Communicable Diseases & Global Health

Communicable Disease Nursing

• Communicable diseases are a primary cause of mortality disparities between wealthy and impoverished nations.
• Non-communicable diseases (NCDs) account for 74% of global deaths, posing a significant global health concern with an expected impact in 2024.
• Approximately 60% of deaths from communicable diseases are attributable to HIV/AIDS, malaria, tuberculosis, measles, diarrheal disease, and acute respiratory infections.
• An acute respiratory infection is an illness stemming from infectious agents or their toxins, readily transmitted directly or indirectly between individuals or animals.
• Both infectious and contagious diseases are communicable.
• All contagious diseases are communicable; however, not all communicable diseases are contagious.

Leading Causes of Morbidity & Mortality in the Philippines (2023)

• Ischemic heart disease is the primary cause of death.
• Cerebrovascular diseases (strokes) are a major health concern.
• Neoplasms (cancer) are the second leading cause of death.
• Diabetes mellitus requires lifestyle changes.
• Chronic lower respiratory diseases (e.g., COPD) are a significant cause.
• Tuberculosis necessitates early detection and treatment.
• Neonatal disorders contribute to infant mortality, requiring maternal and child health services.
• Road traffic accidents are a leading cause of death in younger age groups.
• Liver diseases are a growing concern, requiring hepatitis vaccination and lifestyle modifications.
• Pneumonia was a significant cause of death, especially in 2019.

Host and Microbial Interaction

• Microorganisms typically coexist harmoniously with the human body, but some pathogens can cause infection and disease.
• Infectious diseases span from mild conditions, like the common cold, to severe illnesses, such as AIDS.
• Contact with infected individuals or animals carries the risk of exposure to pathogens.
• Constant exposure to diseases is a reality of our environment.
• A communicable disease spreads from one host to another, directly or indirectly.
• A contagious disease spreads directly from person to person.

Infectious Disease Classification

• An infectious disease isn't necessarily spread by casual contact but needs direct inoculation via a break in an intact mucous membrane; all contagious diseases are infectious.
• Examples of communicable diseases include herpes, malaria, mumps, HIV/AIDS, influenza, chickenpox, ringworm, and whooping cough.
• Cancer is not a communicable disease.
• A carrier is an individual harboring an organism capable of transmission to a susceptible host without showing disease symptoms.
• A contact is any person or animal in close proximity to an infected individual or contaminated material.

Occurrence of Disease

• Sporadic disease occurs occasionally with no specific pattern (e.g., botulism, tetanus).
• Endemic disease is constantly present in a population or country (e.g., pulmonary tuberculosis, malaria).
• Epidemic disease involves patients acquiring the illness in a short timeframe, exceeding the normal number of cases in an area (e.g., cholera, typhoid).
• Pandemic disease is an epidemic occurring worldwide (e.g., HIV infection, SARS-CoV-2, COVID-19).

Severity or Duration of Disease

• Acute disease develops rapidly with a short duration (e.g., measles, mumps, influenza).
• Chronic disease develops slowly with a long duration (e.g., TB, leprosy).
• Subacute disease is intermediate between acute and chronic (e.g., bacterial endocarditis).
• Latent disease involves an inactive causative agent that later becomes active (e.g., chickenpox to shingles, amoebiasis).

Extent Of Affected Host Body

• Local infection: Microbes invade a small area (e.g. ear infection, boil, urinary bladder infection).
• Generalized (Systemic) Infection: Spreads through the body by blood or lymph (e.g., measles).
• Focal infection: Localized or generalized infection from microorganisms or toxic products from a distant area (e.g., microorganisms from the mouth).
• Infective endocarditis is a condition associated with oral cavity diseases.
• Osteomyelitis may arise from oral microorganisms.
• Gastritis can be caused by oral microorganisms.
• Middle-ear suppurations is an infectious disease that can originate from oral microorganisms.

Host Resistance

• Primary infection: Acute infection causing the initial illness (e.g., primary HIV, TB, skin infections).
• Secondary infection: Caused by an opportunistic pathogen when the body's defenses are weakened, can be viral or bacterial.
• Subclinical (Inapparent) Infection: Does not cause noticeable illness.
• Decline Period: Pathogen replication is controlled, increasing vulnerability to secondary infection; symptoms start decreasing.
• Convalescence Period: Pathogen replication stops, strength returns, and the body recovers to its pre-diseased state.

Notes Regarding Immunity

• Acquired immunity against a pathogen might halt disease progression during the prodromal period due to a rapid immune response.
• Acquired immunity can result from vaccination or previous exposure.

