AUBREY SUDARIA, RN MAN

 In order to control diarrheal diseases, DOH

established a program to address this.

(FWDPC) – FOOD AND

WATERBORNE DISEASES
PREVENTION AND CONTROL
PROGRAM
 Covers diseases of a parasitic, fungal, viral,
and bacteria in nature usually acquired
through the ingestion of contaminated
drinking water or food.
1. Prevent occurrence of food and waterborne
outbreaks through strategic placement of
water purification solution
2. Procure Intravernous fluid solutions,
venosets and IV cannula for adult and
pediatric patients in diarrheal outbreaks and
to be stockpiles at the (CHD) 17 Centers for
Health and Development and Central Office
for emergency response
3. Place first line and second-line anti-
microbial and anti-parasitic medicines such as
albendazole and praziquantel at CHDs.
4. Increase public awarenes in preventable
food-borne illness
5. Procure Typhidot-M diagnostic kits
6. Procure typhoid vaccine and oral cholera
vaccine
7. Provide training to local government unit
and allied medical personnel
 The Food and Waterborne Disease Control
Program targets individuals, families, and
communities residing in affected areas
nationwide.
 Case monitoring is maintained through the
(PIDSR) Philippine Integrated Disease
Surveillance and Response
 Outbreaks are being prevented through
public education in print and radio stations
 Multi drug resistant cases of typhoid are
monitored through reports from the hospital
sentinel
1. Typhoid fever
2. Cholera
3. Bacillary dysentery
1. Amoebiasis
2. Schistosomiasis
3. Helminth Infections
 -(aka enteric fever or typhus
abdominalis) an infectious bacterial
fever, potentially fatal
multisystemic illness with an
eruption of red spots on the chest
and abdomen and severe intestinal
irritation.
ETIOLOGIC AGENT: Salmonella typhi

Source of Infection: Feces and Urine of Infected

person

Mode of Transmission: Ingestion of Feces and

Urine of infected person
INCUBATION PERIOD: 6 days to 30 days

MODE OF TRANSMISSION: Direct and indirect

contact with patient or carrier.
Principal vehicles-food and water (by hands of
carrier, food handlers) Flies are known as
vectors.
1. Prodromal stage
2. Fastigial stage
3. Defevescent stage
1. Prodromal stage
fever
abdominal pain
constipation or diarrhea
Malaise
headache
2. Fastigial stage
- 3 cardinal symptoms
a. intermittent/ladderlike fever

b. ROSE spots- pathognomonic sign

rose colored macule

c. spleenomegaly
3. Defervescent Stage

-ulceration of Peyer’s patches (part of Ileum)

-melena (black tarry stool)
-hematochezia (fresh blood in feces)
-intestinal hemmorhage and perforation
1. WIDAL TEST
2. Blood culture
3. Urine culture
4. Stool culture
5. Typhidot
1. Supportive Care- fluids and electrolytes
- enteric precaution
-monitor I and O
2. Increase fluid intake
3. High calorie, low residue and non irritating food
4. WOF a. Perforation of Intestine
– S/S sudden sharp and abdominal pain
- rigidity and signs of shock
b. Typhoid Psychosis stage
–organism goes to brain (coma, vigil
look, blank stare, dilated pupil)
TREATMENT: Antibiotics- CHLORAMPHENICOL
and AMOXICILLIN

PREVENTION and CONTROL:

1. Sanitary disposal of human fecess
2. Sanitary supervision of processing,
preparation, and serving of food particularly
those eaten raw
3. Adequate provision for safe washing
facilities
4. Fly control and screening to protect foods
against fly contamination
5. Protection of purified water supplies and
construction of safe privy
6. Control of infected individual contacts and
environment
7. Reporting to local health office
8. Isolation of patient during acute illness
9. Rigid personal precautions by attendants
NURSING CARE:
1. Hospitalization if facilities are available
2. Teach and demonstrate to family how to
make patient comfortable
3. Low fiber plenty of fluids, easily digestible
foods
4. Nursing care should be prescribed
treatment by the physician
 -is an extremely virulent
disease that can cause severe
acute watery diarrhea.
Etiologic Agent: Vibrio Cholerae

Sources of Infection: Vomitus and fecess of

infected persons and feces of convalescent or
healthy carriers.

Mode of Transmission: Ingestion of food and

water contaminated with vomitus and stools
 Incubation Period:

It takes between 12 hours and 5 days for a

person to show symptoms after ingesting
contaminated food or water.
Cholera affects both children and adults and
can kill within hours if untreated.
DIAGNOSTIC TOOL:
1. Culture of stool and vomitus
2. Serology
A. Mild Cases- Undetectable
B. Severe Cases –
1. starts with colicky pain in abdomen
2.Diarrhea
3. stool is yellow at first
4. marked mental depression
5. Headache
6. continuous vomiting
7. DHN, Oliguria and anuria
8. Violent cramps (lower ext)
9. High grade fever
 RICE WATERY STOOL
 Washer woman’s hands
PREVENTION AND CONTROL:
1. Surveillance – stool sampling
2. Hospitalization- (isolation and medical care)
3. Water and Sanitation Intervention- (piped
water system, interventions at the
household level, safe sewage disposal)
4. Social mobilisation treatment - Health
education campaigns, IEC
5. Oral cholera vaccines- ORS and antibiotics
 Enteric precautions:
1. Isolation
2. Personal hygiene
3. I and O
4. Proper disposal of feces
5. 5 P’s – (food, flies, feces, fingers, fomites)
6. Care of the buttocks (skin care)
NURSING CARE
1. Increase OFI and Increase frequency of BF
2. Additional fluids “am”, soup, cereals
mashed vegetables
3. Coconut water- rich in potassium, one of
the electrolytes found in choleric stools
4. Make patient as comfortable as possible
5. ORS
 -infection of the intestines
resulting in severe diarrhea
with the presence of blood and
mucus in the feces

