Communicable Disease Types & Infection PDF

**[COMMUNICABLE DISEASE]** - - - **TYPES** A. B. **CHAIN OF INFECTION** - 1. - - 2. - 3. - 4. - A. Contact a. b. c. - - Droplet Nuclei ---- aka Airborne - - - Vector-borne - - - - B. VERTICAL ---- mother to child - -...

**[COMMUNICABLE DISEASE]** - - - **TYPES** A. B. **CHAIN OF INFECTION** - 1. - - 2. - 3. - 4. - A. Contact a. b. c. - - Droplet Nuclei ---- aka Airborne - - - Vector-borne - - - - B. VERTICAL ---- mother to child - - - 5\. Portal of Entry ---- to host - 6\. Susceptible Host ---- not everyone Risk Factors a. b. - - c. d. - - - **STAGE OF ILLNESS** 1. - - 2. - 3. - 4. - - - - **[IMMUNITY]** - IMMUNIZATION: process of being immune VACCINE: substance, which when inoculated, [stimulates] the body to [produce] ANTIBODIES SERUM: ready made immunoglobulins (antibodies); immediate but short-term immunity IMMUNITY 1. 2. - a. b. - **[GONORRHEA ---- Gonococcal urethritis]** - - - - - - - - - - Diagnostic test: culture and sensitivity; for bacterial disease ---- swab - - Treatment: 1. +-----------------------------------------------------------------------+ | **CHLAMYDIA (Cloak or the Silent Epidemic)** | | | | - | | | | Agent: Chlamydia trachomatis | | | | - - | | | | sexual/vertical | | | | 1-2 weeks | | | | Same as Gonorrhea, but (+) trachoma (inflammation of eyelid | | follicles) ------ corneal transplant | | | | 1. 2. | | | | DOG: Doxycycline | | | | \*\*Not for pregnant women | | | | If pregnant, use AMOXICILLIN | +=======================================================================+ | **SYPHILIS (Bad Blood Disease)** | | | | Agent: Treponema pallidum | | | | - | | | | sexual/vertical | | | | 3-21 days | | | | STAGES | | | | 1. | | | | - | | | | 2. | | | | - - - | | | | 3. | | | | - | | | | 4. | | | | - - - | | | | Amnesia | | | | Àgnosia/prosopagnosia | | | | Aphasia | | | | Acute onset of hallucinations/blindness | | | | Ataxia | | | | Seizures | | | | confirmatory: Blood-Dark Field microscopy | | | | Penicillin | | | | \- early, IM (Buttocks, at least 2mL) | | | | \- late (tertiary), IV | | | | REACTION: Penicillin and Spirochete bacteria | | | | -dead bacteria releases weak toxins | | | | JARISCH-HERXHEIMER REACTION | | | | 1. 2. 3. 4. 5. | | | | MNGT: | | | | 1. 2. | | | | congenital Syphilis (Fetus) | | | | "HUTCHINSON's TRIAD" | | | | 1. 2. 3. | +-----------------------------------------------------------------------+ | **HIV** | | | | Agent: Human immunodefi virus, Red Ribbon | | | | - | | | | HIV1: LAV - Lymphadenopathy Associated Virus | | | | HIV2: HTLV III - Human T Lymphotropic Virus III | | | | -Country of Origin: Conggo, Africa | | | | -by eating the monkeys | | | | TERMINOLOGIES: | | | | 1. | | | | \*\*If low, | | | | 2. 3. | | | | Sexual - anal | | | | Vertical - pregnancy/delivery/lactation 25%; if mother take | | antiretroviral therapy, 1-9% | | | | Blood | | | | Needle stick or prick injury - heroin | | | | 3-6 months | | | | STAGING: Clinical | | | | 1. | | | | N: 500-1000/mm3 | | | | 2. | | | | \ | | | | a. b. c. | | | | -fatigue even after full sleep | | | | -frequent stomatitis | | | | -frequent flu episodes (relapsing fever) | | | | -leukoplakia(thrush) | | | | -unexplained rashes | | | | -lymphadenitis | | | | -chronic diarrhea | | | | 3\. Latency | | | | a.signs and symptoms subside | | | | b.less communicable | | | | c.may last indefinitely with medications | | | | 4\. AIDS | | | | -severe immunosuppression | | | | \- rapid onset of complications | | | | A.most common cause of death - Pneumonia (PCP- Pneumocystis | | pneumonia; cause - P.jirovecii | | | | old name: P. Caranii | | | | B. Most common cause of death --- Filipino; TUBERCULOSIS | | | | C. Most common malignancy (cancer) --- Kaposi\'s sarcoma | | | | D. Other | | | | - - - - - | | | | A.HIV | | | | -screening | | | | 1.ELISA: detects HIV antibody | | | | 2.WESTERN