MEDSURG

Measles (Rubeola)

• fever, cough, coryza, conjunctivitis, and a spreading maculopapular rash

Measles (Rubeola)

• Source of Infection:

  • Respiratory secretions of infected individuals.

• Mode of Transmission:

  • Airborne droplets from coughing and sneezing

  • Direct contact with nasal or throat secretions

• Period of Communicability:

  • 4 days before to 4 days after rash onset.

• Incubation Period:

  • 7–14 days (average 10 days)

Measles (Rubeola)

• Koplik’s spots (tiny bluish-white spots on buccal mucosa opposite the molars)

• High-grade fever

• 3 C’s: Cough, Coryza, Conjunctivitis

• Maculopapular rash starting from the face and spreading downward

• Malaise, photophobia, anorexia

German Measles (Rubella)

• Source of Infection:

  • Nasopharyngeal secretions of infected individuals.

• Mode of Transmission:

  • Droplet spread from coughs or sneezes

  • Direct contact with nasal or throat secretions

• Period of Communicability:

  • 7 days before to 7 days after rash onset.

• Incubation Period:

14–21 days (average 17 days)

German Measles (Rubella)

• Postauricular, suboccipital, and posterior cervical lymphadenopathy 

• Mild fever, malaise 

• Pink, maculopapular rash starting on the face to trunk to extremities 

• Arthralgia (common in women) 

• Mild conjunctivitis and sore throat

German Measles (Rubella)

1. Supportive: rest, fluids, analgesics, antipyretics

2. Avoid exposure to pregnant women

Chickenpox (Varicella)

• itchy, vesicular rash in successive crops.

Chickenpox (Varicella)

• Source of Infection:

  • Infected individuals via respiratory secretions or fluid from vesicles.

• Mode of Transmission:

  • Airborne droplets 

  • Direct contact with vesicular fluid

  • Indirect contact with contaminated objects

• Period of Communicability:

  • 1–2 days before rash onset until all lesions have crusted (5–7 days).

• Incubation Period:

10–21 days (average 14–16 days).

Chickenpox (Varicella)

• Vesicular rash in different stages of development (“dew drops on a rose petal”)

• Low-grade fever, malaise, anorexia

• Itching and discomfort

Rash appears first on trunk to face to extremities

Chickenpox (Varicella)

1. PCR or direct fluorescent antibody test for confirmation

Chickenpox (Varicella)

1. Supportive care : hydration, rest, antipyretics

2. Acyclovir for high-risk or immunocompromised patients

3. Calamine lotion, oatmeal baths for pruritus

Herpes Zoster (Shingles)

• painful, unilateral vesicular eruptions.

Herpes Zoster (Shingles)

• Source of Infection:

  • Reactivation of endogenous VZV; contagious to those without prior chickenpox (can cause varicella)

• Mode of Transmission:

  • Direct contact with fluid from lesions of active shingles

• Period of Communicability:

  • Until all lesions are crusted.

• Incubation Period:

  • Not applicable (reactivation).

Herpes Zoster (Shingles)

• Painful, unilateral vesicular rash along a dermatome

• Burning, tingling, or stabbing pain preceding rash

• Vesicles that rupture and crust over

• Postherpetic neuralgia(persistent pain after healing)

Herpes Zoster (Shingles)

Tzanck smear or PCR

Herpes Zoster (Shingles)

1. Antivirals: Acyclovir, Valacyclovir, or Famciclovir

2. Analgesics, corticosteroids for pain

3. Wet compresses for comfort

Mumps (Infectious Parotitis)

• Source of Infection:

  • Saliva and respiratory secretions of infected persons

• Mode of Transmission:

  • Droplet spread and direct contact with saliva

• Period of Communicability:

  • 2 days before to 5 days after onset of glandular swelling.

• Incubation Period:

16–18 days (range 12–25 days).

Mumps (Infectious Parotitis)

• Painful swelling of one or both parotid glands

• Fever, headache, malaise

• Earache or pain on chewing/swallowing

• Possible complications: 

  • orchitis, oophoritis, meningitis, pancreatitis

Mumps (Infectious Parotitis)

1. Supportive care: analgesics, antipyretics, hydration

Soft diet, warm or cold compresses to gland

Influenza (Flu)

• Source of Infection:

  • Respiratory secretions of infected individuals.

