CPHM: Communicable Diseases 2 Flashcards by Zelene Ignacio

Q

● Is an infectious disease and is a leading cause of permanent physical disability among the communicable disease
● It is chronic mildly communicable disease that mainly affects the skin the peripheral nerves, the eyes and mucosa of URT

A

LEPROSY

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Q

LEPROSY
Causative agents:
Mode of Transmission:

A

Causative agents:
● Mycobacterium leprae

Mode of Transmission
1. Airborne
2. Prolonged skin to skin contact

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Q

Pinchthesite
Makeanincision
Applytheinterstitialfluidonaslide
AirdryandstainusingZiehl-NeelsenStain 5. Countthenumberofacidfastbacilli

A

Slit Skin Smear (SSS)

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Q

LEPROSY

a.Change in color- either reddish brown/white
b. Loss of sensation on the skin lesion
c. Decrease/loss of sweating and hair growth over the lesion
d. Thickened and painful nerves
e. Muscles weakness and paralysis of extremities
f. Pain and redness of the eyes
g. Nasal obstruction or bleeding

A

Early signs and symptoms

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Q

P. Leprosy
a. Loss of eyebrow- madarosis
b. Inability to close eyelids-lagopthalmus
c. Paralysis and crippling of hands and feet
d. Nose disfigurement
e. Blindness
f. Chronic non-healing ulcers on the bottom of the feet

A

Signs of advanced leprosy

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Q

LEPROSY

Avoidance of prolonged skin to skin contact especially with lepromatous case
Children should avoid close contact with active untreated leprosy case 3. BCG vaccine
Practice personal hygiene
Adequate nutrition, rest, and exercise

A

Prevention and Control

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Q

LEPROSY

● Ambulatory chemotherapy through use of MDT
● Multi-Drug Therapy it is use of 2 or more drugs for the treatment of leprosy.
● Combination: Rifampicin, clofazimine, *Dapsone (Sulfones) for
Multibacillary (MB) leprosy patients
● Other drugs: minocycline, clarithromycin, and some fluoroquinolones

A

Treatment

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Q

● An acute bacterial infection of the intestine characterized by diarrhea, fever, tenesmus and in severe cases bloody mucoid stools.
● Severe infections are frequent in infants and in elderly debilitated persons

A

BACILLARY DYSENTERY (Shigellosis)

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Q

BACILLARY DYSENTERY (Shigellosis)

● Shigella, there are four main groups:
● Shigella sonnei
● Shigella boydii
● Shigella flexneri
● Shigella dysenteriae

A

Causative agent:

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Q

BACILLARY DYSENTERY (Shigellosis)

● Eating of contaminated foods or drinking contaminated water and by hand to mouth transfer of contaminated materials; by flies, by objects soiled with feces pf a patient or carrier.

A

Mode of transmission

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Q

BACILLARY DYSENTERY (Shigellosis)

● Sanitary disposal of human feces
● Sanitary supervision of processing, preparation and serving of food particularly those eaten raw
● Adequate provision for safe washing facilities
● Fly control and screening to protect foods against fly contamination
● Protection of purified water supplies
● Control of infected individual contacts and environment
● Isolation of patient during acute illness

A

Prevention and Control

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Q

BACILLARY DYSENTERY (Shigellosis)

● Ciprofloxacin, ampicillin, doxycycline, and trimethoprim– sulfamethoxazole are most commonly inhibitory for Shigella isolates.
● Many cases are self-limited.
● Give ORESOL to replace lost body fluid

A

Treatment

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Q

BACILLARY DYSENTERY (Shigellosis)

● Sanitary disposal of human feces
● Sanitary supervision of processing, preparation and serving of food particularly those eaten raw
● Adequate provision for safe washing facilities
● Fly control and screening to protect foods against fly contamination
● Protection of purified water supplies
● Control of infected individual contacts and environment
● Isolation of patient during acute illness

A

Prevention and Control

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Q

BACILLARY DYSENTERY (Shigellosis)

● Ciprofloxacin, ampicillin, doxycycline, and trimethoprim– sulfamethoxazole are most commonly inhibitory for Shigella isolates.
● Many cases are self-limited.
● Give ORESOL to replace lost body fluid

A

Treatment

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Q

● Systemic infection with involvement of lymphoid tissue, splenomegaly, rose spots on trunks and diarrhea.
● Many mild typical infections are often unrecognized.

