Infectious Diseases

Question 1

What are infectious diseases?

Answer 1

“Disorders caused by organisms, such as bacteria, viruses, fungi or parasites …which can be passed from person to person”.

Some are transmitted by insect or animal bites while others are passed by ingesting contaminated food or water or being exposed to organisms in the environment.

Question 2

List the top 10 infectious diseases

Answer 2

1. HIV/AIDS
2. Ebola
3. SARs-Severe Acute Respiratory Syndrome
4. Malaria
5. Anthrax
6. Cholera
7. Bubonic Plague
8. Influenza
9. Typhoid fever
10. Smallpox

Question 3

Define endemic

Answer 3

“Constant presence of a disease or infectious agent within a given geographic area.

The usual prevalence of a given disease within such an area.”

Question 4

Define an epidemic

Answer 4

“Occurrence in a community or region of cases of an illness or outbreak clearly in excess of expectancy.”

Question 5

Define a pandemic

Answer 5

”Occurring over a wide geographic area and affecting an exceptionally high proportion of the population, i.e. malaria.”

Question 6

Describe rickettsia

Answer 6

A genus of microorganisms that combines aspects of both bacteria and viruses.
They can be observed with a light microscope, divide by fission, and may be controlled with antibiotics.
They also exist as virus-like intracellular parasites, living in the intestinal tracts of insects such as lice
Thus a human infested with lice is also likely to be infected with a form of typhus transmitted by Rickettsia prowazeki

Question 7

List the types and sub-types of rickettsia diseases

Answer 7

1. The spotted fever group includes diseases such as;
   A. Rocky Mountain spotted fever
   B. Rickettsialpox;
2. The typhus group includes;
   A. Epidemic typhus
   B. Murine typhus;
3. A miscellaneous group includes;
   A. Q fever
   B. Trench fever.

Question 8

List the toxins produced by clostridium botulinum

Answer 8

Botulinal toxin , Botulinum toxin, Botulinus toxin an exotoxin produced by Clostridium botulinum

Question 9

How does the clostridium botulinum toxin work?

Answer 9

The toxin cause paralysis by blocking the release of acetylcholine in the central nervous system

Question 10

What are the therapeutic uses of type A and B botulinum toxins?

Answer 10

Type A is used therapeutically to inhibit muscular spasm in the treatment of dystonic disorders such as blepharospasm and strabismus, as well as to treat wrinkles of the upper face

type B is used to treat cervical dystonia

Question 11

How do bacteria cause disease?

Answer 11

The disease causing method can occur in one of two ways:

1. Invading host tissues, and
2. Producing poisons (toxins)

Question 12

How are infections transmitted?

Answer 12

Direct Contact
Person-to-Person
Animal to Person
Mother to Unborn Child

Indirect Contact
Touching an infected inanimate object, then yourself without thoroughly washing.

The importance of good hygiene and isolation can limit the transmission.
This is particularly important for pregnant women due to the unborn being a “captive” of whatever infects the mother-to-be

Question 13

Briefly describe anthrax

Answer 13

A bacterial infection.
Caused by bacterium Bacillus anthracis. (Aerobic)
Can be transmitted by direct contact with contaminated wool, hides or tissues or through inhalation.
Anthrax spores occur naturally in soil and may lie dormant for years before ingested by domestic animals; horses, cows and sheep as examples

Question 14

List the types of anthrax and briefly state their causes

Answer 14

1. Cutaneous: through cuts or sores in skin. Those who handle meat or hides and game animals.
2. Gastrointestinal: Exposure of the digestive system to anthrax usually by consuming meat products that contain anthrax.
   Severe and often fatal form of anthrax. Results in death in 25% to 60% of cases
3. Inhalation (pulmonary): inhaling spores. Deadliest form and often fatal even with treatment.
4. Injection: identified in Europe with those injecting illegal drugs from regions where naturally occurring anthrax is common

Question 15

State the symptoms, incubation, fatality and treatment of cutaneous anthrax

Answer 15

Symptoms: Sores or blisters on hands and forearms. Cutaneous is contagious.
Incubates: 2-7 days in most cases.
Fatal: Within 48 hours if untreated.
Treatment: Penicillin, immunization. Immune
serum helpful in early stages.

