CPHM MIDTERMS WEEK 11

• Bacillary dysentery (Shigellosis)


  An acute bacterial infection of the intestine characterized by diarrhea, fever, tenesmus and in severe cases bloody mucoid stools
• Bacillary dysentery


  • Severe infections are frequent in infants and in elderly debilitated persons
• Causative agent of bacillary dysentery

  • Shigella sonnei
  • Shigella boydii
  • Shigella flexneri
  • Shigella dysenteriae
• Source of infection for bacillary dysentery


  Feces of infected persons, many in apparent mild and unrecognized infection
• Mode of transmission for bacillary dysentery


  Eating of contaminated foods or drinking contaminated water and by hand to mouth transfer of contaminated materials; by flies, by objects soiled with feces of a patient or carrier
• Methods of prevention and control for bacillary dysentery


  • Sanitary disposal of human feces
  • Sanitary supervision of processing, preparation and serving of food particularly those eaten raw
  • Adequate provision for safe washing facilities
  • Fly control and screening to protect foods against fly contamination
  • Protection of purified water supplies
  • Control of infected individual contacts and environment
  • Isolation of patient during acute illness
• Typhoid


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

  
  

  Many mild typical infections of typhoid are often unrecognized
• Causative agent of typhoid


  Salmonella enterica serotype TYPHI
• Source of infection for typhoid


  Feces and urine of infected people. Family contact may be a transient carrier. Carrier state is common among people over 40 years of age, especially females
• Mode of transmission for typhoid


  Direct or indirect contact with patient or carrier. Principal vehicles are food and water. Contamination is usually by the hands of the carrier. Flies are vectors
• Methods of prevention and control for typhoid


  • Same as preventive and control measures as in Dysentery
  • Immunization with vaccine of high antigenicity
  • Education of the general public and particularly the food handlers
• Hepatitis A


  A form of hepatitis occurring either sporadically or in epidemics and caused by viruses introduced by focally contaminated water or food

  
  

  Young people especially school children are most frequently affected by hepatitis A
• Causative agent of hepatitis A


  Hepatitis A virus
• Predisposing factors for hepatitis A


  • Poor sanitation
  • Contaminated water supplies
  • Unsanitary method of preparing and serving of food
  • Malnutrition
  • Disaster and War time condition
• Signs and symptoms of hepatitis A


  • Influenza-like symptom and headache
  • Malaise and easy fatigability
  • Anorexia and abdominal discomfort
  • Nausea and vomiting
  • Fever
  • Lymphadenopathy
  • Jaundice
  • Bilirubinemia with clay colored stool
• Management of hepatitis A


  • Prophylaxis- IM injection of gamma globulin
  • Complete bed rest
• Prevention and control of hepatitis A


  • Ensure safe water or drinking
  • Sanitary method in preparing, handling and serving food
  • Proper disposal of urine and feces
  • Washing hands very well before eating and after using the toilet
  • Separate and proper cleaning of articles used by patients
• Paralytic shellfish poisoning


  A syndrome of characteristic symptoms predominantly neurologic which occur within a minute or several hours after ingestion of poisonous shellfish
• Causative agent of paralytic shellfish poisoning


  Single-celled organism called Dinoflagellates: it is commonly referred as plankton
• Organism that causes red tide in the seas around Manila bay, Smar, Bataan and Zambales(Paralytic Shellfish Poisoning)


  Pyromidium bahamense var. compressum
• Mode of transmission for paralytic shellfish poisoning


  Ingestion of raw or inadequately cooked seafood usually bi-valve shellfish or mollusk during red tide season
• Signs and symptoms of paralytic shellfish poisoning


  • Numbness of face especially around the mouth
  • Vomiting and dizziness
  • Headache
  • Tingling sensation and eventually paralysis of hands and feet
  • Floating sensation and weakness
  • Rapid pulse
  • Difficulty of speech (ataxia) and difficulty in swallowing (dysphagia)
  • Total muscle paralysis with respiratory arrest and death occur in severe cases
• Management and control of paralytic shellfish poisoning


  • No definite medication indicated
  • Drinking pure coconut milk and sodium bicarbonate solution weakened the toxic effect of red tide. It is advised to take these solutions in the early stage of poisoning only
  • Shellfish affected by red tide must not be cooked with vinegar as the Toxin Pyromidium increases when mixed with acid
  • Toxin of red tide is not totally destroyed upon cooking hence consumers must be educated to avoid bi-valve mollusk such as tahong, talaba, halaan, kabiya when red tide warning has been issued by proper authority
• Leptospirosis


  A World wide zoonotic disease. Rat is the main host of the disease although pigs, cattle, rabbits and other wild animals can also serve as reservoir hosts
• Leptospirosis is an occupational disease affecting veterinarians, miners, farmers, sewer, workers, abattoir workers, etc.
• Causative agent of leptospirosis


  Leptospira interrogans
• Mode of transmission for leptospirosis


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


  • Leptospiremic phase - Leptospires present in blood and CSF. Onset of symptoms are abrupt with fever, headache, myalgia, nausea, vomiting, cough and chest pain
  • Immune phase - Correlates with the appearance of circulating IgM
• Treatment for leptospirosis


  • Penicillin
  • Tetracycline
  • Erythromycin
• Prevention and control of leptospirosis


  • Improved education of people at particular risk
  • Use of protective clothing boots and gloves especially by worker with occupational hazards
  • Rats and other potential hosts control
  • Investigation of contacts and source of infection
• Rabies(Hydrophobia, Lyssa)


  An acute viral encephalomyelitis caused by the Rabies virus, a rhabdovirus of the genus Lyssavirus
• Rabies is fatal once the signs and symptoms appear
• Types of rabies

  • Urban or canine rabies - transmitted by dogs
  • Sylvatic rabies - a disease of wild animals and bats which sometimes spread to dogs, cats, and livestock
• Rabies remains a public health problem in the Philippines. Approximately 300-600 Filipinos die of rabies every year
• Philippines has the highest prevalence rate of rabies in the world
• Mode of transmission for rabies


  Usually by bites of a rabid animal whose saliva has the virus, The virus may also be introduced into a scratch or in fresh breaks in the skin (very rare) transmission from man to man is possible
• Incubation period for rabies


  The usual incubation period is 2 to 8 weeks. It can be as long as a year or several years depending on the severity of wounds, site of the wound as distance from the brain, amount of virus introduced and protection provided by clothing
• All warm blooded mammals are susceptible to rabies. Natural immunity in man is unknown
• Signs and symptoms of rabies


  • Headache
  • Fever
  • Sensory change near the site of animal bite
  • Spasm of muscles or deglutition on attempt to swallow (fear of water)
  • Paralysis
  • Delirium and convulsion
• Without medical intervention, the rabies victim would usually last only 2 to 6 days. Death is often due to respiratory paralysis