Microbes Against Humans

• Symptoms are subjective evidence of disease that are experienced.
• Signs are objective evidence of disease that can be observed and measured.
• A syndrome is a specific group of signs and symptoms that accompany a particular disease.
• Incidence is the number of new cases in a population.
• Prevalence is the total number of cases in a population, both old and new.

Cycle of Disease

• Incubation Period: Time between initial infection and first symptom appearance; the patient is unaware of the disease.
• Prodromal Period: Characterized by early, mild symptoms of the illness.
• Period of Illness: Time of the greatest symptomatic experience where overt signs/symptoms appear, and the white blood cell count may increase or decrease; death can result if immune response or medical intervention fails.
• Infection is a condition caused by the entry and multiplication of pathogenic microorganisms within a host body
• Pathogenicity is the ability to cause disease.
• Infective dose is a number of microorganisms are needed to initiate infection.
• Virulence is the level of disease severity together with the invasiveness of microorganisms and the ability to enter and move through the tissue.
• The organism's specificity is the host preference).
• Resistance is a host and immunity of the host.

Chain of Infection

• Begins with a specific pathogenic microorganism.
• The second link is the reservoir, an environment where the pathogen can survive.
• The third link is the means of escape (mode of exit) from the reservoir.
• The fourth link is the mode of transmission from reservoir to host.
• The fifth link is the means of entry into the host (mode of entry).
• The last link is the host's susceptibility to the pathogenic microorganism.

Infection Control

• As a first line of defense, hand hygiene is paramount for infection prevention.
• Handwashing is the most important preventive measure.
• Immunity is the state of being secure against a particular disease, specifically the power a living organism has to resist and overcome infection.
• Immunity is an individual's resistance against disease.
• The immune system protects against infective or allergic diseases through antibodies, immunoglobulins, and related resistance factors.
• An antibody is a specific substance produced by lymphocytes in response to the introduction of an antigen.
• An antigen triggers the immune system; causing the body to produce antibodies.

Types Of Antigens

• Inactivated (killed) organisms are not long-lasting, need multiple and booster doses;.
• Attenuated (live weakened) organism entails single dose, long-lasting immunity, and all vaccines will lose their potency over time.
• Toxoids are chemically inactivated toxins used in toxoid vaccines.
• Hepatitis A is an inactivated virus vaccine with protection for up to 10+ years.
• Rabies is protected against with an inactivated virus vaccine •.
• Polio is vaccinated against with an inactivated virus vaccine.
• Influenza is defended against with an inactivated vaccine.
• Attenuated antigens: Used for diseases like Measles, Mumps, Rubella, Chickenpox, Shingles, Influenza, Yellow fever, and Japanese encephalitis.

Types Of Immunity

• Natural immunity is an innate part of the immune system within the host.
• Acquired immunity from outside the host, are both natural or artificial (active or passive).
• Natural active immunity is acquired through exposure or diseases and recovery.
• Natural passive immunity through maternal antibodies is acquired through placental transfer.

Vaccination

• Artificial active immunity comes from the introduction of an antigen (e.g., vaccines, toxoids for preventive measures), providing long-term immunity.
• Artificial passive immunity comes from the introduction of antibodies (e.g., antitoxins, immunoglobulin, antiserum), offering temporary protection.
• Tetanus Toxin (TAT) gives short immunity after exposure, and tetanus shots must noted depending on pregnancy..
• All vaccines lose potency over time; expiry dates should be monitored.
• Heat and sunlight damage live vaccines, especially.
• Freezing harms killed vaccines and toxoid vaccines.
• In cleaning the refrigerator or freezer, only use water - antiseptics, disinfectants, detergents, or alcohol lessen vaccine potency.
• Keep Vaccines in the correct cold temperature (0-8c).

Immunization Programs

• The expanded Program on Immunization (P.D. 996) goal is universal child immunization.
• Vaccines include: BCG, Hepatitis B, OPV, Rota Virus, IPV, Pentavalent, Japanese Encephalitis, Vitamin A, DPT, Measles, and MMR
• Republic Act No. 7846, entitled "An Act Requiring Compulsory Immunization Against Hepatitis-B for Infants and Children" covers those under eight years old.
• A common goal to prevent childhood diseases covered by the Expanded Program on Immunization includes TB, Measles, Diphtheria, Pertussis, Polio, and Hepatitis.
• IgG is the most prevalent antibody (80%), produced later in the process.
• IgA is responsible for immune response, the only Ig able to cross placental barrier, is found in colostrum, tears, saliva, and sweat.
• IgM is the principal antibody in blood, produced quickly in response to an antigen, responding to artificial immunization.
• IgE responds to allergic reactions.
• IgD is an unknown antigen receptor, found on the surface of B cells.

