INFECTIOUS DISEASES

Lecture Objectives:

Upon completion of this lecture, you will be better able to:

List the infectious diseases commonly encountered in the school setting

Describe the etiology, signs and symptoms, diagnosis, complications, treatment and prevention of the diseases discussed in the manual

Identify the incubation and isolation periods for these diseases

FIFTH DISEASE

CAUSE:– A virus known as human parvovirus or B19

SYMPTOMS:– “Slapped cheek” rash (starts on face and spreads– Fever, general pruritis, flu symptoms, and

pharyngitis

FIFTH DISEASE Incubation period is 6-14 days Symptoms usually begin one to two

weeks after exposure to the virus NOTE: WHEN THE RASH APPEARS,

THE STUDENT IS NO LONGER CONTAGIOUS!

“Slapped Cheek” rash

FIFTH DISEASE COMPLICATIONS

– Can be dangerous to women who are less than 20 weeks pregnant

– Dangerous to cancer or immunosuppressed students

DIAGNOSIS– Usually made by clinical symptoms

TREATMENT– No definitive treatment at this time

FIFTH DISEASE PREVENTION

– Good handwashing is the best defense against the virus

– Universal substance precautions

NOTE: THERE IS CURRENTLY NO VACCINE AVAILABLE

PERTUSSIS CAUSE:

– Caused by a bacteria known as Bordetella pertussis

– Highly contagious

TRANSMISSION:– By airborne droplets– Incubation period is 5-10 days

PERTUSSIS3 STAGES OF THE DISEASE:

1. CATARRHAL STAGE (1-2 weeks)• Child is MOST CONTAGIOUS in this stage

2. PAROXYSMAL STAGE (2-4 weeks)

3. CONVALESCENT STAGE (3-4 weeks)

PERTUSSIS

COMPLICATIONS Pneumonia Apnea Dehydration, weight loss Atelectasis Seizures

PERTUSSISDIAGNOSIS A nasopharyngeal swab is used to test

for the B. pertussis bacteria

TREATMENT Erythromycin

PREVENTION Vaccination

INFECTIOUS MONONUCLEOSIS

CAUSE The Epstein-Barr virus is the most

common cause of mononucleosis (mono)

In the United States, the incidence of mono peaks in adolescence

INFECTIOUS MONONUCLEOSIS

TRANSMISSION Transmitted through affected saliva. Also known

as the ”kissing disease”

SYMPTOMS High fever Splenomegaly Lymphadenopathy Fatigue Hepatosplenomegaly

INFECTIOUS MONONUCLEOSIS

DIAGNOSIS A blood test is required to confirm the

diagnosis (Monospot) CBC usually shows atypical lymphocytes

COMPLICATIONS Splenic rupture Guillain-Barre

INFECTIOUS MONONUCLEOSIS

TREATMENT Currently no medication to treat the disease Treatment typically palliative - treat the

symptomsPREVENTION There is no vaccine currently available Best defense is to avoid direct exposure to

anyone with symptoms. Always maintain good handwashing

SCARLET FEVER

CAUSE Usually caused by group A

streptococcus

SYMPTOMS Fever, pharyngitis, “sandpaper” rash

SCARLET FEVER

TRANSMISSION Respiratory droplets spread the

disease. Spread by close contact and shared utensils

Incubation period is 3-5 days NOTE: Student is contagious until

antibiotic is taken for 24 hours

SCARLET FEVER

DIAGNOSIS A throat culture determines if Strep A is

present If culture is positive and there is a rash, the

diagnosis is made

TREATMENT The drug of choice is penicillin

SCARLET FEVER

COMPLICATIONS Rheumatic Fever Glomerulonephritis

PREVENTION Avoid close contact or sharing of utensils

with anyone who is symptomatic. Always maintain good handwashing

RESPIRATORY SYNCYTIAL VIRUS

Respiratory syncytial virus (RSV) is the most frequent cause of respiratory tract infections in children less than 4 years old

Most children experience at least one infection by age 3. Confers only partial protection from subsequent infection, so reinfection can occur.

RESPIRATORY SYNCYTIAL VIRUS

SYMPTOMS Wheezing Tachypnea Retractions Nasal flaring Atelectasis

RESPIRATORY SYNCTIAL VIRUS

COMPLICATIONS Hypoxia

Dehydration

Respiratory failure

RESPIRATORY SYNCYTIAL VIRUS

TREATMENT Oxygen Fluid balance Tylenol Albuterol nebulizer or

oral medication

Pediculosis

THREE FORMS OF HEAD LICE NIT- Eggs of head lice. Hatch in approximately

1 week. Usually found attached to hair shaft.

NYMPH - Becomes an adult in approximately 7 days after hatching. Will die without blood supply.

ADULT - Has 6 legs and can live up to 30 days on a head. Needs blood supply to live.

Pediculosis

DIAGNOSIS

A diagnosis is made when one or more live lice are found on the student.

Pediculosis

TREATMENT Only treat a student when live lice

are found. A standard chemical insecticidal

lotion is used. Inform parent/guardian on how to

treat household items.

IMPETIGO

TWO TYPES OF IMPETIGO Nonbullous impetigo- This type is

typically seen to a greater degree in children versus adults. Usually affects the facial area.

Bullous impetigo-This type is highly contagious and can spread to large areas of skin.

IMPETIGO

TREATMENT Impetigo is usually treated with

oral antibiotics such as dicloxacillin.

Occasionally, only a topical antibiotic such as mupirocin is prescribed.

RINGWORM

CAUSE

Ringworm (tinea capitis) is caused by the fungus Trichophyton tonsurans. When ringworm affects the scalp, typically hair loss occurs.

RINGWORM

TREATMENT

The treatment for ringworm is oral griseofulvin for 8 weeks. Antifungal shampoo should also be used 2 times a week for 8 weeks.

RINGWORM

PREVENTION Good handwashing No sharing of personal hair

products Checking pets for signs and

symptoms of ringworm

MENINGITIS

Meningitis is an inflammation of the meninges. Can be bacterial or viral.

Leading cause of bacterial meningitis used to be Haemophilus influenzae type B

Current leading cause is Streptococcus pneumoniae and Neisseria meningitis.

MENINGITIS

SYMPTOMS High fever Headache Stiff neck Nausea, vomiting Photophobia Lethargy

MENINGITIS

TREATMENT Hospitalization IV antibiotics are the treatment of

choice for bacterial meningitis

Summary

Children are subject to a wide variety of infectious illness, ranging in severity from minor annoyances to potentially lethal diseases. It is important to be aware of the findings and progression associated with these diseases in order to expediate evaluation, treatment, prevention and followup.

Remember – contagious illness poses a particular threat to students who have compromised immune systems. Implement special precautions to protect these students from infectious diseases at school.

ANY QUESTIONS??