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THE DISEASE PROCESS

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Title: THE DISEASE PROCESS


1
CHAPTER 3
  • THE DISEASE PROCESS

2
Introduction
  • By understanding how the disease process works,
    health care providers can better protect
    themselves from infectious disease.

3
Differentiation of Infectious Communicable
Diseases
  • An infectious disease is one that results from an
    invasion of a host from a disease-producing
    organisms.
  • This organism may be in the form of a virus,
    bacteria, fungus, or parasite.

4
Differentiation of Infectious Communicable
Diseases
  • A communicable disease is an infectious disease
    that may be transmitted from one person to
    another.
  • Employees at risk of occupational exposure to
    blood and body fluids should be especially
    concerned with HIV, Hepatitis B virus (HBV),
    hepatitis C virus (HCV), and tuberculosis (TB)

5
Direct Exposure
  • Direct may occur by direct person-to-person
    contact through events such as sexual contact or
    a contaminated needlestick.

6
Indirect Exposure
  • Indirect may be through handling soiled linens or
    touching a contaminated object

7
Causes of Disease
  • Viral, bacterial, fungi, protozoa, and rickettsia
    are all known to cause infectious disease.

8
Bacteria
  • Are living microorganisms that can produce
    disease in a host. Bacteria are also capable of
    living outside the host.
  • Bacteria can self-reproduce and some may produce
    toxins that are harmful to their host.

9
Bacteria
  • Diseases like bacterial meningitis, tetanus, food
    poisoning, tuberculosis (TB), and syphilis are
    caused by bacteria.

10
Viruses
  • Are microorganisms that reside within other
    living cells and cannot reproduce outside a
    living cell.
  • Viruses like HIV, HBV, HCV and influenza may pose
    risks to those with occupational exposure.

11
Fungus
  • A plantlike organism that grows as single cells
    (e.g., yeast) or as multicellular colonies (e.g.,
    mold).
  • Since fungi do not contain chlorophyll, they
    depend on a parasitic or saprophytic existence.

12
Fungus
  • Example of fungal infectious disease include
    tinea (ringworm) and dhobie itch.

13
Protozoans
  • Are the simplest organisms in the animal kingdom.
  • Many are single-celled, although some colonize.
  • Examples include malaria, dysentery, and sleeping
    sickness.

14
Rickettisas
  • Parasitical creatures who depend on living cells
    for growth.
  • Usually transmitted by fleas, ticks, lice, and
    mites.
  • Examples include Rocky Mountain Spotted Fever and
    several forms of Typhus.

15
Helminths (worms)
  • May also cause infectious disease.
  • While many worms are not parasitic, parasitic
    worms like pinworms and tapeworms may be acquired
    by eating under-cooked meat

16
TRANSMISSION
  • Communicable disease is passed from one person to
    another, in a series of events, creating a chain
    of infection. Fig.3-3
  • First of these events is transmission, either
    airborne, bloodborne, or vector borne.

17
Airborne Transmission
  • Typically accomplished through droplets in a
    sneeze or cough.
  • These aerosolized droplets travel through the air
    and are inhaled through the respiratory system or
    absorbed through mucous membranes.
  • TB is a common airborne transmissible disease

18
ALERT!!
  • It may be difficult to determine exposure to
    airborne transmissible disease
  • Health care providers should observe standard
    precautions when caring for any patient with a
    cough or sneeze.

19
Bloodborne Transmission
  • Takes place when infected blood or
    blood-containing body fluid is introduced into
    the body of another person.
  • Common ways this is accomplished are through
    needlesticks, splashing into the mucous
    membranes, or blood contacting non-intact skin.

20
Vector Borne Transmission
  • Transmission of a disease-causing organism
    through an outside source, or a vector.
  • This includes a mosquito that carries malaria or
    a tick that carries Rocky Mountain Spotted Fever.

21
Sexual Transmission
  • Transmission of a disease through sexual contact
    with an infected person.
  • Transmission is usually accomplished through the
    contact of infected body fluids with mucous
    membranes.

