CHIKUNGUNYA FEVER

Definition : Chikungunya fever is a viral disease transmitted to humans by the bite of infected mosquitoes. Chikungunya virus was first isolated from blood of a febrile patient with severe rashes in Tanzania in 1953 and has since been identified repeatedly in west, central and southern Africa and many areas of Asia.

SIGNS ANDSYMPTOMS
Chikungunya virus can cause physical weakness such as ( debilitating ilness )

• Fever
• Headache
• Fatique
• Nausea
• Vomitting
• Muscle pain
• Rash
• Joint pain incapacitating joint pain , so called debilitating or crisppling illness ,joint pain misnic like arthritis, and patient become spiral or bends up.The term Chikungunya means that which bends up ( joint pain lasts for few weeks to few months).

INCUBATION PERIOD
Time from infection to ilness can be 2 - 12 days, but is usually 3- 7 days. "Silent chikungunya virus infections do occur ( infections without ilness) but how commonly this happens is not yet known. Accute chikungunya fever typically last last a few days to a couple of weeks.Some patients have prolonged fatique lasting several weeks. Additionally, some patients has reported incapacitating joint pain, or arthritis which may last for weeks or month.

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CHICKEN POX

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PERTUSSIS FOR CHILDREN

DISEASE DESCRIPTION
AGENT - BORDETELLA PERTUSSIS, a small gram negative coccobacillus is responsible for the majority of attacks of whooping cough.

INCUBATION PERIOD - 7 to 21 days.
COMMUNICABLE PERIOD - greatest during the catarrhal stage.
SOURCE - discharge from the respiratory tract of the infected person.

TRANSMISSION :
Direct contact or droplet spread from infected person. Indirect contact with freshly contaminated articles. Whooping cough spreads readily in the home among unvaccinated infant and young children.

STAGES

1. CATARRHAL STAGE
2. PAROXYSMAL STAGE
3. CONVALESCENT STAGE

Signs and symptoms of catarrhal stage

1. Last 1 to 2 weeks
2. Common cold with running nose.
3. Sneezing
4. Dry cough
5. Slight fever or no fever

Signs and symptoms of paroxysmal stage.

1. Last 2 to 4 weeks or larger.
2. Frequent severe violent coughing attacks occuring in clusters leading tovomiting, cyanosis and exhausion.

Signs and symptoms of convalescent stage.

1. Last 2 weeks to several months.
2. Coughing attacks disease, but many return with each respiratory infection.

TREATMENT
Whooping cough in infant , or when complicated by respiratory tract demands skilled treatment in a unit possessing all the necessary facilities. In case of apnoe attack the nurse should remain with the patient by giving O2. A child may turn blue, vomit or exhausted during a coughing attack, the air way shpuld be cleared. Patient feeding and refeeding after vomiting is a fundamental tenet of nursing care. Failure to refeeding results loss of weight and diminished power of resistance. It is wise to give small frequent feeds. Iv therapy and anti mocrobial therapy as prescribed.

NURSING CONSIDERATION

1. Isolate the child during catarrhal stage.
2. Institute respiratory isolation and precautions.
3. Maintain bed rest.
4. Gentle suctioning.
5. Increase fluid intake.
6. Oxygen as prescribed.
7. Reduce environmental factors that promote paroxysmes of coughing such as dust , smoke and sudden changes in temperature.

DIAGNOSTIC TEST
Bordetella pertussis may be isolated from culture of nasopharyngeal mucus.The organism is mostly found in brachial secretions the per nasal swab should only be taken immadiatelly after paroxysm , with this method there is air 80 to 90% chance of isolating the organism in the first 10 days of the ilness.


RESPIRATORY COMPLICATION :

• Pneumonia
• Emphysema
• Aspiration pneumonia
• Pneumothorax

CNS

• Convulsions
• Encephalopathy
• Coma

NURSING ALERT
The nurse should remain with the xchild while giving nebulization. Child should be held with head elevated while feeding. While suctioning , gently rotate and with draw catheter , apply suction 5 to 10 seconds only. Choose correct size of catheter for suctioning. Change the suction tube each time after suctioning.

COMPARISON OF SIGNS AND SYMPTOMPS OF PATIENT WITH BOOK PICTURE.

1. Productive cough with thick secretion related to whoop.
2. Cyanosis
3. Fever
4. Difficulty in breathing
5. Vomiting
6. Loss of appetite
7. Broncheopneumonia.

1. But my patient present ( see E- LEARNING for bed side clinic on pertussis) the following symptomps such as : 1. Productive cough with thick secretion related to whoop.
2. Cyanosis
3. Fever
4. Difficulty in breathing.

In Comparison my patients does have vomiting, loss of appetite and bronchopneumonia as shown in the book picture.

