACHE
-FATIQUE
- CONJUNCTVITIS
-DIGESTIVE PROBLEMS
• DIAGNOSIS
-HISTORY COLLECTION
-PHYSICAL EXAMINATIO
-BLOOD EXAMINATION- ↓LYMBOCYTE COUNT
-PCR
-CULTURE AND SENSITIVITY

43. CONT..
• PREVENTION
-NO VACCINE
-MOSQUITO PREVENTION
• COMPLICATIONS;
-CHRONIC ARTHRITIS
-LIVER FAILURE
-MENINGO ENCEPHALITIS
-NEUROPATHY
-FLACCID PARALYSIS
• TREATMENT
-NO SPECIFIC TREATMENT
-SYMPTOMATIC AND SUPPORTIVE THERAPY

44. 11.OTHER DISEASES
• HIV
• H1N1
• H5N1
• DENGUE FEVER
• YELLOW FEVER ETC

45. CONCLUSION
AN EMERGING INFECTIOUS
DISEASES IS AN INFECTIOUS DISEASE
PRIMARLY CAUSED BY PREVIOUSLY
UNDETECTED OR UNKNOWN INFECTIOUS
AGENTS.PREVENTION OF THESE DISEASES
IS NECESSARY TO PREVENT MORTALTY.