Infectious diseases Ch 26

Question 1

Communicable disease

Answer 1

an infectious disease that can be passed from one person to another

Question 2

Ryan white CARE Act

Answer 2

requires medial facilities to notify emergency personnel of transmitted diseases involving pts they transported

Question 3

endemic
epidemic
pandemic

Answer 3

endemic- incidence of cases of a specific disease in a specific area remains steady over time

Epidemic- a rising case load

Pandemic- infects large number of ppl and spreads all over the world

Question 4

Ryan White Care Act

Answer 4

requires medial facilities to notify emergency personnel of transmitted diseases involving pts they transported

Question 5

communicable disease transmission

Answer 5

contact (direct or indirect)

Droplet- sneezes or coughs and inhalation of infected droplets (3-6ft rule) dont stay in air long

Airborne- are in are much longer periods

Vector- an organism that harbors pathogens that are harmless to the organism but cause disease when transmitted to a human (mosquitos)

Question 6

DICO

Answer 6

designated infection control officer

insures notification and Tx

Question 7

Bacteria

Answer 7

grow and reproduce outside the human cell in an appropriate environment( temp and nutrients)

Question 8

Viruses

Answer 8

smaller than bacteria, multiply only inside host (dies when exposed to environment

Question 9

Fungi

Answer 9

similar to bacteria

Question 10

Parasites-

Answer 10

live in or on another lving creature. (feeds on host cells and tissue

Question 11

Meningitis

Answer 11

Meningitis
inflammation of meninges (not transmitted through air but droplet transmitted)
trasmits through direct contact (mouth to mouth, suctioning, or intubation with spraying secretions) or prolong contact of 8 hrs or more

Bacterial- communicable (unlike viral)

most often type involved- meningococcal meningitis

S/S
classic- same for viral and bacterial forms- sudden onset fever, severe headache, stiff neck, Kernig sign (cant extend leg when thigh is flexed, head will flex), Brudzinski sign (passive flexion of leg on one side causes a smilier movement in opposite leg or movement of neck causes movement of legs), photosensitivity, and a pink rash that becomes purple.

common- changes in mental status( apathy to delirium) and projectile vomiting

PreHosp Tx
Give pt a mask or NRB (you should wear one as well)
lumbar puncture is needed to diagnose.
treat symptoms- airway, fluids, prepare for seizures

hard to get antibiotics to pt cephalitis (infection of brain) common

Question 12

Tuberculosis TB

Answer 12

important cause of disability and death in much of developing world. once was widespread in th U.S., but no longer.

3 types
Typical- communicacle
Atypical- not communicable
extrapulmonary (TB of the bone, kidney, lymph glands and so on) not communicable.

most at risk- malnourished pts, overcrowd places (homeless/incarcerated)

TB infection (latent TB) means person tested positive but doesn’t have and may never develop active disease,(does not pose risk to others).

Multidrug-resistant TB - was untreatable, but therapies are now available. from people who do not complete full course of Tx.

Transmission occurs by large, airborne particles from a person with active untreated disease

Incubation period- 4-12 weeks.
2-14 days of treatment to become virtually no longer communicable

S/S
persistent cough for more than 3 weeks plus one or more of the following: night sweats, headache, fever, fatigue, weight loss, hemoptysis (coughing up blood), hoarseness or chest pain.

PreHosp Tx
surgical mask (N95 or HEPA mask not required)
Airway

Question 13

Pneumonia

Answer 13

inflammation of the lung, may be from bacteria, viruses, fungi, or other organisms. (more than 50 types) most are not communicable (most common-viral)

most susceptible- older adults, heavy smokers, alcoholics, pts with chronic illnesses and immunocompromised pts.
worldwide its the leading cause of death for peds pts (particularly infants)

S/S
may have high fever, chest pain, productive cough, reap distress (check for diminished breath sounds
PreHosp Tx
airway/ Vent support, O2, IV.

Question 14

Respiratory Syncytial Virus (RSV)

Answer 14

leading cause of lower reap tract infections in infants, older people and immunocompromised people.

Transmission- direct contact w/ large droplets or indirect by contaminated objects or hands. (dies within 1 hr on hands but on other surfaces up to 30 hrs)

Incubation- 2-8 days

S/S- upper respiratory infection-sneezing, runny nose, nasal congestion, cough, and fever.
progresses to lower rep tract leading to- pneumonia, bronchiolitis and tacheobronchitis .
hypoxemia and apnea are often seen in infants.

