University of Perpetual Help System Laguna

Dr. Jose G. Tamayo Medical University

College of Nursing

Presented by: JESSALYN F. NOLIAL

GROUP 30

Submitted to: Sir Romeo Belen Villanueva

Clinical Instructor
Understanding and Managing Infectious
and Communicable Disease
 COMMON
TERMS
RELATED TO
INFECTION:
1. Infection -Is the implantation and
successful replication of an organism in the
tissue of the host, resulting in signs and
symptoms, as well as immunologic response

2. A carrier -is an individual who harbors the

organism and is capable of transmitting it to a
susceptible host but does not show
manifestations of the disease
3. A communicable disease is an illness caused
by an infectious agent or its toxic products that
are transmitted directly or indirectly to a well
person through an agent, vector or inanimate
object

4. A contact is any person or animal that is in

close association with an infected person,
animal, or freshly soiled materials

5. A contagious disease is one that is easily

transmitted from one person to another through
6. Disinfection is the destruction of pathogenic microorganisms
outside the body through direct physical or chemical means.

a. concurrent disinfection id a method done immediately

after the infected individual discharges infectious materials/
secretions, i.e., it is done while the patient  is still the source of
infection.

b. terminal disinfection is applied when the patient is no

longer the source of infection (either because the patient has
died or has been discharged). Everything the patient had used,
including the room he/ she occupied, is disinfected.
7. A habitat is a place where an organism lives or where
an organism is usually found.
8. A host is a person, animal, or plant on which a
parasite depends for its survival.

9. An infectious disease is transmitted not only

through ordinary contact but also requires direct
inoculation of the organism through a break on
the skin or mucous membrane. hence, all
contagious are infectious.

10. Isolation is the separation from other

persons of an individual suffering from a
communicable disease.
 11. Quarantine is the limitation of the freedom of
movement of persons or animal which have been
exposed to a communicable disease/s from a period
of time equivalent to the longest incubation period
of that disease.

12. A reservoir is an animal or plant in which an

infectious agent lives and reproduces in such a
manner that it can be transmitted to man.

13. Surveillance it the act of watching.

 
What is infection?
Infection is the invasion and multiplication
of microorganisms in the tissues of the host,
resulting in signs and symptoms, as well as
immunologic response. the production of
microorganisms injures the patient by:

1. competing with the host's metabolism,

2. cellular damage produced by the microbes,
or
3. intracellular multiplication.
Sporadic diseases are diseases that
occur occasionally and irregularly with
no specific pattern. (Example: tetanus,
gas gangrene)

A pandemic is an epidemic that affects

several countries or continents. Current
examples are HIV/AIDS, SARS, and
Influenza AH1N1.
Epidemic diseases are diseases that
occur in a greater number than what
is expected in a specific area over a
specific time

Endemic diseases are present in a

population or community at times.
They usually involve few people
during specific periods
 
WHY
INFECTION
OCCUR?
There are various complex reasons why the microbes that
cause infectious diseases are so difficult to overcome.

1. Some bacteria develop resistance to antibiotics.

2. Some microbes such as influenza viruses have so many

different strains that a single vaccine cannot protect against
all of them.

3. New infectious agents occasionally arise. Examples

include HIV and coronaviruses.

4. Some microbes localize in areas of the body (e.g.,

bones, central nervous system), which makes treatment
5. Opportunistic organisms can cause infection
in immuno-compromised patients.

6. Most people have not received immunization

7. Biologic warfare and bioterrorism using

organisms such as anthrax and plaque is an
increasing threat to public health and safety
throughout the world.

8. The expanded use of immunosuppressive

drugs and invasive procedures increases the risk
of infection.
NURSING CARE
The nursing of patients with communicable
diseases involves the ff:

1. self-protection;

2. prevention of the spread of the infectious

agent through medical asepsis and concurrent
disinfections;

3. physical care of the patient; 

4. emotional support of the patient; and

CHAIN OF INFECTION
[Link] causative agent is any
microbe capable of
producing disease.
KINDS OF CAUSATIVE AGENT

[Link] are simple, one-celled microbes with

double cell membranes that protect them from
harm. They reproduce rapidly and are
considered as the most common cause of fatal
infectious diseases.

