Infectious Diseases

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Chapter 2

• Infectious Diseases

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Infectious Diseases

• Occur whenever a pathogenic microorganism finds a
  suitable environment.
• Suitable means (for most pathogens) dark, moist,
  warm with oxygen supply although some organisms
  prefer an environment without oxygen.

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Communicable Diseases

• AKA contagious
• Any disease readily transferred from one person
  to another.
• Reportable

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Decline in Communicable Diseases

• Immunizations
• Sanitization
• Antibiotics

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Examples and Portals of Exit/Entry

• HIV
• Diphtheria
• Hepatitis A
• Hepatitis B
• Hookworm
• Influenza
• Measles
• Mumps Pertussis
• Rubella

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Infectious Periods

• Important to know
• Gives the opportunity to isolate who has been
  infected.
• This can prevent further exposure.

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Your responsibilities

• All medical personnel and hospital staff are
  required to report confirmed cases of some
  communicable diseases.
• Report to county and state health departments.
• Helps to alert community to problems and reduces
  the risk of epidemics.

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Epidemic, Endemic, Pandemic

• Pan all
• End/owithin
• Epi-above

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Common Cold

• Viral-Mycoplasma
• Acute infection
• URT
• Accounts for more lost work time than anything
  else.
• Common in winter months.

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Signs and Symptoms

• Congestion
• Pharyngitis
• Fever
• Malaise
• Lasts 2-4 days
• Contagious 2-3 days after onsetpretty much the
  entire length of the illness.

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Diagnostic procedures

• None

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Treatment

• Supportive/symptomatic
• Analgesics
• Fluid
• Rest

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Prognosis

• Usually resolves on its own.
• Can lead to secondary bacterial infections.
• Best prevention--handwashing

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Influenza

• Acute
• Highly contagious
• Respiratory disease

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Cause

• Viralorthomyxoviradae family.
• Classified as A, B, or C.
• Frequently mutate
• Transmitted via cough/sneeze/handshakes

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Signs and Symptoms

• Comes on quick.
• Fever
• Chills
• Croup
• Malaise
• Muscle ache/headache
• Laryngitis/cough

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Diagnostic Procedures

• Difficult to differentiateresembles many other
  illnesses.
• Typically diagnosed based entirely on symptoms.
• Perhaps throat culture

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Treatment

• Supportive/symptomatic
• Bed rest
• Fluid
• NEVER ASA to children (Reyes syndrome).
• Antibiotics not indicated.
• Antivirals--Flumadine

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Prognosis

• Good
• Complications are frequentsinusitis, otitis
  media, bronchitis and pneumonia

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Prevention

• Vaccination may reduce risk.
• Those with chronic respiratory disease, heart
  disease, and the elderly should be vaccinated.
• 6th leading cause of death in NC in 2000-all ages
  1,936
• All 1,936 deaths occurred in the 65 older
  population.

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Chronic Fatigue Syndrome

• Debilitating Chronic Fatigue
• Origin unknown
• Epstein-Barr virus
• Twice as prevalent in women
• Age 25-45

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Signs and Symptoms

• Fever/chills
• Sore throat
• Painful lymph nodes
• Muscle weakness
• Arthralgia
• Photophobia
• Sleep disturbances

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Diagnosis

• Originally felt to be a psychiatric disorder
• Complete history and lab work to R/O other
  diseases

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Treatment

• Supportive
• NSAIDS
• Psychiatric evaluation
• Lifestyle changes

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Acquired Immunodeficieny Syndrome

• Associated with HIV infection
• First diagnosed in 1981
• Attributed to the gay community
• Was referred to as GRID until 1982 (Gay-Related
  Immune Deficiency

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Etiology

• HIV
• Retrovirus
• Virus is carried in RNA instead of DNAeasily
  replicates
• Attacks T-4 cellsimperative for proper function
  of immune system.

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Transmission

• Blood
• Semen
• Breast milk
• Saliva
• Transplacental

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Risky Behavior

• IV drug abusesharing needles
• Unprotected sex
• Not following OSHA guidelinesnot wearing PPE and
  taking precautions

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Signs and Symptoms

• Flu-like
• Average time from exposure to clinical
  manifestations10 years.
• After first exposuremay have no symptoms.
• Seroconversion 8-10 wks after exposure.

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Clinical Manifestations

• Numeroussee page 31

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Diagnostic Procedures

• History and physicalrisky behaviors
• Labwork
• Screening test --- ELISA
• Confirmatory test Western Blot
• Even before symptoms occur, the disease can be
  measured in the blood---CD4 cells begin to
  decline
• Below 200 AIDS

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Treatment

• AZT
• DDI
• Other anitviral drugs
• Protease inhibitors
• HIV is now a chronic disease due to these
  advances in drug therapy.

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Prevention

• Education
• Actually on the rise in young adults

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Lyme Disease

• Tick-transmitted spirochete
• Occurs in stages
• Each stage has its own clinical manifestations
• Named for Lyme Connecticut - 1975

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Cause

• Borrelia burgdorferi

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Stages

• Stage IErythema migrans Bulls Eye Rash
• Stage II CNS
• Stage II Chronic conditionsarthritiscontinued
  neurological issues.

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E-Coli 0157H7

• One of several hundred strains of E. Coli
• Most strains are harmless
• Live in intestinal tracts of humans and animals
• The 0157H7 strain produces a powerful toxin.

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Etiology

• Undercooked, contaminated meat
• Unpasteurized milk or juice
• Meat contaminated during the slaughter
• Gets ground into ground beef

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Signs and Symptoms

• Bloody diarrhea
• Cramps
• Can cause death

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Diagnostic Procedures

• Detected in the stool of the patient
• Most labs do not automatically test for it so you
  would have to ask.
• Usually resolves in 5-10 days

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Prevention

• Dont eat rare meat
• Consume only pasteurized products
• Handwashing