In this presentation I introduce the "SFDPH Population Health Division Controlling Infectious Diseases Model." This model integrates concepts from understanding transmission mechanisms, transmission dynamics, and transmission containment. The Model is most useful when facing novel microbial threats and we need simple framework for public health action.
Different environmental drivers of H5N1 outbreaks in poultry and wild birdsHarm Kiezebrink
Different environmental drivers operate on HPAI H5N1 outbreaks in poultry and wild birds in Europe. The probability of HPAI H5N1 outbreaks in poultry increases in areas with a higher human population density and a shorter distance to lakes or wetlands.
This reflects areas where the location of farms or trade areas and habitats for wild birds overlap. In wild birds, HPAI H5N1 outbreaks mostly occurred in areas with increased NDVI and lower elevations, which are typically areas where food and shelter for wild birds are available. The association with migratory flyways has also been found in the intra-continental spread of the low pathogenic avian influenza virus in North American wild birds. These different environmental drivers suggest that different spread mechanisms operate.
Disease might spread to poultry via both poultry and wild birds, through direct (via other birds) or indirect (e.g. via contaminated environment) infection. Outbreaks in wild birds are mainly caused by transmission via wild birds alone, through sharing foraging areas or shelters. These findings are in contrast with a previous study, which did not find environmental differences between disease outbreaks in poultry and wild birds in Europe.
Cattle Ticks and Risk Factors Related to Tick Infestation of Livestock in Per...Agriculture Journal IJOEAR
Tick-borne diseases are a global public health problem, particularly in sub-Saharan Africa, where most of the disease is caused by malaria and many other diseases of viral, parasitic or bacterial origin. This study aimed to identify the bovine tick's species in cattle farms and to determine possible risk factors related to tick infestation in Abidjan district and Azaguié commune. Thus, in July 2019, thirteen (13) herds distributed in these localities were visited for tick sampling and to conduct epidemiological investigations. At each visit, ticks were harvested from 15 cattle per herd. All the farms visited were infested with ticks. 96.92% of sampled animals had ticks. A total of 1796 ticks were collected of which 89.42% (1606) were adults, 10.41% (187) were pupae and 0.17% (3) was larvae. Two species of ticks have been identified, Amblyomma variegatum with 25% of the population and Rhipicephalus (Boophilus) microplus with 75%. 96% of the cattle were infested by ticks of the species R. (B.) microplus and 56% of the cattle were infested by ticks of the species A. variegatum. The co-infestation of cattle by the two identified species was 53%. The distribution of the sexes showed that in the species A. variegatum, males were more numerous (13.44% for males and 8.76% for females). However in the species R. (B.) microplus, females were more numerous (5.08% for males and 62.3% for females).The analysis of risk factors associated with tick infestation in cattle has shown that factors such as Undefined parks, Type of pasture, Training in the use of acaricides and Presence of wild animals contribute to major ectoparasite infestations in cattle. Tick samples collected from peri-urban farms in the district of Abidjan and the locality of Azaguié as part of this study, indicate that the relatively recent introduction of the species Rhipicephalus (Boophilus) microplus presents a threat to animal and human health.
This paper reviews the evolution of the definition of sepsis and the controversy surrounding the sepsis-3 definition and the sepsis screening tool, qSOFA.
Different environmental drivers of H5N1 outbreaks in poultry and wild birdsHarm Kiezebrink
Different environmental drivers operate on HPAI H5N1 outbreaks in poultry and wild birds in Europe. The probability of HPAI H5N1 outbreaks in poultry increases in areas with a higher human population density and a shorter distance to lakes or wetlands.
This reflects areas where the location of farms or trade areas and habitats for wild birds overlap. In wild birds, HPAI H5N1 outbreaks mostly occurred in areas with increased NDVI and lower elevations, which are typically areas where food and shelter for wild birds are available. The association with migratory flyways has also been found in the intra-continental spread of the low pathogenic avian influenza virus in North American wild birds. These different environmental drivers suggest that different spread mechanisms operate.
Disease might spread to poultry via both poultry and wild birds, through direct (via other birds) or indirect (e.g. via contaminated environment) infection. Outbreaks in wild birds are mainly caused by transmission via wild birds alone, through sharing foraging areas or shelters. These findings are in contrast with a previous study, which did not find environmental differences between disease outbreaks in poultry and wild birds in Europe.
Cattle Ticks and Risk Factors Related to Tick Infestation of Livestock in Per...Agriculture Journal IJOEAR
Tick-borne diseases are a global public health problem, particularly in sub-Saharan Africa, where most of the disease is caused by malaria and many other diseases of viral, parasitic or bacterial origin. This study aimed to identify the bovine tick's species in cattle farms and to determine possible risk factors related to tick infestation in Abidjan district and Azaguié commune. Thus, in July 2019, thirteen (13) herds distributed in these localities were visited for tick sampling and to conduct epidemiological investigations. At each visit, ticks were harvested from 15 cattle per herd. All the farms visited were infested with ticks. 96.92% of sampled animals had ticks. A total of 1796 ticks were collected of which 89.42% (1606) were adults, 10.41% (187) were pupae and 0.17% (3) was larvae. Two species of ticks have been identified, Amblyomma variegatum with 25% of the population and Rhipicephalus (Boophilus) microplus with 75%. 96% of the cattle were infested by ticks of the species R. (B.) microplus and 56% of the cattle were infested by ticks of the species A. variegatum. The co-infestation of cattle by the two identified species was 53%. The distribution of the sexes showed that in the species A. variegatum, males were more numerous (13.44% for males and 8.76% for females). However in the species R. (B.) microplus, females were more numerous (5.08% for males and 62.3% for females).The analysis of risk factors associated with tick infestation in cattle has shown that factors such as Undefined parks, Type of pasture, Training in the use of acaricides and Presence of wild animals contribute to major ectoparasite infestations in cattle. Tick samples collected from peri-urban farms in the district of Abidjan and the locality of Azaguié as part of this study, indicate that the relatively recent introduction of the species Rhipicephalus (Boophilus) microplus presents a threat to animal and human health.
