Peds Week 4 Common Childhood Infections and Communicable Diseases

Part 2

Varicella (VZV): presentation

acute diffuse

• macular papularovascular rash without apparent cause

• children lesions are first sign

Varicella: transmission

• airborne

• respiratory secretion

• direct contact with lesions

• contaminated objects

Varicella: incubation

• 10-21 days form exposure to rash onset

• neonates mother with infection can be 2 days after birth

Varicella: communicability

1-2 days before rash —> until last vesicles crust

Varicella:Tx

• acyclovir (zovirax) decrease lesions and tx infection

• intravenous immunglobin (IVIG HIGH risk patients)

• VZV remains latent and can reactivate as shingles

Diphtheria: presentation

Tough grayish-white pseudomembrane over tonsils

non respiratory infectious lesion larynx/nasopharageal

Diphtheria: transmission

• Respiratory droplets

• Contact with skin lesion discharge

Diphtheria: incubation

1-5 days

Diphtheria: communicability

2-6 weeks

• chronic carriers may shed for 6 months or more

Diphtheria: tx

• Antibiotics × 14 days

• Continue precautions until 2 negative cultures

• IV antibotics until able to swallow

Measles: presentation

Think: 3 C's + Koplik 1-2 days before rash

Symptoms:

• Cough

• Coryza (acute inflam resp lining)

• Conjunctivitis

• Fever

• Generalized maculopapular rash

Measles: transmission

direct contact with droplets

transmissions before rash occur

Measles: incubation

10-20 days

Measles: communicable

4 days before and 5th day after rash

Measles: tx

• no antiviral therapy

• symptom control

Polio: presentation

• most, no visible symptoms

• 25% flu like sx

• <5 % meningitis or paralysis

• complcations: resp arrest/perm paralysis

Polio: transmission

• feces

• oropharyngeal secretions w or W/o active infection

Polio: incubation

7-14 days

Polio: communicability

• during incubation period

• up to 2 weeks after sx occur

Polio: tx

• symptom management

• encourage ADL, early ambulation

• assistive devices

Rubella: presentation

subclinical or mild

• 50-80% maculopapular rash head to feet

• infection in preg cause congenital rubella syndrome and fetal death

Rubella: transmission

• airborne

• direct contact with secretion resp tract of infected person

Rubella: incubation

17 days (range 12-23, 14-21

Rubella: communicable

• 7 days before onset rash

• 5–7 days after rash

infants with CRS first year of life unless two culture (1 m apart) negative

Rubella: tx

symptom management

Roseola: presentation

cause by human herpesvirus 6 or 7 in 90% children <2 yrs

• high fever 3-5 days nonpruritic pink papular rash at trunk

15% children experience seizure during illness from high fever and ability virus enter BBB(blood brain barrier)

Roseola: transmission

• droplet (saliva healthy adult)

• not reported contact with infected person

Roseola: incubation

5-15 days

Roseola: communicability

unknown

Roseola: tx

roseola tx, sx managment

hand foot and mouth disease: presentation

• viral infection w/ fever

• mouth sores

• nonpuritic papulovascular rash in PALMS of hands SOLEs of feet

hand foot and mouth disease: transmission

• Droplet

• contact nose/throat secretions

• fluid from blisters

• contaminated objects

• feces

hand foot and mouth disease: incubation

3-6 days

hand foot and mouth disease: communicability

unclear: most contagious 1st week of sx

pneumococcal infection: presentation

• septicemia and meningitis

• bacterial infections children <2 years in lungs, middle ear, bloodstream

• lining of brain

pneumococcal infection: transmission

direct person to person contact via respiratory droplets

pneumococcal infection: incubation

incubation unknown

pneumococcal infection: communicability

pneumococcal unknown

pneumococcal infection: tx

• amoxicillin FIRST line

• sx management

Rotavirus: presentation

diarrhea (gastroenteritis)

• dangerous children less than 2

• highest rate illness children under 5

• vomit/diarrhea 3-8 days

Rotavirus: transmission

direct contact fecal/oral

Rotavirus:incubation

aprox 2 days

Rotavirus: communicability unknown

unknown, sheds before sx appear

Rotavirus: tx

Rotavirus:sx managment

Rotavirus: vaccine

children less likely to get sick and have less severe sx

Scarlet Fever: Presentation

group A strep

• sandpaper paular rash (non puritic)

• strawberry tongue

complication: pericarditis

Scarlet Fever: transmission

• direct contact w/ infected person

• droplet spread

• indirect contact with items/food

Scarlet Fever: incubation

2-5 days ( range 1-7)

Scarlet Fever: communicability

10 days- 2 weeks

• can persit for moths

• contagious until 24 hrs after antibiotics

Scarlet Fever: tx

antibiotics & supportive care