MUMPS

Chain of Infection:
1. Causative Agent: Mumps virus (paramyxovirus), ROBULAVIRUS
2. Reservoir: Infected humans
3. Portal of Exit: Saliva and respiratory secretions
4. Mode of Transmission: Direct contact, respiratory droplets from coughing or
sneezing
5. Portal of Entry: Mucous membranes of the respiratory tract
6. Susceptible Host: Individuals without immunity

Incubation Period: 12 to 25 days.

Stages of Disease:
1. Incubation Period: No symptoms during this time.
2. Prodromal Stage: Low-grade fever, malaise, headache, loss of appetite, and
sometimes mild respiratory symptoms.
3. Parotitis Stage: Swelling and pain in the parotid glands (located near the jaw and
ears). Swelling might be on one or both sides.
4. Recovery Stage: Symptoms start to improve after about 7-10 days.

Pathophysiology:
The mumps virus primarily infects the parotid glands, leading to inflammation. It can
also spread to other organs through the bloodstream, causing complications like
meningitis, orchitis (testicular inflammation), oophoritis (ovarian inflammation), and
pancreatitis.

Diagnostics:
Clinical presentation and history of exposure are important. Laboratory tests such as
viral culture, polymerase chain reaction (PCR), and serology can confirm the
diagnosis.

Treatment:
Supportive care includes rest, hydration, pain relievers, and warm compresses for
parotid gland pain. Most people recover fully without specific antiviral treatment.
Vaccination with the MMR vaccine (MEASLES MUMPS RUBELLA) 2 DOSES is a
key preventative measure.

Nursing Management:
-Isolation precautions to prevent the spread of the virus,
-providing comfort measures for pain and fever
-ensuring proper hydration,
-educating patients and families about the contagious nature of the disease,
-promoting vaccination to prevent future infections.
-soft foods
MEASLES

Chain of Infection:
1. Causative Agent: Measles virus (a paramyxovirus) MORBILIVIRUS
2. Reservoir: Infected humans
3. Portal of Exit: Respiratory secretions (saliva, mucus)
4. Mode of Transmission: Airborne transmission through respiratory droplets from
coughing or sneezing
5. Portal of Entry: Mucous membranes of the respiratory tract
6. Susceptible Host: Individuals without immunity

Incubation Period: Usually 10 to 12 days, range form 7-21 days.

Stages of Disease:
1. Incubation Period: No symptoms during this time.
2. Prodrome Stage: High fever, cough, runny nose, and red, watery eyes
(conjunctivitis). Small white spots (Koplik spots) may appear in the mouth.
3. Exanthematous Stage:** Characteristic rash begins on the face and spreads
downward, covering the body. Fever remains high.
4. Recovery Stage: Rash starts to fade and fever subsides.

Pathophysiology:
The measles virus enters the respiratory tract and infects immune cells, spreading
throughout the body via the bloodstream. It causes widespread inflammation, resulting
in the characteristic symptoms and rash. Measles can suppress the immune system,
leaving individuals vulnerable to secondary infections.

Diagnostics:
Clinical symptoms and history of exposure are important. Laboratory tests such as
serology or polymerase chain reaction (PCR) can confirm the diagnosis.

Treatment:
Supportive care includes rest, hydration, and fever reducers. Vitamin A supplementation
is recommended for children with severe measles. There is no specific antiviral
treatment for measles.

Nursing Management:
Isolation precautions to prevent the spread of the virus, managing fever and discomfort,
ensuring proper hydration, educating patients and families about the contagious nature
of the disease, and promoting vaccination to prevent future infections.
VARICELLA (CHICKENPOX)

Chain of Infection:
1. Causative Agent: Family of Herpesviridae, Varicella-zoster virus (VZV)
2. Reservoir: Infected humans
3. Portal of Exit: Respiratory secretions, skin lesions
4. Mode of Transmission: Airborne transmission through respiratory droplets, direct
contact with skin lesions
5. Portal of Entry: Mucous membranes of the respiratory tract, broken skin
6. Susceptible Host: Individuals without immunity

Incubation Period: 14-16 days ranges from to 10-21 days.

Stages of Disease:
1. Incubation Period: No symptoms during this time.
2. Prodromal Stage: Mild fever, fatigue, loss of appetite, and the appearance of a
generalized rash.
3. Exanthematous Stage: Development of itchy, fluid-filled blisters (vesicles) that crust
over and form scabs. Blisters may appear in waves, covering the body.
4. Recovery Stage: Crusts fall off, leaving behind small, shallow scars.

Pathophysiology:
VZV primarily infects the respiratory tract and then spreads through the bloodstream,
causing a generalized rash and symptoms. The virus establishes latency in nerve
ganglia and can reactivate later in life to cause shingles (herpes zoster).

Diagnostics:
Clinical presentation and history of exposure are important. Laboratory tests such as
viral culture, polymerase chain reaction (PCR), or serology can confirm the diagnosis.

Treatment:
Supportive care includes relieving itching, maintaining good hygiene to prevent
secondary infections, and administering antiviral medications in severe cases or high-
risk patients.

