OTHER COMMUNICABLE DISEASES. Sandra Pinzón and Diana Sánchez. Andalusian School of Public Health Gábor Ternák. University of Pécs

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1 OTHER COMMUNICABLE DISEASES Sandra Pinzón and Diana Sánchez. Andalusian School of Public Health Gábor Ternák. University of Pécs

2 Viral diseases Hepatitis A Hepatitis B Hepatitis C STI HIV Other viral diseases Influenza Avian Influenza Pandemic H1N1 SAR Measles Poliomyelitis Smallpox Crimean-Congo hemorrhagic fever Dengue/dengue hemorrhagic fever Ebola fever Lassa fever Marburg hemorrhagic fever Yellow fever

3 Measles INFORMATION Measles is a highly contagious viral disease that can be very serious or even fatal. It begins with a fever that lasts for a couple of days, followed by a cough, runny nose, and conjunctivitis (pink eye). A rash starts on the face and upper neck, spreads down the back and trunk, then extends to the arms and hands, as well as the legs and feet. After about five days, the rash fades in the same order it appeared. Serious complications of measles include pneumonia and encephalitis (inflammation of the brain). SPREAD Measles is highly contagious. The measles virus lives in the mucus in the nose and throat of infected people. When they sneeze, cough or talk, droplets spray into the air and the droplets remain active and contagious on infected surfaces for up to two hours.

4 Measles SYMPTOMS In the first stage, the individual may have a runny nose, cough and a slight fever. The eyes may become reddened and sensitive to light, fever, Koplik spots (small bluish white spots surrounded by a reddish area) may also appear on the gums and inside of the cheeks. The second stage begins on the third to seventh day and consists of a red blotchy rash lasting five to six days. TREATMENT There is no specific treatment for measles.

5 Measles

6 Poliomyelitis INFORMATION Polio is a viral disease which may affect the spinal cord causing muscle weakness and paralysis. The polio virus enters the body through the mouth, usually from hands contaminated with the stool of an infected person. Polio is more common in infants and young children and occurs under conditions of poor hygiene. Paralysis is more common and more severe when infection occurs in older individuals. SPREAD Polio is spread when the stool of an infected person is introduced into the mouth of another person through contaminated water or food (fecaloral transmission). Oral-oral transmission by way of an infected person's saliva may account for some cases

7 Poliomyelitis SYMPTOMS Up to 95 percent of people infected with polio have no symptoms. However, infected persons without symptoms can still spread the virus and cause others to develop polio. About four to five percent of infected people have minor symptoms such as fever, muscle weakness, headache, nausea and vomiting. One to two percent of infected persons develop severe muscle pain and stiffness in the neck and back. Less than one percent of polio cases result in paralysis. TREATMENT There is presently no cure for polio. Treatment involves supportive care.

8 Poliomyelitis

Smallpox INFORMATION Smallpox is an acute, contagious and sometimes fatal disease caused by the variola virus and marked by fever and a distinctive progressive skin rash. SPREAD Ternák G.

9 Smallpox INFORMATION Smallpox is an acute, contagious and sometimes fatal disease caused by the variola virus and marked by fever and a distinctive progressive skin rash. SPREAD Ternák G. Pictures of diseases probably related to migration. Universidad of Pécs (Hungary), Smallpox spreads from contact with infected persons. Generally, direct and fairly prolonged face-to-face contact is required to spread smallpox from one person to another. Smallpox also can be spread through direct contact with infected bodily fluids or contaminated objects such as bedding or clothing.

10 Smallpox SYMPTOMS The symptoms of smallpox begin with high fever, head and body aches, and sometimes vomiting. A rash follows that spreads and progresses to raised bumps and pusfilled blisters that crust, scab and fall off after about three weeks, leaving a pitted scar. Ternák G. Pictures of diseases probably related to migration. Universidad of Pécs (Hungary), TREATMENT Vaccine administered up to four days after exposure to the virus, and before the rash appears, provides protective immunity and can prevent infection or lessen the severity of the disease. No effective treatment, other than the management of symptoms, is currently available.

