INFECTIOUS DISEASE Topics · Syphilis Latent Early Late No symptoms but serologically evident Syphilis Tertiary (1Tertiary (1--10 yrs)10 yrs) Production of Production of guma’sguma’s

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INFECTIOUS DISEASE INFECTIOUS DISEASE TopicsTopics

Principles of Disease TransmissionPrinciples of Disease TransmissionMicrobiology, Pathogens that cause diseaseMicrobiology, Pathogens that cause diseaseBacterial diseasesBacterial diseasesViral diseasesViral diseasesFungal InfectionsFungal InfectionsParasitic InfectionParasitic Infection

Microorganisms That Cause DiseaseMicroorganisms That Cause Disease

Virus

Fungi Prion

Bacteria (Staph) Parasite (Hookworm)

Bacterial DiseasesBacterial Diseases

PertussisPertussis

TetanusTetanusBotulismBotulism

PlaguePlagueAnthraxAnthrax“Strep”“Strep”BotulismBotulism

Gas gangreneGas gangreneCholeraCholeraTBTB

LeprosyLeprosy

pp“Staph”“Staph”

MeningitisMeningitis

SyphilisSyphilis

PertussisPertussis

Whooping CoughWhooping CoughHighly ContagiousHighly ContagiousVaccine PreventableVaccine PreventableSealSeal--like barking coughlike barking coughGagging, droolingGagging, drooling

PertussisPertussis

ExposureExposureNasal SwabNasal SwabAntibioticsAntibioticsSymptom CareSymptom Care

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PertussisPertussis

PPEPPEGlovesGlovesSafety GlassesSafety GlassesMaskMask

TetanusTetanus

LockjawLockjawNeurotoxinNeurotoxinWound contaminationWound contaminationProlonged muscle Prolonged muscle contractioncontraction

TetanusTetanus

ImmunizationImmunizationImportant Important vaccination question vaccination question to ask patients to ask patients

BotulismBotulism

BotulousBotulous –– “Sausage”“Sausage”NeurotoxinNeurotoxinParalysisParalysis

BotulismBotulism

Infant / AdultInfant / AdultColonization of Colonization of ingested sporesingested spores

BotulismBotulism

Wound Wound contaminationcontaminationIV Drug UsersIV Drug Users

Wear gloves Wear gloves and protect and protect from juicy from juicy woundswounds

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BotulismBotulism

FoodborneFoodborneIngestion of contaminated Ingestion of contaminated FoodsFoods

Clear liquids turned Clear liquids turned milkymilkyCracked jarsCracked jarsSwollen / Dented cansSwollen / Dented cans

BotulismBotulism

SymptomsSymptoms

BotulismBotulism

Care is supportiveCare is supportivePreventionPrevention

Don’t use IV drugsDon’t use IV drugsKeep all foods hot or coldKeep all foods hot or coldPay attention to foods you eatPay attention to foods you eat

Gas GangreneGas Gangrene

Gk “Gk “PutrificationPutrification””Found in soilFound in soilUsually enter body Usually enter body through a woundthrough a woundProduces gas Produces gas within tissueswithin tissuesComplication of Complication of tissue necrosistissue necrosis

Gas GangreneGas Gangrene Gas GangreneGas Gangrene

TreatmentTreatmentDebridementDebridementExcisionExcisionAmputationAmputation

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CholeraCholera

FoodborneFoodborneContaminatedContaminatedContaminated Contaminated water and foodwater and food

GastroenteritisGastroenteritisExhaustive diarrheaExhaustive diarrheaHypohydrationHypohydration

CholeraCholera

Symptoms 1Symptoms 1--5 days5 daysSudden onsetSudden onsetAbdominal painAbdominal painCODE BROWNCODE BROWN

Spread through Spread through ingestion of infected ingestion of infected waterwater

TuberculosisTuberculosis

A third of the world's population are thought to be infected with M. tuberculosis, and new infections occur at a rate of about one per second.


Primarily attacks Primarily attacks lungslungsSpread through airSpread through airHighly contagiousHighly contagious


SymptomsSymptomsLatent / ActiveLatent / ActiveHigh index of High index of suspicionsuspicion


TreatmentTreatmentAntibioticsAntibioticsAnnual Annual titretitre

PPEPPEGlovesGlovesSafety glassesSafety glassesN95N95

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LeprosyLeprosy

Hansen’s DiseaseHansen’s DiseaseInfection of the Infection of the peripheral nerves peripheral nerves and respiratory tractand respiratory tractSkin lesions only Skin lesions only external signexternal sign

LeprosyLeprosy

Spread through Spread through nasal dropletsnasal droplets95% of people are95% of people are95% of people are 95% of people are naturally immunenaturally immuneAuto amputationAuto amputationLeft untreated Left untreated permanentpermanent