This paper reviews the evolution of the definition of sepsis and the controversy surrounding the sepsis-3 definition and the sepsis screening tool, qSOFA.
Influenza in birds is caused by infection with viruses of the family Orthomyxoviridae placed in the genus influenza virus A. Influenza A viruses are the only orthomyxoviruses known to naturally affect birds. Many species of birds have been shown to be susceptible to infection with influenza A viruses; aquatic birds form a major reservoir of these viruses, and the overwhelming majority of isolates have been of low pathogenicity (low virulence) for chickens and turkeys. Influenza A viruses have antigenically related nucleocapsid and matrix proteins, but are classified into subtypes on the basis of their haemagglutinin (H) and neuraminidase (N) antigens (World Health Organization Expert Committee, 1980). At present, 16 H subtypes (H1–H16) and 9 N subtypes (N1–N9) are recognised with proposed new subtypes (H17, H18) for influenza A viruses from bats in Guatemala (Swayne et al., 2013; Tong et al., 2012; 2013). To date, naturally occurring highly pathogenic influenza A viruses that produce acute clinical disease in chickens, turkeys and other birds of economic importance have been associated only with the H5 and H7 subtypes. Most viruses of the H5 and H7 subtype isolated from birds have been of low pathogenicity for poultry. As there is the risk of a H5 or H7 virus of low pathogenicity (H5/H7 low pathogenicity avian influenza [LPAI]) becoming highly pathogenic by mutation, all H5/H7 LPAI viruses from poultry are notifiable to OIE. In addition, all high pathogenicity viruses from poultry and other birds, including wild birds, are notifiable to the OIE.
In 2007, USAID launched a worldwide program to battle outbreaks of Avian Influenza under the name STOP AI: Stamping Out Pandemic & Avian Influenza.
This program was one of the largest Training of trainer programs on Avian Influenza of its kind, with training programs conducted in more than 40 countries.
The training manual contains valuable training materials, presentations, background information and references on various subjects:
Module 1 – Overview of Avian Influenza
Module 2 – National Preparedness & Response Plans for HPAI
Module 3 – OIE Avian Influenza Standards and FAO Emergency Prevention System
Module 4 – Public Health and Occupational Safety
Module 5 – Animal Surveillance
Module 6 – Sample Collection and Transport
Module 7 – GIS and Outbreak Mapping
Module 8 – Biosecurity
Module 9 – Introduction to Outbreak Response
Module 10 – Depopulation, Disposal, and Decontamination
Module 11 – Recovery Options.
This training course was intended for animal and human health experts who have limited experience with avian influenza, but who do have field experience with other animal, zoonotic, or infectious diseases. This course includes modules on avian influenza virology, epidemiology, response, and recovery.
IFPMA Geneva Pharma Forum on 9 May 2014
Bringing Psoriasis into the Light
Presentation of Kim kjoeller, Senior Vice President
Global Development, Leo Pharma
Malaria infection during pregnancy is a major public health problem- especially in tropical and sub-tropical regions; with substantial risks for the mother, her foetus and the new-born, Pregnant women are particularly susceptible to malaria, and in low transmission settings they have a greater risk of severe Plasmodium falciparum malaria. This study aimed at investigating the rate of parasitaemia amongst pregnant and none pregnant women was conducted among people attending clinics at the University of Calabar Teaching Hospital, Mambo hospital, Nosam medical laboratory services in Calabar Cross River state. They fall within the age group 18 to 60 years. They were pregnant women who came for Antenatal clinic, controls were sampled from patients who came to request for medical examination and blood donors. Thick and thin blood smears were made from finger prick samples of 400 candidates attending Antenatal clinics 200 of them were from established pregnant women and the other 200 were from non-pregnant women to serve as control. The blood films were dried and fixed in absolute methanol dried and stained with 2% Giemsa stain for 30 min. it was then rinse in clean water and allowed to dry in a draining rack. Dried slides were viewed using x100 oil immersion objective. Result revealed a parasitic rate of 132 (55.9 %) among pregnant women and104 (44.1%) parasitaemia among none pregnant women. The difference between pregnant women and none pegnant women were significantly different at p < 0.05. Similarly, the mean parasite density of the pregnant women was higher 28.9 against 14.2 of control none pregnant women. In conclusion there was a significant density of malaria parasitaemia amongst pregnant women in this study.
Dr. Thomas J. DeLiberto - Highly Pathogenic Avian Influenza: The Role of Wild...John Blue
Highly Pathogenic Avian Influenza: The Role of Wild Birds - Dr. Thomas J. DeLiberto, NWRC Assistant Director, Wildlife Services, APHIS, USDA, from the 2016 NIAA Annual Conference: From Farm to Table - Food System Biosecurity for Animal Agriculture, April 4-7, 2016, Kansas City, MO, USA.
More presentations at http://www.trufflemedia.com/agmedia/conference/2016_niaa_farm_table_food_system_biosecurity
Relations between pathogens, hosts and environmentEFSA EU
Presentation of the EFSA's second scientific conference, held on 14-16 October 2015 in Milan, Italy.
DRIVERS FOR EMERGING ISSUES IN ANIMAL AND PLANT HEALTH
Human-to-Human transmission of H7H7 in Holland 2003Harm Kiezebrink
The outbreak of highly pathogenic avian influenza A virus subtype H7N7 started at the end of February, 2003, in commercial poultry farms in the Netherlands. In this study, published in The Lancet in 2004, it is noted that an unexpectedly high number of transmissions of avian influenza A virus subtype H7N7 to people directly involved in handling infected poultry, providing evidence for person-to-person transmission.
Although the risk of transmission of these viruses to humans was initially thought to be low, an outbreak investigation was launched to assess the extent of transmission of influenza A virus subtype H7N7 from chickens to humans.
453 people had health complaints—349 reported conjunctivitis, 90 had influenza-like illness, and 67 had other complaints. We detected A/H7 in conjunctival samples from 78 (26·4%) people with conjunctivitis only, in five (9·4%) with influenza-like illness and conjunctivitis, in two (5·4%) with influenza-like illness only, and in four (6%) who reported other symptoms. Most positive samples had been collected within 5 days of symptom onset. A/H7 infection was confirmed in three contacts (of 83 tested), one of whom developed influenza-like illness. Six people had influenza A/H3N2 infection. After 19 people had been diagnosed with the infection, all workers received mandatory influenza virus vaccination and prophylactic treatment with oseltamivir. More than half (56%) of A/H7 infections reported here arose before the vaccination and treatment programme.
