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Infectious Diseases (Communicable diseases)

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Infectious Diseases (Communicable diseases) Symptoms of pneumococcal meningitis not the same as for meningococcal infection * Start with an activity What does ... – PowerPoint PPT presentation

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Title: Infectious Diseases (Communicable diseases)


1
Infectious Diseases(Communicable diseases)
2
Start with an activity
  • What does infectious mean?
  • How many infectious diseases in children can you
    list?
  • How are they transmitted (passed on)?
  • Are the diseases you have named preventable
    through vaccination?

3
(No Transcript)
4
Worldwide causes of death in children under 5
years old (WHO, 2011)
5
Todays focus....
  • Meningitis
  • Pneumococcal disease
  • Measles
  • Mumps
  • Rubella
  • Impetigo
  • Varicella

6
Remember...
  • Meningitis is like a symptom caused by a pathogen
    (virus or bacteria)
  • Any vaccines developed have to be aimed at the
    pathogen
  • There is not one vaccine which protects against
    all causes of meningitis

7
3 main causes of meningitis in children
(historically)
  • Neisseria meningitidis (meningococcal)
  • Haemophilus influenzae type B (Hib)
  • Streptococcus pneunomaie (pneumococcal)

8
Presentation
  • Headache
  • Fever
  • Cold hands and feet
  • Stiff neck
  • Photophobia
  • Lethargy
  • Drowsiness
  • Loss of consciousness
  • Shock tachycardia, tachyapnoea
  • Purpuric /petechial rash (meningococcal disease
    only)
  • These are not in any particular order and you
    must remember that the age of the child will
    impact on the assessment

9
Meningococcal disease (HPA,2012)
  • Caused by infection with Bacteria Neisseria
    meningitidis
  • Gram negative diplococci, divided into 13
    serogroups
  • -Groups B and C are most common in the UK
  • -Less common serogroups include A, Y, W135, and Z
  • Healthy individuals carry the bacteria in their
    nose and throat without symptoms
  • Transmission occurs through frequent and
    prolonged contact with respiratory secretions of
    a carrier from coughing, sneezing, kissing

10
  • Most common presentation of meningococcal disease
    is meningitis and septicaemia
  • Disease onset is sudden
  • 1 in 8 people who recover are left with long term
    complications
  • Case fatality rate is high but varies with age,
    serogroup, clinical presentation and prompt
    treatment

11
Meningococcal septicaemia
12
Impact of the introduction of Meningitis C
vaccination (DH, 2010)
13
Prognosis Complications
  • 10 mortality in UK
  • Higher in cases with septicaemia
  • 25 of survivors experience reduced QOL
  • 10-20 permanent sequelae
  • Common are skin scars, hearing loss, limb
    amputations, seizures and brain damage

14
Pneumococcal disease (HPA)
  • Caused by infection with bacteria Streptococcus
    pneumoniae
  • This bacterium (also called the pneumococcus) is
    responsible for causing pneumococcal disease
  • The bacteria are carried in the nose and throat
  • Transmitted through infected droplets through
    coughing, sneezing close contact
  • Asymptomatic carriage possible
  • Whether infection develops or not depends on
    immune system and on virulence of serotype
    acquired
  • Over 90 serotypes identified (based on
    differences in polysaccharides in outer coating)
  • Not all 90 serotypes cause disease about 80
    invasive infections in UK children caused by just
    8-10 of these types

15
(No Transcript)
16
Pneumococcal meningitis incidence rate per
100,000 population by age group, England and
Wales, 1996-2005 (HPA)
17
Management
  • Antibiotics type depends on pathogen
  • Commonly cephalosporin group (e.g. cefotaxime,
    ceftriaxone)
  • Treatment of symptoms
  • Anti-pyretics
  • Analgesia

18
Measles, mumps and rubella
  • All are viral infections
  • All spread by airborne or droplet transmission
  • Varying incubation periods
  • Immunisation using MMR vaccine

19
Measles
  • Extremely contagious viral illness caused by
    Morbillivirus
  • Most common in 1-4 year olds
  • Spread by contact with nose and throat secretions
    and in airborne droplets released when an
    infected person sneezes or coughs
  • Transmission period is from beginning of first
    symptoms to 4 days after appearance of the rash
  • Incubation period ranges from 7 to 18 days

20
Symptoms
  • Early symptoms include
  • runny nose
  • cough
  • red and watery eyes and
  • small white spots inside the cheeks (Kopliks
    spots)

21
More symptoms
  • Followed by
  • - A slightly raised rash develops, spreading
    from the face and upper neck to the body and then
    to the hands and feet over a period of three days
  • - Rash lasts 5-6 days
  • - Loss of appetite and loose stools

22
Measles
23
Complications
  • Rare complications
  • Common complications
  • Otitis media
  • Pneumonia
  • Diarrhoea
  • Convulsions
  • In 2008, nobody died from measles in the UK
  • In India there were over 81,000 deaths in
    children under 5 years (Black et al. 2010)
  • Encephalitis
  • SSPE
  • Death

24
Mumps
  • Acute viral illness caused by paramyxovirus
  • Transmitted through the air when infected person
    coughs or sneezes
  • Incubation period 14-25 days
  • Transmissible for several days before the parotid
    swelling to several days after it appears
  • Symptoms
  • Headache and fever
  • Parotid swelling which may be unilateral or
    bilateral
  • Photophobia, neck stiffness (meningism) can
    develop
  • At least 30 of cases in children have no
    symptoms
  • Most severe in adults

25
Rubella German measles
  • Often a mild illness
  • May begin with swollen lymph glands, low grade
    fever, malaise conjunctivitis
  • Maculo-papular discreet rash develops on face,
    neck and body
  • Swollen joints and joint pain common in adults
  • Caused by Toga virus
  • Transmitted through direct or droplet contact
    with nasopharyngeal secretions
  • Incubation period is 14 21 days
  • Infectivity period from 1 week before until 5-7
    days after the onset of rash
  • The peak incidence of infection is late winter
    and early spring

26
Congenial rubella syndrome
  • Risk for unprotected pregnant women
  • Risk of foetal damage is estimated at
  • - 90 in first 10 weeks
  • - 10-20 by 16 weeks
  • - Rare after 20 weeks
  • Defects include cardiac, auditory, ophthalmic,
    neurological problems

27
How do we treat these infections?
  • There are no treatments for these infections
  • The symptoms are treated
  • Prevention is immunisation
  • Remember Measles is a major cause of child death
    in developing countries

28
What are these?
29
Impetigo
  • Highly contagious
  • Bacterial
  • localised
  • Caused by staphlococcal or streptococcal skin
    infection
  • Nasal carriage important
  • Local and/or systemic antibiotic treatment

30
Varicella chicken pox
  • Caused by the varicella zoster virus
  • Vesicles are infectious until they are dry
  • Infectious prior to vesicles appearing
  • Contact or droplet spread (virus in nasopharynx)
  • Danger in pregnancy
  • So common in childhood that 90 of adults are
    immune
  • Vaccine available
  • Can be complications especially in adults
  • The shingles connection

31
  • There are many infectious diseases some more or
    less common in children
  • We will come across more tomorrow when we look at
    vaccination
  • There are global variations
  • Nursing care means considering transmission to
    others
  • Some children may be more susceptible to
    infections

32
References/further reading
  • Department of Health (2006) Immunisation against
    Infectious disease. LondonTSO
  • Health Protection Agency website
    http//www.hpa.org.uk/HPAwebHome/
  • Lissauer, T. Clayden, G. (2012) Illustrated
    Textbook of Paediatrics 4th ed. OxfordElsevier
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