29 Lecture 2 public Health Air-borne diseases Dr. Sarwar Arif

Many bacteria and viruses invade the body through the respiratory tract. These microorganisms can affect the upper and lower respiratory tract and some of them can spread to other organs as well. Upper respiratory infections are very common. Acute lower respiratory infections are a major cause of mortality in children in the developing countries.

Major air-borne infections include the following: Viral infections Mumps Measles Rubella(German measles) Influenza Infectious mononucleosis Chickenpox

Bacterial TB Pneumonia (pnemococcus, streptococcus, haemophilus klebsiella, mycoplasma) Whooping cough (Borditella pertusis) Streptococcal infections( tonsillitis, rheumatic fever) Meningitis (Neisseria menegitidis) Diphtheria (Clostridium diphtheriae) Plague, pneumonic

Transmission of air-borne infections Fungal Histoplasmosis(histoplasma capsulatum) Transmission of air-borne infections Air-borne microorganisms are transmitted to the new host through three methods:

Droplets: particles of saliva and mucous secretions are ejected by coughing, sneezing, talking, laughing and spitting. These droplets may contain food debris and microorganisms.

2.Droplet nuclei: When droplets evaporate before settling on the ground Dry nucleus remains which is small and light Hence easily carried away by air and capable of entering the bronchioles and alveoli.

3.Dust: some organisms can persist for a long time in dust which then acts as a reservoir. These organisms may be derived from sputum or settled droplets.

Control of air-borne diseases Main lines of controlling these disease can be grouped under three headings; The agent Mode of transmission The host.

3.Protection of the host: individual can be protected from air-borne infections by Specific immunization in case of diseases for which a specific vaccine is available such as measles, influenza and whooping cough or by using immunoglobulins such as for measles. Using medication to prevent disease in high risk people such as isoniazid for prevention of TB

Mumps Acute viral infection caused by paramyxovirus The v has affinity for glandular and nervous tissue Enlargement and tenderness of one or both parotid glands 0ther organs develop infection in 30 to 40% of cases

Agent Paramyxovirus it can be isolated from saliva, mouth, urine, blood, milk, CSF HOST In any age and sex More common in age 5-15yrs Highest incidence among non immunized children Trans placental antibodies protect infants in first 6months of life

One attack gives life long immunity Rarely second attacks can occur Environment Incidence higher in winter and spring May occur any time during the year due to over crowding Spread by droplet infection through the upper respiratory tract

Period of infection 6-9 days after appearance of parotid swellings Incubation period 16-18 days but may extend to 3-4 weeks

Clinical manifestation Prodromal symptoms like fever, headache, malaise, anorexia Pain around the ears and jaws Swelling of parotid and salivary gland in 1-3 days 75% bilateral One or both parotid gland affected by severe pain and tenderness It may also affect tests, pancreas, nervous system, joints, eyes, ears, ovaries, prostate, breast and heart

Pain and stiffness on opening the mouth The swelling and pain may subside with in 3 weeks of infection Weakness and fatigue may persist for longer time Sever cases associated with dysphagia, dyspnea, myocarditis, hepatitis, meningitis, orchitis (sterility) ovarites, encephalopathy

Diet No restriction of diet except in acute stage, when the patient find difficulty in swallowing: soft and semisolid foods Acid foods e.g fruit juice may increase discomfort so it should be avoided

Active immunization Life attenuated mumps virus in combination with measles and Rubella MMR After 6 moth of age Single dose of 0.5 ml IM protects 95% of cases No morbidity to the vaccine, no significant systemic or local reactions ,it is one of most effective and safe vaccines Must not be given in pregnancy, patient receiving immunosuppressant, severely ill pat

Treatment Pain relived by analgesics , hot and cold compresses focused on relieving symptoms until your body’s immune system fights off the infection. There are currently no medications to treat the mumps virus. Pain relived by analgesics , hot and cold compresses Bed rest Nutritional Emotional needs get plenty of bed rest until your symptoms have passed take over-the-counter painkillers, such as ibuprofen or paracetamol, to relieve any pain (children aged 16 or under should not be given aspirin) drink plenty of fluids, but avoid acidic drinks such as fruit juice as these can irritate your parotid glands; water is usually the best fluid to drink apply a warm or cool compress to your swollen glands to help reduce any pain eat foods that don't require a lot of chewing, such as soup, potatoes and eggs

prevention stay away from school, college or work until five days after you first developed symptoms wash your hands regularly, using soap and water always use a tissue to cover your mouth and nose when you cough and sneeze, and throw the tissue in a bin immediately afterwards