Control of Acute Respiratory Infection: Report by Group G - JU

This report, submitted by Group G, delves into the control of acute respiratory infections (ARI), a significant cause of morbidity, particularly in children. It covers various aspects, including epidemiological determinants such as agent factors and modes of transmission, detailed clinical assessments of common respiratory illnesses like the common cold, pharyngitis, pneumonia, and bronchitis, and a classification of ARIs into upper and lower respiratory tract infections. The report also discusses diagnostic methods, highlighting the importance of respiratory exams and lung function tests. Furthermore, it outlines ARI control programs, emphasizing the identification of ARI in children at the community level and appropriate therapy. Treatment strategies for upper respiratory tract infections, including common colds and pharyngitis, are detailed, along with preventive measures. The report concludes by emphasizing the importance of controlling ARIs to reduce morbidity and mortality, especially in vulnerable populations.

A Report on
Control of Acute Respiratory Infection
Submitted by:
Group G ( 1625 , 1626 , 1627 , 1628 , 1629 , 1630 , 1631 , 1632 , 1633 , 1635 , 2088 , 2191 )
Under the supervision of,
Most. Zannatul Ferdous
Lecturer, Department of Public Health & Informatics,
Jahangirnagar University, Savar, Dhaka .

Declaration
This report entitled “Control of Respiratory Infection” is submitted to, Most. Zannatul Ferdous,
Lecturer, Department of Public health and informatics is carried out by the members of Group
G on 30 December 2020 and has not been submitted to any other university or institute.

Acknowledgement
At the first and foremost, I wish to express all of my devotion and reverence to the Almighty
Allah, most merciful and beneficent creator who has enabled us to perform this report.
Next, We would like to thank to our honorable Lecturer, Most. Zannatul Ferdous, Dept. of
Public Health & Informatics, Jahangirnagar University, who gave us the opportunity to finish
this report.
We would also like to convey our highest thanks to our all group members.

Contents
Abstract…………………………………………………………………………………….. 1
Introduction………………………………………………………………………………… 2
Epidemiological Determinants…………………………………………………………….. 3
Clinical
Assessment…………………………………………………………………………………. 3-6
Classification of ARI………………………………………………………………………. 7
Diagnosis of ARI…………………………………………………………………………… 7
ARI Control Programmes…………………………………………………………………. 8
Treatment of ARI…………………………………………………………………………. 9-16
Prevention of ARI…………………………………………………………………………. 17
Conclusion………………………………………………………………………………….. 18
Refferences…………………………………………………………………………………. 19

1
Abstract
Acute respiratory tract infections (ARTIs) are responsible for considerable morbidity in the
community, but little is known about the presence of respiratory pathogens in asymptomatic
individuals. We realized that asymptomatic persons could have a little infection and thus act as a
source of transmission.
This study confirms that most ARTIs are viral and supports the reserved policy of prescribing
antibiotics. In both case and control subjects, rhinovirus was the most common pathogen. Of
bacterial infections, only group A β-hemolytic streptococci were more common in case patients than
in control subjects. Furthermore, we demonstrated that asymptomatic persons might be a neglected
source of transmission.

2
Introduction
Acute respiratory infection is a serious infection that prevents normal breathing function. It usually
begins as a viral infection in the nose, trachea (windpipe), or lungs. It can affect just upper respiratory
system, which starts at sinuses and ends at vocal chord or just lower respiratory system which starts
at vocal chords and ends at lungs. It prevents the body from getting oxygen and can result death.
Also ARI are infectious, which mean they can spread from one person to another. The infection is
particularly dangerous for children, older adults and people with immune system disorders.

3
Epidemiological Determinants
Agent factors:
• The microbial agents that cause ARI are numerous which includes bacteria and viruses.
• Even within species they show wide diversity of antigenic type.
• Severity of illness is determined by whether secondary bacterial infection occurs or not.
• The manifestations include influenza, sinusitis, acute otitis media, Nasopharyngitis, Onsillitis,
epiglottitis, laryngitis, Tracheitis, acute bronchitis, bronchiolitis and pneumonia.
Mode of Transmission:
• The most common modes of transmission are: Airborne droplets spread when the sick person
coughs or sneezes, and inhaled into the lungs (breathed in) by a susceptible person; direct oral contact
with someone who has pneumonia (e.g. through kissing).
• Chain of transmission is maintained by direct person-person contact.
Clinical Assessment:
Common cold:
• Nasal congestion
• Watery discharge
• Mouth breathing
• Change in Ton of voice
• Shore throat
• Headache
• Slight fever

4
Pharyngitis:
• Sneezing
• Runny nose
• Headache
• Cough
• Fatigue
• Body aches
• Chills
• Fever
Epiglottitis:
• Fever
• Severe sore throat.
• Abnormal, high-pitched sound when breathing in (stridor)
• Difficult and painful swallowing
• Drooling
• Anxiety
Laryngitis:
• Hoarseness.
• Weak voice or voice loss.
• Tickling sensation and rawness in your throat.
• Sore throat.
• Dry throat.
• Dry cough.

