COMMUNICABLE

DISEASE NURSING
Christian Jayson E. Agero, R.N.
 Host and Microbial
Interaction
INTRODUCTION

Although most microorganisms

live in harmony with the
human body, some—called
pathogens—can infect the
body and cause disease.
Infectious diseases range
from mild illnesses, such as
a cold, to fatal illnesses,
such as AIDS.

We occasionally come into

contact with people or
animals that are infected
and thus expose ourselves
to the pathogens of their
diseases. In fact, our
environment is such that
everyday we live with some
risk of exposure to
diseases.
 COMMUNICABLE
DISEASE
Is an illness due to an


infectious agent which is

transmitted directly or
indirectly from one person to
another.


A contagious disease is a


communicable disease
transmitted from one person
to another.


Infectious disease is applied to


 Definition of Terms


Symptoms
 evidence of disease that is experienced or
 perceived (subjective)


Signs
 objective evidence of a disease the
physician can
 observe and measure


Syndrome
 a specific group of signs and symptoms
that
 accompany a particular disease

Incidence
 the number of people in a population who
 develop a disease during a particular
time period


Prevalence
 the number of people in a population who
develop a disease, regardless of when it appeared
refers to both old and new cases

Infection
 presence and proliferation of an
infectious agent in the host



Virulence
 The degree of damage that a
microorganism can do to a host .


Pathogenecity
 The ability of an infectious agent to
cause damage to the host.

Infectivity / Invasiveness
 The ability of an organism to invade
and proliferate within the host
that may or may not result to a
disease state




Fomites
 Inanimate objects that can harbor and
transmit microbes


Vector
 Living organism that can transmit
infectious agent in humans

Inoculation
 Introduction of microbes into the host
tissue.




Carriers
Infected individuals who
harbors and capable of
transmitting infectious
agents causing disease to
a susceptible host while
they them selves remain
symptom free.







 3 FACTORS RELATING
TO THE
DEVELOPMENT OF
Agent INFECTION

Host

Environment
Chain of
Infection
 The chain begins with
the existence of a
specific pathogenic
microorganism

The second link is

the reservoir, an
environment where
the pathogen can
survive.
 A. Human Reservoir
 main reservoir of infection.


 1. Frank or typical
 2. Subclinical
 3. Carriers
 4. Contact
 5. Suspect


 B . Animal Reservoir


 C . Inanimate Reservoir
  Type of Carrier


Incubatory Carrier
 capable of transmitting pathogen during the
incubation period


Convalescent Carrier
 transmit disease during convalescence or
recovery period


Active Carrier
 completely recovered from disease but continue
to harbor the pathogen indefinitely


Passive Carrier
 carry the pathogen without ever having the
 T h e th ird lin k is th e
m e a n s o f e sca p e fro m
th e re se rvo ir.

The fourth link is

the mode of
transmission from
the reservoir to the
host.


 Modes of Disease
Transmission


Ø Contact


ØVehicle


ØAirborne


ØVector



 T h e fifth lin k
is th e m e a n s
o f e n try in to
th e h o st

A n d th e la st lin k is
th e h o st's
su sce p tib ility to th e
p a th o g e n ic
m icro o rg a n ism
Factors affecting entry of
infection to the body

Age, sex, genetic constitution



Nutritional status, fitness, environmental factors


Absent of abnormal immunoglobulins

General physical, mental and emotional factors

Status of hematopoietic system, efficacy of
reticuloendothelial system

Presence of underlying disease

Patients treated with radiation, chemotherapy,
corticosteroids or other immunosuppressive
agents.

 Classification of Infectious
Disease


A.Based on Behavior within host



 1. Communicable Disease


 2. Contagious Disease



3. Non Communicable Disease



 B. Based on Occurrence of
Disease



1. Sporadic Disease


 2. Endemic Disease


 3. Epidemic Disease


 4. Pandemic Disease



 C . Based on Severity or Duration of
Disease


 1 . Acute Disease


 2 . Chronic Disease


 3 . Subacute Disease


 4 . Latent Disease

D. Based on Extent of Affected


Host’s Body


 1. Local Infection


 2. Generalized (Systemic)
Infection


 3. Focal Infection

 E. Based on State of Host Resistance


 1. Primary Infection



2. Secondary Infection


 3. Subclinical (Inapparent
Infection)



 F. Based on Acquisition
of the Disease


 1. Community
Acquired


 2. Nosocomial

PRINCIPLE OF
IMMUNIZATION
 Immunity
 - Refers to the body’s specific protective
responses to invading foreign agent or organisms.


