COMMUNICABLE DISEASES

TETANUS

TETANUS

CLOSTRIDIUM TETANI

Gram (+), spore forming, obligate anaerobic bacterium

• VEGETATIVE
• SPORE FORMING

• TETANOSPASMIN = neurotoxin
• TETANOLYSIN

–Soil

–Animal manure

–Human feces

–Unsterile sutures, pins; rusty materials

• 3-21 days
• AVERAGE: 10 days

Direct contact with open wound and unhealed umbilical stump

INSIDIOUS OR ACUTE

• RISUS SARDONICUS
• TRISMUS (LOCKJAW)
• SEVERE SPASTIC ATTACKS

• MASSETER 
• NECK MUSCLES

TETANUS

• OPISTHOTONUS
• DIFFICLUT SWALLOWING
• GENERAL STIFFNESS
• RESTLESSNESS
• HYPERIRRITABILITY
• ANEMINA-LIKE S/S

• IMMUNIZATION OF TOXOID
• GENERATION OF ANTITOXIN

• NEUTRALIZATION OF TOXINS
• ANTI TETANUS SERUM
• TETANUS IMMUNOGLOBULIN
• DESTRUCTION OF C. TETANI SPORES

• ANTIBIOTICS
• -PENICILLIN, 3RD GENERATION
• CEPHALOSPORIN
• -METRONIDAZOLE

• General Wound care
• Diazepam/ Muscle Relaxants
• Nutrition thru NGT/ TPN
• O2 therapy

• Strict monitoring
• Prevent complication
• Nutritional support
• Isolation
• Avoid stimulation

• meningococcal meningitis
• meningococcal septicemia
• meningococcal bacteremia/ blood poisoning

MENINGOCOCCEMIA

Neisseria meningitidis

Direct contact with respiratory secretions

ACUTE

2-10 days with an average of 3-4 days

INFANTS AND CHILDREN

NEISSERIA MENINGITIDIS

• ASYMPTOMATIC
• RESTRICTED TO NASOPHARYNX OR URTI 
• LEAD TO meningococcal septicemia, or meningitis
• MENINGEAL IRRITATION : N/V , HEADACHE , SEIZURES, SENSORIAL CHANGES
• HIGH GRADE FEVER
• PETECHIAL/PURPURIC RASHES ON BODY AND MUCOUS MEMBRANES
• ADRENAL MEDULLA  HEMORRHAGE EXTEND INTO CORTEX

WATERHOUSE  FRIDERICHSEN SYNDROME

Rapid development of petechiae to purpuric and ecchymotic spots in assoc. with shock

SHORT COURSE BUT FATAL

• BRUDZINSKI'S SIGN
• KERNIG'S SIGN

• Strict Isolation
• IVF/ Blood Transfusion
• O2/ Mechanical Breathing support
• Wound care for areas of skin with blood clots
• Institute Management for SHOCK and DIC

• Penicillin G. 3rd Gen. Cephalosporins, Chloramphenicol
• Prophylaxis:  Rifampin, Ciprofloxacin or Ceftriaxone)

• Avoid stimulation
• Respiratory support
• Complication precautions
• Proper monitoring
• Place on Respiratory Isolation within 24H

Infantile paralysis, Heinemedin disease

POLIOMYELITIS

POLIOMYELITIS

• Airborne
• Direct contact with droplet
• Close association with infected people
• Fecal-Oral route

• 7-21 days
• AVERAGE of 12 days

1ST 3 days to 3 mos. Of the disease

• INAPPARENR/ SUBCLINICAL/ ASYMPTOMATIC/ SILENT Type
• ABORTIVE
• NON-PARALYTIC ASEPTIC MENINGITIS
• PARALYTIC POLIOMYELITIS

