Communicable Diseases

Common Terms
Infection is the implantation and successful
replication of an organism in the tissue of the
host, resulting in s/sx, as well as immunologic
response.
Carrier is an individual who harbors the
organism and is capable of transmitting it to a
susceptible host but does not show
manifestations of the disease
 Communicable disease is an illness caused
by an infectious agent or its toxic products
that are transmitted directly or indirectly to a
well person through an agent, vector or
inanimate object.
Contact is any person or animal that is in
close association with an infected person,
animal, or freshly soiled materials.
 Contagious disease is one that is easily
transmitted from one person to another
through direct or indirect means.
Disinfection is the destruction of pathogenic
microorganism outside the body through
direct physical or chemical means.
 Concurrent disinfection is a method done
immediately after the infected individual
discharges infectious material/secretions, i.e., it is
done while the patient is still the source of
infection.
Terminal disinfection is applied when the
patient is no longer the source of infection (either
because the patient has died or has been
discharged). Everything the patient has used,
including the room he/she occupied, is
disinfected.
 Habitat - is a place where an organism lives or
where an organism is usually found.
Host is a person, animal, or plant on which a
parasite depends for its survival.
Infectious disease is transmitted not only
through ordinary contact but also requires
direct inoculation of the organism through a
break on the skin or mucous membrane.
Hence, all contagious disease are infectious.
 Isolation is the separation from other
persons of an individual suffering from a
communicable disease.
Quarantine is the limitation of the freedom
of movement of persons or animals which
have been exposed to a communicable
disease/s for a period of time equivalent to
the longest incubation period of that disease.
 Reservoir is an animal or plant in which an
infectious agent lives and reproduces in such a
manner that it can be transmitted to man.
Surveillance is the act of watching.
 Infection is the invasion and multiplication
of microorganisms in the tissues of the host,
resulting in signs and symptoms, as well as
immunologic response.
Sporadic diseases are diseases that occur
occasionally and irregularly with no specific
pattern. (Example: tetanus, gas gangrene)
 Epidemic diseases are diseases that occur in a
greater number than what is expected in a
specific area over a specific time.
Pandemic is an epidemic that affects several
countries or continents. Current examples are
HIV/AIDS, SARS, and Influenza AH1N1
Endemic diseases are present in a population or
community at times. They usually involve few
people during specific periods.
 Causative
agent

Susceptible Reservoir
Host

Portal of
Portal of Exit
Entry
Mode of
Transmission
 Causative agent is any microbe capable of
producing disease.
Reservoir of infection refers to the
environment and objects on which an
organism survives and multiplies.
Portal of exit is the path or way through
which the organism leaves the reservoir.
 Mode of transmission is the means by which
the infectious agent passes through from the
portal of exit of the reservoir to the
susceptible host.
Portal of entry is a venue through which the
organism gains entrance into the susceptible
host.
Susceptible host human with weakened
immune system
 The process of completely destroying all
microbial forms on a non-living object:
a. Tyndallization b. Sterilization

c. Disinfection d. Antisepsis
 The process by which most microbial forms in
a non-living object are destroyed, without
necessarily destroying saprophytes and
endospores:
a. Pasteurization b. Sterilization

c. Tyndallization d. Disinfection
 These are agents that are capable of inhibiting
the growth of bacteria without necessarily
killing them:
a. Antiseptic agents b. Bactericidal agents

c. Bacteriostatic agents d. Sporicidal agents

 This is a universally applicable method of
sterilization:
a. Heat b. Dessication
c. Freezing d. Filtration
 An alkylating agent that is used to kill
Mycobacterium tuberculosis in sputum:
a. Glutaraldehyde b. Formaldehyde

c. Ethylene oxide d. Hydrogen

peroxide
 A halogen that is considered as the best
antiseptic because of its broad spectrum
property:
a. Chlorine b. Hydrogen peroxide

c. Iodine d. Formaldehyde
 This compound can be used as prophylaxis to
prevent ophthalmia neonatorum:
a. Silver sulfadiazine b. Silver nitrate

