Epidemiology and nursing management for mumps- CHN.pptx

Community Health Nursing 1

1. EPIDEMIOLOGY AND NURSING MANAGEMENT OF MUMPS Presented by: Angel Fernandes Roll no:- 21

2. CONTENT

3. WHAT IS MUMPS??

4. INTRODUCTION Mumps is an acute infectious disease caused by an RNA virus classified as genus Rubulavirus of the family Paramyxoviridae which has a predilection for the glandular and nervous tissues. Alternative names :- Epidemic parotitis; Viral parotitis; Parotitis Clinically, the disease is recognised by non- supperative enlargement and tenderness of one or both the parotid glands.

5. HISTORY In  1934 , the etiology of the disease, the mumps virus, was discovered by Claude D. Johnson and Ernest William Goodpasture. They showed that mumps could be transmitted from infected patients to rhesus monkeys and demonstrated that mumps was caused by a filterable agent present in saliva.

6. EPIDEMIOLOGICAL FACTORS

7. AGENT FACTORS Agent : * The causative agent, Myxovirus parotiditis is a RNA virus of the myxovirus family. * There is only one serotype. Source of Infection : * Includes both clinical and subclinical cases. * Subclinical cases(30-40%), appear to be responsible for maintaining the cycle of infection. * The virus can be isolated from saliva, surface of stenen’s duct, blood, urine, human milk and occasionally in the CSF.

8. AGENT FACTORS(cont.) Period of communicability: * Usually 4-6 days before the onset of symptoms and a week or more thereafter. * The period of maximum infectivity is just before and at the onset of parotitis. * Once the case swelling of the glands has subsided, the case may be regarded as no longer infectious. Second attack rate: Estimated to be about 86%.

9. HOST FACTORS Age and sex: * Mumps is the most frequent cause of parotitis in children in the age group 5-9 years. * The average age of incidence of mumps is higher than with measles, chicken pox or whooping cough. * However, no age is exempt if there is no previous immunity. * The disease tends to be more severe in adults than in children. Immunity: * One attack, clinical or subclinical, is assumed to induce lifelong immunity. * There is only one antigenic type of mumps virus, and it does not exhibit significant antigenic variation. * Most infants below the age of 6 months are immune because of maternal antibodies.

10. ENVIRONMENTAL FACTORS Mumps is largely an endemic disease. Cases occur throughout the year , but the peak incidence is winter and spring. Epidemics are often associated with overcrowding.

11. MODE OF TRANSMISSION  The most common mumps transmission method is through coughing or sneezing, which can spread droplets of saliva and mucus infected with the mumps virus known as paramyxovirus. Transmission of the virus also occurs when someone touches an infected surface and then touches the eyes, nose, or mouth. It can be transmitted after direct contact with an infected person.

12. INCUBATION PERIOD The average incubation period for mumps is  14 to 18 days , with a range of 12 to 25 days.

13. SIGNS AND SYMPYOMS Fever Loss of appetite Headache Muscle pain Pain when eating Pain in jaw, ears, chin Nausea Dry mouth Swollen parotid glands

14. COMPLICATIONS Though frequent , but not serious. These includes: Orchitis(25-40%): 7-10 days after parotitis, with high fever. Epididymitis Pancreatitis Mild form of Meningitis Thyroiditis, Neuritis, Hepatitis, Ovaritis Oophoritis(5% adult women) Spontaneous abortion(25% in pregnancy) Rare: Hearing loss, Polyarthritis, Encephalitis, Cerebellar ataxia

15. DIAGNOSIS

16. TREATMENT

17. PREVENTION Highly effective live attenuated vaccine is now available for prevention of mumps . Widely-used live attenuated mumps vaccine strains include the Jery -Lynn, RIT 4385, Leningrad-3, L-Zagreb and Urabe strains. A single dose ,0.5ml, intramuscularly produces detectable antibodies in 95% of vaccines.

18. CONTROL

19. MUMPS SURVEILLANCE * Case definitions: WHO recommends the following case definitions for mumps surveillance:- Clinical mumps: Acute onset of unilateral or bilateral tender, self-limited swelling of the parotid or other salivary gland, lasting 2 or more days and without other apparent cause. Laboratory confirmed mumps: A patient with clinical mumps and laboratory confirmation by positive mumps IgM(without mumps immunization in the previous 6 weeks)or; sero -conversion with 4 folds or greater rise in mumps IgG titre ; or isolation of mumps virus from saliva , urine or cerebrospinal fluid. Epidemiologically-confirmed mumps: A patient with clinical mumps who is epidemiologically linked to a laboratory-confirmed mumps case.

20. NURSING INTERVENTIONS Educate patient about mumps. Encourage hydration and rest. Educate about hand washing. Tell patient to keep away from school or work until symptoms subside. Educate caregiver on vaccination. Take acetaminophen for pain. Use saltwater gargles for sore throat. Evaluate patient for other complications like pancreatitis, orchitis, aseptic meningitis, weakness, etc.

21. SUMMARY Introduction History Epidemiological factors Clinical manifestations Complications Diagnosis Treatment Prevention Control Nursing Interventions

22. BIBLIOGRAPHY