Infectious and Communicable diseases
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What do kids get sick? Why are infants vulnerable?
- Infants are vulnerable as passive immunity from mom is limited. This immunity fades after birth
- Kids get exposed to diseases through contacts with others
- This exposure develops antibodies prevent subsequent infections with the same organism
What behaviors contribute to illness?
- Poor Hygiene
- Leaking diapers (fecal/oral rt)
- Poor Handwashing
- Not blowing nose often enough
- Daycare staff may not use proper handwashing
What is the definition of an infectious disease and a communicable disease?
- Infectious disease: any communicable disease caused by microorganisms that are commonly transmitted from one person to another
- Communicable disease: an illness directly or indirectly transmitted from one person to another, by contact with contaminated items, contact with bodily fluids, or through vectors (ticks, mosquitos, or other insect)
What is the difference between Enanthem and Exanthem?
- Enanthem: Rash inside the body, such as kolick spots
- Exanthem: rash outside the body, such as varicella
What is the difference between active and passive immunity?
- Active immunity: body makes the antibodies through vaccines or immunity established by contact with the disease
- Passive Immunity: antibodies made by another human or animal and given to another person; does not confer into long term immunity (Such as passed from mother or IV immunoglobulins)
What is the chain of infection and what three links need to be present/where can we break the chain?
- Infectious Agent
- -Portal of exit
- -Portal of Entry
- Susceptible Host
What is the different between direct and indirect transmission of pathogens?
- Direct: physical contact between source of infection and host
- Indirect: occur when pathogens survive outside of human host before causing infection and disease
How can prevent the spread of disease?
- Primary prevention through vaccinations
- Controlling the spread of disease through hand washing, infection control policies, and reducing the rusk of cross-transmission of organisms
Describe Varicella. What are the s/s and how is it treated?
- Varicella Zoster
- Airborne/direct contact
- Can be spread one day before lesions until 6 days after
- S/S include fever, malaise, HA, abdom pain, and itchy clear fluid filled vesicles all over body
- Treatment is supportive for fever and itching (prevention of secondary infection)
- Airborne isolation
What is Coxsackievirus? How is transmitted and what are the s/s? What is the treatment?
- Hand, foot, Mouth disease and Herpangina
- Caused by Coxsackievirus A16, Enterovirus 71
- Spread by fecal-oral route and respiratory routes
- S/S include fever, sore throat, blister like sores inside cheeks, gums, tongues, as well as hands and feet
- Herpangina has papulovesicular lesions on pharynx only
- Treatment is supportive with cool drinks, topical lotion, and isolation
What is Diptheria? How is it contracted? What are the s/s and how is it treated?
- Caused by Corynebacterium diphtheriae
- Contact with nasal or eye discharge
- S/S include fever, anorexia, rhinorrhea, cough, stridor
- Tonsils and pharynx covered in thick, bluish, white patch
- Treated with antibiotics and IV antitoxin
- Isolation with monitoring for resp distress
What is Erythema Infectiosum? How is it transmitted and what are the s/s? What is the treatment?
- Also called Fifth's disease, its caused by the human parvovuris B19
- Transmitted through resp secretions and blood
- S/S include a flu-like illness and a fiery red rash on cheeks
- Maculopapular rash on trunk and limbs
- Treatment is supportive with fever control, antipruritucs, soothing baths, and isolation
What is Haemophilis Influenza Type B? How is it spread and what are the s/s? How is it treated and prevented?
- Caused by Coccobacilli H Influenzae
- Spread through direct contact or droplet inhalation
- Viral upper respiratory tract infection invades blood stream
- May cause meningitis, epiglottitis, pneumonia, or sepsis
- Antibiotics, isolation, antipyretics, and prophylaxis for close contacts
What is influenza? How is it spread and what are the s/s? How is it treated?
- Types A or B
- Spread by aerosolized particles and direct contact with secretions
- S/S include fever, chills, malaise, HA, N/V
- Antivirals (like tamiflu) may be given to children at risk for complications (within 48 hrs of onset)
- Comfort measures, prevention of dehydration, isolation until afebrile for 24 hrs without medication
What is Measles (Rubeola)? How is it transmitted and what are the s/s? How is it treated?
- Caused by morbillivirus
- Spread by airborne, droplets, and contact
- Communicable 4 days before rash and 5 days after
- S/S include high fever, conjunctivitis, cough, anorexia and malaise
- Koplick spots on oral mucosa appear two days before the rash
- Red, blotchy, maculopapular rash on face, trunk, and limbs that becomes confluent
- Treated with antipyretics, antitussives, monitoring resp status
- Antibiotics for secondary infections
- Airborne precautions
What is Mononucleosis? How is it spread and what are the s/s? How is it treated?
- Caused by the Epstein-Barr virus
- Spread by direct contact with secretions
- S/S include malaise, HA, fever, fatigue, lymphadenopathy, weakness and lethargy (which may persist for months)
- Treatment is supportive, including antipyretics and rest
What is mumps? How is it treated and what are the s/s? How is it treated?
- Also called Parotitis and caused by rubulavirus
- Spread by contact with respiratory secretions
- Communicable immediately before and after swelling appears
- S/S include malaise, fever, pain with chewing, parotid gland swelling
- Disease is usually self limiting and treatment is supportive with isolation
What is pertussis? How is it spread and what are the s/s? How is it treated?
