The document discusses communicable diseases, their causes, definitions, outbreaks, transmission, prevention and control. It defines key terms like epidemic, endemic, pandemic, host, carrier, reservoir, vector, immunity and modes of transmission. It outlines steps for managing disease outbreaks including preparation, detection, response and evaluation. It also discusses emerging/reemerging diseases and global disease eradication efforts. Nurses play an important role in communicable disease control through health education, surveillance and working with at-risk communities.

1. Us:- Waled Amen Moh Head department, Community Health Nursing UMST Communicable Diseases

2. Introduction Communicable Diseases are the major causes of morbidity and mortality. Main causes of morbidity and mortality in emergencies are diarrheal diseases, acute respiratory infections, measles and in areas where it is endemic malaria.

3. Introduction Other communicable diseases that have also in the past caused epidemics amongst population affected by emergencies are meningococcal disease, tuberculosis and typhus. Malnutrition and trauma are additional causes of illness and death amongst populations affected by communicable diseases.

4. Definitions Communicable Disease is one that can transmitted from one person to another and is caused by an infectious agent that is transmitted from a source or reservoir to a susceptible host. Infectious diseases is one that caused by infectious agent.

5. Outbreak o occurrence of new cases of a disease clearly in excess of the baseline frequency of the disease in a defined community over a given time period o point source outbreak: an outbreak due to exposure of a group of people to a noxious influence that is common to the individuals in the group • the exposure is brief and essentially simultaneous, resultant cases all develop within 1 incubation period of the disease o propagated outbreak: an outbreak where there are multiple exposures over a period of time, from host to host (directly or indirectly), resulting in cases that are not within 1 incubation period

6. Epidemic occurrence, in a community or region, of a group of illnesses of a similar nature in excess of normal expectancy Endemic habitual presence of a disease or agent within a geographic area based on the usual prevalence of a given disease within such an area Pandemic an epidemic which is worldwide in distribution Host person/animal that affords subsistence to an infectious agent under natural conditions Carrier person/animal that harbors a specific infectious agent in the absence of discernible clinical disease and serves as a potential source of infection

7. Fomite o contaminated substance (not necessarily a reservoir) serving as an intermediate means of transport for an infectious agent Reservoir o anything (living or inert) in which an infectious agent lives and multiplies in such a manner that it can be transmitted to a susceptible host Vector o invertebrate animal capable of transmitting an infectious agent to vertebrates Virulence o ability of an infectious agent to cause severe or fatal infections

8. IMMUNITY o active • altered organism or its product induces a host to produce antibodies (e.g. natural measles infection or live vaccine) o passive • protective antibodies produced by another host which are introduced into susceptible persons (e.g. natural transplacental IgG from mother to infant) o inherent • endogenous production of antibody o herd • expression used to describe immunity of a group or community • resistance of a group to an infectious agent based on the immunity of many individuals in the group • implies transmission interruption when < 100% of group is immune due to separation of few susceptibles

9. Transmission of Infectious Agents Transmission refers to any mechanism by which an infectious agent is spread from a source or reservoir to a person. Reservoir. Mode of infection. Susceptible host.

10. Six Factors furthering process Agent Reservoir Portal of exit Mode of transmission Portal of entry Susceptible host

11. Man 1=Case :-case can be prevented and controlled by 1-Identification:- --presentation:- This involves signs and symptoms of this disease. --Lab finding :- Diagnostic test, or physical examination --complications That may arise due to this disease. Reservoir

12. Case 2-Treatment 3-Isolation:- this needs to determine communicability period 4 -Health education:- About -S&S of complication -treatment Man

13. carrier 2=carrier:- 1-Types of carrier -by type .healthy carrier .incubatory carrier .convalescence carrier -by portal of exit .respiratory carrier .GIT carrier . GUT carrier 2-active detection .Household surveillance for early detection of disease Man

14. Reservoir 3-health education concerning special hygiene and avoid risk factors 4-Quarantine :- this needs to know Incubation period

15. Animal(Reservoir) Case Identification Treatment Isolation Extermination Carrier - Type - Active detection - Quarantine - Extermination

16. Soil (Reservoir) Disinfection

17. Mode of transmission - Direct :-- Direct contact Vertical transmission Droplet infection Animal bite transmission Contact with soil

18. Indirect Air-borne Vehicle borne Vector-borne transmission Fomite –borne Hand –borne

19. Susceptible host Man 1- the at risk individual Systemic diseases Surgical patients Immunocompromised individuals Genetic based Organ transplant Chemotherapy Radiotherapy HIV infection

20. 2-health education :- about vaccination and preventive measures 3-immunization :- if available. 4-prophylaxis :- 5-special protective measures :- 6-legislation :-

21. Susceptible host Animals 1- the at risk 2-prophylaxis 3-special protective measures

22. Emerging Infectious Diseases Emerging infectious diseases are diseases that have appeared for the first time or that have occurred before appeared in populations where they have not previously been reported.

