FILARIASIS MALARIA DENGUE ZIKA

OTHER NAME "Marsh fever" "Dengue Hemorrhagic Fever" "Flavlvirus"

CAUSATIVE - Chronic parasitic infection Plasmodiumfalciparum - most o Aedes aegypti
AGENT / caused by a nematode serious malarial infection;
INFECTIOUS (Wuchereria) development of high parasitic
AGENTS Wuchereria bancrofti density in RBC; common in PH
o Brugia malayi
D B. Timori Plasmodium vibax - benign
- Can affectthe legs, arms, terrain; not life threatening,
vulva, breast and scrotum South Africa and Eastern Asia
that causes hydrocele Plasmodium malarial - quartant;
- These worms occupy the less frequent, not life
lymphatic system including threatening.
the lymph nodes and in
o Plasmodium ovate - rarest
chronic cases these worms
lead to disease species
elephantiasis
SIGNS & ASYMPTOMATICSTAGE Recurrent chills FIRST 4 DAYS: ASYMPTOMATIC:
SYMPTOMS Presence of microfilarae in the O Fever High fever Fever
blood Profuse sweating Abd pain and headache o Rash
o No clinical signs D Anemia O Flushing accompanied by o Joint pain
Asymptomatic for years Malaise vomiting o Conjunctivitis
Other progress to acute and Hepatomegaly Conjunctival infection D Muscle pain
chronic stages Splenomegaly Epistaxis o Headache
ACUTE STAGE - startswhen
there is already a manifestation
- DAYS:
C] Lowering of temp Incubation period: not known
of recurrent fever O Severe abd pain
o Lymphadenitis —inflamed
O Vomiting and frequent bleeding
lymph nodes
Lymphangitis C]Unstable BP and narrow pulse
Some cases; male genetalia is pressure
affected leading to orchitis — D Shock
redness, painful and tender 7TH- 10THDAYS:
CHRONIC STAGE - develop10- C]Generalized flushing with
15yrs from the onset of the first interventingareas of flushing
attack Aopetite regained
Swelling of the scrotum D Stable blood pressure
 Temporary swelling of upper
ex
o Enlargement and thickening of
the skin of lower and upper ex,
scrotum, breast
o Hydrocele
Lymphedema
o elephantiasis

