> Disease Burden

SOURCE OF INFECTION AND PREVENTION

1.? AIDS

• Caused by a virus called Human Immuno Deficiency virus.
  

• There are about 13 million cases by 1999? Worldwide and 6.7 million in South and South East Asia.
  
• It is transmitted from person to person through sexual contact, sharining of virus contaminated needles and syringes, transfusion of infected blood.
  
• Transmission at the contact with saliva, tears, urine not occured.

Prevention:

• Have sexual intercourse with wife/husband only.
  

• Abstain from sexual intercourse with unknown persons.
  
• Use condoms during sexual acts.
  
• Use of sterilized needles / syringes, disposable needles.
  
• Screening of blood and blood products.
  
• Care in handling, using and disposing of blood and blood products, needles and sharp instruments.
  
• Disinfection of equipment contaminated.

2.? CHICKEN POX:

• It is an acute viral disease, with slight fever, malaise and a skin eruption.
  

• It is caused by a virus Herpes virus 3.
  
• Transmitted from person to person by direct contact by droplet or by air borne spread.

Prevention:

• Report to local health authorities.
  

• Exclude children from school,? emergency rooms (or)? Public places until the varicles become dry.
  
• Articles contaminated should be disinfected.
  
• Vaccine is recommended for suceptible persons following exposure? to virus.
  
• Vaccine may be given to the children aged 12 to 18 months and for the
  
• Children upto 12 years who have not had varicella.
  
• The vaccine has efficacy of? 70-90%.

3.? CHOLERA:

• Caused by a bacteria vibrio cholerae.
  

• Affected person will have suddden onset of Profuse painless watery stools, nausea, vomitting.
  
• If not treated in early stages, rapid dehydration, collapse and renal failure will occur.
  
• Transmitted by ingestion of food or water contaminated directly or indirectly.

Prevention:

• Report to local health authority.
  

• Hospitalization of severe patients.
  
• Mild cases can be treated at house by use of oral rehydration solution.
  
• Treatment consist of:
  • Rehydration therapy.
    
  • Administration of antibiotics.
    
  • Treatment of complications.
• Disinfection of feces, vomitting and of linens, articles used by the patient.
  
• Vaccination is of little practical value in outbreaks.

4.? DENGUE FEVER

• Caused by virus flavi virus.
  

• There will be sudden onset, fever for 3-5 days severe headache, musles pain,
  
• ?joint pain, pain in the eyes, digestive problems.
  
• In haemorrhagic disease, there will be bleeding nose, gum, hypovolemia and abnormal blood clotting properties.
  
• Transmitted by a mosquito Aedesaegypti.

PREVENTION:

• Eliminating mosquito by net, protective clothing, repellants and avoiding stagnation of water.
  

• Treatment is only supportive.
  
• Aspirin should not be used because it may cause bleeding in the stomach.
  
• The haemorrhagic cases has to be hospitalised.

5.? DIPTHERIA:

• Caused by bacteria corny bacterium diptheriae.
  

• It involves tonsils, pharynx, larynx, nose, skin, conjunctiva or vagina.
  
• There will be asymmetrical grayish, whitish membrane, nasal discharge.
  
• Transmitted by contact with a patient or carrier.

Prevention:

• Report to local health authority.
  

• Effective way of control is immunisation with diptheria toxoid.? At present it is given as DPT in 45 days, 75 days, 105 days? of age and? at 18 months as booster and as DT in 5 years of age in India.
  
• Disinfection of articles soiled by discharge of patient.

6.? HEPATITIS

Hepatitis A:

• Start with fever malaise, anorexia, nausea and abdominal discomfort, followed by jaundice.
  

• Caused by Hepatitis A Virus.
  
• Transmitted from person to person by the fecal - oral route.? Common source outbreaks related to contaminated water and food, infected food handlers.

Prevention:

• Education about good sanitation and personal hygiene.
  

• Proper water treatment.
  
• Vaccines are available for 2 years of age and older.

