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Renin Angiotensin Mechanism.

Communicable Diseases


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Communicable Diseases
An infectious disease which gets transferred from infected person to other persons by direct or indirect means is called a communicable disease.

Infection:

Successful entry of a pathogenic microorganism capable of inducing a disease into systemic circulation is called an infection.

Causative Organism:

Microorganism responsible for inducing a disease is called as “Causative organism”.

Vector: 

It is an organism who itself doesn't cause the disease but transfers the pathogen from one host to another host.
E.g. Mosquitos in Malaria.

Measles

Other Names:

Rubella
खसरा

Causative Organism:

Measles RNA paramyxo‐virus i.e. (Rubella virus).

Mode of Transmission: 

  • Directly from person to person by droplet infection & droplet nuclei.
  • Entry of portal respiratory tract.
  • Rarely through conjunctiva.

Symptoms:

  • cough
  • fever
  • runny nose
  • red eyes
  • sore throat
  • white spots inside the mouth
  • Widespread Skin rashes

Prevention & Control: 

  • Immunization‐95%
  • Measles Vaccination 
  • Unvaccinated children immunized by immunoglobulin.
  • Paracetamol is used to reduce body temp.
  • Strict Isolation

Diphtheria

Causative Organism:

Corynebacterium diphtheriae

Mode of Transmission:

  • By droplet infection
  • Directly from infected cutaneous lesions
  • Transmission by objects like toys,cups etc.
  • Portal of entry is mainly the respiratory tract.

Symptoms:

  • A thick, gray membrane covering your throat and tonsils
  • A sore throat and hoarseness
  • Swollen glands (enlarged lymph nodes) in your neck
  • Difficulty breathing or rapid breathing
  • Nasal discharge
  • Fever and chills
  • Malaise

Prevention & Control:

  • Strict Isolation.
  • Early detection of carriers & their treatment.
  • Active immunization combined with DPT vaccine.
  • Antibiotics like Penicillins, Erythromycin.

Tuberculosis

Causative Organism: 

Mycobacterium tuberculosis

Mode of Transmission:

  • It is mainly transmitted by droplet infection and droplet nuclei. 
  • The most common source is the sputum of the patients with pulmonary tuberculosis.
  • Coughing can produce a large number of droplets. Fresh droplets carry viable organisms. (The frequency and vigor of cough and the ventilation of the environment influences the transmission of infection.)
  • It can thrive in organs of relatively high oxygen tension such as apices of the lung, the renal parenchyma, the growing ends of the bones and the cerebral cortex.
  • It is also tolerant to the acid environment of the stomach and it has been isolated from the gastric contents of the patients suffering from tuberculosis.

Symptoms:

  • Coughing that lasts three or more weeks
  • Coughing up blood
  • Chest pain, or pain with breathing or coughing
  • Unintentional weight loss
  • Fatigue
  • Fever
  • Night sweats
  • Chills
  • Loss of appetite

Prevention & Control:

  • One should live in a properly ventilated house.
  • Nourishing and well balanced diet should be taken.
  • Milk should be consumed after proper, boiling.
  • Tuberculosis patients should be detected as early as possible by microscopic examination of sputum, chest x-ray and tuberculin test.
  • Infected persons should be isolated.
  • Detected patients should be promptly treated with specific anti-tubercular drugs.
  • Patients should be advised to spit only in sputum cup containing disinfectant,
  • While coughing he should use a handkerchief, which should be properly disinfected after use.
  • B.C.G, vaccination (Bacillus Calmette Guerin) should be given to newborns below four weeks of age.
  • Vaccination can be done to individuals below 20 years of age.
  • People should be taught that tuberculosis is not an incurable disease. They should be advised that taking the antituberculosis drugs in sufficient doses and for a sufficient period of time is very essential for the complete cure of the disease.

Treatment:

  • It requires long term treatment with multiple drugs so as to avoid resistance.
  • Drugs like Isoniazid, Pyrazinamide, Ethambutol
  • Antibiotics like Minocycline, Streptomycin, Rifampicin.

Polio

Causative Organism: 

A poliovirus which has three serotypes 1, 2 and 3.