c. Methiolate d. Mercuchrome
 The following are general aseptic procedure
that help to preserve and maintain a clean
environment except:
a. Use of common barriers
b. Frequent handwashing
c. Proper labeling of containers regarding the
date and time of disposal
d. Regular checking and emptying of containers
of surgical drains
 A type of precaution that applies to all body
fluids, including blood, skin, and mucous
membrane:
a. Isolation precaution
b. Universal precaution
c. Transmission-based precaution
d. Reverse isolation
 A number of new cases of a particular disease
that occurred during a specified period per a
specifically defined population. (1,000:10,000)
a. Incidence b. Morbidity rate
c. Mortality rate d. Prevalence
 This is the ratio of the number of people who
died of a particular disease during a specified
period per a specified population
a. Incidence b. Morbidity rate

c. Mortality rate d. Point prevalence

 A disease that occurs only occasionally within
the population of a particular geographic area.
a. Endemic disease b. Sporadic disease
c. Epidemic disease d. Pandemic disease
 A disease that is occurring in epidemic
proportions in a many countries
simultaneouslysometimes worldwide.
a. Endemic disease b. Sporadic disease
c. Epidemic disease d. Pandemic disease
 This is greater than usual number of cases of a
disease in a particular region, usually
occurring within a relatively short period.
a. Endemic disease b. Sporadic disease
c. Epidemic disease d. Pandemic disease
 Infection Control Measures
Universal precaution means that all patients
shall be assumed with HIV/AIDS and other
blood-borne pathogens.
Bodily fluids included in universal precaution
-blood -semen -vaginal secretions
-synovial fluid -amniotic fluid
-cerebrospinal fluid -pleural fluid
-peritoneal fluid -pericardial fluid
Bodily fluids not included in universal precaution
-feces -nasal precautions
-urine -vomitus
-sweat -sputum
-saliva (if not contaminated with blood)
 Infection Control Measures
Masking
Handwashing
Gloving
Gowning
Eye protection (goggles)
Environmental disinfection
COMMON COMMUNICABLE
DISEASES
 HIV/AIDS
Etiologic agent
Human T-cell Lymphotrophic Virus 3 HTLV3
MOT
-sexual contact (unprotected, multiple partner)
-blood transfusion of contaminated blood
-sharing contaminated syringes and needles
-direct contact of open wound, mucous membrane,
body secretion
-maternal to offspring
 HIV/AIDS
Signs & Symptoms
-loss of appetite
-weight loss
-fever of unknown origin
-pneumocystic carinii pneumonia
-body malaise
-persistent diarrhea
 HIV/AIDS
Signs & Symptoms
-Kaposi sarcoma
-TB
Early stage: loss of concentration, loss of libido,
apathy, psychomotor retardation, withdrawal
Terminal stage: confusion, disorientation,
seizures, mutism, loss of memory, coma, death
 HIV/AIDS
Diagnostic examination
-EIA or ELISA enzyme-linked immunosorbent
assay (presumptive)
-Western Blot analysis confirmatory
Incubation Period 6 months to 9 years
 HIV/AIDS
Treatment
-Ritonavir (Norvir)
-Zidonavir (ZVD)
 HIV/AIDS
FOUR Cs (DOH 2000)
-Compliance
-Counseling/education
-Contact tracing
-Condoms
 TUBERCULOSIS
Causative agent
-Mycobacterium tuberculosis (human)
-Mycobacterium africanum (human)
-Mycobacterium bovis (animal, cattle)
 TUBERCULOSIS
Mode of transmission
-airborne droplet
-direct invasion though mucous membranes or
breaks in the skin
-ingestion of contaminated unpasteurized milk
 TUBERCULOSIS
Signs & Symptoms
-cough for 2 weeks or more
-fever
-chest or back pains not referable to any musculo-
skeletal disorders
-hemoptysis or recurrent blood-streaked sputum
-significant weight loss
-others: sweating, fatigue, body malaise and SOB
 TUBERCULOSIS
Dx Test
-Direct Sputum Smear Microscopy
(early morning sputum, 3x negative result- rule out)
