COMM.

DSE
MEASLES
-RUBEOLA
-7DAY MEASLES
-MORBILI DSE.
-HARD MEASLES
-LITTLE RED DSE.
AGENT:
MORBILI VIRUS
(PARAMYXOVIRUS)

MOT
DIRECT: RESP.
SECRETIONS

INCUB
1012 DAYS

INDIRECT:
CONTAMINATED
OBJECTS

POC
4 DAYS
BEFORE
& 5 DAYS
AFTER
APPEARANCE
OF RASHES

S/SX
1. PRE-ERUPTIVE
(HIGHLY CONTAGIOUS)
- HIGH FEVER, 3C + 1P
CORYZA, COUGH,
CONJUNTIVITIS,
PHOTOPHOBIA
- PATHOG: KOPLIKS SPOT

AIRBORNE
2. ERUPTIVE
- MACULOPAPULAR
(RED, WARM,
CEPHALOCAUDAL)
- PRURITUS

DX
NOSE/THROAT
SWAB

CX

TX

BRONCHOPNEUMONIA
(MOST
COMMON)

ANTIVIRAL:
ISOPRESNOSINE

VIRAL SEROLOGY
- COMPLEMENT
FIXATION
- HEMAGGLUTININ
INHIBITION TEST
- NEUTRALIZATION
TEST

OTITIS MEDIA
NEPHRITIS
BLINDNESS
ENCEPHALITIS

PEN-G (PREVENT 2ND

INFECTION)

VIRAL ISOLATION
VIRAL SEROLOGY

ENCEPHALITIS
(MOST
COMMON)

URINE & BLOOD

VITAMIN A

PREVENT
-LIVE ATTENUATED MEASLES
(9 MOS)
0.5ML SQ
OUTER UPPER ARM
-MMR
1ST DOSE: 1 YR
2ND: AFTER 10 YRS
-EXPOSED:
MEASLES IMMUNE SERUM
GLOBULIN W/IN 1WK AFTER
EXPOSURE

3. CONVALESCENT
- BRANNY DESQUAMATION

GERMAN
MEASLES
- RUBELLA
- 3DAY MEASLES
AGENT:
RUBIVIRUS
TOGAVIRUS

DIRECT: RESP.
SECRETIONS

23 WKS

INDIRECT:
CONTAMINATED
OBJECTS

7 DAYS
BEFORE & 5
DAYS AFTER
APPEARANCE
OF RASHES

1. PRE-ERUPTIVE
- LOW FEVER
- LYMPHADENOPATHY
- SIMILAR TO MEASLES

3. CONVALESCENT
- NO BRANNY
DESQUAMATION

CHICKEN POX
- VARICELLA
AGENT:
VARICELLA-ZOSTER,
HERPESVIRUS
VARICELLAE
(ONLY PATHOGENIC TO
HUMANS)

DIRECT: RESP.
SECRETIONS
INDIRECT:
CONTAMINATED
OBJECTS
AIRBORNE
TRANSPLACENTAL

1021 DAYS

2 DAYS
BEFORE
RASHES
UNTIL ALL
VESICLES
ENCRUSTED

1. PRE-ERUPTIVE
- FEVER, HEADACHE,
MALAISE , SORETHROAT
2. ERUPTIVE
- VESICULOPAPULAR
(CENTRIFUGAL, EXTREMELY
PRURITIC)
5 STAGES OF RASHES:
-MACULE, PAPULE, VESICLE,
PUSTULE, CRUST/SCAB
- CELESTIAL MAP
3. CONVALESCENT
- RASHES DISAPPEAR

ANALGESIC
ANTIPYRETIC

RUBELLA
SYNDROME:
- IUGR
- MENTAL
RETARDATION
- CARDIAC
DEFECTS
- GLAUCOMA,
CATARACT
- HEARING LOSS

2. ERUPTIVE
- MACULOPAPULAR
- FORSCHEIMER SPOT
- OCULAR PAIN
- POLYARTHRALGIA,
POLYARTHRITIS

TRANSPLACENTAL

SUPPORTIVE

VIRAL ISOLATION
VIRAL SEROLOGY
MISCROSCOPIC
EXAM OF VESICULAR
FLUID

OTITIS MEDIA
SKIN INFECTIONS
- ERYSIPELAS
- CELLULITIS
- IMPETIGO

- LIVE ATTENUATED RUBELLA

VACCINE
- MMR
-EXPOSED: IMMUNE SERUM
GLOBULIN W/IN 1WK AFTER
EXPOSURE
(ESP. PREGNANT)