23. Reemerging Infectious Diseases Reemerging infectious diseases are familiar diseases caused by well-understood organisms that were once under control or declining but now are resistant to common drugs or gaining new footholds in the population and increasing in incidence.

24. Fundamental principles of Control of Communicable Diseases Rapid Assessment Prevention Surveillance Outbreak Control Disease Management

25. Modern Conditions that Favor the Spread of Infectious Diseases Global travel Globalization of food supply and centralization of food processing Population growth, increased urbanization and overcrowding Migration due to wars, famines, and natural disasters

26. Modern Conditions that Favor the Spread of Infectious Diseases Irrigation, deforestation, and reforestation projects that alter habitats Human behaviors, such as IV drug use and risky sexual behavior Increased use of antimicrobial agents and pesticides Increased human contact with wilderness habitats

27. Prevention of communicable diseases:- Communicable diseases can be prevented by appropriate preventive measures which include: Good site planning Provision of basic clinical services Provision of appropriate shelter Clean water supply Sanitation Mass vaccination against specific diseases Regular and sufficient food supply Control of vectors

28. Primary Prevention Increasing the resistance of the host Inactivating the agent Interrupt the chain of infection Restricting spread of infection isolation quarantine segregation personal surveillance

29. Secondary Prevention Activities targeted at detecting disease at earliest possible time to: begin treatment stop progression protect others in the community Examples of activities: case finding, health screening, health education

30. Tertiary Prevention Limits the progression of disability Treatment of symptoms and rehabilitation vary with each specific disease

31. Surveillance Surveillance is the ongoing systematic collection,analysis and interpretation of data in order to plan, implement and evaluate public health intervention. Surveillance system should be simple, flexible, acceptable.

32. Outbreak Control An outbreak is occurrence of a number of cases of a disease that is unusually large or unexpected for a given place and time . Outbreaks and epidemics refer to the one and same thing. Outbreaks in emergency situations can spread rapidly giving rise to high morbidity and mortality rates. Aim should be to detect and control the outbreak as early as possible.

33. Steps in the management of a communicable disease outbreak Preparation Detection Response Evaluation

34. Preparation for the outbreak Health coordination meetings Strong surveillance system Outbreak response plan for each disease Stocks of iv fluids, antibiotics and vaccines Plans for isolation wards Laboratory support

35. Steps in the management of a communicable disease outbreak Preparation Detection Response Evaluation

36. Detection of outbreak Surveillance system with early warning system for epidemic prone diseases. Inform ministry of health and WHO in case of outbreaks of specific diseases. Take appropriate specimens (stool, CSF or serum) for laboratory confirmation. Include case in the weekly report.

37. Steps in the management of a communicable disease outbreak Preparation Detection Response Evaluation

38. Response to the outbreak Confirm the outbreak Activate the outbreak control team Investigate the outbreak Control the outbreak

39. Steps in the management of a communicable disease outbreak Preparation Detection Response Evaluation

40. Evaluation Assess appropriateness and effectiveness of containment measures. Assess timelines of outbreak detection and response. Change public health policy if indicated. Write and disseminate outbreak report.

41. Global Disease Eradication Efforts Methods to accomplish the goal of eradication of diseases include: immunization and vaccination drug therapy community training health education national disease surveillance efforts

42. examples 7 diseases have been targeted for eradication in early 21st century: polio measles leprosy river blindness Chagas’ disease guinea worm disease lymphatic filariasis

43. Nurses’ Role Community health nurses play an important role with regarded to all population at risk for communicable disease Nurses concerned with communicable disease control must Recognize who at risk Where the reservoirs and source of infectious disease agents are located What environmental factors promote the spread

44. What comprise the characteristic of vulnerability of community member and groups-particularly those subject to intervention Community health nurses must work collaboratively with other public health professional to establish immunization and educational programs , to improve community infection control policies , and to develop abroad range of services to population at risk