SELECTED COMMUNICABLE DISEASES

Tuberculosis

A highly contagious bacterial infection, usually affecting the lungs but can also affect other organs of the body like brain, kidney, intestine, and bones

Pulmonary tuberculosis

affect the lungs

Extrapulmonary tuberculosis

spread all over the body

Tubercolosis

Considered as the world's deadliest disease and remains as a major public health problem in the Philippines

Tuberculosis

Top 10 leading cause of morbidity (2020) in the Philippines

DOTS program

Directly Observed Treatment Scheme

the patient having TB is given TB drugs for straight six months; closely monitoring the patient who is diagnosed with Tuberculosis

Mycobacterium tuberculosis

Causative agent of Tubercolosis

Mode of transmission of Tubercolosis

Droplet Spread

Sign and Symptoms of Tubercolosis

Hemoptysis \[coughing out of blood\] or recurrent blood-streaked in the sputum \[plegm\]

Treatment for Tubercolosis

\-          Isoniazid

\-          Rifampacin

\-          Pyrazinamide

\-          Ethambutol

MDR-TB

Multi-drug resistant-Tuberculosis

XDR-TB

Extremely drug resistant-Tuberculosis

Tuberculosis Vaccine

Bacille of Calmette and Guerin (BCG)

Typhoid Fever

Systemic infection characterized by continued fever, malaise, anorexia, slow pulse, involvement of lymphoid tissue, Splenomegaly, rose spots on trunks and diarrhea.

Salmonella typhi

Causative Agent of Typhoid Fever

Primary Source of Infection of Typhoid Fever

Feces and urine of infected person

Principal vehicle of Salmonella Typhi

food and water

Stool culture

Serological tests

Methods of Prevention and Control for Typhoid Fever

Sanitary supervision of processing, preparation and serving of food particularly those eaten raw \[educate food handlers, food vendors, etc. to sanitize their hands properly before serving food\]

Clean food and water

Pneumonia

An acute infectious disease of the lungs usually caused by the pneumococcus resulting in the consolidation of one or more lobes of either one or both lungs

Streptococcus pneumoniae (Diplococcus pneumoniae) Lobar pneumonia \[lobes of the lungs are affected\] Occasionally Klebsiella pneumoniae

Viruses

Causative agents of Pneumonia

Rusty sputum

Productive cough \[green phlegm – pus\]

Highly colored urine

Leptospirosis

Weil’s disease

Leptospirosis

It is an occupational disease affecting veterinarians, miners, farmers, sewer, workers, abattoir workers, etc

Rat is the main host of the disease although pigs, cattle rabbits, and other wild animals can also serve as reservoir hosts

Leptospirosis interogans

Causative Agent of Leptospirosis

Mode of Transmission of Leptospirosis

Through contact of skin, especially open wounds with water, moist soil or vegetation contaminated with urine of infected host

Treatment for Leptospirosis

Penicillin and other B-lactam antibiotics

Tetracycline

Erythromycin

Leptospiremic phase

leptospires present in blood and CSF. Onset of symptoms are abrupt with fever, headache, myalgia \[muscle pain\], nausea, vomiting, cough, and chest pain

Immune phase

correlates with the appearance of circulating IgM

Gonorrhea

STI (Sexual Transmitted Infection)

Neisseria gonorrhea

Mode of Transmission of Gonorrhea

·Sexual contact in adult, transmission in neonates (ophthalmia neonatorum) is during birth

Genital (penis or cervix), anus, throat, and eyes can be infected

Males – burning urination and pus discharges from infection of urethra

Females – vaginal discharge

Signs and Symptoms of Gonorrhea

No drug or vaccines. Condoms offer protection. Trace contacts and treat to interrupt transmission

Gonorrhea Prevention

To Prevent STI

Engage in mutually monogamous relationship

Limit the number of sexual partners

Inspect and question new partners

Avoid certain sexual practices involving anal or fecal contact

Barrier methods of contraception (use of condoms, diaphragms, and spermicides)

The only STI that can be prevented with HBV infection

No single antibiotic covers all potential STIs

Allergic reaction may occur

They may lead to emergence of resistant organism

Why prophylactic antibiotics taken before and after exposure should not be done because:

BACTERIAL DISEASES

Tuberculosis

Typhoid Fever

Pneumonia

Leptospirosis

Gonorrhea (Other STIs)

