Chapter 10

A highly infectious disease caused by a spore-producing bacteria called bacillus anthracis. Most human infections result from handling the meat or products of infected animals such as wool, leather, or meat, eating undercooked meat or infected animals, or inhaling anthrax spores. A vaccine is available for people at risk of exposure to the disease including laboratory workers, military personnel, and people handling animals in areas of high incidence of who work with animal products such as leather or fur imported from countries where anthrax is common. The vaccine is __% effect in preventing the infection upon exposure.

Anthrax; 93%

Sexually transmitted viral disease; blood borne pathogen cause by the human immunodeficiency virus (HIV). The body fails to develop antibodies to infecting organisms, rather than attacking its own cells. This lack of defense leads the body susceptible to opportunistic infections that take advantage of the body's lowered immunity. - the body gradually attacks more & more of the T-lymphocytes over time S/S: flulike nature(may remain undetected)-fever, sweating, diarrhea, headaches, joint/muscle pain, blurred vision, swollen lymph glands, shortness of breath, weakness, cough and a rash; Long term: weight loss, chronic diarrhea, chronic fatigue, weakness, joint arthritis, neurological problems. *NO cure exists / 5th leading cause of death (2006) 1st in 1995

Autoimmune Deficiency Syndrome (AIDS) / Human Immunodeficiency Virus (HIV)

A potentially dangerous bacterial infection also known as food poisoning. The bacteria may be found in improperly bottled, canned, and prepared foods but is usually found in home-canned foods. The extremely potent toxins produced by the spores of the bacteria prevent the release of acetylcholine at the neural synapse, causing paralysis of the muscles. S/S: abdominal cramping, double vision, dry mouth, nausea, respiratory problems/lead to respiratory failure, vomiting, visual disturbances, dysphagia(inability to swallow), dysphasia(speech), weakness/paralysis *weakness and other neurological symptoms may last for up to a year

Botulism

Common sexually transmitted viral infection in adults, with between 50% and 80% of adults infected by the age 40. - related to the herpes virus, is present in all body fluids of an infected person including the saliva, blood, tears, semen, vaginal fluids, breast milk, & urine. The disease may be passed onto the fetus during pregnancy/through breast milk from an infected mother. S/S: if present in adults, mimic flu & include fever, fatigue, malaise, joint/muscle pain, sore throat,lymph node inflammation, thrombocytopenia, splenomegaly. Newborn: low birth weight/size, microcephaly, respiratory problems, MR, motor delay/movement coordination deficits, seizures, hearing/vision loss, jaundice, splenomegaly/hepatomegaly, CNS problems *NO vaccine is currently available

Cytomegalovirus

An acute infectious disease that is now rare in most of the Western world-caused by the Corynebacterium diphtheriae bacteria. The toxins create a reaction with the lining of the tonsils, pharynx, or nasal cavity that causes a characteristic pseudomembrane to form across the pharynx that can prevent breathing. - spread through respiratory droplets from an infected individual coughing & sneezing/through contaminated food or drinks. S/S: cough, low-grade fever/chills, sore throat, edema of the neck, painful swallowing, drooling, hoarseness, changes in color of skin due to hypoxia. If untreated can be life threatening as a result of the pseudomembrane that forms across the trachea and prevents breathing. Medical intervention: vaccine is administered to children in 4 doses before age 6 years. Antimicrobial meds, hospitalization for IV fluids, oxygen therapy, bed rest, cardiac monitoring, intubation, and removal of airway blockage

Diptheria

A group of related viruses that cause disease worldwide especially in poor housing conditions with infestations of mice and rats. - RNA viruses transmitted by contact with infected rodent urine or feces - causes hemorrhagic fever (bleeding in internal organs), can result in kidney damage, pulmonary symptoms, & death. Initial symptoms: fatigue, fever, headache, dizziness, nausea, vomiting, diarrhea, abdominal pain, muscle aches in lower extremities/back. Later stage: hypoxia, hypotension, severe shortness of breath & cough, & ARDS

Hantaviruses

An RNA virus transmitted through contact with body fluids, feces, and ingestion of contaminated food/drinking water. -can remain viable outside the body for several months -incubates within average of 28 days within the liver & larger quantities of the ___ virus are excreted in the feces S/S: vomiting, loss of appetite, fatigue, abdominal pain, diarrhea, fever, joint pains, dark-colored urine, clay-colored feces, and jaundice. Usually resolve within 2 months without liver damage. Prognosis is good - does not lead to liver damage or chronic forms of hepatitis. Best intervention is prevention. Vaccination is available in a two-dose series - can be administered to anyone over 1 year.