DRUG OF CHOICE: ACYCLOVIR (Antiviral Drug)

Nursing Management:
Isolation precautions to prevent the spread of the virus, managing itching and
discomfort, ensuring proper hydration, educating patients and families about the
contagious nature of the disease, and promoting vaccination to prevent future
infections.
DIPHTHERIA

Chain of Infection:
1. Causative Agent: Corynebacterium diphtheriae, Bacteria Gram (+), aerobic,
nonspore
2. Reservoir: Infected humans
3. Portal of Exit: Respiratory secretions, skin lesions
4. Mode of Transmission: Respiratory droplets, direct contact with respiratory
secretions or skin lesions
5. Portal of Entry: Mucous membranes of the respiratory tract, broken skin
6. Susceptible Host: Individuals without immunity

Incubation Period: Typically 2 to 5 days after exposure.

Stages of Disease:
1. Incubation Period: No symptoms during this time.
2. Initial Stage: Sore throat, fever, malaise, and swollen neck lymph nodes.
3. Pseudomembrane Formation: Grayish-white membrane forms in the throat,
potentially blocking the airway.
4. Complications Stage: Toxins can spread to other parts of the body, leading to heart
and nerve damage.

Pathophysiology: Corynebacterium diphtheriae produces a toxin that damages tissue

and forms a pseudomembrane in the throat. The toxin can also affect the heart and
nerves.

Diagnostics: Clinical symptoms and history of exposure are important. Laboratory tests
like culture and PCR can confirm the presence of the bacteria and its toxin.

Treatment: Administering antitoxin to neutralize the effects of the diphtheria toxin, along
with antibiotics to kill the bacteria. Supportive care to manage airway obstruction and
complications is also crucial.

Prevention: Vaccination is the key. DTaP (for children) and Tdap (for adolescents and
adults)

Nursing Management: Isolation precautions to prevent the spread of the bacteria,

monitoring for airway obstruction and complications, providing supportive care, ensuring
proper hydration and nutrition, and promoting vaccination to prevent future infections.
PERTUSSIS (WHOOPING COUGH)

Chain of Infection:
1. Causative Agent: Bordetella pertussis, bacteria gram (-)
2. Reservoir: Infected humans
3. Portal of Exit: Respiratory secretions
4. Mode of Transmission: Respiratory droplets, direct contact with respiratory
secretions
5. Portal of Entry: Mucous membranes of the respiratory tract
6. Susceptible Host: Individuals without immunity

Incubation Period: Typically 5 to 10 days after exposure, range from 4 to 21 days.

Stages of Disease:
1. Catarrhal Stage: mild cough and runny nose, similar to a cold. Lasts 1 to 2 weeks.
2. Paroxysmal Stage: severe, uncontrollable coughing fits with the "whooping" sound.
May last 1 to 6 weeks.
3. Convalescent Stage: Coughing gradually decreases over several weeks.

Pathophysiology: B. pertussis bacteria attach to the respiratory tract, producing toxins

that paralyze and damage cilia and lead to intense coughing and respiratory symptoms.

Diagnostics: Clinical symptoms, history of exposure, and laboratory tests like PCR and
culture. Chest X-rays may show signs of pneumonia.

Treatment: Antibiotics like macrolides (e.g., azithromycin) for early-stage cases to

reduce severity and duration. Supportive care for managing symptoms.

Prevention: Vaccination with the DTaP in childhood and Tdap booster in

adolescent/adulthood.

Nursing Management:
-Isolation precautions to prevent transmission,
-Monitoring for respiratory distress and complications,
-Administer antibiotics and provide supportive care.
-Educating patients and families on pertussis, its treatment and importance of
vaccination.
TETANUS (LOCKJAW)

Chain of Infection:
1. Causative Agent: Clostridium tetani, bacteria gram (+) anaerobic
2. Reservoir: Soil, dust, and manure contaminated with C. tetani spores.
3. Portal of Exit: None; the bacterium remains in the environment.
4. Mode of Transmission: Contamination of wounds or breaks in the skin with C. tetani
spores from soil, dust, manure.
5. Portal of Entry: Wounds or breaks in the skin.
6. Susceptible Host: Individuals without immunity or incomplete vaccination.

Incubation Period: 6 days ranges from 3 to 21 days after exposure

Stages of Disease:
1. Incubation Stage: No symptoms during this time.
2. Early Localized Stage: Muscle stiffness and pain near the wound.
3. Generalized Stage: Severe muscle spasms, "lockjaw" (trismus), and potentially
life-threatening complications.

Pathophysiology: C. tetani releases a neurotoxin that affects the nervous system,

causing muscle spasms and stiffness.

Diagnostics: Clinical symptoms and history of a wound or injury. Laboratory tests aren't
usually helpful in diagnosing tetanus.

Treatment:
- Immediate wound cleaning.
- Tetanus immunoglobulin (TIG) administration to neutralize toxin.
- Tetanus toxoid vaccine booster.
- Supportive care, muscle relaxants, and medications to control spasms.

Prevention:
- Vaccination with tetanus toxoid as part of routine childhood immunization (DTaP) and
booster doses in adulthood (Td or Tdap).
- Proper wound care and immediate medical attention for any injury, especially those at
risk of contamination.