PreHosp Tx
PPE, supportive care

COPD with Pneumonia can be fatal

Question 15

Bronchitis-

Answer 15

inner walls of bronchioles become inflamed, usually due to infection.

S/S-
soreness of chest and throat, congestion, wheezing, dyspnea, and a slight fever

maybe be cause by same virus that causes the common cold and gastric reflux disease (GERD) and/or by common pollutants and smoking.

Chronic bronchitis- cough most days for spans of 3 month or more a year for 2 or more consecutive years

Question 16

Laryngitis-

Answer 16

inflammation of the voice box to overuse, irritation, or infection. (usually viral but can be bacterial)

S/S- hoarseness, weak voice, sore throat, dry mouth, and cough

Question 17

epiglottis

Answer 17

life- threatening swelling of epiglottis and supraglottic,

can occlude airway
can effect any age most reverent in 2-7 yr olds
incidences have dropped 1985 (HIB vaccine to 2 mo old infants became routine)

S/S
difficulty breathing and swallowing with stridor and drooling

caused by Hib bacteria and is contagious by the droplet route via coughing and sneezing

Question 18

Common Cold p1300

Answer 18

infection of the upper resp sys.
S/S- runny nose, sore throat, cough, congestion and watery eyes

any one of 200 viruses can cause the cold (so symptoms may vary)

Pts do not have a fever

last about a week

Question 19

Mononucleosis

Answer 19

caused by EBV (Epstein-Barr virus) a herpes virus. aka kissing disease (grows in the epithelium of the oropharynx and sheds into the saliva.

most causes there are no symptoms

transmision via direct contract with the saliva of an infected person

Incubation period is 4 to 6 weeks following exposure

S/S-
sore throat, fever, secretions from the pharynx, swollen lymph glands, malaise, anorexia, headache, muscle pain (myalgia) and enlarged liver and spleen

pharyngeal secretions may persist for 1 yr or more after infection

in severe causes complications may include anemia, dehydration, spleen rupture, seizures or pneumonia.

PreHosp Tx-
PPE,

Question 20

Seasonal Influenza-

Answer 20

viruses cause acute respiratory illnesses

transmission- airborne also hand to nose to mouth to eye

Incubation period- about 1-4 days

communicable period in adults lasts from the day before symptoms begin until about 5 days after onset of illness.

S/S-
systemic fever, shaking chills, headache, muscle pain (myalgia), malaise, and loss of appetite
Resp symptoms- dry, often protracted (lasting a long time) coughing, hoarseness and nasal discharge.

complications- may include viral or bacterial pneumonia

PreHosp Tx-
Surgical Mask or NRB
very few pts need IV fluid or ventilation assistance

key is preventative measures (Flu Shot!)

Question 21

Gonorrhea-

Answer 21

infection cause by gonococcal bacteria (Neisseria gonorrhoeae).

transmission- sexually (contact with pus)

Incubation- usually 2-7 days but maybe longer

Communicable for months if not treated (noncommunicable with in hrs if treated)

S/S
differ between males and females
males- pus containg dischargee from the urethra and often pain on urination (dysuria) starting a few days after exposure

females- initial inflammation of the urethra or cervix (may be so mild that it passes unnoticed, so may progress to pelvic inflammatory disease, with S/S of an acute abd.)

may also involve anus and throat

Question 22

Syphilis-

Answer 22

caused by spiral shaped bacterium (treponema pallidum)
progresses in 3 stages. considered acute and chronic disease

Transmission by direct contact with infectious fluid of the primary lesion(s).
can be transmitted across the placenta from mother to fetus, or through blood transfusion.

incubation period- 10 days to 3 months
communicable period is variable

if treated with penicillin, person is considered noncontagious within 48 hrs

produces an ulcerative lesion (chancre) of the skin or mucous membrane at site of infection.
most likely located on the genital region

Secondary infection- skin rash, patchy hair loss, and swollen lymph glands

Complications in the third stage- cardiac, ophthalmic (related to the eye), auditory, and CNS complications and lesions of the tissues and bone.