 Resistance
 - the body’s ability to withstand infection, but
it does not absolutely mean that one possesses it is
free from disease.

Classes of
Immunoglobulins
IgG
Most important
75% of the total Ig.

Only Ig that can pass the placental

barrier.
IgA
Present in the blood, mucus, human
milk secretions.
Against respiratory pathogens.

 IgM
Firstantibody detected after an
injection of an antigen.


IgD
Present in small number in normal
adult/individual.


IgE
Responsiblefor allergic and
hypersensitivity reaction.

 Host Defense
First line of Second line of
defense defense
Chemical substances Inflammatory response
Cilia Cell-mediated immunity

Normal flora of the body Humoral immunity

TYPES OF IMMUNITY

ACQUIRED IMMUNITY

ACTIVE PASSIVE

NATURAL ARTIFICIAL NATURAL ARTIFICIAL

  Stages of Disease


1. Incubation Period


2. Prodromal Period


3. Period of Illness


4. Period of Convalescence



 INFECTION CONTROL
ENTERIC PRECAUTION


 VISITORS –report to nurses’ station before entering

room
 PRIVATE ROOM - necessary FOR CHILDREN ONLY
 HANDS - washed on entering and leaving room
 GOWNS - worn by all persons having direct contact with
the patient
 MASKS - not necessary
 GLOVES - worn by all persons having direct contact with
patient or with articles contaminated with fecal material
 ARTICLES - special precautions necessary for articles
contaminated with urine and feces; must be disinfected
or discarded
Respiratory
isolation
Strict isolation
Wound and skin
precautions
Reverse isolation
How to prevent
the spread of
the
communicable
disease?
vHealth education
vImmunization
vEnvironmental
sanitation
vSupervision in the
preparation of foods
 Control
Measures
Isolation
Quarantine
Disinfection
Medical
Asepsis
Lymphatic
Filariasi
s
Elephantiasis
Wuchereria
Bancroftian Filariasis
Malayan Filariasis
Filarioidea Infection
 Causative Agent
WUCHERERIA BANCROFTI
BRUGIA MALAYI

BRUGIA TIMORI


 Mode of
Transmission
Vector-borne
Incubation
Period


 adult worm may live in

the host for over 20
years
Clinical
Manifestations
 ASYMPTOMATIC STAGE
 (+) MICROFILARIAE IN THE BLOOD
 NO CLINICAL S/SX
 ACUTE STAGE
 LYMPHADENITIS
 LYMPHANGITIS
 GENETALIA-FUNICULITIS, EPIDYDIMITIS, ORCHITIS
 CHRONIC STAGE
 HYDROCELE
 LYMPHEDEMA (UPPER AND LOWER EXTREMITIES)
 ELEPHANTIASIS

 INCIDENCE-REGION 5,8,11 AND CARAGA,
MARINDUQUE, SARANGGANI


Drug: Diethyl Carbamazine Citrate

(Hetrazan)


Dx:
 NBE (nocturnal blood exam)
 ICT (immunochromatographic test)

Nursing
Considerations
 ENVIRONMENTAL SANITATION


 PERSONAL HYGIENE

 MOSQUITO NETS

 LONG SLEEVES, LONG PANTS AND SOCKS

 INSECT REPELLENT

 SCREENING OF HOUSES

 HEALTH EDUCATION
Filariasis KEY POINTS
 Night biting aedes
poecilius, plants
 Chronic lymphedema
 DEC
 ICT and NBE
 Lymphatic vessel
obstruction

 MALARIA
Marsh Fever
Periodic Fever
King of Tropical Diseases
 plasmodium ovale
plasmodium vivax
plasmodium malariae
plasmodium falciparum


 Mode of
Transmission
Bite from infected female
anopheles mosquito or
anopheles minimus
flavirostris
Blood Transfusion

Sexual cycle (sporogony)

Asexual cycle (schizogony)