SUPPORTIVE
ANTIVIRAL:
- ACYCLOVIR
- ZOVERAX
ANTIPYRETIC
(NO NSAID CX: REYES SYNDROME)
ANTI-PRURITUS
- ANTIHISTAMINE
- CALAMINE LOTION
- SODA BATH

- LIVE ATTENUATED
VARICELLA VACCINE
(2 DOSES, 1MO INTERVAL)
- MMRV

COMM. DSE
MUMPS
- VIRAL PAROTITIS
- EPIDEMIC PAROTITIS
- INFECTIOUS
PAROTITIS

MOT
DIRECT: RESP.
SECRETIONS
(SALIVA SOURCE
OF INFECTION)

AGENT:
PAROMYXOVIRUS

INDIRECT:
CONTAMINATED
OBJECTS

INFLUENZA

DIRECT: RESP.
SECRETIONS

- LA GRIPPE
- FLU
AGENT:
INFLUENZA VIRUS
TYPE
A:
EPIDEMIC/PANDEMIC
HEMAGGLUTININ 16
NEUROMINIDASE 9
B: EPIDEMIC CASES
C: SPORADIC CASES

PNEUMONIA
AGENT:
- STREP PNEUMONIAE
(MOST COMMON)
- H. INFLUENZAE
- S. AUREUS
- KLEBSIELLA
(FRIEDLANDERS)
- MYCOPLASMA
PNEUMONIA
ANATOMICAL CLASS:
BRONCHOPNEUMONIA
(CATARRHAL)
LOBULES INFLAMMED
LOBAR (CROUPOUS)
ENTIRE LOBE; RUSTY
SPUTUM THEN
YELLOW
PRIMARY ATYPICAL
(VIRUS PNEUMONIA)
PATCHES; GREEN TO
WHITE SECRETIONS

INCUB
1425 DAYS

INDIRECT:
CONTAMINATED
OBJECTS

POC
7 DAYS
BEFORE & 9
DAYS AFTER
ONSET OF
PAROTID
SWELLING

S/SX
LOW FEVER
HEADACHE, MALAISE
MYALGIA
DYSPHAGIA
ANOREXIA
PAIN AND SWELLING IN
FRONT AND BELOW THE
EAR

12 DAYS
(DIONESIA
MONDEJAR
NAVALES)

CHILDREN: UP
TO 10 DAYS
ADULT: UP TO
7 DAYS

CHILLS
HYPERPYREXIA
CORYZA (COMMON COLD)
SORE THROAT
HEADACHE, MALAISE
MYALGIA
N/V

DX
VIRAL ISOLATION
VIRAL SEROLOGY

CX
ORCHITIS (MALES)
OOPHORITIS
(FEMALES)

BLOOD EXAM
SERUM AMYLASE
DETERMINATION
TEST

CONFIRMATORY:
RTPCR (REAL TIME
POLYMERASE CHAIN
REACTION)

MASTITIS
PACREATITIS
MYOCARDITIS

ATYPICAL
PNEUMONIA

NOSE AND THROAT

SWAB
VIRAL CULTURE
VIRAL SEROLOGY

- CHEM.
INHALATION
- FOOD
ASPIRATION
- FLUID
- VOMITUS
CLASSIFICATION:
1) CAP < 36HRS

13 DAYS

CHILLS WITH RISING FEVER

PLEURITIC PAIN
MALAISE
LABORED RESPIRATION
RESP. GRUNTING
TACHYCARDIA
DIAPHORESIS
CONVULSION/VOMITING IN
CHILDREN
PAROXYSMAL COUGH

4) OPPORTUNISTIC
PNEUMONIA
COMPROMISED
IMMUNE SYSTEM

NEUFELD
QUELLUNG TEST
TO KNOW IF S.
PNEUMONIAE
S. PNEUMONIAE
(RUSTY SPUTUM)

PATHOG: RUSTY SPUTUM

S. AUREUS (YELLOW,
BLOOD-TINGED)

2) HAP > 36HRS

3) ASPIRATION
PNEUMONIA
GASTRIC
CONTENTS

CONFIRMATORY:
CHEST X-RAY
(CONSOLIDATION)

MOST IMPORTANT IN
DIAGNOSIS:
FAST BREATHING

KLEBSIELLA
(RED GELATINOUS)
MYCOPLASMA
MUCOID (PUS,
BLOOD)