Nursing Management:
- Wound assessment and cleaning.
- Administering TIG and tetanus vaccine if needed.
- Monitoring for complications, including respiratory distress.
- Pain management and comfort measures.
- Education on tetanus vaccination and wound hygiene.
DENGUE

Chain of Infection:
1. Causative Agent: Aedes Aegypti and Albopictus, from the family of Flaviviridae
Virus, four distinct serotypes (DENV-1 to DENV-4)
2. Reservoir: Infected humans and sometimes primates
3. Portal of Exit: Bloodstream
4. Mode of Transmission: Aedes mosquitoes (primarily Aedes aegypti) transmit the
virus through their bites.
5. Portal of Entry: Bloodstream (via mosquito bite)
6. Susceptible Host: Humans, especially those without immunity to the specific
serotype

Incubation Period: 3 to 14 days

Stages of Disease:
1. Febrile Stage: Sudden onset of high fever, severe headache, joint and muscle pain,
rash, and mild bleeding.
2. Critical Stage: In some cases, a small proportion of patients progress to severe
dengue (dengue hemorrhagic fever or dengue shock syndrome), characterized by
plasma leakage, bleeding, and organ impairment.
3. Recovery Stage: Fever subsides, and the patient enters a period of convalescence.

Pathophysiology: The virus infects immune cells and causes an inflammatory

response. In severe cases, there's increased vascular permeability leading to plasma
leakage, bleeding, and organ dysfunction.

Diagnostics: Clinical symptoms, history of exposure, and laboratory tests including

PCR and serology. Blood tests monitor platelets, hematocrit, and other markers.

Treatment: Supportive care to manage symptoms, hydration, pain relief, and

monitoring for complications. Severe cases may require hospitalization, fluid
management, blood products, and other interventions.

Prevention:
- Mosquito control to reduce breeding sites.
- Personal protection measures, including wearing protective clothing and using
mosquito repellents.
- Dengue vaccination in endemic areas (when available).

Nursing Management:
- Symptom management, including fever and pain relief.
- Monitoring for signs of severe dengue, such as bleeding and plasma leakage.
- Hydration and nutritional support.
- Educating patients about dengue prevention, self-care, and when to seek medical
help.
ZIKA VIRUS

Chain of Infection:
1. Causative Agent: Aedes Aegypti and Albopictus, a member of the Flaviviridae
family.
2. Reservoir: Infected humans and potentially animals.
3. Portal of Exit: Bloodstream, urine, and other bodily fluids.
4. Mode of Transmission: Primarily through the bite of infected Aedes mosquitoes,
also through sexual transmission, blood transfusion, and from mother to fetus during
pregnancy.
5. Portal of Entry: Bloodstream (mosquito bite), mucous membranes, and possibly
skin.
6. Susceptible Host: Humans, including pregnant women and unborn babies.

Incubation Period: Usually 3 to 14 days after mosquito bite.

Stages of Disease:
1. Asymptomatic: Many cases are asymptomatic or have mild symptoms.
2. Symptomatic: Fever, rash, joint pain, muscle pain, headache, and conjunctivitis.
Symptoms usually resolve within a week.

Pathophysiology: ZIKV replicates in skin cells, spreads to lymph nodes, and then
circulates in the bloodstream. The virus can cross the placenta during pregnancy,
potentially causing birth defects.

Diagnostics: Clinical symptoms, history of exposure, and laboratory tests such as PCR
and serology. Diagnosis can be challenging due to similarities with other flaviviruses.

Treatment: Supportive care, rest, hydration, and pain relief. No specific antiviral
treatment is available.

Prevention:
- Mosquito control and avoiding mosquito bites.
- Safe sexual practices to prevent sexual transmission.
- Pregnant women avoiding travel to Zika-affected areas.

Nursing Management:
- Symptom management.
- Education on prevention, particularly for pregnant women.
- Monitoring pregnant women for potential complications.
- Emphasizing mosquito bite prevention.
CHIKUNGUNYA VIRUS

Chain of Infection:
1. Causative Agent: Genus Alphavirus, family of Togaviridae
2. Reservoir: Infected humans and sometimes non-human primates.
3. Portal of Exit: Bloodstream and bodily fluids.
4. Mode of Transmission: Primarily through the bite of infected Aedes mosquitoes
(Aedes aegypti and Aedes albopictus).
5. Portal of Entry: Bloodstream (mosquito bite), mucous membranes, and possibly
skin.
6. Susceptible Host: Humans, especially those without immunity to the virus.

Incubation Period: Usually 1 to 12 days after mosquito bite.

Stages of Disease:
1. Acute Phase: Sudden onset of fever, joint pain, muscle pain, headache, and rash.
Symptoms can be severe and last for weeks.
2. Subacute Phase: Joint pain and fatigue can persist for months.

Complications: Persistent Joint pain, chronic arthritis, GBS, myocarditis, miscarriage

Pathophysiology: CHIKV replicates in skin cells, spreads to the bloodstream, and then
disseminates throughout the body. Joint pain is a characteristic symptom.

Diagnostics: Clinical symptoms, history of exposure, and laboratory tests like PCR and
serology. Diagnosis can be challenging due to similarities with other viral infections.

Treatment: Supportive care, rest, hydration, and pain relief. No specific antiviral
treatment is available.

Prevention:
- Mosquito control and bite prevention.
- Safe sexual practices to prevent sexual transmission.
- Avoiding mosquito exposure, especially during peak mosquito activity times.

Nursing Management:
- Symptom management.
- Education on prevention, especially for mosquito bite avoidance.
- Monitoring patients for complications, particularly in vulnerable populations like the
elderly.
JAPANESE ENCEPHALITIS

Chain of Infection:
1. Causative Agent: Culex Tritaeniorhynchus, family of flavivirus.
2. Reservoir: Pigs and wild birds, with mosquitoes acting as vectors.
3. Portal of Exit: Bloodstream and bodily fluids.
4. Mode of Transmission: Primarily through the bite of infected Culex mosquitoes.
5. Portal of Entry: Bloodstream (mosquito bite).
6. Susceptible Host: Humans, especially in areas with high mosquito populations.

