Communicable Disease Control Handbook, 2nd edition by Jeremy Hawker, Norman Begg, Iain Blair, Ralf Reintjes,

By Jeremy Hawker, Norman Begg, Iain Blair, Ralf Reintjes, Julius Weinberg

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There are four main types of rash: vesicular, maculopapular, punctate and haemorrhagic. Vesicular rashes have a blister-like appearance and sometimes contain fluid. Maculopapular rashes are flat or slightly raised and there is sometimes joining together of areas of the rash. Punctate rashes have small, discrete pinpoint lesions. Haemorrhagic rashes look like bruising. 2. 1). Where fever is present, this usually means the cause is infectious. g. g. enterovirus infections, the fever may be mild or absent.

In herpes simplex meningitis, the illness is more severe and may persist for weeks. It is associated with primary genital herpes. Non-paralytic poliomyelitis can present as meningitis, indistinguishable clinically from other causes of enteroviral meningitis. Poliovirus is detectable in faeces or CSF. Bacterial meningitis Bacterial meningitis is a medical emergency. 4 for causes of bacterial meningitis). In the neonate, the presentation is nonspecific, with features of bacteraemia. The infant is febrile, listless, floppy and does not take feed.

May be severe. Mostly adults, more often males. May be seasonal community epidemic. Affects the unvaccinated. Possible link to sheep, other animals or animal products. May increase in April–June. Male excess, rare in children. Peaks every December and January. Causes outbreaks in nursing homes. g. military recruits). Highest in January–April. Average from a number of prospective studies of patients admitted to hospital (Farr and Mandell, 1988). Will vary according to epidemic cycles. Clinical picture is not a reliable indicator of organism in individual cases.

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