RESPI CAUSED BY VIRUS

8/8/2019 RESPI CAUSED BY VIRUS

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RespiratoryRespiratoryDiseasesDiseases

caused bycaused byVirusesViruses


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MEASLES

RUBEOLAORMORBILLI


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DEFINITION

Measles is an acute highly contagiousviral disease caused by measles virus.It is characterized by fever, URTcatarrhal inflammation, kopliks spotsand maculopapules .


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ETIOLOGY1 . Measles virus.

2 .Site

of

the

measles

virus

exists

measles can be detected from blood and nasal, pharyngeal secretions.


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EPI DEMIOLOGY1.Source of infection

The patients are the only source of infection.2 .Routes of transmission

air-borne

3. Susceptibility of population3.1 All age person is susceptible; 90% of contact people acquire the disease.3.2 The permanent immunity acquire after

disease.4. Epidemic features

season:winter and spiringage:6 months to 5 years old


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CLINIC ALMANIFESTATIONS

Typical type1 . Incubation period is approximately 10-1 2 days.

2 . predromal phase 3~4 days.

2 .1 F ever;2 .2 C atarrhal inflammation of URT;

2 .3 K opliks spots;2 .4 Transient prodromal rashes.


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3. E ruption stage3 .1 . Time: the 3~5 days after fever;but the 4 th day is most common;

3 .2 . Shape:maculopapular3 .3 . Seuqence:behind the ear along the hairline face neck chest back abdomen

limbs hand and feet(palm,sole)3 .4 . The temperature rise continously and

companied w ith the toxic symptoms exaggerate

4 . C onvalescent stage

bro w n staining.fine branny desquamation.course: 10-14 days


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LABORATORY FINDINGSBlood routineSerum A b measurementcomplement combining antibody;hemagglutinin inhibiting antibody;

neutralizing antibody;specific antibody IgM.UA

Nose and throat sw abbing


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treatment1 .General therapy: rest and diet2. Symptomatic therapy: fever and

cough,3.Support threapy:r-globulin

traditional chinese herbsmay be used ;


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Amild viral illness caused by rubellavirus. It causes mild feverish illness

associated with rashes and aches in joints. It has a teratogenic effect onthe fetus

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Infectious Agent

Rubella virus (family-togaviridae;genus-

rubivirus)

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Incubationperiod

From exposure toappearance of rashUsually 14 to 21 days

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P eriod of communicability Th e virus is communicable

approximately 1 week before and fourdays before t h e onset of ras h es butis at worst w h en t h e ras h is at peak

High ly communicable infants wit h congenital rubella may s h ed virus formonth s after birt h

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C linicalManifestations

a. Prodromal stage L ow grade fever H eadac h e M alaise M ild coryza C

onjunctivitis P ost- auricular, sub occipital andposterior cervicallymph adenopat h y( 3 rd -5 t h dayonset1/21/2011 22


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B.Eruptive stage Forsc hh eimers spot

ras h es T esticular pain in youngadultsPolyart h ralgia andpolyart h ritis

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Very little treatment is

necessary:T reatment issymptomatic

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C omplicationsEnceph alitis

Neuritis Art h ritis

Art h ralgiasRubella syndrome manifested by: M icrocep h ally M ental retardation C ataract D eaf-mutism H eart disease

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Clinical mani f estati o n

(Co ngenital Rub ella)Classic congenital rubella syndrome I ntrauterine growt h retardation ( LBW ) Th rombocytopenic purpura blueberry

muffin skin

L et h argy and h ypot h ermia

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I ntrauterine infection M ay result to spontaneous abortion Birt h anomalies

Cleft palate, h are lip, talipes and eruptionof teet h

Cardiac defectsEye defectsEar defects

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P reventi o n

Administration of live attenuatedvaccine ( MM R)

Pregnant women s h ould avoidexposure to patients infected wit h Rubella

Administration of I mmune SerumGlobulin one week after exposure toRubella.