Incubation Period: Typically 5 to 15 days, range from 6-8 days after mosquito bite.

Stages of Disease:
1. Subclinical Infection: Many cases are asymptomatic or result in mild symptoms.
2. Clinical Infection: Symptoms can range from mild febrile illness to severe
encephalitis.

Signs and Symptoms:

- Fever.
- Headache.
- Fatigue.
- Nausea and vomiting.
- Stiff neck.
- Muscle weakness.
- Mental status changes (confusion, irritability, drowsiness).
- Seizures.

Complications:
- Severe cases may lead to encephalitis, inflammation of the brain tissue.
- Neurological deficits.
- Paralysis.
- Seizures.
- Coma.
- Death (in severe cases).

Pathophysiology: JEV infects the central nervous system, causing inflammation and
damage to brain tissue.

Diagnostics: Clinical symptoms, history of exposure, laboratory tests including

serology, PCR, and cerebrospinal fluid analysis.

Treatment: Supportive care, including rest, hydration, and fever management. No

specific antiviral treatment is widely available.

Prevention:
- Vaccination where the virus is endemic.
- Mosquito control and bite prevention.
- Use of bed nets and protective clothing.

Nursing Management:
- Monitoring for signs of encephalitis and neurological deficits.
- Supportive care to manage symptoms.
- Education on prevention and mosquito control.
- In case of severe cases, managing complications and collaborating with the medical
team.
MALARIA

Chain of Infection:
1. Causative Agent: Plasmodium parasites (P. falciparum, P. vivax, P. ovale, P.
malariae, P. knowlesi).
2. Reservoir: Infected humans and sometimes animals.
3. Portal of Exit: Bloodstream of infected humans.
4. Mode of Transmission: Primarily through the bite of infected Anopheles mosquitoes.
5. Portal of Entry: Bloodstream (mosquito bite).
6. Susceptible Host: Humans, particularly those living in or traveling to malaria-
endemic areas.

Incubation Period: usually 7 to 30 days after mosquito bite.

Stages of Disease:
1. Asymptomatic Infection: Some individuals may carry the parasite without
experiencing symptoms.
2. Acute Malaria: Cycles of fever, chills, and sweating, usually occurring every 48 to 72
hours, depending on the Plasmodium species.

Signs and Symptoms:

- High fever.
- Chills.
- Sweating.
- Fatigue.
- Muscle and joint pain.
- Headache.
- Nausea and vomiting.

Complications:
- Severe malaria (particularly caused by P. falciparum) can lead to organ
dysfunction, coma, and death.
- Anemia.
- Neurological complications.
- Kidney and liver dysfunction.

Pathophysiology: Plasmodium parasites infect and replicate within red blood cells,
leading to their destruction and the release of toxins.

Diagnostics: Clinical symptoms, history of exposure, and laboratory tests including

blood smears, rapid diagnostic tests, and molecular methods.

Treatment: Antimalarial medications, which vary based on Plasmodium species and

drug resistance patterns.

Prevention:
- Vector control: Bed nets, insecticides, and mosquito reduction.
- Chemoprophylaxis: Medications to prevent infection in travelers to endemic areas.
- Vaccination (mosquito-based vaccines under development).

Nursing Management:
- Early recognition and diagnosis of symptoms.
- Antimalarial treatment administration and monitoring.
- Fluid and electrolyte management in severe cases.
- Educating patients on prevention, medication adherence, and recognizing
complications.
LEPTOSPIROSIS (CORK-SCREW SHAPE BACTERIA)

Chain of Infection:
1. Causative Agent: Leptospirae interrogans, bacteria gram (-) aerobic
2. Reservoir: Infected animals, especially rodents.
3. Portal of Exit: Urine of infected animals.
4. Mode of Transmission: Contact with contaminated water, soil, or surfaces through
breaks in the skin or mucous membranes.
5. Portal of Entry: Skin, mucous membranes, conjunctiva.
6. Susceptible Host: Humans and animals.

Incubation Period: 7 days after exposure, range from 2 to 29 days.

Stages of Disease:
1. Incubation Stage: No symptoms during this time.
2. Acute Stage: Early symptoms, followed by a brief improvement or worsening.
3. Immune Stage: Fever, jaundice, and kidney damage.

Signs and Symptoms:

- High fever.
- Muscle pain (myalgia).
- Headache.
- Chills.
- Red eyes (conjunctivitis).
- Jaundice.
- Kidney dysfunction.

Complications:
- Weil's disease: Severe form with jaundice, kidney failure, and bleeding.
- Meningitis.
- Pulmonary hemorrhage.
- Acute respiratory distress syndrome (ARDS).
- Organ failure.

Pathophysiology: Leptospira bacteria enter the body through mucous membranes or

skin breaks, spread via bloodstream, and cause damage to various organs.

Diagnostics: Clinical symptoms, history of exposure, laboratory tests including

serology, PCR, and culture.

Treatment: Antibiotics such as doxycycline or penicillin, often combined with supportive

care.

Prevention:
- Avoidance of contact with contaminated water or soil.
- Proper hygiene, especially after exposure to potentially contaminated areas.
- Rodent control.

