Communicable diseases

Question 1

Hand Foot Mouth Disease

Answer 1

Causative agent: Enteroviruses (EV 71, Coxsackie

A16, A6 and echoviruses)

Incubation Period: 2-14 days, usually 3-5 days
Infectious Period: Virus excretion occurs from a few
days before, during the acute stage of illness and
continues for 3–4 weeks from the saliva and 6–12
weeks from the faeces
Mode of Transmission: Direct contact

Question 2

Management for HFMD

Answer 2

Management (Supportive Care)
- Isolate patient in single room or cohort
patients with same condition
- Paracetamol for fever (avoid NSAIDs)
- Strict I/O to maintain hydration
- Monitor for complications: Seizures,
hyper/hypotension, tachycardia
- MC for 10 days after onset of illness
- No swimming for next 3 months to decrease
transmission
- HFMD is legally notifiable within 24 hours of
diagnosis

Question 3

Signs and symptoms

Answer 3

- Vesiculo-popular rash over palms, soles and
buttocks
- Fever
- Pharyngitis
- Mouth Ulcers

Question 4

What is dengue?

Answer 4

Causative agent: Flavirus of four serotypes (DEN-1,
DEN-2, DEN-3, DEN-4)
Incubation Period: 3-14 days, usually 5-7 days
Infectious Period: 1 day before until 5 days after
onset of illness

Question 5

What are the signs and symptoms?

Answer 5

• Maculopapular rash, flushing or petechiae
• Headache
• Retro-orbital Pain
• Myalgia
• Arthralgia

Question 6

What are the management for dengue?

Answer 6

• Paracetamol for fever (avoid NSAIDs)
• Strict I/O to maintain hydration
• IV Plug
• Monitor for complication: Hypovolemia and
  Bleeding
• Prevent and monitor for Dengue Haemorrhagic
  Fever
• Dengue is a notifiable disease to MOH within 24
  hours of diagnosis
• Thrombocytopenia Precaution
• CRIB
• No IM injection
• No brushing of teeth
• Daily platelet count and haematocrit

Question 7

What is chickenpox?

Answer 7

• Contact transmission
• 10-21 days
• 1-2 days before onset of rash until scabs dried up

Complication
pneumonia and Encephalitis

Question 8

What is rubella?

Answer 8

• Droplet transmission
• 14 - 23 days
• 7 days before to 5 days after
  the rash appears

Complications
Teratogenic effect

Question 9

What is measles?

Answer 9

• Airborne transmission
• 8-12 days
• 4 days before to 5 days after the rash appears

Complications
Pneumonia
Encephalitis

Question 10

What is mumps?

Answer 10

• Droplet transmission
• 14-21 days
• immediately before and after swelling appears

Complications :
Meningoencephalitis
Otitis Media
Pneumonia

Question 11

What is poliomyelitis?

Answer 11

• Droplet transmission
• 7-21 days
• 7 - 10 days before and after the onset of symptoms, but may be present in the stool from 3-6 weeks

Complications :
Life-threatening paralysis

Question 12

What is pertussis?

Answer 12

• Contact transmission
• 5-21 days
• Catarrhal stage thru the 4th week

Complications :
Pneumonia
Atelectasis
Convulsions