DIFFERENCE BETWEEN COMMUNICABLE AND NON-COMMUNICABLE DISEASE
 COMMUNICABLE DISEASE- This refers to disease that can transferred from person to person
through direct and indirect contact. This can develop immediately. It Is caused by pathogens that
are highly infectious such as bacteria, virus, fungi and protozoans. An eample f this disese
includes TB, Malaria, cholera.
 NONCOMMUNICABLE DISEASE- Refers to disease that cannot be transmitted from one to
another person. It is caused by allergies, malnutrition, illness, lifestyles, environmental changes,
etc. Unlike CD, this can be inherited from one generation to another and develops over a period
of time and lasts for long.
2 CLASSIFICATION OF COMMUNICABLE DISEASE
EPI
The WHO’s Expanded Programme on Immunizations (EPI) is a global attempt to control morbidity and
mortality for many vaccinepreventable diseases, with each country adapting these guidelines as necessary.
An example of control of pertussis would be to achieve 80% immunization coverage of children against
pertussis.
13 Vaccines recommended by WHO
 Bacillus Calmette-Guerin (BCG)- Against TB (0.05mL, ID, Right deltoid of arm, 1 dose, 90m
after B
 Diphtheria, pertussis, tetanus- (0.5mL, IM, Vastus lateralis, 3 doses 1 &1/2m, 2&1/2m and
3&1/2m)
 Haemophilus influenza type B(Hib)
 Hepatitis B (HepB)- (0.5 Ml IM, Vastus lateralis, 1 dose)
 Polio
 MMR measles-Rubella- (0.5mL, Subq, anteolateral portion of the thigh, 2dose{9m and 12-15m}
 Pneumococcal disease (PNC)- (0.5mL, IM, Vastus Lateralis, 3 doses)
 Rotavirus (Rota)- against diarrhea (oral, 2 dose 1&1/2m and 2 &1/2m)
 Human papillomavirus (HPV)- (0.5mL, IM, deltoid muscle, 3 doses w/ 6mon gap after 1 dose)
 COVID-19
IMMUNITY
1. Natural immunity- is an innate resistance to a specific antigen or toxin.
Active- natural contact and infection with the antigen. Maybe temporary or permanent
Passive- natural contact with the antibody transplacentally. Temporary or through
colostrum and breastmilk.
2. Acquired immunity is derived from actual exposure to the specific infectious agent, toxin, or
appropriate vaccine.
Active- inoculation of antigen. Maybe temporary or permanent
Passive- inoculation of antibody. Temporary
VACCINATION AND IMMUNIZATION
Immunization is a broad term used to describe a process by which active or passive immunity to
an infectious disease is induced or amplified. Immunizing agents can include vaccines, immune
globulins, or antitoxins.
Vaccination is a narrower term referring to the administration of a vaccine or toxoid to confer
active immunity by stimulating the body to produce its own antibodies.
PANDEMEIC, EPIDEMIC, SPORADIC AND ENDEMIC (W/ EXAMPLE)
 An epidemic is a widespread outbreak of a specific infectious disease wherein there happens a
sudden increase in cases spreading through a large population like a country. An epidemic can
turn into pandemic just like what happened in Wuhan China. An epidemic exists when new cases
exceed the expected incidence of that disease. The rate and transmission of the infectious disease
is dependent on multiple factors which include preexisting levels of the disease in the community,
environmental changes that occurred as a result of the disease, population density and
displacement, disruption of utilities, interruption of health services. Example of this are Yellow
fever, smallpox, measles, and polio.
 Endemic referring to disease which is constantly present in a certain population or region in a
specific country, with relatively low spread. An example of this is malaria which is considered as
endemic in a certain countries and regions.
 Pandemic referring to a disease when there is a sudden increase in cases spreading through
several countries, continents, or the whole world. An example of this is the COVID-19 and the
Swine flu on 1918.
 Sporadic on the other hand, refer to a disease that occurs only infrequently, haphazardly,
irregularly, or occasionally, from time to time ina few isolated places, with no discernible
temporal or spatial pattern, a s opposed to a recognizable epidemic outbreak or endemic pattern.