Viral Diseases

Measles

Influenza

Hepa A (Infectious Hepa, Epidemic Hepa, Catarrhal Jaundice)

Rabies

Dengue Hemorrhagic Fever

Hepa B

Measles

An acute highly communicable infection characterized by fever, rashes, and symptoms referable to upper respiratory tract; the eruption is preceded by about 2 days of coryza, during which stage grayish pecks (“Koplik Spots”) maybe found on the inner surface of the cheeks or throat

Morbillivirus under Family Paramycoviridae) (RNA virus)

Incubation period of Measles

10 days from exposure to appearance of fever and about 14 days until rash appears

MMR (Measles, Mumps, Rubella) Vaccine

Vaccine for measles, mumps and german measles

Influenza

Trangkaso

Highly communicable disease characterized by abrupt onset with fever which last 1 to 6 days, chilly sensations or chills, aches or pain in the back and limbs with prostrations. Respiratory symptoms include coryza, sore throat and cough

Influenza Virus A, B, C under Family Orthomyxoviridae (RNA virus)

Causative Agent of Influenze

Source of Infection of Influenza

Discharges/Secretions from the mouth and nose of infected person

Period of Communicability

3 days from clinical onset

Older People

Influenza Vaccine is only free for?

Influenza Prevention

Education of the public as to sanitary hazard from spitting, sneezing, and coughing

Avoid use of common towels, glasses and eating utensils

Active immunization with influenza vaccine provided prevailing strain of virus matches antigenic component of vaccine \[free for older people\]

Hepatitis A

Infectious Hepatitis

Epidemic Hepatitis

Catarrhal Jaundice

Hepatitis A

A form of hepatitis occurring either sporadically or in epidemics and caused by virus by fecaly contaminated water or food.

Young people especially school children are most frequently affected

Causative Agent:

Hepatitis A Virus (HAV)

(Under Family Picornaviridae) (RNA Virus)

Signs and Symptoms of Hepatitis A

Influenza-like symptom like headache

Malaise and easily fatigability

Anorexia and abdominal discomfort

Nausea and vomiting

Fever

Lymphadenopathy

Jaundice (yellowish color of the skin caused by bilirubin)

Bilirubinemia with clay colored stool

Rabies

Hydrophobia

Lyssa

Rabies

Is an acute viral encephalomyelitis caused by the rabies virus, a rhabdovirus of the genus Lyssavirus (RNA virus)

Urban and Canine Rabies

rabies is transmitted by dog

Sylvatic rabies

disease of wild animals and bats which sometimes spread to dogs, cats, and livestock

Two kinds of Rabies

Urban and Canine

Sylvatic Rabies

300-600

Approximately how many rabies morbidity are there in the Philippines every year?

Mode of Transmission of Rabies

Animal bites, Non-intact skin, man to man

Incubation Period of Rabies

2-8 weeks or up to year/s depending on the severity and distance from the brain

Susceptibility and Resistance to Rabies

All warm blooded mammals are susceptible. Natural immunity in man is unknown

Signs and Symptoms of Rabies

Sense of apprehension

Headache

Fever

Sensory change near the site of animal bite

Spasm of muscles or deglutition or attempt to swallow (fear of water)

Paralysis

Delirium and convulsion

Without medical intervention, the rabies victim would usually last only for 2-6 days.

Death is often due to respiratory paralysis.

Management and Prevention of Rabies

The wound must be immediately and thoroughly washed with soap and water. Antiseptic such as povidone iodine or alcohol may be applied.

The patient much be given antibiotics and anti-tetanus immunization

Be a responsible pet owner

Active Immunization of Rabies

aims to induce the body to develop antibodies against rabies up to 3 years.

Passive Immunization of Rabies

is given to provide immediate protection against rabies which should be administered within the first seven days of active immunization. The effect of the immunoglobulin is only short term.

Etiologic agents of Dengue Hemorrhagic Fever (H-Fever)

Dengue Virus Types 1, 2, 3, and 4 (flavivirus, and RNA virus)

Source of Infection of Dengue

Aedes Aegypti

Tiger Mosquito (common household mosquito)

Mode of Transmission of Dengue

Through bite of infected female mosquito

Signs and Symptoms of Dengue

An acute febrile infection of sudden onset with clinical manifestation

3 stages:

First 4 days – invasive stage starts abruptly as high fever, abdominal pain and headache

4th to 7th days -toxic or hemorrhagic stage

lowering of temperature, severe abdominal pain, vomiting, frequent bleeding.

