Transcript Slide 1

Water-borne
and Vectorborne diseases
Cholera
What is Cholera?
• Acute, diarrheal illness caused by
bacterium Vibrio cholerae.
• Source of contamination is usually
the feces of an infected person.
• Infection is often mild or without
symptoms, but sometimes it can be
severe, characterized by profuse
watery diarrhea, vomiting and leg
cramps.
What is Cholera?
What is Cholera?
• Rapid loss of fluids leads to
dehydration and shock. Without
treatment, death can occur within
hours.
• It can be treated with replacement of
fluids and salts lost through diarrhea.
• Antibiotics shortens the course and
diminish the severity of the illness.
Typhoid Fever
What is Typhoid Fever?
• Life threatening illness caused by
bacterium Salmonella typhi.
• Bacterium lives only in humans.
Persons carry bacteria in
bloodstream and intestinal tract.
• Acquired from sewerage
contaminated with S. tryphi bacteria
that gets into the water you use for
drinking and washing food.
What is Typhoid Fever?
What is Typhoid Fever?
• The patient usually has the following
signs & symptoms
o sustained fever as high as 1030 to 1040 F (390
to 400 C).
o The patient feels weak, has stomach pains,
headache, loss of appetite and in rare cases,
has rashes of flat, rose-colored spots.
o Detection for S. typhi is to have samples of
stools or blood to be tested.
What is Typhoid Fever?
• S. typhi is treated with commonly
prescribed antibitiotics
– Ampicillin
– Trimethoprim-sulfamethoxazole
– Ciprofloxacin
• How to avoid having typhoid fever:
– Avoid risky foods and drinks.
– Get vaccinated against typhoid fever.
Leptospirosis
What is Leptospirosis?
• Bacterial disease that affects humans
and animals, caused by bacteria of the
genus Leptospira.
• Caused by exposure to contaminated
urine of infected animals like cattle,
pigs, horses, dogs, rodents and wild
animals.
• The interval from a person’s exposure
to a contaminated source and
becoming sick is between 2 days to 4
weeks.
What is Leptospirosis?
• Leptospirosis has 2 phases:
– First Phase
• Fever, chills, headaches, muscle aches,
vomiting or diarrhea.
• Patient recovers for a time but become ill
again.
– Second Phase
• More severe, a person may have kidney or
liver failure or meningitis.
• Also called Weil’s disease
What is Leptospirosis?
Leptospirosis in Philippine floods
What is Leptospirosis?
• It can be treated with antibiotics like
– Doxycycline
– Penicillin
• It can be prevented by not swimming
or wadding in water that might be
contaminated with animal urine.
Protective clothing or footwear
should be worn by those exposed to
contaminated water or soil due to
their job and recreational activities.
Hepatitis A
What is Hepatitis A?
• A disease affecting the liver, and caused by the
Hepatitis A virus (HAV).
• Symptoms may include:
– Jaundice which first shows up as yellow eyes
– Dark urine
– Nausea
– Fever
– Fatigue
– Loss of appetite
– Abdominal pain
– Vomiting
What is Hepatitis A?
• Young children who develop Hepatitis A often
have a milder form of the disease lasting 1-3
weeks. Adults tend to experience more severe
cases. They are confined to bed and have
minimal activity for 4 weeks due to the illness
What is Hepatitis A?
What is Hepatitis A?
• There is no specific treatment for Hepatitis A.
• Sufferers are advised to rest, avoid fatty
foods and alcohol (these may be poorly
tolerated for some additional months during
the recovery phase and cause minor
relapses), eat a well-balanced diet, and stay
hydrated.
• Approximately 15% of people diagnosed with
Hepatitis A may experience a symptomatic
relapse (s) for nine months to a year after
contracting the disease.
What is Hepatitis A?
• Hepatitis A can be prevented by good hygiene
and sanitation as well as using condoms
during sex. Vaccination is also available and is
recommended in areas where the prevalence
of hepatitis A is high.
• Ways to prevent hepatitis A include:
– Handwashing with soap and warm water before
preparing or eating food, and after sexual activity.
– Keep bathrooms clean and disinfected after every
use.
