Communicable Disease Nursing.docx

- all patients in hospitals

COMMUNICABLE DISEASE NURSING 

Disinfection Concurrent - person is still the source of infection Terminal- when the person is discharged/ dies

Transmission - Based - individuals with suspected infection

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Types of Antigen Inactivated - stored in room temperature; booster; not long lasting Attenuated - stored in cold temperature; single dose

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Infection Competes with metabolism

GASTROINTESTINAL

Cellular damage Intracellular multiplication

I. AMOEBIASIS Causes: Entamoeba hystolytica

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Patterns of Distribution Sporadic- occasional Epidemic- increase in expected cases; place

IP: 3 days (severe) 3-4 wks (onset is gradual) MOT:

Pandemic- global Endemic- at all times Outbreak- time & place; diseases not widely known

Fecal-Oral ( Uncooked leafy vegetables) Sexual (orogenital, oroanal, proctogenital)

S/Sx: Foul-smelling, mucus-streaked watery stool with tenesmus (diff. defecating), Colic, flatulence,tenderness over right iliac, Amoebic Liver Abscess Dx: Stool Exam, Proctoscopy/ Sigmoidoscopy

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Stages of Infection Incubation - period between entry of organism & appearance of 1st S/Sx (vague)

Mgt: Metronidazole (Flagyl) 800 mg TID x 5 days Keep warm, replace fluids, enteric precaution, pressure sore prevention, mouth care

Prodromal - appearance of 1st S/Sx to appearance of hallmark signs

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Acute - manifestations are highly pronounced; most ill period

II. ASCARIASIS (ROUNDWORM)

Convalescence - recovery

MOT:

Infection Control Measures

S/Sx: Periumbilical/ RUQ Pain aggravated by cold stimulation (Nakamura sign), vomiting, cough

Universal - in all environments - considers all patients infectious - avoiding contact to bodily fluids - sharps are carefully handled Standard

Causes: Ascaris lumbricoides Fecal-Oral ( contaminated fingers placed in mouth )

Dx: Stool Exam, (Kato Katz Technique), Abdominal x-ray (“dot” sign) Mgt: Albendazole/ Mebendazole (15cc), Piperazine, Pyrantel pamoate Source: night soil/ contaminated water Affects: Children 4-12 yrs (school age) Developmental Stages:

- Embryonated ova

Mgt: Tetracycline, Replace fluids (IV, Oresol)

- Larval Stage - Adult stage (copulates in 2-3 mos. after ova stage)

III. HOOKWORM

VI. THYPOID FEVER

(Ancyclostomiasis/ Miner’s Disease/ Egyptian Chlorosis)

Causes: Salmonela typhosa

Causes: Ancylostoma duodenale, Nector americanus IP: 40-100 days/ 2-8 weeks MOT: Direct Contact (barefoot), contaminated water/ food S/Sx: Anemia, Abdominal pain, Diarrhea, Protruding abdomen

IP: 5-40 days MOT:

Fecal-Oral ( stool/vomitus)

S/Sx: Onset- Diarrhea, Fever(↑ in AM), Rose abdominal spots Thyphoid stage- Tongue dry and brown, Sordes, Coma vigil (starring balnkly Thypoid Psychosis), Thypoid spina

Dx: Stool Exam, Blood Test reveal eosinophilia

Dx: Typhidot (blood specimen)

Mgt: Pyrantel embonate (Quantel), ↑ caloric diet

Mgt: Chloramphemic of Ampicillin, Co-trimoxazole, replace fluids (SFF), prevent further injury

Source: Soil (oxygen rich) Affects: Young adults (15-25 yrs)

VII. SCHISTOSMIASIS IV. BACILLARY DYSENTERY Causes: Shigella flexneri (common in Phils.), Shigella boydii, Shigella connei, Shigella dysenteriae (most infectious)

Causes: Schistosoma japonicum, Schistosoma masnoni, Schistosoma haematobium, Oncomeiania Quadrasi IP: 2 months Source: Feces

IP: hours-days

MOT: Ingestion of contaminated water, thru skin pores

MOT:

S/Sx: Swimmer’s itch, Bloody diarrhea, Hepatomegaly, Spleenomegaly, Lymphadenopathy, Jaundice, Abdominal distention, Dizziness, Convulsions

Fecal-Oral (contaminated water/ milk)

Vector: flies S/Sx: Diarrhea with bloody-mucoid stools, Fever (esp. Children), Tenesmus, Colic, Rectal Prolapse Dx: Stool Exam, Rectal/ blood culture Mgt: Ampicillin, Tetracycline, Cotrimoxazole, replace fluids

Dx: Circumoval Precipitin Test (COPT), Fecalysis (Kato Katz) Mgt: Praziquantel tab x 6 months (1 tab BID a day for 3 mos., 1 tab OD for next 3 mos.)

