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Management of epidemics

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    Management of epidemics Management of epidemics Presentation Transcript

    • MANAGEMENT OF EPIDEMICS
      Dr. N.C.DAS
    • MANAGEMENT OF EPIDEMICS
      Epidemiology= Epi among, Demos people, Logos study
      Epidemics= It is a sudden and unexpected increase in a disease or health related event in an unidentified area.
      Severity of increase and spread depends on the Geographic location, environmental condition and distribution of host population and socio- cultural behavior of people.
       
      Management= management of epidemics involve step by step activities starting from forecasting to prevention for future occurrences.
    • EPIDEMICS
      The severity of the epidemic depends on---
      Geographic environment condition.
      Characteristic of host population.
      Socio cultural behaviour.
      Types of Epidemics:
      Common source epidemic
      • Point or single exposure
      • Multiple exposure from viable source
      Propagated epidemic
      Seasonal epidemic
      Cyclic epidemics
      Epidemic of non communicable diseases
    • EPIDEMIC MANAGEMENT STEPS
      Investigating
      Forecasting
      EPIDEMICMANAGEMENT
      Preventing
      Controlling
    • 1.FORECASTING EPIDEMIC 
      Forecasting is an early warning system to get prepared to meet the challenge of impending epidemics.
      It is more appropriate in cyclic and seasonal epidemics where the pattern has been studied from the post data.
      By forecasting one may not totally prevent the epidemic, but definitely control its severity and spread to other areas.
    • 1.FORECASTING EPIDEMIC
      4.The various methods needed for forecasting are:
      • Study of incidence and prevalence rate
      • Disease specific morbidity rate
      • Age and sex wise morbidity and disease specific mortality
      • The various data are tabulated month wise/ year wise for last three years for comparison and study pattern
      • Then the collected data is plotted on graph for immediate detection and visual appreciation through trend analysis of the disease.
      • Plotting of data on the map of local area helps in immediate assessment, whether the cases are grouped or clustered.
      • Developing a surveillance system for continuous data reporting and observation.
    • 2.CASE INVESTIGATION
      INVESTIGATION OBJECTIVES
      - To define the magnitude in terms of time, place and person.
      • To identity source and possible cause.
      • Factors contributing to spread.
      • To make recommendation to prevent.
      In spite of accurate forecasting an epidemic may not be aborted.
      In an unfortunate occurrence of an expected epidemic, the case
      investigation must be started to confirm.
    • STEPS IN INVESTIGATION OF EPIDEMICS
      Verification of diagnosis
      Confirmation of existence of epidemics
      Defining the population at risk.
      Rapid search for all cases in the area.
      Analysis the data
      Formulation of hypothesis
      Testing of hypothesis
      Evaluation of ecological factor
      Expand the search in other areas
      Write a final report
    • EPIDEMIC INVESTIGATION
      By asking questions
      By making comparison
      By asking questions:
      What is the problem - what can be done to reduce the problem.
      Where is the problem – what action to be taken by different groups.
      When is the problem – how activities to be planned.
      What is the magnitude – what constraints may be faced.
      Who all are effected – To what extent these can be over come.
      Why did it happen – what action be taken to prevent in future.
      How did it started – what resources are required.
      B) By making comparison:
      Between two groups or two locations compare to find out the crucial difference between the host or environmental factors of effected area and not effected area.
    • CASE INVESTIGATION
      Define population at risk
      Confirm existence
      CASE INVESTIGATION
      Prepare for epidemic
      Start screening of area
    •  CONFIRMATION OF CASES
      Confirmation of existence of epidemics is done through following process:
      Confirm diagnosis through clinical and lab tests.
      Define the gravity of situation by grouping/ clustering of cases on the local map.
      Age and sex wise people are suffering
      Type of disease/ health condition and risk factors
      Approximate number of cases suffering
    • START SCREENING THE AREA
      To apprise the total population at risk, screening of suspected cases starts. The screening depends on the geographic area and population group affected. Therefore the screening may be:
      Mass screening ,when all age and sex groups are involved. E.g. Dengue, swine flu, argemone oil poisoning(epidemic dropsy)
      Age specific screening for pediatric, geriatric disease categories.
      Women group screening for cervical cancer and breast cancer
      High risk group screening. Eg. HIV, Hypertension, Heart disease etc.
       