• SPINAL PARALYSIS
• BULBAR PARALYSIS

SPINAL PARALYSIS

BULBAR PARALYSIS

BULBOSPINAL

Day 1-3: Fever but resolves immediately

Day 3-5: Headache, neck pain, muscle pain, fever

Day 5-7: Mild paralysis

After illness: Permanent paralysis

• Throat Swab
• Stool C/S
• LUMBAR PUNCTURE WITH CSF ANALYSIS
• PANDY TEST

CSF (cerebrospinal fluid) to detect the elevated levels of proteins (mainly globulins)

• CBR
• Warm compress on affected muscles
• Comfort measures
• ROM exercises

• INACTIVATED POLIO VACCINE (IPV)
• SALK Vaccine
• ORAL POLIO VACCINE

JONAS SALK

VARICELLA ZOSTER VIRUS

Direct contact with contaminated objects

2 TO 3 WEEKS

From 1 to 2 days before the rash develops until all lesions are crusted.

VARICELLA OR CHICKENPOX

10-21 DAYS

• Spread by Direct contact
• Droplet
• Contaminated object

CHICKENPOX

1-5 DAYS

• Slight fever, malaise, anorexia
• PRURITIC RASH (macule, then papule then vesicle) with successive crops of all three stages present at any time
• Lymphadenopathy
• Elevated temperature

• VESICULAR RASH
• FEVER
• MALAISE

• ACYCLOVIR (FOR IMMUNOCOMPROMISED) - TO REDUCE SEVERITY AND SYMPTOMS
• FOSCARNET (IF RESISTANT)

• Perform complete physical assessment
• Monitor Vital Signs
• Assess skin for signs of secondary infection
• Trim nails or cover hands of infants and toddlers
• Encourage rest
• Administer medications appropriately
• Encourage hydration and
• Provide client teaching

• Skin Care
• Prevention of pulmonary complications

• Perform complete physical assessment
• Monitor Vital Signs
• Assess skin for signs of secondary infection
• Trim nails or cover hands of infants and toddlers
• Encourage rest
• Administer medications appropriately
• Encourage hydration and
• Provide client teaching

HERPES ZOSTER

Shingles, Zoster, Acute ganglionitis

1-2 WEEKS

ACUTE

Droplet, Direct Contact, Airborne, Indirect contact

A day before the appearance of the 1st rash until 5-6 days after the last crust

• RASH ON ONE SIDE OF FACE OR BODY
• STARTS AS BLISTERS THAT SCAB 3-5 DAYS
• MACULE > PAPULE > VESICLE > CRUST

2-4 WEEKS

fever, headache, chills, and upset stomach.

Localized vesicular skin lesions confined to a dermatome (following peripheral nerve pathway)


Any part of the trunk maybe affected, but the thoracic segment is commonly affected

• RESPIRATORY ISOLATION
• SYMPTOMATIC
• ANTI-VIRALS
• –ACYCLOVIR
• ANALGESICS/ ANTI-INFLAMMATORY

• Bed Rest
• Skin Care, Meticulous hygiene
• Pain Management
• Prevention of pulmonary complications

Herpes zoster vaccine = Zostavax

***does not treat shingles or post-herpetic neuralgia (pain that persists after the rash resolves) once it develops.

9-20 DAYS

Rubeola, Red measles, True measles

MEASLES

It begins with a fever that lasts for a couple of days, followed by a cough, runny nose, and conjunctivitis.

A rash starts on the face and upper neck, spreads down the back and trunk, then extends to the arms and hands, as well as the legs and feet.

After about five days, the rash fades in the same order it appeared

Rubeola virus

RUBEOLA VIRUS

ACUTE

9-20 DAYS

4 days before and 5 days after appearance of rash

• DIRECT CONTACT
• CONTACT WITH CONTAMINATED ARTICLES

Fever and malaise followed by cough and Koplik’s spots on buccal mucosa

Erythematous maculopapular rash with face first affected; turns brown after 3 days when symptoms subside

CONSTITUTIONAL SYMPTOMS

RASH SEEN LATE ON THE 4TH DAY

RASHES FADE AWAY IN THE MANNER AS THEY ERUPTED

• FEVER
• DECREASE IN WBC
• COUGH 
• CORYZA
• CONJUCTIVITIS

• MACULOPAPULAR ERYTHEMATOUS RASH
• KOPLIK'S SPOTS

• begins several days after the fever starts.
• starts on the head before spreading to cover most of the body = itching.
• The rash is said to "stain", changing color from red to dark brown, before disappearing.