PREVENT
MMR
(MEASLES, MUMPS, RUBELLA)

ANALGESIC
ANTIPYRETIC
MOIST HEAT AND COLD
APPLICATION

INFLUENZA A:
AMANTADINE HCL
(SYMMETREL)
AH1N1:
- OSELTAMIVIR
(TAMIFLU)
- ZANAMIVIR (RELENZA)

AIRBORNE

DROPLET
TRANSMISSION

TX
SUPPORTIVE

LIVE ATTENUATED INFLUENZA

VACCINE
- SINGLE DOSE
- YEARLY TO ELDERLY &
IMMUNO-COMPROMISED
- NOT TO CHILDREN D/T
VACCINE RXN

NSG MGMT:
- RESP. ISOLATION
- BED REST
- WOF CX
- VAPORIZER
-

DOC: AMOXICILLIN
ALT: COTRIMOXAZOLE

PNEUMOCOCCAL VACCINE
INFLUENZA VACCINE

BRONCHODILATOR:
- SALBUTAMOL
- AMINOPHYLLINE
EXPECTORANT
ANALGESIC
- CBR ELEVATED HOB
- HUMIDIFIED O2
- MECH VENT (RESP.
FAILURE)
- HIGH CALORIE DIET
- HIGH FLUID IF NOT
CONTRAINDICATED
NSG MGMT:
- ISOLATION
- SUCTIONING
- CPT
- DEEP BREATHING,
COUGHING, AND
TURNING EXERCISE

COMM. DSE
DIPTHERIA
AGENT:
CORYNEBACTERIUM
DIPTHERIAE (KLEBS
LEOFFLER)

MOT
DIRECT CONTACT

INCUB
25 DAYS

INDIRECT:
CONTAMINATED
OBJECTS

POC

S/SX

DX

12 DAYS IN
TREATED PTS

NASAL
EXCORIATION OF THE
UPPER LIP AND ALAE NASI
WITH SECRETIONS:
SEROSANGUINOUS (EARLY)
BLOODY & FOUL (LATE)

NOSE AND THROAT

SWAB

PHARYNGEAL OR FAUCIAL
LOW FEVER
SORE THROAT
HEADACHE
MALAISE
DYSPHAGIA
VISIBLE PSEUDOMEMBRANE
BULL-NECK APPEARANCE

MOLONEY TEST
HYPERSENSITIVITY
TO TOXOID

24 WKS IN
UNTREATED

SCHICK TEST
IMMUNITY TO
DIPTHERIA

CX
MYOCARDITIS
AIRWAY
OBSTRUCTION
POLYNEURITIS

DROPLET

TX
DOC: PENICILLIN
ALT: ERYTHROMYCIN

PREVENT
DPT
BOOSTER < 5 Y/O

TRACHEOSTOMY
(LARYNGEAL)
NSG. MGMT:
BED REST (2WKS)
NOT PERMITTED TO
BATHE ALONE
NOSE/THROAT CARE
ICE COLLAR
SOFT FOOD DIET
VITAMIN C

LARYNGOTRACHEAL OR
LARYNGEAL
COMMON IN INFANTS
BARKING COUGH
LARYNGEAL STRIDOR
HOARSENESS
SX OF RESP. DISTRESS

WHOOPING COUGH

DIRECT: RESP.
SECRETIONS

AGENT:
BORDETELLA
PERTUSSIS

INDIRECT:
CONTAMINATED
OBJECTS

PERTUSSIS

12 WKS

1 WK AFTER
EXPOSURE TO
3 WKS AFTER
TYPICAL
PAROXYSMS

1. CATARRHAL
(MOST CONTAGIOUS)
- FEVER
- CORYZA
- SNEEZING
- LACRIMATION
- DRY, HACKING COUGH

DROPLET
2. PAROXYSMAL
(MOST FATAL)
SPASMODIC, RECURRENT
WHOOPING COUGH
- FACE CYANOTIC
- NECK VEIN DISTENTION
- EYE BULGE
- TONGUE PROTRUSION
VOMITING (END OF ATTACK)
3. CONVALESCENT
AFTER ABOUT 6 WKS:
- PAROXYSMS SUBSIDES
- VOMITING CEASES

CONFIRMATORY:
NASOPHARYNGEAL
SWAB
(BORDET-GENGOU
MEDIUM OR AGAR
PLATE)

