Waterborne and Vectorborne diseases Cholera What is Cholera

Water-borne and Vectorborne diseases

Cholera

What is Cholera? • Acute, diarrheal illness caused by bacterium Vibrio cholerae. • Source of contamination is usually the feces of an infected person. • Infection is often mild or without symptoms, but sometimes it can be severe, characterized by profuse watery diarrhea, vomiting and leg cramps.

What is Cholera?

What is Cholera? • Rapid loss of fluids leads to dehydration and shock. Without treatment, death can occur within hours. • It can be treated with replacement of fluids and salts lost through diarrhea. • Antibiotics shortens the course and diminish the severity of the illness.

Typhoid Fever

What is Typhoid Fever? • Life threatening illness caused by bacterium Salmonella typhi. • Bacterium lives only in humans. Persons carry bacteria in bloodstream and intestinal tract. • Acquired from sewerage contaminated with S. tryphi bacteria that gets into the water you use for drinking and washing food.

What is Typhoid Fever?

What is Typhoid Fever? • The patient usually has the following signs & symptoms o sustained fever as high as 1030 to 1040 F (390 to 400 C). o The patient feels weak, has stomach pains, headache, loss of appetite and in rare cases, has rashes of flat, rose-colored spots. o Detection for S. typhi is to have samples of stools or blood to be tested.

What is Typhoid Fever? • S. typhi is treated with commonly prescribed antibitiotics – Ampicillin – Trimethoprim-sulfamethoxazole – Ciprofloxacin • How to avoid having typhoid fever: – Avoid risky foods and drinks. – Get vaccinated against typhoid fever.

Leptospirosis

What is Leptospirosis? • Bacterial disease that affects humans and animals, caused by bacteria of the genus Leptospira. • Caused by exposure to contaminated urine of infected animals like cattle, pigs, horses, dogs, rodents and wild animals. • The interval from a person’s exposure to a contaminated source and becoming sick is between 2 days to 4 weeks.

What is Leptospirosis? • Leptospirosis has 2 phases: – First Phase • Fever, chills, headaches, muscle aches, vomiting or diarrhea. • Patient recovers for a time but become ill again. – Second Phase • More severe, a person may have kidney or liver failure or meningitis. • Also called Weil’s disease

What is Leptospirosis? Leptospirosis in Philippine floods

What is Leptospirosis? • It can be treated with antibiotics like – Doxycycline – Penicillin • It can be prevented by not swimming or wadding in water that might be contaminated with animal urine. Protective clothing or footwear should be worn by those exposed to contaminated water or soil due to their job and recreational activities.

Hepatitis A

What is Hepatitis A? • A disease affecting the liver, and caused by the Hepatitis A virus (HAV). • Symptoms may include: – Jaundice which first shows up as yellow eyes – Dark urine – Nausea – Fever – Fatigue – Loss of appetite – Abdominal pain – Vomiting

What is Hepatitis A? • Young children who develop Hepatitis A often have a milder form of the disease lasting 1 -3 weeks. Adults tend to experience more severe cases. They are confined to bed and have minimal activity for 4 weeks due to the illness

What is Hepatitis A?

What is Hepatitis A? • There is no specific treatment for Hepatitis A. • Sufferers are advised to rest, avoid fatty foods and alcohol (these may be poorly tolerated for some additional months during the recovery phase and cause minor relapses), eat a well-balanced diet, and stay hydrated. • Approximately 15% of people diagnosed with Hepatitis A may experience a symptomatic relapse (s) for nine months to a year after contracting the disease.

What is Hepatitis A? • Hepatitis A can be prevented by good hygiene and sanitation as well as using condoms during sex. Vaccination is also available and is recommended in areas where the prevalence of hepatitis A is high. • Ways to prevent hepatitis A include: – Handwashing with soap and warm water before preparing or eating food, and after sexual activity. – Keep bathrooms clean and disinfected after every use. – Cook shellfish thoroughly before eating. – Drink water from approved sources only. – Use a dental dam or sheet of plastic wrap during anilingus.

