Communicable Diseases

Childhood communicable diseases

-Most recover without difficulty
-Declined due to immunizations
-antibiotics has reduced serious secondary complications

general nursing care management for childhood communicable diseases

Prevent spread

Primary prevention
-Immunizations
-Control spread to others
-reduce risk of cross-contamination
-Good handwashing
-Follow facility policies for infection control

Prevent complications
-Children with immunodeficiency receiving steroids/immunosuppressive therapy/immunologic disorder

Provide Comfort
-Most communicable diseases cause skin manifestations
-Measures can include cool baths (usually without soap) and lotions (calamine)

primary prevention

preventing the development of disease
ex: immunizations, hand washing

secondary prevention

Disease is detected and being treated early before it gets worse
ex: screening programs mammography, antibiotics

tertiary prevention

an existing, usually chronic disease is MANAGED to prevent complications or further damage
ex: a person who has had a stroke may involve taking aspirin to prevent a second stroke from occurring, diabetes, cancer patient and is getting rehabilitation

Measles is also known as

Rubeola virus

Measles (rubeola): transmission

droplet
-Usually by direct contact with droplets of infected person by respiratory tract secretions, blood, and urine of an infected person

measles (rubeola): incubation period

10-20 days
-Most contagious: 4 days before to 5 days after the rash appears but mainly during prodromal stage

incubation period

period of time between initial exposure/infection and first signs and symptoms

Measles (rubeola): clinical manifestations prodromal stage

-fever
-malaise
-coryza
-cough
-conjunctivitus
-koplik spots

measles rash appears \____ to \____ days after onset of prodromal stage

3 to 4
-starts on face and spreads downward

Measles (Rubeola): complications

-encephalitis (inflammation of the brain that is rare but deadly)
-pneumonia

Measels (Rubeola): treatment

-vitamin A
-supportive bedrest
-antipyretics during febrile period
-maintain isolation until 5th day of the rash
-keep child from rubbing eyes

mumps (paramyxovirus)

infection of the parotid gland

Mumps (paramyxovirus): transmission

direct contact or droplet spread of saliva

Mumps (paramyxovirus): incubation period

14-21 days

When is mumps most contagious?

immediately before and after swelling of glands

Mumps (paramyxovirus): clinical manifestations prodromal stage

-fever
-headache
-malaise
-anorexia
-earache aggravated by chewing

Mumps (paramyxovirus): clinical manifestations parotitis stage

by 3rd day unilateral or bilateral enlargement

Mumps (paramyxovirus): complications

-orchitis (male)
-oophoritis (female)

Mumps (paramyxovirus): therapeutic management

-analgesics for pain
-antipyretics for fever
-encourage rest and fluids
-cool compresses
-maintain isolation when communicating (droplet and contact)

Rubella is also known as

German measles

Rubella (Rubella virus): transmission

direct/droplet
-primarily spread by nasopharyngeal secretions, blood, stool, and urine

Rubella (Rubella virus): incubation period

14-21 days

when is rubella most contagious?

7 days before to 5 days after the appearance of rash

Rubella (Rubella virus): clinical manifestations

-low grade fever
-headache
-malaise
-anorexia
-mild conjunctivitis
-coryza
-sore throat
-cough
-lymphadenopathy for 1-5 days
-rash

where does rubella rash 1st appear?

face then spreads downward
-disappears the same way face down

when is rubella rash gone?

3rd day

Rubella (Rubella virus): complications

teratogenic effect on fetus during pregnancy

what to do if a mother doesn't have the rubella vaccine?

cocooning immunity
-vaccinate everyone around her

Rubella (Rubella virus): therapeutic/nursing management

-avoid contact w pregnant women
-antipyretics for fever
-analgesics for discomfort
-take droplet precautions

Chickenpox (Varicella) is caused by the

Varicella zoster virus

Chickenpox (Varicella): transmission

direct contact, droplet spread, contaminated objects
-secretions of the respiratory tract
-fluid filled skin lesions (lesser degree)

Chickenpox (Varicella): incubation period

2-3 weeks (usually 14-16 days)

when is Chickenpox (Varicella) most contagious?

1 day before skin lesions to 6 days after vesicular lesions crust over

Chickenpox (Varicella): clinical manifestations

-slight fever and anorexia for the 1st 24 hrs then highly pruritic rash develops

Chickenpox (Varicella): centripetal

rash starts on chest and back then moves to the entire body

Chickenpox (Varicella): 3 stages

1. papule
2. vesicle
3. crusting over

Chickenpox (Varicella): complications

pneumonia and encephalitis

Chickenpox (Varicella): treatment

1. antiviral- Acyclovir (Zovirax)
2. IV immunoglobulin (IVIG) after exposure to high risk immunocompromised children

Chickenpox (Varicella): supportive care

-give bath and change clothes/linen daily bc they ooze
-calamine lotion
-keep child's fingernails short
-apply mittens
-remove loose crusts
-apply pressure to pruritic area rather than scratching
-Avoid use of aspirin since it can trigger Reye's syndrome particularly in children with Varicella

Pertussis (whooping cough) is a \_____________ disease

bacterial disease
-bordetella pertussis

Pertussis (whooping cough): transmission

direct and indirect contact/droplet
-spread by discharge from respiratory tract through direct contact or droplet spread
-can be indirect with freshly contaminated articles
-highly contagious

Pertussis (whooping cough): incubation period

6-20 days, usually 7-10 days

when is Pertussis (whooping cough) most contagious?

during catarrhal stage before onset of paroxyms

Pertussis (whooping cough): clinical manifestations catarrhal stage

-coryza
-sneezing
-lacrimation
-cough
-low grade fever

symptoms continue for 1-2 weeks and cough becomes worse

Pertussis (whooping cough): clinical manifestations paroxysmal stage

-cough most common at night
-short, rapid, coughs followed by sudden inspiration associated w high pitch "whoop"
-cheeks become flushed or cyanotic
-eyes bulge and tounge protrudes during paroxysm
-vomiting frequently follows the attack

generally lasts 4-6 weeks

whooping cough can last up to \_____ to \_____ weeks

6-10

Pertussis (whooping cough): complications

-pneumonia (usually cause of death in younger children)
-weight loss
-urinary incontinence
-rib fractures

Pertussis (whooping cough): therapeutic/nursing management

-macrolides antibiotic therapy
-those who are dehydrated and have complications may need hospitalization
-lots of fluids
-maintain isolation during catarrhal stage
-encourage compliance and antibiotic therapy for household contacts

infectious mononucleosis (mono) is caused by

Epstein-Barr virus

infectious mononucleosis (mono): transmission

direct contact through bodily fluids
-blood
-semen
-blood transfusion
-organ transplantation
-saliva

infectious mononucleosis (mono): incubation period

30 to 50 days

infectious mononucleosis (mono): clinical manifestations

-fever
-exudative pharyngitis w petechia
-lymphadenopathy
-hepatosplenomegaly
-increased atypical lymphocytes

symptoms can last from 10 days to 6 weeks

infectious mononucleosis (mono): complications

-meningitis
-encephalitis
-pneumonitis
-ruptured speen

infectious mononucleosis (mono): therapeutic/nursing management

-short course of corticosteroids
-rest
-mild analgesic
-antibiotics are only used if there is a secondary infection
-may develop a nonallergic maculopapular rash
-avoid strenuous activity and contact sports for 21 days after the onset of symptoms

hepatospleenomegaly

enlargement of the liver and spleen
-risk for bleeding
-no contact sports/strenuous activity after 21 days after symptoms