Incubation Period
 P.F. and P.V. – 10 -12 days

P.O. – 11 -26 days

P.M. – 12 – 14 days
 Nursing
Considerations
 Dx:
 Blood Smear


 Fever, chills, profuse

sweating-convulsion

  IV FLUIDS AND ELECTROLYTES
 Cx: Blackwater Fever – hemolysis and
hemoglobinuria
 DECREASE FLUIDS IN CEREBRAL EDEMA
 ASSISTED VENTILATION IN PULMONARY EDEMA
 DIALYSIS IN RENAL FAILURE
 BT IN ANEMIA

  TRAVELERS TO MALARIA ENDEMIC area
SHOULD FOLLOW PREVENTIVE MEASURES


 SOAKING OF MOSQUITO NET IN AN

INSECTICIDE SOLUTION

 ON STREAM CLEARING

 VECTORS PEAK BITING AT NIGHT 9PM-3AM

 PLANTING OF NEEM TREE

 ZOOPROPHYLAXIS

 INFECTED MOTHER CAN STILL CONTINUE
BREAST FEEDING
 MALARIA key points
 Night biting anopheles, running water
 Falciparum – fatal
 Ovale and vivax – exacerbate
 Sporogony – sexual – mosquito
 Schizogony – asexual – human
 Chloroquine
 Seizure, fluid and electolyte loss
 Rbc and liver

 Dengue
Fever
Hemorrhagic Fever
Break Bone or Dandy
Fever
Dengue Shock Syndrome
 Causative Agent
DENGUE VIRUS TYPE
ARBO VIRUS


Mode Of
Transmission
Aedes aegypti
Aedes albopictus

Culex fatigans


Incubation Period

4 – 6 days
  Dx:
 ACUTE FEBRILE ILLNESS WITH NO
IDENTIFIABLE FOCUS OF INFECTION
 Internal and external sign of bleeding

 Torniquet Test or Rumpel Leade Test

 Platelet count

 PT (Prothrombin Time)

 APTT (Activated Partial Thromboplastin

Time)
 Bleeding time

 Coagulation time


  TRIAD (FEVER, RASH, SEVERE
HEADACHE/BACKACHE/MYALGIA)


 1ST STAGE, FIRST 2-3 DAYS HIGH FEVER,

ABDOMINAL PAIN, HEADACHE, FLUSHING,
VOMITING, EPISTAXIS

 2ND STAGE, 4-7 DAYS TOXIC OR
HEMORRHAGIC STAGE LOWERING OF BODY
TEMP., SEVERE ABDOMINAL PAIN, VOMITING,
GIT BLEEDING-HEMATEMESIS, MELENA,
NARROW BP, SHOCK


 3RD STAGE, 7-10 DAYS CONVALESCENT OR

RECOVERY STAGE SIGN OF PLASMA LEAKAGE
PLEURAL EFFUSION, ASCITES,
HYPOPROTEINEMIA
  GRADE 1 (+) TORNIQUET TEST, NO BLEEDING

 GRADE 2 SPONTANEOUS BLEEDING

 GRADE 3 CIRCULATORY FAILURE,,DECREASED
BP, RAPID WEAK PULSE, NARROWING OF
PULSE PRESSURE, COLD CLAMMY SKIN,
RESTLESSNESS

 GRADE 4 PROFOUND SHOCK, UNDETECTABLE
BP AND PULSE

Nursing
Considerations

D - daily monitoring of patient’s status
E - encourage intake of oral fluids

N – note any dengue warning signs

G – give paracetamol for fever and NOT

aspirin
U – use mosquito nets

E – early consultation is advised for any

warning signs
  BLOOD TRANSFUSION
 IV CRYSTALLOIDS (PLAIN LRS, PLAIN 0.9
NSS)
 DEXTRAN (COLLOIDS)

 PLATELETS

 FRESH FROZEN PLASMA

 CRYOPRECIPITATE

 WHOLE BLOOD

 NO KNOWN IMMUNIZATION (VACCINE

CURRENTLY UNDERWAY)

 Dengue KEY POINTS
 Day biting aedes aegypti, stagnant
 Fever with no focal of infection
 Bleeding is imminent when fever subsides
 Fluid replacement
 BT
 Platelets

PREPARE ¼ SHEET
OF PAPER FOR
THE POST TEST