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COMMUNICABLE DISEASE

COMMUNICABLE DISEASE . HEAD START Joyce M. Smith M.D., MPH. CHILD CARE / EARLY EDUCATION SETTING. Group Setting Increased risk of infectious disease spread Among children Younger than 2 years Rates of Infection tend to Increase for first 6 months

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COMMUNICABLE DISEASE

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  1. COMMUNICABLE DISEASE HEAD START Joyce M. Smith M.D., MPH

  2. CHILD CARE / EARLY EDUCATION SETTING • Group Setting • Increased risk of infectious disease spread • Among children • Younger than 2 years • Rates of Infection tend to Increase for first 6 months • Rates decrease after six months of attendance • Children are 2 to 18 times more likely to catch an infectious disease than non-group

  3. CHILD CARE / EARLY EDUCATION SETTING • Adult Care Givers • Increased risk of acquiring and spreading infection in the first year • Spread depends on environmental and host variables • Season, crowding, hygiene practices • Immune status of host • Virulence of germ or pathogen

  4. INCREASE TRANSMISSION (Short List) • Otitis Media – Ear infections • Pneumonia • Diarrhea • Hepatitis A • Streptococcal Infection • Rotavirus • Chicken pox (Varicella)

  5. CONDITIONS FOR TRANSMISSION • Pathogen (Germ) – must be present • Adequate quantity present • Susceptible Host • Correct portal of entry

  6. MODES OF TRANSMISSION • Airborne • Droplet • Direct Contact (Fecal Oral) • Fomites (Common Vehicle) • Bloodborne • Vectorborne

  7. RESPIRATORY CONDITIONSCOMMON COLD • Pathogen • Virus (many strains) • Symptoms: • Runny Nose, Congestion, Headache, Cough, Muscle aches • Little or no fever • Mode of Transmission • Droplets • Respiratory

  8. RESPIRATORY CONDITIONSCOMMON COLD • Incubation Period • 1 to 3 days • Period of Contagiousness • 1 day before up to 5 days after start of symptoms • Management • Supportive • Prevention of Spread • Cover Cough, Hand Hygiene • Only excluded if fever is present

  9. RESPIRATORY CONDITIONSPHARYNGITIS VIRAL • Pathogen – Viruses (Multiple Strains) • Symptoms – • Gradual onset of sore throat, runny nose, cough + diarrhea, + fever • Mode of Transmission: • Respiratory, droplets, close contacts • Management – • Supportive, pain and fever medication as indicated

  10. RESPIRATORY CONDITIONSSTREPTOCOCCAL PHARYNGITIS • Pathogen – • Bacteria Streptococcus “Strep Throat” GABHS • Symptoms – • Rapid onset, painful swallowing, fever, headache, muscle aches, enlarged tonsils, enlarged lymph nodes • Mode of Transmission • Respiratory, Close Contacts

  11. RESPIRATORY CONDITIONSSTREPTOCOCCAL PHARYNGITIS • Incubation Period • 1 – 3 days • May develop scarlet fever • Period of Contagiousness • Treated 24 to 48 hours • Untreated – 10 days • May lead to Rheumatic Fever • Management • Antibiotics within 9 days

  12. PHARYNGITIS Nonspecific Pharyngitis, can be produced by several pathogens. Physical exam + Lab for final diagnosis Nelson’s Textbook of Pediatrics, 19th edition

  13. PHARYNGITIS More erythematous (red) with petechiae on roof of mouth, suggestive of strep infection

  14. PHARYNGITIS White exudate on tonsils suggestive of Strep or Mono infection

  15. RESPIRATORY CONDITIONSCROUP • Upper Respiratory Infection with partial obstruction, causing noisy breathing (stridor) and respiratory distress • Causes Bark-like cough • Mostly affects children 3 months to 5 years • (Video of Croup)

  16. RESPIRATORY CONDITIONSCROUP • Pathogen • Usually a virus • Symptoms • Starts as mild cold-like illness for 1-3 days • then strider and bark-like cough develop • Fever can be low grade or high 102.2 – 104 • Can become hypoxic and need hospitalization • Mode of Transmission - Respiratory

  17. RESPIRATORY CONDITIONSCROUP • Management • Usually can be managed at home • Keep calm, respiratory distress increases with distress and crying • To Emergency Room if respiratory distress worsens • Medication can be used for severe cases

  18. RESPIRATORY CONDITIONSEAR INFECTION (OTITIS MEDIA) • Middle Ear Infection • 80% of children have at least one episode of Otitis Media • Peak incidence in the first 2 years of life • Most cases are self-limited • Pathogen – Virus or Bacteria • Symptoms • Fever, ear pain,

  19. RESPIRATORY CONDITIONSEAR INFECTION (OTITIS MEDIA) • Risk factors • Age – highest rates in 6 to 20 month old • Anatomy – smaller facial structures allow local spread • Smoke Exposure • Preventable risk factor • Pacifier use • Small increase Risk • Breast Milk • Protective affect

  20. COMMUNICABLE DISEASECONJUNTIVIS (PINK EYE) • Viral • Bacterial • Allergic • Other conditions

  21. COMMUNICABLE DISEASECONJUNTIVIS (PINK EYE) • Viral and Bacterial • Highly contagious • Spread by touching contaminated objects (fomites) • Poor hand hygiene • Allergic – Not contagious • Usually bilateral

  22. COMMUNICABLE DISEASECONJUNTIVIS (PINK EYE) • Symptoms • Redness or Pink eyes with white or yellow discharge • May have ild eye pain • Mode of Transmission • Direct Contact • Incubation Period – 1 to 3 days • Period of Contagiousness – until redness resolves or determined to be non-contagious