ACUTE
INTERSTITAL
PNEUMONIA
(MOST
DANGEROUS)
CONVULSION
ATELECTASIS
MALNUTRITION
STARVATION

DOC: ERYTHROMYCIN
ALT: AMPICILLIN
ANTITUSSIVE
HYPERIMMUNE
PERTUSSIS GAMMA
GLOBULIN

NSG. MGMT:
- ISOLATION
- BED REST
- NPO ON ATTACKS
- AVOID FACTORS THAT
PRECIPITATE
PAROXYSMS
DURING PAROXYSMS:
- DO NOT LEAVE PT
ALONE
- READY SUCTION

DPT VACCINE
MIN. AGE: 6 WKS
3 DOSES 1 MO. INTERVAL
0.5 ML (IM UPPER OUTER
THIGH)

COMM. DSE
PULMONARY TB
- KOCHS DISEASE
- PHTHISIS

MOT
AIRBORNE

INCUB
210 WKS

POC
-

UNPASTEURIZED
MILK

AGENT:
MYCOBACTERIUM
TUBERCULOSIS
M. AFRICANUM
M. BOVIS

S/SX
LOW FEVER (AFTERNOON)
CHRONIC COUGH > 2WKS
ANOREXIA, WT LOSS
NIGHT SWEATS
CHEST/BACK PAIN
DYSPNEA
HEMOPTYSIS (BLOODTINGED SPUTUM)

- CEREBROSPINAL
FEVER
AGENT:
N. MENINGITIDES
(MOST CONTAGIOUS)
S. PNEUMONIA
H. INFLUENZA

DROPLET

3 6 DAYS

DIRECT INVASION:
OTITIS MEDIA

AS LONG AS
M.O.
PRESENT IN
DISCHARGE

CX OF HEAD
INJURY

S. AGALACTAE,
LISTERIA
MONOCYTOGENES
(NEWBORN)

CX
CAT
1

DSSM PRIMARY
DIAGNOSTIC TOOL

2
3
4

CXR
BRONCHOSCOPY
MANTOUX/
TUBERCULIN
TEST/PPD (ID)
2-3D INDURATION:
(+) > 10 mm
(+) > 5 mm (HIV)

CLASSIFICATION:
0: NO EXP/INFXN
1: (+) EXP, () INFXN
2: (+) INFXN, () DSE.
3: (+) SX, PTB ACTIVE
4: DSE., NOT ACTIVE
5: PENDING, SUSPECT

MENINGITIS

DX
CONFIRMATORY:
SPUTUM CULTURE

FEVER,
PETECHIAL/PURPURIC RASH

BLOOD CULTURE
AND SENSITIVITY

SX OF ICP:
- FRONTAL HEADACHE
- ALTERED LOC
- RESTLESSNESS
- PROJECTILE VOMITING
- BLURRING, DIPLOPIA,
PAPILLEDEMA
- BULGING FONTANEL
(INFANT)

CSF ANALYSIS
LUMBAR PUNCTURE
LUMBAR TAP

AGENT:
VIBRIO COMA
VIBRIO CHOLERA

INGESTION OF
CONTAMINATED
FOOD/WATER
5 FS
FINGER
FOOD
FOMITES
FLIES, FLEAS
FECES

FEW HOURS
TO 5 DAYS

AS LONG AS
M.O.
PRESENT IN
STOOL

FEVER, DIARRHEA
COLICKY ABD PAIN
WASHER WOMANS HANDS
CRAMPING OF EXTREMITIES
SEVERE DEHYDRATION
PATHOG: RICE-WATERY
STOOL
3 DEFICITS:
- ECF VOLUME DEFICIT
- HYPOKALEMIA
- METABOLIC ACIDOSIS

MAINTENANCE
4 RI

2 RIPES + 1 RIPE
5 RIE
2 RIPE
4 RI
REFER TO FACILITY

PREVENT:
BCG (BACILLUS CALMETTE GUERIN)
PNEUMONIA
DOC: PEN G
BRONCHITIS
ALT: CHLORAMPHENICOL
MASTOIDITIS
BLINDNESS
MANNITOL (OSMOTIC
HYDROCEPHALUS
DIURETIC)

Hib VACCINE
(PROPHYLAXIS)
RIFAMPICIN
ALT: CIPROFLOXACIN

CORTICOSTEROID
(PREDNISONE,
DEXAMETHASONE)
ANTICONVULSANT
(DIAZEPAM, PHENYTOIN)
NSG MGMT:
RESP. ISOLATION
NON-STIMULATING ENV.
SEIZURE PRECAUTION