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Nu rsing

managemento I solationo Bed rest until fever subsides

o D arken room to avoid p h otop h obiao M ild liquid diet but nouris h ingo I rrigate eyes wit h warm normal saline to relieve

irritation .

o Care of t h e ears do not apply h eat or cold unless soordered .o Good ventilationo Prevent spread of infection

o Prevent occurrence of complications1/21/2011 29


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Ch ickenpox (varicella)

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An acute h igh ly contagious disease ofviral etiology t h at is c h aracterized byvesicular eruptions on t h e skin andmucous membrane wit h mildconstitutional symptoms

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E tiologicagent

H erpesvirusvaricellae

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Incubationperiod

10-21 days or maybe prolonged after

passive immunization against chickenpox

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Mod e of

transmissi o nD irect contactI

ndirect contact AirborneD roplet infection

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P eri od of

c o mm u nica b ility Th e patient is capable oftransmitting t h e disease about a daybefore t h e eruption of t h e firstlesion up to about 5 days after t h eappearance of t h e last crop

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C linical

ManifestationsM ild fever and malaise- pre- eruptivestageEruptive stage Rash starts on t h e trunk M ilky and pus like papules ( 4 days) P ruritic vesicular lesions C elestial map M

ucule-papule-vesicles-pustule-crust1/21/2011 36


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Diagn o stic test

Complement fixation test

Electron microscopic examination ofvesicular fluid

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Treatment

mod alities Oral acyclovir O

ral antih

istamineCalamine lotion Antipyretics

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Nu rsing management

Respiratory isolationPrevent secondary infectionLinens must be disinfected

Cut fingernails s h ort and was h h ands A ch ild must wear mittensProvide alternative activities

Oral and nasal care1/21/2011 40


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S mallpox

(variola)1/21/2011 41


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An infectious and h igh lycommunicable disease c h aracterizedby marked symptoms during t h eprodromal period and appearance ofskin eruption, w h ich progressest h rough t h e stages of macule, papule,vesicle, pustule and crust, to end andputting scar formation

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Eti o l o gic agent

Variola virus- remains viable formonth s in a dry climate

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Inc ub ati o n peri od

8 to 17 days; 10 -12 days

(average); 1- 3 weeks

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Mod e of

Transmissi o nD irect contactD ropletinfection andsecretions

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Clinical mani f estati o ns

Fever, h eadac h e, weakness and

backac h e, abdominal pain, nausea andvomiting, severe muscular and jointpains

ras h

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STAGES..1. MUCUL AR STA GE2 . PA PUL AR STA GE3 . VESICUL AR STA GE4 . PAST UL AR STA GE

5 . CRU ST I N G STA GE

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CLINIC AL TYPES1. Variola minor or alatrim (kaffir pox,amaos)

A mild type of variola wit h low mortalityand was believed by some to be due to adifferent or mild type of virus .

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2 . V arill o id o r

Eruption proceed rapidly t h rough t h edifferent stages and said to be to apartial immunity or previousvaccination

Few and more superficial skin lesions

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3. Variolasine eruption

I n wh ich t h e eruptions occur after

a recent small pox vaccination andt h e lesions disappear after t h epopular stage or no eruptiveappears at all .

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4 . Flat type

Pre- eruptive illness- severe wit h

fever Focal lesion mature slowlyVesicles- flat, projecting little

surrounding skin and soft andvelvety to touc h

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5 . Hemorrhagic

type Hemorr h ages occur in t h e vesicles orin t h e surrounding areas .M ost serious clinical type of variolaPre- eruptive illness- severe2 nd

-3rd

day- bleeding from mouth

,conjunctiva, skinD eat h (5- 7 days) wit h maculopapular

lesions 53


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D iagnostic

ProceduresElectro M icroscopyM icroscopic Exam ofSmearsPrecipitation in GelC

omplementF

ixationT estLaboratory D ata

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ComplicationsSecondary skin infection wit h septicemia

F urunculosis- inflammation of furuncles A

bscess formation C ellulitis Gangrene

Laryngitis, pleurisy and emp h ysema Keritis and laryngeal ulcerations wit h edemaEnceph alitis and bronc h opneumonia maydevelop later .

