BRUCELLOSIS
Other Name(s):
Undulant Fever
Malta Fever
Gibraltar Fever
Mediterranean Fever
Signs & Symptoms
Clinical Features:
Dry Cough
Headache
Fever
Lymphadenopathy
Night Sweats
Hepatosplenomegaly
Weight Loss
Malaise and Myalgia
Arthralgia
Complications:
Orchitis
Meningoencephalitis
Endocarditis
Osteomyelitis
Arthritis
Vector:
Cattle
Sheep
Goats
Pigs
Mode of Transmission:
1. Contact Infection
- Direct inoculation into skin by contact with infected
Tissues
Blood
Urine
Vaginal discharges & placenta
Direct conjunctival inoculation
2. Food-borne
, - Ingestion of contaminated raw milk
Cheese (unpasteurized milk)
Raw meat
Raw vegetables
3. Air-borne
- Inhalation of infectious aerosols
INCUBATION PERIOD: Usually 1-3 weeks
Medical Management:
ANTIBIOTIC THERAPY
Regimen A: Doxycycline (100mg) orally b.d. for 6 weeks +
Streptomycin (1g) intramuscularly o.d. for the first 14 – 21 days
Regimen B: Doxycycline (100mg) orally b.d + Rifampicin (15 mg/kg)
orally o.d. for 6 weeks
Prevention in Humans:
: Protective measure
Personal hygiene
Pasteurization of milk
Vaccination: B. abortus strain 19-BA
Early diagnosis and treatment
Prevention in Animals:
: Environmental hygiene
Test and slaughter
Vaccination: B. abortus strain 19
Nursing Management:
If the patient has draining lesions, perform wound care as ordered; keep suppurative
granulomas and abscesses dry.
Adhere to standard precautions and appropriate infection control precautions as
indicated.
Provide meticulous skin care as appropriate.
Administer prescribed medications, such as oral rifampin and doxycycline. Give rifampin
on an empty stomach with a full glass of water 1 hour before or 2 hours after eating.
Administer I.M. streptomycin deeply into a large muscle mass.
Reassure the patient that the infection is curable.
Encourage intake of fluids to maintain fluid balance; suggest intake of high-calorie foods
to prevent weight loss.
Provide frequent rest periods to combat fatigue.
Obtain specimens for laboratory testing, such as cultures and complete blood count.
, BURULI ULCER
Transmission. The exact mode of transmission of M. ulcerans is still unknown.
Causative Agent. Mycobacterium ulcerans grows at temperatures between 29–33 °C The
organism produces a unique toxin mycolactone which causes tissue damage and inhibits the
immune response.
Signs and symptoms.Buruli ulcer often starts as a painless swelling (nodule). It can also
initially present as a large painless area of induration plaqueor a diffuse painless swelling of the
legs, arms or face edema. Local immunosuppressive properties of the mycolactone toxin enable
the disease to progress with no pain and fever. Without treatment or sometimes during
antibiotics treatment, the nodule, plaque or edema will ulcerate within 4 weeks with the
classical, undermined borders. Occasionally, bone is affected causing gross deformities.
Medical Management
Treatment consists of a combination of antibiotics and complementary treatments under
morbidity management and disability prevention/rehabilitation.
Antibiotics.Different combinations of antibiotics given for 8 weeks are used to treat the
Buruli ulcer irrespective of the stage. One of the following combinations may be used depending
on the patient:
a combination of rifampicin (10 mg/kg once daily) and streptomycin (15 mg/kg once daily); or
a combination of rifampicin (10 mg/kg once daily) and clarithromycin (7.5 mg/kg twice daily).
Nursing Management
Assess patient’s condition specifically wound healing process. Comfort the patient and family
members thus improve treatment compliance and outcome. Educate patient regarding diet and
personal hygiene. Register malnourished patient for supplementary nutrients. Encourage patient
to eat high calorie and protein foods. Encourage patient to increase fluid intake in not
contraindicated. Psychological support and education.
AFRICAN SWINE FEVER
-African swine fever (ASF) is a highly contagious hemorrhagic viral disease of domestic and wild
pigs, which is responsible for serious economic and production losses.