A

TYPHOID FEVER (ENTERIC FEVER)

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Q

TYPHOID FEVER (ENTERIC FEVER)

● Salmonella typhi

A

Causative agent:

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Q

TYPHOID FEVER (ENTERIC FEVER)

● Direct or indirect contact with patient or carrier.
● Principal vehicles are food and water. Flies are vectors.

A

Mode of transmission

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Q

TYPHOID FEVER (ENTERIC FEVER)

● Sustained high fever
● Malaise
● Abdominal discomfort
● Headache
● Diarrhea or constipation
● Loss of appetite

A

Signs and Symptoms

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Q

TYPHOID FEVER (ENTERIC FEVER) ● Same as preventive and control measures as in Dysentery in addition, immunization with vaccine of high antigenicity.
● Practice safe eating and drinking habits.
● Education of the general public and particularly the food handlers.
● Wash your hands with soap and water before eating.
● Keep surroundings clean to prevent breeding of flies.

A

Prevention and Control

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Q

TYPHOID FEVER (ENTERIC FEVER)

● Antibiotics, such as ciprofloxacin, may be given to adults. Ceftriaxone (injectable antibiotic) may be
given to pregnant women and children.
● Give ORESOL to replace lost body fluid

A

Treatment

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Q

● An acute serious illness characterized by sudden onset of acute and profuse colorless diarrhea, vomiting, severe dehydration, muscular cramps, cyanosis and in severe cases collapse

A

CHOLERA (El Tor)

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CHOLERA (El Tor)

● Vibrio cholerae serogroup O1 or O139 (El Tor)

A

Causative agent:

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Q

CHOLERA (El Tor)

● Food and water contaminated with vomitus and stool of patients and carrier

A

Mode of Transmission

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Q

CHOLERA (El Tor)

● Profuse watery diarrhea
● Vomiting
● Rapid dehydration (e.g. sunken eyeballs, wrinkled dry skin)
● *Most people infected with cholera are asymptomatic

A

Signs and Symptoms

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CHOLERA (El Tor) ● Bring patient to hospital for proper isolation and prompt and competent medical care ● A WHO pre-qualified oral cholera vaccine is available for travelers and people in endemic areas. It is given in two doses and offers protection for 3 years. ● Other preventive measures are the same as those of Typhoid and Dysentery

Prevention and Control

CHOLERA (El Tor) ● Rehydration therapy ● Antibiotic treatment is indicated for severe cases of cholera (Doxycycline / Azithromycin) ● Zinc treatment has also been shown to help improve cholera symptoms in children.

Treatment

● A form of hepatitis occurring either sporadically or in epidemics and caused by virus introduced by focally contaminated water or food. ● Young people especially school children are most frequently affected

HEPATITIS A (Infectious hepatitis, Epidemic hepatitis, Catarrhal jaundice)

HEPATITIS A (Infectious hepatitis, Epidemic hepatitis, Catarrhal jaundice) ● Hepatitis A virus (HAV)

Causative agent

HEPATITIS A (Infectious hepatitis, Epidemic hepatitis, Catarrhal jaundice) ● Fecal-oral route or consumption of contaminated food or water

Mode of transmission

HEPATITIS A (Infectious hepatitis, Epidemic hepatitis, Catarrhal jaundice) ● Influenza-like symptoms and headache ● Malaise and fatigue ● Anorexia and abdominal discomfort ● Nausea, diarrhea, and vomiting ● Fever ● Dark urine ● Lymphadenopathy ● Jaundice

Signs and Symptoms

HEPATITIS A (Infectious hepatitis, Epidemic hepatitis, Catarrhal jaundice) ● Ensure safe water or drinking ● Sanitary method in preparing, handling and serving food ● Proper disposal of urine and feces ● Washing hands very well before eating and after using the toilet ● Separate and proper cleaning of articles used by patient. ● Hepatitis A Vaccination

Prevention and Control

HEPATITIS A (Infectious hepatitis, Epidemic hepatitis, Catarrhal jaundice) ● Postexposure prophylaxis ● Complete bed rest ● Adequate nutrition, and fluids

Treatment

● It is the third most prevalent infection worldwide second only to the diarrheal disease and tuberculosis ● The prevalence of STH among the 2 to 5 yrs. old but lesser they suffer the greatest impact to the disease when they are infected.

