infectious diseases. lecture objectives: upon completion of this lecture, you will be better able...
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INFECTIOUS DISEASES
Lecture Objectives:
Upon completion of this lecture, you will be better able to:
List the infectious diseases commonly encountered in the school setting
Describe the etiology, signs and symptoms, diagnosis, complications, treatment and prevention of the diseases discussed in the manual
Identify the incubation and isolation periods for these diseases
FIFTH DISEASE
CAUSE:– A virus known as human parvovirus or B19
SYMPTOMS:– “Slapped cheek” rash (starts on face and spreads– Fever, general pruritis, flu symptoms, and
pharyngitis
FIFTH DISEASE Incubation period is 6-14 days Symptoms usually begin one to two
weeks after exposure to the virus NOTE: WHEN THE RASH APPEARS,
THE STUDENT IS NO LONGER CONTAGIOUS!
“Slapped Cheek” rash
FIFTH DISEASE COMPLICATIONS
– Can be dangerous to women who are less than 20 weeks pregnant
– Dangerous to cancer or immunosuppressed students
DIAGNOSIS– Usually made by clinical symptoms
TREATMENT– No definitive treatment at this time
FIFTH DISEASE PREVENTION
– Good handwashing is the best defense against the virus
– Universal substance precautions
NOTE: THERE IS CURRENTLY NO VACCINE AVAILABLE
PERTUSSIS CAUSE:
– Caused by a bacteria known as Bordetella pertussis
– Highly contagious
TRANSMISSION:– By airborne droplets– Incubation period is 5-10 days
PERTUSSIS3 STAGES OF THE DISEASE:
1. CATARRHAL STAGE (1-2 weeks)• Child is MOST CONTAGIOUS in this stage
2. PAROXYSMAL STAGE (2-4 weeks)
3. CONVALESCENT STAGE (3-4 weeks)
PERTUSSIS
COMPLICATIONS Pneumonia Apnea Dehydration, weight loss Atelectasis Seizures
PERTUSSISDIAGNOSIS A nasopharyngeal swab is used to test
for the B. pertussis bacteria
TREATMENT Erythromycin
PREVENTION Vaccination
INFECTIOUS MONONUCLEOSIS
CAUSE The Epstein-Barr virus is the most
common cause of mononucleosis (mono)
In the United States, the incidence of mono peaks in adolescence
INFECTIOUS MONONUCLEOSIS
TRANSMISSION Transmitted through affected saliva. Also known
as the ”kissing disease”
SYMPTOMS High fever Splenomegaly Lymphadenopathy Fatigue Hepatosplenomegaly
INFECTIOUS MONONUCLEOSIS
DIAGNOSIS A blood test is required to confirm the
diagnosis (Monospot) CBC usually shows atypical lymphocytes
COMPLICATIONS Splenic rupture Guillain-Barre
INFECTIOUS MONONUCLEOSIS
TREATMENT Currently no medication to treat the disease Treatment typically palliative - treat the
symptomsPREVENTION There is no vaccine currently available Best defense is to avoid direct exposure to
anyone with symptoms. Always maintain good handwashing
SCARLET FEVER
CAUSE Usually caused by group A
streptococcus
SYMPTOMS Fever, pharyngitis, “sandpaper” rash
SCARLET FEVER
TRANSMISSION Respiratory droplets spread the
disease. Spread by close contact and shared utensils
Incubation period is 3-5 days NOTE: Student is contagious until
antibiotic is taken for 24 hours
SCARLET FEVER
DIAGNOSIS A throat culture determines if Strep A is
present If culture is positive and there is a rash, the
diagnosis is made
TREATMENT The drug of choice is penicillin
SCARLET FEVER
COMPLICATIONS Rheumatic Fever Glomerulonephritis
PREVENTION Avoid close contact or sharing of utensils
with anyone who is symptomatic. Always maintain good handwashing
RESPIRATORY SYNCYTIAL VIRUS
Respiratory syncytial virus (RSV) is the most frequent cause of respiratory tract infections in children less than 4 years old
Most children experience at least one infection by age 3. Confers only partial protection from subsequent infection, so reinfection can occur.
RESPIRATORY SYNCYTIAL VIRUS
SYMPTOMS Wheezing Tachypnea Retractions Nasal flaring Atelectasis
RESPIRATORY SYNCTIAL VIRUS
COMPLICATIONS Hypoxia
Dehydration
Respiratory failure
RESPIRATORY SYNCYTIAL VIRUS
TREATMENT Oxygen Fluid balance Tylenol Albuterol nebulizer or
oral medication
Pediculosis
THREE FORMS OF HEAD LICE NIT- Eggs of head lice. Hatch in approximately
1 week. Usually found attached to hair shaft.
NYMPH - Becomes an adult in approximately 7 days after hatching. Will die without blood supply.
ADULT - Has 6 legs and can live up to 30 days on a head. Needs blood supply to live.
Pediculosis
DIAGNOSIS
A diagnosis is made when one or more live lice are found on the student.
Pediculosis
TREATMENT Only treat a student when live lice
are found. A standard chemical insecticidal
lotion is used. Inform parent/guardian on how to
treat household items.
IMPETIGO
TWO TYPES OF IMPETIGO Nonbullous impetigo- This type is
typically seen to a greater degree in children versus adults. Usually affects the facial area.
Bullous impetigo-This type is highly contagious and can spread to large areas of skin.
IMPETIGO
TREATMENT Impetigo is usually treated with
oral antibiotics such as dicloxacillin.
Occasionally, only a topical antibiotic such as mupirocin is prescribed.
RINGWORM
CAUSE
Ringworm (tinea capitis) is caused by the fungus Trichophyton tonsurans. When ringworm affects the scalp, typically hair loss occurs.
RINGWORM
TREATMENT
The treatment for ringworm is oral griseofulvin for 8 weeks. Antifungal shampoo should also be used 2 times a week for 8 weeks.
RINGWORM
PREVENTION Good handwashing No sharing of personal hair
products Checking pets for signs and
symptoms of ringworm
MENINGITIS
Meningitis is an inflammation of the meninges. Can be bacterial or viral.
Leading cause of bacterial meningitis used to be Haemophilus influenzae type B
Current leading cause is Streptococcus pneumoniae and Neisseria meningitis.
MENINGITIS
SYMPTOMS High fever Headache Stiff neck Nausea, vomiting Photophobia Lethargy
MENINGITIS
TREATMENT Hospitalization IV antibiotics are the treatment of
choice for bacterial meningitis
Summary
Children are subject to a wide variety of infectious illness, ranging in severity from minor annoyances to potentially lethal diseases. It is important to be aware of the findings and progression associated with these diseases in order to expediate evaluation, treatment, prevention and followup.
Remember – contagious illness poses a particular threat to students who have compromised immune systems. Implement special precautions to protect these students from infectious diseases at school.
ANY QUESTIONS??