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Communicable diseases

-known as infectious disease
- Diseases that can be spread from one person to another and can cause large number of people to get sick
- Caused by bacteria, viruses, fungi, parasites, or toxins

Direct contact

Occurs when there is physical contact between an infected person and a susceptible person

Direct contact types

Person to person contact
Mother to unborn child
Droplet spread

Person to person contact

When an infected person touches or exchanges body fluid with someone else
o Ex. HIV & STD

Mother to unborn child

-Pregnant woman may pass germs that cause infectious diseases to an unborn child
-Some germs can pass through the placenta or even in the vagina during birth

Droplet spread

-During coughing or sneezing or even when you speak

-Requires close proximity

Indirect contact

Occurs when there is no direct human to human contact

Indirect contact types

-Airborne transmission
-Contaminated object
-Food and drinking water
-Animal to person contact
-Insect bite (vector-borne)

Airborne transmission

Some germs can remain suspended in the air for an extended period
-Airborne diseases - By breathing in germs
- Ex. Measles, common cold, TB, Chickenpox, Mumps

Contaminated object

-Some microbes can live on objects for a short time
- Transmission occurs when you touch your mouth, nose, or eyes

Food and drinking water

Through contaminated food or water
Ex. E-coli

Animal to person contact

When an infected animal bites or scratches you or when handling cat waste

Insect bite (vector-borne)

Spread through mosquitoes, fleas, and ticks
Ex. Malaria, west Nile virus, tick-bite fever, Yellow fever

Communicable diseases Prevention

-Wash your hands often.
- Keep immunization for self, family, and pets up to date
-Use antibiotics as prescribed
- Practice safe sex
- Use insect repellent
-Practice good hygiene

Stages of Illness

Incubation period
Prodromal period
Period of Illness
Convalescence

Incubation period

Time of interval between the 1 st exposure to the appearance of the 1 st sign and symptoms

Prodomal period

Premonition of an impending attack of a disease (frequent sneezing)

Period of illness

Patient is manifesting the sign and symptoms of the disease

Convalescence

Gradual recovery of health and strength after illness

TUBERCULOSIS OR TB

It is
transmitted from a TB patient to another person through
coughing, sneezing and spitting. Thus, close contacts,
especially household members, could be infected with
TB.

What bacteria commonly causes tuberculosis?

Mycobacterium tuberculosis, Tubercle bacilli

What organs are usually affected by TB?

Lungs are commonly affected but it could also affect
other organs such as the kidney, bones, liver, and
others.

T/F - TB is not curable and preventable

FALSE - It is curable

What could lead to drug resistance or death in TB

Incomplete and irregular treatement

TB is transmitted through

airborne droplet when a person inhales the TB germs in
the air from the cough or sneeze of a person with TB.

TB was the ___leading cause of
mortality with a rate of ____deaths for every ____ population and accounts for____of total deaths.

6th, 26.3 , 100,000, 5.1%

TB is more prevalent among which individuals?

Males 25-55 age groups & Malnourished and individuals with diabetes.

The first national Drug Resistance Survey was done in___

2003-2004

TB IS:

-NOT hereditary
-DOES NOT get caught in fatigue, wakefulness, or
dryness of sweat in the back.
-It is NOT passed on to the use of cutlery or glasses
by a person with TB.
-DO NOT get bitten by mosquitoes.
-It is NOT transmitted through the use of clothing or
blankets by a person with TB.

TB: Period of communicability

as long as viable tubercle bacilli are being discharged in
the sputum. Some untreated or inadequately treated
patients may be sputum-positive intermittently for years.

TB: Susceptibility and Resistance

the most hazardous period for development of critical
disease is the first 6-12 months after infection. The risk of
developing the disease is highest in children under 3 years old, lower in later childhood and high again among
adolescents, young adults and the very old.

Incubation Period

1st instance of exposure to the 1st appearance of signs and symptoms

Prodromal Period

Premonition of an impending attack of a disease

Period of illness

Manifestation of the illness

convalescence

Gradually recovering of health and strength

TB: Types of Bacteria

MYOBACTERIUM TUBERCULOSIS
M.BACTERIUM AFRICANUM
M.BACTERIUM BOVIS - Cattle

Types of TB

Pulmonary and extra-pulmonary

Pulmonary TB

most common form of TB, lodged in the lungs and is considered communicable

Extra-pulmonary TB

occurs outside of the lungs

TYPES OF TB disease

Latent and Active

Latent TB

TB causing bacteria in the body cannot spread to others. From the vaccine

BCG

Bacillus Calmette-Guérin. only vaccine that causes a scar. 1st vaccine to be introduced in the PH. for extrapulmonary TB

Active TB

Infection is spreading and active in the body.