SOIL TRANSMITTED HELMINTHIASIS (STH)

SOIL TRANSMITTED HELMINTHIASIS (STH) The three major causes of intestinal parasitic in the Philippines are: ● Ascaris lumbricoides (Giant intestinal roundworm) ● Trichuris trichiura (Whipworm) ● Hookworm: Ancyclostoma duodenale (Old world hookworm) and Necator americanus ( New world hookworm)

Causative agent

SOIL TRANSMITTED HELMINTHIASIS (STH) ● Fecal-oral route; Ingestion of eggs from fecally contaminated soil or food

Mode of Transmission

SOIL TRANSMITTED HELMINTHIASIS (STH) ● Anemia ● Malnutrition ● Stunted growth in height and body size ● Decreased physical activities ● Impaired mental and school performance

Signs and symptoms

SOIL TRANSMITTED HELMINTHIASIS (STH) 1. Health education a. Good personal hygiene b. Keeping fingernails short and clean c. Use footwear d. Use sanitary facilities like toilets e. Sanitary disposal of feces 2. Early diagnosis and treatment a. Laboratory examination of stool (fecalysis) b. Ensure proper dosage of medication and completion of treatment

Prevention and Control

SOIL TRANSMITTED HELMINTHIASIS (STH) ● Drugs such as Piperazine citrate, pyrantel pamoate, mebendazole, albendazole, and levimazole can be administered depending on what parasite is present.

Treatment

● One of the important tropical disease in our country. ● Since it affects mostly farmers and their families in the rural area it results in manpower losses and lessened agricultural productivity. ● There is a high prevalence of Schistosomiasis in Region 5 (Bicol). Region 8 (Samar and Leyte) and Region 11 (Davao)

SCHISTOSOMIASIS (Bilhariasis or snail fever)

SCHISTOSOMIASIS (Bilhariasis or snail fever) Oncomelania hupensis quadrasi

Intermediate Host

SCHISTOSOMIASIS (Bilhariasis or snail fever) ● Infection occurs when the skin comes in contact with contaminated fresh water in which certain types of snails that carry Schistosomes are living. It is a free-swimming larval form (cercaria) of the parasites that penetrates the skin. Fresh water becomes contaminated when infected people urinate or defecate in water.

Mode of Transmission

SCHISTOSOMIASIS (Bilhariasis or snail fever) ● Diarrhea (bloody stool or urine) ● Enlargement of abdomen ● Splenomegaly ● Weakness ● Anemia ● Inflamed liver

Signs and Symptoms

SCHISTOSOMIASIS (Bilhariasis or snail fever) 1. Preventive measures a. Educate the public in endemic areas regarding the mode of transmission and methods of protection b. Proper disposal of feces and urine c. Improve irrigation and agricultural practices: reduce snail habitats by removing vegetation d. Treat snail breeding sites with molluscicides e. Prevent exposure to contaminated water f. Provide water for drinking, bathing and washing clothes from sources free of cercaria or treatment to kill them. hTravelers visiting in endemic area should be advised of the risk and informed 2. Control of patient contacts and the environment a. Report to local health authority b. No need for isolation and quarantine to infected people and those who are at risk c. Concurrent disinfection; sanitary disposal of feces and urine 3. Investigation of contact and source of infection a. Epidemic measure: examine for schistosomiasis and treat all who are infected but especially those with moderate to heavy infection, pay particular to children b. Motivate people in these areas to have annual stool exam

Prevention and Control

SCHISTOSOMIASIS (Bilhariasis or snail fever) ● Praziquantel is the drug of choice against all species. Alternatively drugs are Oxamniquine for S. mansoni and Metrifonate for S. haematobium

Treatment

SCHISTOSOMIASIS (Bilhariasis or snail fever) ● Shistosoma japonicum – Oriental blood fluke ● Schistosoma mansoni – Manson’s blood fluke ● Schistosoma haematobium – Vesical blood fluke

Causative agent

● It is a chronic parasitic infection, which greatly reduces human productivity and quality of life. ● It is frequently encountered in communities where eating of fresh or inadequately cooked crabs in practice ● The manifestation closely resemble PTB that most often it is misdiagnosed for this disease in endemic areas.