    • CRITERIA FOR SCREENING
      The various criteria used for assessment of screening test are:
      Validity: extent to which test measure the right cases it is supposed to measure
      Sensitivity: minimizes false negative, identify positive cases
      Specificity: identify negative cases.
      Repeatability: on repeated tests value do not change
    • DEFINE POPULATION AT RISK
      The population at risk can be found by:
      Population survey.
      Watch on migration of cases from other areas.
      Study of environmental conditions like air, water, sewarege pollution, food poisoning
      Mapping on local maps.
      Source of infection and family/ contact tracing.
    • PREPAREDNESS FOR EPIDEMICS
      Once the epidemic is suspected and cause identified, action should be taken to contain it by:
      Logistic planning, drugs, immunization, reagents.
      Manpower planning specially field staff, investigations, epidemiologists etc.
      Setting up of surveillance centers.
      Health education to public through media
      Training of medical and paramedical staff
    • SET UP SURVEILLANCE CENTERS
      Over and above the identified sentinel surveillance centers which provides data through out the year, there is need to start more surveillance cum cases reporting centers.
      Active surveillance by field investigators.
      Round the clock controlling room be established for receiving data and providing information.
      Surveillance guide lines be sent to the concerned identified center for case diagnosis and correct reporting.
    • SURVEILLANCE GUIDELINES
      Declare the disease as suspected epidemic
      Develop the standard case definition
      Develop the criteria to be used for diagnosis
      Develop the specific lab diagnostic tool
      Explain the objective of surveillance
      Develop data collection tools and frequency and reporting authority, information to be collected
      Decide the method of surveillance to be put in place i.e. only case reporting, or screening and reporting.
      Categorise the cases as suspected/ probable/ confirmed cases
      Guidelines for collection, transportation, storage of specimens for the lab test
      Data analysis, interpretation, and further action 
    •  CONTROL OF EPIDEMICS
      To control an epidemic one must have the information w.r.t
      Causative organism/ source
      Dynamic of disease transmission
      Mode of transmission… direct contact, indirect contact, vehicle of transmission
      • Root of transmission
      • Skin
      • Blood
      • Urinary tract
      • Respiratory tract
    • 3.CONTROL OF EPIDEMICS
      Three principles of dynamics of disease transmission is used to control the epidemic
      Removal of source of infection
      Prevent transmission
      Vector control measures
    • CONTROL OF EPIDEMICS
      Removal of Source of Infection:
      Treatment of infected cases
      Destruction of reservoir of infection
      Removal/ correction of source of infection
    • CONTROL OF EPIDEMICS
      2. Prevent transmission:
      Isolation of infected cases
      Hand washing and personal protective measures
      Use of sterile supply
      Proper disposal of fomites
      Improve environmental sanitation
      Contact tracing, family, neighbor
      Screening of suspected cases
      Quarantine of migrated cases
      Health education
      Increase resistance of suspects through immunization, prophylactic drugs or immuno globulins.
       
    • CONTROL OF EPIDEMICS
      3. Vector control measures:
      Prevent breeding of mosquitoes, flies and fleas
      Destruction of adult vectors through insecticide, pesticide
      Personal protection like prevent bite, use mosquito nets, use hot food, filtered water
      Increase personal hygiene
      improve environmental sanitation like open air, defecation, use of cut fruits, proper garbage disposal
    • 4. PREVENTING MEASURES
      There is a saying ‘’ more you sweat during peace, less you bleed during wars.’’ Appropriate measures at right time, right place in right quantity can prevent the severity of any epidemic.
      Personal measures:
      Increase body resistance by immunization, nutritional diet
      Change in diet habits
      Regular yoga and exercises
      Pollution free atmosphere
      Giving away addiction
       
    • PREVENTING MEASURES
      2. Environmental measures:
      Clean portable water supply
      Prevent open air defecation
      Proper disposal of garbage
      Adequate sewerage system
      Lighted and well-ventilated houses
       
      3. Regular health education to public through mass media, group meetings, seminars, workshops.
       
    • hospiad
      Hospital Administration Made Easy
      THANK YOU
      http//hospiad.blogspot.com
      An effort solely to help students and aspirants in their attempt to become a successful Hospital Administrator.
      DR. N. C. DAS