Hepatitis B:

• Caused by hepatits B virus.
  

• Start with nausea, vomitting, abdominal discomfort, joint pain and jaundice.
  
• Transmitted by blood and blood produce sexual contacts, infected saliva and other body sections.

Prevention:

• Effective vaccines are available.
  

• Screening of blood products.
  
• Adherence to sterilization procedures.

7.? INFLUENZA

-? Caused by influenza viruses.

-? Characterized by fever, headache, muscle pain, running nose, sore throat
??? and cough.

-? Transmitted by airborne among crowded population.

Prevention:

-? Education about basic personal hygiene, especially danger of unprotected
??? cough and sneezes.

-? Vaccination may provide 70-80% protection.

8.? LEPROSY

-? Caused by a bacteria called mycobacterium lefrae.

-? It is the bacterial disease, that affects skin and peripheral nerves and the
??? upper airway.

-? It will? be presented as hypopigmented patches, thickened nerves and?
??? deformities.


Prevention:

-? Early detection of cases with white and shining patches without any sense.

-? Prompt treatment with multidrug.

-? Health education.

-? Environmental sanitation.

9.? MALARIA

-? Caused by a parasite plasmodia.

-? Start with fever, rigors, headache and nausea, sweating, fever may occurs
??? in an interval depending upon the types.

Prevention:

-? Source reduction and control of larval stages by sanitary improvements.

-? Early diagnosis with blood semar and treatment at the nearest Health
??? facility such as HSC/PHC.

-? Health education

-? Screening of blood.

-? Personal protective measures.

10.? MEASLES

-? Caused by measles virus.

-? Presented as fever, conjunctivitis, cold, cough and small spots with bluish
?? white centers an red base on the buccal mucosa.

-? Transmitted by direct contact or airborne.

Prevention:

-? Active vaccination with measles vaccine after completion of 9 months of age
??? among children.

-? Children affected should be kept out of schools and in isolation.







11.? CEREBRO SPINAL FEVER

-? Caused by a bacteria Neisseria meningititis.

-? Occurs as sudden onset of fever, intense headache, nausea, vomitting,?
??? stiff neck, rash and coma.

-? Transmitted by direct contact, respiratory droplets.

Prevention:

-? Report to? local health authorities.

-? Education on the need to reduce direct contact and droplet infection.

-? Reduce over crowding.

-? Close surveillance of household, day care.

-? Vaccines are available.

12. WHOOPING COUGH (Pertusis)

-? Caused by the bacteria bacilus (Pertusis)

-? Occurs as initiating cough which becomes repeated violent cough
??? followed by high pitched respiratory whoop.

-? It occurs among children.

-? Transmitted by direct contact with discharges.

Prevention:

-? Report to local health authority.

-? Active immunization which is now given along with diptheria and tetanus as DPT.

-?? Isolation of cases.

-? Quaranting from schools for 21 days.

-? Education of public.?







13.? PLAGUE:

-? Caused by the bacteriae Yersinia Pestis.

-? Occurs as fever, chills, tiredness, muscle pain, nausea, sore throat
???? and headache.

-? Enlargement of lymph nodes also occur.

-? Transmitted by the bite of infected fleas.

Prevention:

-? Report to local Health Authorities.

-? Reduction of flea source, control of rates.

-? Personal protection.

-? Isolation of cases.

-? Quarantive for 7 days.

14.? POLIO:

-? Caused by Polio virus types 1, 2, 3.

-? Occurs as fever, malaise, headache, nausea, vomitting, muscle pain,
???? stiffness of the back and neck with FLACCID PARALYSIS.

-? Transmitted from person to person by fecal-oral route.

Prevention:

-? Report to the local Health Authority.

-? Active immunization with Polio vaccines? It is given as oral polio drops.
??? It should be given at birth, 45 days, 75 days, 105 days and 9 months of
??? age and at 1 1/2 years.

-? In view of eradicating polio, 2 rounds Pulse Polio is given since from 1995.
??? The child should also receive these pulse polio in addition to the routine
??? Immunisation.??

