Infectious DIsease Flashcards
1
Q
disease surveillance
A
- “ongoing systematic collection, analysis, interpretation, and dissemination of specific health data for use in public health”
- provides a means for nurses to monitor dz trends in order to reduce morbidity and mortality and to improve health
2
Q
bioterrorism
A
- intentional or threatened use of viruses, bacteria, fungi, or toxins from living organism to produce death or dz in humans, animals, or plansts
3
Q
biological agents of highest concern
A
- Variola major (small pox)
- no longer vaccinate
- live vaccine
- Bacillus anthracis (anthrax)
- Yersinia pesis (plague)
- Francisella tularensis (Tularemia)
- Botulinum toxin (botulism)
- filoviruses and arenaviruses (viral hemorrhagic fevers)
- all suspected or confirmed cases should be reported to authorities immediately
4
Q
advantageous of biologics as weapons
A
- infectious via aerosol
- organisms fairly stable in environment
- susceptible civilian populations
- high morbidity and mortality
- person to person transmission (smallpox, plague)
- difficult to dx and tx
- easy to obtain
- inexpensive to produce
- potential for dissemination over large geographic area
- creates panic
- can overwhelm medical services
- perpetrators escape easily
5
Q
smallpox
A
- successful worldwide vaccination program
- used a 2 pronged/bifurcated needle
- last case in US was in 1949
- last naturally occurring case in world was Somalia in 1977
- in 1972, the routine childhood vaccination was discontinues, meaning that approx half of the US population was never vaccinated
- small pox is caused by the variola virus
- except for lab stockpiles, the variola virus has been eliminated
- however, since the events of Sept and Oct 2001, there is heightened concern that the virus might be used as an agent of bioterrorism
- it is a serious, contagious and sometimes fatal, infectious dz
- no specific tx for dz, and only prevention is vaccination
6
Q
2 clinical forms of small pox
A
- Variola major: severe, most common form w/ more extensive rash and higher fever
- Variola minor:
- less common presentation of small pox
- much less levere dz
- death rates <1%
7
Q
transmission of small pox
A
- generally, direct and fairly prolonged face to face contact is required to spread smallpox from one person to another
- can also be spread through direct contact with infected bodily fluids or contaminated beddings or clothing
- rarely, has been spread in the air in enclosed settings such as buildings, buses, and trains
8
Q
incubation period of small pox
A
- duration 7-17 days: time of exposure to time of first symptoms
- not contagious
- no symptoms and may feel fine
9
Q
initial symptoms of small pox
A
- prodromal
- duration 2-4 days
- sometimes contagious
- first symptoms: fever, malaise, HA, body aches, vomiting
- fever usually high in range of 101-104
- usually too sick to carry on normal activities
10
Q
early rash in small pox
A
- lasts about 4 days
- most contagious
- a rash first emerges first as small red spots on the tongue and in the mouth
- spots develop into sores that break open and spread large amounts of virus into the mouth and throat
- at this time, the person is the most contagious!
11
Q
pustule rash with small pox
A
- lasts about 5 days
- bumps become pustules sharply raised usually round and firm to the touch as if there’s a small round object under the skin
- ppl often say the bumps feel like BB pellets embedded in skin
12
Q
resolving scabs with small pox
A
- lasts about 6 days
- contagious
- scabs begin to fall off, leaving marks on skin that eventually become pitted scars
- most scabs will have fallen off 3 weeks after rash appears
- once the scabs have resolved and fallen off completely, you are no longer contagious
13
Q
post exposure prophylaxis of small pox
A
- vaccination may be effective in preventing mobidity/mortality if given w/in 2-3 days of exposure
- Cidofovir–an antiviral drug with substantial renal toxicity may improve outcomes if given w/in 1-2 days after exposure
- however, there is no definitive to suggest that it is better than vaccine along
14
Q
vaccination contraindications for small pox
A
- apply to both potential vaccinees and their household contacts
- eczema or atopic dermatitis and other acute, chronic, or exfoliative skin conditions
- burns
- impetigo
- chicken pox
- contact dermatitis
- shingles
- herpes
- severe acne
- severe diaper dermatitis
- psoriasis
- HIV/AIDs
- solid organ/stem cell transplant
- generalized malignancy
- leukemia/lymphoma
- pregnancy/breastfeeding
- have to ask if they or any of household contacts are pregnant or intend to become pregnant w/in 4 weeks–if yes, then don’t vaccinate
- infants/children
15
Q
small pox emergency
A
- all contraindications to vaccinate would be reconsidered in the light of the risk of small pox exposure
16
Q
anthrax
A
- caused by spore forming bacterium bacillus anthracis
- aerosolized spore form
- zoonotic dz in herbivores (sheep, goats, cattle) follows ingestion of spores in soil
- human infection typically acquired through contact w/ anthrax, infected animals, or animal products
- one deep breath at site of release
- give antimicrobial prophylaxis for those who are potentially exposed
- but often don’t know you are infected
- abx you are given is usually doxycycline
- 3 clinical forms:
- cutaneous
- inhalational
- dx by: CXR widened mediastinum, pleural effusions, infiltrates, pulmonary congestion
- gastrointestinal
17
Q
Tularemia (Francisella tularensis)
A
- plague like dz in rodents (California)
- deer fly fever (Utah)
- rabbit fever (centralized US)
- not contageious
- dangers, highly virulent organism
18
Q
streptococcus progenies
A
- flesh eating bacteria
- 1994
- improperly cooked hamburgers
- unpasteurized apple juice
19
Q
mad cow dz
A
- bovine spongiform encephalopathy BSE
- transferred to humans through beef consumption
20
Q
worldwide and infectious dz
A
- infectious dz are the leading killer of children and young adults accounting for more than 13 million deaths a year and for half of all deaths in developing countries
21
Q
epidemiologic triangle
A
- agent
- host: has to be a vulnerable host
- environment: has to be an env that it can grow in
22
Q
data sources for surveillance of infectious dz
A
- health care supplies (CDC)
- have to report STIs, TB, ebola, etc
- mortality data–vital stats report (death certificants)
- morbidity data
23
Q
approx half of all deaths are caused by which 3 diseases?