Example of this are tetanus, rabies and plague.
CHAIN OF INFECTION W/ EXAMPLE
 INFECTIOUS AGENT- An organism (virus,
rickettsia, bacteria, fungus, protozoan, helminth, or
prion) capable of producing infection or infectious
disease. Infectious agents act differently, depending on
their intrinsic properties and interactions with their
human host. For example, it may kill cells, like
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Mycobacterium tuberculosis, or interfere with circulation, like the spirochete that causes syphilis.
Or maybe it produces a toxin (toxigenicity) as does Clostridium botulinum, or stimulates an
immune response in the host (antigenicity), as does rubella virus. Other considerations for
understanding the action of agents are their power to invade and infect large numbers of people
(infectivity), their ability to produce disease in those infected with the agent (pathogenicity), and
their ability to produce serious disease in their hosts (virulence).
RESERVOIRS- The environment in which a pathogen lives and multiplies is the reservoir.
Reservoirs can be humans, animals, arthropods, plants, soil, water, or any other organic
substance. Some agents have more than one reservoir. Knowing the reservoirs for infectious
agents is important, because in some cases, transmission can be controlled by eliminating the
reservoir, such as eliminating the standing water where mosquitoes breed.
PORTAL OF ENTRY AND EXIT- Means by which an infectious agent is transported from the
host. Agents leave the human host through a portal of exit and invade through a portal of entry.
Portals of exit include respiratory secretions, vaginal secretions, semen, saliva, lesion exudates,
blood, and feces. Portals of entry are associated with the portal of exit and include the respiratory
passages, mucous membranes, skin and blood vessels, oral cavity, and the placenta.
MODE OF TRANSMISSION- Method whereby the infectious agent is transmitted from one
host (or reservoir) to another host. This can de direct (person to person) or indirect (through
fomites, any inanimate objects, materials or substances like water and cellphones and Vector.
Vectors can be animals or arthropods, and they can transmit through biological and mechanical
routes. The mechanical route involves no multiplication or growth of the parasite or microbe
within the animal or vector. Such is the case when a housefly carries gastrointestinal agents from
raw sewage to uncovered food. Biological transmission occurs when the parasite grows or
multiplies inside the animal, vector, or arthropod. Examples of diseases spread by this method of
transmission include arthropod-borne diseases such as malaria, hemorrhagic fevers, and viral
encephalitis.
HOST SUSCEPTIBILITY- Now, not all humans are equally susceptible to or at risk for
contracting an infection or development of an infectious disease. Biological and personal
characteristics play an important role. Just as the young are at greater risk for diphtheria, older
adults are at greater risk for bacterial pneumonia. That is why the immune system and
immunization status play important roles in the increased number of infections in unimmunized
and immunocompromised persons.
EXAMPLE: COVID-19 spreads from person to person through respiratory droplets when an infected
person coughs or sneezes within 6 ft. These droplets can land in the mouth or noses of people (susceptible
host) and be inhaled in the lungs (portal entry)
HOW TO BREAK THE CHAIN OF INFECTION
Breaking just one link of the chain at its most vulnerable point is, in fact, what is done to control
transmission of an infectious agent.
Controlling the agent is an area in which technology and medical science have been extremely
effective. Inactivating an agent is the principle behind disinfection, sterilization, and radiation of
fomites that may harbor pathogens. Anti-infective drugs, such as antibiotics, antivirals,
antiretrovirals, and antimalarials, play important roles in controlling infectious diseases. Not only
do they permit recovery of the infected person but they also play a major role in preventing
transmission of the pathogens to another.
Eradicating the Nonhuman Reservoir Common nonhuman reservoirs for pathogens in the
environment include water, food, milk, animals, insects, and sewage. Treating or eliminating
them is an effective method of preventing replication of pathogens and thus preventing
transmission.
Controlling the Human Reservoir Treating infected persons, whether they are symptomatic or
not, is effective in preventing transmission of pathogens directly to others. Quarantine is an
enforced isolation or restriction of movement of those who have been exposed to an infectious
agent during the incubation period; this is another method of controlling the reservoir.