MOT o Bites from infected female Cl 9pm —3am biting time Mosquito bite First week —found in blood and
mosquito O Bite of female anopheles C] Period of communicability: 18t passed from infected person to a
- Aedes poecillus(primary) mosquito week of illness; virus is present mosquito through mosquito bites;
- Aedes flavivostris Blood transdusion in the blood infected mosquito can then
(secondary) C]Sharing IV needles spread the virus
- Incubation period: 8-16mos C]transplacental
- Peak biting time: 10pm —
12mn
METHODS OF o Insecticide tx of mosquito net D Eliminate vector by:
CONTROL House spraying - Changing water and
o On stream seeding —bioponds, scrubbing sides of lower
larvavirous fishes; cases once a week
o On stream clearing —cutting - Destroy breeding places of
vegetation overhanging along mosquitos
stream banks - Proper disposal of rubber tis,
empty bottles and cans
- Keep water containers clean
and covered
TARGETS 5-9 years old —peak age
DIAGNOSTIC Physical exam C]Clinical method: S/Sx; been or PRESUMPTIVE: - RT-PCR on serum
- History taking living on a malaria endemic area C]Tomiquet test - Plaque reduction neutralization
- Observationof S/Sx o Microscopic method: blood smear - 20 petechia (herman's sign) testing
Finger prick test —giema stain - QuantitativeBuffy Coat (QBC) - + toumiquettest
—microfilae —fastest Cl Rumpel leads test
Prefered to be done at Malarial smear —best time C] Capillary fragility test
night; feeding time of taken on peak of fever CONFIRMATORY:
vectors
 O Nocturnal blood exam (NBE) — O Platelet count (N: 150-
after 8pm
O Immunochromatographic test
(ICT) —rapid assessment
method; anytime of the day
TREATMENT DOC: Diethylcarbamazine Citrate CHEMOPROPHYLAXIS C)Analgesic: paracetamol O Plenty of rest
(Hetrazan) ++ Anthelmintic: o Chlroquine —given weekly Rapid replacement of body O Drink fluids to prevent
Albendazole and Ivermectin intervals fluids dehydration
- 1-2wks before entering C] Intensive monitoring and follow D Take medicine: acetaminophen
For Elephantiasis: Doxycycline endemic area up O Prevent mosquito bites first week
- Pregnant; entire duration of illness
BLOOD SCHIZONTICIDES:
o Quinine —cinchonism; ototoxic
o Chloroquine —SIE itchiness
o Primaquine
o Fansidar —pyrinmethamine and
sulfodoxine
RECOMMENDED ANTIMALARIAL
o Chloroquine sulfate
o Sulfadoxine
o Quinine sulfate
o Quinine hydrochloride
o Tetracycline hydrochloride
o Quinidine sulfate
o Quinidine gluulate
NSG RESP / SUPPORTIVE CARE o Participate in the implementation DIET: low-fat fiber, non-irritating,
CONSI - Personal hygiene —wash of the ff: non-carbonated
affected areas with soap and - Tx policies
water at least 2x a day or - Provision of drugs
prescribed antibiotic or - Lab confirmationdx
antifungals - Training BHW in dx and tx
Supervision of malaria and
control activities collection,
analysis and submission of
reports
Recognition of early s/sx
- Health education
 Availability of antimalarial
drugs and chemoprohylaxis
ADDITIONAL Severe disease is marked by 2 O Once infected, likely to be
Develops into2 phases:
Erythrocytic—involves RBC problems: protected from future
o Exoerythrocytic —involves hepatic
system O dysfunction of endothelium infections
C]disordered blood clotting O Pregnancy: complication:
MANAGEMENT:
OChemicalIy treated mosquito MICROCEPHALY
net
H- FEVER CLASSIFICATION:
DI-arva eating fish
O Environmental sanitation Severe, frank type —
OAntimosquitosoap flushing, sudden high fever,
ONeem tree (Eucalyptus)
Dzooprphylaxis severe hemorrhage, shock
and terminationin recovery
or death
o Moderate—high fever, less
hemorrhage, no shock
Mild —slight fever w/ or w/o
petechial hemorrhage
 LEPROSY MEASLES CHICKEN POX SCABIES ANTHRX
OTHER NAME "Leproaue" "Hnasen's "Varicella" "Radplcker disease"
Bacilli"
CAUSATIVE Affects the skin, peripheral Filterable virus of measles o Human herpes virus Severe irritation O Bacillus anthracis
AGENT / neræs, eyes, and mucusa kviral o Varicella zoster virus O Sarcoptes scabie
INFECTIOUS of upper respi o Herpes zoster virus - Characterized by eruptive
AGENTS c Confirmed source: PSn10K lesions produced from the
amadillos Source of infection: burrowing of the female
- Secretion of respi tract of parasite
infected person - Burrows beneath the
- Lesions of the skin epidermis to lay her eggs and
Scabs itselfare not infective sets up an intense irritation
SIGNS & EARLY: o Fever Q Slight fever o Itching
SYMPTOMS Changes in skin color — o Rashes o Maculo-papular rash; o When secondarily infected,
reddish or white o Symptoms referrable to vesicular (fluid filled) for skin may feel hot and buming
o Loss of sensation on skin upper respi tract infection few hours with minor discomfort
lesion Kolplk spot —may be O Vesicular for 3-4 days = When large areas are
Decrease or loss sweating Töüöd7TöTnner surface scarring = pneumonia involved and secondary
Thickened and painful of cheek infection is severe, there will
nerves - Eruption is preceded by Incubation: 2-3 weeks be fever, headache, and
o Muscleweakness and about 2 days of coryza commonly 13-17days malaise
paralysis of extremities Pfrnto(gnwntfrrc a Cd)
D Pain and redness of the
eyes
o Nasal obstructionand
ff) CO
bleeding
o Ulcers that do not heal
LATE:
o Madarosis —loss of
eyebrow
o Lagopthalmos —inability to
close lids
o Clawing of finger and toes
D Contractures
o Sinking of the nose bridge
o Gynecomastia
D Chronic ulcers
 MOT Airborne droplet Droplet secretion o Direct contact from droplet O Cutaneous infection
o Prolonged skin to skin Incubation period: 10 days D Indirect: through soiled Contact with infected sol
contact from exposure to appearance linens
of fever, 14 days rashes (8-
13days)

