diseases diphtheria, tb, pertussis

Unit # 4, Microbiology GBSN 1st Semester

1. U-4, 3 OF “HUMAN AND MICROBIAL INTERACTION” By: Aftab H. Abbasi RN, DCHN, BSN, MA, LL.B Lecturer Nursing Qadri College of Health Sciences Karachi QADRI COLLEGE OF HEALTH SCIENCES, KARACHI

2. “HUMAN AND MICROBIAL INTERACTION” At the completion of this unit learners will be able to: 1 - Describe some pathogenic microbes and diseases, i.e. 1- Tetanus 2- Typhoid 3- Cholera 4- Diphtheria 5- Tuberculosis 6- Pertusis 7- Mumps 8- Measles 9- Polio 10- Influenza 11- Ascariasis 12- Taeniasis and 13- dermatomycosis.

3. 4- Diphtheria INTRODUCTION: Diphtheria takes its name from the Greek word “ Dipthera ” meaning leather and was named in 1826 by French physician PIERRE BRITONNEAU. This is because it refers to the leathery, sheath like membrane that grows on the tonsils, throat and in the nose. It was said that the disease killed as many as 80% of the children below 10 years. Edwin Klebs In 1883 demonstrated that Corynebacterium diphtheriae was the agent of diphtheria

4. 4- Diphtheria DEFINITION: Diphtheria is a contagious acute localized infection of mucous membrane or skin caused by CORYNEBACTERIUM DIPHTHERIAE. Respiratory diphtheria characterized by sore throat, fever, an adherent membrane (a psudomembrane) and exudation thrown out on the mucous of tonsils, pharynx, larynx and nasal cavity.

5. 4- Diphtheria CAUSES: Strains of bacteria called Corynebacterium diphtheriae that make a toxin (poison). TRANSMISSION / ROUTES OF ENTRY: Spread from direct close physical contact, person to person , usually through oral or respiratory droplets , like from coughing or sneezing . TESTS AND DIAGNOSIS : Proper clinical examination. Throat Culture and blood tests. ECG INCUBATION PERIOD: 2 to 5 days, with a range of 1 to 10 days.

6. 4- Diphtheria COMMON RISK FACTORS: Lack of immunization. History of contact with  diphtheria  patients. Presence of skin lesions. Presence of eczema. History of chronic health conditions. History of travel to areas endemic for  diphtheria . Overcrowding. Exposure to poor sanitary conditions. Poor personal hygiene. Sharing utensils and fomites with person suffering from diphtheria. Presence of tonsils.

7. 4- Diphtheria SIGHN & SYMPTOMS: Symptoms of pharyngeal diphtheria vary from mild pharyngitis to hypoxia due to airway obstruction by the pseudomembrane . • The involvement of cervical lymph nodes may cause swelling of the neck (bull neck diphtheria), and the patient may have a fever (≥ 103 °F). • The skin lesions in cutaneous diphtheria are usually covered by a gray-brown pseudomembrane . • Life-threatening systemic complications, principally loss of motor function (e.g., difficulty in swallowing ) and congestive heart failure , may develop as a result of the action of diphtheria toxin on peripheral motor neurons and the myocardium.

8. 4- Diphtheria COMPLICATIONS: Airway blockage. Damage to the heart muscle ( myocarditis ). Nerve damage ( polyneuropathy ). Loss of the ability to move (paralysis). Kidney failure.

9. 4- Diphtheria PREVENTION : Vaccination Good hygienic Care

10. 4- Diphtheria TREATMENT : Antibiotics (e.g., penicillin and erythromycin) are used as part of the treatment. Metronidazole , Erythromycin, Procaine penicillin G, rifampin or clindamycin . - Prompt passive immunization with diphtherial antitoxin is most effective in reducing the fatality rate.

11. 5- Tuberculosis INTRODUCTION : (TB) is one of the most prevalent infections of human beings and contributes considerably to illness and death around the world. It is spread by inhaling tiny droplets of saliva from the coughs or sneezes of an infected person. It is a slowly spreading, chronic, granulomatous bacterial infection, characterized by gradual weight loss. TB is the world’s second most common cause of death from infectious disease after HIV/AIDS.

12. 5- Tuberculosis DEFINITION : (TB) is a potentially fatal contagious disease that can affect almost any part of the body but is mainly an infection of the lungs. Neo-Latin word: “Tubercle” – Round nodule/swelling. “ Osis ” – Condition.

13. 5- Tuberculosis TYPES : 1- Pulmonary Tuberculosis. 2- Avian Tuberculosis (Mycobacterium avium ; of birds) 3- Bovine Tuberculosis (Mycobacterium bovis ; of cattle) 4- Miliary Tuberculosis / Disseminated Tuberculosis (Invade the blood stream and spread to all body organs) ROUTE / TRANSMISSION : - Tuberculosis is transmitted through the air (Airborne), not by surface contact. - Transmission occurs when a person inhales droplet nuclei containing M. tuberculosis, and the droplet nuclei traverse the mouth or nasal passages, upper respiratory tract, and bronchi to reach the alveoli of the lungs.

