Health Information

Virus – paramyxovirus
Spread by droplets.
Infectivity – peak in 2-3 days before onset of the parotitis and 3 days after.
Incubation average 18 days.
Mainly school kids and young adults.

Mumps - symptoms
Fever, malaise, headache, anorexia.
Pain in parotid gland and swelling.
Can be submandibular enlargement.
Spread by droplets.

Mumps - Complication
CNS involvement – meningitis.
Epididymo-architis – 1/3 of male get mumps after puberty.
Can result sterility if bilateral involvement

Pancreatitis, myocarditis, mastitis, hepatitis, polyarthritis may occure.

Rubella - complications
Rare
Pulmonary bacterial infections.
Arthralgia, haemorrhagic manifestations, encephalities.
Congenital rubella syndrome.

Congenital rubella syndrome
Affect fetuses of 15-30% of woman get infection in 1st trimester.
Congenital abnormalities
Fetal cardiac malformation (PDA, VSD)
Eye lesions – cataracts
Microcephaly
Mental retardation
Deafness

Expanded rubella syndrome
Congenital rubella syndrome with
Hepatosplenomegaly
Myocarditis
Interstitial pneumonia
Metaphyseal bone lesions.

Rubella - symptoms
Incubation 14 - 21days.
Mild/absent symptom in child under 5 years.
Peak incident of age is 15 years.
Malaise and fever.
Mild conjunctivitis & lymphadenopathy.
Lymphadenopathy – mainly suboccipital, postauricular, posterior cervical groups.
Small petechial lesions on the soft palate.
Splenomegaly.

Rash usually appears within first days of initial symptom.
Rash first appear in forehead then spread to trunk and limbs.
It is pinkish-red, macular and discrete.
Most disappear within 3 days.

Diagnosis
Most case clinically.
Blood antibody titre rise in two blood sample.
Can do viral test and confirm.
Only symptomatic treatment.
Prevention
Important due to Congenital rubella syndrome.
Rubella vaccines.
Vaccine is contraindicated during pregnancy or likely hood of pregnancy within 3 months.

Highly communicable disease.
Incubation 8-14 days
Two stages
Infectious, pre-eruptive – Fever, rhinorrhoea, cough,
Non infectious with rash - from face/forehead spread to rest of the body.
It can Life threatening child with other disease and malnourished.
Vaccination eliminated disease.
Measles
Complications – pneumonia, bronchitis, otits media, Highly communicable disease.
Treatment – antibody need only for secondary infections.

Influenza virus – Two form A & B.
Influenza B – local out brakes
Influenza A – would wide pandemics.
Can form different antigen form – if major shift in antigenic make-up that helps for major pandemic.
1918 – 20 million death, 1957 and 1968 pandemics.
Bird flu (Avian Influenza) 2004/2006 – Asia, parts of Europe, the Near East, and Africa.
(the risk - the virus will change into a form that is highly infectious for humans and spreads easily from person to person.)

Fever, shivering and generalized aching in limbs.
Persistent cough, severe headache.
Can cause prolong debility and depression.
Secondary bacterial infections are common and lead to pneumonia.
Some might need antibiotics with complications.
Vaccine protect only 70% and last only one year.

Acute Laryngotracheobronchitis
Complication of upper respiratory tract infection.
Inflammatory oedma in vocal code and epiglottis causing narrowing.
Children under 3 years affect severely.
Voice became hoarse, poor cough sound and audible laryngel stridor.

Acute epiglottitis
Cause by H. influenzae type B.
Mainly for child.
Extremely ill – high fever, air way obstruction.
Life threatening.
Urgent endotracheal intubation is needed.
There is vaccine for H. influenzae type B –Hib.

Infection of paranasal sinuses.
Common complication of common cold or allergic rhinitis.
Acute infections are usually cause by bacteria
Streptococcus pneumoniae
Haemophilus influenzae
Treatment
Antibiotics
Nasal treatment to unblock sinus– decongestants (eg. Xylometazole) or topical corticosteroids.
Pharyngitis
Most are virus – adnovirus group.
30% cases are haemolytic streptococcus.
Clinical – oropharynx and soft palate are reddened and tonsils are inflamed and swollen.
Local lymph nodes enlarged.
Disease is self-limiting, need only symptomatic treatment.
Persistent cases might need antibiotics.

High infectious.
Due to rhinoviruses – majority Picornavirus group.
More than 100 different antigenic form.
Spread by contact (nasal mucus on hand) and droplets.
Spread is high in early stage of disease.
Incubation – 12 hr to 5 days.
2-3 attacks per year in average – less with age due to immunity.
Clinical –
watery nasal discharge -> thick.
Tiredness, slight pyrexia, Sneezing
Secondary bacterial infection occur in a minority.
?? Vitamin C
Social aspect - Lost days on the job, costs to the economy, remedies.

Fluid/blood replacement
Blood – in haemorrhagic shock
Complication – temperature change, coagulation defect, metabolic acidosis/alkalosis,
Red cell concentration
Crystalloid solutions – saline,
Colloidal solution – Dextrans, albumin,

Oxygen delivery to tissue

Can monitor by p02 or pulse-oximetry.
Heart rate and stroke volume.
Gas exchange in the lungs – airway obstruction, restriction…etc.

Mechanical ventilation
Intermittent positive-pressure ventilation – commonly use
Indicate
Acute respiratory failure – asthma
Acute ventilatory failure – myasthenia gravis
Head injury
Trauma in the chest
Coma with breathing difficulties