Transcript March 2014
Common Infectious Diseases of Children Presented by APIC San Antonio Common Terms Susceptible Host: A person capable of becoming infected Causative Agent: The germ (bacteria, virus, parasite) that causes a disease Common Terms Incubation Period: The time frame from exposure to development of symptoms Transmission Route: The method by which a causative agent infects a susceptible host (Contact, Droplet, Airborne) Hand Hygiene Resident and Transient organisms ◦ Resident organisms – bacteria that stay on the skin. They cannot be removed completely, but their numbers can be reduced. ◦ Transient Organisms – Organisms that we pick up from other people and the environment around us. These organisms can cause serious infections. They can be removed by performing hand hygiene. Hand Hygiene The single most important way to prevent the spread of infection! Two methods: Soap and Water or with Alcohol Hand Rubs Hand Hygiene Soap and Water vs. Alcohol Hand Rubs • Physically removes germs • Kills germs on the skin from hands •Takes over a minute to do properly •Takes about 15 - 20 seconds to do properly •Should be used when hands are visibly soiled •Should not be used when hands are visibly soiled •Can cause skin irritation •Some products improve skin condition Hand Hygiene How To Soap and Water ◦ Turn on water and wet your hands ◦ Apply soap and rub hand together to create a lather ◦ Scrub all surfaces of your hands for at least 15 seconds ◦ Rinse soap from hands ◦ Dry hands with clean paper towel (if possible) ◦ Use paper towel to turn off sink and open door Hand Hygiene Alcohol based hand rubs ◦ Place a dime sized amount in palm ◦ Rub hands together, covering all surfaces ◦ Allow hands to dry completely before touching surfaces Look for a product that contains skin conditioners Antibiotic Usage Main Causes of Disease in Children ◦ Bacteria ◦ Viruses ◦ Fungi ◦ Parasites Antibiotics are only effective against Bacteria! Other medications might be needed for a different type of infection. Antibiotic Usage What harm can result from use of antibiotics when they have no benefit? ◦ Many antibiotics have side effects, including upset stomach and diarrhea ◦ Using antibiotics with viral infections increases child’s risk for future infections with Multi-drug resistant Organisms (MDROs) Antibiotic Usage What are MDROs? ◦ Multi-Drug Resistant organisms are bacteria that cannot be killed by many antibiotics ◦ Infections with these bacteria are difficult to treat; children (and adults) with these infections can become very ill Antibiotic Usage Why are MDROs a major concern? ◦ The number of MDRO infections has been increasing for the last several years ◦ This growth of drug resistance can be slowed by appropriately using antibiotics Rash and Skin Diseases Chickenpox Staphylococcus (MSSA and MRSA) Scabies Measles Rubella Ring Worm Fifth Disease Impetigo Chickenpox Chickenpox Symptoms: Fever, blister-like rash on the face, scalp and trunk. Severe cases can develop brain swelling or pneumonia. Transmission: ◦ Causative agent: Varicella Zoster Virus ◦ Incubation Period: 10-21 days ◦ Transmission Route: Airborne and Contact Chickenpox Prevention: Vaccination! Two doses, first at 1215 months, second at 4-6 years Treatment: Calamine lotion and colloidal oatmeal bath may help relieve hitching. Use non aspirin medication to relieve fever. Severe cases may receive anti-viral drugs. MRSA MRSA Symptoms: Red, swollen, extremely painful bumps. May contain pus or other drainage. Often mistaken for spider bite. Transmission ◦ Causative agent: Methicillin Resistant Staphylococcus Aureus ◦ Incubation Period: Days to Weeks ◦ Transmission: Contact MRSA Prevention: Hand Hygiene, cleaning “high risk” surfaces (sports equipment, bathrooms, toys), keeping open wounds clean, not sharing personal items; covering wounds securely for contact with others Treatment: A physician may prescribe antibiotics. Wound may need to be drained (don’t do it yourself!) Scabies Scabies Symptoms: Severe itching, especially at night. Pimple-like or tunneled rash on wrist, elbows, armpits, genitals, or buttocks Transmission: ◦ Causative Agent: Sarcoptes scabiei var. hominis, the human itch mite ◦ Incubation Period: 4-6 weeks ◦ Transmission: Contact Scabies Scabies Prevention: Avoid contact with infected individuals or with items such as clothing or bedding used by an infested person Treatment: Scabicides, only available by prescription. All members of a household should be treated Measles (Rubeola) Measles (Rubeola) Symptoms: Blotchy rash, fever, cough, runny nose, “run down” feeling Transmission ◦ Causative Agent: Measles virus ◦ Incubation Period: 7-14 days ◦ Transmission: Airborne, 4 days before symptoms Measles (Rubeola) Prevention: Vaccination! First dose 12-15 months, second dose 4-6 years Treatment: Many cases will receive symptom care at home. Severe cases may require hospitalization. Rubella (German Measles) Rubella (German Measles) Symptoms: Rash and fever, disease is relatively mild (significant risk to infant if transmitted to pregnant women) Transmission ◦ Causative Agent: Rubella Virus ◦ Incubation Period: 14-21 days ◦ Transmission: Droplet Rubella (German Measles) Prevention: Vaccination! First dose 12-15 months, second dose 4-6 years Treatment: Symptom relief Ring Worm Ring Worm Symptoms: Round, red, itchy area with clear center. Hair loss may occur. Transmission ◦ Causative Agent: Dermatophytes ◦ Incubation Period: 4-14 days ◦ Transmission: Contact with infected persons or animals. Clothing, bedding and towels can also spread the infection. Ring Worm Prevention: Good hand hygiene, avoid sharing items like hair brushes, hats and clothing that have touched affected areas Treatment: Topical anti-fungals Fifth Disease Fifth Disease Symptoms: “Slapped Cheek” rash, rash on trunk and arms/legs, mild fever Transmission ◦ Causative agent: Parvovirus B19 ◦ Incubation Period: 4-14 days ◦ Transmission: Droplet Fifth Disease Prevention: Hand hygiene and cough etiquette (cover your cough) are the best methods for preventing infection. Treatment: There is no specific treatment for Fifth disease. The rash and fever will go away after a couple days. Risk to infant for pregnant women. Impetigo Impetigo Symptoms: Small yellow blisters or scabs, often on the face and other frequently touched skin surfaces Transmission ◦ Causative Agents: Group A Streptococcus, Staphylococcus ◦ Incubation Period: 1-3 days ◦ Transmission: Direct contact with infected sores Impetigo Prevention: Hand hygiene and cough etiquette (cover your cough) Treatment: Antibiotics are available by prescription Respiratory Diseases Influenza Common Cold Tuberculosis Pertussis RSV Influenza Influenza Symptoms: Fever, cough, sore throat, body aches, runny nose, headache Transmission ◦ Causative Agent: Influenza virus ◦ Incubation Period: 2-4 days ◦ Transmission: Droplet Influenza Prevention: Vaccination! One shot or nasal mist per year (after initial 2 doses). Check with your physician for age limits. Treatment: Symptom management. Severe cases may receive antivirals. Common Cold Common Cold Symptoms: Runny nose, nasal congestion, sneezing, itchy eyes, mild headache and body ache Transmission ◦ Causative Agent: Rhinovirus ◦ Incubation Period: 2-5 days ◦ Transmission: Droplet Common Cold Prevention: Hand hygiene and cough etiquette (cover your cough). Avoid contact with people who have upper respiratory infections. Treatment: Symptom management Tuberculosis (TB) Tuberculosis (TB) Symptoms: Bloody cough, fever, chills, night sweats, weight loss Transmission ◦ Causative Agent: Mycobacterium tuberculosis ◦ Incubation Period: Months to years ◦ Transmission: Airborne Tuberculosis (TB) Prevention: Avoid contact with high-risk populations or infected individuals. (Vaccine is available, but not used in the U.S.) Treatment: Antibiotics. Treatment lasts for 4-9 months. Pertussis (Whooping Cough) Pertussis (Whooping Cough) Symptoms: Begins like common old, but severe coughing begins 1-2 weeks later. Transmission ◦ Causative Agent: Bordetella pertussis ◦ Incubation Period: 7-10 days ◦ Transmission: Droplet Pertussis (Whooping Cough) Prevention: DTaP vaccine. Children should get 5 doses of DTaP, one dose at each of the following ages: 2, 4, 6, and 15-18 months and 4-6 years Treatment: Antibiotics Risk: Severe disease can result RSV RSV Symptoms: Similar to common cold, “wheezing” during breathing Transmission ◦ Causative Agent: Respiratory Syncytial Virus ◦ Incubation Period: 4-6 days ◦ Transmission: Droplet, Contact RSV Prevention: Hand Hygiene, Cough Etiquette (cover your cough). Medication is available to prevent severe illness in high risk infants. Treatment: Symptom management Blood Borne Diseases HIV/AIDS Hepatitis B Hepatitis C HIV/AIDS HIV/AIDS Symptoms: Early symptoms are vague and flu-like. Later symptoms include chronic infections, purplish lesions, weight loss and extreme fatigue. Transmission ◦ Causative Agent: Human Immunodeficiency virus ◦ Incubation Period: HIV: 2-4 weeks AIDS: 2 weeks-20 years ◦ Transmission: Mother to child during birth HIV/AIDS Prevention: Avoid high-risk behaviors such as IV drug use and unprotected sex Treatment: Antiretroviral for mom and baby Hepatitis B Hepatitis B/C Symptoms: Most children are asymptomatic, some may have jaundice Transmission ◦ Causative Agent: Hepatitis Virus B/C ◦ Incubation Period: Hep B: approx. 