PARAGONIMIASIS

PARAGONIMIASIS ● The province of Mindoro, Camarines Sur, Camarines Norte, Sorsogon, Samar, Negros Island, Albay, Basilan, Cebu Commonly patients with Paragonimiasis are misdiagnosed to have PTB are treated as PTB patients. In fact, a study by Dr. Vicente Belizario Jr. et. Al, revealed that 56% of his subjects were non responsive to a multi-drug therapy for PTB but were positive for Paragonimiasis.

Endemic areas identified

PARAGONIMIASIS 1. First IH- Fresh water snail a. Brotia asperata 2. Second IH- small, fresh water crab a. Sundathelpusa philippina

Intermediate Hosts

PARAGONIMIASIS 1. Ingestion of raw insufficiently cooked infected crabs 2. Contamination of food or utensil with metacercaria during food preparation 3. Drinking of contaminated water with infective larvae.

Modes of Transmission

PARAGONIMIASIS ● Cough of long duration ● Hemoptysis ● Chest/back pain ● PTB like symptoms not responding to anti-TB medications

Signs and Symptoms

PARAGONIMIASIS ● Treatment of infected person ● Sanitary disposal of excreta ● Education of the public regarding the sign and symptoms and mode of transmission of the parasite ● Avoid eating insufficient or raw cooked crabs.

Prevention and control

PARAGONIMIASIS ● Praziquantel is the drug of choice given 25mg/kg body weight three times daily for 2 consecutive days. Bithionol is the alternative drug.

Treatment

PARAGONIMIASIS ● Paragonimus westermani (Lung fluke) is the most common important causative agent in Asia.

Causative agent

● Public health concern in many endemic areas (46 Provinces in 12 Regions) ● Chronic parasitic infection caused by nematode parasite

FILARIASIS

FILARIASIS Signs and Symptoms ● Characterized by the presence of microfilariae in the peripheral blood ● No clinical signs and symptoms of the disease

Asymptomatic stage

FILARIASIS Signs and Symptoms ● Lymphadenitis- inflammation of the lymph nodes ● Lymphangitis- inflammation of lymph vessels in some cases, the male genitalia is affected.

Acute stage

FILARIASIS Signs and Symptoms ● Developed 10-15 years from the onset of first attack ● Hydrocoele- swelling of the scrotum ● Lymphedema- swelling of the upper and lower extremities ● Elephantiasis- enlargement or thickening of the skin of the lower and/or upper extremities, scrotum, breast

Chronic stage

FILARIASIS A. Measures aimed to control the vector ● Environmental sanitation such as proper drainage and cleanliness of the surroundings ● Use of insecticides B. Measures aimed to protect the people in endemic areas ● Use of mosquito nets ● Application of insect repellants ● Screening of houses ● Health education

Prevention and Control

FILARIASIS ● The drug of choice is Diethylcarbamazine (DEC) / Hetrazan ● Supportive care for Filariasis: Patients are advised to observe personal hygiene by washing the affected area with soap and water twice a day or prescribe antibiotics or anti-fungal for super infection.

Treatment

FILARIASIS ● Wuchereria spp.: Aedes poecilus, Anopheles minimus flavirostris ● Brugia spp.: Mansonia bonnaea, Mansonia uniformis

Vectors

FILARIASIS ● The disease is transmitted to a person through bites from an infected female mosquito

Mode of Transmission

FILARIASIS ● Wuchereria bancrofti ● Brugia malayi and/or Brugia timori ● Loa loa (African eye worm)

Causative agent

● (Weil’s disease, Mud fever, Trench fever, Flood fever, Spiroketal jaundice, Japanese seven days fever) ● It is a World wide zoonotic disease. ● It is an occupational disease affecting veterinarians, miners, farmers, sewer workers, abattoir workers, etc.

LEPTOSPIROSIS

LEPTOSPIROSIS ● Leptospira interrogans. There are about 200 serovars, var. icterohemorrhagiae thought to be more virulent and cause leptospirosis

Causative agent

LEPTOSPIROSIS ● Rat is the main host of the disease ● Pigs, cattle, rabbits, horses, dogs, and other wild animals can also serve as reservoir hosts

Reservoir

LEPTOSPIROSIS ● Through contact of skin, especially open wounds with water, moist soil or vegetation contaminated with urine of infected host

Mode of transmission

LEPTOSPIROSIS Signs and Symptoms correlates with the appearance of circulating IgM.

correlates with the appearance of circulating IgM.