-Chest x-ray
-sputum, gastric culture
-physical exam (TB symptomatics)
-Mantoux Test (read after 48-72 hrs, 10mm or more
(+); 30mm or higher-suggestive of secondary
infection
 TUBERCULOSIS
Incubation period
-2-10 weeks
Treatment
-Domiciliary treatment
(HRZE/RIPES)
 LEPROSY
Causative agent
-Mycobacterium leprae; Hansens bacillus
MOT
-airborne
-prolonged skin to skin contact
 LEPROSY
Signs & Symptoms
-Early: change of skin color
loss of sensation on the lesion
thickened or painful nerves
nasal obstruction or bleeding
pain and redness of the eyes
decrease/loss of sweating and hair
growth over the lesion
 LEPROSY
Late: madarosis
lagophthalmos
clawing of fingers and toes
contractures
sinking of the nosebridge
gynecomastia
chronic ulcers
 LEPROSY
Diagnostic test
-slit skin smear
Treatment
-ambulatory chemotherapy through use of
multi-drug therapy
MDT Dapsone
Rifampicin Lamprene
-domiciliary treatment
 SCHISTOSOMIASIS
Causative agent
-Schistosoma mansoni
-Schistosoma japonicum
-Schistosoma haematobium
Mode of transmission
-skin comes in contact with fresh water in
certain types of snails that carry schistosomes
 SCHISTOSOMIASIS
Signs & Symptoms
-Early: diarrhea bloody stool
weakness emaciated
anemia
-Late: enlarged liver enlarged spleen
enlarged abdomen
epilepsy
 SCHISTOSOMIASIS
Diagnostic test
-Kato Katz
Treatment
DOC Praziquantel (Biltricide)
Oxaminiquine for mansoni
Metrifonate for haematobium
 FILARIASIS
Causative agent
-Wuchereria bancrofti
-Brugia malayi
-Brugia timori
Mode of transmission
-bites from Aedes poccillus that bites at night
 FILARIASIS
Signs & Symptoms
-Acute stage: Lymphadenitis
Lymphangitis
-In some cases, male genitalia is affected leading
to funiculitis, epidimitis or orchitis
-Chronic stage: Hydrocele
Lymphedema
Elephantiasis
 FILARIASIS
Diagnostic Test
-Nocturnal blood examination (8PM)
-Immunochromatographic Test (ICT) can be
done at daytime
Incubation
-8-16 months
 FILARIASIS
Treatment
-Diethylcarbamazine citrate (DEC) or Hetrazan
-Surgical:
Lymphovenous anatosmosis distal to the site for
mild cases of lymphedema
 MALARIA
Causative agent
-Plasmodium falciparum
-Plasmodium vivax
-Plasmodium ovale
-Plasmodium malariae
 MALARIA
Mode of transmission
-bite of female Anopheles mosquito
Signs & Symptoms
-recurrent chills -hepatomegaly
-fever -spleenomegaly
-profuse sweating
-anemia
 MALARIA
Diagnostic test
-malarial blood smear taken at the height of
fever
Incubation period
-7-30 days months, years
 MALARIA
Treatment
-Chloroquine at weekly intervals starting from 1-
2 weeks before entering the endemic area
-In pregnant women, it is given throughout the
duration of pregnancy
 MALARIA
-Other malarial drugs
Chloroquine phosphate
sulfadoxine
Quinine sulfate
Tetracycline hydrochloride
Quinidine glucolate
 DENGUE HEMORRHAGIC FEVER
Causative agent
-Dengue virus type 1, 2, 3, 4
-Chikugunya
Mode of transmission
-mosquito bite (Aedes aegypti)
 DENGUE HEMORRHAGIC FEVER
Signs & Symptoms
-First 4 days: high fever
abdominal pain
headache
later flushing which may be
accompanied by vomiting
conjuntival infection with
epistaxis
 DENGUE HEMORRHAGIC FEVER
Diagnostic test
-Torniquet test (Rumpel Leeds Test)
-CBC
-Platelet count
Incubation period
-uncertain probably 6 days to one week
 DENGUE HEMORRHAGIC FEVER
Treatment
-supportive and symptomatic
 MEASLES
Causative agent
-Filterable virus of measles
Mode of transmission
-droplet spread or direct contact with infected
person
-or indirectly through particles freshly soiled
with secretions of nose and throat
 MEASLES
Signs & Symptoms
-fever
-rashes
-2 days coryza
-Koplik spot on the 3rd and 4th day affecting the
face, body and extremities ending in branny
desquamation
 MEASLES
Incubation period
-10 days from exposure to appearance of fever