CLASSES OF TB

TB: CLASS 0

NO EPOSURE, NOT INFECTED

TB: CLASS 1

TB EXPOSURE, NO EVIDENCE OF INFECTION. HISTORY OF EXPOSURE - NEGATVIE TUBERCULIN SKIN TES

TB: CLASS 2

TB INFECTION - NO DISEASE. POSITIVE SKIN TEST
NO CLINICAL OR RADIOGRAPHIC EVIDENCE OF TB (EXPOSURE TO HOSPITAL)

TB: CLASS 3

CURRENT TB DISEASE
M.TUBERCULOSIS CULTURED IS DONE / POSITIVE REACTION TO TUBERCULIN SKIN TEST AND CLINICAL AND RADIOGRAPHIC EVIDENCE (CLINICALLY ACTIVE)

TB: CLASS 4

PREVIOUS TB DISEASE THAT HAS BEEN CURED.

TB: CLASS 5

TB SUSPECT - DIAGNOSIS IS PENDING

TB: SIGNS AND SYMPTOMS

COUGH ( 2 WEEKS OR MORE)
FEVER (LOW GRADE 37.5 -38, OCCURS IN THE AFTERNOON)
CHES OF BACK PAIN
SIGNIFICANT WEIGHT LOSS/ LOSS OF APPETITE
SWEATING FATIGUE
BODY MALAISE
DYSPNEA
SPUTUM

TB: SUSCEPTIBLE AND RESISTANT

3 YRS BELOW, YOUNG ADULTS AND VERY OLD INDIVIDUALS
HIV INFECTED
UNDERWEIGHT AND UNDERNOURISHED

TB: DIAGNOSTIC TEST

DIRECT SPUTUM SMEAR MICROSCOPY ( DSSM)
PPD TEST/TUBERCULIN
CHEST XRAY

TB: PREVETION

VACCINE AND BREASTFEEDING

NATIONAL TB CONTROL PROGRAM

STARTED 1987
DETECT AND CURE TB CASES FOR 10 YRS OLD AND ABOVE

TB DOTS

D - DIRECT YOUR ATTENTION TO IDENTIFYING INFECTIOUS TB PATIENTS W/ SMEAR MICROSCOPY
O - OBSERVE THEM IN SWALLOWING EACH DOSE OF MEDICATION
T - MONITORS AND ANALYZE PROCESS OF TREATMENT
S- ENSURE SHORT COURSE ANTI TB DRUGS ARE ALWAYS AVAILABLE
! - SUSTAIN THIS EFFORT W/ POLITICAL AND FINANCIAL COMMITMENT ( FUNDING SUPPORT)

TB: POLICIES

- (+) POSITIVE EVEN WITHOUT ESPOSURE IS POSITIVE
- TESTS DONE ON MON, TUES OR FRIDAY
- 10 CHILDREN ARE TREATED (1 AMPULE FIT FOR 10 CHILDREN)

TB: Treatment partner

STAFF OF HEALTH CENTER
MEMBER OF THE COMMUNITY
MEMBERS OF PATIENTS FAMILY ( least priority)

TB: CATEGORY 1

- New smear + PTB
-New sear - OTB with cardiac XRAY
PTB
▪Severe concomitant HIV disease
Intensive phase -
•2 mos - Rifampicin (R), isoniazid (H),
Pyrazinamide (Z), Ethambutol (E)
▪Maintenance phase:
•4 mos - Rifampicin (R), isoniazid (H)

TB: CATEGORY 2

▪Treatment failure
▪Relapse
▪Return after default
▪Others

Intensive phase
•2 HRZES/ 1 HRZE/ 5 HRE - Streptomycin (S) given IM

Maintenance phase:
•5 HRE

If the client is pregnant Streptomycin is
contraindicated

TB: CATEGORY 3

▪New PTB Patients with (-) sputum for 3 times & a PTB minimal CXR result.

Intervening phase
•2 HRZE

Maintenance phase
•4 HR

TB: CATEGORY 4

▪Chronic, still smear + after supervised re-
treatment
▪Refer to a specialized facility or DOTS
▪ Plus Center
▪Refer to Provincial City NTP Coordinator

WHY IS ETHAMBUTOL NOT GIVEN AGES LESS THAN 6 YRS OLD?