Tx- prevention measures PPE

Question 23

Genital Herpes-

Answer 23

chronic, recurrent illness produced by infection with the herpes simplex virus (type 1 and type 2)

Type 1- transmitted bia oral secretions (activeted from a dormant status by stress and febrile illness) causes blister-like sore, usually on the lips or inside the mouth.

Type 2- spread through sexual contact. vesicular lesions. women initially on the cervix (recurrent infections may paperer around the bulb, legs, and buttocks) male- occur on the penis as well around the anus (depednign on sexual practices

herpetic whilow (herpes infection of the finger)

Incubation period is 2-12 days.

secrection of the virus in saliva has been noted to persist for up to 7 weeks following appearance of a lesion

Genital lesions are infections for 4-7 days

disease is elusive, can suddenly become reactivated

no cure, meds to reduce outbreaks

Question 24

Chlamydia

Answer 24

highest incidence of all STDs
trasmitted through secual contact

Incubation period is believed to be 7-14 days or longer.
communicable period is unknown

S/S
most women initially remain asymptomatic, but pelvic inflammatory disease may develop
in men, may lead to epididymitis (?), prostatitis, proctitis, and proctocolitis

may include inflammation of the urethra, epididymis (?), cervix, and fallopian tubes
urethral discharge may be gray or white (amount is variable)

Tx-
PPE, in hosp- antibiotics

Question 25

Scabies

Answer 25

infection with a parasite (sarcoptes scabies). incidences have been increasing in the U.S. and EU over the past few yrs.

commonly affects families, children, sexual partners, chronically ill pts, and ppl in group homes

Transmission- direct skin-to-skin contact

Incubation period- 4-6 weeks for person with no prior exposure. a second exposure may appear in as little as a few days

Communicable period- last until the mites and eggs are destroyed by Tx.

S/S
rash of small, raised red bumps where the mite has burrowed into the skin, causing intense itching, especially at night
usually appears on hands, flexor aspects of the wrists, axillary fold, ankles, toes, genital area, buttocks and abdomen
pt may have sores from scratching

PreHosp Tx
PPE

Question 26

Lice

Answer 26

small insects that crawl through hair and feed on blood through the skin. they can not hop or fly

3 types
head louse (pediculus humans capitis) usually on any hairy part of head
body louse (pediculus humans corporis) usually found in seams of clothing (can transfer certain diseases)
and pubic louse (phthirus pubis) STD

all acquired through direct contact.
head and body lice can be acquired from objects (hats, combs, clothes)

lice eges look like small white or tan dots on the skin (hatch after about 1 week/ mature in 1-2 weeks) than adult begins to lay eggs over the next 28 days

S/S of public lice-
slight to severe itching and irritation and possible sores. Public lice can effect other areas of the body

Tx-
PPE

Question 27

Viral Hepatitis-

Answer 27

inflammation of the lover produced by a virus (A, B, C, D, and E) A and E are enteric (intestinal) diseases

Question 28

HBV-

Answer 28

aka serum hepatitis
transmitted through sex, blood transfusion or puncture of the skin with contaminated needles(tattoos, acupuncture IV drug users and occasionally other objects)
1982- Immunization prgrams began (3 doe series)

limited data suggest surveil outside the body for as long as 7 days
incubation period varies widely 45 days to 200 days

2-10% percent infected become chronic carriers
3-5% develop cirrhosis of liver or liver cancer

S/S
same for all hep viruses

Question 29

HCV-

Answer 29

most chronic bloodborne infection and leading cause of liver transplantation in th U.S.

transmitted via blood-to-blood with an open area of the skin, secual contact, blood transfusion, organ donation, unsafe medical practices, mother to infant.

cannot survive in the environment long enough to pose any risk

75-80% of infected profess to long-term chronic infection

incubation period ranges from 2-24 weeks (avg 6-7 weeks)

S/S
same

Question 30

HDV-

Answer 30

aka delta hepatitis
host must be infected with Hep B

most noticed with IV drug users
transmitted generally by percutaneous exposure
Incubation period 30-180 days

Question 31

Human Immunodeficiency Virus Infection (HIV)

Answer 31

transmitted by contact with blood and body fluids.
HIV pathogen envelops infected cells and attacks immune system and other body organs- immune system is unable to assist in protecting from other diseases

take about 7 days for the virus to envelop a cell (process may occur 4-6 weeks after the exposure.