LEPTOSPIROSIS Signs and Symptoms Leptospires present in blood and CSF. Onset of symptoms are abrupt with fever, headache, myalgia, nausea, vomiting, cough and chest pain

Leptospiremic phase

LEPTOSPIROSIS ● Improved education of people at particular risk ● Use of protective clothing boots and gloves especially by worker with occupational hazards ● Rats and other potential hosts control ● Investigation of contacts and source of infection

Prevention and Control

LEPTOSPIROSIS ● Penicillin; Doxycycline ● Tetracycline ● Erythromycin

Treatment

● An acute viral encephalomyelitis ● It is fatal once the signs and symptoms appear ● There are two kinds urban or canine rabies is transmitted by dogs while sylvatic rabies is a disease of wild animals and bats which sometimes spread to dogs, cats, and livestock ● Rabies remains a public health problem in the Philippines because it is responsible for the death of 200-300 Filipinos annually.

RABIES (Hydrophobia, Lyssa)

RABIES (Hydrophobia, Lyssa) ● Rabies virus (Rhabdovirus)

Causative agent

RABIES (Hydrophobia, Lyssa) ● Usually by bites of a rabid animal whose saliva has the virus. The virus may also be introduced into a scratch or in fresh breaks in the skin (very rare) transmission from man to man is possible.

Mode of Transmission

RABIES (Hydrophobia, Lyssa) ● Sense of apprehension ● Headache and Fever ● Sensory change near the site of animal bite ● Spasm of muscles or deglutition on attempt to swallow (fear of water) ● Paralysis, Delirium and convulsion ● Without medical intervention, the rabies victim would usually last only 2 to 6 days. Death is often due to respiratory paralysis

Signs and Symptoms

RABIES (Hydrophobia, Lyssa) ● Be a responsible pet owner (dog immunization) ● Consult for rabies diagnosis and surveillance of the area ● Get yourself pre-exposure anti-rabies vaccine ○ Active immunization aims to induce the body to develop antibodies against rabies up to 3 years. ○ Passive immunization is given in order to provide immediate protection against rabies which should be administered within the first seven days of active immunization. Consult a veterinarian or trained personnel to observe your pet for 14 days for sign of rabies

Prevention and Control

RABIES (Hydrophobia, Lyssa) ● The wound must be immediately and thoroughly washed with soap and water. Antiseptic such as povidone iodine or alcohol may be applied. ● Go to the nearest Animal Bite Treatment Center. ● The patient must be given antibiotics and anti-tetanus immunization ● Post exposure treatment is given to persons who are exposed to rabies. It consists of local wound treatment, active immunization and passive immunization.

Management/Treatment

● In the Philippines, only 7 provinces remain with local transmission of the disease

MALARIA

MALARIA Mosquito: Anopheles flavirostris

Vector

MALARIA ● Through the bite of an infected female mosquito or directly from one person to another by passage of blood containing erythrocytic parasites

Mode of Transmission

MALARIA ● Recurrent chills ● High-grade fever ● Profuse sweating ● Severe headache ● Anemia ● Hepatomegaly ● Splenomegaly

Signs and Symptoms

MALARIA ● Sustainable preventive and vector control ● Insecticide-treatment of mosquito nets ● House spraying ● Protective clothing ● Educate the people on endemic areas ● Chemoprophylaxis ● Early diagnosis and prompt treatment

Prevention and Control

MALARIA ● Only Chloroquine should be given. It must be taken at weekly interval starting from 1-2 weeks before entering endemic areas.

Chemoprophylaxis

MALARIA ● Drug of choice is Chloroquine. Pyrimethamine/Sulfadoxine combination may be used in areas with high levels of resistance to Chloroquine ● Uncomplicated P. Falciparum: ○ First-Line: Artemether-Lumefantrine + Primaquine ○ Second-Line: Quinine Sulfate + Doxycycline/Tetracycline/Clindamycin ● Complicated P. Falciparum: ○ Quinine Dihydrochloride Infusion + Doxycycline/Tetracycline/Clindamycin ● P. vivax, P. ovale, P. malariae: Chloroquine + Primaquine

Treatment

Each year, up to 400 million people get infected with dengue. Approximately 100 million people get sick from infection, and 22,000 die from severe dengue.