• irregularly-shaped, bright red spots often with a bluish-white central dot
• LOCATED AT MUCOSA OF CHEEKS AND TONGUE

• ANTIVIRALS
• ISOPRENOSINE

• Isolation
• Nutritional Support
• Complication prevention

• Bed rest
• Irritation prevention
• Skin care
• WOF rolling of head, ear ache, pulling of ear and discharges from the ear
• Prevention of contacts with pregnant women

MMRV VACCINATION

• Trim nails and encourage wearing long sleeves and pants to avoid scratching
• Isolate patient from other patients
• Encourage fluid intake
• Give antipyretics for fever
• Treat conjunctivitis with warm saline when removing secretions and encourage patient not to rub eyes; protect eyes from sunlight or glare of strong light

• Otitis media
• Pneumonia
• Laryngotracheitis
• Encephalitis

• RUBELLA
• THREE DAY RASH

GERMAN MEASLES

RUBELLA VIRUS

ACUTE

14-21 DAYS

• DROPLET SPREAD
• CONTACT WITH CONTAMINATED ARTICLES

• 1 week before and 4 days after onset of rashes
• Most communicable during height of rash

• NONE (CHILDREN) SORE THROAT AND LOW FEVER (ADOLESCENT)
• MACULOPAPULAR RASH ON FACE THEN BODY
• S/S SUBSIDE 1ST DAY AFTER RASH

• POSTERIOR AURICULAR LYMPHADENOPATHY
• MACULAR RASH OF SMALL RED SPOTS
• LIGHT FEVER

FORSCHEIMER'S SPOTS

a fleeting enanthem seen as small, red spots  on the soft palate in 20% of patients with rubella

They precede or accompany the skin rash of rubella

14-21 days

EPIDEMIC PAROTITIS

MUMPS OR EPDIEMIC PAROTITIS

PARAMYXOVIRUS

• Saliva of infected host
• Man is the only natural reservoir

• DIRECT:
• contact with respiratory secretions
• INDIRECT:
• also survive on surfaces and then be spread after contact in a similar manner

• 1-6 days before the 1st symptoms until the swelling disappears
• And 9 days after the onset of parotitis
• Highest: 48 hours immediately preceding onset of swelling

• Parotid inflammation (or parotitis)
• Orchitis

• Malaise
• Low grade fever
• Pain below the ear
• Anorexia

causes swelling and local pain, particularly when chewing and swallowing

It can occur on one side (unilateral) but is more common on both sides (bilateral) in about 90% of cases.

painful inflammation of the testicle

Males past puberty who develop mumps have a 30 percent risk of orchitis

• Supportive
• Relief of Pain
• ANTI-VIRAL DRUGS
• ISOLATION
• Medical Aseptic Protective Care
• Drainage Precautions
• Single Occupancy Room

• CBR
• Prevent Complication
• Scrotal support
• Nutrition:
• -NO DIETARY RESTRICTION except during acute stage
• soft and semisolid foods
• -AVOID ACIDIC FOODS AND BEVERAGES

• Isolation until 9 days after onset of swelling
• Soft, bland diet

DIPHTHERIA

• RESPIRATORY DIPHTHERIA
• CUTANEOUS DIPHTHERIA

• Corynebacterium diphtheriae
• KLEBS LEOFFER BACILLUS

a facultative anaerobic Gram-positive bacterium, non-motile, non spore forming

• 1.GRAVIS
• 2. MITIS
• 3. INTERMEDIUS

• Direct contact through a carrier
• Contact through contaminated articles

2-5 days, longer in adults

• UNTREATED usually 2-4 wks.
• TREATED: 1-2 days

Discharges of the URT, eyes or lesions of infected persons

• Resembles common cold
• Low-grade fever, hoarseness, malaise,
• Pharyngeal lymphadenitis;
• Characteristic white/gray pharyngeal membrane

