Communicable Disease Communicable Diseases An illness that is
Communicable Disease
Communicable Diseases – An illness that is transmitted by contact with body fluids • directly transmitted • acquired from a person or vector (ticks, mosquitoes, or other animal) – indirectly transmitted • by contact with contaminated objects.
Communicable Diseases of childhood include diseases with high transmission rates – Viruses are the leading cause of most pediatric infections
Communicable Diseases • The poor hygiene behaviors of young children promote the transmission of infectious diseases • The fecal-oral and respiratory routes are the most common sources of transmission in children. • Young children may not wash their hands after toileting unless closely supervised.
Immunizations
Immunizations • Prevention of any illness is always better than treatment • Vaccines are the single best technique for prevention • Vaccines are the safer choice to getting the disease
Immunization Schedule – By 24 Months children should have: – 4 Dtap (Tetanus, Diphtheria, and Pertussis), Hib (Haemophilus influenzae type B), PCV (Pneumococcal conjugate vaccine) – 3 Hep B (Hepatitis B), IVP (Polio) – 1 MMR (Measles, Mumps, and Rubella), varicella (Chicken Pox)
Immunizations • Are either inactivated or activated • Inactivated include Dtap, Hib, Hep • Activated (live) multiplies for daysweeks in body MMR, Varicella
Reactions • Vaccines are very safe and have little chance for side effects • Side effects are minor and occur with in days of administration • Reactions to live vaccines can occur 30 -60 days post vaccine (usually in older children)
Reaction to Vaccines Ølocal tenderness ØReddening of skin Øswelling at site Ølow grade fever (possibly high with activated) Øbehavior changes, irritability
Adverse Events • National Law to provide care for those affected by a vaccine’s adverse event • Law requires nurses to – Obtain consent prior to vaccine – record lot #, manufacturer, exp. date of vaccine after administration
Barriers to Immunization • • Complexity of the health care system Expense Inaccurate recordkeeping Reluctance to give more than two vaccines at a time • Lack of public awareness of vaccines • Parental misconceptions
Parental Misconceptions • Parents may understand the dangers inherent in some of these diseases – suffering, permanent disability, death • Unimmunized children are at a greater risk of getting the disease and of spreading it to pregnant women and to infants and children with serious medical conditions.
Parental Misconceptions • Misconception: Correct Information Vaccine-preventable diseases have been eliminated • Travelers may reintroduce the disease • Recent outbreaks of measles, mumps, and pertussis have been linked to groups of children not immunized
Parental Misconceptions • Misconception: • Immunization weakens the immune system. • Fear of giving multiple vaccines. • Correct Information • Child’s immune system is capable of several immunizations at once • No effect on immune system
Parental Misconceptions • Misconception: • Vaccines may cause serious conditions, such as autism • Correct Information • Every valid study has confirmed the lack of association between the measles vaccine and autism, as well as thimerosal in vaccines and autism
True contraindications and precautions ØModerate-severe illness with or without fever ØImmunocompromised ØPrior serious reaction (fever 105, seizure, anaphylatic)
Childhood Illnesses
Childhood Illnesses • Simple childhood illnesses can be life threatening to baby. • Signs of sickness – – Face red or pale Loss of appetite, vomiting, diarrhea Runny nose, cough sore throat Fever
Fever • Take temperature in arm pit or rectally (ear thermometer is good if you have one) • How do you lower a fever? – – Dress lightly Lots of fluids Cool sponge bath, high fever may require cool tub bath Tylenol, NO ASPIRIN (ryes syndrome) use proper dose
Itchy Get them from touching, combs, hats, chairs – they don’t jump Medicated shampoo and washing needed to treat
Childhood Allergies • Symptoms: – Skin rashes or hives (atopic dermatitis or eczema) – Difficulty breathing (asthma) – Sneezing, coughing, a runny nose or itchy eyes – Stomach upset
Common Allergy triggers in Children • Outdoors: tree pollen, plant pollen, insect bites or stings • Indoors: pet or animal hair or fur, dust mites, mold • Irritants: cigarette smoke, perfume, car exhaust • Foods: peanuts, eggs, milk and milk products
Treatment • Avoid Allergens • Treat symptoms – – Anti-itch cream Drink lots of fluids Rest Treat secondary infections (ear/sinus infections)
Childhood Asthma • Children with recurrent cough, wheezing, chest tightness or shortness of breath may have one or more forms of asthma. • Asthma has multiple causes, and it is not uncommon for two or more different causes to be present in one child.