5
Pneumonia:
• Sweating or chills
• Shortness of breath that happens while doing normal activities or even while
resting
• Chest pain that’s worse when you breathe or cough feelings of tiredness or fatigue
• Loss of appetite
• Nausea or vomiting
• Headaches
• Children under 5 years old may have fast breathing or wheezing.
• Infants may appear to have no symptoms, but sometimes they may vomit, lack
energy, or have trouble drinking or eating.
• Older people may have milder symptoms. They can also exhibit confusion or a
lower than normal body temperature.
Tuberculosis:
• A cough that lasts more than three weeks
• Loss of appetite and unintentional weight loss
• Pain in chest
• Sweating at night
• Fever
• Chills
• Night sweats
Bronchitis:
• Cough.
• Production of mucus (sputum), which can be clear,
• White, yellowish-gray or green in color- rarely, it may be streaked with blood.
• Fatigue.
• Shortness of breath.
• Slight fever and chills.
• Chest discomfort.

6
Cough:
• A runny or stuffy nose
• Wheezing and shortness of breath
• Heartburn or a sour taste in mouth
• Sneezing
• Mild fever
• Tiredness
Sinusitis:
While the causes of acute and chronic sinusitis can be quite different, the symptoms are often the
same.
• Nasal obstruction
• Facial pain or pressure
• Fatigue
• Bad breath
• Ear pressure
• Headaches
• Unusual tastes and smells
• Drainage of a thick discolored discharge from the nose
Lung cancer:
• A cough that doesn’t go away after 2 or 3 weeks
• A long-standing cough that gets worse
• Chest infections that keep coming back
• Coughing up blood
• An ache or pain when breathing or coughing
• Persistent breathlessness
• Persistent tiredness or lack of energy
• Loss of appetite or unexplained weight loss
• Wheezing
• A hoarse voice
• Swelling of your face or neck
• Persistent chest or shoulder pain

7
Asthma:
• Shortness of breath
• Chest tightness or pain
• Wheezing when exhaling, which is a common sign of asthma in children
• Trouble sleeping caused by shortness of breath, coughing or wheezing
• Coughing or wheezing attacks that are worsened by a respiratory virus
Emphysema:
• Frequent coughing or wheezing.
• A cough that produces a lot mucus.
• Shortness of breath, especially with physical activity.
• A whistling or squeaky sound when you breathe.
• Tightness in your chest.
Classification of ARI:
Upper respiratory tract infections (AURI): Include common cold, pharyngitis, laryngitis,
Tracheitis, epiglottitis and otitis media.
Lower respiratory tract infections (ALRI): Include bronchitis, bronchiolitis and
pneumonias. It is currently the leading cause of death in young children in Low Income Countries
the World Health Organization (WHO) estimates that one-third of all deaths in children below the
age of five years (4.3 million deaths in real terms in 1993) are due to ARI.
Diagnosis of acute respiratory infection:
In a respiratory exam, the doctor focuses on your breathing. They will check for fluid and
inflammation in the lung by listening for abnormal sounds in your lungs when you breathe. The
doctor may peer into your nose and ears, and check your throat. If your doctor believes the infection
is in the lower respiratory tract, and X –ray or CT scan may be necessary to check the condition of
the lungs. Lung function tests have been useful as diagnostic tools. Pulse oximetry, also known as
pulse ox, can check how much oxygen gets into the lungs. A doctor may also take a swab from your
nose or mouth, or ask you to cough up a sample of sputum (material coughed up from the lungs) to
check for the type of virus or bacteria causing the disease.

8
ARI control programmes:
ARI control programme is the part of RCH programme. And this programme Includes some
important activities such as-:
ARI control in children:
• ARI is an episode of acute symptoms & signs resulting from infection of any part of respiratory
tract & related structures
• Constitutes 22-66% of outpatients & 12-45% of inpatients
• In India: 10-50 children die per 10,000 episodes of ARI
• ARI control programmes.
• Crux of the program is to identify children with ARI at the community level by training the field
workers to recognize easily & reliably identifiable clinical signs of ARI & early reference.
WHO protocol comprises 3 steps:
Step 1: Case finding & Assessment
• Cough & difficult breathing in children < 5 years age
• Fever is not an efficient criteria. ‘
Step 2: Case Classification
• Children grouped into 2:
• Infants < 2months & Older children
• Specific signs to be looked: In younger children like feeding difficulty,lethargy,
hypothermia, convulsions.
In infants < 2 months
•Pneumonia is diagnosed if RR 60/min with other clinical signs
•All should be hospitalized
•All should receive IV medications
•Minimum duration of 10 days
•Combination of Ampicillin& Gentamicin
Step 3: Institution of appropriate therapy