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Community Health Midterm > Infectious DIsease > Flashcards

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
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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
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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
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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
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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
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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%
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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
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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
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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
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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!
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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
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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
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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
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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
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15
Q

small pox emergency

A
  • all contraindications to vaccinate would be reconsidered in the light of the risk of small pox exposure
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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

Community Health Midterm (11 decks)

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