• Mode of Transmission:

  • Droplet spread 

  • Direct contact with contaminated surfaces or secretions

• Period of Communicability:

  • 1 day before to 5–7 days after onset of illness

• Incubation Period:

1–4 days (average 2 days)

Influenza (Flu)

• Abrupt onset of high fever, chills, and myalgia

• Headache, sore throat, dry cough

• Fatigue, malaise

May progress to pneumonia in severe cases

Influenza (Flu)

Antiviral therapy: Oseltamivir, Zanamivir (within 48 hrs of onset)

COVID-19 (Coronavirus Disease 2019)

• Source of Infection:

  • Respiratory droplets and contaminated surfaces from infected individuals.

• Mode of Transmission:

  • Airborne and droplet spread 

  • Direct contact with contaminated surfaces or secretions

• Period of Communicability:

  • 2 days before to 10 days after symptom onset (longer in severe cases)

• Incubation Period:

2–14 days (average 5 days).

COVID-19 (Coronavirus Disease 2019)

• Loss of smell (anosmia) and taste (ageusia)

• Fever, dry cough, fatigue

• Dyspnea, sore throat, myalgia

In severe cases: hypoxia, pneumonia, ARDS

COVID-19 (Coronavirus Disease 2019)

1. RT-PCR (gold standard)

2. Antigen or antibody tests

Chest imaging showing “ground-glass opacities”

COVID-19 (Coronavirus Disease 2019)

1. Supportive therapy (oxygen, IV fluids)

2. Antivirals (Remdesivir), corticosteroids (Dexamethasone), anticoagulants

Viral Meningitis

• Source of Infection:

  • Respiratory secretions, feces, or urine of infected individuals.

• Mode of Transmission:

  • Fecal-oral route, respiratory droplets, or direct contact with contaminated materials.

• Period of Communicability:

  • From a few days before to a few days after symptom onset, depending on the causative virus.

• Incubation Period:

Usually 3–7 days (may vary depending on the virus).

Viral Meningitis

• Kernig’s sign: Pain/resistance when extending the knee while the hip is flexed

• Brudzinski’s sign: Involuntary hip/knee flexion when the neck is flexed

• Fever, headache, nausea, vomiting

• Stiff neck (nuchal rigidity)

• Photophobia (light sensitivity)

• Lethargy, irritability

Viral Meningitis

1. Lumbar puncture: clear cerebrospinal fluid (CSF) with normal glucose, slightly elevated protein, and increased lymphocytes

2. PCR or viral culture from CSF

Brain imaging to rule out complications

Poliomyelitis (Polio)

• Source of Infection:

  • Throat secretions and feces of infected individuals

• Mode of Transmission:

  • Fecal-oral route (most common)

  • Oral-oral route (less frequent)

• Period of Communicability:

  • 7–10 days before and after onset of symptoms; virus may persist in feces for 3–6 weeks.

• Incubation Period:

7–14 days (range: 3–35 days)

Poliomyelitis (Polio)

• Flaccid paralysis without sensory loss, often affecting lower limbs

• May be asymptomatic or present in three forms:

  • Abortive (mild): Fever, sore throat, malaise, headache, vomiting

  • Non-paralytic: Stiff neck, back pain, muscle tenderness

Paralytic:Muscle weakness progressing to paralysis(usually asymmetric)

Poliomyelitis (Polio)

1. stool or throat swab

2. Detection of poliovirus-specific antibodies

CSF analysis showing mild pleocytosis and normal glucose

Poliomyelitis (Polio)

1. Supportive therapy: bed rest, pain relief, adequate nutrition

2. Physical therapy to prevent contractures and maintain muscle strength

Mechanical ventilation for respiratory paralysis

Hepatitis A

• Source of Infection:

  • Feces of infected individuals (highest concentration before symptom onset).

• Mode of Transmission:

  • Fecal-oral route: ingestion of contaminated food or water

  • Person-to-person contact in poor hygiene settings

• Period of Communicability:

  • Most infectious during the 1–2 weeks before symptom onset until about 1 week after jaundice appears.

• Incubation Period:

15–50 days (average 28–30 days)

Hepatitis A

• Jaundice (yellowing of skin and sclera)

• dark-colored urine with clay-colored stool

• Fatigue, malaise, fever, nausea, vomiting

• Right upper quadrant pain

• Anorexia, pruritus

Hepatitis A

1. Elevated liver enzymes (ALT, AST)

2. Presence of anti-HAV IgM antibodies (acute infection)

3. Bilirubin elevation

Hepatitis A

1. Supportive care (hydration, rest, nutrition)

2. Avoid hepatotoxic substances (e.g., alcohol, acetaminophen)

Balanced diet rich in carbohydrates and low in fat