Immunization

• Contraindications include: Severe febrile illness; live virus vaccines generally not administered with altered immune systems; An allergic reaction.
• Permanent contraindications: Allergy, encephalopathy for unknown reason, Convulsion within 7 days after pertussis vaccine.
• Temporary contraindications include: Pregnancy, being immunocompromised, having a very severe disease, previously having blood products/transfusion.

Epidemiology And Disease Transmission

• The reservoirs of infection are any location where the pathogen can multiply and survive until transferred to a host.
• Human Reservoir: The main and primary reservoir of human disease which is transmitted either by direct contact to those who are symptomatic, or by carriers harboring pathogens.
• Susceptible Host: can be recognized through it's high-risk factors such as being immunocompromised, diabetic, having had surgery, or burns, or being elderly.

Preventing The Spread Of Communicable Diseases

• Community vs. Nosocomial. A community-acquired Infection is an Infection present or incubating at the time.
• CA 2-COMMUNICABLE DISEASES, Republic Act No. 7846, entitled “An Act. Requiring Compulsory. Immunization Against. Hepatitis-B for eight or younger year old Infants and Children, Common Goal to Prevent childhood infections covered by the. Expanded Program immunization like. TB, Measles, Diphtheria, Pertussis, Polio, or Hepatitis

Preventing the Spread of Infections

• Nosocomial Infection or hospital acquired is an infection during the course of hospital stay rather than previously at the time of admission. Examples are: surgical, Urinary Tract Infections, Lower Respiratory Infections, or Bacteremia.
• Factors and prevention methods include: Controlling contamination in the Microorganism/Hospital Environment; and handling Food and Utensils with high quality.
• A compromised host can be caused by impaired resistance or a suppressed immune system,. with precautions like use of airborne contamination, removing linen and bacteria.
• Medical Asepsis (CLEAN TECHNIQUE): Reduces the number and transfer of pathogens as well thorough washing.
• Use proper cleaning of supplies and equipment plus sterlization.

Universal Precautions (Standard Precautions)

• These are defined the center for disease control (CDC) 1996, and designed as a Primary strategy for both reducing the risks of Nosocomial infections while used for each hospitalized patient,
• Protect yourself with routine and antimicrobial soap, hand washing, and body protecting during blood or fluid touchups.
• Use patient care equipment for those whom may get microbes
• Handling linens as cleanly as possible through contaminated areas

Transmission - Based Percautions

• The second tier of precaution is for patients who have a known or suspected highly transmissible infection.
• The three transmissions are: Airborne precautions, Droplet precautions, and contact precaution.
• It is imperitave to report to the Nurse Station Before Entering the Room as a patient
• Proper personal protection is crucial, or Protective Equipment (PPE).
• Isoloation of patients is needed in protective or sterile ways depending on their diseases.

Isolations

• Stict Isolation: Highly Virulent Infections Spread Through air and Contact
• Respiratory: Transmitted infectious diseases Primarily Over, Mask needed for close contact, not gloves,.
• Contatct: Highly Transmissible infections that do not require strcit isolation. Type TUBERCULOSIS. For Client With PTB Who Has Positive.

Precaution For Blood Borne Pathogens

• All those entering must be as sterile as possible in masking and sanitation.
• CA 2. - COMMUNICABLE is essential to wear. For Client With PTB Who Has Positive,. Isolate if necessary, masks/Gloves and Wear if soiled.
• Diseases are Required and sterilized for like hepatitis and diahrea
• Other precautions for secreations in draining
• More severe with enteric cases

Other Factors in infection controls

• Care needs to be given regarding both proper secreation expulsions as well as environmental controls
• Precatuions such as blood sugar and glucose need to be given before in any case of contact through mucous or infectious membranes
• Care needs to be shown to injuries (needles, scalpels)
• Waste management follows protocols with colored/marked bags depending on item being disposed of (sharps to Black plastic bags )
• The spread can be managed by: 1.Limination 2. Interruption 3. Protection

Infetious Diseases

• CLASSIFIED AS: Blood/vector borne, diseases. Enteric, Eruptive fever. Respiratory, diarrhea etc
• CLASSIFIED AS: Blood/vector, malaria, Leptospirosis,
• Enteric, Hepittis,
• Erupt, Measles, Rubeola, Varicella
• Repiraroty, Pneumonia, Mumps, Diptheira, TB