SKIN V. CHOLERA Causes: Vibrio cholera, Vibrio coma IP: 1-3 days MOT: Fecal-Oral S/Sx: Rice-watery stools, usually no intestinal cramping or tenesmus, Washerwoman’s hands Dx: Stool Exam, (darkfield or phase microscopy), Rectal swabbing

I. ANTHRAX Causes: Bacillus anthracis Types: Cutaneous, Inhalation, GI MOT: Direct (ingestion of inadequacy cooked meat), Indirect, Airborne

S/Sx: Fever, Lymphadenopathy, Edema, Dyspnea/ stridor, Abdominal pain, Ascitis, More severe if lesions appear in face or chest; Anthrax meningitis, Anthrax sepsis

S/Sx: Post auricular, posterior cervical lymphadenopathy, photophobia, Forcheimer’s spot Mgt: Isolation, darken room, Fluids, Caution pregnant women

Dx: Blood culture Mgt: Penicilin G 2M units q6 (IV then PO for 7-10 days) Source: animals, vegetation

V. HERPES SIMPLEX (Virus of Love) Causes: Varicella zoster Types: 1 - not sexually transmitted, infancy & childhood; sharing of utensils

II. CHICKEN POX/ VARICELLA Causes: Herpes virus 3 ( Varicella zoster virus) IP: 10-21 days 2-7 days MOT: Direct, Indirect, Airborne S/Sx: Fever, Maculo-papularvesicular rash (torso first) Dx: Compliment fixation test, Microscopic examination of vesicular fluid Mgt: Acyclovir 800 mg TID x 5days, Antihistamine, Calamine lotion, Antipyretic, Respiratory Isolation (1wk exclusion from school), Disinfect linens (under sunlight or thru boiling), Short fingernails, Immunization (live attenuated vaccine)

2 - sexual xcontact; genital MOT: Direct, Indirect, Droplet, Airborne S/Sx: Vesicular lesions confined in a dermatode (commonly at the thoracic segment) [Always unilateral- does not cross the body], Neurologic pain Dx: Tissue culture/ smear Mgt: Symptomatic, same with chicken pox

VI. SCABIES Causes: Sarcoptes scabie @ interdigital spaces, warm folds in skin, axillae, crotch MOT: Direct, Indirect (wearing/ lying in infested clothing)

III. MEASLES Causes: Measels virus IP: 10-12 days (ave. 7 days)

S/Sx: Pruritus (night), Papules Dx: Microscopy

MOT: Direct, Indirect

Mgt: Pediculicide (permethrin cream). Kwell, antihistamin, Apply at HS, Properly laundry lines

S/Sx: Fever, Catarrhal Sx, Koplik’s spots, Maculo-papular rash (from periphery tonsillitis)

FUNGAL INFECTIONS

Dx: Nose and throat swab, Complement fixation/ Hemoglutinin Test Mgt: Isoprinosine (antiviral), Supportive therapy, Isolation

A. TINEA FLAVA (Tinea alba/ tinea

versicolor)

MOT: Direct S/Sx: Hypo/hyper pigmentation on the skin usually in back or chest, Pruritus

IV. GERMAN MEASLES (Rubella/ 3- day Measles)

DX: Microscopy Mgt: Micoconazole, Benzoyl, peroxide

Causes: Rubivirus IP: 14-21 days MOT: Direct, Droplet, Transplacental (congenital rubella)

B. BARBER’S ITCH

Causes: Trichophyton mentogrophyt (cattle), Trichophyton verrucasum (horses) MOT: Direct contact with cattle, Person-to- person (shavers)

BLOOD

I. DENGUE FEVER

S/Sx: Erythema, Perifollicular papules, Brittleness of hair in bearded areas of males, Crusting around hair, Alopecia

Cause: Dengue virus 1,2,3,4 & Chikungunya

DX: Microscopy

Vector: Female Aedes Aegypti mosquito

Mgt: Griseofulvin, Ketoconazole, Fluconazole (systemic antifungals)