-14 days until rashes disappear
 CHICKEN POX (Varicella)
Causative agent
-Human (alpha) herpes virus 3 (varicella zoster
virus)
Mode of transmission
-direct contact or droplet spread
-indirect through articles freshly soiled by
discharges of infected persons
 CHICKEN POX (Varicella)
Signs & Symptoms
-sudden onset with slight fever
-maculo-papular eruptions for a few hours
-vesicular for 3-4 days and leaves granular scabs
Incubation period
-2-3 weeks, commonly 13-17 days
 CHICKEN POX (Varicella)
Treatment
-antiviral (zovirax)
-antipyretic
-isolation
-steroid
 MUMPS (Epidemic parotitis)
Causative agent
-Mumps virus, a member of the family
Paramyxoviridae
Mode of transmission
-direct contact
-indirect contact with contaminated articles
 MUMPS (Epidemic parotitis)
Signs & Symptoms
-swollen parotid glands
-slight fever
-anorexia
-earache
-difficulty of swallowing
-body malaise
-orchitis
 MUMPS (Epidemic parotitis)
Incubation period
-12-26 days (18 days ave.)
Treatment
-symptomatic
-antiviral
-immunization
-sedative to relieve pain in orchitis, best rest,
sling between thighs to support the testes
 DIPHTHERIA
Causative agent
-Corynebacterium diphtheriae (Klebs-Loeffler
bacillus)
Mode of transmission
-direct
-indirect thru soiled articles or contaminated
milk
 DIPHTHERIA
Signs & symptoms
-fever
-pseudomembrane
-infection of tonsils, nose, throat
-nasal diphtheria marked by one side nasal
discharges and exocriated nostrils
-non-respiratory or cutaneous diphtheria
localized as punched out ulcers
 DIPHTHERIA
Diagnostic test
-Schicks test
Incubation period
-2-5 days
Treatment
-Immunization
-pasteurization of milk
-proper management of antibiotics and other
treatment
 WHOOPING COUGH (Pertussis)
Causative agent
-Hemophilus pertussis
-Bordet-Gengou bacillus
-Pertussis bacillus
Mode of transmission
-direct spread, through respiratory and salivary
contact
-droplet
 WHOOPING COUGH (Pertussis)
Signs & Symptoms
-cold
-2nd wk proxysmal coughing characteristics
with whoop like sound as breath is drawn in
-vomiting may follow spasm
-coughing last several weeks up to 2-3 months
 WHOOPING COUGH (Pertussis)
Incubation period
-7-10 days, not exceeding 21 days
Treatment
-DPT immunization
-isolation for 3 wks from appearance of paroxysmal
cough
-aseptic technique, disinfection
-abdominal support during coughing
-nose and throat care
 TETANUS
Causative agent
-Tetanus bacillus ABC
Mode of transmission
-contamination through droplet infection or by
articles freshly soiled with discharge of nose and
throat of infected person
 TETANUS
Signs & Symptoms
-muscular contractions
-high fever
-respiratory symptoms
-body malaise
-joint pains
 TETANUS
Incubation period
-3 days 1 month
Treatment
-immunization
 PNEUMONIA
Causative agent
-Diplococcus pneumoniae
-Pneumococcus of Friedlander
Mode of transmission
-droplet, direct or contact with nasal, throat
secretions
 PNEUMONIA
Signs & symptoms
-rhinitis -chest drawing
-rusty sputum -productive cough
-fast respiration -high fever
-vomiting -pain on affected lungs
-highly colored urine due to low chloride and
high urates
 PNEUMONIA
Diagnostic test
-Chest X-ray
-Dull percussion of affected lungs
Incubation period
-2-3 days
Treatment
-Increase fluids, increase nutrients
-antibiotics
-care for fever and other s/sx manifested
 CHOLERA
Causative agent
-Vibrio El Tor
Mode of transmission
-food and water contaminated with vomitus and
stools
 CHOLERA
Signs & symptoms
-acute serious illness
-profuse colorless diarrhea
-vomiting
-severe dehydration
-muscular cramps
-cyanosis
-shock
 CHOLERA
Diagnostic test
-stool exam
Incubation period
-few hours to 5 days (3 days ave.)
Treatment
-Isolation of (+) cases
-Oral Rehydration Therapy
coconut water, breastfeeding, ORESOL, am
soup
 TYPHOID FEVER
Causative agent
-Salmonella typhosa
