COMMUNICABLE D

• Communicable disease


  Illnesses caused by an infectious agent or its toxic products that is transmitted directly or indirectly to a person, animal, or intermediary host or inanimate environment
• Contagious disease


  Transmitted through direct physical contact
• Infectious disease


  Transmitted indirectly through contaminated food, body fluids, objects, airborne inhalation or through vector organisms
• Communicable diseases are one of the major public health problems in the Philippines and leading causes of morbidity
• Globally, new HIV infections declined by 38% between 2001 and 2013, and existing cases of tuberculosis are declining, along with deaths among HIV-negative tuberculosis cases
• Epidemiologic Triangle Model


  • Agent (organism involved in the development of the disease)
  • Host (any organism that harbors and provides nutrition for the agent)
  • Environment (condition in which the agent may exist, survive or originate)
• Chain of Infection


  1. Causative agent

  2. Reservoir

  3. Port of exit

  4. Mode of transmission

  5. Portal of entry

  6. Susceptible host
• Causative agent


  Any organism capable of producing a disease, including bacteria, viruses, rickettsiae, fungi, protozoa and helminths
• Reservoir


  The environment or object in or on which an organism survives and multiplies. Inanimate objects, human beings and other animals can serve as reservoir
• Portal of exit


  Path by which an agent leaves its reservoir, e.g. respiratory, genitourinary
• Mode of transmission


  Means by which the agent passes from the portal of exit in the reservoir to the susceptible host, e.g. airborne, droplet, vector
• Portal of entry


  Path by which an agent invades a susceptible host, usually the same as portal of exit
• Susceptible host


  Various factors of the individual that present barriers to the invasion and multiplication of agent
• Diseases targeted for global eradication and elimination

  • Poliomyelitis
  • Smallpox
  • Lymphatic filariasis
  • Measles
  • Hepatitis B
  • Rubella
  • Taeniasis
  • Dracunculiasis (guinea worm disease)
  • Malaria
  • Neonatal tetanus
  • Rabies
  • Leprosy
  • Filariasis
  • Schistosomiasis
  • Chagas disease
  • Trachomatis
  • Onchocerciasis
  • Iodine deficiency disorders
  • Yaws
• Functions of public health nurses in control of communicable diseases

  • Report immediately to the Municipal Health Office any known case of notifiable disease
  • Refer immediately to the nearest hospital
  • Conduct a strong health education program directed toward prevention of an outbreak
  • Assist on the diagnosis of the suspect based on the signs and symptoms
  • Conduct epidemiological investigations as a means of contacting families' case finding and individual as well as community health education
• Tuberculosis


  Also known as Phtisis, Consumption disease, Koch's disease
• Tuberculosis


  • Causative agent: Mycobacterium tuberculosis, Mycobacterium africanum, Mycobacterium bovis
  • Mode of transmission: Airborne droplet through inhalation of coughing, singing or sneezing
  • Incubation period: 4-6 weeks
  • Signs and symptoms: low grade fever in late afternoon, loss of appetite, easy fatigability, night sweats, dry cough then later productive with hemoptysis, chest pain

  
• Laboratory diagnostic tests for tuberculosis

  • Direct Sputum Smear Microscopy (DSSM)
  • Chest x-ray
  • Tuberculin skin test (TST) / PPD test or Mantoux test
• Sputum specimen collection for tuberculosis

  1. Motivate the presumptive TB patient to undergo sputum exam (DSSM)

  2. Explain the importance of the procedure and that of submitting two (2) sputum specimens

  3. Prepare the sputum cups and the Form 2a. NTP Laboratory Request Form

  4. Demonstrate how to produce quality sputum

  5. Collect at least 1 teaspoonful (5-10ml) for DSSM. For Multi Drug Resistant TB, sputum sample should not be less than one (1) ml

  
• Roles and responsibilities of the nurse in the NTP and DOTS strategy

  • Administrator
  • Health educator
  • Case manager and coordinator
  • Community organizer
  • Treatment partner
  • TB program advocate
• Dengue Hemorrhagic Fever


  Also known as Hemorrhagic fever, Break bone, Dandy fever, Dengue Shock syndrome
• Dengue Hemorrhagic Fever


  • Causative agent: 4 serotypes - DENV-1, DENV-2, DENV-3, and DENV-4
  • Mode of transmission: Mosquito-borne
  • Symptoms: 3 categories - Undifferentiated Fever, Dengue Fever (DF), Dengue Hemorrhagic Fever (DHF)
• Laboratory/Diagnostic tests for Dengue Hemorrhagic Fever

  • Tourniquet test (Rumpel Leads test)
  • Capillary refill test or Nail blanch test
  • Platelet count and Hematocrit
  • Hemagglutination–inhibition test

  
• Nursing management for Dengue Hemorrhagic Fever

  1. Give Paracetamol every 6 hours

  2. Encourage oral intake of Oral Rehydration Solution (ORS)

  3. Avoid dark-colored foods

  4. Ensure bed rest and protect from trauma

  5. Do not give IM injections

  6. Instruct to bring to the hospital if with severe symptoms

  7. Provide blood transfusion if severe bleeding is suspected

  8. Place patient in DORSAL RECUMBENT position in case of shock

  9. Monitor laboratory results especially platelet and hematocrit
• Malaria


  Also known as Marsh fever, Periodic fever, King of tropic disease
• Malaria


  • Causative agents: Protozoa genus Plasmodium (P. Falciparum, P. Vivax, P. Ovale, P. Malariae, P. Knowlesi)
  • Mode of transmission: Vector - Female Anopheles mosquito
• ds


  • Ensure bed rest and protect from trauma
  • Do not give IM injections
  • Instruct to bring to the hospital if with severe abdominal pain, no clinical improvement, persistent vomiting, cold and clammy extremities, lethargy or irritability, bleeding, black stools or coffee ground vomiting, no urine more than 4-6 hours
• Blood transfusion


  Should be given as soon as severe bleeding is suspected or recognized
• Shock


  Place patient in DORSAL RECUMBENT position
• Monitor laboratory results especially platelet and hematocrit
• Malaria


  A serious and sometimes fatal disease caused by a parasite that commonly infects a certain type of mosquito which feeds on humans
• Other names for malaria

  • Marsh fever
  • Periodic fever
  • King of tropic disease
• Causative agents of malaria

  Protozoa genus Plasmodium (P. Falciparum, P. Vivax, P. Ovale, P. Malariae, P. Knowlesi)
• Mode of transmission of malaria

  Vector - female Anopheles mosquito
• Travel history in a malaria-endemic area e.g. Palawan and Mindoro
• Laboratory / Diagnostic tests for malaria

  • Blood smear
  • Rapid Diagnostic test (RDT)
• Triad of malaria symptoms

  • Recurrent fever preceded by chills and profuse sweating
  • Malaise
  • Anemia
• Prevention and control methods for malaria

  • Mosquito control
  • Chemical methods - use of insecticides
  • Biological methods - steam seeding
  • Zooprophylaxis - larvae-eating fish, farm animals should be kept near the house
  • Environmental methods - cleaning and irrigating canals
  • Screening of houses
  • Educational methods
  • Mechanical methods - use of fly swats or traps
  • Universal precaution
  • Screening of blood donors
• Filariasis


  A serious and sometimes fatal disease caused by a parasite that commonly infects a certain type of mosquito which feeds on humans
• Causative agents of filariasis

  Wuchereria bancrofti, Burgia malayi