DENGUE HEMORRHAGIC FEVER (H-Fever)

DENGUE HEMORRHAGIC FEVER (H-Fever) ● Dengue virus serotypes (DENV1, DENV2, DENV3, DENV4)

Causative agent

DENGUE HEMORRHAGIC FEVER (H-Fever) Mosquito: Aedes aegypti; Aedes albopictus

Vector

DENGUE HEMORRHAGIC FEVER (H-Fever) ● Through bite of infected female mosquito

Mode of transmission

DENGUE HEMORRHAGIC FEVER (H-Fever) ● An acute febrile infection of sudden onset with clinical manifestation of 3 stages. ● First 4 days- febrile or invasive stage starts abruptly as high fever, abdominal pain and headache, petechiae ● 4th to 7th days- toxic or hemorrhagic stage-lowering of temperature, severe abdominal pain, vomiting, frequent bleeding, death may occur ● 7th to 10th day- convalescent or recovery

Signs and Symptoms

DENGUE HEMORRHAGIC FEVER (H-Fever) ● Enhanced 4S Strategy S - earch and Destroy S - eek Early Consultation S - elf Protection Measures S - ay yes to fogging only during outbreaks

Prevention and Control

DENGUE HEMORRHAGIC FEVER (H-Fever) ● There is no specific medication to treat dengue. ● Paracetamol, analgesic for fever, muscle pain or headache. ● DON’T GIVE ASPIRIN or IBUPROFEN ● Drink plenty of fluids such as water or drinks with added electrolytes to stay hydrated.

Treatment

● First identified in Uganda in 1974 in monkeys

ZIKA

Zika Virus ● Zika Virus

Causative agent

Zika Virus ● Mosquito: Aedes aegypti; Aedes albopictus

Vector

Zika Virus ● Through bite of infected female mosquito ● From a pregnant woman to her fetus ● Through sex ● Through blood transfusion (very likely but not confirmed)

Mode of transmission

Zika Virus ● Fever and headache ● Rashes ● Joint and muscle pain

Signs and Symptoms

Zika Virus ● Self Protection Measures ● Search and Destroy the mosquitos ● Practice safe sex

Prevention and Control

Zika Virus There is no specific medicine or vaccine for Zika virus. Treat the symptoms: ● Get plenty of rest. ● Drink fluids to prevent dehydration. ● Take medicine such as paracetamol to reduce fever and pain. ● Do not take aspirin or other non-steroidal anti-inflammatory drugs (NSAIDs).

Treatment

their complications belong to the top five categories for which adults seek health care in the developing countries. ● Many STIs can be treated and cured relatively easily and cheaply if diagnosed early enough. From among the STI, the most common treatable are: Chlamydia, Gonorrhea, Trichomoniasis, and Syphilis

SEXUALLY TRANSMITTED INFECTIONS

SEXUALLY TRANSMITTED INFECTIONS 1. Modification of sexual activity – this would decrease the like hood of exposure to or contact with infectious agents a. Abstinence b. Engage in mutually monogamous relationship c. Limit the number of sexual partners d. Inspect and question new partners e. Avoid certain sexual practices involving anal or fecal contact.

PRIMARY PREVENTION OF STI

SEXUALLY TRANSMITTED INFECTIONS 2. Barrier methods of contraception (use of condoms, diaphragms and spermicides) 3. Prophylactic antibiotics taken before and after exposure should not be done because: a. No single antibiotic covers all potential STIs b. Allergic reaction may occur c. They may lead to emergence or resistant organism 4. Pre-exposure vaccination

PRIMARY PREVENTION OF STI

BACTERIAL STI Causative agent: ● Neisseria gonorrheae Mode of transmission ● Transmission in neonates is during birth ● Direct contact between infectious mucous membrane Signs and Symptoms ● Genital (penis or cervix), anus, throat and eyes can be infected ● Males- burning urination and pus discharges from infection of urethra ● Females- vaginal discharge Prevention ● No drugs or vaccine. Condom offer protection. Trace contacts and treat to interrupt transmission. Treatment ○ Cefriaxone for uncomplicated cases. ○ If resistant, spectinomycin is used