BLOT:identifies the proteins and structure unique to HIV; | | confirmatory - type of infiltration; 5 days to 3 weeks | | | | B.AIDS:CD4 T CELL COUNT | | | | -check every 6 months | | | | \- to confirm | | | | (+) \ emtricitabine | | | | \> didanosine | | | | \> abacavir | | | | \> tenofovir | | | | \> lamivudine | | | | B.NNRTI: prevents viral RNA to DNA conversion by altering R | | transcriptase ----non competitive inhibitor | | | | \>efavirenz | | | | \> delavirdine | | | | \> etravirine | | | | \> rilpivirine | | | | \> doravirine | | | | \> nevirapine | | | | C. Enzyme blockers | | | | Anti protease: | | | | \- | | | | Indinavir | | | | -saquinavir | | | | -lopinavir | | | | -ritonavir | | | | Anti integrase | | | | -raltegravir | | | | -eltegravir | | | | -dolutegravir | | | | D. Fusion/entry inhibitor | | | | Prevents CD4 t cells, good for early phase | | | | \> maraviroc | | | | \> enfuvirtide | +-----------------------------------------------------------------------+ HIV PROPHYLAXIS 1. 2. Generic Name: Emtricitabine + Tenofovir = 2in1 drug; FTC + TDF , PO, 300mg, 200mg, PrEP Brand Name: Truvada +-----------------------------------+-----------------------------------+ | PrEP | PEP | +===================================+===================================+ | - - - - - | - - - - - - | +-----------------------------------+-----------------------------------+ +-----------------------------------------------------------------------+ | **FILARIASIS (elephantiasis)** | | | | Agent: wuchereria bancrofti (worm) | | | | 8-16 months | | | | vector - mosquito (aedes poecilus) | | | | Day biting -4PM | | | | Low flying | | | | Stagnant water | | | | Urban areas | | | | STAGES | | | | A. B. C. | | | | | | | | 1. 2. | | | | - | | | | DEC, PO, 1-12 days | | | | - | +=======================================================================+ | **DENGUE FEVER (break bone or dandy fever or acute infectious | | thrombocytopenia purpura)** | | | | Agent: dengue virus (flavivirus) | | | | DENGUE GRADING | | | | DF 1: | | | | \>Prognosis: Good | | | | \>High Grade fever + 2 of HHARM (Headache, [hemorrhage (bleeding, | | rashes, petechiae, skin flushing(herman's Sign)], | | Arthralgia, | | | | Warning: | | | | Platelets: \Prognosis: Good | | | | \>Platelets: \Prognosis: Guarded - not allowed to go home; under the custody of | | hospital | | | | \>Platelets: \Prognosis: Critical ---- ICU | | | | vector | | | | - - | | | | a)Screening: | | | | \*\*(+), suspected dengue case | | | | \>Tourniquet/Capillary Fragility Test: "Rumpel Leede Test" | | | | -inflate BP cuff halfway between Systolic + Diastolic / 2 | | | | -Lock the cuff for 2 mins | | | | -Draw a 1x1 inch sq (antecubital space) | | | | -Count petechiae: (+) if [\>]10 | | | | b)Laboratory: Possible case | | | | \>Blood | | | | -!Platelet | | | | -!WBC: initial spike (increased), ff by gradual/decline | | | | -iHematocrit---hemo concentration | | | | c)Laboratory: Confirmatory | | | | \>ELISA | | | | -MAC (IgG Antibody Capture) ELISA: (+) increased IgM; (+) dengue | | antibodies | | | | -Platelia non structural protein 1 antigen test: antigen test; | | detects dengue on 1st 2 days of fever | | | | 1. 2. 3. 4. | +-----------------------------------------------------------------------+ | **MALARIA (King of Tropical Diseases)** | | | | Hallmark: Ague (intermittent fever/chills) | | | | Agent: Plasmodium: 5 species | | | | Vector: Anopheles | | | | 10 days to 1 year | | | | 1. 2. 3. 4. 5. 6. | | | | Screening | | | | 1. | | | | \>Blood | | | | \>Parasite detection | | | | \>Rapid testing | | | | **Confirmatory** | | | | 2. | | | | \>To be collected at PEAK OF FEVER --- 2 hrs after the onset | | | | Antimalarial Drugs | | | | 1. 2. 3. 4. 5. 