Roseola  Infantum

 is a common, mild, viral infection that can cause a temperature and rash in babies and young
children.
 In the past, roseola was sometimes referred to as 'baby measles'.
 Roseola commonly affects children aged between six months and two years, and 95 per cent of
children have been infected with it by the age of two.
 Roseola is contagious before the symptoms appear, so it is difficult to prevent its spread to
others. 
  It's also known as sixth disease, exanthem subitum, and roseola infantum.

Causative Agent
 The most common cause of roseola is the human herpes virus 6, but the cause also can be another
herpes virus — human herpes virus 7.

Mode of transmission
 roseola spreads from person to person through contact with an infected person's respiratory
secretions or saliva
 Roseola is contagious even if no rash is present. That means the condition can spread while an
infected child has only a fever, even before it's clear that the child has roseola.

Incubation period-It may take 5 to 15 days for a child to have symptoms of roseola after being exposed
to the virus. 

Period of Communicability- The individual remains contagious until one or two days after the fever
subsides. 

Signs and Symptoms

 Fever. Roseola typically starts with a sudden, high fever — often greater than 103 F (39.4 C) and
may also develop swollen lymph nodes in his or her neck along with the fever. The fever lasts
three to five days.
 Rash. Once the fever subsides, a rash typically appears — but not always. The rash consists of
many small pink spots or patches. These spots are generally flat, but some may be raised. There
may be a white ring around some of the spots. The rash usually starts on the chest, back and
abdomen and then spreads to the neck and arms. It may or may not reach the legs and face. The
rash, which isn't itchy or uncomfortable, can last from several hours to several days before
fading.
 Irritability in infants and children
 Mild diarrhea
 Decreased appetite
 Swollen eyelids

Diagnostic Test
  Physical examination (assessment)
 confirm a diagnosis of roseola by the telltale rash
 by a blood test to check for antibodies to roseola.
o Specific immunoglobulin M (IgM) serology or a rise in HHV-6-specific immunoglobulin G
(IgG) and HHV-6 DNA polymerase chain reaction can document infection, even
distinguishing between HHV-6a and 6b. 
o If a complete blood count (CBC) is obtained, leukopenia may be noted. The white blood cell
(WBC) count usually returns to reference ranges within a week.

Treatment modalities
 There's no specific treatment for roseola, although some doctors may prescribe the antiviral
medication ganciclovir (Cytovene) to treat the infection in people with weakened immunity. 
 medications to reduce fever, such as acetaminophen (Tylenol, others) or ibuprofen (Advil, Motrin,
others).

Prevention and Control

 avoid exposing your child to an infected child
 make sure that all family members wash their hands frequently to prevent spread of the virus to
anyone who isn't immune.

Red tide
 is a phenomenon caused by algal blooms during which algae become so numerous that they
discolor coastal waters (hence the name "red tide").
 The algal bloom may also deplete oxygen in the waters and/or release toxins that may cause
illness in humans and other animals.
 Harmful algal blooms, or HABs, occur when colonies of algae—simple plants that live in the sea
and freshwater—grow out of control while producing toxic or harmful effects on people, fish,
shellfish, marine mammals, and birds.

Causative Agent
 Red tides are caused by an explosive growth and accumulation of certain microscopic algae,
predominantly dinoflagellates, in coastal waters. Some species of dinoflagellates produce toxins
that are among the most potent known to man.
 Mode of Transmission- ingesting of contaminated sea foods (clams, mussels , fish, shellfish etc)

Incubation Period- These symptoms were described as having a rapid onset (median incubation of 3
hours), mild, and of short duration (maximum malaise and vertigo up to 72 hours.

Signs and Symptoms

 Paralytic shellfish poisoning (PSP) is a syndrome that people can develop if they eat seafood
contaminated by a red tide.
 Tingling
  Burning
 Numbness
 Drowsiness
 incoherent speech
 and respiratory paralysis
 severe cases result in respiratory arrest within 24 hours of consumption of the toxic shellfish.