Hepatitis A (HAV)

(DNA virus) A blood borne pathogen transmitted through contact with contaminated blood, blood products, or through sexual contact. - can remain viable for as long as 7 days - incubation period between the transmission of the virus and appearance of symptoms can be anywhere from 6 wks to 6 mos S/S: loss of appetite, nausea/vomiting, weakness, fatigue, low-grade fever, joint/muscle pains/aching, possible skin rash. May cause jaundice from liver damage. Medical intervention: prevention is most effective. Series of vaccinations is available - 3 injections at Day 0, 30, 60

Hepatitis B (HBV)

An RNA virus transmitted via infected blood that is most common in persons who use intravenous illicit drugs or have multiple sexual partners. S/S: acute: reduction in appetite, fatigue, abdominal pain/tenderness on palpation over the region of he liver in the RUQ of abdomen, & muscle/joint pains chronic: may cause liver cirrhosis in those who are immunosuppressed as a result of HIV or alcoholism or may lead to an increased risk of liver cancer. Medical intervention: prevention; no vaccine exists. *Over 4 million people in the U.S. & 180 million worldwide have chronic ___

Hepatitis C (HCV)

Hepatitis __ is a fairly rare virus found in relation to HBV. It relies on HBV virus to replicate. The virus is a blood-borne pathogen usually transmitted through sexual activity, blood transfusion, or intravenous drug use. *In rare cases, HDV can be life threatening as a result of end stage liver disease. *The HBV vaccination protects against HDV because the viruses occur together.

Hepatitis D (HDV)

Hepatitis __ is another RNA virus spread in contaminated food and drinking water in parts of Asia, Africa, and South America.

Hepatitis E (HEV)

Hepatitis __ also called GB virus-C is transmitted through skin wounds and is most prevalent in people who use intravenous drugs and people undergoing hemodialysis. S/S: jaundice, fatigue, abdominal pain, diarrhea, nausea, vomiting, loss of appetite, headache, dark colored urine, and fever

Hepatitis G (HGV)

Most common sexually transmitted disease in the U.S. - more than 20 million people are infected; each year an addition 6.2 mil become infected - cause condylomata acuminata (warts) by stimulating skin cells to undergo metaplasia (change to another type of cell) - more than 100 types exist, some of which are classified as "low risk" because they only cause warts, others "high risk" because they cause cancer - many people with _ do not know they have it because they do not have signs/symptoms - condylomata may be surgically excised with cyrotherapy (freezing), loop electrosurgical excision procedure (LEEP), also called electrocautery, laser, or with conventional surgery

Human Papillomavirus (HPV)

Also known as the "kissing disease", is an acute disease cause by the Epstein-Barr virus(EBV) or the cytomegalovirus(CMV), which are both types of herpes virus. After people contract HBV, the virus remains in the body the rest of their life, and they can pass on the infection even though they are not symptomatic. S/S: fever, sore throat, loss of appetite, headache, general feelings of fatigue, muscle aching, stiffness, lympadenopathy-esp. in neck. Complications: hepatitis & inflammation of the spleen Interventions: general nonsteroidal anti-inflammatory medications for pain/fever. Avoid contact sports if inflammation of spleen is present - could rupture.

Infectious Mononucleosis

A serious infectious disease transmitted to humans by the plasmodium parasite via the female Anopheles mosquito. - the parasites grow in the liver of the human host and then spread to the red blood cells where they multiply and destroy the red cells S/S: occur 6-9 days after bite; mimic flu, include bouts of child and fever, profuse sweating, gastrointestinal disturbances,dizziness, backache, muscle/joint pains, and cough. Severe complications: anemia, kidney failure, and cerebral malarial infection - other plasmodium species cause disease that can lie dormant in the liver for many years and cause repeated exacerbations of signs and symptoms for the rest of the person's life. *Prevention is the best medical intervention