2. A spirochete is a bacterium with flexible,

slender, undulating spiral rods that possess cell
wall. There are three forms of spirochete that
cause a disease:
a. Treponema
3. Viruses are the smallest known microbes. They
cannot replicate independently of the host's cells;
rather, they invade and stimulate the host's cells to
participate in the formation of additional viruses.

4. Rickettsiae are small, Gram (-), bacteria-like

microbes that can induce life-threatening infections.
Like viruses, they require a host cell for replication.
They are usually transmitted through the bite of
arthropod carriers like lice, fleas, ticks, as well as their
waste products. The rickettsial diseases are:

a. Rocky Mountain spotted fever

b. typhus fever; and
c. Q fever
5. Chlamydiae are smaller than rickettsiae but
larger than viruses. These are the common
cause of infection in the urethra, bladder,
fallopian tubes, and prostate glands. The most
common chlamydial infection is transmitted
through sexual contact.

6. Fungi are found almost everywhere on

earth. They live in organic matter, soil, water,
animals, and plants. They thrive either inside
or outside the body and may be harmful or
beneficial. Fungi are beneficial in the
manufacturing of cheese, yogurt, beer, wine,
7. Protozoa are much larger than bacteria. They
are the simplest single-celled organisms of the
animal kingdom. Parasitic protozoa absorb
nutrients from the body of the host.

8. Parasites live on or inside other organisms

(called “hosts”) at the expense of these
organisms. They don’t usually kill their host but
take only nutrients they need.
B. Reservoir of infection
refers to the environment and
objects on which an organism
survives and multiplies. The
following are reservoirs of
infection:
1. Human reservoir
a. Frank cases or the very ill
b. Sub-clinical or ambulatory
c. Carriers

An incubatory carrier is a person who is incubating the

illness.

A convalescent carrier is a person who is at the recovery

stage of illness but continues to shed the pathogenic
organism.

An intermittent carrier is a person who occasionally sheds

the pathogenic organism.

A chronic or sustained carrier is a person who always has

the infectious organism in his or her system.
 C. The portal of exit is the path or
way through which the organism
leaves the reservoir. Usually, this is
where the organism grows.
Common Portal of Exit:

Respiratory system,

Genitourinary tract (GUT),

Gastrointestinal tract (GIT),

Skin and mucous membranes, and

Placenta (in transplacental

D. Mode of transmission is
the means by which the
infectious agent passes
through from the portal of
exit of the reservoir to the
susceptible host. This is
the easiest link to break the
chain of infection.
There are four modes by which the infectious agents
can be transmitted:
1. Contact transmission is the most common
mode of transmission. There are three types:
a. Direct contact refers to a person-to-
person transfer of organism.
b. Indirect contact refers occurs when the
susceptible person comes in contact with a
contaminated object.
c. Droplet spread is transmission through
contact with respiratory secretions when the infected
person coughs, sneezes, or talks.
2. Air-borne transmission occurs when fine microbial
particles or dust particles containing microbes remain
suspended in the air for a prolonged period. The
infectious disease is spread by air current and is
inhaled by a susceptible host.
 
3. Vehicle transmission is the transmission of
infectious disease through articles or substances that
harbor the organism until it is ingested by or
inoculated into the host.
 
4. Vector-borne transmission occurs when
intermediate carriers, such as fleas, flies, and
E. A portal of entry is a venue
through which the organism
gains entrance into the
susceptible host. The infective
microbes use the same avenues
when they exit from the
reservoir.
 
 F. Susceptible host- the human
body has many defenses against
the entry and multiplication of
organisms. When the defenses are
good, no infection takes place.
However, in a weakened host,
microbes launch an infectious
disease.
 
INFECTION CONTROL
MEASURES
GENERAL

Universal precaution shall be

observed to prevent contact with
blood and other potential infectious
materials. Universal precaution
means that all patients shall be
assumed infected with HIV/ AIDS
and other blood-borne pathogens.
This refers to the practice in medicine
of:

1. Avoiding contact with the patient’s

bodily fluids by means of wearing non-
porous articles such as medical gloves,
goggles, and face shields.

2. Medical instruments, especially

scalpel and hypodermic needles, should
be handled carefully and disposed of
3. Proper handwashing.

4. Considering all patients

infectious.
 
