Communicable Disease NURS4160A Goldfarb School of Nursing Emily Myers DNP, RN, CPNP-PC Conjunctivitis Viral Bacterial Allergic ● Viral: secondary to viral infection, self limiting (7-14 days) ● Bacterial: Starts in one eye and spreads to the other Spreads: Direct contact Clinical Manifestations: Pink or redness to sclera Swelling to conjunctiva Excessive tearing Yellow, green discharge from eye Crusting of eyelids in the am ○ ● Antibiotic tx Allergic: occurs with rhinorrhea and other symptoms when exposed to allergens Epstein-Barr Virus & Mononucleosis Epstein Barr Virus Spread: Saliva, Droplet Incubation: 30-50 days Clinical Manifestations: Fever Lethargy Sore throat Swollen lymph glands Loss of appetite HA Elevated WBC Atypical lymphocytes Hepatosplenomegaly Complications: Splenic rupture Erythema Infectiosum (Fifth Disease) Parvovirus B19 Spread: Droplet, blood Incubation: 4-14 days, can be up to 21 days Clinical Manifestations: Before Rash: Fever Runny nose HA Rash: Red rash on face “Slapped cheek” appearance Maculopapular red spots symmetrically distributed on upper and lower extremities progressing proximal to distal surfaces through 1 week Secondary generalized itchy rash, including soles of feet Complications: Self-limited arthritis and arthralgia Mumps Paramyxovirus Spread: Direct contact, droplet Incubation: 14-21 days Clinical Manifestations: Painful, swollen parotid glands Fever and muscles aches HA Earache, worsens with chewing Fatigue Loss of appetite Complications: Orchitis Encephalitis Meningitis Oophritis Mastitis Deafness Myocarditis Arthritis Hepatitis Pertussis – Whooping Cough Bordatella pertussis Spread: direct contact, droplet, indirect contact with freshly contaminated particles Incubation: 6-20 days, usually 7-10 Clinical Manifestations: Rhinorrhea Congestion / Coryza Sneezing Fever Mild cough Progression to severe coughing 1-2 weeks Coughing fits Violent and rapid coughing Loud “whoop” sound on inspiration Complications: PNA Apnea Otitis media Weight loss Hernias Rib fractures Rubella – German Measles Rubella Virus Spread: Direct contact, droplet Incubation: 14-21 days Communicability: 7 days preceding rash to 5 days after Clinical Manifestations: Low-grade fever Sore throat HA Malaise Cough Lymphadenopathy Red rash (starts on face spreads to rest of body lasting 2-3 days) Complications: BIRTH DEFECTS **Pregnant women exposed to rubella >> deafness, heart defects, brain, liver, or spleen damage Measles (Rubeola) Rubeola virus Spread: Direct contact, droplet Incubation: 10-20 days Communicability: 4 days before to 5 days after rash Clinical Manifestations: 3-4 days preceding rash: mild to moderate fever, conjunctivitis, fatigue, cough, runny nose, red eyes, sore throat Rash onset Koplik spots appear 2 days preceding rash Red to reddish brown rash starting on face and spreading downward Spike in fever Complications: Otitis media PNA Diarrhea Encephalitis Laryngitis DEATH Varicella (Chicken Pox) Varicella Virus Spread: Direct contact, droplet, contaminated objects, AIRBORNE Incubation: 2-3 weeks, typically 14-16 days Communicability: 1 days before lesions appear until all lesions are crusted Clinical Manifestations: 1-2 days preceding rash Fever Fatigue HA Loss of appetite Rash phase Macules on trunk >> extremities & face Macules >> papules >>vesicles >>crust Scabs after 1 week Complications: PNA Bleeding Problems Bacterial infections of the skin Encephalitis RN Interventions Isolation Precautions Varicella TB **Covid-19 (Risk with aerosolization) Fifth Disease Mumps Pertussis Rubella Human Metapneumovirus RSV Flu A & B Airborne Droplet Conjunctivitis Mononucleosis Standard Supportive Care Treat the symptoms, support the patient Antipyretics (Acetaminophen or Ibuprofen) Analgesics for pain (PO or topical) Meet fluid and nutrition needs Rest Mouth care for ulcerations **Notify school, daycare, contacts, public health dept. Skin Care Calamine lotion for topical relief Clean and dry Keep cool Lightweight, loose clothing Tepid baths Keep fingernails clean and short, mittens Pharmacotherapy Antihistamines Diphenhydramine Hydroxizine Antibiotics / Antivirals Acyclovir Abx (pertussis) Abx eye drops (conjunctivitis NSAIDs Ibuprofen Ketorolac Antipyretic Anaglesic Sedating or hyperalert Target source of infection 5-10mg/kg/dose >6mo Acetaminophen Acetaminophen Ofirmev Antipyretic Anaglesic 10-15mg/kg/dose Questions?