TWO TYPES:
1. BACILLARY DYSENTERY - bacteria
2. AMOEBIC DYSENTERY- parasite
ETIOLOGIC AGENT:
- shigella bacillus; Also known as shigellosis, is a
potentially dangerous and extremely
contagious bacterial infection of the colon.

SOURCES OF INFECTION: contaminated food and water

MODE OF TRANSMISSION: ingestion of contaminated

food and water (fecal-oral transmission)

INCUBATION PERIOD: 1-4 weeks

1. Fever – initial symptom
2. Vomiting and headache
3. Colicky or cramping abdominal pain-
anorexia, body malaise
4. Bowel movements- numerous accompanied
with abdominal cramps, TENESMUS 
5. Diarrhea- watery, scanty and bloody
6. Rectal prolapse
1. Maintain fluid and electrolyte balance
-assess weight, skin turgor, mucous membrane, I
and O
-give IVF and offer clear liquids

2. Restrict food till nausea and vomiting subsides

3. Supervision on food storage, cooking and
perforation
4. Medical handwashing
1. Fly control program
2. Surveillance of water sanitation
3. Handwashing after defecation
4. Detection and treatment of carriers
Etiologic agent: parasitic; ENTAMOEBA Histolytica

Clinical Variations: stools contain blood and mucus

may give rise to amoebic hepatitis or liver abscess

Mode of transmission:
1. Indirect contact: (flying insects) ingestion of
contaminated food and water
2. Direct contact: orogenital and oroanal sexual
activity

Diagnostic Exam: stool exam

 Liver abscess
 Lung abscess
 Brain abscess
 Peritonitis
 Meninggoencepalitis

Pathognomonic sign:
ANCHOVY SAUCE- aspiration of abcess
-aka also known as snail fever
and blood fluke; an acute and
chronic disease caused by
parasitic worms from snails.
ETIOLOGIC AGENT: flukes (trematodes) of the
genus Schistosoma
3 Species of blood fluke:
1. Schistosoma Haematobium –URINARY
SCHISTOSOMIASIS (iran and portugal)
2. Schistosoma Mansoni- HEPATO-INTESTINAL
SCHISTOSOMIASIS (Africa and South America
3. SCHISTOSOMA JAPONICUM- Philippines
MODE OF TRANSMISSION: direct penetration of the
Cercaria to the skin (3 to 5 min) found in
contaminated water

INCUBATION PERIOD: at least 2 months

CLINICAL MANIFESTATION: dermatitis, itchiness,

redness and pustule formation on cercarial
penetration areas, cough and hepatomegaly with
cirrhosis
Pathognomonic sign: SWIMMER’S ITCH
DIAGNOSTIC EXAM: Fecalysis, urinalysis
CPT- ( CERCUM OVAL PRECIPITIN TEST)
recommended in view of difficulty in
demonstrating eggs in fecess
TREATMENT:
1. PRAZIQUANTEL- drug of choice in all
species
2. Stibuphen (Fuadin)
3. Niridazole
 PREVENTION
1. Proper disposal of human feces
2. Spraying against snails
3. Creating foot bridges
4. Protective clothing
5. Agro-engineering measures- Improved
irrigation system
6. IEC
7. Treatment of small breeding size
8. Prevent exposure to contaminated water
-caused by different species of
parasitic worms. They are
transmitted by eggs present in
human faeces, which
contaminate the soil in areas
where sanitation is poor.
Caused by: Paragonimus Westermani
-ingestion of raw or insufficiently cooked crab
or crayfish containing larvae

S/Sx: 1. Voracious appetite – Greedy in eating

2. Pot belly – protruding abdomen
3. Malnourished
4. anemia
Diagnotic tool: stool exam

Nursing Care: Symptomatic, focused on

hygiene of the patient

Treatment: Anti Helminthics- Combantrin/ Antiox

Prevention: 1. proper preparation of food

2. proper disposal of waste
3. precaution of the 5 F’s
Caused by nematode TRICHINELLA SPIRALIS
-roundworms taken thru ingestion of
uncooked pork and pork products secondary
to feeding of uncooked food or garbage
 Thru contaminated soil by human feces
containing hookworm ova
 Caused by: Ancylostoma duodenale –Asia
Necator Americanus- America
 Caused by Ascaris lumbricoides
 -large round worm about 4-12 inches
 -ingestion of eggs thru soil contaminated by
human fecess and contaminated food water
 PINWORM, THREADWORM or SEATWORM
 -caused by Enterobius Vermicularis
 -thru anal-oral transmission of eggs or
indirect transmission from contaminated
clothing, beddings or food
 Characterized by nocturnal anal itchiness
Caused by:
Taeniasis Saginata- beef tapeworm
Taenia Solium- pork tapeworm
Dyphyllobothrium Latum- fish tapeworm
Caused by Trichiuris Trichiuria
-soil and food contaminated with fecess