Health and Disease

HealthState of complete physical , mental, intellectual, spiritual and social well-being and not merely the absence of disease or infirmity.

Were you be able to identify the health dimensions being shown in the picture?

Emotional Health- the ability to express emotions in appropriate way.

Spiritual Health- Refers to the values, principles, ways and beliefs of an individual.

Physical Health- The ability to perform routine tasks without physical restriction.

Mental or Intellectual Health- the ability to learn and think coherently

Social Health- the ability to get along with other people.

DISEASE-RELATED TERMS

Disease Vs. Illness

DiseaseIt is a pathological condition that disrupt the normal functioning of the body.It is objective, characterized by an abnormality in the structure or function of body organs.

Objective- information or analysis is fact-based, measurable and observable.

IllnessIt is the human response to disease. It is subjective because it is based on the experience of the patient.

Four Stages of Illness• Experiencing signs and

symptoms• Assuming the sick role or

validating the sickness• Seeking medical care• Assuming dependent role while

recovering

Subjective -information is based on personal opinions, interpretations, points of view, emotions and judgment.

Communicable Disease Vs.

Non-Communicable Disease

Communicable Disease –disease which can be transmitted from one person to another

Non-Communicable Disease - Also known as chronic disease. It is not passed from one to anothet

Sign Vs.

Symptoms

Sign- is an objective physical manifestation of illness, injury or disease. Examples: rapid pulse,High temperature, low blood pressure, muscle weakness.

Symptoms -it is what the patience experience about the illness, injury or disease.Examples: chills, numbness, fatigue.

Endemic Vs.

Sporadic

Endemic -infectious disease that occurs frequently and in cycles in a specific geographical area. Influenza is an example.

Sporadic -disease that occurs singly, occasionally or in irregular intervals.

Epedemic Vs.

Pandemic

Epidemic- refers to a contagious, or viral illness that spreads to many people in one geographic region that occurs in excess of number of cases that usually be expected.

Pandemic- contagious or viral illness that spreads in many areas across large region or across the globe.

Fomite Vs.

Vector

Vector- is an infected insect/animal or insect/animal that carries and transfers infectious agent.

Fomite- is an inanimate (meaning it can not move itself) object which can possibly harbor infectious agent.

The Causes of Disease

Supernatural Belief-Ancient times belief explained that disease is caused by a supernatural being ( a God or a dead ancestor), or a person with special powers ( a witch or a sorcerer).

Poisonous Gas Belief-Major beliefs during the 1800s. explained that disease (such as malaria) is caused by rotting plants or bad vapour that came from swamps.

Malaria- came from mala aria meaning bad air.

Germ Belief-Holds that microscopic organisms are responsible for infectious diseases.

Agent-Host-Environment Belief (Classic Agent)-This belief explains disease as a product of the complex interaction among three factors ( agent, host and environment)

Agent-Host-Environment Triangle

Host- is an organism usually a person or an animal affected by the disease.

Environment- is the condition outside the host that allows disease to be transmitted.

Agent- is the organism that cause disease.

Factors in the Development of

Disease

Personal Factor- referring to a practices and etiquettes in managing disease.

Economic Factor- Relating to poverty that leads to a lack of accurate education and information about nutrition, hygiene and disease management.

Cultural Factor-referring to beliefs that provide false sense of security and delaying healthcare and appropriate treatment.

Some superstitious beliefs.• Taking a bath on Friday will

make one sick.• Washing the eyes with the

first urine early in the morningis an effctive cure for sore eyes

• An amulet or anting-anting protects the wearer from diseases and helps counteract witchery.

• Relapsed or binat is caused by eating certain kinds of food or by cutting the hair soon after illness.

Environmental Factor- Referring to unsanitary conditions, presence of toxic chemicals, hazardous pollutants, extreme weather condition that makes people weaken and vulnerable to a lots of infection.

Political Factor- Referring to political issues, such as corruption that affect the provision of health care services and resources to the people. In many cases people’s health is not given utmost priority.

Educational Factor- Disease transmission can also be due to misinformation or lack of information thus education is crucial in disease prevention and control.

CHAIN OF INFECTION

INFECTIOUS AGENT/ CAUSATIVE AGENT/ PATHOGENS-disease-causing organisms.The greater the organism's virulence (ability to grow and multiply), invasiveness (ability to enter tissue) and pathogenicity (ability to cause disease), the greater the possibility that the organism will cause an infection. Infectious agents are bacteria, virus, fungi, and parasites.

