Communicable Diseases

Chicken Pox

Agent: Varicella-Zoster Virus

Source: Resp tract secretions, Lesions

Transmission: DIrect, Droplet, Contaminated Objects

Incubation: 2-3 weeks

Comm: 1 day before eruption of lesions unless crusted lesions

Chicken Pox (Manifestations)

Prodromal: Slight fever, malaise, anorexia, Macule/Papule —> Vesicle —> Crust, pruritic

Management: Acyclovir, IVIG, Diphenhydramine, Anti-Histamines, Skin Care

Chicken Pox (Complications)

Complications: Bacterial Infections. Encephalitis, Varicella Pneumonia

Prevention: Vaccine

Diphtheria

Agent: Corynebacterium Diptheriae

Source: Discharge

Transmission: Direct, Contaminated Objects

Incubation: 2-5 days

Comm: Variable till bacteria present; 2-4 weeks

Diphtheria (M&M)

Manifestation: Malaise, sore throat, fever, white or gray membrane on tonsils, “bull neck”, airway obstruction

Management: Antitoxin, Abxs, Bedrest, Tx of infected contacts & carriers

Diphtheria (C&P)

Complications: Toxic Cardiomyopathy (2nd or 3rd week)

Prevention: Vaccine

Mumps

Agent: Paramyxovirus

Source: Saliva

Transmission: Direct, Droplet

Incubation: 14-21 days

Comm: Immediately before or after swelling

Mumps (M&M)

Manifestations: Fever, Headache, Malaise, Anorexia, Earache, Enlarged Parotid Glands (pain + tenderness)

Management: Analgesics, Antipyretics

Mumps (C&P)

Complications: Sensorineural Deafness, Myocarditis, Arthritis, Oophritis, Orchitis, Sterility, Meningitis

Prevention: Vaccine

Measles

Agent: Virus

Source: Resp tract secretions, blood, & urine

Transmission: Direct, Winter

Comm: 4 days before to 5 days after rash appears, Prodromal Stage

Measles (M&M)

Manifestations: Fever, Malaise, Anorexia, Coryza, Cough, Conjunctivitis, Koplik Spots (2 days prior to rash)

Management: Bedrest, Antipyretics, Abxs, Vit. A

Measles (C&P)

Complications: Otitis Media, Pneumonia, Encephalitis

Prevention: Vaccine

Pertussis

A: Bordetella Pertussis

S: Discharge from Resp tract

T: Direct, Droplet

C: Prodromal

Pertussis (Manifestations)

Prodromal: URTI S&S (Coryza, Sneezing, Coughing, Fever) approx 1-2 weeks; Dry Hacking Cough becomes Severe

Paroxysmal: Cough (short & rapid) followed by sudden inspiration (whoop), Flushed Cheeks & Cyanotic, Bulging Eyes, Protruding Tongue till mucuos dislodged, possible vomitting after cough

Pertussis (MCP)

M: Hospitalization, O2, Humidity, Fluids, Mechanical Ventilation, Abxs

C: Pneumonia, Atelectasis, Otitis Media, Seizures, Hemorrhage. Weight Loss, Dehydration, Hernias

P: Vaccine, Immunizations (don’t offer lifelong immunity)

Poliomyelitis

A: Enterovirus

S: Feces, Oropharyngeal Secretions

T: Direct, Fecal-Oral, Pharyngeal-Oropharyngeal

C: 1 week in oropharynx, 4-6 weeks in feces

Poliomyelitis (M&M)

M:

• Abortive/Inapparent: Fever, sore throat, headache, anorexia, vomiting, abd pain

• Nonparalytic: Same as above however more severe pain & stiffness in neck back, & legs

• Paralytic: Initially Nonparalytic, recovery then S&S of CNS paralysis

M: Bedrest, Mechanical Ventilation, Physical Therapy

Poliomyelitis (C&P)

C: Permanent Paralysis, Respiratory Arrest, HTN, Kidney Stones

P: Vaccine

Rubella (“German Measles”)

A: Rubella Virus

S: Nasopharyngeal Secretions, Blood, Stool, & Urine

T: Direc

C: 7 Days Prior to 5 Days After Rash

Rubella (M&M)

