LO4 Study Notes on Infectious and Communicable Diseases

Medical Fluid Infusion Precautions

  • Infusion of normal saline or lactated Ringer solution may be appropriate depending on clinical indications.
  • Standard Precautions:
    • Always take standard precautions when handling fluids.
    • Properly dispose of sharps, including needlesafe devices.
    • Follow your agency's infection prevention and control plan to clean suction units and any reusable equipment.
    • Discard disposable supplies and linens appropriately.

Airborne Diseases

Common Communicable Diseases of Childhood

  • Historical Context:
    • Common communicable diseases (e.g., measles, chickenpox, mumps) were widespread among children 40 years ago, affecting nearly every child before they reached their teens.
    • In developed countries like Canada, these diseases are now much less common due to widespread vaccination.

Immunization Programs in Canada

  • Children in Canada are offered a comprehensive immunization schedule for various vaccine-preventable diseases.
  • Many immunizations are provided free of charge by provincial and territorial governments (specific vaccines may vary).
  • Canada enjoys a high rate of immunization, effectively eliminating many diseases, although occasional sporadic cases and epidemic outbreaks still occur, sometimes linked to vaccine non-compliance related to religious exemptions.

Vulnerability of Infants and Young Children

  • Infants and small children have relatively immature immune systems, making them susceptible to infectious diseases.
  • Pediatric immunizations not only protect vaccinated children but also provide a form of herd immunity to unvaccinated individuals.

Essential Pediatric Vaccinations

  • At a minimum, children should be immunized against the following diseases:
    • Diphtheria, pertussis, and tetanus
    • Haemophilus influenzae type b (Hib)
    • Hepatitis A and B viruses
    • Measles, mumps, and rubella (MMR)
    • Meningococcal disease
    • Pneumococcal disease
    • Polio
    • Varicella (chickenpox)
  • Other vaccinations may be recommended; consult a local public health department (PHD) for specific schedules.

Clinical Protocols at the Scene

  • Use a surgical mask on any patient presenting with fever and a rash.
    • This helps prevent the transmission of droplet and airborne pathogens.

Measles (Rubeola)

  • Description:
    • Highly communicable viral disease characterized by a blotchy red rash.
    • Transmission occurs via respiratory droplets and can be through direct contact with nasal or throat secretions.
  • Symptoms and Incubation:
    • Incubation period: Approximately 10 to 12 days.
    • Symptoms include fever, conjunctivitis, cough, and characteristic Koplik spots in the mouth.
    • The communicable period begins 4 days before the rash appears and continues for about 4 days after.
  • Preventive Measures:
    • Vaccination is the only certain protection against measles.
    • Infection control involves placing a surgical mask on the patient and ensuring proper disinfection measures following patient transport.

Rubella (German Measles)

  • Description:
    • Typically a mild illness in children but can cause severe complications if contracted in pregnant women (e.g., congenital rubella syndrome).
  • Symptoms:
    • Low-grade fever, headache, runny nose, swollen lymph glands, and a diffuse rash.
  • Transmission:
    • Spread mainly by respiratory secretions through direct contact or droplet transmission.

Mumps

  • Description:
    • Viral illness that primarily affects the salivary glands.
  • Symptoms and Incubation:
    • Symptoms include swelling and tenderness of the salivary glands, typically accompanied by fever.
    • Male patients may experience orchitis (inflammation of the testicles) in around 25% of cases, though it does not lead to sterility.
    • Incubation period: Approximately 16-18 days.
  • Transmission:
    • Transmitted via respiratory droplets or direct contact with saliva.
    • Post-exposure vaccination is not recommended, and infected individuals should follow isolation protocols.

Chickenpox (Varicella)

  • Description:
    • Highly contagious viral disease with characteristic vesicular rash.
  • Symptoms:
    • Initial symptoms include slight fever, followed by a vesicular rash that crusts over.
    • The communicable period starts 1-2 days before and lasts until all lesions have crusted over.
  • Prevention:
    • Vaccination offers lifelong immunity.
    • Place a surgical mask on the patient during transport and use gloves when handling lesions.

