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    CPH Prefinal CHAPTER 5 Control and Prevention of Communicable Diseases

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    Kristelle Marie Enanoria Bardon
    This document discusses communicable diseases and the immune system. It covers the differences between innate and adaptive immunity. The innate system provides non-specific defenses like physical barriers and inflammatory responses. The adaptive system mounts pathogen-specific immune responses through antibodies and T-cells. Vaccines help develop adaptive immunity. Several diseases are also summarized, including tuberculosis, malaria, dengue, rabies, schistosomiasis, and filariasis. Their causes, modes of transmission, diagnosis, treatment and prevention are outlined.

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    CPH Prefinal CHAPTER 5 Control and Prevention of Communicable Diseases

    Uploaded by

    Kristelle Marie Enanoria Bardon
    121 views79 pages
    This document discusses communicable diseases and the immune system. It covers the differences between innate and adaptive immunity. The innate system provides non-specific defenses like physical barriers and inflammatory responses. The adaptive system mounts pathogen-specific immune responses through antibodies and T-cells. Vaccines help develop adaptive immunity. Several diseases are also summarized, including tuberculosis, malaria, dengue, rabies, schistosomiasis, and filariasis. Their causes, modes of transmission, diagnosis, treatment and prevention are outlined.

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    This document discusses communicable diseases and the immune system. It covers the differences between innate and adaptive immunity. The innate system provides non-specific defenses like physical barriers and inflammatory responses. The adaptive system mounts pathogen-specific immune responses through antibodies and T-cells. Vaccines help develop adaptive immunity. Several diseases are also summarized, including tuberculosis, malaria, dengue, rabies, schistosomiasis, and filariasis. Their causes, modes of transmission, diagnosis, treatment and prevention are outlined.

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    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    121 views79 pages

    CPH Prefinal CHAPTER 5 Control and Prevention of Communicable Diseases

    Uploaded by

    Kristelle Marie Enanoria Bardon
    This document discusses communicable diseases and the immune system. It covers the differences between innate and adaptive immunity. The innate system provides non-specific defenses like physical barriers and inflammatory responses. The adaptive system mounts pathogen-specific immune responses through antibodies and T-cells. Vaccines help develop adaptive immunity. Several diseases are also summarized, including tuberculosis, malaria, dengue, rabies, schistosomiasis, and filariasis. Their causes, modes of transmission, diagnosis, treatment and prevention are outlined.

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    of 79

    CONTROL AND

    PREVENTION OF
    COMMUNICABLE
    DISEASES
    PRECIOUS DIANNE E. BARDON, RMT

    - COMMUNICABLE VS
    NONCOMMUNICABLE
    - GERM THEORY
    - PATHOGEN
    - SUSCEPTIBILITY
    - PATHOGENICITY

    IMMUNE SYSTEM
    INNATE IMMUNITY
    - PHYSICAL (ANATOMICAL BARRIERS)
    - CELLULAR
    - CHEMICAL
    ACQUIRED IMMUNITY
    -HUMORAL (B-CELLS & AB)
    - CELLULAR (T-CELLS & LYMPHOKINES)

    FUNCTIONS OF INNATE IMMUNE


    SYSTEM
    1. RECRUIT IMMUNE CELLS TO SITES OF INFECTION (CYTOKINES)
    2. ACTIVATION OF COMPLEMENT CASCADE FOR IDENTIFICATION
    AND CLEARANCE
    3. IDENTIFICATION AND REMOVAL OF FOREIGN SUBSTANCES
    (WBC)
    4. ACTIVATES ADAPTIVE IMMUNE SYSTEM (AG-AB)
    5. PHYSICAL AND CHEMICAL BARRIERS

    REACTION OF BODY TO PATHOGEN


    1. INFLAMMATION
    4 CLASSIC SIGNS:
    - RUBOR (REDNESS)
    - CALOR ( TEMPERATURE)
    - DOLOR (PAIN)
    - TUMOR (SWELLING)

    LEUKOCYTES (WBC)
    NEUTROPHIL MOST ABUNDANT, 1ST TO ARRIVE
    DENDRITIC CELL PRESENT IN TISSUES, LINK BETWEEN INNATE AND
    ADAPTIVE
    BASOPHIL RELEASE HISTAMINE
    EOSINOPHIL RELEASE TOXIC MOLECULES, MAY DAMAGE TISSUES
    MAST CELL RELEASE HEPARIN, HISTAMINES, CHEMOKINES, CHEMOTAXIC
    CYTOKINES. INVOLVED IN ALLERGIC/ANAPHYLAXIS AND WOUND HEALING.
    MACROPHAGE - PHAGOCYTIC CELL
    NATURAL KILLER CELL - AUTOLYTIC ACTION

    ADAPTIVE IMMUNE SYSTEM


    - HIGHLY SPECIFIC
    - LONG TERM
    E.G IMMUNIZATION

    ADAPTIVE IMMUNE SYSTEM


    RECOGNITION AND ANTIBODY PRODUCTION TO
    ANTIGENS
    GENERATION OF RESPONSES FOR MAXIMAL
    ELIMINATION OF PATHOGENS
    DEVELOPMENT OF IMMUNOLOGICAL MEMORY
    (B-CELLS)