Nursing Management:
- Early recognition and diagnosis.
- Administration of appropriate antibiotics.
- Monitoring for complications.
- Fluid and electrolyte management in severe cases.
- Educating patients about prevention, hygiene, and recognizing complications.
MENINGOCOCCEMIA

Chain of Infection:
1. Causative Agent: Neisseria meningitidis bacteria, particularly serogroups A, B, C,
W, X, and Y. Bacteria gram (-) aerobic non spore.
2. Reservoir: Infected humans, especially carriers of the bacteria.
3. Portal of Exit: Respiratory tract (nose and throat) of infected humans.
4. Mode of Transmission: Respiratory droplets from close contact, such as coughing,
sneezing, or kissing.
5. Portal of Entry: Respiratory tract (nose and throat).
6. Susceptible Host: Humans, particularly those with close contact to carriers or in
crowded settings.

Incubation Period: Usually 3 to 4 days after exposure, range from 2 to 10 days.

Stages of Disease:
1. Bacteremia Stage: Initial infection in bloodstream.
2. Meningococcal Sepsis: Bacteria cause widespread inflammation and sepsis.
3. Meningococcal Meningitis: Bacteria infect the meninges, leading to inflammation of
the brain and spinal cord.

Signs and Symptoms:

- High fever.
- Severe headache.
- Stiff neck.
- Fatigue.
- Nausea and vomiting.
- Rash (petechiae or purpura) that doesn't fade when pressed.

Complications:
- Disseminated intravascular coagulation (DIC).
- Septic shock.
- Meningitis with potential for brain damage.
- Amputation of extremities due to tissue damage.

Pathophysiology: Bacteria invade the bloodstream and spread rapidly, causing

widespread inflammation and damage to blood vessels.

Diagnostics: Clinical symptoms, history of exposure, blood culture, cerebrospinal fluid

analysis.

Treatment: Antibiotics (such as ceftriaxone or cefotaxime) and supportive care for

shock and complications.

Prevention:
- Meningococcal vaccines (different serogroups have specific vaccines).
- Antibiotics for close contacts of infected individuals.
- Respiratory hygiene to prevent transmission.

Nursing Management:
- Early recognition and diagnosis.
- Administering antibiotics promptly.
- Monitoring for complications.
- Fluid and electrolyte management in severe cases.
- Educating patients and close contacts about prevention and recognizing
complications.
ACUTE GASTROENTERITIS (AGE)

Chain of Infection:
1. Causative Agents: AGE can be caused by various pathogens, including bacteria
(e.g., E. coli, Salmonella, Campylobacter), viruses (e.g., norovirus, rotavirus), and
parasites (e.g., Giardia, Cryptosporidium).
2. Reservoir: Infected humans and animals.
3. Portal of Exit: Fecal matter of infected individuals.
4. Mode of Transmission: Contaminated food, water, and surfaces, as well as person-
to-person contact.
5. Portal of Entry: Mouth.
6. Susceptible Host: Humans, particularly those with compromised immune systems,
the elderly, and children.

Incubation Period: 12 to 48 hours

Stages of Disease:
1. Exposure: Contact with contaminated sources.
2. Incubation: Time between exposure and appearance of symptoms.
3. Symptomatic Phase: Onset of symptoms, which can range in severity and duration.

Signs and Symptoms:

- Diarrhea (loose or watery stools).
- Vomiting.
- Nausea.
- Abdominal cramps or pain.
- Fever.
- Muscle aches.

Complications:
- Dehydration.
- Electrolyte imbalances.
- Malnutrition.
- Secondary infections due to weakened immune system.

Pathophysiology: Different pathogens affect the gastrointestinal tract, leading to

inflammation, disruption of absorption, and increased fluid secretion.

Diagnostics: Clinical symptoms, stool culture, polymerase chain reaction (PCR)

testing, and microscopy for parasites.

Treatment: Supportive care to manage symptoms, including rehydration, electrolyte

replacement, and a bland diet. Antibiotics are not routinely prescribed for viral causes.

Prevention:
- Hand hygiene.
- Safe food handling and preparation.
- Proper water sanitation.
- Vaccination (rotavirus vaccine for children).

Nursing Management:
- Rehydration and electrolyte management.
- Educating patients about proper hygiene and prevention.
- Monitoring for signs of dehydration, especially in children and the elderly.
- Infection control measures in healthcare settings.
TYPHOID FEVER

Chain of Infection:
1. Causative Agent: Salmonella enterica serotype Typhi (S. Typhi).
2. Reservoir: Infected humans, especially carriers of the bacteria.
3. Portal of Exit: Feces and urine of infected individuals.
4. Mode of Transmission: Ingestion of contaminated food or water, often due to poor
hygiene practices.
5. Portal of Entry: Mouth and digestive tract.
6. Susceptible Host: Humans, particularly those living in areas with inadequate
sanitation and hygiene.

Incubation Period: Typically 6 to 30 days after exposure, usually around 10 to 14

days.

Stages of Disease:
1. Incubation Period: No symptoms during this time.
2. First Week: Gradual onset of fever and other non-specific symptoms.
3. Second Week: High fever, gastrointestinal symptoms, and possible complications.
4. Third Week: Either recovery or progression to severe symptoms and complications.

Signs and Symptoms:

- High fever.
- Headache.
- Weakness.
- Abdominal pain.
- Diarrhea or constipation.
- Rose-colored spots on the abdomen.
- Enlarged spleen and liver.
- Generalized malaise.

Complications:
- Intestinal perforation.
- Peritonitis.
- Hemorrhage.
- Encephalitis.
- Death (in untreated severe cases).

Pathophysiology: S. Typhi invades the intestines, spreads through the bloodstream,

and can affect multiple organs.

