Communicable disease


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Communicable diseases

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  • The source or reservoir can be a person ,animal , insect, or inanimate material
  • Communicable disease

    1. 1. Us:- Waled Amen Moh Head department, Community Health Nursing UMST Communicable Diseases
    2. 2. Introduction <ul><li>Communicable Diseases are the major causes of morbidity and mortality. </li></ul><ul><li>Main causes of morbidity and mortality in emergencies are diarrheal diseases, acute respiratory infections, measles and in areas where it is endemic malaria. </li></ul>
    3. 3. Introduction <ul><li>Other communicable diseases that have also in the past caused epidemics amongst population affected by emergencies are meningococcal disease, tuberculosis and typhus. </li></ul><ul><li>Malnutrition and trauma are additional causes of illness and death amongst populations affected by communicable diseases. </li></ul>
    4. 4. Definitions <ul><li>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. </li></ul><ul><li>Infectious diseases is one that caused by infectious agent. </li></ul>
    5. 5. <ul><li>Outbreak </li></ul><ul><li>o occurrence of new cases of a disease clearly in excess of the </li></ul><ul><li>baseline frequency of the disease in a defined community over a </li></ul><ul><li>given time period </li></ul><ul><li>o point source outbreak: an outbreak due to </li></ul><ul><li>exposure of a group of people to a noxious influence that is </li></ul><ul><li>common to the individuals in the group </li></ul><ul><li>• the exposure is brief and essentially simultaneous, resultant </li></ul><ul><li>cases all develop within 1 incubation period of the disease </li></ul><ul><li>o propagated outbreak: an outbreak where there are multiple </li></ul><ul><li>exposures over a period of time, from host to host </li></ul><ul><li>(directly or indirectly), resulting in cases that are not within </li></ul><ul><li>1 incubation period </li></ul>
    6. 6. <ul><li>Epidemic </li></ul><ul><li>occurrence, in a community or region, of a group of illnesses of a </li></ul><ul><li>similar nature in excess of normal expectancy </li></ul><ul><li>Endemic </li></ul><ul><li>habitual presence of a disease or agent within a geographic area </li></ul><ul><li>based on the usual prevalence of a given disease within such an area </li></ul><ul><li>Pandemic </li></ul><ul><li>an epidemic which is worldwide in distribution </li></ul><ul><li>Host </li></ul><ul><li>person/animal that affords subsistence to an infectious agent </li></ul><ul><li>under natural conditions </li></ul><ul><li>Carrier </li></ul><ul><li>person/animal that harbors a specific infectious agent in the </li></ul><ul><li>absence of discernible clinical disease and serves as a </li></ul><ul><li>potential source of infection </li></ul>
    7. 7. <ul><li>Fomite </li></ul><ul><li>o contaminated substance (not necessarily a reservoir) serving as </li></ul><ul><li>an intermediate means of transport for an infectious agent </li></ul><ul><li>Reservoir </li></ul><ul><li>o anything (living or inert) in which an infectious agent lives and </li></ul><ul><li>multiplies in such a manner that it can be transmitted to a </li></ul><ul><li>susceptible host </li></ul><ul><li>Vector </li></ul><ul><li>o invertebrate animal capable of transmitting an infectious agent </li></ul><ul><li>to vertebrates </li></ul><ul><li>Virulence </li></ul><ul><li>o ability of an infectious agent to cause severe or fatal infections </li></ul>