-? Personal and environment hygiene.





15.? RABIES:

-? Caused by virus Rabies virus.

-? Followed by a bite or scratch of a rabies affected animal.

-? Occurs as headache, fever, tiredness, indefinite sensory changes

-? The main features is excitability, aerophobia (fearness to the speed air),?
??? difficulty in swallowing, hydrophobia (fear of water).

-? Without treatment death occurs due to respiratory paralysis.

Prevention:

-?? Register license and vaccinate all dogs.

-? Treat the wound immediately by thorough cleaning.? The wound
??? should not be sutured.

-? Effective? vaccination is available for the both exposed and non-exposed
??? persons.

16.? SMALL POX:

-? Caused? by Variola virus.

-? Occurs as sudden fever, malaise, headache, prostration, severe back ache,
??? abdominal pain and vomitting.

-? A deep-seated rash developed with face and extremities.

-? Transmitted from person to person.

-? In Biowar it would most likely be disseminated in an aerosol cloud.

Prevention:

-? Report to local Health Authority.

-? Vaccine is available.

-? This disease was eradicated globally in 8th May, 1980.






17.? SCARLET FEVER:

-? Caused by bacteria Group A Streptoccoci.

- Occurs as fever, sore throat, exudative tonsillitis, pharyngitis, tender
?? enlarged lymphnods at neck, ear infection.

-? Typical rash will occur which is usually a fine, reddish, blanching on?
??? pressure, appears on neck, chest, axilla, elbow groin and inner surfaces of thighs.

-? Transmitted by direct contact or by respiratory droplets.

-? Rheumatic fever and effect on kidney may occur as complication.

Prevention:

-? Education? -? about modes of transmission.
???????? -? relationship with Rheumatic fever.
????????? -? adherence to the treatment.

-? Pasteurize the milk.

-? Exclude infected people from handling milk and food.

-? Treatment with penicillin may reduce the complication.

18.? TETANUS:

-? Caused by bacteria clostridium tetani.

-? Occurs as painful muscular contraction, first affecting the cheek
??? and neck muscles and then trunk muscles.

-? A common first sign in older children and adult is adbominal rigidity.

-? Transmitted by wound contaminated with soil, feces.

-? It occurs in new borns which is called as neonatal tetanus if safety methods
??? are not followed during delivery.

Prevention:

-? Immunization with tetanus toxoid.

-? Pregnant Women:

??? -? 2 doses of tetanus toxoid.
??? -? at 16-20 weeks and 24 weeks of pregnancy.
??? -? to prevent neonatal tetanus.


-? For Infants:

??? -? included in DPT and to be given at 45 days, 75 days, 105 days
?????? and 1 1/2 years of birth.
??? -? DT at fifth year.
??? -? TT at 10th year and once in five years.
??? -? Thorough cleaning of the wound.

???? -? AVOID FREQUENT T.T. INJECTION, WHENEVER YOU GET INJURED

19.? TUBERCULOSIS:

-? Caused by bacteria mycobacterium tuberculosis.

-? It affects lungs, mainly intestine, brain, bones and joints lymph glanes.

-? Occurs as cough more than 3 weeks, fever, loss of weight, loss of
??? appetite.

-? Transmitted as airborne droplet.

Prevention:

-? Education about the importance of early diagnosis and prompt treatment.

-? Improvement in housing venitlation.

- Environmental sanitation.

-? BCG Vaccine at the time of birth.

To combat the tuberculosis now, revised? National Tuberculosis Control Programme is being implemented in Govt.PHCs / Hospitals which ensures the successful treatment.

20.? TYPHOID FEVER:

-? Caused by bacteria salmonella typhi.

-? Occurs as sustained fever, severe headache, tiredness, splenomegaly, slowing
??? of heart beat (Bradycardia), rose spots on the trunk.

-? Transmitted by contaminated food and water.