Malaria

What is Malaria? • A vector-borne infectious disease that is widespread in tropical and subtropical regions. • One of the most common infectious diseases and an enormous public-health problem. • Disease is caused by protozoan parasites of the genus Plasmodium. • Most serious forms of the disease are caused by Plasmodium falciparum and Plasmodium vivax, • Malarial parasites are transmitted by female Anopheles mosquitoes.

What is Malaria? Transmission of Malaria Parasites

What is Malaria? • Symptoms of malaria include fever, shivering, arthralgia (joint pain), vomiting, anemia caused by rupture of red blood cells and convulsions. • The classical symptom of malaria is cyclical occurrence of sudden coldness followed by rigor and then fever and sweating lasting four to six hours, • Severe malaria is almost exclusively caused by P. falciparum infection and usually arises 6 -14 days after infection. • Chronic malaria is seen in both P. vivax and P. ovale but not in P. falciparum.

What is Malaria? • Active malaria infection with P. falciparum is a medical emergency requiring hospitalization. Infection with P. vivax, P. ovale or P. malariae can often be treated as out-patient. • Treatment of malaria involves supportive measures as well as specific antimalarial drugs like: – – – – Quinine Chloroquine Cotrifazid Primaquine Doxycycline Mefloquine Hydroxychloroquine

What is Malaria? – Methods used to prevent the spread of the disease, or to protect individuals in areas where malaria is endemic, include: • Prophylactic (preventive) drugs against malaria • Mosquito eradication • Prevention of mosquito bites

Dengue/Dengue Hemorrhagic Fever

What is Dengue/Dengue Hemorrhagic Fever? • Dengue and dengue hemorrhagic fever are acute febrile diseases, found in the tropics, with a geographical spread similar to malaria. • Caused by one of four closely related virus serotypes of the genus Flavivirus, each serotype is sufficiently different that there is no cross-protection and epidemics caused by multiple serotypes (hyper-endemicity) can occur. • Dengue is transmitted to humans by the mosquito Aedes aegypti

What is Dengue/Dengue Hemorrhagic Fever? – This infectious disease is manifested by • Sudden onset of fever • Severe headache • Muscle and joint pains (myalgias and arthralgias, severe pain give it the name break-bone fever or bone crusher disease) • Rashes - dengue rash is characteristically bright red petechia and usually appears first on the lower limbs and the chest - in some patients, it covers most of the body. • Gastritis with combination of associated abdominal pain, nausea, vomiting or diarrhea.

What is Dengue/Dengue Hemorrhagic Fever?

What is Dengue/Dengue Hemorrhagic Fever?

What is Dengue/Dengue Hemorrhagic Fever? • The mainstay of treatment is supportive therapy. • To keep up oral intake, especially fluids. If the patient is unable to maintain oral intake, supplementation with intravenous fluids may be necessary to prevent dehydration and significant hemo-concentration. • A platelet transfusion is rarely indicated. But if the platelet level drops significantly or if there is significant bleeding, transfusion is recommended.

What is Dengue/Dengue Hemorrhagic Fever? – Steps in the primary prevention of dengue: • Eliminating or reducing the mosquito vector for dengue. • Public spraying against mosquitoes is the most important aspect of this prevention • Application of larvicides such as Abate® to standing water is more effective in the long term control of mosquitoes. • Eliminating pools of standing water such as in flowerpots, old tires

What is Dengue/Dengue Hemorrhagic Fever? – Steps in the primary prevention of dengue: • • • Use of mosquito nets, Use of insect repellants Cover exposed skin Use DEET-impregnated bednets Avoiding areas with many mosquitos

The Philippine College of Physicians wishes to acknowledge the following for his invaluable efforts in the preparation of this module Cristobal Dumo, MD