Microorganisms

Virus• Small infectious agent that

replicates only inside the living cells of other organisms. • Infects all types of life forms.

•Requires intracellular parasite (can’t survive outside the host’s cell)•On the borderline

between living and non-living matter

• Can have varied shapes:helical – like a coiled springicosahedrons – with 20 triangular

sides or a very complex shape.• Attacks all kinds of biological agents,

even bacteria• Consist of a bit of nucleic acid ( RNA

or DNA, but never both within a protein coat)

Specific Disease Caused by a Virus• AIDS- Acquired Immune Deficiency

Syndrome• Chickenpox• Common cold• Dengue fever• Influenza• Measles• Poliomyelitis• Rabies• Warts

Influenza Virus

HIV Virus

Bacteria• Single-celled• No true nucleus• Can be aerobic (needs

oxygen) and anaerobic (does not need oxygen)

• Can be spherical (coccus), rod-shaped (bacillus), or spiral (spirillum)

• Can be in pairs (diplo-), in clusters (staphylo-), or in chains (strepto-)

• Majority comprise the normal flora (live in the human body)

• Majority are good/friendly (probiotic)

• Can be opportunistic (friendly bacteria turn harmful when the immune system weakens)

• Causes disease by directly attacking tissues or releasing toxins

• Some can live in a dormant state as spores

Specific Disease Caused by Bacteria

• anthrax• cholera• diptheria• gonorrhea• leprosy• Tetanus• tuberculosis

Bacillus Bacteria

Staphylococcus Bacteria

Streptococcus Bacteria

Protozoa• Parasitic or free living

(can survive outside the host)

• Has a variety of shapes and sizes

• Various types; amoeba, ciliates, flagellates or sporozoans found most often in stagnant water or moist soil.

Specific Disease Caused by Protozoa

• Malaria• Amoebic dysentery

Fungus• Thrive on dead or

decaying matter• Multicellular (like

molds), or unicellular (like yeasts)

• Spore-forming (this is the reason why it’s sometimes difficult to treat)

• Cause diseases of the skin, mucous membranes and lungs

Specific Disease Caused by Fungus

• Tinea or ringworm (jock itch, athlete’s foot)

Tinea Pedis Fungus (Athlete’s Foot)

Parasitic Worm• Largest among the

pathogens• Can either be flatworms

or roundworms

• Examples of flatworms are tapeworms (can be transmitted by eating raw fish/pork/beef) and flukes (example is schistosoma japonicum/mansoni that causes schistosomiasis

Tape Worm

Fluke

• Examples of roundworms are pinworms and hookworms.

Hook Worm

Specific Disease Caused by Parasitic Worm

• Ascariasis• Elephantiasis• Enterobiasis• Schistosomiasis• Taeniasis

RESERVOIRThis is the place wherein the infectious agent lives and multiplies.This can be living (animal, human, plant) or non-living(air, water, food, utensils/equipment).

Sick Person

PORTAL OF EXITA route or a place of exit providing a

way for a microorganism to leave the reservoir. The common most mode of exits are break in the skin, nose, mouth or anus and special body openings such as vagina, penis, urethra, ears and eyes.

It may be through the bite of mosquito or needle prick.

Coughing or Sneezing

MODE OF TRANSMISSIONMethod of transfer by which the organism moves or is carried from reservoir to a new host.

Direct Transmission- Throug close contact or direct person to person contact

Shaking of Hands

Indirect Transmission- Through an intermediate item or carrier . Examples: • Vector-borne transmission -bite of

mosquito• Vehicle-borne transmission

-contaminated items (utensils), contaminated water, air, and 3F’s ( food, flies and fingers)

Mosquito Bite

PORTAL OF ENTRYAn opening allowing the microorganism to enter the host. Examples: mouth, nose skin and urogenital organs.The mode of entry is same as the mode of exit.

Eating With Bare Hand

SUSCEPTIBLE HOSTThis is a person who is vulnerable to disease due to weak immunity or a prior infection. Children and elderly are more prone to a lot of infections. Immunization is one way to strengthen one’s immunity to disease.

