Infectious Disease Objectives

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Infectious Disease Objectives

• Upon completion of this lecture, you will be
  better able to
• List the infectious diseases commonly encountered
  in the school setting
• Describe the etiology, signs and symptoms,
  diagnosis, complications, treatment and
  prevention of the diseases discussed in the
  manual
• Identify the incubation and isolation periods for
  these diseases

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INFECTIOUS DISEASES
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FIFTH DISEASE

• CAUSE
• A virus known as human parvovirus or B19
• SYMPTOMS
• Slapped cheek rash (starts on face and spreads
• Fever, general pruritis, flu symptoms, and
  pharyngitis

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FIFTH DISEASE

• Incubation period is 6-14 days
• Symptoms usually begin one to two weeks after
  exposure to the virus
• NOTE WHEN THE RASH APPEARS, THE STUDENT IS NO
  LONGER CONTAGIOUS!

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Slapped Cheek rash
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FIFTH DISEASE

• COMPLICATIONS
• Can be dangerous to women who are less than 20
  weeks pregnant
• Dangerous to cancer or immunosuppressed students
• DIAGNOSIS
• Usually made by clinical symptoms
• TREATMENT
• No definitive treatment at this time

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FIFTH DISEASE

• PREVENTION
• Good handwashing is the best defense against the
  virus
• Universal substance precautions
• NOTE THERE IS CURRENTLY NO VACCINE AVAILABLE

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PERTUSSIS

• CAUSE
• Caused by a bacteria known as Bordetella
  pertussis
• Highly contagious
• TRANSMISSION
• By airborne droplets
• Incubation period is 5-10 days

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PERTUSSIS

• 3 STAGES OF THE DISEASE
• 1. CATARRHAL STAGE (1-2 weeks)
• Child is MOST CONTAGIOUS in this stage
• 2. PAROXYSMAL STAGE (2-4 weeks)
• 3. CONVALESCENT STAGE (3-4 weeks)

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PERTUSSIS

• COMPLICATIONS
• Pneumonia
• Apnea
• Dehydration, weight loss
• Atelectasis
• Seizures

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PERTUSSIS

• DIAGNOSIS
• A nasopharyngeal swab is used to test for
  the B. pertussis bacteria
• TREATMENT
• Erythromycin
• PREVENTION
• Vaccination

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INFECTIOUS MONONUCLEOSIS

• CAUSE
• The Epstein-Barr virus is the most common cause
  of mononucleosis (mono)
• In the United States, the incidence of mono peaks
  in adolescence

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INFECTIOUS MONONUCLEOSIS

• TRANSMISSION
• Transmitted through affected saliva. Also known
  as the kissing disease
• SYMPTOMS
• High fever
• Splenomegaly
• Lymphadenopathy
• Fatigue
• Hepatosplenomegaly

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INFECTIOUS MONONUCLEOSIS

• DIAGNOSIS
• A blood test is required to confirm the diagnosis
  (Monospot)
• CBC usually shows atypical lymphocytes
• COMPLICATIONS
• Splenic rupture
• Guillain-Barre

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INFECTIOUS MONONUCLEOSIS

• TREATMENT
• Currently no medication to treat the disease
• Treatment typically palliative - treat the
  symptoms
• PREVENTION
• There is no vaccine currently available
• Best defense is to avoid direct exposure to
  anyone with symptoms. Always maintain good
  handwashing

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SCARLET FEVER

• CAUSE
• Usually caused by group A streptococcus
• SYMPTOMS
• Fever, pharyngitis, sandpaper rash

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SCARLET FEVER

• TRANSMISSION
• Respiratory droplets spread the disease. Spread
  by close contact and shared utensils
• Incubation period is 3-5 days
• NOTE Student is contagious until antibiotic is
  taken for 24 hours

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SCARLET FEVER

• DIAGNOSIS
• A throat culture determines if Strep A is present
• If culture is positive and there is a rash, the
  diagnosis is made
• TREATMENT
• The drug of choice is penicillin

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SCARLET FEVER

• COMPLICATIONS
• Rheumatic Fever
• Glomerulonephritis
• PREVENTION
• Avoid close contact or sharing of utensils with
  anyone who is symptomatic. Always maintain good
  handwashing

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RESPIRATORY SYNCYTIAL VIRUS

• Respiratory syncytial virus (RSV) is the most
  frequent cause of respiratory tract infections in
  children less than 4 years old
• Most children experience at least one infection
  by age 3. Confers only partial protection from
  subsequent infection, so reinfection can occur.

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RESPIRATORY SYNCYTIAL VIRUS

• SYMPTOMS
• Wheezing
• Tachypnea
• Retractions
• Nasal flaring
• Atelectasis

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RESPIRATORY SYNCTIAL VIRUS

• COMPLICATIONS
• Hypoxia
• Dehydration
• Respiratory failure

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RESPIRATORY SYNCYTIAL VIRUS

• TREATMENT
• Oxygen
• Fluid balance
• Tylenol
• Albuterol nebulizer or oral
  medication

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Pediculosis

• THREE FORMS OF HEAD LICE
• NIT- Eggs of head lice. Hatch in approximately
  1 week. Usually found attached to hair shaft.
• NYMPH - Becomes an adult in approximately 7
  days after hatching. Will die without blood
  supply.
• ADULT - Has 6 legs and can live up to 30 days on
  a head. Needs blood supply to live.

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Pediculosis

• DIAGNOSIS
• A diagnosis is made when one or more live lice
  are found on the student.

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Pediculosis

• TREATMENT
• Only treat a student when live lice are found.
• A standard chemical insecticidal lotion is used.
• Inform parent/guardian on how to treat household
  items.

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IMPETIGO

• TWO TYPES OF IMPETIGO
• Nonbullous impetigo- This type is typically seen
  to a greater degree in children versus
  adults. Usually affects the facial area.
• Bullous impetigo-This type is highly contagious
  and can spread to large areas of skin.

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IMPETIGO

• TREATMENT
• Impetigo is usually treated with oral antibiotics
  such as dicloxacillin.
• Occasionally, only a topical antibiotic such as
  mupirocin is prescribed.

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RINGWORM

• CAUSE
• Ringworm (tinea capitis) is caused by the fungus
  Trichophyton tonsurans. When ringworm affects
  the scalp, typically hair loss occurs.

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RINGWORM

• TREATMENT
• The treatment for ringworm is oral griseofulvin
  for 8 weeks. Antifungal shampoo should also be
  used 2 times a week for 8 weeks.

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RINGWORM

• PREVENTION
• Good handwashing
• No sharing of personal hair products
• Checking pets for signs and symptoms of ringworm

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MENINGITIS

• Meningitis is an inflammation of the meninges.
  Can be bacterial or viral.
• Leading cause of bacterial meningitis used to be
  Haemophilus influenzae type B
• Current leading cause is Streptococcus pneumoniae
  and Neisseria meningitis.

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MENINGITIS

• SYMPTOMS
• High fever
• Headache
• Stiff neck
• Nausea, vomiting
• Photophobia
• Lethargy

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MENINGITIS

• TREATMENT
• Hospitalization
• IV antibiotics are the treatment of choice for
  bacterial meningitis

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Summary

• Children are subject to a wide variety of
  infectious illness, ranging in severity from
  minor annoyances to potentially lethal diseases.
  It is important to be aware of the findings and
  progression associated with these diseases in
  order to expediate evaluation, treatment,
  prevention and followup.
• Remember contagious illness poses a particular
  threat to students who have compromised immune
  systems. Implement special precautions to
  protect these students from infectious diseases
  at school.

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ANY QUESTIONS??