• Pseudo-membrane
• Bull-neck
• Brassy cough
• Stridor
• Fatigue
• Malaise
• Fever
• Sore throat
• Dyspnea

• SCHICK TEST
• MOLONEY'S TEST
• ELEK'S TEST
• ECH, EEG, SGOT

• Positive:
• when the test results in a wheal of 5–10 mm diameter

• Pseudo-positive:
• when there is only a red colored inflammation and it disappears rapidly

Hypersensitivity to diphtheria toxoid

• virulence test performed upon Corynebacterium diphtheriae
• used to test for toxigenicity of C. diphtheriae.

immuno diffusion technique

• NASAL - foul smelling
• TONSILAT - low fatality
• NASOPHARYNGEAL
• LARYNGEAL - most fatal
• CUTANEOUS

ANTITOXIN

• ANST
• Since antitoxin does not neutralize toxin that is already bound to tissues
• Therefore, the decision to administer diphtheria antitoxin is based on clinical diagnosis, and should not await laboratory confirmation

• Prevention of Airway Obstruction
• Nutrition
• Adequate FEB
• Bed Rest
• O2

• ANTIBIOTICS 
• Metronidazole
• Erythromycin (orally or by injection)
• Procaine penicillin G given (intramuscularly for 14 days)
• Patients with allergies to penicillin G or erythromycin can use Rifampin or Clindamycin.

• CBR
• Emergency tray @ Bedside – epinephrine & Hydrocortisone
• Oral care – do not remove pseudo-membrane
• Hydration
• WOF complications

• Strict isolation until two successive negative nose and throat cultures are obtained.
• Complete bedrest.
• Watch for signs of respiratory distress and obstruction.
• Provide for humidification and suctioning as needed; severe cases can lead to sepsis and death.

PERTUSSIS

Whooping Cough, 100 days cough

6 WEEKS

BORDETELLA PERTUSSIS

NON- MOTILE, GRAM (-) BACILLUS

EASILY DESTROYED BY LIGHT, HEAT, DRYING

• Inc. Period
• > Bordetella confined to the T-B mucosa
• > produces progressively tenacious mucus
• > irritates mucosa
• > initiates spasmodic cough
• > tenacious material not readily expelled
• > WHOOPING COUGH

• Direct toxic effect of the organism in the CNS
• > Coughing center
• >WHOOPING COUGH

5 – 21 days, usually 10 days

• DIRECT CONTACT
• DROPLET SPRAY
• CONTAMINATED ARTICLES

Early catarrhal stage-paroxysm (7 days after exposure)

Until 3 weeks after typical paroxysms

Secretions from the Nasopharynx of infected persons

Upper respiratory infection for 1 – 2 weeks

Severe cough with high-pitched, especially at night, lasts 4 – 6 weeks;

Vomiting

• CATARRHAL STAGE
• PAROXYSMAL STAGE
• CONVALESCENCE STAGE

Catarrhal Stage: 7-14 days

• -Characterized by non-specific symptomatology
• Coryza
• Sneezing
• Lacrimation
• Cough
• Slight elevation of temperature

• Paroxysmal Stage:  occurs on the 7th-14th day
• Lasts for 4-6 weeks
• Rapid succession of cough
• -spasmodic and recurrent with excessive explosive outbursts rapid 5-10 rapid coughs in one expiration
• -provoked by crying, eating, drinking or exertion
• Whoop
• -each cough ends in a loud crowing inspiratory whoop; and a choking on mucus that causes vomiting

Convalescence Stage

• occurs after 6 weeks from the onset
• Characterized by gradual diminution of:
• cough
• Vomiting
• Return of appetite and gradual weight gain
• Indices of recovery

• Antitoxin
• ANTIBIOTICS
• -decrease the duration of infectiousness and thus prevent spread
• Erythromycin
• -currently the first line treatment
• Trimethoprim-sulfamethoxazole
• -used in those with allergies to first line agents