  23. COMMUNICABLE DISEASECONJUNTIVIS (PINK EYE) VIRAL – Usually watery discharge Medicine.net.com

  24. COMMUNICABLE DISEASECONJUNTIVIS (PINK EYE) BACTERIAL HAS THICK GREENISH YELLOW DISCHARGE

  25. COMMUNICABLE DISEASECONJUNTIVIS (PINK EYE) BACTERIAL ASSOCIATED WITH YELLOW CRUSTED DISCHARGE

  26. COMMUNICABLE DISEASECONJUNTIVIS (PINK EYE) • MANAGEMENT • Hand Hygiene- Prevent spread to other eye, prevent spread to other people • Prevent progression of viral or allergic to bacterial • Bacterial – Antibiotic Eye Drops • Viral – Self limited • Allergic – Topical Antihistamines

  27. COMMON SKIN PRESENTATIONS • **Measles – Viral, preventable through vaccination • Pathogen • Symptoms • Mode of Transmission • Incubation Period • Period of Contagiousness • Management

  28. ***MEASLES • Pathogen – Measles Virus • Symptoms • 2 – 4 days of prodrome • Fever, 103-105, Harsh Cough, Watery Reds Eyes, • Then blotchy red rash starts 14 to 21 days post exposure on face and spreads to the body • Rash lasts 4 to 7 days • Mode of Transmission • Highly Contagious • Direct Contact with oral and nasal secretions • Contaminated clothing • (*** Reportable; One case reported in Illinois in 2013)

  29. MEASLES • Incubation Period • 8 to 12 days – range 7 to 18 days • Period of Contagiousness • Slightly before prodrome until 4 days after rash develops • Complications may include • Pneumonia • Meningitis • Otitis Media • Death

  30. MEASLES Intensely erythematouspathches of the face with spreading inferiorly onto the trunk Hurwitz Clinical Pediatric Dermatology Third Edition

  31. RUBELLA – GERMAN MEASLES • Pathogen – German Measles Virus • Symptoms – 3-Day Measles • Mild disease, mild fever, swollen glands • Rash last 2 to 3 days • Mode of Transmission • Contact with respiratory droplets • Incubation Period • 14 to 21 days • Period of Contagiousness • Management - Immunization

  32. RUBELLA GERMAN MEASLES Nonspecific “rose pink” macules and papules on the trunk of an adolescent male Hurwitz Clinical Pediatric Dermatology Third Edition

  33. ***VARICELLA (CHICKEN POX) • Pathogen - VZV Varicella-Zoster Virus • Incubation Period • 10 to 21 days • Symptoms • Sudden onset, mild fever itchy rash starts as maculopapular and progresses to vesicles, then crust, more develop – different stages of healing, • Ave about 300 lesions. Much worse in older children and adults

  34. ***VARICELLA (CHICKEN POX) • Mode of Transmission • Direct Contact with respiratory droplets and contaminated items, touching skin vesicles • Period of Contagiousness • 24 to 48 hours before the rash until lesions are crusted • Management / Complications • ***Reportable to the city • Notification of parents, VZIG within 96 hours of exposure • Immunizations

  35. ***VARICELLA (CHICKEN POX) UNIMMUNIZED CHILD

  36. ***VARICELLA (CHICKEN POX) BREAK THROUGH LESIONS OF IMMUNIZED CHILD

  37. FIFTH DISEASE (ErythemaInfectiosum) • Pathogen – Parvovirus B19 • Incubation Period – 4 to 28 days • Symptoms – Usually benign, mild fever slapped cheek rash, progress to lacy appearance • Mode of Transmission – Respiratory nasal droppings • Period of Contagiousness – right before rash

  38. FIFTH DISEASE (ErythemaInfectiosum) Erythema of the cheeks giving a “slapped cheeks” appearance

  39. FIFTH DISEASE (ErythemaInfectiosum) Reticulate erythema lacy rash on upper arm

  40. HAND-FOOT AND MOUTH DISEASE • Pathogen –Coxsackie Virus A 16 • Incubation Period • Symptoms – Mild Illness with low grade fever, on ulcers on Mouth and blisters Hands and Feet • Mode of Transmission • Period of Contagiousness – Before lesions appear and for several weeks after

  41. HAND-FOOT AND MOUTH DISEASE Deep-seated vesicles with erythema involving the palmar surface of the hand

  42. HAND-FOOT AND MOUTH DISEASE A painful ulcer on the lateral aspect of the tongue

  43. HAND-FOOT AND MOUTH DISEASE Red to purple vesicles involving the knee

  44. HAND-FOOT AND MOUTH DISEASE

  45. WARTS (VERRUCA) • Pathogen – HPV • Human Papilloma Virus (Multiple strains more than 200) • Usually benign in children and adolescents • Incidence is highest in children and adolescents • Incubation Period – • Develop lesions one month after inoculation • Symptoms – • Slow developing growth, sometimes painful • Usually less than 3 in mm in size

  46. WARTS (VERRUCA) • Mode of Transmission – • Direct contact, autoinoculation and fomites • Period of Contagiousness, no limits, can be covered to avoid direct contact • Management / Complications • 65% disappear within 2 years • Liquid Nitorgen • Salicyclic Acid – Compound W • podophyllin

  47. WARTS (VERRUCA) • Multiple Forms • Flat • Filiform • Plantar • Common • Periungual

  48. COMMON WARTS (VERRUCA) A dome-shaped lesion on the nose and filliform wart down below

  49. COMMON WART (VERRUCA) Common Wart on the Tongue

  50. PLANTAR WARTS (VERRUCA)

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