1. 1 Copyright © 2012 by Mosby, an imprint of Elsevier Inc. Copyright © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Chapter 13 Infectious Disease Prevention and Control

2. 2 Copyright © 2012 by Mosby, an imprint of Elsevier Inc. Copyright © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Objectives 1. Discuss the current impact and threats of infectious diseases on society. 2. Explain how the elements of the epidemiologic triangle interact to cause infectious diseases. 3. Provide examples of infectious disease control interventions at the three levels of public health prevention. 4. Explain the multisystem approach to control of communicable diseases.

3. 3 Copyright © 2012 by Mosby, an imprint of Elsevier Inc. Copyright © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Objectives, Cont’d 5. Define surveillance and discuss the functions and elements of a surveillance system. 6. Discuss the factors contributing to newly emerging or reemerging infectious diseases. 7. Discuss the illnesses most likely to be associated with the intentional release of a biological agent. 8. Discuss issues related to obtaining and maintaining appropriate levels of immunization against vaccine-preventable diseases.

4. 4 Copyright © 2012 by Mosby, an imprint of Elsevier Inc. Copyright © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Objectives, Cont’d 9. Describe issues and agents associated with foodborne illness and appropriate prevention measures. 10. Define the bloodborne pathogen reduction strategy and universal precautions.

5. 5 Copyright © 2012 by Mosby, an imprint of Elsevier Inc. Copyright © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Historical and Current Perspectives  In the early twentieth century, infectious diseases were leading causes of death  Respiratory diseases (e.g., TB) and diarrheal diseases were major killers  Infectious disease currently is third leading cause of death in United States and second worldwide  Current concerns  HIV  Pneumonias and influenza  VRSA and MRSA  SARS

6. 6 Copyright © 2012 by Mosby, an imprint of Elsevier Inc. Copyright © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Transmission of Communicable Diseases  Agent, host, and environment  Modes of transportation  Vertical; horizontal; common; vector  Disease development  Infection; disease; incubation period; communicable period  Disease spectrum  Endemic; epidemic; pandemic

7. 7 Copyright © 2012 by Mosby, an imprint of Elsevier Inc. Copyright © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Surveillance of Communicable Diseases  Elements of surveillance  Surveillance for agents of bioterrorism  9/11 attack  Syndromic surveillance systems  Early Aberration Reporting System (EARS)  List of reportable diseases  National Notifiable Disease Surveillance System (NNDSS)

8. 8 Copyright © 2012 by Mosby, an imprint of Elsevier Inc. Copyright © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Emerging Infectious Diseases  Emerging factors  Societal events  Health care  Food production  Human behavior  Environmental  Public health  Microbial

9. 9 Copyright © 2012 by Mosby, an imprint of Elsevier Inc. Copyright © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Examples of Emerging Diseases

10. 10 Copyright © 2012 by Mosby, an imprint of Elsevier Inc. Copyright © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Prevention and Control  Goal  Primary, secondary, and tertiary prevention  Role of nurses  Multisystem approach to control  Imbalance between human host and environment

11. 11 Copyright © 2012 by Mosby, an imprint of Elsevier Inc. Copyright © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Agents of Bioterrorism  Anthrax  Smallpox  Plague  Tularemia

12. 12 Copyright © 2012 by Mosby, an imprint of Elsevier Inc. Copyright © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Vaccine-Preventable Diseases  Routine childhood immunization schedule  Measles  Rubella  Pertussis  Influenza  Novel influenza A H1N1 (spring 2009)  Avian Influenza A (H5N1) (1997)

13. 13 Copyright © 2012 by Mosby, an imprint of Elsevier Inc. Copyright © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Foodborne and Waterborne Diseases  FoodNet  Role of safe food preparation  Salmonellosis  E. coli  Waterborne disease outbreaks and pathogens

14. 14 Copyright © 2012 by Mosby, an imprint of Elsevier Inc. Copyright © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Vectorborne Diseases  Lyme disease  Usually occurs in the summer in rural and suburban areas of the northeast, mid-Atlantic, and north-central states, particularly Wisconsin and Minnesota  Rocky Mountain Spotted Fever  Most commonly occurs in the southeast, Oklahoma, Kansas, and Missouri  Prevention and control of tick-borne disease

15. 15 Copyright © 2012 by Mosby, an imprint of Elsevier Inc. Copyright © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Diseases of Travelers  Malaria  Foodborne and waterborne disease  Diarrheal disease

16. 16 Copyright © 2012 by Mosby, an imprint of Elsevier Inc. Copyright © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Zoonoses  Rabies (hydrophobia)  Highest case fatality rate of any known human infections, essentially 100%  Best protection remains vaccinating domestic animals (dogs, cats, cattle, and horses)

17. 17 Copyright © 2012 by Mosby, an imprint of Elsevier Inc. Copyright © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Parasitic Diseases  Intestinal parasitic infections  Parasitic opportunistic infections  Control and prevention of parasitic infections

18. 18 Copyright © 2012 by Mosby, an imprint of Elsevier Inc. Copyright © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Hospital-Acquired Infections  Diseases transmitted during hospitalization or developed within a hospital or other health care setting  May involve clients, health care workers, visitors, or anyone who has contact with a hospital

19. 19 Copyright © 2012 by Mosby, an imprint of Elsevier Inc. Copyright © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Universal Precautions  In 1985, in response to HIV transmissions during health care procedures, the CDC recommended a universal precautions policy for all health care settings.