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7/28/2019 cd nursing

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Communicable Disease NursingBryan Romulus T. Savellano RN MAN


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What is a Communicable Disease?

Is an illness caused by an infectious agent or

its toxic products that are transmitted directly

or indirectly to a well person through an

agency, and a vector or an inanimate object.


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TERMINOLOGIES IN COMMUNICABLE

DISEASECarrier-a person who without apparent symptoms of acommunicable disease, harbors and disseminates thespecific microorganisms

2. Contact-any person or animal known to have been in suchassociation with an infected person or animal as tohave been presumably exposed to infection

3. Communicable period-the period which etiologic agent may be transferreddirectly or indirectly from the body of the infectedperson to the body of another person


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Contamination

- invasion of surface (wound) or article (handkerchief) ormatter (water and milk) implies the presence of certainamount of undesirable substance which may containpathogenic microorganisms

Disinfection

- destruction of the vitality of pathogenic microorganismsby chemical or physical means directly applied.

Fumigation- any process by which destruction of insects, fleas, bugs,etc. and is accomplished by the employment of gaseousagents

Isolation- the separation for the period of communicability ofinfected persons, in such places and under such conditionsas will prevent the direct or indirect conveyance ofinfectious agent from infected person to another person.


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Quarantine

- limitation of freedom of movement of suchsusceptible persons or animals as have been exposedto communicable diseases

Vector

- a biting insect or arthropod which conveys thepathogenic organisms from one person to another

Pathogenecity- the ability to produce a disease; the ability ofmicrobes to overcome the defensive powers of thehost to induce disease

Virulence- the vigor with which the organism can grow andmultiply; refers to the degree or intensity of diseaseproduced


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Nosocomial Infection

- infections associated with the delivery of

health care services in a health care facility

Opportunistic pathogen

- causes disease in a susceptible person

Resident flora

- microorganisms that are always present inspecific areas of the body usually in numbers

compatible with individuals health


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Transient flora

- microorganisms that are present episodically in

specific areas of the body

Colonization

- a process by which strains of microorganisms

become resident flora, but their presence does

not cause disease


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ECOLOGIC TRIAD

AGENT

Microorganism that is living and capable ofinvading and multiplying in the body of the host

Bacteria-autonomously replicating unicellular cell

Viruses- are the smallest obligate intracellular pathogensand are incapable of replication outside the living cell

Fungi- free-living, eukaryotic saprophytes found in everyhabitat of the earth

Parasites- any organism that derives benefits from itsbiologic relationship with another organism

Protozoa- simplest single-celled organism of the animalkingdom. They absorb nutrients from the body of the host


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HOST

is a person, animal or plant capable of

supporting the nutritional status and physical

growth requirements of another


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ENVIRONMENT

The sum total of all external and internal

influences that affects the life and

development of one disease


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Contagious Disease

Includes only those which are spread by direct

contact with the infectious agents causing the

disease.

Term to a disease that is easily transmitted

from one person to another through direct orindirect means


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Infectious disease

Is transmitted not only by ordinary contact butrequires direct inoculation of the organism

through a break on the skin or mucous

membrane. Hence all contagious diseases are infectious.


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Infection Is produced by the invasion of the body

tissues with pathogenic microorganisms which

multiply and produce the signs and symptoms

of disease The entry and multiplication of a particular

pathogen in the body of man or animal


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CLASSIFICATION OF INFECTIOUS

DISEASES

Based on behavior within the host Communicable Disease

Non-Communicable Disease


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Based on severity or duration of diseaseAcute Disease

Develops rapidly (rapid onset) but lasts only a short time

Ex. Measles, Mumps, InfluenzaChronic disease

Develops more slowly but lasts for a long period

Ex. TB, Leprosy

Sub-acute DiseaseIntermediate between acute and chronic

Develops rapidly and has long duration

Ex. Bacterial endocarditis

Latent Disease

Causative agent remains inactive for a time but then becomes active toproduce symptoms of the disease

an infection held in check by the defensive forces of the body butactivated when the body resistance is reduced

Ex. Chicken pox- Shingles Zoster


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Based on extent of affected hosts bodyLocal Infection

Microbes invade a relatively small area of the body Localization of the disease at one point in the body

General (Systemic) Infection

Spreads throughout the body by blood or lymph

Focal Infection

Local infection that spread but are confined tospecific areas of the body

Ex. tooth abscess

Mixed Infection

- infection is caused by two or more organisms


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Based on state of host resistance

Primary Infection

Acute infection that causes the initial illness

Secondary Infection

One caused by an opportunistic pathogen after the

primary infection has weakened the bodys

defenses

Subclinical (Inapparent)Infection

an infection that does not cause any detectable

manifestations


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Recurrent Infection

- REAPPEARANCE OF SYMPTOMS after an infectiousdisease has been treated or subsided and renewed

presence of the same infectious agentReinfection

- after an initial infectious agent has been eliminated,a NEW infection occurs caused by the same organismor by another strain of same species