22
Sexual Transmission
  • Sexually transmitted diseases (STDs) include
  • Gonorrhea
  • Syphilis
  • Genital herpes

23
Transmission by Casual Contact
  • Some disease are transmitted person-to-person by
    casual contact or household contact.
  • This includes close body-to-body contact,
    sleeping in the same bed, and sharing hairbrushes
    or combs.

24
Transmission by Casual Contact
  • Children who become infested with lice or scabies
    frequently catch them through casual contact at
    school.

25
Seroconversion
  • Once a disease is introduced into the body, a
    period of time elapses before a blood test will
    read positive.
  • This process of converting from a negative to a
    positive blood test is called seroconverison.

26
Seroconversion
  • The period of time that elapses between an
    exposure and a positive blood test is referred to
    as the Window Phase.

27
Seroconversion
  • The duration of the window phase may vary
    considerably from one individual to another,
    depending on the overall health, response of the
    immune system in the infected person, and the
    strength of the pathogen.

28
Seroconversion
  • Symptoms do not normally appear immediately with
    seroconversion.
  • The time that passes between seroconversion and
    the appearance of symptoms is called the
    Incubation Period.

29
Seroconversion
  • For hepatitis B (HBV) this period may be up to
    200 days.
  • For HIV may be as long as 10 years.

30
Seroconversion
  • IMPORTANT that both the patient and the caregiver
    realize that a single negative blood test and
    lack of immediate symptoms do not necessarily
    mean that a person is free from a disease.
  • Follow-up testing at prescribed intervals is
    highly recommended.

31
Seroconversion
  • The importance of protecting oneself from
    exposure to blood and other potentially
    infectious material (OPIM) is apparent when we
    realize that the carrier of HIV may display no
    signs or symptoms for up to 10 years.

32
Stop And Consider!!
  • Consider the example of why knowledge of
    seroconversion is important to health care
    providers
  • Nancy, a RN is attending her sons Little League
    baseball game when another child is struck in the
    face by a batted ball, resulting in profuse
    bleeding from the nose and mouth. The patient
    appears in good health, but Nancy has no gloves
    readily available. She helps control the
    bleeding without the benefit of personal
    protective equipment (PPE)..

33
Stop and Consider!!
  • Though the childs young age and apparent state
    of health may make Nancy feel comfortable
    treating him without personal protective
    equipment, she may be placing herself in danger
    by assuming that he is free from infectious
    disease

34
Stop and Consider!!
  • Suppose the seven-year-old has been exposed to
    hepatitis C (HCV) but does not yet know he is
    infected?
  • Though he feels fine and looks healthy, he could
    still pass the virus on to anyone who comes in
    contact with his blood, including Nancy.

35
Stop and Consider!!
  • Many nurses do not use PPE with the elderly
    patients because they do not believe that they
    are high risk for communicable disease.

36
Stop and Consider!!
  • What about all the 90 year-old patients that have
    received numerous blood transfusions?
  • What about the 90 year-old patients that are
    still sexually active without using protection?

37
Stop and Consider!!
  • What about the newborn that looks so sweet and
    cuddly, but yet mom was HIV positive?

38
Rule of Thumb!!
  • Regardless of how safe the patient looks, he may
    still be infected with a communicable disease.

39
ALERT!!
  • Regardless of the situation, use standard
    precautions with EVERY patient.

40
Latent Period
  • Period after infection when an infectious agent
    can not be transmitted to another host.

41
Communicable Period
  • Period after infection when an infectious agent
    can be transmitted to another host.

42
Incubation Period
  • Time between exposure and onset of symptoms

43
Window Phase
  • Period where antigen is present but
    seroconversion has not yet taken place.

44
Disease Period
  • Time between onset of symptoms and resolution of
    symptoms

45
Conclusion
  • By knowing how the disease process works, the
    employee at risk of occupational exposure can be
    better protected against exposure to disease.
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