Dengue Fever

• Symptoms include: (H-Feveer, Dandy Fever, Breakbone fever) with fever and HemMorhagic ManiFestations and. Laboratory Findings Of Thrombocytopenia and Hemoconcentration.
• Pathogenisis is through complex rx, and thrombocytopenia and Faulty Maturity
• Vectors are Aedes Aegypti's where They Appear by Biting After Sunrise/Sunset where Mosquitoes have Stripes

Diagnoisis Criteria and Assessment for Dengue

• Diagnose by High Continuos Fevering and Torniquet as Assessment.
• Test also by Spontaneous Bleeding or laborarotry tests for lower platelets
• Labortoty test for Platelets and Hematoocrit
• Assessments for these count, fever and tourniwuiet
• Treatment for Platelet Count and Labortorty
• DHF and HcT may cause Shock for high hemoglovin leading to Dengue Shock

Pathophysiologu and Dengue S/Sx

• Transmission by Aedes Mosquitos as Pathophsiologu. and results by high infection. Pathogensis by activation ad lymphocres
• SymtptomS, mild fever, headached abdominal pains,
• Severe types can can purpligsh extremeties,
• Leads to treatement

Medial management of Dengue, and Prevention

• No antivial availbale. only treatmnet for Symphomatic
• Donnt provie aspirint/ivf
• O2 therapy ad sedation and nasal packing are needed.
• Symptomatic tx
• Mosquito free environent
• Vs Monitorization as priority

Preventative Steps and Treatments

• Use Water drums or flower base protectors like C- hemcially treated Mosquito Nets
• Use Self Protection of long sleeves forday time with early dectection
• Use 4 " s to Find Destroy Mosquitoes or fogging

Malaria(Ague)

• In fevers, or Topicaal Disease, malaria is trasnmitted though parastictics
• Tranmission though protoza, sporiutation for segmentaiton

Med Management, s//Sx, Stages of Malariaa

• Treat with IV and Anti- Malaria where consideraiton is also given to mosquito nets and skein preotection Cold: Chilling and chattering Hot stage: High grade and temeprature Wet stage: Sweating

Types of Infections and Clinical Manifestations

Infections can start from Vector or through Transmition, where 1 st clinical signs include : Significant increase of malaria

• S/SX mindoro zambanga Cavaite
• Classify through Lympth
• Transmission through Person

Filariasis Prevention

Affects many men, womends, and children causing disfigurement by worm transmition

Leptospirosis and s//Sx

• Comes Through Animal Contaimantion often causing jaundice Leptospirosis, Canicola Fever • a zoonotic systemic infection caused by Leptospira, that penetrate intact and abraded skin through exposure to water

Transmission, Preventative Measures,and Managmentn for Leptospirosis

• Through animal transmition and Urine, where Treatmens inclue supportice/antihestimane/ or antibiotics and Cleaniness for preventaitive Contact of skin or open wound from soil Contact - Transmitted food contaminated in feces, and Prevent with Hand sanatiation,

Typhoid Fever, Signs, and Trasmission

• Transmission through Contaimated water(Bacterial) with Contanimatined oyster , where it affecs the lymphoid system (SI) and is prevented by aboiding expore, as well as roedent controo . MODE OF TRANSMISSION Oral ingestion Bacterial Contaiminitaiojn

Diagnostics for Typhoid Fever, and S/SX

Prodromal 1st week: Step ladder fever

• Diagnosist 1st week step, 2nd week rose + spots as Blood test . with antibiotics as treatmnet

Medical Support of Diseases

• Transmitted though Feces, a type of infection can be controlled with hygiene(shytosome)
• Transmitted though Feces, a type of infection can be avoided with cleaner, and sanation. and preogesterations are in place
• Transmited though Blood with B, AIDS requires reverse isolation for transmittions:

General Preventitive Actions and Diagnosis

• Test with cultrues, and prevent though good hand wash, and sanation

TB and Menongococcus

• To fully sanitize and use proper tools, TB can be fully eradicated and be a threat.

Menongogoccus comes through bacteria in droplets and must be managed through Antibiotics.

Diptheria and its Treatment

Airborn diseases can require proper ventilation, and must have the patient take proper steps to maintain safety

###Pertusis and Pneumonia

• With proper medications and intervention, many disease cycles can be broken to aid a patient with a particular disease.

• CA 2 – COMMUNICABLE DISEASES Observe

IsolationObserve respiratory

• Isoloation needs to have as many precautions and a the high attention to detail , plus full follow up as needed.

Genital War, and Infection Control

• Through sexual Transmittions it is essential to be as sanitary as possible by taking the correct medication and following medical routes for recovery from Sexually Transmitted Infection
• Contaminate may require Antibiotics or with cleaness