1. (c) 2005 The McGraw-Hill Companies, Inc. All rights reserved. Chapter Thirteen: Preventing Infectious Diseases

2. 7 Major Pathogens Table 13-1 Viruses Viruses Prion Prion Bacteria Bacteria Fungi Fungi Protozoan Protozoan Rickettsia Rickettsia Parasitic worms Parasitic worms Disease producing agent

3. Chain of Infection Figure 13-1

4. 5 Stages of an Infection 1. Incubation stage 2. Prodromal stage 3. Clinical stage 4. Decline stage 5. Recovery stage

5. Identify Body Defenses Figure 13-2

6. Identify Immune Response Against Pathogens Figure 13-3

7. Immunizations Vaccinations should be given against the following infectious conditions: Vaccinations should be given against the following infectious conditions: diphtheria (inflammation of throat lining) diphtheria (inflammation of throat lining) whooping cough (bacterial respiratory infection) whooping cough (bacterial respiratory infection) hepatitis B (viral infection affecting liver function) hepatitis B (viral infection affecting liver function) haemophilus Influenza type B (bacterial infection leading into meningitis) haemophilus Influenza type B (bacterial infection leading into meningitis) tetanus (bacterial infection that damages the central nervous system) tetanus (bacterial infection that damages the central nervous system)

8. Immunizations, cont’d Vaccinations should be given against the following infectious conditions: Vaccinations should be given against the following infectious conditions: rubella (viral infection causing respiratory damage and birth defects) rubella (viral infection causing respiratory damage and birth defects) measles (viral infection leading into a fever/rash) measles (viral infection leading into a fever/rash) polio (viral infection causing paralysis of the extremities) polio (viral infection causing paralysis of the extremities) mumps (viral infection of the salivary glands) mumps (viral infection of the salivary glands) chicken pox (viral infection leading into a rash/blisters) chicken pox (viral infection leading into a rash/blisters) Pneumoccocal infection (bacterium causing pneumonia, heart, kidney, and middle ear infections) Pneumoccocal infection (bacterium causing pneumonia, heart, kidney, and middle ear infections)

9. Recognize Causes and Management of the Selected Infectious Diseases The common cold (virus) The common cold (virus) Influenza (virus) Influenza (virus) Tuberculosis (bacterium) Tuberculosis (bacterium) Pneumonia (different types of pathogenic causes) Pneumonia (different types of pathogenic causes) Mononucleosis (virus) Mononucleosis (virus)

10. Recognize Causes and Management of the Selected Infectious Diseases, cont’d Chronic fatigue syndrome (virus) Chronic fatigue syndrome (virus) Meningitis (bacterial) Meningitis (bacterial) Mumps (viral) Mumps (viral) Lyme disease (bacterial) Lyme disease (bacterial)

11. Recognize Causes and Management of the Selected Infectious Diseases, cont’d Hanta virus pulmonary syndrome (virus) Hanta virus pulmonary syndrome (virus) West Niles (virus) West Niles (virus) Toxic shock syndrome (bacterial) Toxic shock syndrome (bacterial)

12. Hepatitis A, B, C, D, E Virus Virus Inflammation of the liver Inflammation of the liver Symptoms – fever, nausea, abdominal pain, jaundice Symptoms – fever, nausea, abdominal pain, jaundice Type A – associated with fecal contamination of food due to poor food handling Type A – associated with fecal contamination of food due to poor food handling Type B – sexual contact, IV drug use, tattooing, piercing Type B – sexual contact, IV drug use, tattooing, piercing Type C – similar to type B Type C – similar to type B Type D – difficult to treat and found in type B sufferers; bodily fluids contact Type D – difficult to treat and found in type B sufferers; bodily fluids contact Type E – water contamination (rare) Type E – water contamination (rare)

13. Sudden Acute Respiratory Syndrome (SARS) Fall (2002), China became the starting point for this unknown respiratory disease Fall (2002), China became the starting point for this unknown respiratory disease Characterized by high fever (100.4+), headaches, chills, and dry cough Characterized by high fever (100.4+), headaches, chills, and dry cough Virus (related to the corona family) entered the human germ pool via consumption of civet cats Virus (related to the corona family) entered the human germ pool via consumption of civet cats Diagnostic tests and treatment protocols have curtailed this disease Diagnostic tests and treatment protocols have curtailed this disease

14. Sexually Transmitted Diseases HIV/AIDS HIV/AIDS Chlamydia Chlamydia HPV HPV Gonorrhea Gonorrhea Herpes Simplex Herpes Simplex Syphilis Syphilis Pubic lice Pubic lice Vaginal infections (candida albicans) Vaginal infections (candida albicans) Cystitis/urethritis Cystitis/urethritis