Diagnostics: Clinical symptoms, blood culture, stool culture, and serology tests.

Treatment: Antibiotics, commonly ciprofloxacin, azithromycin, or third-generation

cephalosporins. Fluid and electrolyte management is also crucial.

Prevention:
- Improved sanitation and hygiene practices.
- Safe food and water consumption.
- Typhoid vaccines for travelers and in endemic areas.

Nursing Management:
- Administering prescribed antibiotics.
- Monitoring for complications and signs of dehydration.
- Educating patients about hygiene and prevention.
- Hydration and electrolyte management.
CHOLERA

Chain of Infection:
1. Causative Agent: Vibrio cholerae, a bacteria gram (-) anaerobic non spore
2. Reservoir: Contaminated water sources.
3. Portal of Exit: Feces of infected individuals.
4. Mode of Transmission: Ingestion of contaminated food or water.
5. Portal of Entry: Mouth.
6. Susceptible Host: Individuals with inadequate access to clean water and poor
sanitation.

Incubation Period: usually 24-48 hours.

Stages of Disease:
1. Acute Stage: Sudden onset of profuse, painless, watery diarrhea and vomiting.
2. Second Stage: Rapid loss of fluids and electrolytes leading to severe dehydration.

Signs and Symptoms:

- Copious "rice water" diarrhea.
- Vomiting.
- Dehydration symptoms: sunken eyes, dry mouth, decreased urine output.

Complications:
- Severe dehydration leading to shock and organ failure.
- Death if not treated promptly.

Pathophysiology:
Vibrio cholerae produces cholera toxin, which affects the intestinal lining, leading to the
release of large amounts of electrolytes and water into the intestines, causing the
characteristic watery diarrhea.

Diagnosis:
- Clinical assessment of symptoms.
- Stool sample analysis for Vibrio cholerae.
- Rapid diagnostic tests for cholera toxin.

Treatment:
- Rehydration is the cornerstone: oral rehydration solution (ORS) or intravenous fluids.
- Antibiotics can reduce severity and duration.
- Zinc supplements for children.

Prevention:
- Access to clean water and proper sanitation.
- Vaccination.
- Hygiene education.
- Safe food handling.

Nursing Management:
- Isolation to prevent spread.
- Frequent monitoring of vital signs, fluid balance, and electrolytes.
- Administering rehydration therapy.
- Educating patients on hygiene and prevention.
COVID-19

Chain of Infection:
1. Causative Agent: novel coronavirus Sarbecovirus/SARS-CoV-2, Merbecovirus/Merscov,
Betacoronavirus, from a family of coronavirinae
2. Reservoir: Infected humans.
3. Portal of Exit: Respiratory secretions (coughing, sneezing, talking).
4. Mode of Transmission: Respiratory droplets, aerosols, and contact with contaminated
surfaces.
4. Portal of Entry: Eyes, nose, mouth.
5. Susceptible Host: Individuals exposed to the virus.

Incubation Period: is typically 2 to 14 days

Stages of Disease:
1. Asymptomatic or Mild Stage: Some individuals may not develop noticeable symptoms or
only experience mild symptoms.
2. Moderate Stage: Respiratory symptoms like fever, cough, and shortness of breath.
3. Severe Stage: Severe respiratory distress, acute respiratory distress syndrome (ARDS), and
multi-organ failure.

Signs and Symptoms:

- Fever or chills.
- Cough.
- Shortness of breath or difficulty breathing.
- Fatigue.
- Muscle or body aches.
- Loss of taste or smell.
- Sore throat.
- Congestion or runny nose.
- Headache.
- Gastrointestinal symptoms (nausea, vomiting, diarrhea).

Complications:
- Pneumonia and respiratory failure.
- Blood clotting disorders.
- Organ damage, particularly to the lungs, heart, kidneys, and brain.
- Long COVID (post-acute sequelae), with symptoms persisting for weeks or months.

Pathophysiology:
SARS-CoV-2 primarily infects cells lining the respiratory tract, particularly the cells expressing
the ACE2 receptor. The immune response can lead to excessive inflammation and damage in
severe cases.

Diagnosis:
- Real-time Reverse Transcription Polymerase Chain Reaction (RT-PCR) test for detecting viral
RNA.
- Rapid antigen tests.
- Serology tests to detect antibodies.

Treatment:
- Supportive care for mild cases: rest, fluids, over-the-counter medications.
- Severe cases: supplemental oxygen, mechanical ventilation, antiviral medications (e.g.,
remdesivir), and anti-inflammatory drugs (e.g., dexamethasone).

Prevention:
- Vaccination.
- Wearing masks.
- Practicing physical distancing.
- Hand hygiene.
- Avoiding large gatherings.

Nursing Management:
- Infection control measures.
- Monitoring vital signs and symptoms.
- Providing emotional support to patients.
- Educating patients on self-isolation and quarantine.
H1N1 INFLUENZA

Chain of Infection:
1. Causative Agent: caused by the H1N1 influenza virus, which is a subtype of the
influenza A virus.
2. Reservoir: Infected humans and sometimes pigs or other animals.
3. Portal of Exit: Respiratory secretions (coughing, sneezing, talking).
4. Mode of Transmission: Respiratory droplets, close contact, and occasionally from
contaminated surfaces.
5. Portal of Entry: Eyes, nose, mouth.
6. Susceptible Host: Individuals exposed to the virus.

