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Communicable Diseases


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Lock jaw

An acute exotoxin mediated infection

characterized by neuromuscular manifestations.

CA: clostridium tetani (soil, dust) MOT: through traumatic breaks in the skin

Contamination of unhealed umbilical stump.

IP: 7-14 days


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Anaerobic, spore-forming, gram positive (+)rod

With round terminal spores giving it a drum-stick appearance


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Wound

Clostridium tetani will germinate in he wound

Release of exotoxin

Blocks the release of inhibitory neurotransmitters

Unopposed excitatory neurons

Extreme muscle spasm


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Onset: insidious with muscular spasms andcramp-like pain around the site ofinoculation

Irritability and restlessness with progressivelyincreasing stiffness of the voluntary muscles


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Jaw: trismus or lockjaw Neck & back: opisthotonus

Face: risus sardonicus

Trunk: rigid, board-like abdomen Extremities: stiff and extended


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Localized

Signs of onset are spasms and increasedmuscle tone around the wound


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Systemic or Generalized Marked muscular tonicity

Hyperactive deep tendon reflexes

Painful involuntary muscle contraction

lockjaw or trismus risus sardonicus Boardlike abdominal rigidity

Opisthotonus Intermittent tonic convulsions


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Neonatal tetanus is always generalized. Difficulty in sucking between 3-10 days after

birth.

inability to suck (jaw becomes too stiff), with

excessive crying

irritability and nuchial rigidity

May end with flaccidity, anorexia, exhaustion,

and finally death


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Hyperimmune human globulin

to neutralize toxin

Antibiotics - Penicillin-G Diazepam


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Plasmodium species

Vector-borne infectious disease caused by

protozoan parasites that invade the RBC. Female Anopheles mosquito

Vector and definitive host


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Plasmodium has 4 important species that affect

humans:

Plasmodium Vivax

Plasmodium Falciparum

most severe and life threatening Plasmodium Oval

Plasmodium Malariae


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MOT: Bite of female Anopheles mosquito. mature sporozoites are injected into the victim.

Blood transfusion Contaminated needles and syringes.


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EPIDEMIOLOGY: Occurs primarily in the tropical areas ofAsia, Africa, and Latin America

INCUBATION PERIOD: P. Falciparum - 12 days P. Vivax and Ovale - 14 days

P. Malariae - 30 days

Infection from blood transfusion depends on the numberof parasites, usually takes 2 months or shorter.


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Chills, sweating, headache, myalgia

Has 3 stages:

Cold stage - ranging from chills to extreme shaking;lasts from 2-3 hrs.

Hot stage - high fever up to >41C; lasts from 3-4 hrs. Wet stage - characterized by profuse sweating; lasts for

about 2-4 hrs.

`


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Signs and symptoms occurs when RBCs

rupture

Complications: cerebral malaria

Black water fever severe destruction of RBCs

dark-colored urine; high fever, jaundice, liverspleen enlargement, acute renal failure;

poor prognosis


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Thick and thin blood smears are the most

reliable test for malaria

Thick smear detect the presence of malarial parasites

determine parasite density

Thin smear Identify the species of plasmodium.


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Chemoprophylaxis Chloroquine - pre-exposure prophylaxis

Primaquine to prevent relapses.

areas with a high risk of chloroquine resistance,

Chloroquine resistant cases. Protection from bites.

Control mosquitoes

insecticides

draining water from breeding areas.


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Hansens Disease

A chronic disease of the skin and peripheral

nerves.

Onset of the disease is gradual.

Incubation period averages several years.

Humans are the natural hosts.

Cannot be cultured in vitro.


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Characteristics:

Hypopigmented or reddish skin lesions

Definite loss of sensation

Damage to the peripheral nerves

Positive skin smear


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Optimal growth at less than body

temperature (30C)

Grows preferentially in the skin andsuperficial nerves.

Has 2 distinct forms:

Tuberculoid leprosy

Lepromatous leprosy


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Features Tuberculoid leprosy LepromatousLeprosyType of Lesion One or few lesions

with little tissuedestruction

Many lesions withmarked tissuedestruction

Number of acid-fastbacilli (AFB)

Few Many

Likelihood oftransmitting leprosy

Low High

Cell-mediatedresponse toM.Leprae

Present Reduced or absent

Lepromin skin test Positive Negative


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CA: Mycobacterium Leprae HABITAT:Human skin and nerves. MOT: Prolonged contact; direct contact

Droplet infection

Lepromatous form is more contagious than

the Tuberculoid form.


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Tuberculoid leprosy hypopigmented macular skin lesions

thickened superficial nerves

significant anesthesia of the skin lesions occur.

Lepromatous leprosy

multiple nodular skin lesions occur

Leonine facies


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Multi-drug therapy:*Multibacillary leprosy = clients with (+)smear at any site

combination of Rifampicin, Clofazimine,Dapsone

*Paucibacillary leporsy = clients w/ (-) smearsat all sites

combination of Rifampicin & Dapsone


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Multi-drug therapy:*Rifampicin urine may be slightly reddish incolor for a few hours

-- most important drug for leprosy


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Completion of treatment & cure:*Paucibacillary leprosy six doses of MDTw/n 9 months considered as cured

*Multibacillary leprosy 24 doses of MDTw/n 36 months considered cured


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Isolation of all lepromatous patients

Chemoprophylaxis with Dapsone for exposed

children and close family contacts.

Good personal hygiene.

Adequate nutrition.

Health education.

No vaccine is available.


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Acute systemic zoonotic infection.

Characterized by extensive vasculitis, influenza-

like illness, jaundice, and renal dysfunction.

CA: Leptospira interogans Source of infection: Water or soil contaminated

w/ infected urine or tissues from infectedanimals.


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IP: 7 -12 days Range of 2-20 days

MOT: Direct contact w/ urine or tissue ofinfected animals.

Occasionally through ingestion of contaminated

food and droplet inhalation.


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First Phase 4- 7 days: non specific symptoms,

Conjunctivitis

Diarrhea and abdominal pain

Jaundice and hemorrhagic rash. Second Phase

Kidney or liver failure

meningitis for 3 weeks or more.


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Isolation of Leptospira in body fluid

Blood - 1st week

CSF - 4th to 10th days during acute illness

Urine - 10th day


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Amoxicillin and Ampicillin Adult

Amoxicillin 500 mg. QID, PO

Ampicillin 500-750 MG.QID,IV

Pedia Amoxicillin 30-50 mg/Kg./Day TID, PO

Ampicillin 100 mg./Kg./Day QID, IV


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Proper disposal of infected urine

Use Gloves

Avoid wading in flood waters Control of rodents

Chemoprophylaxis for high risk people

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