HEALTH TEACHING

1. Advised mother to give vaccination in time and explained about vaccination schedule.
2. Explained about medication and to give in proper time.
3. Instruction given to the mother about cleanliness hand hygiene, to wash hand before and after giving feed, personal hygiene, importance of sterilization of feeding others etc.
4. Explained the motrher how to take care of baby. Child should be held with head elevated while feeding. Dont place infant in prone position. Place the child in a comfortable position to promote easier ventilation. Dont allow to contact with other children. Dont give cold items of food. Give small amount frequent feeds. While vomiting , keep the child on side line position to prevent aspiration.

REFERENCE
Paediatric Infectious diseases
Hal B. Jensen and Robert S.BALTIMORE 1995

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WHAT IS AIDS....?

publish : Dudih hidayat

Npm :20111080025

APAKAH AIDS ITU ?

Penyakit menular yang disebabkan oleh virus yang merusak sistem kekebalan tubuh.Virus penyebab AIDS adalah HIV (Human Immunodeficiency Virus)Penderita AIDS yang meninggal, bukan semata-mata disebabkan oleh virus AIDS, tetapi juga oleh penyakit lain yang sebenarnya bisa ditolak, seandainya sistem kekebalan tubuh tidak rusak oleh virus AIDS.

APAKAH HIV ITU ?

HIV adalah virus seperti influenza,cold.sebenarnya virus bukan sesuatu yang istimewa akan tetapi kemampuanya yang bisa berkembang biak, membuat virus-virus baru hal ini yang menjadikan sangat berbahaya karena bisa membunuh sel tubuh.HIV menginfeksi T-cell yang mana \t-cell ini merupakan sell kekebalan tubuh manusia.

APA HIV TEST

HIV test adalah test yang akan memperlihatkan apakah seseorang terinfeksi virus hiv,virus yang menyerang system kekbalan tubuh dan menyebabkan AIDS.

ELISA atau enzyme linked immunosorbent assay adalah test yang biasa di gunakan untuk mengetahui infeksi dari virus hiv.

SIKLUS HIDUP HIV

· STEP 1: BINDING

· STEP 2:REVERSE TRANCRIPT

· STEP 3:INTEGRATION

· STEP 4: TRANCRIPTION

· STEP 5: TRANSLATION

· STEP 6. VIRAL ASSEMBLY AND MATURATION

BAGAIMANA AIDS MENULAR ?

· 75-85 % Penularan terjadi melalui hubungan seks (5-10 % diantaranya melalui hubungan homoseksual)

· 5-10 % akibat alat suntik yang tercemar (terutama pada pemakai narkotika suntik)

· 3-5 % melalui transfusi darah yang tercemar

· 90 % infeksi pada bayi dan anak terjadi dari Ibu yang mengidap HIV

· 25-35 % bayi yang dilahirkan oleh Ibu pengidap HIV akan menjadi pengidap HIV

GEJALA AIDS

· Rasa lelah berkepanjangan

· Sesak nafas dan batuk berkepanjangan

· Berat badan turun secara menyolok

· Pembesaran kelenjar (di leher, ketiak, lipatan paha) tanpa sebab yang jelas

· Bercak merah kebiruan pada kulit (kanker kulit)

· Sering demam (lebih dari 38 °C) disertai keringat malam tanpa sebab yang jelas

· Diare lebih dari satu bulan tanpa sebab yang jelas

SIAPA KELOMPOK RESIKO TINGGI TERKENA AIDS ?

· Siapa saja yang memiliki perilaku seksual berganti-ganti pasangan

· Pemakai atau pengkonsumsi narkoba akibat alat suntik yang tercemar

BAGAIMANA MENCEGAH AIDS

· Tidak berganti-ganti pasangan seksual

· Pencegahan kontak darah, misalnya pencegahan terhadap penggunaan jarum suntik yang diulang

· Dengan formula A-B-C

· ABSTINENSIA artinya tidak melakukan hubungan seks sebelum menikah

· BE FAITHFUL artinya jika sudah menikah hanya berhubungan seks dengan pasangannya saja

· CONDOM artinya pencegahan dengan menggunakan kondom

BLOOD TEST YANG DI PERLUKAN UNTUK PASIEN AIDS

· T-sell

· Viral load

· Complet blood count ( cbc )

· Chem. Screen test

PENYAKIT-OPORTUNIST

·Aspergillous

· Campylobacteriosis, and Shigellosis)

· Bacterial Pneumonia

· Candidiasis

·Hepatitis C

·Herves simplex

· Herpes Zoster Virus

· Kaposi sarcoma

· Thrombocytopenia

· Tuberculosis

· pcp

· DLL

Resources.

- aids.org

- aidsupdated.org

-mayoklinik.com

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