COVID-19 Presentation - Zhang et al. (2020) - 07.23.2020CurtisHoffmann1
Zhang, X., Huang, H., Zhuang, D. et al. Biological, clinical and epidemiological features of COVID-19, SARS and MERS and AutoDock simulation of ACE2. Infect Dis Poverty 9, 99 (2020). https://doi.org/10.1186/s40249-020-00691-6.
Influenza in birds is caused by infection with viruses of the family Orthomyxoviridae placed in the genus influenza virus A. Influenza A viruses are the only orthomyxoviruses known to naturally affect birds. Many species of birds have been shown to be susceptible to infection with influenza A viruses; aquatic birds form a major reservoir of these viruses, and the overwhelming majority of isolates have been of low pathogenicity (low virulence) for chickens and turkeys. Influenza A viruses have antigenically related nucleocapsid and matrix proteins, but are classified into subtypes on the basis of their haemagglutinin (H) and neuraminidase (N) antigens (World Health Organization Expert Committee, 1980). At present, 16 H subtypes (H1–H16) and 9 N subtypes (N1–N9) are recognised with proposed new subtypes (H17, H18) for influenza A viruses from bats in Guatemala (Swayne et al., 2013; Tong et al., 2012; 2013). To date, naturally occurring highly pathogenic influenza A viruses that produce acute clinical disease in chickens, turkeys and other birds of economic importance have been associated only with the H5 and H7 subtypes. Most viruses of the H5 and H7 subtype isolated from birds have been of low pathogenicity for poultry. As there is the risk of a H5 or H7 virus of low pathogenicity (H5/H7 low pathogenicity avian influenza [LPAI]) becoming highly pathogenic by mutation, all H5/H7 LPAI viruses from poultry are notifiable to OIE. In addition, all high pathogenicity viruses from poultry and other birds, including wild birds, are notifiable to the OIE.
In 2007, USAID launched a worldwide program to battle outbreaks of Avian Influenza under the name STOP AI: Stamping Out Pandemic & Avian Influenza.
This program was one of the largest Training of trainer programs on Avian Influenza of its kind, with training programs conducted in more than 40 countries.
The training manual contains valuable training materials, presentations, background information and references on various subjects:
Module 1 – Overview of Avian Influenza
Module 2 – National Preparedness & Response Plans for HPAI
Module 3 – OIE Avian Influenza Standards and FAO Emergency Prevention System
Module 4 – Public Health and Occupational Safety
Module 5 – Animal Surveillance
Module 6 – Sample Collection and Transport
Module 7 – GIS and Outbreak Mapping
Module 8 – Biosecurity
Module 9 – Introduction to Outbreak Response
Module 10 – Depopulation, Disposal, and Decontamination
Module 11 – Recovery Options.
This training course was intended for animal and human health experts who have limited experience with avian influenza, but who do have field experience with other animal, zoonotic, or infectious diseases. This course includes modules on avian influenza virology, epidemiology, response, and recovery.
IFPMA Geneva Pharma Forum on 9 May 2014
Bringing Psoriasis into the Light
Presentation of Kim kjoeller, Senior Vice President
Global Development, Leo Pharma
Malaria infection during pregnancy is a major public health problem- especially in tropical and sub-tropical regions; with substantial risks for the mother, her foetus and the new-born, Pregnant women are particularly susceptible to malaria, and in low transmission settings they have a greater risk of severe Plasmodium falciparum malaria. This study aimed at investigating the rate of parasitaemia amongst pregnant and none pregnant women was conducted among people attending clinics at the University of Calabar Teaching Hospital, Mambo hospital, Nosam medical laboratory services in Calabar Cross River state. They fall within the age group 18 to 60 years. They were pregnant women who came for Antenatal clinic, controls were sampled from patients who came to request for medical examination and blood donors. Thick and thin blood smears were made from finger prick samples of 400 candidates attending Antenatal clinics 200 of them were from established pregnant women and the other 200 were from non-pregnant women to serve as control. The blood films were dried and fixed in absolute methanol dried and stained with 2% Giemsa stain for 30 min. it was then rinse in clean water and allowed to dry in a draining rack. Dried slides were viewed using x100 oil immersion objective. Result revealed a parasitic rate of 132 (55.9 %) among pregnant women and104 (44.1%) parasitaemia among none pregnant women. The difference between pregnant women and none pegnant women were significantly different at p < 0.05. Similarly, the mean parasite density of the pregnant women was higher 28.9 against 14.2 of control none pregnant women. In conclusion there was a significant density of malaria parasitaemia amongst pregnant women in this study.
Dr. Thomas J. DeLiberto - Highly Pathogenic Avian Influenza: The Role of Wild...John Blue
Highly Pathogenic Avian Influenza: The Role of Wild Birds - Dr. Thomas J. DeLiberto, NWRC Assistant Director, Wildlife Services, APHIS, USDA, from the 2016 NIAA Annual Conference: From Farm to Table - Food System Biosecurity for Animal Agriculture, April 4-7, 2016, Kansas City, MO, USA.
More presentations at http://www.trufflemedia.com/agmedia/conference/2016_niaa_farm_table_food_system_biosecurity
Relations between pathogens, hosts and environmentEFSA EU
Presentation of the EFSA's second scientific conference, held on 14-16 October 2015 in Milan, Italy.
DRIVERS FOR EMERGING ISSUES IN ANIMAL AND PLANT HEALTH
Human-to-Human transmission of H7H7 in Holland 2003Harm Kiezebrink
The outbreak of highly pathogenic avian influenza A virus subtype H7N7 started at the end of February, 2003, in commercial poultry farms in the Netherlands. In this study, published in The Lancet in 2004, it is noted that an unexpectedly high number of transmissions of avian influenza A virus subtype H7N7 to people directly involved in handling infected poultry, providing evidence for person-to-person transmission.