Incubation Period:1 to 4 days, with an average of around 2 days.

Stages of Disease:
1. Initial Stage: Fever, cough, sore throat, body aches, fatigue, and sometimes diarrhea
and vomiting.
2. Complications Stage: Severe respiratory symptoms, pneumonia, and exacerbation
of underlying health conditions.

Signs and Symptoms:

- Fever or chills.
- Cough.
- Sore throat.
- Runny or stuffy nose.
- Body aches.
- Fatigue.
- Headache.
- Some cases might have gastrointestinal symptoms (nausea, vomiting, diarrhea).

Complications:
- Pneumonia and respiratory failure.
- Exacerbation of chronic health conditions.
- Secondary bacterial infections.
- Neurological complications in rare cases.

Pathophysiology:
H1N1 influenza viruses primarily target the respiratory tract, causing inflammation and
damage to the lung tissues. This can lead to severe respiratory symptoms and
complications.

Diagnosis:
- Clinical symptoms and history.
- Rapid influenza diagnostic tests.
- Reverse transcription-polymerase chain reaction (RT-PCR) tests.

Treatment:
- Supportive care for mild cases: rest, fluids, and over-the-counter medications.
- Antiviral medications like oseltamivir (Tamiflu) if started early in the course of illness.

Prevention:
- Vaccination.
- Practicing good respiratory hygiene (covering mouth when coughing/sneezing).
- Frequent handwashing.
- Avoiding close contact with sick individuals.
- Staying home when feeling unwell.

Nursing Management:
- Infection control measures.
- Monitoring vital signs and symptoms.
- Providing education on self-care, when to seek medical attention, and preventive
measures.
MONKEYPOX

Chain of Infection:
1. Causative Agent: Variola and Vaccinia Virus, which is a member of the
Orthopoxvirus family
2. Reservoir: Rodents and animals in the rainforest, particularly in central and West
African countries.
3. Portal of Exit: Respiratory secretions, skin lesions.
4. Mode of Transmission: Direct contact with infected animals or their bodily fluids,
and human-to-human transmission through respiratory droplets or contact with infected
skin lesions.
4. Portal of Entry: Respiratory tract, broken skin.
5. Susceptible Host: Individuals exposed to the virus, especially those with no
immunity.

Incubation Period: 7 to 14 days.

Stages of Disease:
1. Prodromal Stage: Fever, headache, muscle aches, and exhaustion.
2. Rash Stage: Rash develops, usually beginning on the face and then spreading to
other parts of the body.
3. Lesion Stage: Development of pustules and ulcers that crust and eventually scab
over.

Signs and Symptoms:

- Fever.
- Headache.
- Muscle aches.
- Rash, which evolves from macules to papules, vesicles, and pustules.
- Enlarged lymph nodes.

Complications:
- Secondary bacterial infections of skin lesions.
- Scarring.
- In severe cases, organ involvement and respiratory distress.

Pathophysiology:
The monkeypox virus primarily enters the body through the respiratory tract or broken
skin. It then replicates in various tissues, leading to the characteristic skin lesions and
other symptoms.

Diagnosis:
- Clinical presentation.
- Laboratory tests, including PCR and virus isolation from blood, skin lesions, or other
bodily fluids.

Treatment:
- Supportive care for mild cases: rest, fluids, and pain relief.
- Antiviral medications may be used for severe cases.

Prevention:
- Avoiding contact with animals that might carry the virus.
- Proper hand hygiene.
- Isolation of infected individuals.
- Smallpox vaccination might offer some protection.

Nursing Management:
- Isolation precautions to prevent transmission.
- Monitoring symptoms and vital signs.
- Wound care for skin lesions.
- Educating patients and contacts about transmission and prevention.
RABIES (BULLET SHAPE VIRUS)

1. Causative Agent: Rhabdovirus, a member of the Lyssavirus

2. Reservoir: Infected mammals, primarily dogs, bats, raccoons, and skunks.
3. Portal of Exit: Saliva of infected animals, through bites or scratches.
4. Mode of Transmission: Direct contact with infected saliva through bites, scratches,
or mucous membranes.
5. Portal of Entry: Broken skin, mucous membranes (eyes, nose, mouth).
6. Susceptible Host: Individuals exposed to the virus, especially those with no
immunity.

Incubation Period: usually ranging from a few weeks to several months.

Stages of Disease:
1. Incubation Stage: Virus replicates at the site of entry and travels along peripheral
nerves towards the central nervous system (CNS).
2. Prodromal Stage: Fever, headache, malaise, and pain or tingling at the site of
exposure.
3. Acute Neurological Stage: Agitation, confusion, delirium, muscle spasms,
hydrophobia (fear of water), and difficulty swallowing.
4. Coma Stage: Progressive paralysis, coma, and death.

Signs and Symptoms:

- Pain, itching, or tingling at the site of exposure.
- Fever, headache, malaise.
- Irritability, anxiety, hallucinations.
- Hydrophobia (fear of water).
- Muscle spasms and convulsions.

Complications:
- Severe neurological damage.
- Death.

Pathophysiology:
The rabies virus enters the body through a bite or scratch, then spreads along
peripheral nerves to the central nervous system (CNS) and the brain, causing
inflammation and neurological symptoms.

Diagnosis:
- Clinical symptoms and history of exposure to an infected animal.
- Detection of viral RNA in saliva, skin biopsy, or cerebrospinal fluid.
- Postmortem brain examination.