6. | | | | \*2in1 good for drugs resistance | | | | Safe for Pregnant: | | | | \*Chloroquine | | | | \*IV Artesunate | | | | \*Quinine | | | | \*Co Artem | | | | \*Fansidar | | | | 3,4,5,6 | | | | - - | +-----------------------------------------------------------------------+ | **ZIKA FEVER** | | | | Agent: Zika Virus (Flavivirus) | | | | minor capillary refill --- experience vasodilation; skin cushin | | | | vector: mosquito (aedes) | | | | Sexual: can be seen draining in the semen | | | | 1-2 weeks | | | | 1. 2. 3. | | | | Implications: | | | | 1. | | | | Complications | | | | 1. | | | | -Cerebral edema | | | | -GLD/ID - General learning Disability / Intellectual Disability | | | | 2. | | | | -AIDP variant --- GBS (MFS type) --- Miller Fisher Syndrome | | | | -Ataxia | | | | -Areflexia | | | | -Ophthalmoplegia | | | | Blood RT PCR Test | | | | \>(+), Polymerase Chain Reaction Test --- detection of RNA and | | proteins in Specimen --- BLOOD | | | | 1. 2. 3. | +-----------------------------------------------------------------------+ PLASMODIUM MON TUES WED THUR FRI SAT SUN FEVER CYCLE 10-14 days / / / Fever After every 72 hrs —- BENIGN QUARTA MALARIA 17days-1 year / / / / Fever after every 48 hours —- BENIGN TERTIAN MALARIA 16 days - 26 days Both Both Both Both Both Both Both Fever after every 24 hours —- BENIGN QUOTIDIAN MALARIA 6AM: fever 6PM: Normal Next Day 6AM: Fever 11-26 days BENIGN TERTIAN MALARIA *Weakest strain Main: Anemia; RBC arises >60% 10-12 days MALIGNANT TERTIAN MALARIA -potential to spread — BRAIN ( Cerebral Malaria: elevated ICP, Coma); BLACKWATER FEVER (Renal Failure Mahogany/Dark Red Urine - diffused and intense hemolysis; severe flank pain) *Deadliest TUBERCULOSIS (Koch's Disease) --- ROBERT KOCH, PHTHISIS, GALLOPING CONSUMPTION - - *M.tuberculosis\>\>Lungs(alveoli)\>\>Macrophage(phagocytosis)\>Bacteria: DORMANCY\>\>Granuloma (debris formation)\>\>OUTCOME\>Recovery\_\_\_Stress/decreased immunity\>Active/Symptomatic TB* *PrimaryComplex/Initial Infection: from Lungs to Outcomes* Agent: Myobacterium tuberculosis MoT: Airborne ---- Droplet Nuclei Incubation: 8-10 weeks Terminologies: 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. \*\*If you missed 29 days or more than one month, BACK TO ZERO 11. 12. 13. 14. primary tb (asymptomatic) active tb (symptomatic) ----------------------- ------------------------------------------------------------------- ---------------------------------------------------------------- symptomatic no but may feature weight loss and slow growth yes contagious no yes x-ray (-) initially; (+) granuloma lymphadenopathy tubercle (\>2months) (+) tubercle and density accumulations of fluids/consolidation mantoux test (+) (+) sputum (confirmatory) (-) (+) Period of communicability: - 1. 2. Signs and Symptoms 1. 2. 3. 4. 5. 6. 7. \*\*All 1-7, ACTIVE TB Diagnostic Test SCREENING 1. - 2. 3. CONFIRMATORY: Sputum, 5-15ml (1-3tsp) 4. 5. \*\*Result for 2-5 Days 6. Management TB DOTS --- Directly observed treatment short-course - - Multiple Drugs 1. 2. Phases 1. GOAL: To kill most bacteria --- need more drugs, short duration 2. - \*\*Take with light snacks/empty stomach First TB MEDS: Streptomycin TB MEDS +-----------------------+-----------------------+-----------------------+ | TB MEDICATION | SIDE EFFECTS (cont. | ADVERSE EFFECTS (stop | | | meds) | meds) | +=======================+=======================+=======================+ | Rifampicin ® | Red orange secretions | Reduction of RBC and | | | (urine) | platelet --- | | | | anemia/thrombocytopen | | | | ia | +-----------------------+-----------------------+-----------------------+ | Isoniazid (H, INH) | Intended B6 depletion | Intense Neuritis --- | | --- 600mg | --- pyridoxine; | Seizures | | | Peripheral Neuritis | | | | (Heaviness, Burning | | | | sensation, Tingling) | | +-----------------------+-----------------------+-----------------------+ | Pyrazinamide (Z) --- | Urine --- high uric | Progressive liver | | 2-3g | acid --- purine | fibrosis --- always | | | derivative, \