IP: 7-10 days

C. RING WORM (Trichophytosis) MOT: Direct S/Sx: Dry type - round macular areas of reddish color, elevated Moist type - secondary infection to dry type Mgt: Avoid sharing combs/ razors

D. ATHLETE’S FOOT S/Sx: Infection at groin and upper thighs Mgt: Wash feet daily, dry feet completely, Wear clean socks

(Breakbone fever, Hemorrhagic fever)

MOT: Bite of Female Aedes Aegypti mosquito S/Sx: Fever (39-40°C), Arthralgia, Flushed palms, (+)Torniquet Test, Petechial rash, Herman’s sign (bluish / purplish discoloration or blanching of the skin), Epistaxis/ gum bleeding, Cyanosis, Rapid pulse, ↓ temp, hypotension DX: Torniquet Test/ Rumpel Leads Test (presumptive), ↓Platelet count (confirmatory), Polymerase Chain Reaction Test, Occult blood Mgt: No antivirals, symptomatic tx, Fluid mgt, dim room, warm light-clothing covers, ice packs @ abdomen and forehead Classifications: - Grade 1: Fever + nonspecific s/sx (+) Tourniquet Test - Grade 2: Grade 1+ bleeding (nose, gums, GIT)

E. JOCK’S ITCH S/Sx: Infection at groin and upper thighs

- Grade 3: Circulatory failure (weak pulse, narrow pulse pressure, hypotension, cold clammy skin, SHOCK)

Mgt: Avoid sharing undergarments with infected individuals, Cotton underwear, Loose-fitting pants

- Grade 4: Profound shock (undetectable BP & pulse) Prevention:

GUT

C - chemically treated mosquito nets L - larvae -eating fish/ long sleeved clothing

I. LEPTOSPIROSIS

E - environmental sanitation

Cause: Leptospira Interrogans

A - anti-mosquito soap (Basil + Ditranelli)/ mosquito repellants (use of Diethyltoluamide toluence or “katol”)

Source: Urine MOT: Direct, Open-wound

N - neem tree/ eucalyptus

S/Sx: Catarrhal, Jaundice, Hepatic Dx: Blood Culture Mgt: Penicillin, Cotrimoxazole

4S’s: Search & destroy breeding places Secure self-protection

Seek early consultation Support spraying to prevent impending outbreak

or paralysis/ pain, nasal obstruction or bleeding, ulcers that do not heal Late - Madarosis (loss of eyebrows), Lagopthalmos (difficulty of closing the eyelids bec. Of contractures), Sinking of the nose Aedes Aegypti

Anopheles

II. MALARIA

Day biting

Night biting

Cause: Plasmodium, Vivrax, Falcifarum ( most common in Phils; most fatal), Malariae, Ovale

Low flying

High flying

Stagnant (clean)

Clean running

Urban/ Ulan

Rural

Vector: Female Anopheles mosquito IP: 10-12 days bridge, Gynecomastia

MOT: Contaminated Bt, needles & syringes S/Sx: Cold Stage - intermitent severe chills, anemia/ palllor, hapatomegaly Hot Stage - malaise, fever, easy fatigueability Wet Stage - diaphoresis, tea colored urine, stiff neck Dx: Malarial smear, Rapid Dx Test (RDT) [@night] Mgt: Quanine IM (major side effect : hypotension) Chloroquine (prophylaxis), Comefrantine, Antemether, Iron rich foods

Dx: Skin Slit Smear (not confirmatory; determines presence of mycobacterium), Lepromin Test (susceptibility to mycobacterium leprae) Blood: ↓serum Ca, albumin, ↑RBC and ESR Mgt: Domicillary treatmentm (RA 4073), MDT (Multiple Drug Treatment) Sulfone Therapy *If pt has TB & Leprosy, follow TB Rifampicin - Day 1: @ RHU (day 1 of every month x 6months) - Day 2-28: @ home MULTIPLE DRUG TREATMENT