• CBR
• Do not Agitate
• Environmental control
• Nebulization
• Supportive care
• WOF respiratory complications

Hospitalization for infants; bedrest and hydration

Complications: pneumonia, weight loss, dehydration, hemorrhage, hernia, airway obstruction

Maintain high humidity and restful environment; suction

DENGUE HEMORRHAGIC FEVER

• Break bone fever
• Hemorrhagic fever
• Dandy Fever
• Infectious Thrombocytopenic Purpura

DENGUE VIRUS (1-4)

vector borne – Aedes aegypti MOSQUITO

COMMON DURING RAINY AND TROPICAL IN ORIGIN

• 3-14 days
• Average: 7-10 days

sought by reducing the habitat and the number of mosquitoes and limiting exposure to bites.

Within 1 week of illness while virus is still present in blood

–From a day before the febrile period to the end of it

–Mosquito becomes infective from day 8-12 after the blood meal

Remains infective all throughout life

• INFECTED PERSONS
• STANDING WATER

• Day biting
• 2 hours after sunrise, 2 hours before sunset
• Low flying

• Stripped
• white markings on legs and a marking in the form of a lyre on the thorax.

ONLY FEMALES BITE FOR BLOOD TO MATURE EGGS

• GRADE I - MILD
• GRADE II - MODERATE
• GRADE III - FRANK/SEVERE
• GRADE IV - SHOCK

• slight fever, non-specific constitutional symptoms
• (+) tourniquet test

All signs of Grade I with (+)

–Epistaxis

–Gum bleeding,

–GIT Bleeding

• (+) Circulatory failure (s/sx of beginning shock)
• may terminate in recovery or death

• there is profound shock
• undetectable BP and pulse
• Poor prognosis; may lead to DIC à Death

• FEBRILE
• CRITICAL/ CIRCULATORY/ TOXIC/ HEMORRHAGIC
• CONVALESCENT/ RECOVERY

• lasting from 2-3 days
• high fever, frequently over 40 °C

associated with generalized pain and a headache, n/v

– (+) TOURNIQUET TEST

–(+) HERMAN’S SIGN

–some mild bleeding from mucous membranes of the mouth and nose

usually on the 3rd-5th day

• -the resolution of the high fever and typically lasts one to two days.
• -there may be significant fluid accumulation in the chest and abdominal cavity

This leads to depletion of fluid from the circulation and decreased blood supply to vital organs

–(-) TOURNIQUET TEST

organ dysfunction and severe bleeding may occur

the 7TH -10TH  day

• Generalized flushing with Intervening areas of blanching
• BP stable
• Appetite regained
• The improvement is often striking, but there may be severe itching and a slow heart rate.
• It is during this stage that a fluid overload state may occur

• –which if it affects the brain
• may reduce the level of consciousness or cause seizures

• Non resolving fever
• Body pain
• Low platelet count
• Bleeding
• Herman’s Sign

appears on the upper and lower extremities

purplish or violaceous red with blanched areas about 1 cm or less in size.

• Oral rehydration therapy
• IV fluids administration 
• Blood transfusion and blood products

• Avoid crowded places
• Mosquito repellents
• Proper clothing
• Mosquito-free environment
• Stagnant water

