Transcript Lect.05 - Infectious Diseases in Children. Immunization

INFECTIOUS DISEASES
Lecture 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
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



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!
“Slapped Cheek” rash
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
FIFTH DISEASE

PREVENTION
– Good handwashing is the best defense against
the virus
– Universal substance precautions

NOTE: THERE IS CURRENTLY NO
VACCINE AVAILABLE
PERTUSSIS

CAUSE:
– Caused by a bacteria known as
Bordetella pertussis
– Highly contagious

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





Pneumonia
Apnea
Dehydration, weight loss
Atelectasis
Seizures
PERTUSSIS
DIAGNOSIS

A nasopharyngeal swab is used to
test for the B. pertussis bacteria
TREATMENT

Erythromycin
PREVENTION

Vaccination
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
INFECTIOUS
MONONUCLEOSIS
TRANSMISSION

Transmitted through affected saliva. Also known
as the ”kissing disease”
SYMPTOMS





High fever
Splenomegaly
Lymphadenopathy
Fatigue
Hepatosplenomegaly

Infectious monomucleosis
INFECTIOUS
MONONUCLEOSIS
DIAGNOSIS
 A blood test is required to confirm the
diagnosis (Monospot)
 CBC usually shows atypical lymphocytes
COMPLICATIONS
 Splenic rupture
 Guillain-Barre
INFECTIOUS
MONONUCLEOSIS
TREATMENT
 Currently no medication to treat the disease
 Treatment typically palliative - treat the
symptoms
PREVENTION
 There is no vaccine currently available
 Best defense is to avoid direct exposure to
anyone with symptoms. Always maintain
good handwashing
SCARLET FEVER
CAUSE
 Usually caused by group A
streptococcus
SYMPTOMS
 Fever, pharyngitis, “sandpaper” rash
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
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
SCARLET FEVER
COMPLICATIONS
 Rheumatic Fever
 Glomerulonephritis
PREVENTION
 Avoid close contact or sharing of utensils
with anyone who is symptomatic. Always
maintain good handwashing
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.
RESPIRATORY SYNCYTIAL
VIRUS
SYMPTOMS





Wheezing
Tachypnea
Retractions
Nasal flaring
Atelectasis
RESPIRATORY SYNCTIAL
VIRUS
COMPLICATIONS
 Hypoxia
 Dehydration
 Respiratory
failure
RESPIRATORY SYNCYTIAL
VIRUS
TREATMENT




Oxygen
Fluid balance
Tylenol
Albuterol nebulizer or
oral medication
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.
Pediculosis
DIAGNOSIS
A diagnosis is made when one or
more live lice are found on the
student.
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.
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.
IMPETIGO
TREATMENT

Impetigo is usually treated with
oral antibiotics such as
dicloxacillin.

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
Good handwashing
 No sharing of personal hair
products
 Checking pets for signs and
symptoms of ringworm

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.
MENINGITIS
SYMPTOMS






High fever
Headache
Stiff neck
Nausea, vomiting
Photophobia
Lethargy
MENINGITIS
TREATMENT


Hospitalization
IV antibiotics are the treatment of
choice for bacterial meningitis

Koplik spots
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.
ANY QUESTIONS??