Causes blurring of vision leading to blindness

TB: Adult infects children

77% of children admitted in the hospital

TB: SOURCE OF INFECTION

Mother or father / Yaya
90 % of TB infection in children occurred in the
family

Pulmonary TB / Primary complex

TB among children below 10 years old
Non-infectious

TB IN CHILDREN

- History of exposure
- Child with confirmed exposure to an adult/adolescent RB case either a smear (+ or (-) case

MONO RESISTANCE

-Resistance to one first-line anti-TB drug

MULTI RESISTANT

First line + other TB drugs

POLY RESISTANT

More than 1 first line anti-TB drug

EXTENSIVE RESISTANCE

3 or more TB drugs + any antibiotics

TB symptomatic

▪ child w/ any 3 signs and symptoms
•Cough or wheezing of 2 weeks or more
•Unexplained fever 2 weeks or more
•loss of weight/ failure to gain weight
•Unexplained loss of appetite
•Failure to respond to 2 weeks of appropriate antibiotic therapy for LRTI
•Failure to regain the previous state of health 2 weeks after viral infection or exanthem
Positive x-ray result

▪Tuberculin test
Children with induration of * mm w/ or w/o BCG scar
▪ Best test for children

TB: TREATMENT REGIMEN

PTB
•Most common symptom is persistent cough/wheezing for 2 weeks or more
•2 HRZ / 4 HR
•Follow- up check-up every month

EPTB
•TB meningitis, lymphadenopathy, effusions, and spinal TB
•General symptoms are: weight loss & fever
•2 HRZE or S/10 HR

TB: ADMINISTERING OF DRUGS

▪Isoniazid - before breakfast (ideal)
▪After drug intake, eat 30 minutes after
▪All drugs may be given one after the other 2
hours after meal
▪Ethambutol not given to children below 6 y.o.
▪Streptomycin IM (anterolateral thigh)

TB: Causes of resistance

MICROBIAL, CLINICAL AND PROGRAMMATIC BUT DRUG-RESISTANCE IS PRIMARILY MAN MADE

Factors causing drug-resistant TB

DR-TB is a consequence of human error through

▪Health-care providers: inadequate regimens
▪Drugs: inadequate supply or quality
▪Patients: inadequate drug intake

TB: INITIAL RESISTANCE ( TRANSMITTED RESISTANCE)

A person who has never received or has received < 1 month of anti-TB treatment is infected by a patient afflicted with drug-resistance TB

TB: AQUIRED OR SECONDARY RESISTANCE

Person has had previous anti-TB treatment

TB: Outcome of treatment

oTreatment success
o Cured
o Treatment completed
o Defaulter
o Transfer out
o Treatment failure
o Died

SCHISTOSOMIASIS

•Sometimes known as Bilhariasis or Snail Fever
•It is an important tropical disease affecting farmers and
their families.

SCHI: Vector of Schistosomiasis

SNAIL

What bacteria cause Schistosomiasis?

Cause by bacteria or parasite known as Schistosoma

SCHI: snail that carries Schistosomiasis disease

ONCOMELENIA QUADRASI

SCHI: INFECTIOUS AGENS AND VECTOR

•Schistosoma japonicum - One that exist in the
Philippines
•Schistosoma Mansoni
•Schistosoma haematobium

SCHI: SIGNS AND SYMPTOMS

•Diarrhea
•Redness or itchy patches on lower extremities
•Dysentery (Bloody stool)
•Enlargement of the abdomen
•Body Malaise
•Splenomegaly
•Weakness
•Anemia
•Inflamed liver

SCHI: MODE OF TRANSMISSION AND DIAGNOSTIC TEST

•Direct skin contact (Cercariae)
•Ova in urine/ stool Mucosal lesion biopsy- best way

SCHI: MANAGEMENT AND TREATMENT

•Reduction of snail habitats
•Take Praziquantel (Biltricide)deworming drug

SCHI: FREE SWIMMING LARVAL FORMS

CERCARIAE

FILARIASIS

•Sometimes known as elephantiasis
•It is achronic, debiliting and disfiguring disease caused by
nematodes.
• It is an endemic type of disease

FIL: THE BACTERIA RESPONSIBLE FOR FILARIASIS

WUCHERERIA BANCROFTI

FILARIASIS VECTOR

MOSQUITO

AREAS IN REGION 6 WITH FILARIASIS

LEON AND JANIUAY

FIL: INFECTIOUS AGENTS

Wuchereria bancrofti ,Brugia
malayi ,Brugia timori

FIL: VECTORS

Aedes peocilius (1st) and Anopheles flavirostris
(2 vectors that exist in the Philippines)
-Mansonia bonnea
-Mansonia uniformis
- Culex Quinquifaciatus

FIL: MODE OF TRANSMISSION

Bitten by this kind of mosquito
(Aedes peocilius, Anopheles flavirostris, Mansonia bonnea, Mansonia uniformis, Culex
Quinquifaciatus)

FIL: DISEASE IS TRANSMITTED THROUGH MOSQUITO BITES DURING WHAT TIME

NIGHT TIME

FIL: INCUBATION PERIOD

Starts from the entry of infective larvae to the development of clinical manifestations

8-16 months

FIL: SIGNS AND SYMPTOMS

•Asymptomatic for years or for life

FIL: ACUTE STAGE

starts when there are already manifestations:
- Lympgadenitis
- Lymphangitis
-Funiculitis/epidydimitis/
orchitis

LYMPGADENTITS

INFLAMMATION OF LYMPH NODES