Other Name(s):
Undulant Fever
Malta Fever
Gibraltar Fever
Mediterranean Fever
Signs & Symptoms
Clinical Features:
Dry Cough
Headache
Fever
Lymphadenopathy
Night Sweats
Hepatosplenomegaly
Weight Loss
Malaise and Myalgia
Arthralgia
Complications:
Orchitis
Meningoencephalitis
Endocarditis
Osteomyelitis
Arthritis
Vector:
Cattle
Sheep
Goats
Pigs
Mode of Transmission:
1. Contact Infection
- Direct inoculation into skin by contact with infected
Tissues
Blood
Urine
Vaginal discharges & placenta
Direct conjunctival inoculation
2. Food-borne
, - Ingestion of contaminated raw milk
Cheese (unpasteurized milk)
Raw meat
Raw vegetables
3. Air-borne
- Inhalation of infectious aerosols
INCUBATION PERIOD: Usually 1-3 weeks
Medical Management:
ANTIBIOTIC THERAPY
Regimen A: Doxycycline (100mg) orally b.d. for 6 weeks +
Streptomycin (1g) intramuscularly o.d. for the first 14 – 21 days
Regimen B: Doxycycline (100mg) orally b.d + Rifampicin (15 mg/kg)
orally o.d. for 6 weeks
Prevention in Humans:
: Protective measure
Personal hygiene
Pasteurization of milk
Vaccination: B. abortus strain 19-BA
Early diagnosis and treatment
Prevention in Animals:
: Environmental hygiene
Test and slaughter
Vaccination: B. abortus strain 19
Nursing Management:
If the patient has draining lesions, perform wound care as ordered; keep suppurative
granulomas and abscesses dry.
Adhere to standard precautions and appropriate infection control precautions as
indicated.
Provide meticulous skin care as appropriate.
Administer prescribed medications, such as oral rifampin and doxycycline. Give rifampin
on an empty stomach with a full glass of water 1 hour before or 2 hours after eating.
Administer I.M. streptomycin deeply into a large muscle mass.
Reassure the patient that the infection is curable.
Encourage intake of fluids to maintain fluid balance; suggest intake of high-calorie foods
to prevent weight loss.
Provide frequent rest periods to combat fatigue.
Obtain specimens for laboratory testing, such as cultures and complete blood count.
, BURULI ULCER
Transmission. The exact mode of transmission of M. ulcerans is still unknown.
Causative Agent. Mycobacterium ulcerans grows at temperatures between 29–33 °C The
organism produces a unique toxin mycolactone which causes tissue damage and inhibits the
immune response.
Signs and symptoms.Buruli ulcer often starts as a painless swelling (nodule). It can also
initially present as a large painless area of induration plaqueor a diffuse painless swelling of the
legs, arms or face edema. Local immunosuppressive properties of the mycolactone toxin enable
the disease to progress with no pain and fever. Without treatment or sometimes during
antibiotics treatment, the nodule, plaque or edema will ulcerate within 4 weeks with the
classical, undermined borders. Occasionally, bone is affected causing gross deformities.
Medical Management
Treatment consists of a combination of antibiotics and complementary treatments under
morbidity management and disability prevention/rehabilitation.
Antibiotics.Different combinations of antibiotics given for 8 weeks are used to treat the
Buruli ulcer irrespective of the stage. One of the following combinations may be used depending
on the patient:
a combination of rifampicin (10 mg/kg once daily) and streptomycin (15 mg/kg once daily); or
a combination of rifampicin (10 mg/kg once daily) and clarithromycin (7.5 mg/kg twice daily).
Nursing Management
Assess patient’s condition specifically wound healing process. Comfort the patient and family
members thus improve treatment compliance and outcome. Educate patient regarding diet and
personal hygiene. Register malnourished patient for supplementary nutrients. Encourage patient
to eat high calorie and protein foods. Encourage patient to increase fluid intake in not
contraindicated. Psychological support and education.
AFRICAN SWINE FEVER
-African swine fever (ASF) is a highly contagious hemorrhagic viral disease of domestic and wild
pigs, which is responsible for serious economic and production losses.