14. 5- Tuberculosis RISK FACTORS : Close contact with someone who have active TB. Immuno - compromised status. Drug abuse and alcoholism. People lacking adequate health care. Pre existing medical conditions (Diabetes Mellitus, c hronic r enal failure) Immigrants from countries with higher incidence of TB. Living in substandard conditions. Occupation (Health care workers)

15. 5- Tuberculosis CAUSES / AGENT : Mycobacterium tuberculosis. S pread when a person with active TB disease in their lungs coughs or sneezes and someone else inhales the expelled droplets, which contain TB bacteria.

16. 5- Tuberculosis SIGN AND SYMPTOMS : Anorexia Low grade fever Night sweats Fatigue Weight loss Dyspnea Non Productive cough Mucopurulent sputum with hemoptysis Chest pain

17. 5- Tuberculosis DIAGNOSIS / TESTS : Chest X-ray Chest CT scan Sputum examination and culture Thoracentesis Tuberculin skin test (also called a PPD test)

18. 5- Tuberculosis COMPLICATIONS : - Bones: Spinal pain and joint destruction may result from TB that infects your bones (TB spine or pot’s spine). Brain: (Meningitis) Liver or kidneys Heart Pleural effusion Pneumonia Serious reactions to drug therapy ( Hepato - toxicity; Hypersensitivity)

19. 5- Tuberculosis PREVENTION : - Vaccination Isolation Ventilated room Hygienic care Wear Mask Complete Entire TB course

20. 5- Tuberculosis MEDICAL MANAGEMENT : Pulmonary TB is treated primarily with anti-tuberculosis agents for 6 to 12 months. STREPTOMYCIN 15mg/kg/day. ISONIAZID or INH 5mg/kg/day. RIFAMPICIN 10mg/kg/day. PYRAZINAMIDE 15 to 30mg/kg/day. ETHAMBUTOL 15 to 25mg/kg/day.

21. 6- Pertusis INTRODUCTION : Pertussis , also known as whooping cough, is an acute respiratory tract infection caused by the bacterium  Bordetella pertussis . After an incubation period of 9 to 10 days, the clinical symptoms of the disease start with a catarrhal (Copious  discharge of mucus associated with inflammation of mucous  membranes,  especially  of the  nose  and  throat .) phase followed by paroxysmal ( a fit, attack, or sudden increase or recurrence of symptoms / a sudden violent emotion or action) cough and ending with persistent cough and whooping. - The cough and whooping are characteristic of the diseases and make the clinical diagnosis easy to establish.

22. 6- Pertusis DEFINITION : Pertussis , also known as whooping cough, is a highly contagious respiratory infection caused by the bacterium  Bordetella pertussis . Pertussis spreads easily from person to person mainly through droplets produced by coughing or sneezing. The disease is most dangerous in infants, and is a significant cause of disease and death in this age group.

23. 6- Pertusis EPIDEMIOLOGY : Worldwide 1922 – 1948 - Leading causes of deth . Endemic , Epidemic cycles. Extremely contagious attack rate 100% Adolescents and adults are major reservoirs. Age – 1 to 5 years. Infectivity first 4 weeks. INCUBATION PERIOD : 7 to 10 Days. TRANSMISSION / ROUTE : Airborne droplets  from the respiratory mucous membranes ( coughing and sneezing ) of infected individuals.

24. 6- Pertusis RISK FACTORS : Non-vaccination in children. Contact with an infected person. Epidemic exposure. Pregnancy . CAUSES / AGENT : Caused by a type of bacteria called Bordetella pertussis . When an infected person coughs or sneezes, tiny germ-laden droplets are sprayed into the air and breathed into the lungs of anyone who happens to be nearby.

25. 6- Pertusis SIGHN AND SYMPTOMS : Runny nose Nasal congestion Red, watery eyes Fever Cough Provoke vomiting Result in a red or blue face Cause extreme fatigue End with a high-pitched "whoop" sound during the next breath of air. Vomit Turn red or blue Seem to be struggling to breathe or have noticeable pauses in breathing. Inhale with a whooping sound.

26. 6- Pertusis COMPLICATIONS : 1- Respiratory : Apnea, Broncho -pneumonia, Atelectasis , Bronchiectasis , Emphysema, Otitis media. 2- Sequelae of forceful cough : Epistaxis , Sub- conjunctival hemorrhage, Intracranial Bleeding, Rectal prolapse , Umbilical hernias, Dehydration, Malnutrition, Tetany . 3- CNS : Convulsions, Hypoxemia, Hemorrhage, Encephalopathy. DIAGNOSIS / INVESTIGATIONS : CBC ( Lymphocytosis ) Florescent Antibody staining. Cultures (Nasopharyngeal aspirates) X-ray Chest.

27. 6- Pertusis PREVENTION : Vaccine (DPT) All household contacts should get Erythromycin for 14 days. Close contacts < 7 years should get booster. TREATMENT : Erythromycin 40-50 mg/kg/day for 14 Days. Clarithromycin 15mg/kg for 7 days. Azithromycin 10mg/kg for 5 days.

28. “HUMAN AND MICROBIAL INTERACTION”

29. QADRI COLLEGE OF HEALTH SCIENCES, KARACHI By: Aftab H. Abbasi RN, DCHN, BSN, MA, LL.B Lecturer Nursing Qadri College of Health Sciences Karachi