COMMUNITY HEALTH NURSING -1

GUIDED BY :-MISS KINJAL JADAV

PRESENTED BY :- VHORA MAHIR

PRESENTATION ON COMMON COMMUNICABLE DISEASE

ZOONOSIS&

RABIES

zoonosis

ZOONOSIS Zoonosis is also called zoonotic disease . It

refers to the disease which can be passed from animal to human beings . According to centres for disease control in Atlanta .The most emerging disease around the world are zoonotic . The director of CDC has said that 11 of the last 12 emerging infaction in the world with serious health consequences has arisen from animal sources. This rise in the number of zoonotic disease is due to wild animal trade across the countries and keeping of animal as domestic pets.

Animal Disease

Bats Rabies and viral infection

Cat Plague,Anthrax,Cowpox,Tape worm and Bacterial infection

Dogs Plague,tape worm, rabies,rocky mountain spotted fever and lyme disease

Horses Anthrax, rabies, salmonella infections

Cattle Anthrax,European tick borne encephalitis, rabies, tapeworm, salmonella infection

Pigs Tape worm,anthrax,influenza,rabies

Rabbits Plagu ,Q-fever

Birds Salmonellosis,Campylobacteriosis,chlamydia psittaci, pasteurella multocida, histoplasm capsulatum

There are different methods of transmission of zoonotic diseases. There are:

A) Direct contact : Infectious disease can spread by being near

to an infected animal especially coming in close contact with infected animal.

B) By ingestion : Some diseases occur in human beings after

ingesting the flesh of an animal. For exampel – Tape worm can spread to human when people eat meat of infected cattle, swine etc . Even drinking water which contains eggs of parasite, can cause disease in man

C) Vector Borne : The disease spread by insect vectors

such as flea or tick, as they feed on infected animal and on human beings and these blood feeding insect often carry the disease from animal to human .

RABIES

IntroductionsRabies is a zoonotic disease which is cause by

LYSSAVIRUS Type -1 of family RHABDOVIRIDAE.

It is know as HYDROPHOBIA. It is deadly virus disease affecting the central nerveous system. It is almost contracted to rabid animal . It is widely distributed acroos the globe. More than 55000 people die each year due to rabies . Most human deats follow abite from an infected dog. The victims of dog bite are under the age of 15, which is about 30-60 %.

In India , it occurs in all part of country except Andaman & Nicobar Islands, Lakshadweep. Every year 1.1 to 1.5 million people receive anti rabies treatment. More than 95 % of these cases are bitten by dogs.

Epidemiological Triad AGENT(Lyssavirus type 1of

Rhabdoviridae family)

HOST ENVIRONMENT

(Warm blooded (Rabid dog population

mammals) -stray dogs , bats)

AGENT The causative organism is lyssavirus type

1 family rhabdoviridae. The virus is excreted through saliva of

affected animal,. Saliva of rabid animal is source of infection.

Rabies occurs in three epidemiological forms such as urban, wild life & bat rabies .

One rabid dog is capable of biting a large number of human & animals.

HOST Warm blooded mammals including man is

at high risk for rabies. Dog handlers Hunters Veterinarians Laboratory staff working with rabies

virus.

ENVIRONMENTAL FACTOR Rabid dogs and cats, which have the

rabies virus in saliva. Vampire bat Jackal ,fox ,hyena are wild life carriers

which are the main reservoir and transmitter of rabies.

MODE OF TRANSMISSION By bite of an infected animal Open scratch or wound in contact with

infectious material such as blood or saliva of an infected animal.

Human to human in case of corneal transplant from an infected individual.

By mucous membrane when it comes in contact with material.

INCUBATION PERIOD : Two to eight weeks

CLINICAL MANIFESTATIONS The first symptom can appear a few days to

more than year after being infected by bite . The distinctive sign of rabies infection is a tingling or twitching sensation around the area of the animal bite. It is accompained by :-

Fever Headache Muscle aches Loss of appetite Nausea Fatigue

As the infection progress, then Irritiability Confusion Agitation Abnormal thoughts Posture change Convulsions Paralysis Extreme sensitivity to bright light, sound ,

touch Increased production of saliva or tears Difficulty in speaking

In advanced stages, it spreads to nervous system ,then patient has:

Double vision Problems moving facial muscles Abnormal movements of diaphragm Difficulty in swallowing Increased production of saliva causing

foaming at mouth.

DIAGNOSIS History of bite by a rabid animal Clinical signs/symptoms especially

hydrophobia Antigen detection using immuno

fluorescence of skin biopsy Isolation of virus from saliva

PREVENTION AND CONTROL OF RABIES

A) Early diagnosis :

Early dignosis of rabies , with or without laboratory confirmation is important for prevention of exposure of health care workers and for initiation of specific therapy . Early clinical features of rabies are pain ,paresthesia & prurities at site of virus entry . Patients should be diagnosed and those who need aggressive care must be admitted to hospital where they can have access to critical care unit.

TREATMENT In case , a dog has bitten a man ,then Promptly scrub the site with water & soap Apply alcohol on wound Administer rabies immuno-globulin (RIG)

around the site of bite Administer fine doses of tissue culture

vaccine including human diploid cell rabies vaccine on the days 0,3,7,14 and 28 after exposure.

Other measures of tretment include: 1) Isolation : The patient of rabies should be isolated in

dark room and quite room, where the stimuli are less, as the stimuli may precipitate the spasms or convulsions.

2) Reduce anxiety and pain : The patient & anxiety can be relieved by

admini- stering sedatives such as morphine sulphate to allay acute sufferings.

3)Hydration : patient should be hydrated but make sure that

the I/V fluid bottles are covered. Monitor urine output as to assess the kidney function.

4) Intensive care :If the patient is having respiratory or cardiac

problem due to rabies, then patient should be kept in intensive care unit to provide intensive care.

5) Vaccine :Vaccine used is rabies is rabies human diploid cell

vaccine (HDCV) and tissue culture vaccine. It should be given to high risk groups like animal handlers, lab workers, zoo keepers, trappers etc.

It given either I/M or I/D . The three doses are on the day 0 then 7th,then 21st or 28th day.Booster dose is required after every two years,

Who are at risk of contracting rabies. This vaccine schedule is before the exposure to rabies .and after exposure to rabies ,RIG &vaccine schedule is followed as given under treatment.

Control the dogs/animals causing rabies &proper handling :-

Remove all stray dogs and cats Have all pets (dogs& cats)vaccinated. Do not allow bats to live in house chimney Avoid picking up dead or abandoned animals. Do not eat animal that do not look normal use gloves while skinning animals and

handling nervous tissue or organs.

NURSING MANAGEMENT Isolate the patient Provide optimum comfort Darken the room and provide quiet

environment Patient should not be bathed and there

should not running water in room or near the room at hearing distance.

I/V fluids should be wrapped and needle should be securely anchored to avoid Dislodging.

THANK YOU