Death may occur (organ failure; dehydration) -

7th to 10th day – convalescent or recovery

Diagnostic Test for Dengue

Tourniquet test (Rumpel Leads Test)

Platelet count

Increased Hematocrit = Dehydration

Control Measure for Dengue

Vector elimination

Changing water and scrubbing sides of lower vases once a week

Destroy breeding places of mosquito

Keep water container clean and covered

Avoid too many hanging clothes inside the hose

Spray with insecticides

Health education of the public

Vaccination (dengvaxia)

Hepatitis B Causative Agent:

Hepatitis B Virus (HBV) under Family Hepadnaviridae (DNA Virus)

Dark Colored Urine

Can be an indication of Hepa B

Schistosomiasis

A.K.A Bilharziasis or Snail Fever

Schistosomiasis

one of the important tropical disease on our countr

Schistosomiasis

It is caused by blood fluke that is transmitted by a tiny snail

Farmer and their Families

Mostly affected by Schistomiasis

Causative Agents of Schistomiasis

Schistosoma jabonicum

Signs and Symptoms of Schistomiasis

Diarrhea

Bloody stool enlargement of abdomen

Splenomegaly

Weakness

Anemia

Inflamed liver

Mode of Transmission of Schistomiasis

Infection occurs when the skin comes in contact with contaminated fresh water in which certain types of snails that carry Schistosomes are living, it is a free-swimming larval form (cercaria) of the parasite that penetrates the skin

Fresh water becomes contaminated when infected people urinate or defecate in water

Drugs for Schistosomiasis

Praziquantel is the drug of choice against all species. Oxamniquine for S. mansoni

Metrifonate for S. heamatobium

Paragonimiasis/Pulmonary Distomiasis

It is chronic parasitic infection, which greatly reduces human productivity and quality of life

It is frequently encountered in communities where eating of fresh or inadequately cooked crabs is practice

Mostly misdiagnosed with PTB in endemic areas

Endemic areas identified of Paragonimiasis

The provinces of Mindoro, Camarines Sur, Camarines Norte, Sorsogon, Sama, Negros Island, Albay, Basilan, Cebu

Causative Agent for Paragonimiasis

Paragonimus westermani

First intermediate host of Paragonimiasis

fresh water snail (Antemelania aspirate)

Second intermediate host of Paragonimiasis

small, fresh water crab:

Sundathelpusa philippina

Varona litterata

Paragonimiasis

Ingestion of raw insufficiently cooked infected crabs can cause?

Paragonimiasis diagnosis

Sputum collection

Serological test like complement fixation test Cerebral paragonimiasis – eosinophilia in CSF

Soil Transmitted Helminthiasis (STH)

common to children because they used to play soil

Causative Agents of STH

Ascaris lumbricoides (Giant intestinal roundworm) Trichuris trichiura (Whipworm)

**Hookworm:**

Ancylostoma duodenale (Old worls hookworm) Necator americanus (New world hookworm)

Signs and symptoms of STH

Anemia

Malnutrition

Stunted growth in height and body size \[natigil na paglaki\]

Decreased physical activities

Impaired mental development and school performance

Treatment for STH

Piperazine citrate, pyrantel pamoate, mebendazole, albendazole, levimazole; depends on what parasite is present

Filariasis

A.K.A Elephantiasis

Filariasis

enlargement of part/s of the body

Causative agents of filariasis

**Wuchereria bancrofti:** - Aedes poecilus, Anopeles minismus flavirostris, Culex fatigans

**Brugia malayi:** - Aedes poecilus, Anopeles minismus flavirostris, Culex fatigans

Asymptomatic Stage of Filariasis

Characterized by the presence of microfilariae in the peripheral blood

Acute Stage of Filariasis

Lymphadenitis – inflammation of the lymph nodes Lymphangitis – inflammation of lymph vessels

In some cases, the male genitalia is affected

Chronic Stage

Developed 10-15 years from the onset of first attack

**Hydrocoele** – swelling of the scrotum - **Lymphedema** – swelling of the upper and lower extremities

**Elephantiasis** – enlargement o thickening of the skin of the lower and/or the upper extremities, scrotum, breast

10pm to 2am

Blood specimen for the detection of Wuchereria should be collected at