Superinfection

- during the illness, additional infection occurs byanother infectious agent

Autoinfection

the infected person is his own direct source of the re-exposure

PATTERN OF INFECTION


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PATTERN OF INFECTION (Course of Infectious Process)Incubation Period

Extends from the entry of microorganism into the body to the

onset of signs and symptoms Is the phase wherein pathogen begins active replication

without producing recognizable symptoms in the host

Prodromal Period

Extends from the onset of nonspecific signs and symptoms tothe appearance of specific signs and symptoms

The hallmark of this stage is the appearance of symptoms inthe host

Period of Illness/ Period of Invasion/ Acute Stage

is the period wherein the host experiences the maximumimpact of the infectious process

Convalescent Period/ Period of Decline

stage during which the manifestations subside


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CHAIN OF INFECTION1. CAUSATIVE AGENT/ ETIOLOGIC AGENT

Invading microorganisms capable of producing adisease

These may be bacteria, virus, fungi, parasites, orprotozoa

2. RESERVOIR Refers to the environment and objects on which an

organism survives and multiplies.

The following are the reservoir of infection:

Humans

Animals

Inanimate objects (Nonliving things)


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3. PORTAL OF EXIT

Is the path or way in which the organism leaves

the reservoir

Usually, this portal is the site where the

organism grows

The common portals of exit are:

Respiratory System

Genitourinary Tract (GUT)

Gastrointestinal Tract (GIT)

Skin and mucous membrane


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4. MODE OF TRANSMISSION

Is the means by which the infectious agent

passes through from the portal of exit of the

reservoir to the susceptible host

This is the easiest link to break the chain of

infection

Th f d b hi h i f ti t


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There are four modes by which infectious agents can

be transmitted:

1. Contact Transmission- is the most common mode

of transmissiona. Direct contact- refers to person to person transferof organism. Example is Droplet Infection.

Droplet Spread- transmission through contact with

respiratory secretions when the infected person coughs,sneezes or talks. Microbes carried in droplets can travelup to 3 feet or 1 meter. The organism is not suspendedin the air but settles on a surface

b. Indirect Contact Occurs when the susceptible person comes incontact with a contaminated object.


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2. Airborne Transmission

Occurs when fine microbial particles or

dust particles containing microbes remain

suspended in the air for a prolonged period. The

infectious disease is spread by air current and is

inhaled by a susceptible host.


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3. Vehicle Transmission

Is the transmission of infectious disease

through articles or substances that harbor theorganism until it is ingested or inoculated into the

host

Refers to the spread of the etiologic agent ofdisease by conveyers such as milk, food, water, air,

contaminated hands.

Fomites: refers to inanimate objects that canspread the infection (handkerchiefs, linens, glass,

etc.)


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4. Vector-borne transmission

Occurs when intermediate carries, such as

fleas, flies, and mosquitoes transfer the microbesto another living organism

Types of Vectors:

o Mechanical- transfers the disease merely byholding the pathogens on their feet or other

parts of the body. Ex: housefly, cockroaches

o Biologic- transfer of the disease when thevector bites a person or animal and ingests some

of the infected blood. Ex. mosquitoes


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5. PORTAL OF ENTRY

Is the venue where the organism gains

entrance into the susceptible host.

Usually, this path is THE SAME as the portal of

exit


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6. SUSCEPTIBLE HOST

Final and most important link in the chain ofinfection

A person who is at risk for infection whose own

body defense mechanism, when exposed areunable to withstand the invasion of pathogens.

The human body has many defenses against theentry and multiplication of organism. When the

defenses are good, no infection will take place.However, in a weakened host, microbes willlaunch an infectious disease.

Ris Factors:


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Ris Factors:1. Intrinsic Risk Factors- specific to patient (host)

o Age

o Gendero Ethnic Background

o Socioeconomic status

o Lifestyle and marital status

o Occupation

o Overall immune status

2. Extrinsic Risk Factors- external factors in the

delivery of careo Devices and procedures

o Provider

o Environment


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EPIDEMIOLOGY

is the study of occurrences and distribution of

diseases as well as the distribution and

determinants of health states or events in

specified population, and the application ofthis study to the control of health problems.


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USES OF EPIDEMIOLOGY

Study the history of the health population and the

rise and fall of diseases and changes in their character. Diagnose the health of the community and thecondition of people to measure the distribution anddimension of illness in terms of incidence, prevalence,disability and mortality, to set health problems inperspective and to define their relative importance and toidentify groups needing special attention.

Study the work of health services with a view ofimproving them.

Estimate the risk of disease, accident, defects, andthe chances of avoiding them.

Identify syndromes by describing the distribution


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Identify syndromes by describing the distribution

and association of clinical phenomena in the

population.

Complete the clinical picture of chronic disease and

describe their natural history.

Search for causes and diseases by comparing the

experience of groups that are clearly defined by

their composition, inheritance, experience,

behavior and environments.