Although the risk of transmission of these viruses to humans was initially thought to be low, an outbreak investigation was launched to assess the extent of transmission of influenza A virus subtype H7N7 from chickens to humans.
453 people had health complaints—349 reported conjunctivitis, 90 had influenza-like illness, and 67 had other complaints. We detected A/H7 in conjunctival samples from 78 (26·4%) people with conjunctivitis only, in five (9·4%) with influenza-like illness and conjunctivitis, in two (5·4%) with influenza-like illness only, and in four (6%) who reported other symptoms. Most positive samples had been collected within 5 days of symptom onset. A/H7 infection was confirmed in three contacts (of 83 tested), one of whom developed influenza-like illness. Six people had influenza A/H3N2 infection. After 19 people had been diagnosed with the infection, all workers received mandatory influenza virus vaccination and prophylactic treatment with oseltamivir. More than half (56%) of A/H7 infections reported here arose before the vaccination and treatment programme.
COVID-19 Presentation - Zhang et al. (2020) - 07.23.2020CurtisHoffmann1
Zhang, X., Huang, H., Zhuang, D. et al. Biological, clinical and epidemiological features of COVID-19, SARS and MERS and AutoDock simulation of ACE2. Infect Dis Poverty 9, 99 (2020). https://doi.org/10.1186/s40249-020-00691-6.
Considerations of the Ebola Outbreak, Haddon's Matrix and Reason's Swiss Chee...Wes Chapman
In 1970, Dr. William Haddon wrote a brilliant editorial that changed forever how we evaluate accidents and other failures in complex systems. The paper was titled, On the Escape of Tigers: An Ecological Note, and it looked at accidents through an etiological rather than descriptive approach. The work was immediately applied to automotive and aviation safety, beginning the enormous reduction in accidents in both fields that continues to this day. In 1990, Dr. James T. Reason published his first work on the role of barriers to sequential failure, and how they fail in truly catastrophic accidents. Together, their combined work forms the basis for much of the best practice for risk mitigation in the automotive, airline, oil & gas and healthcare industries. In this article, I take a look at the failed efforts to control the Ebola outbreak relative to the concepts of Drs. Haddon and Reason.
Global Health Security Webinar 12_3_2014TridentCADC
The Preparing for a Career in Global Health Security outlines the program of study at Trident University International, and careers and opportunities in GHS. This informative webinar was presented by Drs. Hegamin, Anglin, and Taylor
Its all about Bio terrorism. Here i am trying to involve all content(maximum) those are available on online like ready.gov; CDC. i think it will cover all information that are need to know.
Scientific Facts on Global Public Health ThreatsGreenFacts
Global public health security depends on actions to prevent and respond to threats that endanger the collective health of the global population. Those threats have an impact on economic or political stability, trade, tourism, access to goods and services and, if they occur repeatedly, on demographic stability.
Global public health security covers a wide range of complex and daunting issues, including the health consequences of human behavior, climate change, weather-related events and infectious diseases, as well as natural catastrophes and man-made disasters, all of which are discussed here.
This is a CLC assigment, I have attached topic 1, 2 and 3 , APA form.docxgasciognecaren
This is a CLC assigment, I have attached topic 1, 2 and 3 , APA format, 3 references, 500 words
This is a Collaborative Learning Community (CLC) assignment.
In your Collaborative Learning Community, write a formal paper of 500-1,000 words that examines the previously addressed aspects of health policies, finance, global/national prevention, or treatment initiatives related to the health issue by identifying applicable ethics principles.
Differentiate how application of the identified ethics principles to the health issue has resulted in population disparities.
Hypothesize how existing disparities might be eliminated using alternate ethics principles.
Critique whether the applicable ethics principles are consistent with the ANA's Code of Ethics for Nurses.
Topic 1
Influenza CLC group essay 11-28-2017
Introduction
Influenza commonly known as flu is a contagious respiratory infection that attacks the general respiratory system that is, the nose, throat, and even the lungs. It is caused by the two types of influenza viruses which are influenza A, influenza B and influenza C (Wang & Tao, 2010). Attacks from both viruses are epidemic and seasonal as they are common within specific periods within a year. Attack mechanisms for influenza A viruses depends on the genes on the surface protein of a patient. They are normally spread through sneezing and coughing from an infected individual to the surrounding air (Wang & Tao, 2010).
The flu can also attack an individual in case they get into direct body tissue contact with an infected individual for example handshaking. Health professionals argue that the flu virus is stubborn and spreads mainly over tiny droplets which are produced when the infected individuals’ cough, talk, and sneeze (Wang & Tao, 2010). Such droplets are easily carried by the surrounding air and can be landed in the nose and mouths of the immediate persons. Additionally, it can enter into one’s system if he or she gets into direct contact with a surface or object that has the influenza bacteria and consequently rubs or touches their nose, mouth or even eyes (Wang & Tao, 2010).
Health departments have overtime identified initiative to address the problem of influenza, such initiatives include:
Reducing human exposure to the flu viruses, this initiative works by notifying the public on the safe ways to prevent and control the spread of the virus and it actively works to reduce infection opportunities and curbs the spread of the pandemic virus (Abramson, 2011).
They have built able capacities to cope with the pandemic, measures have been taken and put in place to cope with the virus since helping the society to stay free from the virus (Abramson, 2011).
They have innovated much on early warning and acknowledgments, information about influenza and its impacts to the society are made clear since it is effective for the society to stay free from the influenza virus (Abramson, 2011).
Necessary global scientific researches ...