15. HIV/AIDS Cause – HIV, virus that attacks the helper T cells of the immune system Cause – HIV, virus that attacks the helper T cells of the immune system Spread Spread direct contact involving the exchange of bodily fluids (blood, semen, vaginal secretions) direct contact involving the exchange of bodily fluids (blood, semen, vaginal secretions) sharing of hypodermic needles sharing of hypodermic needles through infected blood products through infected blood products perinatal transmission (mother to fetus) perinatal transmission (mother to fetus) (Human Immuno-Deficiency Virus/ Acquired Immuno-Deficiency Syndrome)

16. HIV/AIDS, cont’d HIV cannot be transmitted by sweat, saliva, or tears, even though trace elements are observed HIV cannot be transmitted by sweat, saliva, or tears, even though trace elements are observed Women are higher risk than men due to HIV concentration is higher in semen vs. vaginal secretions Women are higher risk than men due to HIV concentration is higher in semen vs. vaginal secretions Bleeding gums and gingivitis can be another source of transmission Bleeding gums and gingivitis can be another source of transmission (Human Immuno-Deficiency Virus/ Acquired Immuno-Deficiency Syndrome)

17. HIV/AIDS Symptoms Most infected people are asymptomatic or can remain symptom-free for years, even though antibodies have been formed within weeks of infection Most infected people are asymptomatic or can remain symptom-free for years, even though antibodies have been formed within weeks of infection Eventually the following may appear (HIV with symptoms) Eventually the following may appear (HIV with symptoms) tiredness tiredness fever fever loss of appetite/weight loss of appetite/weight diarrhea diarrhea night sweats night sweats swollen glands (neck, armpit, groin) swollen glands (neck, armpit, groin)

18. Diagnosis of HIV Infection Enzyme Linked Immunosorbent Assay (ELISA) Enzyme Linked Immunosorbent Assay (ELISA) Western BLOT test Western BLOT test

19. Treatment for HIV/AIDS No cure at this time No cure at this time Combination drugs reverse transcriptase inhibitors and protease inhibitors; both assist the body by disallowing replication of the virus in various cycles Combination drugs reverse transcriptase inhibitors and protease inhibitors; both assist the body by disallowing replication of the virus in various cycles HARRT (highly active antiretroviral therapy) HARRT (highly active antiretroviral therapy)

20. Prevention of HIV Infection Learn the sexual history and HIV status of your partner Learn the sexual history and HIV status of your partner Limit the number of sexual partners Limit the number of sexual partners Use condoms correctly and consistently Use condoms correctly and consistently Avoid contact with body fluids Avoid contact with body fluids Curtail the use of drugs Curtail the use of drugs

21. Prevention of HIV Infection, cont’d Never share hypodermic needles Never share hypodermic needles Refrain from sex with known injectable drug users Refrain from sex with known injectable drug users Get regular tests for STD’s Get regular tests for STD’s Do not engage in unprotected anal intercourse Do not engage in unprotected anal intercourse

22. Other Prevalent STD’s Chlamydia (bacterium) – thought to be most prevalent in the U.S., causing painful urination Chlamydia (bacterium) – thought to be most prevalent in the U.S., causing painful urination HPV (virus) – genital warts which can lead to cervical cancer in women HPV (virus) – genital warts which can lead to cervical cancer in women Gonorrhea (bacteria) – known for painful urination and colored discharges Gonorrhea (bacteria) – known for painful urination and colored discharges Herpes Simplex (virus) – Type I (oral) and Type II (genital) rivals chlamydia is the most prevalent STD; appearing as a sore, they erupt and become extremely painful. Breakouts are common recurrences. Herpes Simplex (virus) – Type I (oral) and Type II (genital) rivals chlamydia is the most prevalent STD; appearing as a sore, they erupt and become extremely painful. Breakouts are common recurrences.

23. Other Prevalent STD’s, cont’d Syphilis (bacteria) – left untreated, can cause death. 3 stages allow lesions to form and cause permanent damage if not treated. Women appear asymptomatic compared to men. Syphilis (bacteria) – left untreated, can cause death. 3 stages allow lesions to form and cause permanent damage if not treated. Women appear asymptomatic compared to men. Pubic lice (parasitic) – a.k.a. “crabs” cause intense itching within the pubic region of the genitals Pubic lice (parasitic) – a.k.a. “crabs” cause intense itching within the pubic region of the genitals Vaginal infections (yeast) – can cause thrush, allowing colored discharges and itching. Protozoan infections are “trichomonisis.” Vaginal infections (yeast) – can cause thrush, allowing colored discharges and itching. Protozoan infections are “trichomonisis.” Cystitis/urethritis (various pathogens) – bladder infections causing painful and frequent urination Cystitis/urethritis (various pathogens) – bladder infections causing painful and frequent urination

24. Nosocomial Infections Infections spread in conjunction with the delivery of health care services (i.e., staphylococcus, enterococcus faccium) Infections spread in conjunction with the delivery of health care services (i.e., staphylococcus, enterococcus faccium) Over 100,000 deaths are attributed to these infections Over 100,000 deaths are attributed to these infections

25. (c) 2005 The McGraw-Hill Companies, Inc. All rights reserved. Chapter Thirteen: Preventing Infectious Diseases