RABIES

An acute, progressive, fatal

encephalomyelitis caused by neurotropic
viruses
Always almost fatal once manifestations
develop
RHABDOVIRUS a bullet-shaped virus with
strong affinity to CNS tissues
Saliva of a rabid animal
All mammals are believed to be
susceptible, but reservoirs are carnivores
and bats.
Bite of an infected animal
Licking of open wounds by a rabid animal
Scratch of a rabid animal
Man to man transmission (10%)
Airborne (Rare)
Dogs: 1 week to 7 and months
Humans: 10 days to 1 year
Pain and numbness at the site of bite
Flu-like symptoms
Fever
Headache
Malaise/myalgia
Sore throat
Marked insomnia
Apprehensive, Restlessness
Sensitivity to light and sound
Marked excitation and apprehension
Maniacal behavior
Paranoia, Hallucinations, Delirium
Hydrophobia, Aerophobia
Drooling of saliva
Quiet and unconcscious
Spasm ceases with progressive paralysis
Tachycardia, labored respirations
Respiratory paralysis, circulatory collapse
DEATH
Isolation of virus from saliva
Detection of antibodies to virus of serum or
spinal fluid

Examination for rabies antigen in the

cutaneous nerves at the base of hair
follicles through Skin Biopsy
Clinical observation (10-14 days)
Direct Fluorescent Rabies Antibody Test
(DFRAT)
Brain Biopsy: Detection of Negri Bodies
No specific treatment
Care of the patient is symptomatic and
supportive
Clean the wound with soap and water
Antiseptic solution: Povidone-Iodine
Tetanus prophylaxis
Post-exposure prophylaxis

PASSIVE VACCINATION
1. Human Rabies Immunoglobulin (RHIg)

Rabuman, Imogam

20 IU/kg
2. Animal Serum Equine Rabies Immunoglobulin
(ASERIg)

Antirabies Serum, HyperRAB

40 IU/kg
ACTIVE VACCINATION

PVCV (Vero Rab): IM Day 0,7,21,90

PDEV (Lyssavac): ID Day 0,3,7,28,90

HDCV: IM 0,3,7,14,28

PCEV: IM 0,3,7,14,28
ACTIVE VACCINATION
PASSIVE VACCINATION

Is not required

Isolation of patients
Restrain when necessary
Darken the room and provide a quiet
environment
Stimulation of any senses by fluid is
prohibited
Wear protective barriers
Responsible Pet Ownership
Victim Immunization
Dog Immunization
Immunization
Keep away from stray animal

TETANUS

Is an infectious disease caused by

Clostridium tetani which produces potent
exotoxin with prominent systemic
neuromuscular effects
manifested by generalized spasmodic
contraction of the skeletal musculature
Lockjaw
CLOSTRIDIUM TETANI - Anaerobic, sporeforming Gram (+) rod with drumstick
appearance
Two types of toxin:
Tetanospasmin, tetanolysin
Soil
Street dust
Animal and human feces
Rusty materials
Through punctured wound that is
contaminated by dust, soil, or animal
excreta containing Clostridium tetani
Adult: 3 days 3 weeks
Newborn: 3 30 days
st
1 sign: difficulty in feeding and sucking
High grade fever
Stiffness of the jaw
Excessive crying
Muscle spasm
Convulsion
Low grade fever
Diaphoresis
Trismus
Opisthotonus
Risus sardonicus- pathognomonic sign

Abdominal rigidity
Stiffness of the extremity
Severe cases: Laryngospasm

The diagnosis is almost always made

clinically
History of wound
Lack of immunization: A factor

ANTITOXINS
Tetanus Immunoglobulin (TIG): 3,0006000 units IM
Tetanus Antitoxin (TAT): 50,000100,000 units, half IV, the rest IM
Antitetanus Serum (ATS): 40, 000 units
Antibiotic: METRONIDAZOLE- drug of
choice
Muscle Relaxant: Diazepam, Baclofen
Maintain adequate airway
Wound care: debridement
Maintain fluid and electrolyte balance
Place patient in quiet, darkened
environment
Minimal handling
Protect from injury
Exteroceptive: bright lights and noise
Interoceptive: Stress, pain
Propioceptive: Turning, touching
Ineffective breathing pattern related to
muscles spasm and neurologic impairment.
Risk for injury related to muscle spasms.
Immunization with tetanus toxoid for adults
DPT for babies and children

LEPTOSPIROSIS

1.

2.

