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INFECTIOUS DISEASESEmerging infectious diseases - Diseases of infectious origin with human incidences that have increased within the past two decades or that are likely to increase in the futureA. West Nile virus- emerging pathogens in humans caused by flavivirus - Most human infections are asymptomatic, when sx are present headache and fever are most frequently reported - Incubation period: 5-15days - No treatment - Transmission: birds are the natural reservoir for the virus - Bite of infected mosquito that has fed on infected bird - Not transmitted person to person - Aedes albopictus - Implication for nursing: teach prevention of mosquito bites by wearing proper clothing and using insect repellent - Teach people in affected areas to wear gloves in handling dead birdsB. Legionnaire’s disease- caused by gram-negative bacteria, Legionella pneumophila - Legionella organisms are found in many man-made and naturally occurring water sources - Transmission: aerosolized route from an environmental source to an individual’s respiratory tract - Risk factors: dses that lead to severe immunosuppression such as AIDS, hematologic malignancy, end-stage renal disease, use of immunosuppressive agents (steriods) - CxMx: early sx: malaise, myalgias, headache, dry cough; inc pulmonary sx, productive cough, dyspnea, chest pain, usually frebile may reach 39.4C or higher) - Med mgt: Azithromycin (Zithromax), Clarithromycin, Erythromycin, Levofloxacin - Nsg mgt: described for the pt with any pneumonia - Isolation not necessaryC. Lyme Disease- Borrelia burgdorferi - Transmittted to humans by ticks - Ticks may feed on infected white-tailed deer or white-footed mice which serve as a vector to transmit to humans - CxMx: erythema migrans is the best clinical marker, flu-like sx, inflamed painful arthritis, limb weakness; in later stage, neurologic manifestations from mild Bell’s palsy to GBS (Guillaine Barre’s Syndrome) (paralysis) or dementia - Nsg con: not communicable from person-person o Best means of prevention is the avoidance of tick-infested areas o Ticks should be removed with tweezers or forceps to avoid leaving mouth parts in the skin: pull upward o Insect repellantD. Hantavirus pulmonary syndrome (Hps) - Caused by a member of hantavirus family of viruses - Infected rodents known to carry the virus are found worldwide - Thrombocytopenia and hemoconcentration are common - No specific tx has been approved - Transmission: believed to occur through aerosolization of rodent excreta - Nsg con: rodent control, proper storage of food, careful wet mop cleaning and disinfection of rodent- contaminated areas.E. Ebola and Marburg Viruses - Caused by filoviruses characterized by severe hemorrhagic fevers, often accompanied by hepatic and renal damage - Mortality rate: marbug virus: 25% o Ebola: 50-90% - Filoviruses: clincal course- often occur rapidly o Fever, rash, encephalitis o Profound hemorrhage, organ destruction, shock o Mortality rate: 90% o Survivors: prolonged recovery period (weakness, malaise, cachexia common)
o Human-human transmission (blod or body fluid) o Percutaneous transmission o Mucous membrane exposure o Possible airborne transmission o Strict infection control measures o No antiviral tx approved yet o Supportive tx (MechVent, dialysis) o Contact CDC asapF. Severe Acute Respiratory Syndrome (SARS) - Caused by member of coronavirus family - An influenza-like dse (s/sx: cough, fever) - Respiratory distress in minority of cases - Barrier precautions - Nsg con: measure body temp, ventilation, drink more water, wash hands frequently, wear gauze maskG. AH1N1 virus (swine flu) - Is a combination of 4 viruses from swine, bird - First reported in the US in April of 2009 - Transmitted from person-person, same with seasonal influenza virus - Caused by infection with a novel coronavirus - CxMx: similar sx with regular flu: o Fever and headache, fatigue and muscle aches, loss of appetite, nasal congestion, sore throat and cough, others report of diarrhea and N/V - Mode of transmission: exposed to persons who are sneezing and coughing and positive of the virus o Touching the mouth, nose, and eyes after contact with persons positive of the virus - What to do? o Should wear surgical mask o Separate room or if not, give 1 meter distance from each family member o Good ventilation o Handwashing after each contact with the patient o Environmental sanitation - Prevention: o Hand washing o Avoid people who are positive o Increase body’s resistance: Inc fluid intake 8 hours of sleep - Home based care: reducing risk to the patient: o Hand hygiene o Equipment care o Patient teaching - Reducing risk to household members: o Establishing barriers o Food preparation
Dse Causative agents Mode of Clinical manifestations Treatment transmissionWEST NILE VIRUS Birds: Flavivirus Mosquito: aedes albopictusLEGIONNAIRE’S DSE Water resources: Aerolized route malaise, myalgias, Azithromycin Legionella headache, dry cough; inc pneumophilia pulmonary sx, productive cough, dyspnea, chest pain, usually frebile may reach 39.4C or higher)LYME DSE White-tailed deer Ticks Erythema migrans, mild Ticks removed or white-footed Bell’s palsy to GBS or with tweezers mice: Borrelia dementia burgdorferiHANTAVIRUS Rodents: Aerolization of Hemoconcentration, Rodent controlPULMONARY hantavirus rodent excreta thrombocytopeniaSYNDROMEEBOLA AND MARBURG Filoviruses Severe hemorrhagic fever, Contact CDC asap often accomp. By hepatic and renal failureSEVERE ACUTE Coronavirus Flu-like sx Barrier protectionRESPIRATORYSYNDROMEAH1N1 Swine, birds: Flu-like sx Barrier protection coronavirus