Other shellfish poisoning syndromes include:

 Amnesic shellfish poisoning (ASP). ASP symptoms include nausea, vomiting, and diarrhea. If left
untreated, it may lead to permanent damage to the central nervous system.
 Diarrheal shellfish poisoning (DSP). DSP may cause nausea, vomiting, and abdominal cramps, and
individuals are prone to becoming extremely dehydrated.
 Neurotoxic shellfish poisoning (NSP). NSP can cause vomiting, nausea, and other neurological
symptoms as well.

Diagnostic Procedure
 ask about Recent shellfish ingestion
 toxin testing related to the microscopic epidemiology of red tide

Treatment Modalities
 Anticurare drugs were ineffective, while DL amphetamine (benzedrine) was most effective in
aiding the artificial respiration and decreasing the recovery period.
 supportive measures are the basis of treatment for PSP, especially ventilatory support in severe
cases.
 Close monitoring for at least 24 hours and aggressive airway management at any sign of
respiratory compromise should prevent severe morbidity and mortality.

Nursing Management
 Gastrointestinal decontamination with activated charcoal is recommended for patients who
present within 4 hours of ingestion.
 Nasogastric or orogastric lavage may be performed if the patient presents within 1 hour of
ingestion, but this is often unnecessary.
 If gastric lavage is performed, the use of isotonic sodium bicarbonate solution as a lavage irrigant
has been suggested because many of the shellfish toxins have reduced potency in an alkaline
environment.

Prevention
 Avoid entering bodies of water that have a distinct foul odor, appear discolored, or have foam,
scum, or algal mats (sheet-like accumulations of blue-green algae) on the surface.
 Follow local or state guidance about the safety of the water.
 Check environmental or state websites for local beach or lake closures before visiting.
 Do not drink directly from lakes, rivers, or ponds.
 Do not fish, swim, boat, or participate in water sports in areas experiencing a red tide.
 Rinse off pets with clean water after they’ve been in the pond, lake, or ocean. Do not allow them to
lick their fur until they’ve been rinsed.
  Follow local guidance when consuming harvested fish or shellfish.
 Avoid eating large reef fish.

Pediculosis
 Pediculosis is an infestation of the hairy parts of the body or clothing with the eggs, larvae or
adults of lice. The crawling stages of this insect feed on human blood, which can result in severe
itching. Head lice are usually located on the scalp, crab lice in the pubic area and body lice along
seams of clothing. Body lice travel to the skin to feed and return back to the clothing.

Causative Agent
 Pediculosis is infestation with the human head-and-body louse, Pediculus humanus. There are
three subspecies, the head louse (P. h. capitis) , the body louse (P. h. humanus) and the P
pubis (pubic louse).

Mode of Transmission
 The main mode of transmission of head lice is contact with a person who is already infested (i.e.,
head-to-head contact). Contact is common during play (sports activities, playgrounds, at camp,
and slumber parties) at school and at home.
 For both head lice and body lice, transmission can occur during direct contact with an infested
individual. Sharing of clothing and combs or brushes may also result in transmission of these
insects. While other means are possible, crab lice are most often transmitted through sexual
contact.

Incubation Period
  P. capitis: 8 days.
 P. corporis: 6-10days.
 P. pubis: 6 - 8 days

Signs and Symptoms

 the first indication of an infestation is the itching or scratching in the area of the body where the
lice feed.
 Scratching at the back of the head or around the ears should lead to an examination for head louse
eggs (nits) on the hair
 Itching around the genital area should lead to an examination for crab lice or their eggs.
 Scratching can be sufficiently intense to result in secondary bacterial infection in these areas.

Diagnostic Procedure
 The diagnosis of pediculosis is best made by finding a live nymph or adult louse on the scalp or
in the hair of a person. Finding numerous nits within 6 mm of the scalp is highly suggestive of
 active infestation. Finding nits only more than 6 mm from the scalp is only indicative of
previous infestation.