- Also called whooping cough, caused by bordetella pertussis
- Spread through respiratory droplets and direct contact with secretions
- S/S include runny nose, fever, mild cough that becomes more severe at night, infants may not manifest the whooping sound
- Treated within the first 21 days with antibiotics (zithromax, erythromycin, clarithomycin)
- Droplet isolation, monitor resp status and hydration
What is a pneumococcal infection? How is it spread and what are the s/s? How is it treated?
- Caused by streptococcus pneumoniae
- Spread through respiratory droplets and secretions
- S/S related to the area of infection, such as otitis, sinusitis, bacteremia, pneumonia, meningitis
- Treated with antibiotics, antipyretics, encouraging fluids, and droplet isolation
What is Poliomyelitis? How is it spread and what are the s/s? How is treated and how is it prevented?
- Spread through the fecal-oral route and possibly respiratory
- Symptoms can be mild or severe including CNS symptoms, respiratory weakness and paralysis
- Supportive treatment only for comfort and to monitor resp status
What is roseola? How is it spread and what are the s/s? How is it treated?
- Also called Sixth disease and exanthe subitum
- Spread by respiratory secretions and possibly the saliva of healthy people
- S/S includes high fever for 3-8 days
- Pale, pink, maculopapular rash on trunk, face, neck, limbs
- Antipyretics and supportive treatment
- Usually self-limiting
What is Rubella (German Measles)? How is it spread and what are the s/s? How is it treated?
- Spread through droplets and direct contact
- Communicable 7 days before the rash and 5 days after
- S/S include low grade fever, HA, malaise, anorexia
- Pink, maculopapular rash that starts at face and moves downward, leaving in the same order it came (nonconfluent)
- Droplet precautions, avoid exposure to pregnant women, supportive treatment
What is streptococcus A? How is it spread and what are the s/s? How is it treated?
- Caused by Group A Beta-Hemolytic Streptococci
- Spread by contact with respiratory secretions and direct contact
- Causes systemic infections, such as sore throat and fever
- Can also cause impetigo skin infections
- Treated with antibiotics, antipyretics, warm fluids
What is scarlet fever? How is it spread?
- Caused by group A beta-hemolytic streptococci
- Spread through droplet and direct contact
- Communicable during the incubation phase (2-5 days) and during the illness; may become a carrier
What are the s/s of scarlet fever? How is it treated? What are the possible complications?
- First 1-2 days: white strawberry tongue
- Red, pinsized, rash becomes generalized; prevalent in armpits, groin, folds of knees and elbows and absent on face
- Days 4-5: Strawberry red tongue
- By the end of the week, desquamation of skin occurs leaving sandpaper like skin on torso and sloughing on palms and feet
- Treated with penicillin or erythromycin
- Droplet precautions for the first 24 hrs of antibiotics
- Complications: peritonsillar abcess, sinusitis, otitis media, glomerulonephritis, acute rheumatic fever, polyarthritis
What is tetanus? How is it spread? What are the s/s and how is it treated?
- Caused by clostridium tetani or tetanus bacillus
- Transmitted through wounds
- S/S include neck or jaw stiffness, facial spasms, prolonged muscle contractions
- Treated with the tetanus immune globulin and prevented by vaccination of tetanus toxoid
- Monitor hydration and respiratory status, as mechanical ventilation may be necessary
What is Lyme Disease? How is it spread and what are the s/s? How is it treated?
- Caused by the spirochete Borrelia Burgdorferi
- Transmitted through tick bite
- S/S include malaise, HA, mild fever, joint aches, red bulls-eye shaped rash around tick bite site
- Treated with antibiotics-doxycycline and rest
- Teaching to prevent tick bites and proper tick removal
What is Rabies? How is it spread and what are the s/s? How is it treated?
- Also called hydrophobia, caused by Rhabdoviridae (there are 2 types, one for dogs and one for other wildlife)
- Transmitted through infected saliva (animal bites)
- Systemic manifestations include HA, fever, malaise, difficulty swallowing and can lead to coma and death if untreated
- Human rabies is treated with Immune globulins for passive immunity at bite site and Rabies vaccine given IM for active immunity
- Educate on rabies prevention and side effects
What is the West Nile Virus? How is it spread and what are the s/s? How is it treated?
- Caused by Arbovirus
- Spread by infected wild birds to mosquitos who carries the virus from birds to humans
- Most people are asymptomatic
- 20% show flu like symptoms
- 2% show severe neurologic illness
- Treatment is supportive
- Teach prevention of mosquito bites
What are the important assessments for a child with an infectious disease?
- Hydration status, fluid intake
- Vital signs, esp fever
- Comfort level
- Toxic appearance such as lethargy, poor perfusion, changes in respiratory status
When a child has an infectious disease, who should be notified?
- The school or day care should be notified, as many diseases are contagious prior to the outbreak of a rash
- The local health department should be notified for Pertussis, measles, and mumps
What are the possible complications of Varicella?
- Secondary skin infections from scratching
- Secondary bacterial infections
- Transient Thrombocytopenia
What are the possible complications of Rubella?
Teratogenic effect on exposed fetuses
What are the potential complications of pertussis?
- Otitis Media
- Prolapsed Rectum
- Weight loss
What are the possible complications of Rubeola (measles)?
- Otitis Media
What are the possible complications of Mumps?
- Epididymo-orchitis in older males
- Sterility, esp during adolescent
- Hearing loss
What are the possible complications of Mononucleosis?
- Ruptured Spleen
- Avoid contact sports
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