-Typhoid bacillus
Mode of transmission
-direct or indirect contact with patient or carrier
and contact with contaminated water and food
 TYPHOID FEVER
Signs & symptoms
-continued fever
-anorexia
-slow pulse
-ulceration of Peyers patches
-enlarged spleen
-rose spots on trunk
-diarrhea
 TYPHOID FEVER
Diagnostic test
-Widal test
Incubation period
-1-3 weeks (ave. 2 weeks)
Treatment
-Immunization
 Soil transmitted helminthiases
Causative agent
-Ascaris lumbricoides
-Trichuris trichiura
-Hookworm (Ancylostoma duodenale and
Necator americanus)
 Soil transmitted helminthiases
Mode of transmission
-contaminated fingers, food and water with
parasitic ova
-Hookworm contact with the skin
 Soil transmitted helminthiases
Signs & symptoms
-anemia
-malnutrition
-stunted growth in height & body size
-decreased physical activity
-impaired mental development and school
performance
 Soil transmitted helminthiases
Diagnostic test
-stool exam
-blood exam
Treatment
-Proper dosage of medication and completion of
treatment
 Hepatitis A
Causative agent
-Hepatitis A virus
Mode of transmission
-fecally contaminated water and food
 Hepatitis A
Signs & symptoms
-influenza
-malaise and fatigability
-anorexia and abdominal discomfort & pain
-nausea & vomitting
-Lymphadenopathy
-jaundice with pruritus & urticaria
-bilirubinemia with clay-colored stools
-fever
 Hepatitis A
Diagnostic test
-HAV test or anti-HAV
Incubation period
-15-50 days depending on dose of infecting virus
Treatment
-Prophylaxis-IM injection of gamma globulin
-Low fat diet but high in sugar
 Paralytic shellfish poisoning
Causative agent
-dinoflagellates (Plankton)
Mode of transmission
-ingestion of raw or inadequate cooked shell
 Paralytic shellfish poisoning
Signs & symptoms
-numbness of face around the mouth
-vomiting and dizziness
-headache
-tingling sensation- paralysis of hands & feet
-floating sensation
-increased pulse rate
-difficulty in speech (ataxia)
-difficulty in swallowing (dysphagia)
 Paralytic shellfish poisoning
Incubation period
-30 mins - several hours after ingestion
Treatment
-induce vomiting
-drink fresh coconut milk
 LEPTOSPIROSIS
Causative agent
-Leptospira interrogans
Mode of transmission
-contact with open wounds with contaminated
water, moist soil or vegetation contaminated
with urine of infected host
 LEPTOSPIROSIS
Signs & symptoms
-fever
-headache
-myalgia and cough
-GIT s/sx and chest pain
 LEPTOSPIROSIS
Diagnostic test
-culture of blood and CSF and urine
Incubation period
-7-19 days (10 days ave.)
Treatment
-Penicillin
-Tetracycline
-Erythromycin
 RABIES
Causative agent
-Rhabdovirus or lyssavirus
Mode of transmission
-bite of rabid animal
 RABIES
Signs & symptoms
-increased sense of apprehension
-headache
-fever
-sensory changes near the animal bite
-fear of water
-paralysis
-delirium and convulsion
-death due to respiratory paralysis
 RABIES
Incubation period
-2-8wks with history of 20 years
Treatment
-passive immunization
 SCABIES
Causative agent
-Sarcoptes scabies
Mode of transmission
-parasitic infestation caused by itch mites
Signs & symptoms
-itching
-when secondarily infected, skin may feel hot and
burning but this is a minor discomfort
-fever, headache and malaise when secondary
infection is severe
 SCABIES
Incubation period
-24 hours from the original contact
Treatment
-warm soapy bath to remove scaling debris from
crusts
-Lindane lotion (Kwell 1%)
-encourage to change clothing frequently
-separate clothing from the rest of the family
 ANTHRAX
Causative agent
-Bacillus anthracis
Mode of transmission
-contact with tissue of contaminated animal or
biting
 ANTHRAX
Signs & symptomps
-Cutaneous anthracis
skin itch-papule appearance
vesicles black eschars
patchy hair loss
-Inhalational anthrax (woolsorters disease)
