COMMON COMMUNICABLE DISEASES IN CHILDHOOD

COMMON COMMUNICABLE DISEASES IN CHILDHOOD Ms.Ann Mariam George MSc.Nursing IInd yearKIMS CON

INTRODUCTION

DEFINITIONA communicable disease is an illness caused by a specific infectious agent or its toxic products through a direct or indirect mode of transmission of that agent from a reservoir. Wikipedia

Common communicable diseases in childhoodChickenpox DiphtheriaErythema infectiosumMeasles

Scarlet feverPertussis (whooping cough)MumpsPoliomyelitisRubella (german measles)TuberculosisScabies

Chickenpox

Agents: varicella-zoster virusSource: primary secretions of respiratory tract of infected persons; to a lesser degree, skin lesions (scabs not infectious).Transmissions: direct contact, droplet spread and contaminated objects.Incubation period: 2-3 weeks, usually 14-16 days.Period of communicability: probably 1 day before eruption of lesions to 6 days

Clinical manifestations: Prodromal stageConstitutional signs and symptomsDistribution: centripetal, spreading to face and proximal extremities but sparse on distal limbs and less on areas not exposed to heat Management:Complications:

DIPHTHERIAAgent: corynebacterium diphtheriaSource: discharges from mucous membranes of nose and nasopharynx, skin and other lesions of infected person.Transmission: direct contact with infected person, carrier or contaminated articles.Incubation period: usually 2-5 days, possibly longerPeriod of communicability: usually 2 week but as long as 4 week.

Clinical manifestations: Nasal Pharyngeal LaryngealManagement:Complications:

ERYTHEMA INFECTIOSUMAgent: human parvovirus B19(HPV)Source: infected personsTransmission: possibly respiratory secretions (droplet infections) and bloodIncubation period: 4-14 daysPeriod of communicability: uncertain but before onset of symptoms in children with aplastic crisis.

Clinical manifestation:Therapeutic management:Nursing management:

MEASLES (RUBEOLA):Agent: Myxo virusSource: respiratory tract, secretions, blood, and urine of infected persons.Transmission: usually by direct contact with droplets of infected person.Incubation period: 10-20 daysPeriod of communicability: from 4 days before to 5 days after rash appears, but mainly during prodromal stage.

Clinical manifestation:Prodromal stage: fever, malaise followed in 24 hours by coryza, cough, conjunctivitis, koplik spot (small irregular red spots with a minute bluish white center first seen on the buccal mucosa opposite the molars) 2 days prior to rash; symptoms gradually increase in severity.Rash: appears 3-4 days after onset of prodromal stage, begins as a maculopapular eruption on face and gradually spreads downwards.

Constitutional signs and symptoms: anorexia, malaise, generalized lymphadenopathy.Therapeutic management:Nursing management:

MUMPSAgent: rabula virusSource: saliva of infected personsTransmission: direct contact with or droplet spread from an infected personIncubation period: 14-21 daysPeriod of communicability: most communicable immediately before and after swelling begins.

Clinical manifestation:Management:

PERTUSSIS (WHOOPING COUGH)Agent: bordetella pertussisSource: discharge from respiratory tract of infected personsTransmission: direct contact or droplet spread from infected person, indirect contact with freshly contaminated articles.Incubation period: 5-21 days, usually 10 days.Period of communicability: greatest during catarrhal stage before onset and may extend to 4th week.

Clinical manifestation:Catarrhal stage: begins with symptoms of upper respiratory infection- coryza, sneezing, lacrimation etc. symptoms continue for 1-2 weeks, when dry hacking cough becomes severe.Paroxysmal stage: short, rapid coughs mostly occurs at night, followed by sudden inspiration associated with a high pitched crowing sound or whoop during paroxysms, cheek becomes flushed or cyanotic, eyes bulge and tongue protrudes.Management

POLIOMYELITISAgent: enterovirus, 3 types: type 1-most frequent cause of paralysis, type 2 -least frequently associated with paralysis, type 3- second most frequent.Source: feces and oro-pharyngeal secretions of infected persons, especially young children.Transmission: direct contact with apparent or inapparent active infection, spread is via fecal-oral and pharyngeal-oropharyngeal routes.