    8. 8. <ul><li>IMMUNITY </li></ul><ul><li>o active </li></ul><ul><li>• altered organism or its product induces a host to produce </li></ul><ul><li>antibodies (e.g. natural measles infection or live vaccine) </li></ul><ul><li>o passive </li></ul><ul><li>• protective antibodies produced by another host which are </li></ul><ul><li>introduced into susceptible persons (e.g. natural transplacental </li></ul><ul><li>IgG from mother to infant) </li></ul><ul><li>o inherent </li></ul><ul><li>• endogenous production of antibody </li></ul><ul><li>o herd </li></ul><ul><li>• expression used to describe immunity of a group or community </li></ul><ul><li>• resistance of a group to an infectious agent based on the </li></ul><ul><li>immunity of many individuals in the group </li></ul><ul><li>• implies transmission interruption when < 100% of group is </li></ul><ul><li>immune due to separation of few susceptibles </li></ul>
    9. 9. Transmission of Infectious Agents <ul><li> Transmission refers to any mechanism by which an infectious agent is spread from a source or reservoir to a person. </li></ul><ul><ul><li>Reservoir. </li></ul></ul><ul><ul><li>Mode of infection. </li></ul></ul><ul><ul><li>Susceptible host. </li></ul></ul>
    10. 10. Six Factors furthering process <ul><li>Agent </li></ul><ul><li>Reservoir </li></ul><ul><li>Portal of exit </li></ul><ul><li>Mode of transmission </li></ul><ul><li>Portal of entry </li></ul><ul><li>Susceptible host </li></ul>
    11. 11. <ul><li>Man </li></ul><ul><li>1=Case :-case can be prevented and controlled by </li></ul><ul><li>1-Identification:- </li></ul><ul><li>--presentation:- </li></ul><ul><li>This involves signs and symptoms of this disease. </li></ul><ul><li>--Lab finding :- </li></ul><ul><li>Diagnostic test, or physical examination </li></ul><ul><li>--complications </li></ul><ul><li>That may arise due to this disease. </li></ul>Reservoir
    12. 12. Case <ul><li>2-Treatment </li></ul><ul><li>3-Isolation:- </li></ul><ul><li>this needs to determine communicability period </li></ul><ul><li>4 -Health education:- </li></ul><ul><li>About </li></ul><ul><li>-S&S of complication </li></ul><ul><li>-treatment </li></ul>Man
    13. 13. carrier <ul><li>2=carrier:- </li></ul><ul><li>1-Types of carrier </li></ul><ul><li>-by type </li></ul><ul><li>.healthy carrier </li></ul><ul><li>.incubatory carrier </li></ul><ul><li>.convalescence carrier </li></ul><ul><li>-by portal of exit </li></ul><ul><li>.respiratory carrier </li></ul><ul><li>.GIT carrier </li></ul><ul><li>. GUT carrier </li></ul><ul><li>2-active detection </li></ul><ul><li>.Household surveillance for early detection of disease </li></ul>Man
    14. 14. Reservoir <ul><li>3-health education </li></ul><ul><li>concerning special hygiene and avoid risk factors </li></ul><ul><li>4-Quarantine :- </li></ul><ul><li>this needs to know Incubation period </li></ul>
    15. 15. Animal(Reservoir) <ul><li>Case </li></ul><ul><li>Identification </li></ul><ul><li>Treatment </li></ul><ul><li>Isolation </li></ul><ul><li>Extermination </li></ul><ul><li>Carrier </li></ul><ul><li>- Type </li></ul><ul><li>- Active detection </li></ul><ul><li>- Quarantine </li></ul><ul><li>- Extermination </li></ul>
    16. 16. Soil (Reservoir) <ul><li>Disinfection </li></ul>
    17. 17. Mode of transmission <ul><li>- Direct :-- </li></ul><ul><li>Direct contact </li></ul><ul><li>Vertical transmission </li></ul><ul><li>Droplet infection </li></ul><ul><li>Animal bite transmission </li></ul><ul><li>Contact with soil </li></ul>
    18. 18. Indirect <ul><li>Air-borne </li></ul><ul><li>Vehicle borne </li></ul><ul><li>Vector-borne transmission </li></ul><ul><li>Fomite –borne </li></ul><ul><li>Hand –borne </li></ul>