11 Crimean-Congo hemorrhagic fever (CCHF) INFORMATION Crimean-Congo Hemorrhagic fever is a viral hemorrhagic fever transmitted by ticks SPREAD Either by tick-bites, or through contact with viraemic animal tissues during and immediately post-slaughter. SYMPTOMS First mood instability, agitation, mental confusion and throat petechiae, then soon nosebleeds, bloody urine and vomiting, and black stools. The liver becomes swollen and painful. Disseminated intravascular coagulation may occur as well as acute kidney failure and shock, and sometimes acute respiratory distress syndrome. TREATMENT Antiviral drugs (Ribavirin)

12 Crimean-Congo hemorrhagic fever (CCHF)

13 Dengue/ dengue hemorrhagic fever INFORMATION Dengue fever is a mosquito-borne disease caused by a virus SPREAD The bite of infected Aedes mosquitoes. SYMPTOMS Fever, intense headache, joint and muscle pain and a rash. The rash develops on the feet or legs three to four days after the beginning of the fever. The hemorrhagic form of dengue fever is more severe and associated with loss of appetite, vomiting, high fever, headache and abdominal pain. Shock and circulatory failure may occur. TREATMENT There is no specific treatment available. Intravenous fluids and oxygen therapy are often used for patients who experience shock during their illness.

14 Dengue/ dengue hemorrhagic fever

Ebola fever INFORMATION Ebola hemorrhagic fever is caused by several Ebola viruses. SPREAD People get the disease by direct contact with virus-infected blood, body fluids, organs, or semen.

15 Ebola fever INFORMATION Ebola hemorrhagic fever is caused by several Ebola viruses. SPREAD People get the disease by direct contact with virus-infected blood, body fluids, organs, or semen. SYMPTOMS Fever, weakness, muscle pain, headache, and sore throat, followed by vomiting, diarrhea, rash, limited kidney and liver functions, and both internal and external bleeding. Ternák G. Pictures of diseases probably related to migration. Universidad of Pécs (Hungary), 2010.

Ebola fever TREATMENT Severe cases require intensive supportive care, as patients are frequently dehydrated and in need of intravenous fluids or oral rehydration with solutions containing

16 Ebola fever TREATMENT Severe cases require intensive supportive care, as patients are frequently dehydrated and in need of intravenous fluids or oral rehydration with solutions containing electrolytes. No specific treatment or vaccine is yet available for Ebola hemorrhagic fever. Ternák G. Pictures of diseases probably related to migration. Universidad of Pécs (Hungary), 2010.

17 Ebola fever

18 Lassa fever INFORMATION Lassa viral hemorrhagic fever is an acute illness of 1-4 weeks duration that occurs in West Africa. SPREAD Humans usually become infected with Lassa virus from exposure to excreta of infected Mastomys. Both direct exposure, (touching the excreta) and Lassa virus may also be spread between humans through direct contact with the blood, urine, feces, or other bodily secretions of a person with Person-to-person transmission occurs in both community and health care settings, where the virus may be spread by contaminated medical equipment, such as re-used needles. Sexual transmission of Lassa virus has been reported.

19 Lassa fever SYMPTOMS The disease is usually gradual, starting with fever, general weakness, and malaise. After a few days, headache, sore throat, muscle pain, chest pain, nausea, vomiting, diarrhea, cough, and abdominal may follow. Severe cases may progress to show facial swelling, fluid in the lung cavity, bleeding from mouth, nose, vagina or gastrointestinal tract, and low blood pressure. Protein may be noted in the urine. Shock, seizures, tremor, disorientation, and coma may be seen in the late stages. TREATMENT The antiviral drug ribavirin is effective treatment for Lassa fever if given early on in the course of clinical illness. There is no evidence to support the role of ribavirin as post-exposure prophylactic treatment for Lassa fever.

20 Lassa fever

21 Marburg hemorrhagic fever INFORMATION Marburg originated in Central and East Africa, and infects both human and nonhuman primates. The Marburg Virus is in the same taxonomic family as Ebola, and both are identical structurally although they elicit different antibodies. SPREAD People get the disease by direct contact with virus-infected blood, body fluids, organs, or semen.