Treatment modalities
 Medicated shampoos or cream rinses containing pyrethrins or permethrin
 oral ivermectin effectively treats lice with two doses, eight days apart. This drug is typically
used to treat infestations that haven't responded to other treatments.
 Malathion (Ovide) is a prescription medication that you apply to your hair and then rub into
your hair and scalp
 Benzyl alcohol lotion (Ulesfia) is a prescription treatment that you apply to the scalp and hair
for 10 minutes and then rinse off with water

Prevention
 Physical contact with infested individuals and their belongings, especially clothing, headgear
and bedding, should be avoided.
 Health education on the life history of lice, proper treatment and the importance of laundering
clothing and bedding in hot water or dry cleaning to destroy lice and eggs is extremely
valuable.
 Regular direct inspection of children for head lice, and when indicated, of body and clothing,
particularly of children in schools, institutions, nursing homes and summer camps, is
important.

Coronavirus disease (COVID-19)

 is an infectious disease caused by a newly discovered coronavirus.
 Coronaviruses are a group of viruses belonging to the family of Coronaviridae, which infect both
animals and humans.
 Human coronaviruses can cause mild disease similar to a common cold, while others cause more
severe disease (such as MERS - Middle East Respiratory Syndrome and SARS – Severe Acute
Respiratory Syndrome).
 Most people infected with the COVID-19 virus will experience mild to moderate respiratory illness
and recover without requiring special treatment. 
 Older people, and those with underlying medical problems like cardiovascular disease, diabetes,
chronic respiratory disease, and cancer are more likely to develop serious illness.

Causative Agent
 caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).

Mode of transmission
 The virus is primarily spread between people during close contact, often via small
droplets produced by coughing, sneezing, or talking.
  After breathing out produces these droplets, they usually fall to the ground or onto surfaces rather
than remain in the air over long distances.
 People may also become infected by touching a contaminated surface and then touching their
eyes, nose, or mouth. The virus can survive on surfaces for up to 72 hours

Incubation Period- Most estimates of the incubation period for COVID-19 range from 1-14 days, most
commonly around five days

Period of Communicability- It is most contagious during the first three days after the onset of
symptoms, although spread may be possible before symptoms appear and in later stages of the disease

Signs and Symptoms

 Common symptoms include:
o fever
o tiredness
o dry cough.
 Other symptoms include:
o shortness of breath
o aches and pains
o sore throat
o and very few people will report diarrhea, nausea or a runny nose.

Diagnostic Procedure
 The standard method of testing is real-time reverse transcription polymerase chain reaction (rRT-
PCR)
o The test is typically done on respiratory samples obtained by a nasopharyngeal swab;
o nasal swab or sputum sample may also be used
 Blood tests can be used, but these require two blood samples taken two weeks apart
 polymerase chain reaction (PCR) tests to detect infection by the virus
  antibody tests (which may detect active infections and whether a person had been infected in the
past) were in development, but not yet widely used
 Swab test- A health care provider will use a special swab to take a sample from your nose or
throat.
 Nasal aspirate-A health care provider will inject a saline solution into your nose, then remove the
sample with gentle suction.
 Tracheal aspirate- A health care provider will put a thin, lighted tube called a bronchoscope down
your mouth and into your lungs, where a sample will be collected.
 Sputum test-Sputum is a thick mucus that is coughed up from the lungs. You may be asked to
cough up sputum into a special cup, or a special swab may be used to take a sample from your
nose.
Treatment Modalities
  There is no specific vaccine and medications for Covid-19,  there are many ongoing clinical trials
evaluating potential treatments.

Prevention
 Wash your hands regularly with soap and water, or clean them with alcohol-based hand rub.
 Maintain at least 1 metre distance between you and people coughing or sneezing.
 Avoid touching your face.
 Cover your mouth and nose when coughing or sneezing.
 Stay home if you feel unwell.
 Refrain from smoking and other activities that weaken the lungs.
 Practice physical distancing by avoiding unnecessary travel and staying away from large groups of
people.

Nursing Management
 Place patient in an isolated room
 Close monitoring to the patient
 Instruct the patient to report unnecessary symptoms
 Always perform handwashing
 Don PPE at all times