Menigococcal Meningitis and Ebola virus disease.pptx

Menigococcal Meningitis And Ebola Virus Disease
Community Health Nursing - I
Communicable disease and it's prevention

1. Meningococcal meningitis

2. Meningococcal meningitis INTRODUCTION Meningococcal meningitis is a bacterial form of meningitis, a serious infection of the thin lining that surrounds the brain and spinal cord. the most important pathogen for meningitis is Neisseria meningitides Meningococcal meningitis has a fatality rate of about 10% and about 15% of the survivors have residual central nervous system (CNS) damage and long term disabilities such as loss of limbs, deafness.

3. Epidemiological traid

4. Causative agent Bean shaped gram negative, aerobic diplococci. At least 13 serogroups have been described :A, B, C, D, E, H, I, K, L, W - 135, X, Y and Z. Almost all meningococcal infections are caused by six serogroups A, B, C, W, X & Y

5. HOST FACTORS Neisseria meningitides is found in the nasopharyngeal secretions of cases and carriers. Normal population of 5 – 30% may harbour the organism in the nasopharynx during inter epidemics. During epidemics the carrier rate may go up to 70 – 80% Cases become non infectious with in 24 hrs of specific treatment. All age groups are susceptible; younger age groups are more susceptible.

6. environment Epidemics are common in dry and cold months. Over crowding Poor housing conditions Low socio economic groups.

7. Mode of Transmission Disease is spread from person to person. The bacteria are spread by exchanging respiratory and throat secretions (saliva or spit) during close (for example, coughing or kissing) or lengthy contact. Close contact like living same household, roommates, or anyone with direct contact with a patient's oral secretions

8. Incubation period The incubation period is 4 days, but it can range from 2 to 10 days.

9. SYMPTOMS Stiff neck High fever Sensitivity to light Confusion Headache Vomiting

10. COMPLICATION Brain damage Hearing loss Learning disability Meningococcal septicaemia may lead to haemorrhagic rash and circulatory collapse

11. Prevention and control Meningococcal disease is fatal and should be considered as medical emergency Hospitalization is essential; no need to isolate the patient. Appropriate antibiotic therapy should be started as soon as the diagnosis is confirmed with necessary diagnostic tests. It is always best to start the treatment after lumbar puncture (LP). If treatment is initiated before LP it may be difficult to grow the bacteria in cerebrospinal fluid to confirm the diagnosis. There are a good number of antibiotics available to treat the infection like penicillin, ampicillin, chloramphenicol and ceftriaxone, etc.

12. treatment CASES: The drug of choice is penicillin. If patients are allergic to penicillin chloramphenicol is the alternative drug . Carriers: The drug of choice is rifampicin. Chemoprophylaxis: Suggested for contacts. Sulfadiazine 1g BD for 2 days. Rifampicin 600mg BD for 2 days if allergic to sulfadiazine. MASS treatment Though it causes immediate drop in the incidence rate, it requires close medical supervision of the population.

13. immunization Meningococcal polysaccharide vaccines are: Bivalent (groups A & C) Trivalent (group A, C & W) Tetravalent (groups A, C, Y & W) help to control the disease . The first vaccine against NmB, made out of 4 protein components, was released in 2014. Meningococcal conjugate vaccines against group C is widely in practice since 1999. Tetravalent A, C, Y & W conjugate vaccines are used in children and adults since 2005 in Canada, The united states of America, and Europe.

14. Environmental improvement Improved housing conditions. Avoid overcrowding Health educate the population about preventive measures.

15. WHO INITIATIVE IN HIGH – EPIDEMIC COUNTRIES

16. PREPARDNESS For adequate preparedness WHO uses surveillance, starting from case identification to investigation. PREVENTION WHO aims to vaccinate 1 – 29 years of all in the “African meningitis belt” with the MenA conjugate vaccine. RESPONSE WHO aims at providing technical support regularly at the field level to countries facing epidemics. Promote case management with ceftriaxone Mass vaccination specifically to cover those who were not protected through vaccination.

17. Ebola virus disease

18. Ebola virus disease INTRODUCTION Ebola virus disease (EBV) or African haemorrhagic fever is a highly infectious and deadly disease affecting humans and animals such as monkeys, gorillas, chimpanzees, bats, birds, reptiles, amphibians, arthropods. It is caused by Ebola virus and it occurs in sporadic outbreaks. Ebola virus is an RNA virus which is from the filoviruses family. It is morphologically identical but immunogically distinct from Marburg virus. Where as Marburg virus can probably be transmitted by Aedes Aegyptus mosquitoes; Ebola virus infection requires close contact with infected patient/specimen

19. Causative agent The virus family FILOVIRIDAE includes three genera: Ebola virus has 5 species : The current outbreak is caused by Zaire species

20. HOST It is thought that fruit bats of the pteropodidae family are natural Ebola virus hosts. People remain infectious as long as their blood contains the virus.

21. Transmission Direct contact with an infected animal or humans. Direct contact with the blood and or secretions of an infected person especially within families. Contact with contaminated medical equipment's such as needles, drip stand, etc. Re use of unsterilized instruments in hospitals. Handling of the carcass of infected animals. Inhalation of contaminated air in hospital environment. Use of infected non human primate/bats as food source (BUSH MEAT). Non implementation of universal precautions e.g. Hand washing.

22. Incubation period The incubation period is 2 – 21 days

23. SYMPTOMS EARLY SYMPTOMS: Fever vomiting chest pain hepatomegaly stomach pain Headache Diarrhoea Orchitis Cold Pancreatitis Cough Joint and muscles pain Sore throat

24. LATE SYMPTOMS: W eakness D epression C onfusion R ed eyes I nternal and external bleeding DIC Maculopapular rash in about 50% cases. Patient may be vomiting blood, coughing out blood or passing blood in stool.

25. DIAGNOSIS Antibody-capture Enzyme-linked Immunosorbent Assay (ELISA). Antigen-capture Detection Tests. Serum Neutralization Test. Reverse Transcriptase Polymerase Chain Reaction (RT-PCR) Assay. Electron Microscopy. Virus Isolation By Cell Culture.

26. Treatment and vaccines Rehydration with oral or intravenous fluids Symptomatic treatment A range of potential treatments including blood products, immune therapies and drug therapies are currently being evaluated. No licensed vaccines are available yet, but 2 potential vaccines are undergoing human safety testing.

27. CONTROLLING INFECTION IN HEALTH – CARE SETTINGS Health – care workers should be always cautious since they work very closely with the patients. They must always use “standard precautions” while caring for patients, no matter the diagnosis is confirmed or only provisional . THE STANDARD PRECAUTIONS ARE: Basic hand hygiene Respiratory hygiene Use of personal protective equipment's to prevent any splashes or other materials. Use safe injection practices while procedure. Safe disposal and burial practices

28. GENERAL PREVENTION AND CONTROL MEASURES Case management Continuous monitoring using surveillance and contact tracing Provision of good laboratory service Safe burials and social mobilization Community engagement in controlling outbreaks Raising awareness on risk factors of “Ebola infection” and enhancing individual protective measures for effective reduction of human transmission.