Community health nursing 1 kenil

COMMUNITY HEALTH NURSING-1

Guided by, Presented by, Ms. Kinjal Jadav Kenil Chauhan

PRESENTATION ON COMMON

COMMUNICABLE DISEASE

POLIOMYELITIS

INTRODUCTION Polio can occur sporadically, endemically

or epidemically. Poliomyelitis was found worldwide before the development of vaccine.

After the development of vaccine, It has been eliminated from developed countries.

In india, this is a still problem. The government is taking all efforts to eradicate this disease by pulse polio compaigns.

EPIDEMIOLOGICAL TRIAD

Agent (PolioVirus)

Host Environment(Infant & children under (contaminated water and 3 years males>females) food overcrowding,rainy season)

AGENT

• The causative agent of poliomyelitis is POLIOVIRUS. It has three types of sero-types 1,2 and 3. mostly the polio occurs due to type-1 polio virus.

• The virus is found in the oropharyngeal secretions of a patients infected with polio virus.

• The cases of polio are infective 7-10 days before and after the onset of symptoms i.e. The period of communicability is 7-10 days before and after the onset of symptoms.

HOST FACTOR

• Polio is a disease of infancy and childhood. It means most vulnerable age is between 6 months and 3 years.

• It occurs three times more than female i.e. occurrence of disease is 3:1 in males & females.

ENVIRONMENTAL FACTORS

• It is more likely to occur in rainy season.• Contaminated water,food, flies are the

environmental factors which can cause the poliomyelitis.

• Polio virus is excreated in the faeces for 2-3 week, sometimes 3-4 months in polio case.

• Other causes of environment include overcrowding, poor santitation etc.

MODE OF TRANSMISSION

• Faeco-oral routeDirectly spread through fingers which are

contaminated with polio virus or indirectly milk, water, food, flies and articles.

• Droplet InfectionDroplet infection is the mode of transmission of

infection. Personal contact with an infected person with facilitate the spread of infection.

• Incubation period : 7 to 35 days

• CLINICAL MANIFESTATION: Asymmetrical flaccid paralysis Fever at the onset of paralysis which is suggestive of polio. Anorexia Vomiting Nausea Malaise Headache Sore throat Abdominal pain Constipation

Stiffness of neck and back muscles.Difficulty in swallowingWeak or diminished deep tendon reflaxes

before the onset of paralysis.– The paralysis in a case of polio reaches to its

maximum in less than 4 days. Paralysis occurs in descending way i.e. starting at hip and then moving down to distal parts of the extremity.

– In case of bulbar and bulbospinal form paralytic poliomyelitis, cranial nerve involvement can cause facial asymmetry, difficulty in swallowing. Death can also occur due to respiratory insufficiency.

PREVENTION AND CONTROL

(1) Immunisation : it is one of the effective means to achieve

prevention of poliomyelitis. The vaccine used for immunisation is of two

types. Inactivated polio vaccine(IPV) Oral polio vaccine(OPV)

Inactivated Polio Vaccine : It is the salk vaccine. It contains all the three types of

virus of polio which are inactivated by formalin. The main advantage of giving advantage of giving this vaccine is that it does not contain live virus so it can be administered safely to patients with immune deficiency, on radiation therapy and on corticosteroids.

Oral Polio Vaccine :The oral polio vaccine is sabin vaccine and contain live

virus according to National Immunisation Schedule in india and WHO programme on EPI recommend the administration of three polio doses at an interval of 1 month.

At birth, OPV-Odose is given, then 1st dose of OPV is given at age of 6 weeks. Booster dose of OPV is given at an age of 16-24 months.

Vaccine Dose Route Age

Oral polio vaccine

3 drops doses +

Oral At birth- 0 Dose

2 booster doses 6 weeks – 1st dose

10 weeks – 2nd dose

14 weeks – 3rd dose

16-24 months – Booster dose

• Oral polio vaccine induces humoral and intestinal immunity. It should not be administrated in cases such as:

FeverDiarrhoeaDysentryAcute infectious diseaseLeukemiasMalignancyTaking corticosteroids

• Note :Oral polio vaccine should be kept at 4 degree celcius if the

vaccine is stabilised vaccine.Non-stabilised vaccine should be kept at -20 degree celcius

in a deep freeze.Vaccine should not be frozen and thawed repeatedly, as this

can have deleterious effects on the potency of live vaccine. Passive Immnunisation : Human normal Ig is used as a passive immunisation. But the

use of passive immunisation is eliminated due to active immunisation with oral polio vaccine.the dose of normal human Ig is 0.25- 0.3 ml per kg of body weight.after a few weeks, the active immunisation should be started.

(2)Early Diagnosis And Treatment of Cases :The polio cases should be detected as early as

possible and appropriately treated in order to prevent the spread of infection as well as to control the disease.

(3) Surveillance :Surveillance is one of the way to achieve, control

and prevention by identifying the rise, stability or decreasing in number of cases.

(4) Isolation :The polio cases should be isolated during the

period of communicability i.e. 7-10 days before and after the onset of symptoms.

(5) Environmental sanitation :As polio occur due to certain environmetal

condition such as contaminated water, food etc. it also occurs due to poor sanitation and overcrowding. Appropriate sanitary measures should be adpoted to decrease the incidence of polio. The over crowding should be avoided.

(6) Handwashing :Handwashing is one of the effective way to achieve

prevention. As a polio virus is excreated in faeces and it can go into GI tract through fingers, if hands are not washed after defaecation. So, it is important to wash the hands.

(7) Pulse Polio Compaign/Immunisation :In pulse polio immunisation, oral polio vaccine is

given to all children 0-5 years of age regardless of previous immunisations. It includes 3 rounds for 3 days. On 1st day, polio drops are administrated at booth. On 2nd day, homes are visited to administer.

• Polio drops to children under 5 years of age. To those who did not come to booth on first day. On third day the children left without polio drops,are administered polio drops by visiting the homes.

Thank You

DRACUNCULIASIS(GUINEA WORM DISEASE)

Dracunculiasis cases reported during 2003 were 32193 world-wide. Out of these 63% were reported from sudan, nigeria and ghana. According to WHO, weekly epidemiological record NO. 13,2004, india is declared free of guinea worm disease.

EPIDEMIOLOGICAL TRIAD Agent (dracunculus medinensis)

Host Environment (all ages, both sexes) (water contaminated with cyclops)

Agent

• Dracunculiasis is caused by dracunculus medinesis which is a vector borne parasitic disease .

• The female dracunculus makes her way to the limbs near skin surface in an infected person.

• Blisters are formed due to inflammatory response & these break on contact with water and release a number of parasites into water , which are taken by cyclops and develpoment of parasites inside the cyclop takes 15 days.

• Cyclops are present in water and when the human beings drink water contaminated with cyclops , it goes into G.I. tract.

• In the G.I. tract with digested by gastric juice, parasites are released and penetrate the duodenal wall.

• Form here the agent moves to the subcutaneous tissue of various parts of the body and takes 9-12 month to become an adult.

• The reservoir of infection is a person who harbours the gravid female dracunculus medinesis.

• HOST• It can occur among all ages, both sexes .• Multiple & repeated infections can occur in

the same person.

ENVIRONMENTAL FACTOR

• Contaminated water with cyclops.• Dry season(March- May)

MODE OF TRANSMISSION

• Water –borne route. Under Eradication• Guinea-worm disease has been eradicated.

The eradicated strategies used were :-• Diagnosis and treatment of cases. The drug

used were mebendazole, metronidazole etc.• Surveillance for reserch of new cases .• Control of cyclops.

Thank you