Communicable Diseases Comp Review

Precautions, infection control, immunizations, etc

Conjunctivitis

Spread: direct contact (viral and bacterial)

Incubation: depends on infection

Viral clears on its own in 7-14 days secondary to some other vial infection

Bacterial clears with topical antibiotics

Isolation Precautions: viral - contact, bacterial - standard

Expected: pink/red sclera, swelling of conjunctiva, excessive tearing, purulent discharge (with crusting in morning) if bacterial, watery discharge if viral

Epstein Barr virus (infections mononucleosis)

Spread: oral secretions

Incubation: 30-50 days

Communicable for weeks; even healthy people can transmit for lifetime

Isolation Precautions: standard

Expected: fever, lethargy, sore throat, swollen lymph nodes, loss of appetite, HA, increased WBC atypical lymphocytes, spelnomegaly, hepatic involvement

Complications: ruptured spleen

Fifth disease/parvovirus B19 (erythema infectiosum)

Spread: respiratory secretions, transfusion of blood or blood products

Incubation: 4-14 days, sometimes up to 21 days

Communicable at the onset of manifestations before rash appears

Isolation Precautions: droplet

Expected: before rash - fever, runny nose, HA; rash - on face (slapped check), maculopapular red spots symmetrically distributed on the body, particularly on the arms and legs, and may be itchy

Complications: self-limited arthritis and arthralgia (more common in adult females)

Mumps (paramyxovirus)

Spread: direct contact with respiratory droplets

Incubation: 14-21 days

Communicable at least 2 days before swelling and up to 5 days after

Isolation Precautions: droplet

Expected: painful, swollen parotid glands, fever and muscle aches, HA, earache made worse by chewing, fatigue and loss of appetite

Complications: orchitis, encephalitis, meningitis, oophoritis, mastitis, deafness, myocarditis, arthritis, hepatitis

Pertussis/Whooping cough (Bordetella pertussis)

Spread: direct/indirect contact with respiratory secretions

Incubation: 6-20 days, usually 7-10 days

Communicable for several weeks, particularly in the early stages; greatest during catarrhal stage

Isolation Precautions: droplet

Expected: common cold manifestations during the catarrhal stage, severe coughing 1-2 weeks followed by the characteristic whoop sound during inspiration (paroxysmal stage)

Complications: infants, children - pneumonia, seizures, apnea, encephalopathy, death, ear infections, hemorrhage, weight loss, hernias; teens, adults - weight loss, loss of bladder control, syncope, rib fractures, pneumonia

Rubella/German measles (RUBElla virus)

Spread: direct or indirect contact with respiratory sectretions

Incubation: 14-21 days

Communicable 7 days before to 5 days after the rash appears

Isolation Precautions: droplet

Expected: low grade fever, sore throat, HA, malaise, cough, lymphadenopathy, red rash that typically starts on the face and spreads to the rest of the body

Complications: rare but results in birth defects in pregnant women

Rubeola/measles (RUBEOla virus)

Spread: direct/indirect contact with respiratory secretions

Incubation: 10-20 days

Communicable 4 days before to 5 days after the rash appears

Isolation Precautions: airborne

Expected: before rash - mild-mod fever, conjunctivitis, fatigue, cough, runny nose, sore throat; rash - koplik spots (tiny white spots) appear in mouth before rash, red/reddish-brown rash beginning on face spreading downward, spike in fever with rash

Complications: ear infections, pneumonia, encephalitis, death, laryngitis

Varicella/chickenpox (varicella-zoster virus)

Spread: direct/indirect contact with respiratory secretions and skin lesions/contaminated objects

Incubation: 2-3 weeks, usually 14-16 days

Communicable 1-2 days before the rash appears until all lesions have crusted over

Isolation Precautions: airborne, contact

Expected: before rash - fever, fatigue, loss of appetite, HA, rash - macules start in center of trunk spreading outward, then progress to vesicles and eventually crust over.

Complications: Pneumonia, bleeding problems, bacterial infection of the skin, encephalitis

MRS WEE

Contact precautions:

MRSA, Respiratory, Skin, Wound, Enteric, Eye and standard precautions for all patients.

SPIDERMAn

Droplet precautions:

Sepsis/scarlet fever, Parvo/pertussis/PNA, influenza, diphtheria, epiglottitis, rubella, mumps/meningitis/mycoplasma, adenovirus

MTV

Airborne precautions:

measles, tuberculosis, varicella (chickenpox, shingles)

Donning PPE

Hand hygiene, gown, mask, googles, gloves

Doffing PPE

gloves, googles, gown, mask, hand hygiene,

Live attenuated vaccines

MMR (measles, mumps, rubella), rotavirus, smallpox, chickenpox, yellow fever

not best for those with weakened immune system and needs to be chilled

Inactivated vaccines

hepatitis A, flu, polio, rabies

not as good as attenuated vaccines for immunity (boosters needed), but requiring no refrigeration.

Subunit & conjugated vaccines

shingles, meningicoccal disease, pneumococcal disease, HPV, whooping cough (part of DTap), hepatitis B, haemophilus influenzae B

pieces of a germ that stimulate an immune response without causing disease; safer for immunocompromised individuals

Toxoid vaccines

tetanus and diphtheria

inactivated toxins that stimulate an immune response; boosters needed about every 10 years

mRNA vaccines

COVID-19

makes proteins that trigger an immune response, does not cause immune response and easy to manufacture

Viral vector vaccine

COVID-19, Ebola, Zika virus

uses a modified virus (for example adenovirus) to deliver genetic material as a vector which does illicit immune response to the vial vector