A
- TB
- malaria
- HIV/AIDs
24
Q
what are 3 problems having to do with infectious dz?
A
- new pathogenic orgs have emerged
- new strains are more virulent
- organisms have become resistant to many abx
25
Q
foodborne diseases
A
- can involve biological and non-biological agents
- can be caused by microorganisms, marine orgs, fungi and toxins, and chemical contaminants
- raw and undercooked foods of animal origin are most likely to be contaminated
26
Q
top 5 pathogens contributing to foodborne illness
A
- norovirus
- salmonella
- clostridium perfringens
- campylobacter
- staphylococcus aureus
27
Q
norovirus
A
- responsible for most cases of GE
- spread by fecal oral route
- aerosolized vomitus has been implicated in some cases
- 12-48 hours incubation period
- usually resolves in 48 hours
- elderly, children, and those with severe conditions are at inc risk for volume depletion
- most cases occur in long term care facilities
- prevention: good handwashing, thorough and immediate disinfection, isolation of sick indivs until 72 hours after they are symptom free
- tx: oral hydration solns, IVF and electrolyte replacement
28
Q
campylobacter enteritis
A
- most common cause of bacterial illness
- important cause of diarrhea illness thru world regardless of ppl’s age
- often implicated in traveler’s diarrhea
- consumption of contaminated poultry is common source
- other sources: undercooked meats, ground beef, cheese, eggs, shellfish
- incubation period 2-5 days
- diarrhea illness last no more than a week
- S/S: n/v, abdominal pain, fever, HA, muscle pain
- dx: stool culture
- tx: antidiarrheal drugs, abx
29
Q
Listeria monocytogenes
A
- primarily affects older ppl and pregnant women
- can result in miscarriage, still birth, or severe illness/death in newborn
- risk reduced by recommendations for safe food prep, consumption, storage
30
Q
nontyphoid salmonella
A
- bacterial dz transmitted by contaminated food/water, or contact w/ infected animals or reptiles
- infants, elderly, and immunocompromised at highest risk
- S/S: diarrhea, fever, abdominal cramps 12-72 hrs
- lasts 4-7 days
- tx: not always needed, but dehydration and electrolyte imbalance replacement is essential
31
Q
E. coli
A
- shiga toxin producing deadly form of E. coli
- S/S: severe abdominal cramps, bloody diarrhea, vomiting
- usually resolves in 7-10 days
- in very young and very old, can cause hemolytic-uremic syndrome leading to renal failure
- assoc with commercially packaged foods and fresh produce
32
Q
waterborne dz
A
- diarrhea dz (like cholera) kill more children than AIDS, malaria, and measles combined, making it the 2nd leading cause of death among children less than 5
- in the US, the gov’t establishes and reinforces regulations for protecting recreational water
- EPA sets water quality guidelines for nat’l and untreated recreational water
33
Q
the top 5 pathogens for waterborne dz
A
- norovirus
- cryptosporidium
- E. coli
- pseudomonas
- legionella
34
Q
2 criteria must be met for an event to be defined as a water assoc outbreak:
A
- 2 or more ppl must be linked epidemiologically by time, location of exposure to water, and illness characteristics
- epidemiologic evidence must implicate recreational water or volatilization of water assoc cpds into the air surrounding the water as a probable source of illness
35
Q
what do they check in a swimming pool to make sure it can be decontaminated by the chlorine?
A
- pH
- chlorine
36
Q
STDs
A
- majority of cases b/w 15-24
- affects men and women equally
- 8 most common STIs:
- chlamydia
- gonorrhea
- hep B
- HSV-2
- HIV
- HPV
- syphilis
- trichomoniasis
37
Q
chlamydia
A
- give 1 g of azithromycin one time dose
- can also do doxycycline but will be for multiple days