Diagnosis • An allergist / immunologist, often referred to as an allergist, has specialized training and experience to determine if your child has asthma, what is causing it and develop a treatment plan.
Asthma Management • The most important part of managing asthma is for you and your child to be very knowledgeable about how and when asthma causes problems, how some of the triggers can be avoided and how to use medications.
Viral Infections
The Common Cold Causes and Symptoms • Caused by one of several respiratory viruses, most commonly rhinovirus. These viruses, which concentrate in nasal secretions, are easily transmitted through sneezing, coughing, or nose blowing. Signs and symptoms of the common cold include fever, cough, rhinorrhea, nasal congestion, sore throat, headache.
Common Cold • Antibiotics are not effective in children or adults. In children, there is a potential for harm and no benefits with over-the-counter cough and cold medications; therefore, they should not be used in children younger than four years. Other commonly used medications, such as inhaled corticosteroids, oral prednisolone, and Echinacea, also are ineffective in children.
Care for the Common Cold • • • Vapor Rub Zinc Sulfate (Zicam) Probiotics Saline Nasal Irrigation Acetomeniphan for fever/pain.
Diarrhea • Diarrhea is the body's way of ridding itself of germs, and most episodes last a few days to a week. Diarrhea often occurs with fever, nausea, vomiting, cramps, and dehydration.
Diarrhea Causes • Infection from viruses like rotavirus, bacteria like salmonella and, rarely, parasites like giardia. Viruses are the most common cause of a child's diarrhea. Along with loose or watery stools, symptoms of a viral gastroenteritis infection often include vomiting, stomachache, headache, and fever.
Diarrhea Causes • Medications like laxatives or antibiotics can also lead to diarrhea in children as well as adults. • Food poisoning
Care for Diarrhea • Offer additional breast milk or an oral rehydration solution (ORS) to infants and young children. Water alone doesn't have enough sodium, potassium, and other nutrients to safely rehydrate very young children.
• Popsicles can also be a good way to get fluids into a child who's been vomiting and needs to rehydrate slowly. • Probiotics can help or prevent diarrhea.
When to see the Doctor • Severe dehydration is dangerous; it can cause seizures, brain damage, even death. • • • Dizziness and light-headedness Dry, sticky mouth Dark yellow urine, or very little or no urine Few or no tears when crying Cool, dry skin Lack of energy
Begins with fever and rash Blisters appear 10 -20 days later Don’t scratch them Oatmeal bath Can receive vaccine between 12 - 18 months
Varicella • The Key to diagnosis is varying stages of rash • Rash starts on trunk and progresses to body including genitalia, mucous membranes • Also can detect presence of disease after 1 month through serum antibody testing
Management • Isolation at home until vesicles dry (2 -3 weeks) and 1 week after lesions are gone • Very young and immunocompromised may need isolation in hospital • Relief of itching (Anti-itch cream) • Treat secondary complications (bacterial infections from scratching)
Fifth’s Disease • Parvovirus (HPV B 19) • No vaccine available • Transmitted by probable respiratory secretions • Easily Communicable up to 14 days after infection
Symptoms Ø Classic rash of erythema on face (cheeks), “slapped face appearance” Ø High fever, lethargy, abd. Pain,
Symptoms Ø Followed with maculopapular red spots appear in 1 week, symmetrically on upper and lower extremities has a lacelike appearance Ø rash subsides, but reappears if skin is irritated (sun, heat, cold)
Management • Explain the stages of rash development to parents. • The immune-competent child can return to school or daycare once the body rash has appeared
Influenza Symptoms • • Comes on quickly A high-grade fever up to 104 degrees F Chills and shakes with the fever Extreme tiredness Headache and body aches Dry, hacking cough Sore throat Vomiting and belly pain
Treatment • If your doctor thinks there might be complications, they may proscribe Tamiflu, an antiviral medicine. • Antibiotics WILL NOT help. • Prevention is the best treatment!