Mode of Transmission:

  • Faeco-oral route is the main route of transmission of the disease. Man is the reservoir of the virus.
  • Another route is the droplet infection, this occurs in the acute phase of disease when the virus occurs in the throat. 
  • Close personal contact with an infected person facilitates droplet infection.

Symptoms:

  • Fever
  • Sore throat
  • Headache
  • Vomiting
  • Fatigue
  • Back pain or stiffness
  • Neck pain or stiffness
  • Pain or stiffness in the arms or legs
  • Muscle weakness or tenderness

Prevention & Control:

  • Notification of the case to the health authorities.
  • Proper disposal of urine and faeces. 
  • Protection of water sources and supply of safe drinking water. 
  • Personal hygiene should be strictly maintained.
  • Poliovirus vaccine live oral (Trivalent oral polio vaccine, Sabine vaccine) is the vaccine of choice for primary Immunization of children. 
  • It is indicated for active immunization against infections of poliovirus caused by type 1, 2 and 3 in infants starting at 6-12 week.

Cholera

Causative Organism:

A bacteria called Vibrio cholerae

Mode of Transmission: 

  • Spread is mainly by contaminated food, water, milk. 
  • Human beings are the only reservoir of cholera infection.
  • Immediate source of infection is the stools and vomitus of cases and carriers.

Symptoms:

  • Diarrhoea
  • Nausea
  • Vomiting
  • Electrolyte imbalance

Prevention & Control:

  • Early detection of suspected cases and Bacteriological examination of stools for confirmation.
  • Cholera cases should be notified to the local health authority.
  • Patient's stools, vomitus should be collected in a pot containing disinfectant.
  • Water and milk should be consumed only after boiling.
  • Fruits, vegetables should be thoroughly cleaned before use
  • Strict isolation.

Treatments:

  • Oral rehydration therapy.
  • IV fluids.
  • Rehydration is the key to save life.
  • Antibiotics like Ciprofloxacin, Doxycycline.

Typhoid

Causative organism:

Salmonella typhi
Salmonella para typhi‐ A
Salmonella para typhi‐ B1

Mode of Transmission: 

  • Faecal‐Oral route
  • Urine‐ Oral route
  • Direct transmission through contaminated hands or fingers.
  • Indirect transmission through contaminated water, milk, food or through flies.

Symptoms:

  • poor appetite;
  • abdominal pain and peritonitis;
  • headaches;
  • generalized aches and pains and weakness;
  • high fever, often up to 104 F;
  • lethargy (usually only if untreated);
  • intestinal bleeding or perforation (after 2-3 weeks of the disease);
  • Cough;

Diagnosis: 

Microscopic testing of blood, urine, feces.

Prevention & Control: 

  • Control of reservoir.
  • Sanitation.
  • By immunization   TAB vaccine‐S. typhi,S. paratyphiA, S. paratyphi B
  • Oral typhoid vaccine 
  • Anti typhoid vaccine

Treatment:

  • Antibiotics like Ciprofloxacin, Azithromycin.

Filariasis

Causative Organism:

nematodes :
1)W. Bancrofti
2)B. Malayi
3)B. Timosi

Mode of Transmission: 

  • By bite of infected mosquito

Symptoms: 

  • Fever.
  • Inguinal or axillary lymphadenopathy.
  • Testicular and/or inguinal pain.
  • Skin exfoliation.
  • Limb or genital swelling

Prevention & Control:

  • By vector control:‐ Elimination of breeding places of mosquitoes by sanitation & waste water disposal.
  • Chemotherapy – Diethylcarbamazine (DEC)

Trachoma

Causative organism:

Bacteria Chlamydia trachomatis

Mode of Transmission:

  • It occurs by direct or indirect contact with ocular discharges of infected people or fomites. 
  • Swimming pools where water can get contaminated is also a source of infection.
  • Overcrowding also helps in transmission

Symptoms:

  • Mild itching and irritation of the eyes and eyelids
  • Discharge from the eyes containing mucus or pus
  • Eyelid swelling
  • Light sensitivity (photophobia)
  • Eye pain

Prevention & Control:

  • Early diagnosis and treatment of cases.
  • Common use of eye cosmetics like kajal, surma should be avoided.
  • Health education and community hygiene plays an important role in prevention and control of trachoma.
  • Strict isolation.