Day 1

Paucibacillary

Multibacillary

Rifampicin 600mg

Rifampicin 600mg

Dapsone 100mg

Dapsone 100mg Clofazimine 300mg

Paucibacillary Noninfectious type

Infectious type

6 months

12 months

- Tuberculoid ≤ 5 lesions

- Lepromatous- all s/sx are present

- (-) SSS Day 2-28

Dapsone 100mg

Dapsone 100mg

-Borderline ≥6 or more lesions + paresthesia

Clofazimine 50mg Full course duration

Multibacillary

- (+) SSS

6 blister packs x 6 12 blister packs x 12 mos. mos. Rifampicin: reddish urine

NERVOUS SYSTEM I. LEPROSY Cause: Mycobacterium leprae IP: 5 mos - 8 yrs

Clofazimine: brownish flaking of skin, pruritus

II. RABIES (RA 9482) Cause: Rhabdo virus Source: blood, urine, saliva

MOT: Airborne, Droplet, Prolonged skin-to-skin contract

IP: 1wk-7mos (animals), 20-90 days (human)

S/Sx:

MOT: Bite of dog, Airborne (rare), Infected tissue transplant, Scratch in the Skin (rare)

Early - change in skin color, loss of sensation, no sweating & hair growth, muscle weakness

S/Sx: Invasive Stage - hydrophobia

IV. POLIOMYELITIS

Paralytic Stage - gradual, generalized flaccid paralysis, laryngospasm,

Cause: Legio debilitans, Polio virus

death

Source: Man is the only reservoir, nasopharyngeal secretions, feces

Dx: Brain biopsy of animal/ post mortem, Fluorescent Rabies Antibody Staining Test

IP: 1-7 days

Mgt: observe dog (10 days), anti-rabies vaccine, rabies Ig, quiet dim room, restrain when needed

S/Sx: Paralysis, muscular weakness, uncoordinated movements, Hoyne’s sign

RABIES VACCINATION - PCVC (Purified Vero Cell Vaccine) - 0.1 ml - PDEV (Purified Duck Embryo Vaccine) - 0.2 ml [reduce-multi-site IM] Sched

Site/ Route

Dose

Day 0

Deltoid IM

2 doses

Site of bite

(RV + Ig)

Deltoid IM

1 dose (RV)

Day 7,14,21 Day 28

MOT: Direct contact with secretions (Droplet), Fecal-oral

If dog is still alive

4 COMPONENTS OF NATIONAL RABIES PREVENTION AND CONTROL PROGRAM - Networking

Minor - A. Abortive (from mother, baby dies after 5 days) B. Non-Paralytic Major - A. Paralytic/ Spinal B.Bulbar (face/head) Dx: CSF analysis/ lumbar tap, fecalysis, throat swab of the pharynx, Pandy’s test Mgt: No specific tx Complications: Hypertension, Encephalitis, Respiratory Paralysis, Post-Polio Muscle Atrophy Syndrome Prevention: OPV immunization (live-sabin), IPV immunization (killed-salik), proper disposal of waste, frequent handwashing

- Manpower Development - Social Mobilization V. BOTULISM - Local Program Implementation Cause: Clostridium botulinum -Dog Immunization Type: Foodborne ( classical), Woumd botulism, Infant botulism III. TETANUS

MOT: Oral, Direct

Cause: Clostridium tetani

S/Sx: Flaccid paralysis ( bulbar musculature), symmetrical weakness, diplopia, ptosis, dysphagia, dysphagia, dysarthria, death

Source: Soil, street dust, animal (horses), human feces IP: 3 days- 1 month, 3-10 days (neonate)

Dx: Blood culture, Wound Culture

MOT: Break in skin integrity, IM injection, tattoo, burns, hx of tetanus, unvaccinated mothers, tooth decay, unhealed stumo of umbilical cord

Mgt: Supportive mgt

S/Sx: Trismus, difficulty sucking (excessive crying, stiff jaw, body weakness), opisthotonus, rissus sardonicus

VI. MENINGITIS Cause: Neisseria meningitides

Dx: wound culture, serologic tests (eia) IP: 1-10 days Mgt: ATS/TIG, Anticonvulsant (diazepam), maintain pt airway, quiet semi-dark environment

MOT: droplet, direct invasion thru otitis media, skull fracture, penetrating head wound, lumbar puncture

S/Sx: Meningococcemia (high grade fever, petechial/purpuric), asepsis meningitis ( headache, fever, confusion, muscle rigidity, (+) Brundzinski & Kernig’s sign

MOT: Bite of Aedes Poecillus S/Sx: Assymptomatic Stage - presence of microfillariae in the blood