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T reatmentSymptomatic

and supportive


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HES PES ZOSTE R

Sh ingles/ AcutePosterior Ganglionitis

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D efinition

An acute viral infection of t h esensory nerve caused by variety ofch icken pox virus

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E tiologic AgentVaricella Agent (V-Z virus) Th is agent h as been found two diseases,

varicella and h erpes zoster . Th e virus still occurs in partially immune

individuals due to previous varicella

infection .


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Period ofC

ommunicability Herpes zoster is communicable a daybefore t h e appearance of t h e firstras h until five to six days after t h elast crust

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M ode of transmission

D irect contactD roplet infection

AirborneI ndirect contact

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Clinical manifestationEryt h ematous base of skin lesionPain

Fever, malaise, anorexia and h eadac h eRegional lymph nodesParalysis of t h e facial nerve(ramsayh unt syndrome)Gasserian ganglionitis



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D iagnostic exam

T issue cultureSmear of vesicle fluidM icroscopySkin ras h may be diagnostic



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Complications

Enceph alitisParalytic ileus, bladder paralysis

Opt h almic h erpes may lead toblindness



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M odalities of

treatmentSymptomatic Antiviral drugs Analgesic to control pain Anti-inflammatory

antiviral



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N ursing management

Keep patient comfortable, maintainmeticulous h ygieneStrict isolation

Apply cool, wet dressing wit h N SS topruritic lesionsEfforts s h ould be made to preventsecondary infection



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Prevent entrance of microorganismsinto t h e lesions especially if t h eybreak

Assess degree of pain and to avoidneuralgic pain do not delay t h eadministration of pain relievers asprescribed



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INFLU E N ZA

La Grippe, F lu



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An acute viral infectious diseaseaffecting t h e respiratory system



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RNA containing myxoviruses,influenza virus types A , B and C



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I N CU BAT I ON PER

I O D

24 to 3 8 h ours (in some books 3 days)



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Period of

communicability Th e disease is communicable until t h e5 t h day of illness and up to 7 days inch ildren



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Airborne spreadD irect contactD roplet I nfluenza virus persists for h ours in

dried mucus



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Clinical

manifestationsCh illy sensation, h yperpyrexia,malaise . Sore t h roat,coryza,rinorr h ea, myalgia and h eadac h eBack pain, severe sweatingVomiting



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Complications

Hemorr h agic pneumoniaEnceph alitisM yocarditisS ID S

myoglobinuria



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D iagnostic

proceduresBlood examinations Oroph aryngeal swab cultureViral serology C omplement fixation test H emo-agglutination test



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A contagious disease of animalscaused by viruses t h at normallyinfect only birds and less commonlypigs.

Avian influenza viruses are h igh lyspecies specific but h ave on rareoccasions, caused t h e species barrierto infect h uman



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Causative agent

Avian influenza A (H 5N 1) virus



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D irect contact wit h infected poultryor surfaces and objects contaminatedby t h eir feces .



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I ncubation period

2 to 8 days and possibly as long as 17 days .


P i d f


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Period of

communicability15 to 17 days after illness onset .I n t h e absence of corticosteroidadministration, immunocompetent A (H 5N 1) infected persons probablycease to excrete t h e infectious virusin 3 weeks after illness onset .



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F orms:

Low pat h ogenic form- may comeunnoticed .

High ly pat h ogenic form- h igh mortality rate often wit h in 48 h ours



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D iagnostic test

Collection of multiple respiratoryspecimensBlood and stool samples



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Complications

BacteremiaBacterial pneumoniaSh ockRenal failure

Respiratory failure


N i


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N ursing

interventionsM onitor clinical status includingoxygenationEducation on personal h ygiene andinfection control measures



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Sw ine I nfluenza



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A very contagious acute viralrespiratory disease of pigs



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Causative agent

Swine influenza virus H 1N 1

H 1N 2 H 3N 1 H 3N 2



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D irect contactRespiratory secretions and bodilyfluids



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I ncubation period

U nknown; 1 to 7 days


Period of


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Period ofC

ommunicability One day before until 7 days aftert h e case onset of illness


C d fi i i f i f i i h


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Case definition for infection wit h swine-origin influenza A (H 1N 1)