Prevention:

-? Proper hand washing and other personal hygiene.
-? Drinking of chlorinated, purified and boiled water.
-? Control of flies.
-? Preventing typhoid patients and carriers from handling of foods.
-? Using latrines for defaecation.
-? Vaccination is also available.
21.? VIRAL ENCEPHALITIS:

-? Caused by many viruses.
-? Occurs as sudden fever, severe headache, vomitting, stiffness of neck.
-? Transmitted person to person, direct contact.

Prevention:

-? Report to local Health Authority.
-? Environment and personal hygiene.
-? Food and water sanitation.
-? Prompt treatment.
????
1.? MAL NUTRITION:

Protein energy Malnutrition is an important healh and nutrition problem in India.? It is the important cause of childhood diseases and death, permanent impairment of physical and mental growth.? It found in 1-2% of pre-school age children.

Proteins are rich in milk, meat, eggs, cheese, fish.? They also found in pulses, cereals nuts, etc.

It is mainly due inadequate intake of food both in quality and quantity.? Infectiions like diarrhoea, respiratory infection, measles and intestinal worms will aggrevate the malnutriton.

It is divided as mild, moderate and severe grades.? The severe grades may be classified into two categories marasmus and kwashiorkar.

The common features are muscle wasting, fat wasting, oedema, low weight for height, mental changes, poor appetite, frequent diarrhoea, skin changes, hair changes.

The first indicator of protein energy malnutrition is under-weight for age.


Preventive measures:

1.? Education and distribution of supplements to pregnant and breast feeding women.
2.? Encouraging breast feeding.
3.? Improvement in the quality and quantity of family diet.
4.? Family Planning.
5.? Education about nutrition.
6.? Immunization.
7.? Environmental sanitation.


2.? VITAMIN A DEFICIENCY:

It is important Vitamin for normal vision. It is rich in liver, eggs, butter, cheese, whole nut, fish, meat, green and yellow fruits and vegetables, green leafy vegetables.

In deficiency, there will be:

-? night blindness
-? dryness of conjunctiva.
-? foamy spots on conjunctiva (Bitots' spot)
-? dryness of cornea.

Prevention:

-? Improvement in diet.
-? Reduction of infections like, diarrhoea, measles.
-? Administration of single dose of 2,00,000 International? units (IU) of
??? Vitamin A oil orally every 6 months to pre-school children (1-6 years)?
??? and 1,00,000 IU to children between 6 months to one year of age.

3.? ANAEMIA:

Anaemia occurs mainly due to iron deficiency.? It is found especially among adolescents, young children, pregnant women and lactating women.

It occurs due to inadequate intake of iron and other infections like hook worm and malaria.

The foods rich in iron are meat, liver, fish, cereals, green leafy vegetables, nuts, jaggery.

The person suffering from anaemia will have, tiredness, lack of interest in doing work, breathlessness, pale coloured face, palms, pale tongue and eyes, reduced work capacity, etc.






Prevention:

-? Intake of iron containing foods.

-? Control of infection? like malaria and hookworm.

-? Iron and folic acid (IFA) supplementation.

?????????? -? During pregnancy and lactation, IFA Tablets supplied freely.

?????????? -? For adolescents girls the IFA tablets are supplied by teachers,
?? Volunteers and Self help group under adolescent anaemia?
?? Control Programme.

IODINE DEFICIENCY:

Iodine is required for the synthesis of the thyroid hormones.

The sea foods are best sources of iodine. They are found in smaller amounts in milk, meat, vegetables and cereals, etc.

The deficiency will lead to:

-? Goitre (Enlargement of thyroid glands, which is found as a swelling hooks
??? like butterfly in lower part of the front? of the neck).

-? Decreased intelligence, hearing defects, speech defects in children.

-? Myxedema

-? Cretinism

-? Spontaneous abortion, miscarriage.

Prevention:

-? Use of iodized salt.

-? Increased intake of sea food.

-? Health Education.

The Iodised salt pocket will be shown with "smiling sun" logo.

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