S/S
may include acute febrile illness, malaise, swollen lymph glands, headache and possibly rash.

if infection is eft untreated the number of T-helper lymphocytes (CD4 cells) gradually decline

Question 32

Acquired Immunodeficiency Syndrome (AIDS)

Answer 32

end stage process cause by HIV

pt become extremely vulnerable to numerous opportunistic infections ( would not affect a regular person)

Question 33

Norovirus Infection

Answer 33

Previously Termed Norwalk agent
causes about 90
5 of epidemic nonbacterial out breaks of astroenteritis

maay be responsible for up to 50% of food-bor outbreaks in the U.S>

effects all ages

multiples in small intestines

transmission fecal-oral (contaminated food/water

Symptoms may appear with 1-2 days

S/S-
N/V, forceful vomiting, watery diarrhea, abdominal pain, weakness, and low-grade fever (rarely admitted to hospital)

bleach is needed to clean!

Question 34

Hepatitis A Virus Infection

Answer 34

(HAV) aka infectious hepatitis
most common in the U.S.

Transmission Fecal-Oral
most outbreaks(epidemics) are traced to contaminated drinking water, milk, scliced meats, and undercooked shellfish

often described as benign (mild) disease. once acquired it provides a lifelong immunity to it

vaccine is usually administered at 12 month

incubation period is usually about 2-4 weeks can range from 15-50 days

S/S-
phase 1- fatigue, loss of appetite, fever, nausea, and abdominal pain; smokers lose their interest in smoking
Phase 2- pts have jaundice, dark colored urine and whitish stools

good PPE and Cleaning habits

Question 35

Hepatitis E Virus Infection

Answer 35

HEV
50% of hep cases in developing countries, strongly associated with floods and poor sanitaion and hygiene

transmission is fecal-oral by ingestion of contaminated water.

not chronic
incubation period of 15-64days

S/S
same as other Hep viruses

PPE and good cleaning habits

Question 36

zoonotic

Answer 36

diseases transmitted through a vector (ticks or mosquitos)

Question 37

West Nile Virus

Answer 37

relatively new in the U.S.
first discovered in Uganda in 1930s
and first in western hemishpere in NYC in 1999

transmission- mosquitos (1% carry)

not communicable (person to person)

incubation perios is from 3-14 days after transmission

S/S-
majority of cases, mild and uneventful
80% of peole who acquire it are unaware

20% symptomatic- fever, headache, body rash, swollen lymph gland

Question 38

Lyme Disease

Answer 38

named after Lyme, Connecticut ( first identified)
most common tick borne disease in the U.S.
deer tick spread bacterium Borrelia burgdorferi

highest prevalence is along the atlantic coast, upper midwest and pacific coast

peak season june and august

not communicable

more often in children less than 10 and middle aged adults

incubation period- 3-32 days

affects the skin, heart, joints, and nervous system (some pt remain asympto)

3 stages
1- early localizsed- round, red skin lesion (red bull’s eye rash) most common in groin, thigh or axilla. warm to the touch and may blister or scab

2- early disseminated- secondary lesions may develop with days and pt may have flu like symptons (fever, chills, headache, malaise, and mucle pain) nonproductive cough, testiicular swelling, sore throat, enlarged spleen and enlarged lymph nots may be present.
neuro including meningoencephalitis and cranial and peripheral neuropath occurs in 15-20% of untreated pts within 2-8 weeks
cariaic involvement incudes pericarditis, myocarditis, and A/V conduyction difficulites occurs in 10% of untreated pts

3- late manifestaion- arthritis in about 60% of untreated pts, chronic neurologic symptoms are uncommon

Question 39

Rocky Mountain Spotted Fever

Answer 39

RMSF
tick borne cause by bacterium Rickettsi rickettsii
potentially fatal if not treated in first few days of symptoms

S/S- fever, headache, abdominal pain, vomiting, and muscle pain, rash amy develop but is often absent in the first few days (some pt never develops)

must be confirmed with lab tests

Question 40

Hantavirus

Answer 40

Hemorrhagic fever with pulmonary syndrome
associated with mice and rats ( in urine, feces and saliva)

transmission is direct contact with waste (often when cleaning and kicking it up in air)

not communicable

flu like symptomes that progress ropidly to potentially life threatening breathing problems

Question 41

Rabies

Answer 41

a