severe viral respiratory disease
fever, stridor, hypoxia, dyspnea, hypotension
 ANTHRAX
-Gastrointestinal anthrax
hemorrhagic lymphadenitis
fever, nausea & vomiting, abdominal pain,
bloody diarrhea, ascitis
 ANTHRAX
Treatment
-immunization
-Parenteral Penicillin G
-erythromycin, tetracyline, chloramphenicol
 Entamoeba histolytica
Intestinal protozoa
2 stages of life cycle non-motile cyst; motile
trophozoite
Trophozoite is found within the intestinal and
extraintestinal lesions and in diarrheal stools
Cysts are usually found in non-diarrheal stools
 Entamoeba histolytica
Pathogenesis and epidemiology
- Organism can be acquired by cyst ingestion
(fecal-oral route)
- Enzymes of trophozoites cause local necrosis
producing the typical flask-shaped ulcer
- Invasion of portal circulation may occur
leading to development of abscess in the liver
- Common in tropical country esp. with poor
sanitation
 Entamoeba histolytica
Disease Amebiasis
1. Acute intestinal amebiasis presents as
dysentery (bloody, mucus-containing
diarrhea) accompanied with lower abdominal
discomfort, flatulence, and tenesmus
Chronic infection- occasional diarrhea, wt
loss, fatigue or granulomatous lesion
(ameboma) may form in cecum or
rectosigmoid area of the colon.
 Entamoeba histolytica
2. Amebic abscess of the liver
- RUQ pain, wt loss, fever, tender and enlarged
liver
- abscess is like anchovy-sauce appearance
- abscess found on the right lobe of the liver
may penetrate the diaphragm and cause lung
disease
 Entamoeba histolytica
Laboratory diagnosis
- Trophozoites in diarrheal stools or cysts in
formed stools
- Trophozoites contain ingested RBC
- Diarrheal stool should be examined within 1
hour of collection to see the motility of the
trophozoite
- Serologic testing may be useful for the
diagnosis of invasive amebiasis
 Entamoeba histolytica
Treatment
- DOC is metronidazole or tinidazole
- Asymptomatic carrier should be treated with
iodoquinol or paromomycin
Prevention
- Good personal hygiene
- Purification of water source
- Avoid using night soil for fertilization
- Adequate cooking of vegetables
 Trichomona vaginalis
Important properties
- pear-shaped organism with central nucleus
and four anterior flagella
- Exists only in the trophozoite form (infective
and pathogenic form)
 Pathogenesis and epidemiology
- Transmitted mainly by sexual contact
- Organism is primarily located in the vagina
and the prostate
- Most common worldwide infection
- Frequency of infection is highest among
sexually-active women in their thirties and
lowest in postmenopausal women
 Disease: Trichomoniasis
- Infection leads to vaginitis
- Watery, foul-smelling, greenish vaginal discharge
accompanied by itching (pruritus) and burning
sensation
- Cervix is very red, with small, punctuate
hemorrhages giving rise to a strawberry cervix
- Asymptomatic in men (some may manifest
urethritis or prostatitis)
 Laboratory diagnosis
- Visualization of the characteristic trophozoite in a wet
mount of vaginal or prostatic secretions
Treatment & prevention
- DOC metronidazole
- To prevent ping-pong infections, there should be
simultaneous treatment of both sexual partners
- Maintenance of low pH of vagina
- Use of condoms
- Health and sex education
 Neisseria meningitidis
Meningococcus
Transient flora of the nasopharynx
Gram negative diplococci
Transmitted through respiratory droplets
Infection begins in the throat
Meningococcemia is life-threatening; may
lead to destruction of adrenal glands
(Waterhouse-Friderichsen Syndrome)
 Neisseria meningitidis
Blood & CSF are most useful specimen for
culture
DOC penicillin; alternatives are broad
spectrum cephalosporins and
chloramphenicol
Minocycline and rifampicin are used to treat
carriers
Sulfonamides and rifampicin for prophylaxis