22 Marburg hemorrhagic fever SYMPTOMS The disease is spread through bodily fluids, including blood, excrement, saliva, and vomit. Fever, headache and myalgia after an incubation period of three to nine days. After five days, a maculopapular rash is often present on the trunk. Later-stage Marburg infection is acute and can include jaundice, pancreatitis, weight loss, delirium and neuropsychiatric symptoms, haemorrhaging, hypovolemic shock and multi-organ dysfunction, with liver failure most common. TREATMENT There is no specific antiviral therapy indicated for treating Marburg, and hospital care is usually supportive in nature. Hypotension and shock may require early administration of vasopressors and haemodynamic monitoring with attention to fluid and electrolyte balance, circulatory volume, and blood pressure.

23 Marburg hemorrhagic fever

24 Yellow fever INFORMATION Yellow fever is a mosquitoborne viral disease. The disease occurs in tropical and subtropical areas. SPREAD A certain type of mosquito, Aedes aegypti, is most often responsible for transmitting the virus. Ternák G. Pictures of diseases probably related to migration. Universidad of Pécs (Hungary),

25 Yellow fever SYMPTOMS Initial symptoms may be dengue-like and include fever, headache, vomiting and backache. As the disease a progress, the pulse slows and weakens, and bleeding of the gums and bloody urine occur. Jaundice may also occur. TREATMENT There is no specific treatment for yellow fever. People traveling to areas where yellow fever may exist should be immunized. Ternák G. Pictures of diseases probably related to migration. Universidad of Pécs (Hungary), 2010.

26 Yellow fever

27 Other viral diseases HENDRA VIRUS (HeV) INFECTION NIPAH VIRUS (NiV) INFECTION VARICELLA HERPES ZOSTER ENCEPHALITIS RABIES

28 Bacterial diseases Cholera Meningococcal disease Pneumococcal disease STI Syphilis Tuberculosis Other bacterial diseases Antrax Pertussis Plague Tetanus Tularaemia

Anthrax INFORMATION Rare infectious disease caused by the bacterium Bacillus anthracis. There are 3 types of anthrax in humans: cutaneous, gastrointestinal tract and pulmonary. SPREAD Ternák G.

29 Anthrax INFORMATION Rare infectious disease caused by the bacterium Bacillus anthracis. There are 3 types of anthrax in humans: cutaneous, gastrointestinal tract and pulmonary. SPREAD Ternák G. Pictures of diseases probably related to migration. Universidad of Pécs (Hungary), Humans generally acquire the disease directly or indirectly from infected animals, or occupational exposure to infected or contaminated animal products.

High fever, rapid pulse and severe difficulty breathing Gastrointestinal: fever, abdominal pain, loose, watery

30 Anthrax SIMPTOMS Skin: break in the skin, itching where the skin has been exposed. Boil or sore appears. The sore becomes covered by a black scab. Inhalation: fever, fatigue, malaise and a cough or chest pain. High fever, rapid pulse and severe difficulty breathing Gastrointestinal: fever, abdominal pain, loose, watery bowel movements, and vomiting with blood. Ternák G. Pictures of diseases probably related to migration. Universidad of Pécs (Hungary), 2010.

Anthrax TREATMENT Antibiotic therapy usually results in dramatic recovery of the individual or animal infected with anthrax if given before

31 Anthrax TREATMENT Antibiotic therapy usually results in dramatic recovery of the individual or animal infected with anthrax if given before onset or immediately after onset of illness. Ternák G. Pictures of diseases probably related to migration. Universidad of Pécs (Hungary), 2010.

32 Anthrax

Pertussis INFORMATION Pertussis, or whooping cough, is a highly contagious bacterial infection that causes an uncontrollable, violent cough lasting several weeks or even months.

33 Pertussis INFORMATION Pertussis, or whooping cough, is a highly contagious bacterial infection that causes an uncontrollable, violent cough lasting several weeks or even months. It is caused by a bacterium that is found in the mouth, nose and throat of an infected person. SPREAD Pertussis is primarily spread from person to person by direct contact with mucus or droplets from the nose and throat of infected individuals. Frequently, older siblings who may be harboring the bacteria in their nose and throat can bring the disease home and infect an infant in the household.