Question 16

State the symptoms, incubation, fatality and treatment of GI anthrax

Answer 16

Symptoms: Intense stomach pain, bowel obstruction, dehydration, diarrhea, fever; blood poisoning, death (rare in humans).
Fatal: 1,000 spores required. Within 24 hours of acute phase if untreated.
Incubates: 1-7 days.
Treatment: Doctors can prescribe effective antibiotics.
Bacillus anthracis usually responds effectively to several antibiotics including penicillin, doxycycline, and fluoroquinolones (such as ciprofloxacin).
To be effective, treatment should be initiated early. If left untreated, the disease can be fatal.

Question 17

State the symptoms, incubation, fatality and treatment of inhalational anthrax

Answer 17

Also known as Pulmonary Anthrax;
Flu-like symptoms ; Mild chest discomfort; Shortness of breath; Nausea; Coughing up blood; Painful swallowing
Progresses to:
High fever; Difficulty breathing; Shock; Meningitis
Initial symptoms may resemble a common cold. After several days, the symptoms may progress to severe breathing problems and shock. Inhalation anthrax is often fatal.
Fatal: Untreated: 90% fatal 8,000 to 10,000 spores required
Incubates: Sick in 1-5 days; sickness lasts 3-5 days (usually fatal)
Treatment: Protective vaccine

Question 18

Which bacterial species cause plague?

Answer 18

Pasturella pestis
Yersinia pestis

Question 19

List the types of plague and their modes of infection

Answer 19

Bubonic: From rats by the bite of an infected fleas.
Septicemic: When plague bacteria multiplies in the blood stream.
Pneumonic: May result from septicemic form or from inhalation of the organism

Question 20

Describe the bubonic plague

Answer 20

Black Death transmittable by bite of an infected flea or person to person by respiratory route.
This can include domesticated animals, i.e. cats to include wild animals, i.e. rabbits, rats, squirrels.
Characterized by buboes.
Symptoms can appear suddenly-usually within 2 to 5 days of exposure.
“Disease only lasts for 1 to 2 days before death occurs (if untreated).”

Question 21

Describe the septicemic plague

Answer 21

This form of the disease occurs when the bacteria multiply in the blood, causing bacteremia and severe sepsis.
Septicemic plague is rarely transmissible human to human but may become transmissible if the disease reaches the pneumonic stage.
Septicemic plague, either primary or secondary, has approximately 40% mortality when treated, and in untreated cases, the mortality is 100%.

Question 22

Differentiate between primary and secondary septicemic plague

Answer 22

Primary septicemic plague results from direct inoculation of the bacteria into the bloodstream, typically via the bite of an infected animal or flea or direct contact with infected tissues.

Secondary septicemic plague occurs when there is progression of disease and dissemination of bacteria following bubonic presentation

Question 23

How does the pneumonic plague spread?

Answer 23

Spread person to person by way of cough droplets.

Cough with bloody sputum
Difficulty breathing
High fever
Nausea/vomiting
Weakness

Progresses quickly leading to respiratory failure and shock in 2 days of infection

Question 24

List the plague symptoms

Answer 24

High fever, headache, general aches, extreme weakness, glandular swelling, pneumonia, hemorrhages in skin and mucous membranes possible, extreme lymph node pain.

Question 25

What is the treatment for plague?

Answer 25

Tetracycline with streptomycin

Question 26

What are the complicarions of plague?

Answer 26

Death
Gangrene
Meningitis

Question 27

What are the risk factors of plague?

Answer 27

Where you’re located
Your occupation
Diet diversification - Eating rodents
Hobbies

Question 28

Describe the ebola virus

Answer 28

EBOLA Virus caused by Filo virus and other African Hemorrhagic Fevers.
These are marked by severe bleeding, organ failure and often death.
**One of the most pathogenic viruses known to science, causing 50-90% fatalities in all clinically ill cases

Question 29

Describe the mode of transmission for the ebola virus

Answer 29

This virus lives in animal hosts and can be contracted through contact with blood and waste products.
It is then spread through person to person contact with body fluids or contaminated needles of those infected.
Cases of transmission included direct contact with blood, secretions, organs or semen of infected persons and by handling ill or infected chimps.
Persons are not contagious until symptoms are developed. Lack of PPE by medical personnel may be the cause of them becoming infected.
This should also be a concern of emergency response personnel when working around accident victims.
Epidemics in Africa are attributed to reusing needles and syringes due to lack of equipment

Question 30

State the symptoms, incubation, fatality and treatment of ebola virus

Answer 30

Symptoms: Fever, weakness, muscle pain, headache, sore throat. Then vomiting, diarrhea, rash, limited kidney and liver functions & both internal & external bleeding.

