BP2 DISEASES

An occurrence of more cases of disease than would normally be expected in a specific place or group of people over a given period of time

What defines an epidemic?

A very widespread, often global disease, crossing international boundaries and usually affecting a large number of people

What defines a pandemic?

Infectious disease transmissible from person or animal to another

What defines a communicable disease?

Identify risk factors, track disease patterns, and design targeted interventions that disrupt the transmission cycle

What is the purpose of using basic principles of infectious disease epidemiology?

Disease surveillance, outbreak investigations, and contact tracing

What are the three critical epidemiological methods used in disease control?

Detecting outbreaks early, monitoring disease trends, and informing public health decisions

What are the essential purposes of public health surveillance?

Monitor health events and link to public health action

What are the two main objectives of a surveillance system?

Changes and interventions are strategically planned, and tests are designed to evaluate their potential impact

What happens during the "Plan" stage of the Plan-Do-Check-Act (PDCA) cycle?

Implementing the planned change on a small scale to observe its effects

What happens during the "Do" stage of the PDCA cycle?

Evaluating the results of an intervention to understand its effectiveness and any unexpected outcomes

What happens during the "Check" stage of the PDCA cycle?

Determine whether the change should be adopted, modified, or abandoned based on results

What happens during the "Act" stage of the PDCA cycle?

Pro-active case finding through field investigations, requiring regular communication with health facilities, and being resource-intensive

What defines active surveillance?

Routine reporting by health facilities, relying on healthcare providers to report cases, and being practical and cost-effective for long-term monitoring

What defines passive surveillance?

Limit the spread of the disease and reduce its impact on individuals and communities

What is the primary goal of disease control?

The interruption or stopping of disease transmission within a specific area or region

What defines disease elimination?

The permanent worldwide reduction of a disease to zero cases, such that the intervention measures are no longer needed

What defines disease eradication?

Actions aimed at eradicating, eliminating, or minimizing the impact of disease and disability through measures like vaccination, health education, and environmental modifications

What defines disease prevention?

Elimination of the source of contamination, interruption of transmission, reduction/exhaustion of susceptibles, and modification of the effect of the primary pathogen

What must occur for an outbreak to be considered over or to achieve cessation?

Focus on control measures ("Control +++"), while investigation efforts are moderate ("Investigation +")

What is the strategy employed in the Matrix Diagram when the etiology and transmission are both known?

Intensive investigation ("Investigation +++") becomes the priority to determine the transmission pathway, while control measures are implemented cautiously ("Control +")

What is the strategy employed in the Matrix Diagram when the etiology is known but the transmission is unknown?

Equal emphasis is placed on both intensive investigation and control ("Investigation +++" and "Control +++") to simultaneously identify the pathogen and prevent further spread

What is the strategy employed in the Matrix Diagram when the etiology is unknown but the transmission route is known?

Maximum efforts are required for investigation ("Investigation +++") to uncover the disease origin and control ("Control +") to mitigate risk until more information is obtained

What is the strategy employed in the Matrix Diagram when both etiology and transmission are unknown?

Sanitation and hygiene, vaccination programs, surveillance and early detection, and community engagement and public health education

What are the four core management strategies for disease control?

To reduce public anxiety and provide clear guidance on protective actions

What are the two goals that formal risk messages are structured to meet?

Delivering the single overriding communication objective (SOCO) consistently to ease concern about the risk

What does staying "on message" refer to in risk communication?

Fever, malaise, myalgia, chills, and itching (viral incubation and viremia), followed by a short-lived erythematous facial rash and arthralgia/arthritis (immune complex formation)

What are the phases of clinical symptoms in Erythema Infectiosum caused by Parvovirus B19?

A constellation of congenital anomalies resulting from maternal rubella during pregnancy, consisting of cataracts, congenital heart disease, and sensorineural hearing loss

What is the Classic Triad of Congenital Rubella Syndrome (CRS)?

Discontinuing or tapering corticosteroids, delaying chemotherapy, or giving colony stimulating factors in cases where neutropenia is present

What measures should be attempted when possible to manage Parvovirus B19 infection in immunodeficient patients?

Intravenous immune globulin (IVIG)

What is the therapy used to ameliorate persistent Parvovirus B19 infection in immune-deficient patients and for hydrops fetalis during pregnancy?

Supportive care only

What is the current treatment for most patients infected with Parvovirus B19, Human Bocavirus (HBoV), Human Metapneumovirus (hMPV), Mumps, Rubella, Japanese Encephalitis, and West Nile Virus?

Aerosolized Ribavirin

What antiviral has been used with some benefit in immunocompromised patients with more serious lower respiratory tract disease caused by Parainfluenza Virus?

Supportive care, including Paracetamol, Bioflu, and annual vaccination

What is the management for Influenza infection in pregnant patients, in addition to antivirals?