Dx: CSF analysis, blood and urine culture

Acute Stage - lymphadenitis, lymphangitis, orchitis, epidydimitis

MGT: ↓ ICP, Ampicillin, Ceftriaxone, Mannitol, fluid mgt, isolation

Chronic Stage - lymphedema Dx: Nocturnal Blood Exam, Immunochromatographic Test

VII. REDTIDE/ Paralytic Shellfish Poisoning Cause: Dinoflagelletes (single- celled aka Phytoplankton) IP: 30 mins to few hours after ingestion MOT: Ingestion of raw or inadequately cooked seafoods (bivalve mollusks) S/Sx: Numbness of the face (around the mouth), vomiting, and dizziness, headache, tingling sensation/ paresthesia and eventful paralysis of the hands, floating sensation and weakness, rapid pulse, dysphonia, dysphagia, total muscle paralysis leading to respiratory arrest and death. Mgt: Induce vomiting, Activated charcoal, Sodium bicarbonate solution

Mgt: Heltrazan (Diethylcarbazine citrate / DEC) 6mg/kg single dose per year

II. HEPATITIS B Cause: Hepatitis B virus IP: 45-100 days MOT: BT, injections, piercings, tattooing, sex, sharing of razor, toothbrush, nail clipper, delivery transplacental S/Sx: RUQ pain, jaundice, yellowish sclera, anorexia, nausea & vomiting, joint/ muscle pain, steatorrhea, dark-colored urine, low-grade fever Dx: Hepatitis B Surface Agglutination (HBSAg) Test Mgt: Hepatitis B Immunoglobulin, Diet (↑CHO)

VIII. JAPANESE ENCEPHALITIS Cause: japanese encephalitis virus (most severe)

III. MUMPS

At risk: rural, travelers, military

Cause: Mumps virus

MOT: mosquito bite (culex triteaniorhynchus)

Source: Secretions of mouth and nose

S/sx: flu-like, neuro manifestations, distrubances in swallowing, mastication, phonation, convulsions, coma and death

IP: 12-26 days; average 18 days

Dx: CSF analysis, serologic test (day 7 - confirmatory) Mgt: supportive, TTS, control convulsions, oral care

MOT: Direct (droplet) S/Sx: Painful swelling in front of ear, angle of the jaw and down the neck, Fever, Malaise, Loss of appetite, Swelling of one or both testicles in boys (Orchitis) Mgt: Supportive symptomatic (analgesics, anti-inflammatory), Soft/ liquid diet as tolerated

HEPATIC & LYMPHATIC SYSTEM

Prevention: MMR Vaccine, isolation, terminal disinfection

I. FILARIASIS

IV. MONONUCLEUS/ Glandular Fever (Kissing Disease)

Cause: Wucheriria bancrofti, Brugia malayi, Brugia timori

Cause: Epstein-Barr virus (member of the herpes virus)

Vector: Aedes Poecillus

MOT: Oral/ kissing

IP: 8-16 months

S/Sx: Exudate tonsilitis, dysphagia, palatine petechiae, puffy eyelids

Cause: Mycobacterium tuberculosis/ africanum (humans), Mycobacterium bovis (cattle)

Dx: Cephalin-cholesterol Flocculation Test

IP: 2-10 weeks

Mgt: No antibiotics, ↑OFI

Source: Sputum, nasal discharges, saliva

Complication: Gullain-Barre Syndrome

MOT: droplet, Airborne, Direct (kissing), Indirect (shared utensils)

RESPIRATORY

S/Sx: afternoon fever, night sweating, body malaise, weight loss, dry to productive cough, dyspnea, hoarseness of voice, hemoptysis

I. INFLUENZA/ La Grippe

Dx: Sputum Analysis (confirmatory), Chest x-ray, tubercullin test (Mantoux test/ PPD)

Cause: Influenza virus (Type A [prime], B & C)

Mgt: TB-DOTS, respiratory isolation

IP: 24-48 hours POC: until DS of illness

Quantitative Classification:

MOT: Airborne, Droplet, Indirect

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Minimal - small lesions w/o demonstrable excavation that are confined to a small part of one of both lungs

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Moderately Advanced- 1/more lungs are involved, volume affected should not extend to 1 lobe, diameter does not exceed 4cm

Mgt: TSB, ↑OFI, respiratory isolation

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Advance - more extensive than moderate

II. PNEUMONIA

TB-DOTS/ “Tutok Gamutan”