Confirmed caseProbable caseSuspected case

***reverse transcriptase polymerasech ain reaction (R T -PCR)


S I GN S AN D


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S I GN S AN D

SYMP TO M

S Fever Headac h eU pper respiratory tract symptomsM yalgia

FatigueVomiting

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treatment

Oseltamivir (tamiflu) and zanamivir(relenza)- initiated as soon as

possible after t h e onset of symptomsfor 5 days



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Complications

Exacerbation of underlying c h ronicmedical conditionU pper respiratory tract diseaseLower respiratory tract diseaseCardiac complication

Neurologic complication



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A void close contact( 6 feet away) P roper disposal of articles used by

infected person D isinfection W ash linens in h ot water

C ontact h ealt h provider if a sick personh as t h e ff symptoms:Ch est pain



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D O B

Purplush / bluish lip discolorationV

omitingSeizuresConfused / less responsivedeh ydrated



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M U M PS

I nfectious Parotitis/Epidemic Parotitis



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D efinition

An active viral disease manifested byt h e swelling of one or bot h parotid

glands, wit h occasional involvement ofot h er glandular structures,particularly t h e testes in male



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Etiologic A gent

Paramyxovirus group t h at is usuallyfound in saliva of an infected person



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I ncubation Period

14 to 2 5 days (t h e average is 18 days)


Period of


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Period ofC

ommunicability Th e disease is communicable 6 daysbefore and 9 days after t h e onset of

parotid gland swelling Th e 48 - h our period immediatelypreceding onset of swelling isconsidered t h e time of h igh estcommunicability


Clinical


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Clinical

manifestations Headac h e J oint pains*Pain on c

hewing and swallowing(earliestsymptom)

Earac h e*Back pain*loss of appetiteLow grade fever

swelling of th

e parotid gland* 110


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Complications Orc h itis in male Ooph oritis in femaleM astitis

Nuch al rigidityD eafness

J uvenile DMLow or absent sperm countCongenital malformations in pregnantwomen


D iagnostic test


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D iagnostic test

Blood exam- h igh leukocyte countComplement fixationViral culture


T reatment


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T reatment

modalitiesSupportive care Hot or cold compressanalgesics



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N ursing management

1. M edical aseptic protective careA . I solation

B. W ash h ands regularlyC. D isinfectionD . O ral and personal h ygiene

2 . General managementa. Bed restb. D iversional activities



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3 . D ieta. no restriction to foodb. soft and semisolid food



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VI RAL E N CE PH ALI T I S

Brain F ever


O


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D EF I N I T I ON

An inflammation of t h e centralnervous system resulting in abnormal

function of t h e different parts oft h e brain and t h e spinal cord .


I b P d


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I ncubation Period

5- 15 days wit h a range from 4 to 21 days


Classification and


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lassification andPat h ology

PRIM ARY EN CEPHA LI T I S Eastern Equine Encep h alitis W estern Equine Encep h alitis J apanese B St . Louise Encep h alitis



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PO ST I NF ECT I O U S / SECON D ARY EN CEPHA LI T I S U sually a complication or a sequelae to

some viral diseases like measles, c h ickenpox and mumps


General


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GeneralM anifestations

Fever, h eadac h e, dizziness, vomitingad apat h y

Sore t h roat, conjunctivitis, at h ralgia,myalgia and abdominal pain

Nuch al rigidity, ataxia, tremors,mental confusion, speec h difficulties,stupor and h yper-excitability,convulsions, coma, deat h



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D isturbances in swallowing,movements of t h e muscles of t h e

eyes and faceM uscle twitc h ing


D i i


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D iagnostic exams

CSF analysis Neutralization test


T


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T reatment T reatment must be symptomatic andsupportiveC

onvulsions must be controlled Nose and t h roat secretions s h ouldbe sanitarily disposed

T SB Oral fluid s h ould be encouraged Oral care


Cli i l


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Clinical management

Provide comfort Keep patient in a quiet, well ventilated

room Stretc h linens Encourage or do oral h ygiene D o bed bat h if not contraindicated



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Prevention from complication T urn patient to sides at least every 3 to

4 h ours Encourage increase oral fluid intake Encourage h igh caloric intake M onitor intake and output



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Th ank y ou

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RESPI CAUSED BY VIRUS