Oseltamivir (Tamiflu), Zanamivir, and Peramivir

What are the most recommended antiviral treatments for Influenza, used to shorten the illness course and infectious period?

Supportive care (eg, Paracetamol)

What is the management for pregnant patients infected with common respiratory viruses (Rhinovirus, Adenovirus, Coronavirus) and COVID-19?

Acyclovir IV (or oral)

What is the recommended treatment for a pregnant patient who develops Varicella Zoster Virus (VZV) pneumonia?

Varicella-zoster Immunoglobulin (VariZIg)

What is given to exposed, seronegative pregnant women within 96 hours to 10 days from the time of exposure to VZV?

Ganciclovir (IV) or oral Valganciclovir for 6 weeks or 6 months

What is the antiviral therapy used for treating CMV systemic infection in immunocompromised patients or congenital CMV to control progressive hearing loss?

Foscarnet

What antiviral is recommended for treating retinitis due to CMV infection and can be used as an alternative to Ganciclovir?

Valacyclovir (oral) and Valganciclovir (IV)

What are the antiviral treatments for CMV infection?

Good hygiene, handwashing, safe sex, and not sharing utensils

What are the preventive measures for Cytomegalovirus (CMV) infection?

IV Ganciclovir, oral Valganciclovir, Foscarnet, Letermovir, Cidofovir, and Maribavir

What are the specific antivirals used in the treatment of CMV infections?

Chronic suppressive therapy with antivirals until immune reconstitution is achieved with antiretrovirals

What is the management for PLHIV with a history of CMV end-organ disease to prevent recurrence?

Intravenous Immune Globulin (IVIG)

What may be administered to pregnant mothers exposed to Measles, Mumps, and Rubella as a post-exposure prophylaxis (PEP)?

Within 6 days of exposure

When must Post-Exposure Prophylaxis (PEP) IVIg be given to mothers exposed to Measles?

Within 5 days of exposure

When must Post-Exposure Prophylaxis (PEP) IVIg be given to mothers exposed to Mumps or Rubella?

Live attenuated Measles, Mumps, and Rubella (MMR) vaccine

What is the immunization that must be administered preconception or postpartum, with pregnancy avoidance for 1 month after?

No specific treatment besides supportive and symptomatic treatment, including analgesics for tenderness associated with inflammation

What is the management for Mumps infection?

Vitamin A treatment

What supportive therapy is recommended by WHO for all children with measles to decrease morbidity and mortality?

Antibiotics

What medication is given for secondary bacterial infection (pneumonia) brought about by immune suppression in Measles patients?

Spiramycin

What drug is used for acute Toxoplasmosis infection in early pregnancy to reduce vertical transmission?

Pyrimethamine-sulfadiazine plus folinic acid

What is the treatment for fetal Toxoplasmosis infection acquired after 18 weeks of gestation?

Cook meat adequately, peel or wash fruits and vegetables, clean utensils after contact with raw meat, wear gloves when cleaning cat litter, avoid feeding cats raw or undercooked meat, and keep cats indoors

What are the preventive measures for Toxoplasmosis infection?

Chloroquine or Hydroxychloroquine

What are the appropriate antimalarial drugs for P vivax, P malariae, P ovale, and chloroquine-sensitive P falciparum during pregnancy?

Mefloquine

What antimalarial is recommended for chloroquine-resistant P vivax during pregnancy?

Primaquine

What antimalarial is recommended postpartum for malaria?

Chloroquine prophylaxis (when traveling to endemic areas), vector control (insecticide-treated netting, DEET-based insect repellent, pyrethroid insecticides)

What are the prevention measures for Malaria?

Metronidazole or Tinidazole

What drugs are safe to use during pregnancy for the management of invasive amoebiasis or amebic colitis?

Iodoquinol or Paromomycin

What drugs are used for the management of noninvasive amoebiasis?

Penicillin G (first line) or Ampicillin (alternative)

What is the prophylactic antibiotic treatment for Group B Streptococcus (GBS) during labor for mothers with positive recto-vaginal cultures?

Cefazolin, Clindamycin, or Vancomycin (if resistant to Clindamycin)

What antibiotics are used as alternatives for GBS prophylaxis if the patient is resistant or allergic to Penicillin G/Ampicillin?

Ampicillin + Gentamicin (first line) or Trimethoprim-sulfamethoxazole (for penicillin-allergic)

What antibiotics are used to treat Listeriosis?

Fluoroquinolones or third generation cephalosporins (cefixime, ceftazidime)

What are the treatments for Salmonella GI infections?

Fluoroquinolones, Ceftriaxone (third generation cephalosporins), or Azithromycin

What are the treatments for Shigella GI infections?

Amoxicillin, Cefuroxime, or Doxycycline

What are the treatments for early Lyme disease infection (Stage 1)?