The PlagueThe Plague

The Black Plague or The Black Plague or Black DeathBlack DeathZ iZ iZoonoticZoonotic

RatsRatsFlea bitesFlea bites

Unrivaled scale of Unrivaled scale of death / devastationdeath / devastation


ZoonoticZoonoticRatsRatsFlea bitesFlea bitesFlea bitesFlea bites

Unrivaled scale of Unrivaled scale of death / death / devestationdevestation


Flea bites contaminate Flea bites contaminate wound with regurgitated wound with regurgitated blood carrying the plague blood carrying the plague bacteria. bacteria. Bacteria enter the tissue Bacteria enter the tissue and seek out the and seek out the lymphatic systemlymphatic system“Bubo” develop which “Bubo” develop which are related to swollen are related to swollen lymph nodes.lymph nodes.

AnthraxAnthrax

Affects mostly animalsAffects mostly animalsInfects humans viaInfects humans via

IngestionIngestionggInhalationInhalation

ColdCold--flu like symptoms flu like symptoms –– respiratory collapse / respiratory collapse / deathdeath

CutaneousCutaneousSymptoms based on site of entrySymptoms based on site of entry

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AnthraxAnthrax

Can be grown in vitroCan be grown in vitroCannot be spread personCannot be spread personCannot be spread person Cannot be spread person to person, but can expose to person, but can expose others to sporesothers to sporesVaccination availableVaccination available

SyphilisSyphilis

The French DiseaseThe French DiseaseThe Great ImitatorThe Great ImitatorThe Great ImitatorThe Great ImitatorSTDSTD

Can be spread without Can be spread without sexual contactsexual contact

Several stagesSeveral stages

SyphilisSyphilis

Primary (21 days)Primary (21 days)Painless chancrePainless chancreAn here on bodAn here on bodAnywhere on bodyAnywhere on body

Secondary (1Secondary (1--6 months)6 months)Reddish pink non Reddish pink non itchy rashitchy rashTrunk of body or Trunk of body or palms of hands feetpalms of hands feetMost infectiousMost infectious

SyphilisSyphilis

LatentLatentEarlyEarlyLateLateLateLate

No symptoms but No symptoms but serologically evidentserologically evident

SyphilisSyphilis

Tertiary (1Tertiary (1--10 yrs)10 yrs)Production of Production of guma’sguma’sInflammator processInflammator processInflammatory processInflammatory process

TreatmentTreatmentAbstinenceAbstinencePCNPCN

MRSAMRSA

MRSA AcronymMRSA AcronymNosocomialNosocomialTraditional and Traditional and community acquiredcommunity acquiredSpider bite!Spider bite!

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Traditional MRSA Risk Factors

Prolonged hospitalization

CA-MRSA Risk Factors

Sports team with close contact

MRSAMRSA

Prolonged hospitalizationProlonged ABXSurgeryProximity to pt. with infectionIndwelling linesPrior MRSA infectionDialysis infection

contactPrisonersSame gender sex, more common in malesIV Drug abusersLiving in close contact with infected personSchools

MRSAMRSA

MRSAMRSA MRSAMRSA

MRSAMRSA MRSAMRSA

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MRSAMRSA

TreatmentTreatmentAntibioticAntibioticLance and DrainLance and Drain

MRSAMRSA

SpreadsDirect contactR iRespiratory secretions

MRSAMRSA

Cover WoundsWash HandsPPE

GlovesSafety GlassesGown

Clostridium Clostridium DifficileDifficile

Causes diarrhea

TransmissionShed in feces

Contact with contaminated items

Extremely virulent

Clostridium Clostridium DifficileDifficile

PreventionAntimicrobial

Probiotics

Discontinue antibiotics


Types of MeningitisTypes of MeningitisBacterialBacterialViralViral

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Types of MeningitisTypes of MeningitisBacterialBacterial

Newborn (streptococci, ENewborn (streptococci, E--coli)coli)Children Children ––NeisseriaNeisseria(streptococci, Influenza B, (streptococci, Influenza B, TBTB


Types of MeningitisTypes of MeningitisViralViral

Herpes simplex 2, Herpes simplex 2, varicellavaricella zoster, zoster, mumps, HIV, mumps, HIV, LCMVLCMV

Meningitis Meningitis

TreatmentTreatmentBacterialBacterial

AntibioticsAntibioticsViralViral

SymptomsSymptomsVaccinationVaccination

MeningococcemiaMeningococcemia

Meningitis Meningitis

PPEPPEGlovesGlovesSafety GlassesSafety GlassesMaskMask

ReviewReview

What bacteria can be transmitted through What bacteria can be transmitted through uncooked food or honey and may cause uncooked food or honey and may cause flaccidity and respiratory arrest?flaccidity and respiratory arrest?What is the most important symptomWhat is the most important symptomWhat is the most important symptom What is the most important symptom characteristic of characteristic of PertusisPertusis? (Whooping Cough)? (Whooping Cough)What bacterial disease presents with a patient What bacterial disease presents with a patient who is fine in the morning, sick at noon and who is fine in the morning, sick at noon and dead at night?dead at night?