Ague, Basra

MALARIA

• P. VIVAX
• P. OVALE
• P. FALCIPARUM
• P. MALARIAE

Vector borne – anopheles mosquito

12-14 days, depends on the strain

• HEPATOMEGALY
• HEADACHE
• FEVER
• FATIGUE
• PAIN
• CHILLS AND SWEATING
• DRY COUGH
• N/V

• Chills
• fever
• Nausea and vomiting
• Hepatomegaly and splenomegaly
• Pallor

• QUININE
• CHLOROQUINE
• PRIMAQUINE

ELEPHANTIASIS

FILARIASIS

• Wuchirea bancrofti
• Brugea malayi

• Vector borne – Aedes species
• ARMIGERES SUBALBATUS
• CULEX NIL

MARINDUQUE

Asymptomatic in early stages

Progressive lymphedema

Slow developing physical deformity

Legs

Testicular sac in males

Labia majora in females

It can also affect other parts of the body

• DEC – Diethyl carbamazepine
• Reconstructive surgery
• Diuretics

• INPUT AND OUTPUT MONITORING
• METICULOUS SKIN CARE

HANSEN'S DISEASE

LEPROSY

MYCOBACTERIUM LEPRAE

DROPLETS

CHRONIC ILLNES

• Paucibacillary (Tuberculoid)
• Multibacillary (Lepromatous)

GERHARD ARMAUER HANSEN

Ziel-Nielsen carbolfuchsin (Acid Fast Stain)

Loss of sensation and sweating

Hypopigmentation

Desquamations

Deformations

• MDT
• Dapsone
• Rifampin
• Clofazimine
• Ambulatory

• SKINCARE 
• NUTRITION

• Dapsone
• Rifampin
• Clofazimine

• Weil’s Disease
• Canicola fever
• Swineherd’s disease
• Icterohemorrhagic spirochetosis

LEPTOSPIROSIS

• Leptospira canicola
• Leptospira icterohemorrhagiae

Direct inoculation by wading in flood water or animal bites

• 4-20 DAYS
• COMMON DURING RAINY SEASON

• Leptospiremic Phase
• -Low grade fever, chills, headache, malaise
• -Photophobia, Conjunctival erythema
• -GI manifestations

• Immune/Toxic Stage
• -Meningeal involvement
• -Hepatic manifestations

• IF SYMPTOMATIC
• PENICILLIN G
• FLUID SUPPORT 
• DOXYCYCLINE

• Environmental control
• CBR
• Nutrition
• Monitoring

• Diarrhea with alternating constipation
• Mucoid stools
• Occult blood in stools
• Tenesmus
• Abdominal discomfort

ENTAMOEBA HYSTOLYTICA

• ORS
• IV Fluid
• Metronidazole
• Contact prophylaxis

• Viral Hepatitis A
• Infectious Hepatitis
• Epidemic Jaundice
• Food Worker’s Hepatitis
• Poor man’s Hepatitis
• Acute Hepatitis

HEPATITIS A

15- 50 DAYS

FECAL-ORAL ROUTE

• Viral Hepatitis B
• Serum Hepatitis
• Homologous Serum Hepatitis
• Chronic Hepatitis

HEPATITIS B

45-180 DAYS

• Blood borne
• Sexual Contact

• PERCUTANEOUS PERMUCOSAL
• BODY FLUIDS/BLOOD

• Jaundice
• Icteric sclerae
• Kernicterus
• Loss of Appetite
• Hepatic manifestations
• Weakness
• Enzymatic changes
• Fat intolerance
• Tea colored urine
• Clay like stools
• Cirrhosis

• Hepatic Support
• Fluids
• Supportive
• Serum Isolation
• Immunization
• Blood Screening

• NUTRITION 
• CBR

ENTERIC FEVER

TYPHOID FEVER

SALMONELLA TYPHOSA

FECAL ORAL ROUTE

1-2 WEEKS

as long as agent is excreted in excreta

ROSE SPOTS

• red macular lesions 2-4 millimeters in diameter 
• bacterial emboli to the skin (approx 1/3 of cases )

appear as a rash between the 7th and 12th day from the onset of symptoms.

groups of five to ten lesions on the lower chest and upper abdomen

MARY MALLON

• ANTIBIOTICS
• FLUOROQUINOLONE (OFLOXACIN)
• CEFTRIAXONE  
• CEFOTAXIME

• ALTERNATIVE
• CHLORAMPHENICOL
• AMOXICILLIN
• TMP-SMX

• 1ST - SMALL INTESTINAL MUCOSA
• 2ND - LIVER, SPLEEN, LYMPHATICS
• 3RD - ULCERATION OF PEYER'S PATCHES (INTESTINAL)

