CPHM

• Bacillary dysentery (Shigellosis)


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


  • Shigella sonnei
  • Shigella boydii
  • Shigella flexneri
  • Shigella dysenteriae
• Source of infection for Shigellosis


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


  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
• Susceptibility, Resistance and Occurrence of Shigellosis

  Disease is more common and more severe in children than in adults
• Methods of prevention and control for Shigellosis


  • 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, Spleenomegaly, rose spots on trunks and diarrhea
• Causative agent of Typhoid

  Salmonella enterica serotype TYPHI
• Source of infection for Typhoid

  Feces and urine of infected person. Family contact may be transient carrier. Carrier state is common among person over 40 years of age especially female
• Mode of transmission for Typhoid

  Direct or indirect contact with patient or carrier. Principal vehicles are food and water. Contamination is usually by hands of 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 virus introduced by focally contaminated water or food
• 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 patient
• 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

  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 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


  It is 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
• 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


  Is an acute viral encephalomyelitis caused by the Rabies virus, a rhabdovirus of the genus Lyssavirus
• Types of rabies


  • Urban or canine rabies is transmitted by dogs
  • Sylvatic rabies is a disease of wild animals and bats which sometimes spread to dogs, cats, and livestock
• Prevalence of rabies in the Philippines


  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
• Susceptibility and resistance to rabies

  All warm blooded mammals are susceptible. 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
• Management and prevention of rabies


  • The wound must be immediately and thoroughly washed with soap and water. Antiseptic such as povidone iodine or alcohol may be applied
  • The patient must be given antibiotics and anti-tetanus immunization
  • Post exposure treatment is given to persons who are exposed to rabies. It consists of local wound treatment, active immunization and passive immunization
  • Consult a veterinarian or trained personnel to observe your pet for 14 days for sign of rabies
  • Be a responsible pet owner
  • Consult for rabies diagnosis and surveillance of the area
  • Mobilize for community participation
• Goals and objectives of the National Rabies Prevention and Control Program


  • Goal: Human rabies is eliminated in the Philippines and the country is declared rabies-free
  • To reduce the incidence of human rabies from 7 per million to 1 per million population by 2010 and eliminate human rabies by 2015
  • To reduce the incidence of canine rabies from 70 per 100,000 to 7 per 100,000 dog by 2010, and eliminate canine rabies by 2015
• Scabies


  A communicable disease of the skin characterized by eruptive lesions produced by the burrowing of the female parasite into the skin
• Causative organism of Scabies


  Sarcoptes scabiei, itch mite. The female parasite is easily visible with a magnifying glass. Burrows beneath the epidermis to lay her eggs, and set up an intense irritation