ReviewReview

What does MRSA stand for and how is it What does MRSA stand for and how is it spread?spread?A rash that does not blanch is symptom of A rash that does not blanch is symptom of which bacterial disease?which bacterial disease?which bacterial disease?which bacterial disease?Which bacteria is so virulent it can survive Which bacteria is so virulent it can survive outside the host for long periods of time and is outside the host for long periods of time and is transmitted primarily from surface to human or transmitted primarily from surface to human or from contaminated feces?from contaminated feces?

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Break!Break!

Please go wash your hands!Please go wash your hands!

Viral diseasesViral diseases

HepatitisHepatitisSmall poxSmall poxVaricellaVaricella

RubellaRubellaYellow FeverYellow FeverCommonCommon coldcoldVaricellaVaricella

HerpesHerpesRabiesRabiesInfluenza (flu)Influenza (flu)

Common Common coldcoldAvian FluAvian FluSwine FluSwine FluWest Nile diseaseWest Nile disease

Human blood C f

Substances of Substances of Concern Concern

Human blood Components of human blood

Products made from human

blood

Human blood

Substances of Substances of ConcernConcern

Cerebrospinal fluidSemen and

vaginal secretions

Synovial fluid

Substances of ConcernSubstances of Concern

Pleural fluid Pericardial Fluid

Substances of Concern

Peritoneal fluid Amniotic fluid

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Hepatitis AHepatitis A

HAVHAVAcute infection of liverAcute infection of liver

Does not become Does not become chronicchronic

Transmitted fecalTransmitted fecal--oraloralContaminated food / Contaminated food / waterwater



SymptomsSymptomsFatigueFatigueFeverFeverNauseaNauseaDiarrheaDiarrhea


PreventionPreventionVaccinationVaccinationSanitationSanitationWash handsWash hands

Hepatitis BHepatitis B

HBVHBVAcute infection of liverAcute infection of liver

Death is rareDeath is rareChronic infection of liverChronic infection of liver

CirrhosisCirrhosisLiver cancerLiver cancer


SymptomsSymptomsAcuteAcute

General ill healthGeneral ill healthLoss of appetiteLoss of appetiteppppNauseaNauseaVomitingVomitingBody achesBody achesMild feverMild feverDark urineDark urineJaundiceJaundice

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SymptomsSymptomsChronicChronic

A t tiA t tiAsymptomaticAsymptomaticChronic Chronic inflammation of inflammation of liverliver


TransmissionTransmissionInfectious blood or Infectious blood or OPIM (substances of OPIM (substances of concern)concern)Sexual contactSexual contactBlood transfusionBlood transfusionContaminated Contaminated needlesneedlesVertical transmissionVertical transmission


TreatmentTreatmentAntiAnti--viralsviralsLiver transplantLiver transplantMost people rapidly Most people rapidly clear the virusclear the virus


PreventionPreventionVaccinationVaccination

Hepatitis B accineHepatitis B accineHepatitis B vaccine: Hepatitis B vaccine: 1, 2, 6 mo (95% 1, 2, 6 mo (95% achieve protection)achieve protection)

PPEPPE

Hepatitis CHepatitis C

HCVHCVAcute phase is Acute phase is asymptomaticasymptomatic

Most discovered by Most discovered by accidentaccident

Chronic liver infectionChronic liver infectionMost common cause of Most common cause of liver transplantliver transplant


TransmissionTransmissionInfectious blood or Infectious blood or OPIM (substances of OPIM (substances of concern)concern)Sexual contactSexual contactContaminated Contaminated needlesneedles

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PreventionPreventionSafe sexual practicesSafe sexual practices

ddNeedle exchangeNeedle exchangePPEPPENO NO VACCINATIONVACCINATION


Small PoxSmall Pox

Small PoxSmall PoxVariolaVariola virus meaning virus meaning “ p tt d” i“ p tt d” i LL“spotted” in “spotted” in LnLn

Unique to HumansUnique to HumansLocalizes in blood vessels Localizes in blood vessels of skin, mouth and throatof skin, mouth and throatResults in Results in maculopapularmaculopapularrash and fluidrash and fluid--filled filled blistersblisters