Exposure to Toxic Environmental Agents - Resources for Healthy Children www.scribd.com/doc/254613619 - For more information, Please see Organic Edible Schoolyards & Gardening with Children www.scribd.com/doc/254613963 - Gardening with Volcanic Rock Dust www.scribd.com/doc/254613846 - Double Food Production from your School Garden with Organic Tech www.scribd.com/doc/254613765 - Free School Gardening Art Posters www.scribd.com/doc/254613694 - Increase Food Production with Companion Planting in your School Garden www.scribd.com/doc/254609890 - Healthy Foods Dramatically Improves Student Academic Success www.scribd.com/doc/254613619 - City Chickens for your Organic School Garden www.scribd.com/doc/254613553 - Huerto Ecológico, Tecnologías Sostenibles, Agricultura Organica www.scribd.com/doc/254613494 - Simple Square Foot Gardening for Schools - Teacher Guide www.scribd.com/doc/254613410 - Free Organic Gardening Publications www.scribd.com/doc/254609890 ~
Bioterrorism is using living organsims as weapons of mass destruction or to cause panic in population. it has existed since ancient times and yet pose a potential future threat. this compilation is not exhaustive and contains references at the end for further reading
In your Collaborative Learning Community, write a paper of 500-1,000.docxlanagore871
In your Collaborative Learning Community, write a paper of 500-1,000 words and include the following:
Assess the past and present impact nurses, including advanced professional/advanced practice nurses, have made in addressing this health issue.
Describe how nurses can become more broadly involved with influencing health policy related to this issue. Include resources available.
Hypothesize how nurses can positively impact future outcomes related to the provision of care for persons affected by the health issue.
Synthesize all aspects of the health care issue through a summary conclusion, concisely tying up Parts 1-6 of the CLC - Health Issue Analysis.
This is APA format, 3 references, I have attached topics 1-5 that is needed for this CLC project
Topic 1
Influenza CLC group essay 11-28-2017
Introduction
Influenza commonly known as flu is a contagious respiratory infection that attacks the general respiratory system that is, the nose, throat, and even the lungs. It is caused by the two types of influenza viruses which are influenza A, influenza B and influenza C (Wang & Tao, 2010). Attacks from both viruses are epidemic and seasonal as they are common within specific periods within a year. Attack mechanisms for influenza A viruses depends on the genes on the surface protein of a patient. They are normally spread through sneezing and coughing from an infected individual to the surrounding air (Wang & Tao, 2010).
The flu can also attack an individual in case they get into direct body tissue contact with an infected individual for example handshaking. Health professionals argue that the flu virus is stubborn and spreads mainly over tiny droplets which are produced when the infected individuals’ cough, talk, and sneeze (Wang & Tao, 2010). Such droplets are easily carried by the surrounding air and can be landed in the nose and mouths of the immediate persons. Additionally, it can enter into one’s system if he or she gets into direct contact with a surface or object that has the influenza bacteria and consequently rubs or touches their nose, mouth or even eyes (Wang & Tao, 2010).
Health departments have overtime identified initiative to address the problem of influenza, such initiatives include:
Reducing human exposure to the flu viruses, this initiative works by notifying the public on the safe ways to prevent and control the spread of the virus and it actively works to reduce infection opportunities and curbs the spread of the pandemic virus (Abramson, 2011).
They have built able capacities to cope with the pandemic, measures have been taken and put in place to cope with the virus since helping the society to stay free from the virus (Abramson, 2011).
They have innovated much on early warning and acknowledgments, information about influenza and its impacts to the society are made clear since it is effective for the society to stay free from the influenza virus (Abramson, 2011).
Necessary global scientific researches are being ...
Population Health Data Science, Complexity, and Health Equity: Reflections fr...Tomas J. Aragon
Annual Population Health Sciences Colloquium at the Stanford Center for Population Health Sciences on October 26, 2015.
This one-day program will showcase population health sciences research from the Stanford community and experts around the world.
This one-day program will showcase population health sciences research from the Stanford community and experts around the world. The PHS Initiative aims to bring together basic, translational and clinical scientists, along with researchers from disciplines across the entire University, to provide resources and facilitate collaborations focused on population-level questions, data and approaches.
We have an exciting full-day session with keynote speakers - Lloyd Minor, Dean of the Stanford School of Medicine; Muin Khoury, Associate Director of Epidemiology and Genomics Research Program at NCI; and Tomas Aragon, Director of Population Health Division at the San Francisco Department of Public Health - and some time to do the vital work of growing our center.
Designing a Learning Health Organization for Collective ImpactTomas J. Aragon
"Designing a Learning Health Organization for Collective Impact" was my presentation given at the California HealthCare Foundation (CHCF) Health Care Leadership Program final seminar and graduation. Congratulations to the amazing fellow graduates!!!
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
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Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
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New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...
Preparing for Microbial Threats to Health: What Every Professional Should Know
1. Preparing for Microbial Threats to Health:
What Every Professional Should Know
Tom´as J. Arag´on, MD, DrPH
Health Officer, City & County of San Francisco
Director, Population Health Division (PHD), SFDPH
June 9, 2014
Tom´as J. Arag´on, MD, DrPH (SFDPH) Preparing for Microbial Threats to Health June 9, 2014 1 / 33
2. Acknowledgments
Robert S. Nakao, Executive Publisher, Advantage Business Media
SFDPH Population Health Division leadership and staff
Association of Bay Area Health Officials (ABAHO)
California Conference of Local Health Officers (CCLHO)
Center for Infectious Disease & Emergency Readiness*
Cal PREPARE Systems Research Center*
California Department of Public Health (CDPH)
National Association of County & City Health Officials (NACCHO)
Centers for Disease Control and Prevention (CDC)
* UC Berkeley School of Public Health
Tom´as J. Arag´on, MD, DrPH (SFDPH) Preparing for Microbial Threats to Health June 9, 2014 2 / 33
3. Contagion—The movie! vs. Contagion—Your reality!
Glass RJ, et al. Targeted social distancing
design for pandemic influenza. Emerg Infect
Dis. 2006 Nov;12(11):1671-81. PubMed:
17283616.