Roseola • Viral infection • No vaccine available • Transmitted most likely by contact with saliva • Disease of younger children, rarely affects children >3 years Communicability unknown, but believed NOT to be communicable once rash appears
Symptoms • Persistent high fever for 3 -4 days in a child who appears well • Then drop in fever to normal => rash appears • rose-pink macules first on trunk, spread to neck, face, extremities, not itchy, lasts 1 -2 days
Diagnosis and Management • Diagnosis is made based on classis rash and symptoms, serum testing available • antipyretics, analgesics, isolation not necessary • May result in fetal death if woman is infected during pregnancy. • Since fever is very high can have febrile seizures
Rubeola (measles) • Viral infection • Vaccine available “M” in MMR • Transmitted by respiratory secretions, blood and urine of infected person Communicable just before the rash appears to 4 -5 days after rash appears=highly contagious
Symptoms • First 24 hours – Fever, malaise, cough, coryza, conjunctivitis • In 48 hours – “Koplik spots” (small, irregular, red spots with minute bluish-white center) first seen on buccal mucosa • Raised erythema rash on face that spreads downward • Discrete, then turns confluent on the third day • Other symptoms persist
Diagnosis and Management Diagnosis made on symptoms, serology 1 month later Management: • Isolation until rash disappears • Bed rest • Antipyretics • Fluids and vaporizer for cough • Skin care (itchy rash) • Decrease lighting-photophobia may cause eye rubbing and corneal abrasion
Bacterial Infections
Ear hurts Can’t hear well Discharge from ear if drum is ruptured Treat w/ antibiotics Ear tube if necessary
Red pussy eye Very contagious Treat w/ Medicated eye drops
Pertussis (whooping cough) • Bacterial infection • Vaccine available “P” in Dtap • Transmitted by direct contact, droplet • Communicable for up to 4 weeks
Symptoms • Begins with URI symptoms: – dry, hacking cough that becomes severe, worse at night **short, rapid coughs followed by sudden inspiration and whooping** – Cheeks flush, eyes bulge, tongue protrudes – Thick secretions, often vomits – Sick for 4 -6 weeks – www. whoopingcough. net for sound and video
Diagnosis and Management • Diagnosed by classic presentation • Treatment: – hospitalization for infants or children who are dehydrated – BR – increase fluids – abx – Suctioning – Humidifier – Observe for airway obstruction (restlessness, retractions, cyanosis)
Fever Spots on throat Swollen glands Treated w/ antibiotics Contagious for first 24 hours
Scarlet fever • Bacterial infection (strep), often sequela to strep throat • No vaccine available • Transmission by direct contact, droplet • Communicable for 10 days to 2 weeks
Symptoms • • • Abrupt high fever Very high pulse, Vomit, HA, Maliase, chills, abd. Pain tonsils enlarged: (edematous, red, covered with patches of white exudate). • First 1 -2 days tongue is coated with papules, is also red & swollen = “white strawberry tongue”
• By 4 th or 5 th day white coat sloughs off leaving prominent papillae = “red strawberry tongue” • Rash: red, pin head sized lesions, rash is intense in folds and joints, flushed cheeks
Diagnosis and Management • Diagnosis + TC, ASO titer • Management: – respiratory isolation x 24 hours – full course of PCN/EES – analgesics for sore throat
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