    T-LYMPHOCYTES
    T HELPER CELL (CD4+ T CELLS)
    SECRETES CYTOKINES
    ASSIST B CELLS MATURATION
    ACTIVATES CYTOTOXIC T-CELLS & MACROPHAGE

    CYTOTOXIC T CELL (CD8+ T CELLS)


    DESTROYS VIRUS INFECTED CELLS

    MEMORY T CELL (EITHER CD8+ OR CD8+)


    GETS REACTIVATED UPON EXPOSURE

    SUPPRESOR T CELL
    SHUTS DOWN T CELL-MEDIATED IMMUNITY

    NATURAL KILLER T CELL


    PRODUCE SYTOKINES AND CYTOLYTIC MOLECULES

    IMMUNOGLOBULINS
    IgG - majority, trans placental
    IgA mucosal areas, prevents colonization of
    pathogens
    IgM eliminates pathogen in the early stage
    IgE binds allergens and triggers histamine
    release from mast cells and basophils, protects
    from parasite
    IgD antigen receptor

    HOW THEY SEES AND ANTIGEN


    T cells
    MHC - Processed form of antigen (peptide)
    B cells
    Needs helper T cells
    Differentiates into an effector cell (plasma cell)

    IMMUNOLOGICAL MEMORY
    Passive (short term)
    Active (long term)
    Immunization process where person is made immune
    or resistant to an infectious disease, typically by
    administration of a vaccine.
    - Live attenuated (modification)
    - Inactivated (wholes or fractions)

    Live attenuated
    - VIRUS
    Measles, mumps, rubella, varicella, rotavirus,
    influenza (intranasal)
    oral polio vaccine
    - BACTERIA
    Bacile Calmette- Guerin (BCG)
    Oral typhoid vaccine

    INACTIVATED VACCINES
    Needs booster
    INACTIVATED WHOLE VIRAL VACCINES
    - polio, hepatitis, rabies, influenza
    INACTIVATED WHOLE BACTERIAL VACCINES
    - pertussis, typhoid, cholera, plague
    FRACTIONAL VACCINES
    - Subunits: hepatitis B, influenza, acellular pertussis, human
    papillomavirus ,anthrax
    - Toxoids: diphtheria, tetanus

    POLYSACCHARIDE VACCINES
    - Pneumococcal disease, meningococcal
    disease and salmonella typhi
    - Haemophilus influenza

    RECOMBINANT VACCINES
    - genetic engineering
    - Hep B & HPV
    - Look at pp. 66 table

    BACTERIA
    Prokaryotic
    Biofilms (bacterial mats)
    Do not usually have membrane bound
    organelles within cytoplasm
    Taxis influenced behaviors (chemo,
    photo,energy,magneto)
    Gram Staining + (blue) (pink)

    ANTIBIOTICS

    - Bacteriocidal (KILL)
    - Bacteriostatic (prevent
    growth

    VIRUS
    3 major components
    - Genetic material
    - Protein coat
    - Envelope of lipids
    Virion (complete virus particle)
    Capsid (protein protective coat) (formed by capsomeres)
    - Bacteriophage, mutation, Antigenic Shift

    VIRUS REPRODUCTION
    1.Attachment
    2.Penetration
    3.Replication
    4.Release

    PARASITES
    PROTOZOA
    HELMINTHS (Egg-Larvae-Adult): Flatworms,
    Acanthocephalans, Roundworms
    ECTOPARASITES
    ARTHROPODS

    IMPLICATION OF PUBLIC HEALTH


    ACUTE vs CHRONIC
    TRANSMISSION: direct, indirect, airborne, bloodborne, droplet, sexual contact
    Infectivity: DISEASE
    (Host, Pathogen, Environment)
    Add: TIME

    CHAIN OF INFECTION
    Insert chart here

    THE GOALS OF EPIDEMIOLOGY


    Eradicate
    Prevention
    Intervention
    Control

    PREVENTIVE MEASURES
    Primary forestall onset
    Secondary (self-diagnosis & Self
    Treatment); isolation & quarantine
    Tertiary Control and Prevention

    COMMUNICABLE
    DISEASES

    TUBERCULOSIS

    TUBERCULOSIS OR TB
    an infectious disease caused by the bacteria called
    Mycobacterium tuberculosis.
    Transmitted from a TB patient to another person through
    coughing, sneezing and spitting. Thus, close contacts,
    especially household members, could be infected with TB.
    Lungs are commonly affected but it could also affect other
    organs such as the kidney, bones, liver and others.
    Curable and preventable. However, incomplete or irregular
    treatment may lead to drug-resistant TB or even death.

    CASE FINDING THROUGH (PASSIVE,


    ACTIVE, INTENSIFIED)
    Diagnosis
    1. DSSM
    2. TB Culture & Drug Susceptibility
    3. Tuberculin Skin Testing (PPD)
    4. Rapid Molecular Diagnostic Test (GenEXpert)

    Lowenstein Jensen
    media

    PPD test/ Mantoux Test


    -delayed hypersensitivity

    TB CLASSIFICATION
    1. Bacteriological Status
    a. Bacteriologically-confirmed
    b. Clinically diagnosed
    2. Anatomical location
    c. Pulmonary TB
    d. Extra-pulmonary TB
    3. History
    e. New Case
    f.