Tom´as J. Arag´on, MD, DrPH (SFDPH) Preparing for Microbial Threats to Health June 9, 2014 3 / 33
4. Middle East Respiratory Syndrome (MERS), June, 2014
Deadly Virus’s Spread Raises Alarms in Mideast: Saudis
Defend Approach to MERS Outbreak, Even as Cases
Increase. Wall Street Journal Online, April 13, 2014 Saudi Ministry of Health, June 7, 2014
Tom´as J. Arag´on, MD, DrPH (SFDPH) Preparing for Microbial Threats to Health June 9, 2014 4 / 33
5. Overview
1 Challenge of complexity
2 Controlling microbial threats
Transmission mechanisms
Transmission dynamics
Transmission containment
3 Integrated model for controlling microbial threats
Tom´as J. Arag´on, MD, DrPH (SFDPH) Preparing for Microbial Threats to Health June 9, 2014 5 / 33
6. Well established cause of outbreaks!
Tom´as J. Arag´on, MD, DrPH (SFDPH) Preparing for Microbial Threats to Health June 9, 2014 6 / 33
7. Well established response to outbreaks!
Tom´as J. Arag´on, MD, DrPH (SFDPH) Preparing for Microbial Threats to Health June 9, 2014 7 / 33
8. Challenge of complexity
SFDPH PHD Controlling Infectious Diseases (CID) Model
Addressing complexity with a simple framework for action (Tom´as J. Arag´on, 2014)
The PHD CID Model
The PHD CID model is an
integrated model for
preventing and controlling
infectious diseases. Also
consider the following: (1)
Is there asymptomatic
infectiousness? (latent
period is shorter than
incubation period), (2)
What is the generation
time?, (3) What are the
ethical considerations?,
and (4) Do you have the
political and logistical
support to be successful?
A) Microbial Agent in
B) Reservoir or
C) Source
E) Mode of
Transmission
G) Susceptible
Host
D) Portal
of Exit
F) Portal
of Entry
Reservoir / Source
1 Air
2 Water
3 Food
4 People
5 Animals & vectors
6 Vehicles (e.g., injection)
7 Soil & debris
Modes of transmission
1 Contact - direct
2 Contact - indirect
3 Droplets
4 Airborne
5 Vehicle-borne
6 Vector-borne
7 Vertical (mom-child)
The 7 Habits of Uninfected People
1 Safe consumption
2 Personal hygiene
3 Covering your cough
4 Getting vaccinated
5 Using “protection”
6 Reducing special risks
7 Basic infection control
Transmission Containment Strategies
1 Reduce contact rate
2 Reduce fraction of population that is infectious
3 Reduce biological infectiousness
4 Reduce biological susceptibility
5 Interrupt transmission (physical, chemical)
6 Reduce fraction of population that is susceptible
Tom´as J. Arag´on, MD, DrPH (SFDPH) Preparing for Microbial Threats to Health June 9, 2014 8 / 33
9. Challenge of complexity
Complexity and why it matters
What is a complex system?
1 A population of diverse agents, all of which are
2 connected, with behaviors and actions that are
3 interdependent, and that exhibit
4 adaptation and learning.
Why do we care?
Often unpredictable
Can produce large events
Can withstand substantial trauma
Can evolve along divergent pathways
Can produce “tipping points” (e.g., epidemics)
Can produce emergent phenomena (e.g., self-organization)
Tom´as J. Arag´on, MD, DrPH (SFDPH) Preparing for Microbial Threats to Health June 9, 2014 9 / 33
10. Challenge of complexity
Spread of novel influenza A (H1N1) via global air travel
Destination cities and corresponding volumes of international passengers arriving from
M´exico between March 1 and April 30, 2008. A total of 2.35 million passengers flew
from M´exico to 1018 cities in 164 countries. Source: Khan et al. (2009), PMID
19564630
Tom´as J. Arag´on, MD, DrPH (SFDPH) Preparing for Microbial Threats to Health June 9, 2014 10 / 33
11. Challenge of complexity
Mitigating complexity
Be humble
Expect to fail
Expect the unexpected
Expect unintended consequences
Expect big events and tipping points (e.g., epidemics)
Beware of pathway dependence (irreversible evolutionary divergence)
Harnessing complexity
Balance exploration (learning) and exploitation (execution)
Develop/use “simple” frameworks for action (this talk!)
Design for agility, adaptability, and responsiveness
Develop/use “simple rules” that spread
Every failure is a learning opportunity
Tom´as J. Arag´on, MD, DrPH (SFDPH) Preparing for Microbial Threats to Health June 9, 2014 11 / 33
12. Controlling microbial threats
Concepts for controlling infectious diseases
Transmission mechanisms
1 Chain model of infectious diseases
2 Natural history of infection and infectiousness
3 Convergence model of microbial threats
Transmission dynamics
1 Reproductive number
2 Infection rate among susceptibles
3 Generation time
Transmission containment
1 Control points, strategies, and measures
Tom´as J. Arag´on, MD, DrPH (SFDPH) Preparing for Microbial Threats to Health June 9, 2014 12 / 33
13. Controlling microbial threats Transmission mechanisms
Chain model of infectious diseases
Chain model
A) Microbial agent
B) Reservoir / Source
C) Portal of exit
D) Mode of transmission
E) Portal of entry
F) Susceptible host
A) Microbial Agent in
B) Reservoir or
C) Source
E) Mode of
Transmission
G) Susceptible
Host
D) Portal
of Exit
F) Portal
of Entry
Reservoir / Source
1 Air
2 Water
3 Food
4 People
5 Animals & vectors
6 Vehicles (e.g., injection)
7 Soil & debris
Tom´as J. Arag´on, MD, DrPH (SFDPH) Preparing for Microbial Threats to Health June 9, 2014 13 / 33
14. Controlling microbial threats Transmission mechanisms
Chain model—Reservoir / Source
Reservoir / Source
Humans
Animals
Environment
A reservoir can always
be a source, but not
all sources are
reservoirs.
For disaster planning
or response, consider
7 sources (see Figure).