Treatment:

  • Ciprofloxacin eye drops
  • Azithromycin eye drops
  • Chloramphenicol eye drops

Leprosy

Causative Organism:

A bacteria “Mycobacterium leprae”

Mode of Transmission:

  • Leprosy may be transmitted by droplet infection, direct or indirect contact of an infected patient. 
  • It may be transmitted through breast milk of lepromatous mother, by insect vectors or by tattooing needles.

Symptoms:

  • the appearance of skin lesions that are lighter than normal skin and remain for weeks or months
  • patches of skin with decreased sensation, such as touch, pain, and heat
  • muscle weakness
  • numbness in the hands, feet, legs, and arms, known as “glove and stocking anesthesia”
  • eye problems
  • enlarged nerves, especially in the elbows or knees
  • stuffy nose and nosebleeds
  • curling of the fingers and thumb, caused by paralysis of small muscles in the hand
  • ulcers on the soles of the feet.

Detection of the cases:

Lepromin Skin Test

Prevention & Control: 

  • Detection of the cases.
  • Multidrug therapy for control and cure.
  • Surveillance
  • Immunoprophylaxis
  • Chemoprophylaxis and rehabilitation of patients
  • To interrupt the transmission of the disease.
  • Treat the patient for complete cure and rehabilitation..
  • Isolation of patients.

Treatment:

  • It also requires long term treatment with multiple drugs to avoid resistance.
  • Drugs like Dapsone, Solapsone, Clofazimine.
  • Antibiotics like Streptomycin, Rifampicin, tetracycline

AIDS

(Acquired Immunodeficiency Syndrome)

Causative Organism:

Human Immunodeficiency Virus (HIV)

Mode of Transmission:

  • HIV is transmitted from person to person by Sexual contact: Any vaginal, oral or anal sex with infected partner can spread AIDS, as the virus is present in the vaginal secretions, semen.
  • Transfusion of the infected blood or through contaminated needles and syringes.
  • The virus can be transmitted from the infected mother to foetus through the placenta.

Symptoms:

  • Fever
  • Headache
  • Muscle aches and joint pain
  • Rash
  • Sore throat and painful mouth sores
  • Swollen lymph glands, mainly on the neck
  • Diarrhea
  • Weight loss
  • Cough
  • Night sweats

Diagnosis:

  • ELISA (Enzyme Linked Immunosorbent Assay)
  • Western Blot Method.

Prevention & Control:

  • Screening of blood donors for AIDS.
  • Screening of high risk groups like drug addicts and prostitutes.
  • Avoid indulgence in multiple sexual partners, avoid oral, anal sex.
  • Use of contraceptive devices like condoms.
  • Use of disposable syringes and needles.

Treatment:

  • Antiviral drugs like Lamivudine, Zidovudine.
  • Immunomodulators.
  • Symptomatic.



Syphilis


Causative Agent:

A spirochaete bacteriumTreponema pallidum

Symptoms:

  • Unusual discharge, sore/rash usually in groin area.

Mode of Transmission:

  • Sexual contact with an infected person.
  • Affected mother to child.

Prevention & Treatment:

  • Avoid unsafe sexual contact
  • Use of condoms.
  • Penicillin 600000 units/day


Gonorrhoea

Causative Organism:

Gonococcal-Neisseria gonorrhoea

Mode of Transmission:

  • Sexual contact with an infected person.
  • Affected mother to child.

Symptoms:

  • Painful urination
  • Pus-like discharge from the tip of the penis
  • Pain or swelling in one testicle
  • Increased vaginal discharge
  • Painful urination
  • Vaginal bleeding between periods, such as after vaginal intercourse
  • Abdominal or pelvic pain

Prevention & Treatment:

  • Single I.M.injection of  600,000 Units of procaine penicillin is in most instances sufficient.
  • Avoid unsafe sexual contact
  • Use of condoms.

With Special Thanks to Prof. Pravin Awate.





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