    19. 19. Susceptible host <ul><li>Man </li></ul><ul><li>1- the at risk individual </li></ul><ul><ul><li>Systemic diseases </li></ul></ul><ul><ul><li>Surgical patients </li></ul></ul><ul><ul><li>Immunocompromised individuals </li></ul></ul><ul><ul><ul><li>Genetic based </li></ul></ul></ul><ul><ul><ul><li>Organ transplant </li></ul></ul></ul><ul><ul><ul><li>Chemotherapy </li></ul></ul></ul><ul><ul><ul><li>Radiotherapy </li></ul></ul></ul><ul><ul><ul><li>HIV infection </li></ul></ul></ul>
    20. 20. <ul><li>2-health education :- </li></ul><ul><li>about vaccination and preventive measures </li></ul><ul><li>3-immunization :- </li></ul><ul><li>if available. </li></ul><ul><li>4-prophylaxis :- </li></ul><ul><li>5-special protective measures :- </li></ul><ul><li>6-legislation :- </li></ul>
    21. 21. Susceptible host <ul><li>Animals </li></ul><ul><li>1- the at risk </li></ul><ul><li>2-prophylaxis </li></ul><ul><li>3-special protective measures </li></ul>
    22. 22. Emerging Infectious Diseases <ul><li>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. </li></ul>
    23. 23. Reemerging Infectious Diseases <ul><li>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. </li></ul>
    24. 24. Fundamental principles of Control of Communicable Diseases <ul><li>Rapid Assessment </li></ul><ul><li>Prevention </li></ul><ul><li>Surveillance </li></ul><ul><li>Outbreak Control </li></ul><ul><li>Disease Management </li></ul>
    25. 25. Modern Conditions that Favor the Spread of Infectious Diseases <ul><li>Global travel </li></ul><ul><li>Globalization of food supply and centralization of food processing </li></ul><ul><li>Population growth, increased urbanization and overcrowding </li></ul><ul><li>Migration due to wars, famines, and natural disasters </li></ul>
    26. 26. Modern Conditions that Favor the Spread of Infectious Diseases <ul><li>Irrigation, deforestation, and reforestation projects that alter habitats </li></ul><ul><li>Human behaviors, such as IV drug use and risky sexual behavior </li></ul><ul><li>Increased use of antimicrobial agents and pesticides </li></ul><ul><li>Increased human contact with wilderness habitats </li></ul>
    27. 27. Prevention of communicable diseases:- <ul><li>Communicable diseases can be prevented by appropriate preventive measures which include: </li></ul><ul><li>Good site planning </li></ul><ul><li>Provision of basic clinical services </li></ul><ul><li>Provision of appropriate shelter </li></ul><ul><li>Clean water supply </li></ul><ul><li>Sanitation </li></ul><ul><li>Mass vaccination against specific diseases </li></ul><ul><li>Regular and sufficient food supply </li></ul><ul><li>Control of vectors </li></ul>
    28. 28. Primary Prevention <ul><li>Increasing the resistance of the host </li></ul><ul><li>Inactivating the agent </li></ul><ul><li>Interrupt the chain of infection </li></ul><ul><li>Restricting spread of infection </li></ul><ul><ul><li>isolation </li></ul></ul><ul><ul><li>quarantine </li></ul></ul><ul><ul><li>segregation </li></ul></ul><ul><ul><li>personal surveillance </li></ul></ul>
    29. 29. Secondary Prevention <ul><li>Activities targeted at detecting disease at earliest possible time to: </li></ul><ul><ul><li>begin treatment </li></ul></ul><ul><ul><li>stop progression </li></ul></ul><ul><ul><li>protect others in the community </li></ul></ul><ul><li>Examples of activities: case finding, health screening, health education </li></ul>
    30. 30. Tertiary Prevention <ul><li>Limits the progression of disability </li></ul><ul><li>Treatment of symptoms and rehabilitation vary with each specific disease </li></ul>
    31. 31. Surveillance <ul><li>Surveillance is the ongoing systematic collection,analysis and interpretation of data in order to plan, implement and evaluate public health intervention. </li></ul><ul><li>Surveillance system should be simple, flexible, acceptable. </li></ul>