A) Microbial Agent in
B) Reservoir or
C) Source
E) Mode of
Transmission
G) Susceptible
Host
D) Portal
of Exit
F) Portal
of Entry
Reservoir / Source
1 Air
2 Water
3 Food
4 People
5 Animals & vectors
6 Vehicles (e.g., injection)
7 Soil & debris
Tom´as J. Arag´on, MD, DrPH (SFDPH) Preparing for Microbial Threats to Health June 9, 2014 14 / 33
15. Controlling microbial threats Transmission mechanisms
Chain model—Modes of Transmission
Modes of transmission
1 Contact—direct
2 Contact—indirect
3 Droplet
4 Airborne
5 Vehicle-borne (food)
6 Vector-borne (bugs)
7 Vertical (mom-child)
A) Microbial Agent in
B) Reservoir or
C) Source
E) Mode of
Transmission
G) Susceptible
Host
D) Portal
of Exit
F) Portal
of Entry
Reservoir / Source
1 Air
2 Water
3 Food
4 People
5 Animals & vectors
6 Vehicles (e.g., injection)
7 Soil & debris
Modes of transmission
1 Contact - direct
2 Contact - indirect
3 Droplets
4 Airborne
5 Vehicle-borne
6 Vector-borne
7 Vertical (mom-child)
Tom´as J. Arag´on, MD, DrPH (SFDPH) Preparing for Microbial Threats to Health June 9, 2014 15 / 33
16. Controlling microbial threats Transmission mechanisms
Chain model—The 7 Habits of Uninfected People
The 7 Habits of
Uninfected People
1 Safe consumption
2 Personal hygiene
3 Covering your cough
4 Getting vaccinated
5 Using “protection”
6 Reducing special risks
7 Basic infection control
A) Microbial Agent in
B) Reservoir or
C) Source
E) Mode of
Transmission
G) Susceptible
Host
D) Portal
of Exit
F) Portal
of Entry
Reservoir / Source
1 Air
2 Water
3 Food
4 People
5 Animals & vectors
6 Vehicles (e.g., injection)
7 Soil & debris
Modes of transmission
1 Contact - direct
2 Contact - indirect
3 Droplets
4 Airborne
5 Vehicle-borne
6 Vector-borne
7 Vertical (mom-child)
The 7 Habits of Uninfected People
1 Safe consumption
2 Personal hygiene
3 Covering your cough
4 Getting vaccinated
5 Using “protection”
6 Reducing special risks
7 Basic infection control
Tom´as J. Arag´on, MD, DrPH (SFDPH) Preparing for Microbial Threats to Health June 9, 2014 16 / 33
17. Controlling microbial threats Transmission mechanisms
Good infection control starts with common sense:
Cover the source!
Source: American Society of Microbiology
Tom´as J. Arag´on, MD, DrPH (SFDPH) Preparing for Microbial Threats to Health June 9, 2014 17 / 33
18. Controlling microbial threats Transmission mechanisms
Disease scare at San Jose airport: 5 on flight from Asia
examined—none found with SARS I
San Francisco Chronicle, Wednesday, April 2, 2003
In a false alarm heard ’round the world, the Santa Clara County health
system jumped into high alert Tuesday morning when an American Airlines
flight from Tokyo radioed that it might have five cases of the mysterious
flulike illness known as SARS on board.
[Joan] Krizman said she had no hard feelings about being treated as a
potential health threat. The couple had just completed an exhausting,
monthlong journey that included stops in Vietnam, Thailand and Hong
Kong—three Southeast Asian hot spots for SARS.
“There were four fire trucks and eight police cars and four or five
ambulances,” she recalled. “I couldn’t believe it. I thought, ‘Wow! What’s
going on here?’ Little did I know that we were to be the ‘victims.’ ”
Tom´as J. Arag´on, MD, DrPH (SFDPH) Preparing for Microbial Threats to Health June 9, 2014 18 / 33
19. Controlling microbial threats Transmission mechanisms
Disease scare at San Jose airport: 5 on flight from Asia
examined—none found with SARS II
The couple were asked twice to go to Valley Medical Center, and twice
they politely declined. “And then,” Krizman said, “they soon opened up
the ambulance doors and said, sorry, we’re taking you to the hospital.”
At the hospital, according to Krizman, “we were the only ones there not
wearing masks.” When word got out just who they were, she said, “People
started running like crazy, like we were the bubonic plague. They put us in
a room full of people with plastic boots and face shields and masks.”
Tom´as J. Arag´on, MD, DrPH (SFDPH) Preparing for Microbial Threats to Health June 9, 2014 19 / 33
20. Controlling microbial threats Transmission mechanisms
Nurse wearing N-95 respirator outside of intensive care unit
Associated Press: In a ward at Sunnybrook and Womens Hospital in
Toronto, a nurse waits outside the door of a patient diagnosed with the
illness [SARS].
Tom´as J. Arag´on, MD, DrPH (SFDPH) Preparing for Microbial Threats to Health June 9, 2014 20 / 33
21. Controlling microbial threats Transmission mechanisms
Public-devised infection control, SARS outbreak, 2003
Tom´as J. Arag´on, MD, DrPH (SFDPH) Preparing for Microbial Threats to Health June 9, 2014 21 / 33
22. Controlling microbial threats Transmission mechanisms
Infection control practices, SARS outbreak, 2003
Reuters: An Indian woman diagnosed with SARS sits on her bed at the
Doctor Naidu Infectious Diseases Hospital in the western city of Pune.
Doctors reported India’s first case of the disease in a marine engineer from
the western coastal state of Goa on Friday, April 18, 2003.
Tom´as J. Arag´on, MD, DrPH (SFDPH) Preparing for Microbial Threats to Health June 9, 2014 22 / 33
23. Controlling microbial threats Transmission mechanisms
WHO: Infection control gaps helped fuel UAE MERS surge
CIDRAP News, June 6, 2014
“Infection control breaches led to a
list of factors that contributed to the
April surge of MERS-CoV cases in
the United Arab Emirates (UAE),
the World Health Organization
(WHO) said today after a team of
WHO and partner experts spent 5
days assessing the situation there.”
Source: http://www.cidrap.umn.edu
WHO finds hospital breaches worsened MERS
outbreak in UAE. Source: ArabianBusiness.com,
June 7, 2014
Tom´as J. Arag´on, MD, DrPH (SFDPH) Preparing for Microbial Threats to Health June 9, 2014 23 / 33
24. Controlling microbial threats Transmission mechanisms
Natural history of infection and infectiousness (A vs. B)
Susceptible Latent period Infectious period
Incubation period Symptomatic period
Time of
infection
Non-infectious
Non-diseased
No symptoms,
Infectious
Susceptible Latent period Infectious period
Incubation period Symptomatic period
Time of
infection
Non-infectious
Symptomatic,
Not infectious
Non-diseased
A
B
When the latent period is shorter than the incubation period (B), an infected person becomes
infectious before symptom onset.