Treatment:
- Rabies post-exposure prophylaxis (PEP) includes wound cleansing, rabies vaccine,
and sometimes rabies immune globulin (RIG).
- Once symptoms develop, rabies is almost always fatal. There is no effective treatment
for advanced disease.

Prevention:
- Vaccination of domestic animals, especially dogs and cats.
- Avoiding contact with potentially rabid animals.
- Post-exposure prophylaxis for those bitten or scratched by a potentially rabid animal.

Nursing Management:
- Providing wound care and wound cleaning.
- Educating patients about the importance of prompt medical attention after exposure.
- Administering rabies vaccine and immune globulin as indicated.
PULMONARY TUBERCULOSIS (PTB)

Chain of Infection
1. Causative Agent: Mycobacterium tuberculosis, bacteria gram (+), aerobic
2. Reservoir: Infected humans with active tuberculosis.
3. Portal of Exit: Respiratory secretions expelled through coughing, sneezing, or
talking.
4. Mode of Transmission: Inhalation of infectious droplets containing M. tuberculosis.
5. Portal of Entry: Respiratory tract, especially the lungs.
6. Susceptible Host: Individuals exposed to the bacterium, particularly those with
weakened immune systems.

Incubation Period: 2 to 12 weeks.

Stages of Disease:
1. Exposure Stage: Initial inhalation of infectious droplets.
2. Latent Infection Stage: Bacteria remain dormant within the body's immune system.
3. Active Disease Stage: Bacteria multiply and cause symptoms.

Signs and Symptoms:

- Chronic cough lasting for more than 3 weeks.
- Chest pain.
- Coughing up blood or sputum.
- Fatigue.
- Fever.
- Night sweats.
- Unintended weight loss.

Complications:
- Progressive lung damage.
- Spreading to other parts of the body (extrapulmonary TB).
- Secondary bacterial infections.
- Miliary tuberculosis (disseminated TB).

Pathophysiology:
M. tuberculosis primarily infects the lungs. It triggers an immune response that forms
granulomas (tubercles) to contain the bacteria. In active disease, these tubercles can
break down, releasing bacteria into the airways.

Diagnosis:
- Tuberculin skin test (TST) or interferon-gamma release assay (IGRA) for latent
infection.
- Chest X-rays and sputum tests (smear microscopy, culture, and molecular tests) for
active disease.

Treatment:
- Standard tuberculosis treatment consists of a combination of antibiotics, usually
isoniazid, rifampin, pyrazinamide, and ethambutol, taken for several months.
- Drug-resistant TB may require different antibiotics and a longer treatment duration.

Prevention:
- BCG (Bacillus Calmette-Guérin) vaccine for prevention in some regions.
- Treatment of latent tuberculosis infection to prevent progression to active disease.
- Infection control measures to prevent transmission.

Nursing Management:
- Educating patients about the importance of completing their full course of antibiotics.
- Monitoring and managing medication side effects.
- Promoting adherence to infection control measures.
- Supporting patients emotionally and providing education about transmission.
HIV (HUMAN IMMUNODEFICIENCY VIRUS)

Chain of Infection
1. Causative Agent: human immunodeficiency virus, which attacks the immune
system, specifically CD4 T cells.
2. Reservoir: Infected humans with HIV.
3. Portal of Exit: Blood, semen, vaginal fluids, breast milk, and other bodily fluids.
4. Mode of Transmission: Unprotected sexual contact, sharing needles, mother-to-
child transmission during childbirth or breastfeeding, and less commonly, blood
transfusions or organ transplants.
5. Portal of Entry: Mucous membranes, broken skin.
6. Susceptible Host: Individuals exposed to the virus, particularly those engaging in
high-risk behaviors.

Incubation Period: it's typically several weeks to a few months.

Stages of Disease:
1. Acute HIV Infection: Initial few weeks after exposure, some individuals experience
flu-like symptoms.
2. Clinical Latency: Virus replicates at low levels; this stage can last for years.
3. AIDS (Acquired Immunodeficiency Syndrome):Severe immune system damage,
indicated by a low CD4 cell count and the presence of opportunistic infections or
cancers.

Signs and Symptoms:

- Acute infection: Fever, fatigue, muscle aches, sore throat, swollen lymph nodes, rash,
and headache.
- Later stages: Weight loss, chronic diarrhea, night sweats, recurrent infections, and
neurological symptoms.

Complications:
- Weakened immune system, making the body susceptible to opportunistic infections
and certain cancers.
- AIDS-related illnesses, including pneumonia, tuberculosis, and Kaposi's sarcoma.

Pathophysiology:
HIV targets CD4 T cells, progressively reducing the immune system's ability to fight
infections and diseases.

Diagnosis:
- HIV antibody test (ELISA) followed by a confirmatory test (= or PCR).
- Rapid tests are also available.

Treatment:
- Antiretroviral therapy (ART) to suppress viral replication and maintain immune
function.
- Combination therapy involves taking multiple medications from different drug classes.
- Pre-exposure prophylaxis (PrEP) for individuals at high risk of HIV.

Prevention:
- Safe sexual practices, including condom use.
- Needle exchange programs for injection drug users.
- Treatment as Prevention (TasP) for those already infected to reduce transmission.
- Pre-exposure prophylaxis (PrEP) for high-risk individuals.

Nursing Management:
- Counseling and education about HIV transmission, prevention, and treatment.
- Monitoring ART adherence and side effects.
- Providing support for patients coping with the diagnosis.
- Managing opportunistic infections and complications.