Weak Person

The Spread of Infection

Patient Situation: 1An elderly patient, hospitalized with a gastrointestinal disorder, was on bed rest and required assistance for activities of daily living. The patient had frequent uncontrolled diarrhea stools and the nurse provided excellent care to maintain cleanliness and comfort. Following one episode of cleaning the patient and changing the bed linen, the nurse immediately went to a second patient to provide care. The nurse's hands were not washed before assisting the second patient.

Infectious agent: Escherichia coli

Reservoir: Large intestineE. coli, bacteria in the large intestine of humans forms the greater part of the normal intestinal flora.

Portal of Exit : E. coli exited the body in feces.

Mode of Transmission: The nurse removed the contaminated linen from the bed. The E. coli organism contaminated the hands of the nurse who then provided morning care to another patient.

Portal of Entry: The second patient receiving care had a Foley catheter. The nurse manipulated the tubing attached to the catheter. The E. coli organism on the nurse's hands contaminated the catheter tubing and ascended to the patient's meatus and then into the urinary bladder. Susceptible Host: The second patient with a Foley catheter. This patient was elderly and had a chronic illness necessitating complete bed rest. The Foley catheter contaminated by the E. coli organism provided a direct route into the urinary bladder.

Breaking of the Chain

Patient Situation: 2A patient assigned for morning care has an open wound on her left lower leg. The wound is draining and when last cultured, the microorganism MRSA was identified.

In preparation for bedmaking, hands of the nurse were washed. Clean linen and a bag for soiled linen were gathered from the linen room and placed on the patient's clean bedside stand.

To remove the soiled linen from the bed, the following procedure was followed:

Hands washed Gloves worn Each side of the soiled linen ends folded towards the middle of the bed Soiled linen held away from the nurse's clean uniform Soiled linen placed in the linen bag for later discard Protective gloves removed Hands washed

Infectious Agent: MRSA (Methicillin-resistant organism)

Reservoir: Patient's infected wound

Portal of Exit: Draining from the open wound BREAK IN THE CHAIN = Nurse used proper hand

washing techniques, wore protective gloves and properly handled the linen.

Mode of Transmission: MRSA commonly transferred on hands of the nurse by indirect contactBREAK IN THE CHAIN =Proper hand washing, gloving and handling of linen

Portla of Entry: The nurse manipulated the tubing attached to the catheter. BREAK IN THE CHAIN=Organisms isolated with use of medical asepsis and body substance isolation

Susceptible Host: PROTECTED

STAGES OF INFECTION

Incubation Stage- This is the time from the entry of germ to the appearance of the first sign of symptom.This can last from several hours to several months or even years.

Early Symptom Stage- This is when the general signs and symptoms of the disease appear such as fever, nasal discharge, and rashes. It is the early stage of the battle between the germs and the body.During this time , the disease is higly contagious and diagnosis is difficult at this stage.

Clinical Stage- This is the height of the disease when the infection is very severe. During this period one is obviously sick as characteristic signs and symptoms of the disease appear.

Recovery Stage- During this stage, there is a gradual return to health as signs and symptoms begin to disappear.The body is now on its way to recovery. However when the body is unable to recover, disability or death may result.

There are times when a person experienced a relapsed or binat. It happens when a sick person partially recovers but goes back to clinical stage.Recovery takes much longer after a relapse because the body defenses are still weak from a previous infection.

PREVENTION AND CONTROL OF INFECTION

Medical Asepsis-helps to contain infectious organisms and to maintain an environment free from contamination. Include hand washing, gowning and wearing facial masks when appropriate, as well as separating clean from contaminated or potentially contaminated materials and providing information to patients about basic hygienic practices.

Standard Precautions-combine the major features of universal precautions and body substance isolation. These standard precautions alert the health care worker to patient situations that require special barrier techniques. These barrier techniques are used when working with any patient where potential or actualized contact with blood or body fluid exists.

Universal Precautions-help control contamination from bloodborne viruses such as human immunodeficiency virus (HIV) and hepatitis viruses. When in contact with a patient's blood or any body secretion that may be contaminated with blood, protective measures such as wearing gloves, gown, facial mask, and/or goggles must be.

Body Substance Isolation-protects against bacterial organisms that may exist in body substances. Body substance isolation applies in all patient encounters regardless of the diagnosis. The application of gloves for contact with moist body surfaces and areas of nonintact skin, gowns when in contact with body secretions, and facial mask when in danger of contact with respiratory droplet secretions, prevents the contamination of both health care worker and patient.

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