34 Pertussis SIMPTOMS Pertussis begins as a mild upper respiratory infection. Initially, symptoms resemble those of a common cold, including sneezing, runny nose, low-grade fever and a mild cough. Within two weeks, the cough becomes more severe and is characterized by episodes of numerous rapid coughs followed by a crowing or high pitched whoop. A thick, clear mucous may be discharged from the nose. TREATMENT The recommended antibiotics for the treatment and postexposure prevention.

35 Plague INFORMATION Plague is a severe disease caused by an infection with a type of bacteria that is found in rodents and their fleas. Plague can exist in different forms in people and can require strict isolation and disinfection procedures. SPREAD The most common means of transmission is by exposure to infected fleas. Other important sources include the handling of infected animals (especially cats, rabbits and rodents), airborne droplets from humans or household pets with plague pneumonia, or by laboratory exposure.

Plague SIMPTOMS The initial symptom is usually a swollen, inflamed and tender lymph gland in the body near where the infected flea bit the person (a

36 Plague SIMPTOMS The initial symptom is usually a swollen, inflamed and tender lymph gland in the body near where the infected flea bit the person (a bubo). Fever is usually present. With or without a bubo, the disease may progress to a generalized blood infection, with nonspecific flu-like symptoms.

37 Plague SIMPTOMS Pneumonia may also develop. People or animals with pneumonic plague may transmit the disease to other people by coughing. TREATMENT Certain antibiotics such as streptomycin, tetracyclines and chloramphenicol are effective in treating the disease.

38 Plague

39 Tularaemia INFORMATION Tularaemia is a bacterial disease associated with both animals and man. Although many wild and domestic animals have been infected, the rabbit is most often involved in disease outbreaks. SPREAD The common routes include inoculation of the skin or mucous membranes with blood or tissue while handling infected animals, bites from infected deer flies or ticks, or handling or eating insufficiently cooked rabbit meat. Less common means of spread are drinking contaminated water, inhaling dust from contaminated soil or handling contaminated pelts or paws of animals.

40 Tularaemia SIMPTOMS When it enters through the skin, tularaemia can be recognized by the presence of a skin lesion and swollen glands. Ingestion of the organism may produce a throat infection, intestinal pain, diarrhoea and vomiting. Inhalation of the organism may produce a fever alone or fever combined with a pneumonia-like illness. Pneumonia with tularaemia may also occur subsequent to infection through the skin or by ingestion. TREATMENT Certain antibiotics such as streptomycin are effective in treating tularaemia. Others such as gentamycin and tobramycin have also been reported to be effective.

41 Tetanus INFORMATION Tetanus, commonly called lockjaw, is a serious bacterial disease that affects muscles and nerves. SPREAD In unvaccinated individuals, tetanus is contracted through a cut or deep wound which becomes contaminated with the organism. Tetanus has also been associated with clean wounds, surgical procedures, insect bites, dental infections, and intravenous drug use. It is not transmitted from person to person.

42 Tetanus SIMPTOMS A common first sign of tetanus is muscular stiffness in the jaw (lockjaw), followed by stiffness of the neck, difficulty in swallowing, rigidity of abdominal muscles, spasms, sweating, and fever. TREATMENT The use of tetanus toxoid-containing vaccine and tetanus immune globulin (TIG) or antitoxin in the management of wounds depends on the nature of the wound and the history of immunization.

43 Other bacterial diseases TYPHOID BRUSELOSIS SALMONELLA DISENTERY LEPROSY BORRELIOSIS DIPHTHERIA

PHBLM PROJECT Increasing Public Health Safety alongside the New Eastern European Border Line

PHBLM PROJECT Increasing Public Health Safety alongside the New Eastern European Border Line Health Professionals Module II: Well-being public / individual health Training Unit 5: Communicable diseases Activity 3 The group will be divided on 6 and each one of them will read and present one of