Universal precautions should be practiced in
any environment where workers are exposed
to bodily fluids, such as:

Blood
Semen
Vaginal secretions
Synovial fluids
Cerebrospinal fluids
Pleural fluids
Peritoneal fluids
Pericardial fluids
Bodily fluids that do not require such
precautions include:

Feces
Nasal secretions
Urine
Vomitus
Sweats
Sputum
Saliva if not contaminated with blood)
 
Engineering and Work
Practice Control
1. Employees shall wash their hands
immediately as soon as possible after removal
of gloves or other personal protective
equipment and after hand contact with blood
or other potentially infectious materials.

2. All protective equipments shall be remove

immediately upon leaving the work are or as
soon as possible if overtly contaminated and
place in an appropriately designated area, or
container for storage, washing,
decontamination or disposal.
3. Used needles and other sharps shall not
be sheared, bent, broken, recapped, or re-
sheathed by hands.

4. Eating, drinking, smoking, applying

cosmetics or lip balm or handling contact
lenses are prohibited in work areas where
there is potential for occupational exposure.
5. Foods, drinks shall not be stored in
refrigerators, freezers, or cabinets where blood
or other potentially infectious materials are
stored or in other areas of possible
contamination.

6. All procedures involving blood or other

potentially infectious materials shall be
performed in such so as to minimize splashing
these substances.

7. Mouth pipetting or suctioning is prohibited.

Suggested Control Measures for
Primary Care Clinics
Masking
All staff members should wear masks.
Patients with respiratory problems
should be asked to wear masks.

Handwashing
Practice proper handwashing with soap
and water.
Wash hands before and after contact
removing gloves.
Gloving
Wear gloves for all direct contact with
patients
Change gloves and wash hands after
contact with patients

Gowning

Eye protection (goggles)

Environmental disinfection
LEVELS OF PREVENTIVE CA
Primary Prevention
Providing specific protection against disease
to prevent its occurrence is the most
desirable form of prevention. Primary
preventive efforts spare the client the cost,
discomfort and the threat to the quality of
life that illness poses or at least delay the
onset of illness. Preventive measures consist
of counseling, education and adoption of
specific health practices or changes in
lifestyle.
Secondary Prevention

It consist of organized, direct screening efforts or

education of the public to promote early case
finding of an individual with disease so that prompt
intervention can be instituted to halt pathologic
processes and limit disability. Early diagnosis of
a health problem can decrease the catastrophic
effects that might otherwise result for the
individual and the family from advanced illness
and its many complications.
Tertiary Prevention

It begins early in the period of recovery from

illness and consists of such activities as
consistent and appropriate administration of
medications to optimize therapeutic effects,
moving and positioning to prevent complications
of immobility and passive and active exercise to
prevent disability. Continuing health supervision
during rehabilitation to restore an individual to an
optimal level of functioning. Minimizing residual
disability and helping the client learn to live
productively with limitations are the goals of
ISOLATIO
N
Isolation is the separation of patients with
communicable diseases from others so as to
prevent or reduce transmission of infectious
agents directly or indirectly.

It also refers to the precautions taken in

hospitals to prevent the spread of an
infectious agent from an infected or
colonized patient to susceptible persons.
Purpose of
Isolation
a. Placement of a patient in a private room or
with a select roommate.
b. The use of protective barriers such as
mask, gowns and gloves;
c. A special emphasis on handwashing
(which is always important);
d. Special handling of contaminated articles.
e. Due to differences among infectious
diseases, more than one of these precautions
may be necessary to prevent the spread of
some diseases but may not be necessary for
others.
SEVEN (7) CATEGORIES
RECOMMENDED IN
ISOLATION
1. Strict isolation- to prevent highly contagious
or virulent infections.
  a. Wash hands after every contact with the
patient or potentially contaminated articles and
before taking care of another patient.
  b. Articles contaminated with infectious
materials should be appropriately discarded or
bagged and labeled before they are sent fro
decontamination and processing.
  c. The healthcare worker or nurse may use a
private room.
  d. Use of mask, gowns, and gloves is a must.
  e. Negative pressure to surrounding areas is
2. Contact isolation- to prevent
infections that are spread primarily
 by close or direct contact.
 