Virus enters the alimentary tract (alimentary phase)

Virus multiplies and get into the blood stream

Reaches CNS and causes meningeal symptoms and paralysisIncubation period: usually 7-14 daysPeriod of communicability: The cases are most infectious 7-10 days before and after onset of symptoms. In th efeces the virus is excreted commonly for 2-3 weeks ,sometimes as long as 3-4 months.

Clinical manifestation:Inapparent infection: Occurs approximately in 91-96 % of poliovirus infections .There are no presenting symptoms.Abortive polimyelitis- the child is asymptomatic during abortive phase, produces fever in viremic phase.Non-paralytic polimyelitis- meningeal irritation (headache, vomiting, neck pain, stiffness), no paralysis.Paralytic polimyelitis- paralysis involving spinal cord and sometimes brain stem, muscle pain, tenderness, retention of urine, constipation, spinal and abdominal muscles are also involved.

Management TherapeuticNursing

RUBELLA (GERMAN MEASLES)Agent: RNA virus of togavirus familySource: nasopharyngeal secretions of persons with apparent or inapparent infection, virus also present in blood, stool and urine.Transmission: direct contact and spread via infected person, droplet infection, through feces or urine. Incubation period: 14-21 daysPeriod of communicability: 7 days before to about 5 days after appearance of rash.

Clinical manifestation: FeverPain in jointsPosterior cervical and posterior auricular lymphadenopathyMaculo-papular rash (rapid progression from face to extremities)Infant borne to mother exposed to rubella- growth retardation, macula-papular rash, heart murmurs, cataracts, visceromegaly, microcephaly, mental retardation etc.

SCARLET FEVERAgent: group A beta hemolytic streptococci virusSource: nasopharyngeal secretions of infected persons and carriersTransmission: direct contact with infected person or droplet spread, ingestion of contaminated milk or other food.Incubation period: 2-4 days Period of communicability: during incubation period and clinical illness approximately 10 days.

Clinical manifestation: Prodromal stage: abrupt high fever, increased pulse, vomiting, headache, chills, malaise, abdominal pain.Enanthema: enlarged tonsils, edematous, reddened and covered with patches of exudates, pharynx is edematous and beefy red, red and swollen papillae, and palate is covered with erythematous punctate lesions.Exanthema: rash appears within 12 hours after prodromal signs, red pin-head sized punctate lesions rapidly become generalized but are absent on face, rash is more intense on folds of joints.

TUBERCULOSISAgent: mycobacterium tuberculosisSource: respiratory secretions of actively infected personsTransmission: direct contact with infected personsIncubation period: from infection to primary lesion, about 4-6 weeksPeriod of communicability: as long as bacilli are discharged

Clinical manifestations: Usually asymptomatic Demonstration of bacilli in sputum or gastric aspirates. In advanced cases, fever, pallor, weakness, weight loss, cough, hoarseness, and tachypnea.Treatment:

SCABIESAgent: Sarcoptes scabiei or Acarus scabieiSource: actively infected personsTransmission: direct contact with infected Persons and contaminated clothesSite of leisions: Hands and wrist(63%); the extensor aspect of elbows(10.9%); axillae,buttocks,lower abdomen, feet and ankles.Control measures: Treat with Benzyl Benzoate (25%) weekly twice HCH:0.5 -1.5% ,2-3 Days of interval Tetmosol: thrice a day applicationSulphur ointment: 2.5 to 10% daily for 4 days

NURSING MANAGEMENT

SUMMARY

What disease is this?

Good job everyone!

ASSIGNMENT

DOTS THERAPY FOR TUBERCULOSIS

CONCLUSION