METHODS OF Avoidance of prolonged D Avoid exposing children to o Case over 25 years of age o Good personal hygiene o Immunize the high risk
CONTROL skin to skin contact any person with catarrhal should be investigated to Regular changing of clean person with cell free
o BCG vaccination acid symptoms eliminate the possibility of clothing and beddings and o Educate employees handing
fast bacillus o Isolationcases from the small pox towels potentiallycontaminabd
o Good personal hygiene diagnosis until 5-7 days o Isolation o Eating the right kind of food, articles about mode of
Adequate nutrition after the onset rash o Current disinfection of the green leafy vegetables, and transmission
o Health education o Disinfection of soiled with throat and nose discharges plenty of fluids D Control dusts and proper
infected secretions o Avoid contact with o Keeping the house clean ventilation in hazardous
o Administration of measles susceptible D Improving sanitation in the industries especially those
immune globulin to surrounding that handle raw animal
susceptible infants materials
TARGETS Children below 12 years VAR: qolb(«
DIAGNOSTIC O SSS —slit skin smear test : U-nnw O Appearance of the lesion, and
- Determinethe presence Intense itching
of M.Leprae Scraping from its burrow with
Lepromin test a bypodemic need or curette
- Susceptibility to leprosy and examined under
microscope
TREATMENT • First: Promin drugs O Benzyl benzonate emulsions
• Dapsone O Kwell ointment

• Clofazamine
• Rifampicin —
multibacillary
RA 4073 —advocates home
treatment of leprosy
 MULTIDRUG THERAPY
- Reduces communicability
period of leprosy in 4-6wks
- Prevents developmentof
resistance to drugs
- Shortens the duration of
treatment
NSC RESP / Emphasize the need for
CONSI isolation
o Observe closely for the
acute stage
o Explain proper disposal of
throat and nose discharges
o Teach concurrentterminal
disinfection
o Protect eyes of patientfrom
glare
Keep the pt in adequately
ventilated room
D Teach, guide, supervise
adequate nursing care as
indicated
o Check of
medication"åd treatment
prescribed by the physician
ADDITIONAL • Paubacillary (tuberculoid Signs of rash: facial rash Whole family must be o Cutaneous form
and immediate) —non- Stimson's line: bilateral examined, as long as one - Exposed part of the skin
red line on the lower member is infected, others will begins to itch
infectious type conjunctiva get the infection - Papule appear in the
C]Duration: 6-9mos Prevent: pneumonia, inoculationsite
diarrhea, malnutrition - Papule becomes vesicle
D Rifampicin and dapsone and then evolve into
depressedscars
HT: dapsone —itchiness
O Pulmonary form
- Onset resembles as the
upper respi tract infection
• Multibacillary (lepromatous —After 3-5 days infection
and borderline) —infectious becomes acute
- Fever, shock and death
Clofazimine —s/s: o Gastrointestinal anthrax
-- Violent gastroenteritiswith
dryness or flaking of the
vomiting and bloody stools
skin Contacted by eating a meat
from infected animals
Self administered —
dapsone and lamparene
 TUBERCULOSIS DIPTHERIA PERTUSSIS INFLUENZA PNEUMONIA
OTHER NAME "Myobacterium tuberculae" "Klebs Lofller" "Whoopingcough" "Common Flu ABC"
CAUSATIVE Corynebacterium diptheria o Hemophilus pertussis Influenza virus ABC Infectious disease resulting
AGENT / tuberculosis 0 o Bordet gengou pertussis Source of infection:discharges to consolidation
INFECTIOUS Myobacteriumaf can åÅ Chlorine diphtheriae o Bordetella pertussis from mouth or nose of infected o Diplococcus pneumoniae
AGENTS a Bovine TB. exposure of Hallmark: o Pertussis bacilis person (majority)
TB from cattle psuedomembrane o Pneumococcus of Friedlander
(occasionally)
o Viruses
Predisposing causes:
Fatigue
- Overexposure to inclement
weather
Exposure to polluted air
Malnutrition
SIGNS & Cough - productivewith Source of infections Source of infection: o Abruptonset fever o Rhinitis
SYMPTOMS rusty or blood sputum o Discharge and secretion o Discharges from o Chilly sensations I chills o Chest indrawing
Fever - low grade from mucus surface of laryngeal and o Aches or pain in the back o Rusty sputum
aftemoon nose and nasopharynx, bronchial mucus o Respiratory symptoms: a Productive cough
Chest or back pains and from skin and other membrane of infected coryza, sore throetand cough o Fast respiration
Hemoptysis (coughing lesions person FIRST SIGN: CORYZA (flu- o Fever
blood) is mtraindl Acute febrile infection of Ordinary cold which like symptom) o Vomiting
o Significant weight loss the tonsil, nose, throat, becomes increasingly Q Convulsions (may occur)
Others: sweating, fatigue, and larynx marked by severe a Flushed fece
body malaise, shortness grayish membrane from Paroxysmal cough o Dilated pupil
of breathe which diptheria bacillus o Vomiting may follow o Severe chills in young
is readily cultured spasm children
o Cough may last several o Pain over the affected lung
weeks and 2-3 months
MOT Airbome droplet/ Contact with a patient or o Direct spread through Droplet —direct contact
Direct invasion carrier or with solid salivary contacts Incubation period: 24-72 hrs
o Period communicability: particles with discharge of o Crowding and close
o Depends on the number ingected persons association w/ pt —
of bacilli discharged o Milk has serced as spread
The virulence vehicle
Adequacy of ventilation
 CPT -
ccp.
Incubation period:7-10 days
but won't extend up to 21
days