– Cook shellfish thoroughly before eating.
– Drink water from approved sources only.
– Use a dental dam or sheet of plastic wrap during
anilingus.
Malaria
What is Malaria?
• A vector-borne infectious disease that is
widespread in tropical and subtropical regions.
• One of the most common infectious diseases
and an enormous public-health problem.
• Disease is caused by protozoan parasites of
the genus Plasmodium.
• Most serious forms of the disease are caused
by Plasmodium falciparum and Plasmodium
vivax,
• Malarial parasites are transmitted by female
Anopheles mosquitoes.
What is Malaria?
Transmission of Malaria Parasites
What is Malaria?
• Symptoms of malaria include fever,
shivering, arthralgia (joint pain), vomiting,
anemia caused by rupture of red blood cells
and convulsions.
• The classical symptom of malaria is cyclical
occurrence of sudden coldness followed by
rigor and then fever and sweating lasting four
to six hours,
• Severe malaria is almost exclusively caused
by P. falciparum infection and usually arises
6-14 days after infection.
• Chronic malaria is seen in both P. vivax and
P. ovale but not in P. falciparum.
What is Malaria?
• Active malaria infection with P. falciparum is a
medical emergency requiring hospitalization.
Infection with P. vivax, P. ovale or P. malariae
can often be treated as out-patient.
• Treatment of malaria involves supportive
measures as well as specific antimalarial
drugs like:
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Quinine
Chloroquine
Cotrifazid
Primaquine
Doxycycline
Mefloquine
Hydroxychloroquine
What is Malaria?
– Methods used to prevent the spread of
the disease, or to protect individuals in
areas where malaria is endemic,
include:
• Prophylactic (preventive) drugs
against malaria
• Mosquito eradication
• Prevention of mosquito bites
Dengue/Dengue
Hemorrhagic Fever
What is Dengue/Dengue
Hemorrhagic Fever?
• Dengue and dengue hemorrhagic fever are
acute febrile diseases, found in the tropics,
with a geographical spread similar to
malaria.
• Caused by one of four closely related virus
serotypes of the genus Flavivirus, each
serotype is sufficiently different that there is
no cross-protection and epidemics caused
by multiple serotypes (hyper-endemicity)
can occur.
• Dengue is transmitted to humans by the
mosquito Aedes aegypti
What is Dengue/Dengue
Hemorrhagic Fever?
– This infectious disease is manifested by
• Sudden onset of fever
• Severe headache
• Muscle and joint pains (myalgias and
arthralgias, severe pain give it the name
break-bone fever or bone crusher disease)
• Rashes - dengue rash is characteristically
bright red petechia and usually appears first
on the lower limbs and the chest - in some
patients, it covers most of the body.
• Gastritis with combination of associated
abdominal pain, nausea, vomiting or
diarrhea.
What is Dengue/Dengue
Hemorrhagic Fever?
What is Dengue/Dengue
Hemorrhagic Fever?
What is Dengue/Dengue
Hemorrhagic Fever?
• The mainstay of treatment is supportive
therapy.
• To keep up oral intake, especially fluids. If
the patient is unable to maintain oral intake,
supplementation with intravenous fluids
may be necessary to prevent dehydration
and significant hemo-concentration.
• A platelet transfusion is rarely indicated.
But if the platelet level drops significantly or
if there is significant bleeding, transfusion is
recommended.
What is Dengue/Dengue
Hemorrhagic Fever?
– Steps in the primary prevention of
dengue:
• Eliminating or reducing the mosquito vector
for dengue.
• Public spraying against mosquitoes is the
most important aspect of this prevention
• Application of larvicides such as Abate® to
standing water is more effective in the long
term control of mosquitoes.
• Eliminating pools of standing water such as
in flowerpots, old tires
What is Dengue/Dengue
Hemorrhagic Fever?
– Steps in the primary prevention of
dengue:
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Use of mosquito nets,
Use of insect repellants
Cover exposed skin
Use DEET-impregnated bednets
Avoiding areas with many mosquitos
The Philippine College of Physicians wishes to
acknowledge the following for his invaluable
efforts in the preparation of this module
Cristobal Dumo, MD