Controlling the Portals of Exit and Entry The transmission chain may be broken at the portal
of exit by properly disposing of secretions, excretions, and exudates from infected persons.
Additionally, isolation of sick persons from others and requiring that persons with tuberculosis
wear a mask in public can be effective. The portal of entry of pathogens also can be controlled by
using barrier precautions (masks, gloves, condoms); avoiding unnecessary invasive procedures,
such as indwelling catheters; and protecting oneself from vectors, such as mosquitoes. Universal
guidelines developed by CDC to control transmission from asymptomatic patients and with
blood.
Improving Host Resistance and Immunity Many factors, such as age, general health status,
nutrition, and health behaviors, contribute to a host’s resistance, or ability to ward off infections.
Immunity, however, is an incredible defense against infection.
TETANUS - It is a serious bacterial disease that affects the nervous system leading to painful muscle
contractions, particularly to the jaw and neck muscles. That’s why it is commonly known as “lockjaw”.
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Anatomy
Nsg & Surg Management
 Assess the pt’s general condition
 Provide diversional therapies such as TV, radio, etc
 Administer analgesics as prescribed
 Clear the airway by adjusting the position of head so that th process of respiration is still
running smoothly by removing the blockageAuscultate breathsounds for ronchi due to
secretions in URT
 Oxygenation as prescribed
 Observe for the onset of respiratory failure
Complications
Broken bones due to severity of spasm
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Disability due to prolonged immobility due to the use of powerful sedatives to control the
muscle spasm.
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Death- severe muscle spasm can interfere with breathing, causig periods in which
breathing is suppressed. As we know respiratory failure is the most common cause of
death and lack of O2 may also induce cardiac arrest and death.
Signs and Symptoms- Incubation period(7-8 days)Sx include:
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Spasms and stiffness in your jaw muscles
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Stiffness of your neck muscles
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Difficulty swallowing
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Stiffness of the abdominal muscles
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Other SX include fever, sweating, elevated BP and rapid heart rate
Pathophysiology:
 Wound from nai introduced tetanus spores into the wound
 Spore release a toxin called tetanospasmin which enters the blood stream
 Bacterial numbes increase as they grow nd devide (some bacterial cells develop spores at
one end which release more tatanospasmin, even bacteria with no lyse)
 Toxin enters the blood stream
Movement is enabled by skeletal msucles and these muscles are controlled by the motor neurons. An
electrical message is sent down the axon of a motor neuron and arrives at the terminal buds.Chemical
neurotransmitters are released, which bind to mscle fibers causing them to contract. Shortly after, the
neurotransmitters are released from the muscle fibers, allowing them to relax. Repetition of this process
tells the muscle fibers to contract and relax as required. If you are infected with tetanus, the tetanospasmin
toxin can reach motor neurons via the blood stream
 Toxins enters the motor neuron via terminal buds
 The toxin then travels up the xon towards the neuron cell body (which is found in the
spinal cord)
 After 2-14 days, the toxin reaches the motor euron cell body in the spinal cord.
In the spinal cord, the motor neurons are controlled by inhibitory interneurons that prevent the motor
neurons from constantly firing. The interneurons release inhibitory neurotransmitters into the synaptic
junction. These prevent the firing of motor neurons, so that the muscle fibers they control do not
constantly contract.
 Tetanospasmin interfere with the inhibitory interneuoron (Tetanospasmin toxin moves
out of the motor neuron, across the synapse into the inhibitory interneuron)
The interneuoron can no longer control the motor neuron, so the motor neuron fires constantly which
leads to continual release of neurotransmitters from the motor neuron terminal buds which then cause the
muscle fibers to contract repeatedly until spasm occurs
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 Severe muscle spasm occurs
Possible Vaccines: TDaP
Synonyms
Causes: Clostridium tetani which are found in soil, dust and animal feces. When they enter a
deep flesh wound, spores of the bacteria may produce a powerful toxin , tetanospasm, which
actively impairs the motor neurons, nerves that control the muscles. The effect of the toxin on
motor neurons can cause muscle stiffness and spasms, the major sign of tetanus.