SEPTICEMIA > ENDOTOXEMIA > FEVER/SHOCK > DEATH

• Widal’s test
• Thypidot

indirect agglutination test for enteric fever whereby bacteria  is mixed with a serum w/ specific antibodies from infected individual

• Rose spots
• Blood in stools
• Spleen enlargement
• Diarrhea

• Chloramphenicol
• Electrolyte Balance
• Enteric Isolation

• CBR
• Temp monitoring
• V/S
• Nutrition – Advised regimen

HYDROPHOBIA

RABIES

Neurotropic virus

ANIMAL BITES

• Prodromal Stage
• Headache
• Fever
• Hyperesthsia
• Pupil dilation
• Salivation

• Excitation Stage
• Agitation
• Restlessness,
• Hallucinations
• Aimless motor activities

• Paralytic Stage
• Progressive paralysis
• Respiratory failure

• Headache
• Fever
• Hyperesthsia
• Pupil dilation
• Salivation

• Agitation
• Restlessness,
• Hallucinations
• Aimless motor activities

• Paralytic Stage
• Progressive paralysis
• Respiratory failure

SCRATCHING DISEASE

SCABIES

SARCOPTES SCABIEI

DIRECT CONTACT

4-6 WEEKS

• Scab formation
• Itching
• Burrows

• PERMETHRIN
• SULFUR OINTMENT

• METICULOUS SKIN CARE
• PREVENTION OF INFECTION

EL TOR

CHOLERA

VIBRIO CHOLERAE

1 HR - 5 DAY

FECAL ORAL ROUTE

• Massive diarrhea
• Dehydration
• Electrolyte imbalance
• Hypovolemia
• Weakness
• Vomiting
• Cramps - tetany
• Exhaustion
• Washer woman’s hands
• Low grade fever
• Oliguria, anuria

• ORS
• Aggressive fluid replacement
• Tetracycline

• I/O monitoring
• Fluid & electrolyte replacement
• CBR
• Enteric Isolation

• Bad Blood
• Lues
• Pox
• Syph

Treponema pallidum

10-90 DAYS

DIRECT CONTACT

VARIABLE

Infections may be multi-systemic in chronic cases

• Darkfield Examination
• Wasserman Test
• Flourescent Tagged Antibody
• Rapid Plasma Reagin card test
• VDRL

• Chancre
• Fever
• Headache
• Weight Loss
• Sore Throat
• Malaise
• Muscle/joint pain
• Lymph node enlargement

• Penicillin-Benzathine 2.4 M units
• Ceftriaxone + Tetracycline
• Identification and treatment of Contacts

If persistent for a long time, a multi-systemic problem is anticipated

Clap, Whites, Dose, Drips

Neisseria gonorrheae

2-7 DAYS OR LONGER

• Burning sensation in urination
• Redness and edema on meatus
• Thin clear mucus discharge
• Inflammation may spread to anal area and prostate
• Painful intercourse

Procaine Pen B

Ceftriaxone + doxycycline

Creeds' prophylaxis

HIV/AIDS

6 MONTHS- YEARS

WINDOW PERIOD

• Lowering CD4 count
• 500 HIV +
• 200 AIDS
• 100 Full blown AIDS
• Decrease host resistance
• Reoccurrence of simple infections
• Loss of weight
• Oral thrush
• Dimentia
• Kaposi’s Sarcoma

• Cocktail
• Azidithymidine
• Zetrovir
• Zidovudine
• Reverse Isolation

• Universal Precautions
• Suportive

CORONA VIRUS

• The most acute form of viral pneumonia
• Highly pathogenic but less virulent
• Has a natural predisposition in cold regions
• Characterized by onset of manifestations of pneumonia within 72 hours.

• High fever for 24 hours
• Body aches, malaise
• Pneumonia like manifestations
• Pleural complications – leading to pleural congestion

• Aggressive fluid support
• Supportive
• Isolation

• Strict Respiratory Isolation
• Monitor for progression
• Supportive
• I/O