Tom´as J. Arag´on, MD, DrPH (SFDPH) Preparing for Microbial Threats to Health June 9, 2014 24 / 33
25. Controlling microbial threats Transmission mechanisms
Convergence model for human-microbe interaction
Institute of Medicine. Microbial threats to health: Emergence, Detection, and Response.
National Academy Press, 2003
Tom´as J. Arag´on, MD, DrPH (SFDPH) Preparing for Microbial Threats to Health June 9, 2014 25 / 33
26. Controlling microbial threats Transmission dynamics
Epidemic curve in action, SARS outbreak, 2003
Number of probable cases of severe acute respiratory syndrome, by date of fever onset
and reported source of infection, Singapore, Feb 25-Apr 30, 2003. Source: CDC MMWR
(2003) PMID: 12807088
Tom´as J. Arag´on, MD, DrPH (SFDPH) Preparing for Microbial Threats to Health June 9, 2014 26 / 33
27. Controlling microbial threats Transmission dynamics
Reproductive number in action, SARS outbreak, 2003
Probable cases of severe acute respiratory syndrome, by reported source of infection,
Singapore, Feb 25-Apr 30, 2003. Source: CDC MMWR (2003) PMID: 12807088
Tom´as J. Arag´on, MD, DrPH (SFDPH) Preparing for Microbial Threats to Health June 9, 2014 27 / 33
28. Controlling microbial threats Transmission dynamics
In Contagion, Dr. Erin Mears (Kate Winslet) explains R0
Contagion is a 2011 public health thriller
directed by Steven Soderbergh.
The reproductive number (R) is the number of
infectious cases produced by an infectious case
during its infectious period. R0 is the initial R
when an index case is introduced into a
completely susceptible population with no
control measures. Source (figure): PMID:
19620267
Tom´as J. Arag´on, MD, DrPH (SFDPH) Preparing for Microbial Threats to Health June 9, 2014 28 / 33
29. Controlling microbial threats Transmission dynamics
Dynamics: Reproductive number and infection rate
Basic reproductive number
R0 = d × c × p
Transmission probability (p)
Biologic infectiousness
Biologic susceptibility
Interruptors (e.g., PPE)
Effective reproductive number
R(t) = R0 × x(t)
Infection rate among susceptibles
I(t) = c × p × P(t)
Source (figure): PMID: 19620267
d = duration of infectiousness
c = contact rate
p = transmission probability
x = fraction of population that is susceptible
P = fraction of population that is infectious
Tom´as J. Arag´on, MD, DrPH (SFDPH) Preparing for Microbial Threats to Health June 9, 2014 29 / 33
30. Controlling microbial threats Transmission dynamics
Reproductive number vs. Infection rate in susceptibles
Control strategies are derived from control points
Parameter control points
d = duration of infectiousness
c = contact rate
p = transmission probability
x = fraction of population
that is susceptible
P = fraction of population
that is infectious
Design control strategies
All communicable disease
control strategies are designed
to affect the five control
points.
A) Microbial Agent in
B) Reservoir or
C) Source
E) Mode of
Transmission
G) Susceptible
Host
D) Portal
of Exit
F) Portal
of Entry
Transmission
probability (p)
Contact
rate (c)
Fraction of population
that is infectious (P)
Fraction of population
that is susceptible (x)
Duration of
infectiousness (d)
Tom´as J. Arag´on, MD, DrPH (SFDPH) Preparing for Microbial Threats to Health June 9, 2014 30 / 33
31. Controlling microbial threats Transmission containment
Transmission containment
Control strategies
1 Reduce contact rate (c)
2 Reduce fraction of population that is infectious (P)
3 Reduce biological infectiousness (affects p)
4 Reduce biological susceptibility (affects p)
5 Interrupt transmission (physical, chemical) (affects p)
6 Reduce fraction of population that is susceptible (x)
Control measures . . .
are interventions designed to address control strategies. Always consider
mutliple perspectives: host, agent, infectious sources, and environment
(physical, social, economic, political, etc.)
Tom´as J. Arag´on, MD, DrPH (SFDPH) Preparing for Microbial Threats to Health June 9, 2014 31 / 33
32. Integrated model for controlling microbial threats
SFDPH PHD Controlling Infectious Diseases (CID) Model
Transmission mechanisms, dynamics, and containment (Tom´as J. Arag´on, 2014)
The PHD CID Model
The PHD CID model is an
integrated model for
preventing and controlling
infectious diseases. Also
consider the following: (1)
Is there asymptomatic
infectiousness? (latent
period is shorter than
incubation period), (2)
What is the generation
time?, (3) What are the
ethical considerations?,
and (4) Do you have the
political and logistical
support to be successful?
A) Microbial Agent in
B) Reservoir or
C) Source
E) Mode of
Transmission
G) Susceptible
Host
D) Portal
of Exit
F) Portal
of Entry
Reservoir / Source
1 Air
2 Water
3 Food
4 People
5 Animals & vectors
6 Vehicles (e.g., injection)
7 Soil & debris
Modes of transmission
1 Contact - direct
2 Contact - indirect
3 Droplets
4 Airborne
5 Vehicle-borne
6 Vector-borne
7 Vertical (mom-child)
The 7 Habits of Uninfected People
1 Safe consumption
2 Personal hygiene
3 Covering your cough
4 Getting vaccinated
5 Using “protection”
6 Reducing special risks
7 Basic infection control
Transmission Containment Strategies
1 Reduce contact rate
2 Reduce fraction of population that is infectious
3 Reduce biological infectiousness
4 Reduce biological susceptibility
5 Interrupt transmission (physical, chemical)
6 Reduce fraction of population that is susceptible
Tom´as J. Arag´on, MD, DrPH (SFDPH) Preparing for Microbial Threats to Health June 9, 2014 32 / 33
33. Integrated model for controlling microbial threats
Thank you! Any questions?
Tom´as J. Arag´on, MD, DrPH (SFDPH) Preparing for Microbial Threats to Health June 9, 2014 33 / 33