    32. 32. Outbreak Control <ul><li>An outbreak is occurrence of a number of cases of a disease that is unusually large or unexpected for a given place and time . </li></ul><ul><li>Outbreaks and epidemics refer to the one and same thing. </li></ul><ul><li>Outbreaks in emergency situations can spread rapidly giving rise to high morbidity and mortality rates. </li></ul><ul><li>Aim should be to detect and control the outbreak as early as possible. </li></ul>
    33. 33. Steps in the management of a communicable disease outbreak <ul><li>Preparation </li></ul><ul><li>Detection </li></ul><ul><li>Response </li></ul><ul><li>Evaluation </li></ul>
    34. 34. Preparation for the outbreak <ul><li>Health coordination meetings </li></ul><ul><li>Strong surveillance system </li></ul><ul><li>Outbreak response plan for each disease </li></ul><ul><li>Stocks of iv fluids, antibiotics and vaccines </li></ul><ul><li>Plans for isolation wards </li></ul><ul><li>Laboratory support </li></ul>
    35. 35. Steps in the management of a communicable disease outbreak <ul><li>Preparation </li></ul><ul><li>Detection </li></ul><ul><li>Response </li></ul><ul><li>Evaluation </li></ul>
    36. 36. Detection of outbreak <ul><li>Surveillance system with early warning system for epidemic prone diseases. </li></ul><ul><li>Inform ministry of health and WHO in case of outbreaks of specific diseases. </li></ul><ul><li>Take appropriate specimens (stool, CSF or serum) for laboratory confirmation. </li></ul><ul><li>Include case in the weekly report. </li></ul>
    37. 37. Steps in the management of a communicable disease outbreak <ul><li>Preparation </li></ul><ul><li>Detection </li></ul><ul><li>Response </li></ul><ul><li>Evaluation </li></ul>
    38. 38. Response to the outbreak <ul><li>Confirm the outbreak </li></ul><ul><li>Activate the outbreak control team </li></ul><ul><li>Investigate the outbreak </li></ul><ul><li>Control the outbreak </li></ul>
    39. 39. Steps in the management of a communicable disease outbreak <ul><li>Preparation </li></ul><ul><li>Detection </li></ul><ul><li>Response </li></ul><ul><li>Evaluation </li></ul>
    40. 40. Evaluation <ul><li>Assess appropriateness and effectiveness of containment measures. </li></ul><ul><li>Assess timelines of outbreak detection and response. </li></ul><ul><li>Change public health policy if indicated. </li></ul><ul><li>Write and disseminate outbreak report. </li></ul>
    41. 41. Global Disease Eradication Efforts <ul><li>Methods to accomplish the goal of eradication of diseases include: </li></ul><ul><ul><li>immunization and vaccination </li></ul></ul><ul><ul><li>drug therapy </li></ul></ul><ul><ul><li>community training </li></ul></ul><ul><ul><li>health education </li></ul></ul><ul><ul><li>national disease surveillance efforts </li></ul></ul>
    42. 42. examples <ul><li>7 diseases have been targeted for eradication in early 21st century: </li></ul><ul><ul><li>polio </li></ul></ul><ul><ul><li>measles </li></ul></ul><ul><ul><li>leprosy </li></ul></ul><ul><ul><li>river blindness </li></ul></ul><ul><ul><li>Chagas’ disease </li></ul></ul><ul><ul><li>guinea worm disease </li></ul></ul><ul><ul><li>lymphatic filariasis </li></ul></ul>
    43. 43. Nurses’ Role <ul><li>Community health nurses play an important role with regarded to all population at risk for communicable disease </li></ul><ul><li>Nurses concerned with communicable disease control must </li></ul><ul><li>Recognize who at risk </li></ul><ul><li>Where the reservoirs and source of infectious disease agents are located </li></ul><ul><li>What environmental factors promote the spread </li></ul>
    44. 44. <ul><li>What comprise the characteristic of vulnerability of community member and groups-particularly those subject to intervention </li></ul><ul><li>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 </li></ul>