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PATTERNS OF DISEASE OCCURRENCE

Sporadic Disease

Intermittent occurrence of a few isolated and unrelatedcases in a given locality

Disease that occurs occasionally and irregularly with nospecific pattern

Ex. Tetanus, RabiesEndemic Disease

Continuous occurrence throughout a period of time, of theusual number of cases in a given locality

Constantly present in a population, community or country.They usually involve few people during specific periods

Ex. TB, Schistosomiasis (Leyte and Samar), Filariasis(Sorsogon), Malaria (Palawan)


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Epidemic disease

Occurrence is of unusually large number of casesin a relatively short period of time

Example: Mumps

Pandemic DiseaseEpidemic disease that occurs worldwide

Simultaneous occurrence of epidemic of the

same disease in several countriesEx. AIDS, SARS


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ISOLATION PRECAUTIONS

Isolation

The separation of patient with communicable

disease from others so as to prevent or reduce

transmission of infectious agent directly of

indirectly

Purpose: To confine the infectious agent to a

circumscribed areas and to prevent its escape

from that area


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UNIVERSAL PRECAUTIONS

Introduced in response to the risk of transmission ofblood-borne pathogens (Hepatitis B, HIV) to healthcare workers

Blood and body fluid precautions

Apply to HIV and Hepatitis B and C Intended to prevent parenteral, mucous membrane

and non-intact skin exposure of health care workersto blood-borne pathogens

Apply to blood, semen, vaginal secretions, and otherbody fluids (CSF, synovial fluid, pleural fluid,peritoneal fluid, pericardial fluid amniotic fluid), andtissues containing blood.


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Tier 1: Standard Precautions These precautions are used in the care of all hospitalized

persons regardless of their diagnosis or possible infection

status.

Primary strategy for reducing risk and controlling nosocomialinfection

They apply to:

Blood

All body fluids, secretions, and excretions except sweat(whether or not blood is present or visible)

Non-intact skin Mucous membranes

Designed to reduce risk of transmission of microorganismsfrom recognized and unrecognized sources

The following are Standard Precautions


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The following are Standard Precautions

1. Handwashing. Wash hands immediately after

contact with blood, body fluids, secretions,

excretions, and contaminated objects whether or

not gloves are worn.

2. Gloves. Wear clean gloves when touching blood,

body fluids, secretions, excretions, and

contaminated items (e.g. soiled gowns)

3. Mask, eye protection (goggles), face shield.

Worn during procedures that are likely to generate

splashes or sprays of blood, body fluids, secretions

and excretions.

4 Gown Worn also during procedures that are


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4. Gown. Worn also during procedures that arelikely to generate splashes or sprays of blood, bodyfluids, secretions and excretions. The gown is

intended to protect clothing. 5. Client Care equipment. Handle client care

equipment that is soiled with blood, body fluids,secretions, or excretions carefully to prevent the

transfer of microorganisms to others and to theenvironment.

6. Linens. Handle linens in manner that prevents

skin and mucous membranes exposure 7. Sharps. Do not recap needles, do not break,

bend, and manipulate used needles. Place them inpuncture-resistant containers.


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Tier 2: TRANSMISSION-BASED

PRECAUTIONS

These precautions are used in addition to

Standard Precautions instituted who are

known to be suspected of being infected withhighly transmissible infection

AIRBORNE PRECAUTIONS


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AIRBORNE PRECAUTIONS Are used for clients known to have or suspected ofhaving serious illness transmitted by airborne droplet

nuclei smaller than 5 microns. Small particles (5 micrometer or smaller) canremain suspended in air and can be dispersed widely byair currents within a room or over a long distance

Examples of such illnesses that require AirbornePrecautions:

o Active pulmonary or laryngeal TB not adequatelytreated

o Chicken pox (varicella)

o Measles (Rubeola)

o Small pox

o SARS

DROPLET PRECAUTIONS


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DROPLET PRECAUTIONS Are used for clients known or suspected to have seriousillnesses transmitted by particle droplet larger than 5 microns.

Large droplets do not remain suspended in the air anddo not travel greater than 3 feet from the patient.

Examples of such illnesses that require dropletprecautions:

o Diptheria

o Pneumonia

o Pertussis

o Mumpso German measles

o Meningitis

o Influenza

CONTACT PRECAUTIONS


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CONTACT PRECAUTIONS Are used for clients known or suspected to have seriousillnesses easily transmitted by direct client contact or contact with

items in the clients environment. Diseases that require Contact Precautions:

o Enteric infections with low infectious dose or prolongedenvironmental survival (Clostridium difficile)

o Enterohemorrhagic E. coli, Shigellosis, Hepatitis A, Rotavirus

for patients wearing diapers ot those who are incontinento Respiratory syncytial virus, enteroviral infections in infantsand children

o Skin infections that are highly contagious that may occur ondry skin including:

Herpes simplex virus

Impetigo

Pediculosis

Scabies

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