Malaria

Causes inflammation of the meninges of the brain and spinal cord Causes: viruses, bacteria, fungi, brain tumors, drug allergies. *viruses are most common S/S: fever, nausea, vomiting, photophobia, severe headaches, meningismus(stiffness of neck), altered levels of consciousness, seizures, tachypnea, agitation, opisthotonus, reduced appetite. Viral - usually not serious, resolves within 2 weeks Bacterial - can be serious; sometimes fatal Medical intervention: prevention is possible through vaccination with the mococcal conjugate and meingococcal vaccine. Bacterial - treated with antimicrobials. Viral - not treatable with meds; usually resolves on its own in 2 weeks

Meningitis

Pain, stiffness, muscle tenderness, spasm in lumbar/cervical spines, L&U extremities & abdomen. Fever, headaches, diarrhea, fatigue, skinrash, vomiting. Last 1-2 weeks.

Non-Paralytic Poliomyelitis

Hospital acquired or health care associated infections, are those that are acquired while the patient is in the hospital or other health care setting. Causes: viruses, bacteria, and fungi. Most common causative agents are: Streptocci, Staphylococcus aureus, Enterococci, Pseudomonads, E.Coli, Enterobacter species, and pseudomonas types of bacteria Patient related risk-factors include: seriousness of illness, whether the immune system is compromised, and the length of the stay necessary Risk Factors: contamination of air conditioning or water systems, how close patient beds are, nurse to patient ratio. Factors are increased when invasive procedures are performed: indwelling catheters, IV lines, intubation, mechanical ventilation S/S: fever, rash, fatigue, general malaise, tachycardia. Medical intervention: prevention and handwashing

Nosocomial Infection

Causes more severe neurological symptoms. A particularly sever form of paralytic polio is called ___ polio because it destroys the motor neurons or brainstem, causing swallowing, breathing, and speech difficulties.

Paralytic Poliomyelitis Bulbar

An acute viral infectious disease infecting humans. Transmitted through direct person-to-person contact with nasal/oral secretions, infected mucous or infected feces. Enters the body through mouth/nose & multiplies within the throat & intestines. Infection is absorbed into the circulatory & lymphatic systems & transmitted throughout the body. Three types are recognized: subclinical, non paralytic, and paralytic.

Poliomyelitis

_ develops in people who previously had paralytic poliomyelitis with associated muscle atrophy and weakness and gained either partial or complete functional recovery. Symptoms have to be present for at least one year: gradual/sudden onset of progressive new muscle weakness & muscle fatigue originally affected by the disease. Reduced endurance to activity and muscle/joint pains. Other s/s: heat/cold sensitivity, sleeping problems, reduced ability to perform activities of daily living (ADL's). Rarely: breathing/swallowing problems Prevention: inactivated polio vaccine (IPV)

Post-Polio Syndrome

Painless and infectious chancres on the skin of the genitalia, anus, lips, or mouth which appear between 10&90 days after the infection. If undetected/untreated, goes into secondary stage approx. 1 year after initial reaction

Primary Syphilis

The most well-known animal transmitted viral disease in humans but is fairly rare in the U.S. Animals most associated: raccoons, foxes, bats, skunks. Domestic animals rarely transmit the disease because they must be vaccinated in the U.S. -it is a type of encephalitis virus transmitted through contact with the saliva of an infected animal. Earliest symptoms include: pain/paresthesia at the site of the bite, fever, headache, general malaise-similar to flu. Later signs: associated with encephalitis and myelitis. Neurological signs include mental confusion, paralysis, hallucinations, difficulty swallowing, hypersalivation, hydrophobia. Medical intervention: may require post exposure prophylaxis, administration of the immune globulin around the area of the bite and several doses of __ vaccine.

Rabies

One of the most severe and frequently reported rickettsia-related illnesses in the United States. - caused by the Rickettsia ricketsii bacteria transmitted to humans through tick bites S/S: early: sudden headaches, muscle pain, fever/chills, cough/respiratory symptoms, occasionally coma. Skin rash may appear on wrists and ankles. Gastrointestinal problems are common. Long term complications: gangrene, loss of bowel and bladder control, movement disorders, hearing loss, even partial paralysis in lower extremities. Neurological complications: encephalitis, seizures, cranial nerve damage, blindness, deafness. Lung involvement can cause pulmonary edema, interstitial pneumonia, &ARDS. Treatment includes: antimicrobial medications(tetracycline, doxycycline, chloramphenicol). Severe cases may require hospitalization and intubation, IV hookups, blood transfusions, or platelet transfusions

Rocky Mountain Spotted Fever

Also called German measles, is an infectious virus transmitted in air droplets form an infected person. Particularly dangerous when contracted by a pregnant woman during the first ___ weeks of pregnancy because it can cause fetal defects.