METHODS OF Prompt diagnosis and Active immunization on o Routine DPT o Education of the public as to
CONTROL treatment all infants and children immunization in all sanitize hazard from spitting,
BCG vaccination with 3 doses of DPT infants sneezing and coughing
Health education Pasteurization of milk
vaccint Improve social conditions
Booster dose given at o Avoid use of common towels,
Health education to 2yrs and again at 4-5 glasses, and eating utensils
such as overcrowding parents years o Active immunizationwith
Make available medical Reporting of case to the Pt should be influenza vaccine, provided
activities health officer for proper segregated until after prevailing strain of virus
Provide PHN and medical care 3wks from the matches the antigenic
outreach services for appearance of component of vaccine
home supervision paroxysmal cough
TARGET*A Cure —at least 80% of Children Communicable: Catarrhal
WI-thesputum smear stage
positive Paroxysmal cough
Detect —at least 70% of 4 days —3 weeks
the estimated new o 7 years old
sputum smear positive o Highest mortality:<
TB cases 6mos.
DIAGNOSTIC DSSM (Direct Sputum
o Based on history and
Smear Microscopy) —
clinical S/Sx
aws need at least 110-120mL Dull percussion noted on
of specimen the affected side of the
Antigen skin testing —not lungs
totally used X-ray
Confirmatory test:
culture and sensitivity
TREATMENT PULMONARYTB DOC: Erythromycin DOC:Erythromycin
Drugs: Pentavalent 6:10:14 mos

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 Intensive: INH, RIF,
PYRAZINAMIDE
CONT.: INH RIF
EXTRAPULMONARY PTB
Drugs:
• INH, RIF,
PYRAZINAMIDE,
ETHAMBUTOL OR
STREP CONT.: INH RIF
• RIFAMPICIN — body fluids
discolorations, permanent
•ISONIAZID — peripheral
neuropathy >> Vit. B6,
pyridoxine
•PYRAZINAMIDE — gouty
arthritis/hyperuricemia—
increase fluid intake of at
least 6-8 glasses of water
• ETHAMBUTOL optic
neuritis, inability to
recognize green from
blue
• STREPTOMYCIN —
damage cranial nerve 8th,
nephrotoxic
NSG RESP 1 Follow prescribed dosage Care should be focused o Keep pt warm and away o Bedrest
CONSI in administering anti-toxin on prevention and from individuals, esp who o Adequate salt, fluid, calorie
o Comfort of the pt, should complication:special suffers with resp infection and vitamin
- Picc{ always be in mind attention to diet is needed
if pt vomits after
o TSB for fever
o Proper sneezing and
o TSB forfever
o Frequent turningfrom side to
o The visiting bag set up
ecktRrq should be outside the room paroxysms coughing precaution side
of the pt or far from the o Teach parents how to o Buming method and proper o Antibioticbased on care of
bedside pick up the infant or child disposal the HCP
nrnd during paroxysmal cough;
c giving abdominal support
o General care of the nose
and throat
ADDITIONAL TUBERCULIN TEST = WOF: myocarditis COMPLICATIONS:
Emphysema or pleural
EXPOSURE effusion
aquilin.c • Mantoux test — read or o Endocarditisor
pericarditis
interpreted after 72hrs; o Pneumococcal
re-GM-all ? meningitis
single
o Otitis media in children
Screening Hypostatic edema and
• Tine test— mass hyperemia of unaffected
lung in elderly
screening; 48 hours Jaundice
. 0-4 mm— insignificant o Abortion
• 5mm or more — significant
= HIV or impaired immunity
• 10mm or greater—
significant with normal
immunity