Small PoxSmall Pox

TransmissionTransmissionrespiratoryrespiratoryp yp y

ProgressionProgressionSymptomsSymptoms

Fever (>101)Fever (>101)

Small PoxSmall Pox

VaccinationVaccinationWithin 3 days of Within 3 days of

p rp rexposureexposureWithin 4Within 4--7 days 7 days of exposureof exposure

Small PoxSmall Pox

Famous people in Famous people in history that have history that have contracted and contracted and recovered fromrecovered fromrecovered from recovered from Small PoxSmall Pox

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Small PoxSmall Pox

Small Pox vs. Small Pox vs. chicken poxchicken poxPPEPPE

GlovesGlovesSafety Safety GlassesGlassesMaskMask

Chicken PoxChicken Pox

VaricellaVaricellaShinglesShinglesTransmissionTransmission

respiratoryrespiratory


ProgressionProgressionSigns/SymptomsSigns/Symptoms

FeverFeverMalaiseMalaise

PPEPPEGlovesGlovesSafety glassesSafety glassesMaskMask


HerpesHerpes

Gk for “Creeping”Gk for “Creeping”HSVHSV--11

Most commonMost commonHSVHSV--22

ProdromeProdrome22--21 days 21 days Shed virus Shed virus anytimeanytime

HerpesHerpes

TransmissionTransmissionDirect contact Direct contact with open sore with open sore

i di dor contaminated or contaminated skinskin

PreventionPreventionNo vaccinationNo vaccinationAntiviralsAntivirals may may reduce viral reduce viral sheddingshedding

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RabiesRabies

Causes acute Causes acute encephalitisencephalitisAlmost always fatal Almost always fatal

i h i dii h i diwithout immediate without immediate treatmenttreatmentEarly SymptomsEarly Symptoms

MalaiseMalaiseHeadacheHeadacheFFeverever

RabiesRabies

Late symptomsLate symptomsParalysisParalysisAgitationAgitationHallucinationsHallucinationshydrophobiahydrophobia

97% dog bites97% dog bitesPreventionPrevention

Vaccinations Vaccinations

RubellaRubella

German MeaslesGerman Measles“little Red”“little Red”

Mild diseaseMild diseaseLasts 1Lasts 1 3 days3 daysLasts 1Lasts 1--3 days3 daysAirborneAirborneVirus present in Virus present in urine, feces and on urine, feces and on skinskinSimilar to fluSimilar to fluVaccinationVaccination

Yellow FeverYellow Fever

HemorrhagicHemorrhagic


“The black vomit”“The black vomit”HemorrhagicHemorrhagicTransmittedTransmittedTransmittedTransmitted

Female Female mosquito bitemosquito bite


SymptomsSymptomsFeverFeverNauseaNauseaPainPainPainPainjaundicejaundice

PreventionPreventionVaccinationVaccination

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Avian FluAvian Flu

Bird FluBird FluType AType AH1N1 is only one H1N1 is only one subtypesubtypesubtypesubtypeTransmission?Transmission?Vaccination?Vaccination?PPEPPE

GlovesGlovesSafety glassesSafety glassesmaskmask

Swine FluSwine Flu

Type AType AInfluenza CInfluenza CTransmission?Transmission?Vaccination?Vaccination?PPEPPE

GlovesGlovesSafety glassesSafety glassesmaskmask

Athletes FootAthletes Foot

RingwormRingworm“Jock itch”“Jock itch”SymptomsSymptoms

ScalingScalingItchingItchingPeelingPeeling

TransmissionTransmissionBathhousesBathhousesShowersShowersLockeroomsLockerooms

CandidaCandida

ThrushThrushYeastYeast

The story of the guinea wormThe story of the guinea worm

A boil forms, a worm begins to emerge ...

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The worm gets wrapped around a stick.

Caduceus: Snake on a staff or worm on a stick?

ScabiesScabies

WHAT IS WHAT IS SCABIES?SCABIES?HOW IS IT HOW IS IT SPREAD?SPREAD?SPREAD?SPREAD?HOW IS IT HOW IS IT TREATED?TREATED?WHAT WHAT MEASURES MEASURES SHOULD WE SHOULD WE TAKE?TAKE?

SCABIES SKIN LESIONSSCABIES SKIN LESIONS

Sickness

Many symptoms of illness — swollen lymph nodes, fever, runny nose — are side effects of your immune system gearing up to fight the invader.

Questions….Questions….

Documents

INFECTIOUS DISEASE Topics · Syphilis Latent Early Late No symptoms but serologically evident Syphilis Tertiary (1Tertiary (1--10 yrs)10 yrs) Production of Production of guma’sguma’s