90 days Hep C: 1-3 months ◦ Transmission: Mother to child Hepatitis B/C Prevention: Hep B:Vaccination, 3 doses given 1 and 6 months apart Hep C: Avoiding high risk behaviors such as IV drug use and unprotected sex Treatment: There is no treatment for acute infection. Chronic infection can be managed with antivirals. Diarrhea Bacterial Viral Diarrhea Symptoms: Abdominal cramps, loose watery stool Transmission: ◦ Causative agent: Bacteria and viruses ◦ Incubation period: Hours to weeks ◦ Transmission: Mostly fecal-oral Diarrhea Prevention: Avoid contaminated water (swimming pools), use good hand hygiene and proper food handling. Vaccine available for Rotavirus. Treatment: Antibiotics or anti-parasitics for severe cases Important Bacteria Salmonella, Shigella and Campylobacter, E. coli ◦ Found mainly on contaminated meats ◦ Can be avoided by thorough cooking Staphylococcus spp. ◦ Found mainly in contaminated “hand made” dishes ◦ Can be avoided with proper hand hygiene and refrigeration Important Viruses Rotavirus, Norovirus, Adenovirus, Hepatitis A All are spread by the fecal-oral route, adenovirus can also be spread by the droplet Other Diseases Strep/Scarlet Fever Meningitis Mumps Lice Conjunctivitis Mononucleosis Otitis Media Strep/Scarlet Fever Strep/Scarlet Fever Symptoms: Red rash, fever, sore throat, swollen glands. The tongue may have a "strawberry"-like appearance , a whitish coating and appear swollen Transmission ◦ Causative Agent: Streptococcus group A ◦ Incubation Period: 1- 3 days ◦ Transmission: Contact and Droplet Strep/Scarlet Fever Prevention: Hand Hygiene, avoid sharing utensils with sick individuals Treatment: Antibiotics Meningitis Meningitis Symptoms: Fever, headache, stiff neck, rash in severe cases Transmission ◦ Causative Agent: Viral – Enterovirus, Measles, Mumps, Chickenpox Bacterial – N. meningitidis, S. pneumoniae, H influenzae, Group B Strep ◦ Incubation Period: 3-7 days ◦ Transmission: Droplet and Contact Meningitis Prevention: Vaccination is available for N. meningitidis, S. pneumoniae and H. influenzae, Measles, Mumps, and Chickenpox Treatment: Antibiotics are available for bacterial infections Mumps Mumps Symptoms: Fever, headaches, muscle aches, swollen glands under the ears or jaw Transmission ◦ Causative Agent: Myxovirus parotiditis ◦ Incubation Period: 16-18 days ◦ Transmission: Droplet/contact Mumps Prevention: Vaccination! First dose 12-15 months, second dose 4-6 years; Respiratory Etiquette; Hand Hygiene. Treatment: Symptom Management Lice Lice Symptoms: Itching or tickling sensation on the scalp, especially when trying to sleep. Transmission ◦ Causative Agent: Pediculus capitis ◦ Incubation Period: 4-6 weeks ◦ Transmission: Contact Lice Prevention: Avoid sharing hats, clothing, bedding or hair accessories among children. Wash sheets/linen often. Treatment: Over the counter shampoos that kill lice. Prescription treatments are available if over the counter treatments are not effective. Conjunctivitis Conjunctivitis Symptoms: Red itchy eyes, drainage Transmission ◦ Causative Agent: Several Bacteria and Viruses ◦ Incubation Period: 2 -10 days ◦ Transmission: Contact Conjunctivitis Prevention: Hand Hygiene. Avoid contact with infected individuals Treatment: Antibiotic drops or ointment for bacterial infections. Symptom management for viral infections Mononucleosis Mononucleosis Symptoms: Fever, sore throat, and swollen lymph glands Transmission ◦ Causative Agent: Epstein-Barr Virus ◦ Incubation Period: 4-7 weeks ◦ Transmission: Contact with saliva Mononucleosis Prevention: Hand hygiene. Avoid sharing drinks, utensils, and lip makeup with others Treatment: Symptom management Otitis Media (Ear Infections) Otitis Media (Ear Infections) Symptoms: Pain, pus draining from ear, redness of ear drums, irritability, pulling on the ear Transmission ◦ Causative Agent: A variety of Bacteria/Viruses ◦ Incubation Period: 4-7 days ◦ Transmission: Typically occurs after an upper respiratory infection Otitis Media (Ear Infections) Prevention: Keep up to date on immunizations, avoid second hand smoke and heavy air pollution Treatment: Antibiotics may be given. Symptoms may be managed with over the counter pain medication Questions?