3.

A zoonotic infectious bacterial disease

carried by animals, both domestic and wild,
whose urine contaminates water or food
which is ingested or inoculated through skin
Weils disease
Canicola Fever
Mud Fever
Hemorrhagic jaundice
Swineherds Disease
LEPTOSPIRA INTERROGANS
Spirochete, Motile, Beta-hemolytic
Chiefly saprophytic aquatic organisms
river
lake water
Sewage
sea
6-15 days
Leptospira is found in the urine between 10
to 20 days after the onset
Urine of infected animal
Reproductive fluids (RARE)
Ingestion or contact with the skin and
mucous membrane of the infected urine or
carcasses of wild and domestic animals.
Through the mucous membrane of the
eyes, nose, and mouth, and through a break
on the skin.
Direct human to human transmission is
rare.
Leptospira enters the blood to cause
damage, thereafter, in the:
Kidney
Liver
Eyes
Meninges
Occupational risk factors include
veterinarians, slaughter house workers,
farmers, and sewer workers.
Clinical course is generally biphasic and the
majority of the cases are anicteric.
Remittent fever

Chills
Headache
Anorexia
Nausea and vomiting
Prostration
Abdominal pain
Diarrhea
UNICTERIC TYPE
Conjunctival suffusion
Uveitis or iritis
Meningeal manifestations
With CSF findings of aseptic
meningitis
ICTERIC TYPE
Jaundice and renal failure (Weils
syndrome)
Hemorrhage
CHF in severe cases
th
Relapse may occur during the 4
th
to 5 week
Usually based on Serology
Culture
Blood, CSF, Urine
ELISA
MAT: the recognized standard reference
test for serologic diagnosis of leptospirosis

Antibiotic: PENICILLIN G (drug of choice)

Oral doxycycline 100mg PO every 12 hours
x 1 week (prophylactic)

Fight complications: require hospitalization

Peritoneal dialysis
Symptomatic and supportive
Isolate the patient, urine must be properly
disposed of.
Darken patients room
Observe meticulous skin care to ease
pruritus.
Keep clients under close surveillance.
Sanitation in homes, workplaces, and farms
Eradication of rats
Animals must be vaccinated (cattle, dogs,
cats, and pigs)

SCHISTOSOMIASIS

Is a parasitic disease caused by several

species of trematodes("flukes)

Primarily affects the liver and GIT.

Capable of producing obstructive jaundice

and liver cirrhosis

Second most socioeconomically devastating

parasitic disease after malaria

Schistosoma japonicum- Intestinal

schistosomiasis

Schistosoma mansoni- Intestinal

schistosomiasis

Schistosoma haematobium- Urinary

schistosomiasis

Skin penetration by cercaria

Through ingestion of contaminated water

Incubation Period

About 2-6 weeks from skin penetration

Adult female and male parasites

Ova

Miracidium infective stage in snails

Cercaria infective stage in man and

animals

Snail (Oncomelania quadrasi)

Thrives best along river banks, fresh water

streams, creeks, canals and swamps

Greenish-brown in color and is just as big as

the smallest grain of palay

Low-grade fever
Abdominal pain- due to hepatomegaly,
splenomegaly, and lymphadenopathy
Myalgia; fatigue
Cough
Bloody-mucoid stool, dysentery-like
Swimmers itch
Anemia and malnutrition
When parasites reaches the brain--- severe
headache, dizziness, and convulsion

Portal hypertension and signs of liver

cirrhosis
Hematemesis
Pulmonary hypertension
Glomerulonephritis--- Renal failure
KATO-KATZ TECHNIQUE
is a laboratory method for preparing human
stool samples prior to searching for parasite
eggs
is now most commonly used for detecting
schistosome eggs
CIRCUM OVA PRECIPITIN TEST (COPT)
Was used to detect serum antibodies
to Schistosoma mansoni, S. haematobium,
or both species by using eggs of either
species of schistosome
Praziquantel (biltricide) drug of choice;
single oral dose annually
Oxamniquine- exclusively for treating S.
mansoni
Metrifonate- exclusively for treating s.
haematobium
No vaccines are currently available
Eliminating the water-dwelling snails that
are the natural reservoir of the disease
Clearing vegetation thus exposing the snail
to sunshine
Constructing drainage to dry the land
surface where the snails thrive
Improve farming by proper irrigation and
drainage
Diminish infection rate:
Proper waste disposal
Control of stray animals
Avoid bathing in infested streams