Ceftriaxone, Cefotaxime, or Penicillin G

What are the treatments for complicated early Lyme disease infection (Stage 2)?

Doxycycline

What drug used for Lyme disease is contraindicated in pregnancy?

Intensive supportive care, including fever control, fluids and nutrition, respiration and oxygenation, and managing secondary bacterial infection

What is the therapeutic management for Japanese Encephalitis (JE)?

Control of seizures and increased Intracranial Pressure (ICP)

What is a critical therapeutic intervention for severe Japanese Encephalitis ( the treatments for early Lyme disease infection (Stage 1)?

Ceftriaxone, Cefotaxime, or Penicillin G

What are the treatments for complicated early Lyme disease infection (Stage 2)?

Doxycycline

What drug used for Lyme disease is contraindicated in pregnancy?

Intensive supportive care, including fever control, fluids and nutrition, respiration and oxygenation, and managing secondary bacterial infection

What is the therapeutic management for Japanese Encephalitis (JE)?

Control of seizures and increased Intracranial Pressure (ICP)

What is a critical therapeutic intervention for severe Japanese Encephalitis (JE) cases?

JE vaccine

What is available for the prevention of Japanese Encephalitis?

An outbreak or epidemic occurring worldwide, or over a very wide area, crossing international boundaries

What defines a pandemic?

Cholera

What disease, starting in the 1800s, has spread around the globe in pandemics, and is currently in its seventh pandemic?

Smallpox

What disease, one of the earliest recorded epidemic diseases, was eradicated in 1979?

Antiretroviral therapy (for HIV), directly observed treatment (for tuberculosis), and insecticide-treated nets (for malaria)

What are examples of effective control methods for major communicable diseases?

Mass immunization, which aims to achieve herd immunity

What is the core function of vaccination programs in public health?

Strengthening surveillance networks, improving laboratory capacity, and ensuring real-time data sharing across countries

What are the key priorities for strengthening global health systems?

Hepatitis B Immunoglobulin (HBIg) and antivirals (eg, Tenofovir)

What treatments are used for Hepatitis B Virus (HBV) management in pregnancy, besides vaccination?

Inactivated subcutaneous (SC) polio vaccine and Oral polio vaccine

What are the vaccines available for Poliovirus?

Vaccination

What is the management for Hepatitis A Virus (HAV) infection?

The development of B-cell proliferation, which can progress to monoclonal B-cell lymphoma

What is a serious complication of EBV infection in those lacking T-cell immunity?

The primary method of diagnosing Human Bocavirus in immunocompromised patients

What is the utility of Polymerase Chain Reaction (PCR) in Human Bocavirus (HBoV) diagnostics?

Neutropenia, myelotoxic and myelosuppressive signs and symptoms

What is the most important adverse drug effect of Ganciclovir and Valganciclovir used for CMV treatment?

It is not recommended due to limited evidence, potential side effects, and high costs

What is the routine recommendation regarding the use of aerosolized Ribavirin for RSV bronchiolitis in infants?

Palivizumab and Nirsevimab

What are the two FDA-licensed monoclonal antibodies available for the prevention of Respiratory Syncytial Virus (RSV)?

Vaccination (MMR) and Post-Exposure Prophylaxis (PEP) IVIg within 5 days

What is the primary management strategy for Rubella in pregnant women to prevent severe outcomes?

Supportive care (nonspecific therapy, frequent bathing, Acetaminophen for fever)

What is the main management approach for Varicella (chickenpox) in otherwise healthy people?

Oral Acyclovir or Valacyclovir

What antiviral treatment is not routinely recommended for otherwise healthy younger children with Varicella due to only moderate decrease in symptoms?

IV Acyclovir

What antiviral is usually indicated for immunocompromised patients with Varicella?

IVIG as an alternative for post-exposure prophylaxis within 6 days

What is the alternative post-exposure prophylaxis for Measles if vaccines are contraindicated?

Varicella-containing vaccines (monovalent varicella or MMRV)

What is used for pre-exposure prophylaxis against Varicella?

Varicella vaccine within 3 to 5 days of exposure, or Varicella Immunoglobulin (VariZIg) or IVIG within 10 days of exposure, or Oral Acyclovir starting day 7 post-exposure

What are the post-exposure prophylaxis options for Varicella?

Supportive care

What is the treatment for most cases of African Trypanosomiasis (sleeping sickness)?

Benznidazole and Nifurtimox

What are the specific antiparasitic treatments for Chagas disease (American Trypanosomiasis)?

Supportive treatment

What is the management for uncomplicated Visceral Leishmaniasis?

Liposomal Amphotericin B

What is the preferred drug for severe Visceral Leishmaniasis?

Miltefosine

What is the oral drug used for Cutaneous Leishmaniasis?

Ivermectin

What is the treatment for Onchocerciasis (river blindness) that kills only immature worms, requiring retreatment every 3 to 6 months?