Peds E2 Communicable Diseases

Measles

•        Virus

•        Found in respiratory tract, blood, urine

•        Contact, droplet, airborne

•        Fever, malaise, cough, Koplik spots (tiny white bluish spots) on buccal mucosa, rash on face that spreads downward, anorexia

•        Bed rest while febrile, antipyretics

•        Prevent with MMR

•        Photophobia

•        Encourage fluids

Mumps:

•        Paramyxovirus

•        Contact or droplets of saliva from infected person

•        Fever, headache, malaise, “earache” aggravated by chewing, parotitis (inflammation of the parotid salivary glands)

•        Analgesics for pain, antipyretics, fluids

•        Can progress to deafness, hepatitis, meningitis, sterility

•        Prevent with MMR

•        Hot or cold to neck dependent on which is more comforting

Varicella

•        Varicella-zoster virus

•        Respiratory secretions + lesions of infected people spread the disease

•        Contact, droplet, airborne precautions

•        Infectious until all lesions have crusted

•        Fever, malaise, anorexia, itchy rash- papule > vesicle > crust

•        Starts central, spreads to face and proximal extremities

•        Prevent with varicella vaccine

•        Skin care, oatmeal baths, remove loose crusts, teach to apply pressure to itchiness not scratch

Rubella:

•        Nasopharyngeal secretions, blood, feces, urine

•        Low-grade fever, headache, malaise, rash starts on face then rapidly spreads down neck, arms, and trunk, discrete, fine

•        No treatment necessary

•        Antipyretic for fever discomfort

•        Prevent with MMR

•        Teratogenic effect on fetus

Fifth Disease:

•        Human parvovirus B19

•        Transmitted through respiratory secretions, blood

•        Rash starts on cheeks (“slapped face”), then maculopapular red spots on upper and lower extremities, rash goes away unless irritated or in the sun

•        Give antipyretics

•        Can lead to serious arthralgia/arthritis

•        Worse in sickle-cell disease 

DO NOT CARE FOR IF PREGNANT

Pertussis

•        Bordetella pertussis

•        Respiratory contact or droplets

•        Starts as URI- sneezing, cough, low-grade fever for 1-2 weeks, then dry, hacking, severe cough

•        Then goes into paroxysmal stage with coughing mostly at night, high-pitched “whoop” sound, with rapid inhale, vomiting after coughing spell

•        For 4-6 weeks

•        Can occur in adolescents/adults

•        Antibiotic therapy (-mycin) for the whole household

•        Adequate fluid intake- may require hospitalization

•        Ensure adequate oxygenation

•        Prevent with DTaP/Tdap + booster every 10 years

Lice (Pediculosis Capitis):

Common in school age because all at school together, share all kinds of things which spreads lice.

Lice will appear as small grayish tan, no wings, visible to the naked eye.

When lice is present, females lay eggs called nits at the base of the hair shaft and those nits actually hatch in 7-10 days.

The nits look like white ovals, they can resemble dandruff so we can tell by blowing gently on them because dandruff will fall off or move but the nits are attached to the hair shaft and have to be actually picked at to remove.

We will see scalp itching because the lice are crawling around and sucking out the blood and their saliva gets in there and causes itching.

They lay eggs at the occiput, behind the ears, or at nape of the neck.

Treatment of lice:

with pediculicide or medicated shampoo and usually happens for a couple of days because we want to treat the lice and the nits. We treat the lice by killing them with shampoo, and we have to go through with a fine tooth comb to treat the nits by removing them. Then do same treatment again a few days later incase we missed some knits and they became lice. Cycle continues until all lice and nits are gone.

Important to watch kids especially school agers to see if they itch the head and check for lice because it spreads very quickly.

Do not share anything that touches the head. Coats, bows, combs, hats, etc.

Lice do not fly they do not have wings, it spreads by objects being contaminated and that spreads lice or person to person contact, they can jump from one area to another but do not fly.