3. Respiratory isolation- to prevent
transmission of infectious diseases
over short distances through the air.
 
4. TB isolation- for TB patients with
positive smears or with chest x-rays
which strongly suggest active
tuberculosis.
 
5. Enteric isolation- for infections that
are  spread through direct contact with
feces.
6. Drainage/secretions precaution- to prevent
infections that are transmitted by direct or
indirect contact with purulent materials or
drainage from an infected body site.
 
7. Universal precaution is applied when handling
blood and body fluids. 
 a. This precaution is applied to patients with
HIV/HBC.
 b. It is intended to prevent parenteral, mucous
membrane, and non-intact skin exposure of
healthcare workers to blood-borne pathogens.
 
Expanded Program for
Immunization (EPI)
Immunization is the process by which an
individual's immune system becomes fortified
against an agent (known as the immunogen).

The standard routine immunization schedule for

infants in the Philippines is adopted to provide
maximum immunity against the seven vaccine
preventable diseases in the country before the
child's first birthday. The fully immunized child
must have completed BCG 1, DPT 1, DPT 2,
DPT 3, OPV 1, OPV 2, OPV 3, HB 1, HB 2, HB
3 and measles vaccines before the child is 12
months of age
Vaccine Minimum No. Dose Minimum Route Site
Ageat 1st of Interval
Dose Doses Between Doses

Bacillus Birth or 1 0.05 mL -- Intraderm Right deltoid

Calmette- anytime al region of the
Guérin after birth arm

Diphtheri 6 weeks 3 0.5 mL 4 weeks Intramusc Upper outer

a- ular portion of
Pertussis- the thigh
Tetanus
Vaccine
Oral Polio 6 weeks 3 2-3 drops 4 weeks Oral Mouth
Vaccine
Hepatitis At birth 3 0.5 mL 6 weeks interval Intramusc Upper outer
B Vaccine from1st dose to ular portion of
2nd dose,8 the thigh
weeks interval
from2nd dose to
third dose.
Measles 9 months 1 0.5 mL -- Subcutane Upper outer
Vaccine ous portion of
the arms
TYPES OF IMMUNITY
•Natural active: Occurs during infection. It is active
because lymphocytes are activated by antigens on
pathogen's surface.

•Artificial active: Injecting or taking antigens by mouth.

Takes time for T and B cells to be activated but gives
long lasting immunity.

•Natural passive: Mother to child through placenta or

milk.

•Artificial passive: Used during potentially fatal

diseases. Provides an instant response but only
temporary as antibodies are not the body's own so
Severe Acute
Respiratory Syndrome
(SARS)
 Severe acute respiratory
syndrome (SARS) is a viral respiratory
illness caused by a coronavirus, called
SARS-associated coronavirus (SARS-
CoV). SARS was first reported in Asia in
February 2003.

Over the next few months, the illness

spread to more than two dozen countries
in North America, South America,
Europe, and Asia before the SARS global
outbreak of 2003 was contained.
Mode of Transmission:

1. The primary mode of transmission appears to be

direct mucous membrane (eye, nose, and mouth)
2. Contact with infectious respiratory droplets and/or
through exposure to fomites.
3. Transmission through casual and social contacts has
occasionally occurred as a result of intense exposure to
a case of SARS (in work place, in vehicles) or in high
risk transmission settings, such as health care settings,
and in household settings.
4. Contamination of inanimate materials or objects by
infectious respiratory secretions or body fluids (saliva,
tears, urine, and stool) which have been found to
contain the virus.
Signs and symptoms of SARS
 
1. Sudden onset of high grade fever, usually
greater than 38ºC

2. Headache and overall feeling of

discomfort and body aches

3. Mild respiratory symptoms at the start and

after two days, the patient develops dry
cough and have respiratory difficulty.
Preventive Measures:

1. Consult a doctor promptly if there are

respiratory symptoms such as fever, malaise,
chills, headache, joint pain, dizziness, rigors,
cough, sore throat and runny nose.
Early treatment is the KEY.
2. Build up good body immunity. This means
taking proper diet, having regular exercise and
adequate rest, reducing stress, and avoiding
smoking.
3. Maintain good personal hygiene. Cover nose
and mouth when sneezing or coughing.
4. Wear mask if you develop runny nose, sore
throat and cough.

5. Wear protective mask in public areas,

classrooms, computer rooms, public transports,
and communal areas in hostels.

6. Wash hands properly and keep them clean.

Use liquid soap for hand washing and
disposable towels for drying hands.
 END
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