Incubation: 2-21 days, 5th day: hemorrhagic symptoms

Fatality: 50-90%

Treatment: Supportive care

Question 31

What are the complications of ebola virus?

Answer 31

According to the Mayo Clinic staff, complications for Ebola may include:

Multiple organ failure
Severe bleeding
Jaundice
Delirium
Seizures
Comma
shock

Hemorrhagic fevers are lethal for a high percentage of those infected. They interfere with the immune system’s ability to mount a defense
Recovery is slow and may require months.

People may experience:
Sensory changes
Liver inflammation
Weakness
Fatigue
Headaches eye inflammation.

Question 32

Describe the smallpox virus

Answer 32

Caused by Variola virus.
Highly contagious, disfiguring and often deadly.
No cure or treatment exists. A vaccine exists as a preventative.
Side effects are high for the vaccine which did not warrant vaccinations on a large scale.
If you were vaccinated as a child, it may provide partial immunity

Question 33

List the smallpox modes of transmission

Answer 33

Direct contact person to person
Indirectly via an airborne virus
Contaminated items
As a terrorist weapon

Question 34

Describe the symptoms of smallpox with reference to its incubation period

Answer 34

Incubation period: 7 to 17 days during which time you can not infect others.
Following incubation:
Fever
Overall discomfort
Headache
Severe back pain and fatigue
Vomiting is possible
A few days later, flat, red spots on your face, hands and forearms which then appear on your trunk.
Lesions may then turn into small blisters with clear fluid
8-9 days later scabs fall off leaving deep, pitted scars.
Lesions may also form on mucus membranes of nose and mouth.
Most who contract smallpox survive. Blindness may occur in some.
More lethal smallpox affects pregnant women and those with compromised immune systems.
Lethality: High to moderate

Question 35

How can you prevent anthrax?

Answer 35

Antibiotics for those exposed to anthrax spores.
Cipro
Doxycycline
Levaquin

Vaccine for military and those in high risk professions

Question 36

How can you prevent pneumonic plague?

Answer 36

Isolation
Rodent-proof your home
Use insect repellent to kill fleas

Question 37

How can you prevent ebola?

Answer 37

Avoid contact with virus.
Stay away from outbreak areas.
Wash hands frequently
Avoid local meat sold in their markets, if traveling abroad
Do NOT contact infected persons
Follow PPE procedures and requirements
Do NOT handle remains

Question 38

How can you prevent smallpox?

Answer 38

Vaccine may lessen infection if given within 4 days of exposure.
Childhood vaccination may provide partial immunity

Question 39

What is the treatment guideline for anthrax?

Answer 39

Antibiotic (60 day course); Cipro, doxycycline. The antibiotic depends on how you were infected.

Advanced inhalation anthrax may not respond to antibiotics; the drugs may be over ridden by the amount of toxin produced.

Injection anthrax has been treated by surgically removing infected tissue.

Question 40

What is the treatment guideline for plague?

Answer 40

No vaccine available, antibiotics can prevent infection. Gentamicin, Cipro, doxycycline.

If treatment is not received within 24 hours of when the first symptoms occur, death can result.

Antibiotics: streptomycin, gentamicin, doxycycline, or ciprofloxacin

Oxygen, intravenous fluids, and respiratory support usually are also needed.

Question 41

What is the treatment guideline for pneumonic plague?

Answer 41

Pneumonic plague patients should be strictly isolated from caregivers and other patients.

People who have had contact with anyone infected by pneumonic plague should be watched carefully and given antibiotics as a preventive measure.

Without treatment, about 50% of persons with bubonic plague die. Almost everyone with pneumonic plague dies if not treated. Treatment reduces the death rate to 50%

Question 42

What is the treatment guideline for ebola?

Answer 42

No drug is approved to treat and supportive care is provided:
- Rehydrating
- Blood pressure maintenance
- Oxygen as needed
- Lost blood replacement
Treating other infections which may develop due to suppressed immune system.

Question 43

What is the treatment guideline for smallpox?

Answer 43

No cure - treat symptoms.
Rehydrate.
Antibiotics may be used for those who have a bacterial skin or lung infection.

Treatment
Vaccine exists which is a preventative-not cure.
No specific therapy, supportive care must include prevention of secondary infections.