M: Absent in children; in Adults & Adolescents: Fever, Headache, Malaise, Anorexia, Coryza, Sore Throat, Conjunctivitis 1-5 days then subsides after 1 day upon appearance of rash

M: Antipyretics, Analgesics, Avoid contact w/ pregnant women, Rubella titer monitoring in Pregnant Adolescent

Rubella (C&P)

C: Rare (Arthritis Encephalitis, Purpura), Benign, Teratogenic to Fetus

P: Vaccine

Tetanus (“Loackjaw”)

A: Clostridium Tetani

S: Soil, dust, GI Tract

T: Wounds

I: 3 days - 3 weeks

Tetanus (M&M)

M:

• Neonatal: Difficulty sucking, excessive crying, irritability, nuchal rigidity

• Generalized: Stiffness of muscles in neck & jaw, spasm of facial muscles, abd & limb muscle rigidity, difficulty swallowing, convulsive muscle contractions

M: Tetanus Immuoglobulin (TIG), Tetanus Toxid, Cleansing + Debridement Wounds. Resp Support, Paralyzing agents

Tetanus (C&P)

C: Resp Arrest, Atelectasis, Pneumonia

P: Vaccine, Booster q 10 years

Rotavirus Process

Transmitted via ingestion, damages lining of SI, causing diarrhea, dehydration, & death

Rotavirus

A: Rotavirus

S: Food, Water, Stool, Objects

T: Fecal-Oral

C: Illness + 3 Days after recovery

Rotavirus (M&M)

M: Fever, Vomiting

M: Oral Rehydration, BFing, diet, Antipyretics

Rotavirus (C&P)

C: Dehydration, Intussusception

P: Handwashing, Vaccine

Fifth Disease

A: Human Parvovirus B19

S: Infected People, School-Aged

T: Resp Secretions, Blood/Blood Products

C: Uncertain, possibly before onset of S&S

Fifth Disease (M&M)

M:

• Stage I: “Slapped Cheek”

• Stage II: Red Spots

• Stage III: Rash subsiddes but may reappear is skin is irritated/traumatized

M: Antipyretics, ANalgesics, Anti-Inflammatories, Blood Transfusion (Transient Aplastic Anemia)

Fifth Disease (C&P)

C: Arthritis & Arthralgia (Self-Limiting), Anemia, Hydrops, Fetal Death if During Pregnancy, aplastic crisis in children with hemolytic disease

P: No Vaccine

Roseola

A: Human Herpesvirus Type 6

S: Saliva

T: Year-round

C: Unknown

Roseola (M&M)

M: High fever, child appears well, drop in temp hen rash begins, rash appears rose-pink, starts on trunk, spreads to neck, face, & extremities, nonpruritic, fades on pressure, lasts 1-2 days

M: Nonspecific, Antipyretics

Roseola (C&P)

C: Febrile Seizures, Encephalitis, Hepatitis

P: No Vaccine

Scarlet Fever

A: Group A Beta-Hemolytic Streptococci

S: Nasopharyngeal Secretions

T: Direct, Droplet

C: Incubation Period (2-5 Days), Clinical Illness (approx 10 days), 1st 2 weeks of carrier phase

Scarlet Fever (M&M)

M: Barupt high fever, high pulse, vomiting, headache, chills, malaise, abd pain, enlarged tonsils with exudate, white-red strawberry tongue, rash, red pin-headed punctuate lesions, flushed face, desquamation

M: Penicillin or Erythromycin, Abxs, Rest, Analgesics, Antipyretics

Scarlet Fever (C&P)

C: Peritonsillar Abcesses, Sinusitis, Otitis Media, Acute Glomerulonephritis, Acute Rheumatic Fever

P: No Vaccine, Avoid sharing drinking & eating utensils

Conjunctivitis

A: Viral Bacterial (“Pink Eye”)

S: During birth, exposure to pathogen, allergic reactions, blocked tear duct

T: Contact

Conjunctivitis (M&M)

M: Purulent drainage, cursting eyelids, inflamed conjuntiva, swollen eyelids

M:

• Bacterial: Topic Abxs

• Viral: Self-Limiting

• Keep Eye Clean

Conjunctivitis (C&P)

C: Corneal irritation, severe vision loss

P: Seperate washcloth & towels, discard tissues used to cleanse the eye, Handwashing