S/Sx: chills, fever, malaise, sore throat, myalgia, headache Complication: pneumonia, myocarditis, otitis media Dx: CBC, Hemoagglutination Test

Cause: Pneumococcus, Streptococcus pneumoniae, Staphylococcus aureus, Haemophilus influenza, Klebsiella pneumoniae (Friedlander’s bacilli)

I

*New smear (+) PTB

S/Sx: chills, fever, chest pain, rusty sputum, body malaise, labored breathing

*New smear (-) PTB w/extensive parenchymal lesions on CXR

Dx: Chest X-ray, Sputum culture

*Extrapulmonary TB

MOT: Droplet, Indirect

Mgt: Penicillin, Strepoxacillin, Klebminoglycosides

II.

Classifications: CAP (<36hrs after admission), Nosocomial, Aspiration, Pneumocystic, Actinomyosis (poor dental hygiene), Nocardia (found in soil; causes brain abscess)

*Relapse *retard after RAD (2 Interruption)

Anatomical: -Bronchopneumonia (lobular/catarrhal)

III.

-Lobar (croupous) -Primary atypical (viral)

III. TUBERCULOSIS/ Koch’s Disease

*Treatment Failure (stops at 5 mos.)

IV.

default/ mos.

*New smear (+) PTB w/ minimal parenchymal lesions on CXR

HRZE (2months)

HRZE (4 months)

HRZES (2mos) + HRZE (1month)

HRE (5mos.)

HRZE (2 mos)

HR (4mos)

*Chronic - smear (+) 2nd line Gen. Antibiotics even after complete tx based on C&S results

IV. DIPHTHERIA

MOT: airborne

Cause: Corynebacterium diphtheriae (Klebs-Loeffer bacillus)

S/sx: flu-like

Source: saliva, respiratory discharges, unpasteurized milk

Dx: blood culture Mgt: similar to influenza

MOT: direct (droplet), Vehicle borne (milk) S/Sx: Nasal Diphtheria - pseudomembrane in nasal sputum, coryza Pharyngeal Diphtheria - sore throat/ tonsillitis, Bull Neck appearance

VII. MERSCOV Cause: Mers Cov Source; human, camels MOT: droplet, direct

Laryngeal Diphtheria - Croup Cough (hoarseness of voice), dyspnea, dysphagia Non-respiratory/ Cutaneous Diphtheria localized punched out ulcers

S/sx: fever, cough, SOB, pneumonia Dx: Blood culture Mgt: supportive/ symptomatic

Dx: Nose and throat culture Moloney’s Test (resistance to diphtheria) -Skin Test Shick’s Test (susceptibility) - Skin Test Mgt: Erythromycin (20,000 - 100,00 units IM once only), penicillin, Tracheostomy, maintain patent airway, respiratory isolation

CD AFFECTING THE EYES I. ACUTE CONJUNCTIVITIS Cause: bacterial (staphylococcus aureus) or viral

V. PERTUSIS

MOT: contaminated fingers, air, towels, contact lenses

(whooping cough/ tusperina)

Mgt: saline irrigations, topical antibiotics, aseptic technique

Cause: Haemophilus pertusis, bordet gengou bacillus, bordatella pertusis, pertussis bacillus Source: nasopharyngeal secretions

II. ONCOCERCIASIS

MOT: direct (droplet)

Cause: Oncocerca volvolus

S/sx: Invasive/ catarrhal stage - 7 days to 3 wks fever, watery eyes, cough, coryza (inflammation of mucous membrane esp in the nose)

Vector: Black simolium fly

Invasive stage - 3rd - 4th wk, paroxysmal cough (up to 2-3 mos), swollen neck and veins, abdominal hernia Convalescent stage - 5th - 6th wk

S/sx: pruritus, severe elevation of affeted skin, leopard skin, blindness Mgt: Metrican (by MERCK & Co.) given free for 3rd world countries, Albendazole 400mg/tag, Mebendazole (antiox) 500 mg/tab

Dx: Bordet-Gengou Agar test, cough plate/ Agar plate Mgt; same as avian flu, apply abdominal binder, respiratory isolation

STD I. HIV/ AIDS

VI. BIRD/ AVIAN FLU

Cause: retrovirus (lentivirus)

Cause: Avian influenza virus

MOT: unprotected sex, BT, sharing of needles, pregnancy, organ donation

IP: 3-5 days

Mgt: 4 C’s-

Compliance

Counseling Contact tracing Condoms