Rubella; 20

Rough reddish brown rash develops on the soles of the feet & palms of the hands. Rash is infectious. Fever, sore throat, headache, weight loss, hair loss, swollen lymph glands, fatigue, muscle aches.

Secondary Syphilis

Mild fever, general malaise, headache, sore inflamed throat, vomiting. Some experience no symptoms. If present, last approximately 72 hours.

Subclinical Poliomyelitis

A sexually transmitted disease caused by the spirochete bacteria treponema pallidum. Transmission of the infection is through sexual intercourse contact w/the chancre on the genitalia, vagina, anus, rectum, lips, and inside the mouth. Other modes include: toilet seats, doorknobs, swimming pools, hot tubs, bath tubs, eating utensils, and clothing. Transmission to a fetus is possible after the 10th week of pregnancy and causes congenital _ in the child. Prognosis: good for primary/secondary. Those who enter tertiary can still be treated but damage to internal organs/bones/joints cannot be reversed. Treatment: penicillin or other antimicrobial medications are administered by intramusclar injection.

Syphilis

Disease goes undetected and untreated and affects internal organs. Syphilitic infection of the spinal cord takes the form of tabes dorsal is, also called progressive locomotor ataxia or syphilitic spinal sclerosis, which destroys sensory nerve axons and causes personality changes and dementia. S/S: incoordination movement disorders, such as ataxic gait, paralysis, weakness, numbness, blindness, deafness, severe pain, even death. May occur as much as 25 years after infection.

Tertiary, Late-Stage Syphilis

Acute bacterial disease, also known as lockjaw, is caused via spores of the clostridium tetani bacteria found in soil, house dust, and in the intestines of animals and humans. Spores can remain viable in the soil for more than 40 years and are resistant to heat, desiccation, and most disinfectants. When the spores enter the body through the open wound, they reproduce and excrete an extremely toxic neurotoxin called tetanospasmin that attacks the CNS by interfering with neurotransmission across the synapses. Wounds susceptible: deep punctures, insect bites, burns, self performed tattoos/body piercings, IV illicit drug sites. S/S: tetany (involuntary tonic/tetanic muscle spasms) near onsite of wound, progresses to whole body, spasms of jaw muscle causing trismus (tightness of mouth/jaw muscles) gives name "lockjaw" Tonic spasms include respiratory muscles making breathing/swallowing difficult. Can cause spinal fractures/muscle tears. Other S/S: fever, excessive sweating, neck stiffness, headaches, irritability, incontinence of bowel/bladder, severe body extensor muscle spasms, causing rigidity & convulsions Mortality rate: 45% Medical intervention: disease can be prevented by immunization with the DTaP vaccine in the infant. Four doses of the DTaP are given before age 2, and a booster shot at age 4 to 6. After that, booster shots are given every 10 years, or within 5 years when injury occurs likely transmitting bacteria. Antimicrobial meds: penicillin G, metronidazole, doxycycline, antitoxins to neutralize effect of toxins produced by the bacteria.

Tetanus

An acute infectious disease transmitted to humans by fleas and lice. Mainly found in areas of overcrowding

Typhus

Common highly infectious viral disease. More commonly known as the chickenpox, is infection with the herpes zoster virus. The same virus causes chickenpox in children and shingles in adults

Varicella (chickenpox)

Smallpox is caused by the ___ virus. The disease is extremely infectious and spread by saliva droplets and by secretions from the skin rash on bedding and clothing. S/S: high fever, severe headaches/backaches, rash that starts off pink and red, and turns into pus filled spots which then crust over. Vomiting, severe diarrhea, hemorrhage, extreme fatigue. *since 1977 the small pox vaccination has not been used

Variola (smallpox)

A potentially serious viral infection that affects human, mammals, and birds. The birds carry the live virus the mosquitoes can pick up the virus during a bite and transmit the virus to humans/other animals. The symptoms can range from severe headaches & fever to meningitis & encephalitis. NO vaccination is available

West Nile Virus (WNV)