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2. Objectives
Introduction
Key definitions
Transmission
Epidemiological triad
Chain of infection
Factors & mx
Fundamental principles of CD control
Steps in CD outbreak mx
Medical officers role
References

3. Introduction
• Communicable disease- Disease transmission from 1 person to
another caused by infectious agent via a source/ reservoir to a
susceptible host.
• Major causes of morbidity & mortality. Emergencies e.g. Diarrheal
diseases, acute respiratory infections, measles & endemic areas
e.g. Malaria in Vanuatu & Solomon Islands.
• Other epidemics among populations affected by emergencies are
meningococcal, TB & Typhoid.
• Deaths; malnutrition & trauma.

4. Key definitions:
• Outbreak-Increase new cases of diseases in a community in a given time
period.
• Epidemic-Increase group of illnesesses of similar nature in a community.
• Endemic: Presence of a disease/agent within a geographical area
.
• Pandemic: An epidemic which is worldwide in distribution.
• Host: Habitual place to an infectious agent.
• Carrier: Person/animal that habours a specific infectious agent & is a
symptomatic.
• Reservoir: Anything (living/non) whereby an infections agent resides in &
multiplies.

5. Transmission:
• Refers to any mechanism by which an infectious agent is spread
from a source/reservoir or to a person.
• Mode of transmission:
1.Direct- direct contact, vertical transmission,droplet infection,
animal bite transmission.
1.Indirect- Airborne, vehicle borne, vector borne, formite borne &
hand borne.

8. 6 factors furthering process:
1)Agent-bacteria, viruses,parasites etc.
2)Reservoir-Identification;px presents w/ signs & sx’s. Physical
examination & diagnostic test are done and also complications are
being identified.
Carriers- healthy, incubatory& convalescence.
1)Portal of exit-respiratory carrier, GIT carrier, GUT carrier
2)Mode of transmission-Direct/indirect
3)Portal of entry- mouth,skin cut
4)Susceptible host- anyone

9. What to do?
Reservoir Carrier Animal
Identification Type Identification
Treatment Active detection-household surveillance
for early detection of diseases.
Treatment
Isolation Quarantine Isolation
Health education Extermination Extermination
Aim: To break the chain of infection

11. Fundamental principles of control of
communicable diseases
1.Rapid assessment
2.Prevention
3.Surveillance
4.Outbreak control
5.Disease management

12. 1. Rapid assessment:
Westernization conditions contributing to spread of infectious diseases.
Poor nutrition
Immigrants- traveling in and out of the country unaware of incubated infectious
agents within themselves. (E.g. Chikungunya from PNG)
Location- Hub of trade (Fiji) in South Pacific increases the populations vulnerability &
risk to new emerging communicable diseases.
Climate change- occurrence of natural disasters e.g. Cyclones, flooding etc
Deforestation
Human behaviors such as IV drug use & risky sexual behaviors
Excessive use of anti microbial agents & pesticides

13. 2. Prevention
Primary Secondary Tertiary
 Increase the resistance of
the host.
 Inactivate etiological agents
 Break the chain of infection
 Limiting spread of infection:
 Isolation
 Quarantine
 Segregation
 Personal surveillance
 Early detection to activities
targeted to:
 Begin treatment
 Stop progression
 Protect others in the community
 E.g. Activities such as case
finding (identification), health
screening, health education.
 Limits the progression of
disability.
 Focuses on rehabilitation
which varies in specific
disease.

14. 3. Surveillance
• Surveillance: Ongoing systematic collection, analysis &
interpretation of data in order to plan, implement and evaluate
public health intervention.

15. Outbreak control
Outbreak: Increase new cases of diseases in a community in a
given period of time.
 In emergency situations it can rapidly spread cause an increase in
morbidity & mortality rates.
 Aim: To detect & control as early as possible.

16. Steps in communicable disease
outbreak mx:
• Preparation- Health coordinated meetings, strong surveillance, outbreak
response plan per disease, requirements in stock (e.g. IV fluids,
antibiotics & vaccines), isolation ward plans e.g. TB & laboratory
support.
• Detection- Surveillance system for early warning of epidemic prone
diseases, inform ministry of health & WHO in cases of specific disease
outbreak, specimen collection for lab confirmation.
• Response- confirm, activate, investigate & control the outbreak
• Evaluation- Assessing the effectiveness of containment measures and
response to the outbreak and also health prevention.

17. Medical officer’s role:
Zone nurses: outreach/awareness in communities to record
individuals whom are at risk, location of reservoirs & source of
infection and also the environmental factors which promote the
spread of disease.
Role of Dr’s:
• Controlling the reservoir- identification, early dx, isolation &
quarantine.
• Interruption of transmission- “break the chain of infection”
• Susceptible host
• Non specific measures- proper sanitation, better housing, nutrition,
education and legislative measures.

18. References:
 http://www.acphd.org/communicable-disease.aspx
 https://www.afro.who.int/health-topics/communicable-diseases
 http://www.health.gov.fj/?p=3414
 https://www.ncbi.nlm.nih.gov/books/NBK470303/

19. “The greatest wealth is health”