SX OF MENINGEAL
IRRITATION:
- NUCHAL RIGIDITY
- OPISTHOTONUS
- KERNIGS SIGN
- BRUDZINSKIS SIGN

FECAL-ORAL

PREVENT
INTENSIVE
2 RIPE

NSG. MGMT:
REST PERIODS, HIGH CALORIE
ORAL HYGIENE, HANDWASHING
COVER NOSE/MOUTH
MONITOR DOTS

AVOID ICP:
- COUGHING, STRAINING,
BENDING, DIGITAL EXAM
VALSALVA, ENEMA

LATE SIGNS:
DECEREBRATE (BRAINSTEM)
DECORTICATE (CORTEX)

CHOLERA

TX

TYPE OF PATIENT
(+) SPUTUM
() SPUTUM + CXR LESIONS
EXTRAPULMONARY TB
RELAPSE
() SPUTUM + CXR MINIMAL
CHRONIC

STOOL OR VOMITUS
CULTURE
DARK FIELD OR
PHASE MICROSCOPY

DOC: TETRACYCLINE
NO ANTI-DIARRHEAL
REHYDRATION
- IVF
- ORESOL
- ORAL FLUID INTAKE
ENTERIC ISOLATION

CHOLERA VACCINE

COMM. DSE
TYPHOID FEVER
- ENTERIC FEVER
- TYPHUS
ABDOMINALIS
- NERVOUS FEVER
AGENT:
SALMONELLA TYPHI

MOT
FECAL-ORAL

INCUB
USUALLY 1
3 WKS

INGESTION OF
CONTAMINATED
FOOD/WATER

POC
AS LONG AS
M.O.
PRESENT IN
STOOL

5 FS

S/SX
PRODROMAL
- FEVER
- ABD PAIN
- N/V
- DIARRHEA/CONSTIPATION

DX

CX

CBC
BLOOD CULTURE
WIDAL TEST
TYPHIDOT

TX
DOC: CIPROFLOXACIN
ALT: FLUOROQUINOLONE

PREVENT
VIVOTIF BERNA (PO)
TYPHIM VI (SQ)

ANTIPYRETIC
ANTI-ULCER

PYREXIAL
- ROSE SPOTS
- LADDER-LIKE FEVER
- SPLENOMEGALY

NSG. MGMT:
REHYDRATION
I & O MONITORING
ENTERIC ISOLATION

DEFERVESCENCE
- INTESTINAL HEMORRHAGE
- INTESTINAL PERFORATION
- PERITONITIS
LYSIS STAGE
- RELAPSE MAY DEVELOP

POLIOMYELITIS
AGENT:
LEGIO DEBILITANS
TYPE I BRUNHILDE
TYPE II LANSING
TYPE III LEON

FECAL-ORAL
INGESTION OF
CONTAMINATED
FOOD/WATER
DIRECT CONTACT

1 2 WKS

36 HRS
(THROAT)
72 HRS
(FECES)
HIGHER RISK
DURING
PRODROMAL

1. ABORTIVE
- FEVER
- SORE THROAT
- GI SYMPTOMS
- LOW LUMBAR ACHE /
CERVICAL STIFFNESS
2. NON-PARALYTIC OR
MENINGITIC TYPE
- RECURRING FEVER
- POKER SPINE
- HAMSTRING SPASM
- HYPERSENSITIVITY
- EXAGGERATED DEEP
REFLEXES
- PARESIS
3. PARALYTIC
- PARALYSIS DEPENDS ON
AFFECTED PART
(+) HOYNES SIGN HEAD
DROP
TYPES OF PARALYSIS:
A. BULBAR
B. SPINAL
C. BULBO-SPINAL
D. LANDRYS PARALYSIS

BLOOD AND
THROAT CULTURE
STOOL EXAM
LUMBAR TAP
(PANDYS TEST)
EMG ELECTROMYOGRAPH

RESP. PARALYSIS
PNEUMONIA
BRONCHITIS
PULM. EDEMA
MYOCARDITIS
SKELETAL & SOFT
TISSUE INJURY

ANALGESICS
ENTERIC ISOLATION
CBR ON FIRM BED
ROM EXERCISES
WOF FECAL IMPACTION

OPV
MIN. AGE: 6 WKS
3 DOSES 1 MO INTERVAL
2-3 DROPS (ORAL)
HAND WASHING
AVOID MOT