    Retreatment Case

    CASE HOLDING
    Set of procedures which ensures that patients
    complete their treatment

    Directly Observed Treatment


    Method developed to ensure treatment

    compliance by providing constant and


    motivational supervision to TB patients.

    TB DISEASE REGISTRATION GROUPS


    New
    Relapse
    Treatment after Failure
    Treatment After Lost to Follow-up
    Previous Treatment Outcome Unknown
    Others

    DRUG TREATMENT
    Fixed Dose combination
    Single drug formulation
    Type of treatment regimen given depends on
    category
    Treatment discontinued either by disappearance
    of symptoms or by adverse reactions (Minor &
    Major)

    STAGES OF TB PATHOGENESIS
    Exposure to infection
    Progression to disease
    Late or inappropriate diagnosis and
    treatment
    Poor treatment adherence and
    success.

    PLASMODIUM
    P. falcifarum
    P. vivax (hypnozoites)
    P. ovale
    P.malariae
    P. knowlesi

    ENDEMICITY
    a.Stable Malaria Areas
    b.Unstable Malaria Areas
    .Uncomplicated Malaria
    .Complicated Malaria
    * Signs and symptoms are nonspecific

    PARASITOLOGICAL DIAGNOSIS
    Improved
    Identification
    Prevention
    Confirmation
    Improved

    TYPE OF STAINS
    Romanowsky (Nucleus(RED);
    Cytoplasm (BLUE)
    Giemsa Stain Gold Standard
    Leishmans stain (thin smear)
    Wrights stain (rapid)

    MALARIA RAPID DIAGNOSTIC TEST

    TREATMENT FOR P. FALCIFARUM


    MALARIA
    Uncomplicated Malaria
    Antipyretics
    Anti-emetics
    Convulsions

    TREATMENT FOR NON- P. FALCIFARUM


    MALARIA
    Oral chloroquinoline
    Primaquine (contraindicated
    with G6PD)

    PROPHYLAXIS
    NO prophylaxis regimen offers complete
    protection
    Chloroquine
    Chloroquine plus proguanil
    Mefloquine
    doxycyline

    INSECTICIDE TREATED BED NETS


    Pyrethoid insecticides
    Piperonyl butoxide
    Long lasting insecticide-treated nets

    DENGUE

    DENGUE FEVER/ DENGUE


    HEMORRHAGIC FEVER

    ADMINISTRATIVE ORDER NO. 20120006


    Revised Dengue Clinical Case Management
    Guidelines 2011
    Classification of levels of severity &
    Appropriate Clinical Management (Dengue w/o
    warning signs, Dengue w/ warning signs,
    Severe Dengue)

    TREATMENT AND PREVENTION

    RABIES

    INCUBATION PERIOD (TIME OF EXPOSURE


    TO SIGNS AND SYMPTOMS APPEARANCE)
    FACTORS
    - amount of virus
    inoculated
    - severity of exposure
    - Location of Exposure

    PRODROMAL
    STAGE

    Acute Neurologic
    Stage

    Initial viral
    multiplication in
    muscle cells
    Paresthesia pain
    at the site of bite

    Virus reach brain (Gray


    matter)
    2 types
    - encephalitic/ furious
    - paralytic/ dumb
    - hypersalivation

    DIAGNOSIS
    Clinical Manifestations (hydrophobia/
    aerophobia)
    History of Exposure
    If paralytic: lab diagnosis on fresh tissue
    specimen with glycerine preservative
    Post-Exposure Prophylaxis (PEP)

    RABIES
    Vaccine- preventable disease (active and
    passive immunization)
    Intradermal (ID) 0.1 ml (PVRV & PCECV);
    One dose per deltoid (0,3,7,28 days)
    Passive: Rabies Immunoglobulin (RIG)
    Human RIG (HRIG): 21 days hf
    Equine RIG (ERIG) : 14 days hf

    SKIN TEST
    Performed prior to ERIG
    Positive (>6 mm)

    TREATMENT AND PREVENTION


    Chemical and Physical Means
    Pets Vaccination
    Pre-exposure immunization

    SCHISTOSOMIASI
    S

    MOT:
    CONTAMINATED
    WATER

    PATHOPHYSIOLOGY
    Its not the egg, but the cellular infiltration from the immune
    response
    Katayama Fever.

    Treatment: Praziquantel (annual)

    FILARIASIS
    Elephantiasis

    PARASITES
    Wuchereria bancrofti
    Brugia malayi & timori

    Microfilaraemic Direct
    observation on Peripheral
    Blood
    Amicrofilaraemic Clinical
    Observations or Antigen
    Detection

    DIAGNOSIS
    Microfilariae in blood smear
    Giemsa Stained
    Finger prick test gold
    standard

    MASS ANNUAL TREATMENT


    Diethylcarbamazine Citrate &
    Albendazole
    November as Filiriasis Mass
    Treatment Month

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