Pertussis (Whooping Cough)

  • Description:
    • Caused by Bordetella pertussis bacteria, historically a significant problem among children.
  • Symptoms:
    • Characterized by a persistent cough that becomes paroxysmal after 1-2 weeks.
    • Lasts 1-2 months.
  • Transmission:
    • Spread through droplets and direct contact with secretions.

Meningitis

  • Description:
    • Inflammation of the protective membranes (meninges) of the brain and spinal cord; classified into bacterial and viral forms.
  • Transmission:
    • Mainly droplet transmission from nasopharyngeal secretions.
  • Symptoms:
    • Fever, severe headache, stiff neck, nausea, vomiting, and potential altered mental status.
  • Common Pathogens:
    • Neisseria meningitidis, Streptococcus pneumoniae, Haemophilus influenzae type b (Hib).

Tuberculosis (TB)

  • Description:
    • Infectious disease caused by Mycobacterium tuberculosis, prevalent among vulnerable populations.
  • Transmission:
    • Airborne via droplet nuclei released into the air when an infected person coughs.
  • Symptoms:
    • Persistent cough, chest pain, weight loss, night sweats, and fever.

Pneumonia

  • Description:
    • Lung inflammation caused by infections, leading to symptoms like cough, chest pain, fever, and difficulty breathing.
  • Risk Groups:
    • Higher risk in older adults, smokers, and those with chronic illnesses or compromised immunity.
  • Incidence:
    • Common cause of illness and mortality, especially in the elderly and pediatric populations.

Other Respiratory Infections

  • Bronchiolitis:
    • Primarily affects infants; caused by viral infections which lead to inflammation of bronchioles.
  • Croup:
    • Affects children under 5; diagnosed by the presence of a barking cough.
  • Epiglottitis:
    • Life-threatening swelling of the epiglottis; common causes include H. influenzae.

Sexually Transmitted Diseases (STDs)

Gonorrhea
  • Description:
    • Caused by Neisseria gonorrhoeae bacteria, primarily spread through sexual contact.
  • Symptoms:
    • Males often complain of discharge and painful urination; females may be asymptomatic.
Syphilis
  • Description:
    • Infection caused by Treponema pallidum characterized by chancre.
  • Transmission:
    • Primarily sexual contact but can be passed from mother to fetus.
Genital Herpes
  • Description:
    • Chronic infection caused by herpes simplex virus, characterized by painful vesicles.
  • Transmission:
    • Spread through sexual contact or from mother to child during delivery.
Chlamydia
  • Description:
    • Asymptomatic in many women but can lead to pelvic inflammatory disease.
  • Transmission:
    • Sexual contact; antibiotic treatment is effective.

Viral Hepatitis

Hepatitis A and B
  • Description:
    • Inflammation of the liver caused by viral infection. Hepatitis B is bloodborne.
  • Transmission:
    • Hep A is fecal-oral; Hep B is through blood and sexual contact.
  • Prevention of HBV:
    • Vaccination is key for healthcare workers.
Hepatitis C
  • Description:
    • Chronic infection leading to liver disease; largely transmitted through blood exposure.
  • Symptoms:
    • Often asymptomatic initially; significant in chronic cases.
HIV/AIDS
  • Description:
    • HIV infects T-cells, leading to progressive immunodeficiency.
  • Symptoms:
    • Initial flu-like illness can progress to AIDS, leading to opportunistic infections.
  • Prevention:
    • Standard precautions, testing source patients, and possible post-exposure prophylaxis.

Lice and Scabies

Lice
  • Description:
    • Parasitic infestations that cause itching and irritation.
  • Transmission:
    • Close physical contact or sharing personal items.
Scabies
  • Description:
    • Caused by Sarcoptes scabiei mites leading to intense itching.
  • Transmission:
    • Direct skin-to-skin contact.