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Infectious Disease Objectives. Upon completion of this lecture, you will be better able to: List the infectious diseases commonly encountered in the school setting

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Infectious Disease 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

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INFECTIOUS DISEASES

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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

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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!

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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

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FIFTH DISEASE

  • PREVENTION

    • Good handwashing is the best defense against the virus

    • Universal substance precautions

  • NOTE: THERE IS CURRENTLY NO VACCINE AVAILABLE

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PERTUSSIS

  • CAUSE:

    • Caused by a bacteria known as Bordetella pertussis

    • Highly contagious

  • TRANSMISSION:

    • By airborne droplets

    • Incubation period is 5-10 days

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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)

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PERTUSSIS

COMPLICATIONS

  • Pneumonia

  • Apnea

  • Dehydration, weight loss

  • Atelectasis

  • Seizures

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PERTUSSIS

DIAGNOSIS

  • A nasopharyngeal swab is used to test for the B. pertussis bacteria

    TREATMENT

  • Erythromycin

    PREVENTION

  • Vaccination

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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

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INFECTIOUS MONONUCLEOSIS

TRANSMISSION

  • Transmitted through affected saliva. Also known as the ”kissing disease”

    SYMPTOMS

  • High fever

  • Splenomegaly

  • Lymphadenopathy

  • Fatigue

  • Hepatosplenomegaly

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INFECTIOUS MONONUCLEOSIS

DIAGNOSIS

  • A blood test is required to confirm the diagnosis (Monospot)

  • CBC usually shows atypical lymphocytes

    COMPLICATIONS

  • Splenic rupture

  • Guillain-Barre

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INFECTIOUS MONONUCLEOSIS

TREATMENT

  • Currently no medication to treat the disease

  • Treatment typically palliative - treat the symptoms

    PREVENTION

  • There is no vaccinecurrently available

  • Best defense is to avoid direct exposure to anyone with symptoms. Always maintain good handwashing

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SCARLET FEVER

CAUSE

  • Usually caused by group A streptococcus

    SYMPTOMS

  • Fever, pharyngitis, “sandpaper” rash

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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

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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

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SCARLET FEVER

COMPLICATIONS

  • Rheumatic Fever

  • Glomerulonephritis

    PREVENTION

  • Avoid close contact or sharing of utensils with anyone who is symptomatic. Always maintain good handwashing

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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.

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RESPIRATORY SYNCYTIAL VIRUS

SYMPTOMS

  • Wheezing

  • Tachypnea

  • Retractions

  • Nasal flaring

  • Atelectasis

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RESPIRATORY SYNCTIAL VIRUS

COMPLICATIONS

  • Hypoxia

  • Dehydration

  • Respiratory failure

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RESPIRATORY SYNCYTIAL VIRUS

TREATMENT

  • Oxygen

  • Fluid balance

  • Tylenol

  • Albuterol nebulizer or oral medication

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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.

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Pediculosis

DIAGNOSIS

A diagnosis is made when one or more live lice are found on the student.

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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.

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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.

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IMPETIGO

TREATMENT

  • Impetigo is usually treated with oral antibiotics such as dicloxacillin.

  • Occasionally, only a topical antibiotic such as mupirocin is prescribed.

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RINGWORM

CAUSE

Ringworm (tinea capitis) is caused by the fungus Trichophyton tonsurans. When ringworm affects the scalp, typically hair loss occurs.

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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.

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RINGWORM

PREVENTION

  • Good handwashing

  • No sharing of personal hair products

  • Checking pets for signs and symptoms of ringworm

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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.

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MENINGITIS

SYMPTOMS

  • High fever

  • Headache

  • Stiff neck

  • Nausea, vomiting

  • Photophobia

  • Lethargy

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MENINGITIS

TREATMENT

  • Hospitalization

  • IV antibiotics are the treatment of choice for bacterial meningitis

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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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ANY QUESTIONS??

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