Gonorrhea (GC, Clap, Drip)

BACTERIAL STI Causative agent: ● Treponema pallidum Signs and Symptoms ● Primary syphilis (Chancre)-painless sore at the site of entry of germs, swollen glands ● Secondary syphilis (condylomata lata)- maculopapular rash notably on the palms and soles, or as moist papules on the skin and mucous membranes. Moist lesion of the genitals ● Tertiary syphilis (Gummas)- varies from no symptoms to indication of damage to body organs such as brains, heart and liver Prevention ● Same as other bacterial STI. No vaccine available. Benzathine penicillin is given to contacts. Treatment ● Penicillin is effective in all stages of syphilis

Syphilis (Sy, Bad blood, The pox)

BACTERIAL STI Causative agent ● Chlamydia trachomatis Mode of Transmission ● Transmission in neonates is during birth Signs and Symptoms ● In males- discharge from penis, burning and itching of the urethral opening, burning sensation during urination ● In females- slight vaginal discharge, itching and burning sensation of vagina, painful intercourse, and abdominal pain. Prevention ● No vaccine available. Erythromycin is effective in infected mother to prevent neonatal disease. Treatment ● Tetracycline and Erythromycin

Chlamydia

PARASITIC STI Causative agent ● Trichomonas vaginalis Signs and Symptoms ● Males- slight itching of penis, painful urination, clear discharge from penis ● Females- white or greenish-yellow odorous discharge, vaginal itching, painful urination; Itching, burning, redness or soreness of the genitals Prevention ● Condoms limit transmission Treatment ● Metronidazole or Tinidazole for both partners

Trichomoniasis

VIRAL STI ● The first case of AIDS in the Philippines was reported in 1984. ● According to the DOH HIV/AIDS and ART Registry of the Philippines (HARP), there are now a total of 81,169 HIV and AIDS cases reported from January 1984 to October 2020. In October 2020, there were a total of 735 confirmed HIV-positive individuals. Ninety-six percent (704) of whom were male. Causative agent ● HIV (Human Immunodeficiency Virus) Mode of Transmission ● Transfer of body fluids (blood, semen, discharges); Sharing contaminated needles, syringe; Transplacental Signs and Symptoms ● Physical ● Rashes ● Loss of appetite ● Weight loss ● Fever of unknown origin ● Pneumocystis carinii pneumonia (Pneumocystis jiroveci) ● Esophageal candidiasis ● Kaposi’s Sarcoma (skin cancer)

AIDS (Acquire Immunodeficiency Syndrome)

VIRAL STI Signs and Symptoms Mental ● Forgetfulness ● Loss of concentration ● Loss of libido Psychomotor- retardation ● Confusion ● Disorientation ● Seizures ● Mutism ● Loss of memory ● Coma Prevention ● Screening of blood prior to transfusion, safe sex. There is no vaccine Treatment ● Azidothymidine (AZT) and Didanosine inhibit HIV replication by inhibiting reverse transcriptase. Clinical improvement occurs but the virus persists. Treatment of opportunistic infection depends on the organism

AIDS (Acquire Immunodeficiency Syndrome)

VIRAL STI Causative agent: ● Herpes simplex Virus type 2 (HSV2) Mode of transmission ● During passage through the birth canal in neonates Signs and Symptoms ● Painful vesicular lesion of the male and female genitals and anal area. Prevention ● Primary disease can be prevented by protection from exposure to vesicular lesion. There is no vaccine. Treatment ● Acyclovir is useful in the treatment of both primary and recurrent diseases.

Genital herpes

VIRAL STI Causative agent: ● Hepatitis B Virus (HBV) Mode of Transmission ● Transmitted through blood transfusion, sharing of unsterilized needles, and during birth Signs and Symptoms ● Loss of appetite ● Easy fatigability ● Joint and muscle pain ● Low grade fever ● Right sided abdominal pain ● Jaundice ● Dark colored urine Prevention ● Hepatitis B immune globulin (HBIG) for postexposure prophylaxis and hepatitis B vaccine ● Education of chronic carriers regarding precautions

Hepatitis B