INFECTIOUS DISEASES

Lecture Objectives: Upon completion of this lecture, you will be better able to: n List the infectious diseases commonly encountered in the school setting n Describe the etiology, signs and symptoms, diagnosis, complications, treatment and prevention of the diseases discussed in the manual n 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 n Incubation period is 6-14 days n Symptoms usually begin one to two weeks after exposure to the virus n NOTE: WHEN THE RASH APPEARS, THE STUDENT IS NO LONGER CONTAGIOUS!

“Slapped Cheek” rash

FIFTH DISEASE n COMPLICATIONS –Can be dangerous to women who are less than 20 weeks pregnant –Dangerous to cancer or immunosuppressed students n DIAGNOSIS –Usually made by clinical symptoms n TREATMENT –No definitive treatment at this time

FIFTH DISEASE n PREVENTION –Good handwashing is the best defense against the virus –Universal substance precautions n NOTE: THERE IS CURRENTLY NO VACCINE AVAILABLE

PERTUSSIS n CAUSE: –Caused by a bacteria known as Bordetella pertussis –Highly contagious n TRANSMISSION: –By airborne droplets –Incubation period is 5-10 days

PERTUSSIS 3 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 n Pneumonia n Apnea n Dehydration, weight loss n Atelectasis n Seizures

PERTUSSIS DIAGNOSIS n A nasopharyngeal swab is used to test for the B. pertussis bacteria TREATMENT n Erythromycin PREVENTION n Vaccination

INFECTIOUS MONONUCLEOSIS CAUSE n The Epstein-Barr virus is the most common cause of mononucleosis (mono) n In the United States, the incidence of mono peaks in adolescence

INFECTIOUS MONONUCLEOSIS TRANSMISSION n Transmitted through affected saliva. Also known as the ”kissing disease” SYMPTOMS n High fever n Splenomegaly n Lymphadenopathy n Fatigue n Hepatosplenomegaly

INFECTIOUS MONONUCLEOSIS DIAGNOSIS n A blood test is required to confirm the diagnosis (Monospot) n CBC usually shows atypical lymphocytes COMPLICATIONS n Splenic rupture n Guillain-Barre

INFECTIOUS MONONUCLEOSIS TREATMENT n Currently no medication to treat the disease n Treatment typically palliative - treat the symptoms PREVENTION n There is no vaccine currently available n Best defense is to avoid direct exposure to anyone with symptoms. Always maintain good handwashing

SCARLET FEVER CAUSE n Usually caused by group A streptococcus SYMPTOMS n Fever, pharyngitis, “sandpaper” rash

SCARLET FEVER TRANSMISSION n Respiratory droplets spread the disease. Spread by close contact and shared utensils n Incubation period is 3-5 days n NOTE: Student is contagious until antibiotic is taken for 24 hours

SCARLET FEVER DIAGNOSIS n A throat culture determines if Strep A is present n If culture is positive and there is a rash, the diagnosis is made TREATMENT n The drug of choice is penicillin

SCARLET FEVER COMPLICATIONS n Rheumatic Fever n Glomerulonephritis PREVENTION n Avoid close contact or sharing of utensils with anyone who is symptomatic. Always maintain good handwashing

RESPIRATORY SYNCYTIAL VIRUS n Respiratory syncytial virus (RSV) is the most frequent cause of respiratory tract infections in children less than 4 years old n 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 n Wheezing n Tachypnea n Retractions n Nasal flaring n Atelectasis

RESPIRATORY SYNCTIAL VIRUS COMPLICATIONS n Hypoxia n Dehydration n Respiratory failure

RESPIRATORY SYNCYTIAL VIRUS TREATMENT n Oxygen n Fluid balance n Tylenol n Albuterol nebulizer or oral medication

Pediculosis THREE FORMS OF HEAD LICE n NIT - Eggs of head lice. Hatch in approximately 1 week. Usually found attached to hair shaft. n NYMPH - Becomes an adult in approximately 7 days after hatching. Will die without blood supply. n 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 n Only treat a student when live lice are found. n A standard chemical insecticidal lotion is used. n Inform parent/guardian on how to treat household items.

IMPETIGO TWO TYPES OF IMPETIGO n Nonbullous impetigo- This type is typically seen to a greater degree in children versus adults. Usually affects the facial area. n Bullous impetigo-This type is highly contagious and can spread to large areas of skin.

IMPETIGO TREATMENT n Impetigo is usually treated with oral antibiotics such as dicloxacillin. n 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 n Good handwashing n No sharing of personal hair products n Checking pets for signs and symptoms of ringworm

MENINGITIS n Meningitis is an inflammation of the meninges. Can be bacterial or viral. n Leading cause of bacterial meningitis used to be Haemophilus influenzae type B n Current leading cause is Streptococcus pneumoniae and Neisseria meningitis.

MENINGITIS SYMPTOMS n High fever n Headache n Stiff neck n Nausea, vomiting n Photophobia n Lethargy

MENINGITIS TREATMENT n Hospitalization n 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.

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