Infectious Disease Prevention and Management -myassignmenthelp

Question: Discuss about theInfectious Disease Prevention and Management. Answer: Analysis Of The Risk Factors For The Spread Of Infectious Disease In The Gold Coast Commonwealth Games, 2018 Gold Coast environment in relevance to infectious disease The XXI Commonwealth Games (2018) is scheduled in Gold Coast in Queensland, Australia, and will be the fifth Commonwealth Game hosted by Australia. The game start on April 4th, and has provisioned the accommodation of 6600 athletes and officials in the form of an athletes village comprising of 1252 houses, 1170 apartments and 82 townhouses in Southport. As a result, there will be an enormous influx of people (athletes, audiences, dignitaries) in the city, and therefore increasing the chances of introducing infectious disease into the community. If not checked and controlled properly, a potential outbreak scenario can ensue due to the influx, and can jeopardize the public health as well as the health of the visitors. It is therefore vital to identify the diseases most prevalent in the city, and the diseases that can potentially be favored by the environmental conditions of Gold Coast. Identifying the pathogenicity and etiologies of these communicable diseases can allow the implementat ion of preventative measures to control disease outbreaks/spreads. Gold Coast has a humid subtropical climate. The winters are warm (average of 25 to 29 degree Celsius) and hot and humid summers (average 23 to 27 degree Celsius with 106% to 121 % humidity) (Surfers Paradise Forecast, 2017). This can provide a good sustainable environment for different kinds of pathogens that exists or can be introduced to Gold Coast. Currently, the Gold Coast environment has seen the prevalence of different types of infectious diseases like diseases borne of contaminated food or water, diseases carried by mosquito (like Dengue), Viral Zoonotic Disease (like Australian Bat Lyssavirus or Q fever), Influenza, and infections (like meningococcal disease). Tick borne disease like Lyme disease has shown several incidences in Australia (Tick Borne Diseases | Gold Coast Hyperthermia Dr Craig Thompson Integrative GP, 2017). Some of the more relevant diseases in Gold Coast are Mosquito Borne diseases (like Dengue and Zika), and Influenza. As per Gold Coast Bulletin (August 26th, 2017), have reported an increased number of Influenza infections, with teenagers between 10 and 19 years being at the highest risk Statistics from Gold Coast Hospital Health Services shows a 20% increase (520 cases in a week) in the incidence of Influenza (Coast fully sick as flu numbers soar, 2017). Similarly Mosquito borne disease like Zika, have also been reported before. Presumably the Aedes aegypti (Dengue mosquitoes) can pick up the Zika virus from an infected traveler, and spread it (Zika virus | Queensland Health, 2017). Infrastructure related to infection control and management The infrastructure applicable to/ associated with Infection Control and Management Plan (ICMP) enables better management of communicable diseases, and its treatment. The infrastructure can be comprised of an Infection Prevention Team, Long Term Care Facilities and Hospital Surveillance of Health Associated Contagion. ICMP is a standard design aimed for reduction or prevention of infectious diseases in regards to healthcare services for patients, healthcare professionals working in the facility as well as individuals who can get infected in the facility. The declared healthcare facilities includes public hospitals, blood banks, occupational therapists, dental clinic, pathology laboratories, podiatry clinic, acupuncturists, specialist practice clinic, physiotherapists, speech therapists, pharmacies, hyperbaric medicines, aboriginal healthcare services, dermatology service, pharmaceuticals, nursing service, optometrists, correctional service, diabetes educators, radiological and diagnos tic imaging services, stem cell transplant service and Chinese medicines. Infection control program involves components like basic measures for infection control; education, training of healthcare workers; protecting the health of people through the processes of immunization; health hazard identification and risks mitigation; conducting routine activities and practices and effective work practices; surveillance; monitoring of incidence; investigation of outbreaks; research and controlling infections in specific situations (Poff, Browning, 2014). An Infection Control Committee acts as a forum for sharing information and allows a multidisciplinary input and help, and should include representatives from a wide variety of professions like management, healthcare workers, pharmacies, clinical microbiologists, housekeeping, sterilization services, maintenance and training services. They should be able to review and commend surveillance and prevention activities, identify scope of intervention from surveillance data, promote better health practice and assess the existing practice standards, ensuring proper training of staff in the domains of infection control and management. Quarantine Centers are applicable in conditions to stop further spread of the disease, by isolating the infected cases from non infected individuals. The quarantine centers will allow a safe study of the remedy and treatment, while ensuring safety for the population and health workers (Drazen et al., 2014). Vaccination protocols can allow preventative measures, providing protection to healthcare providers and to public. The vaccines help to build up immunity against diseases, and therefore is an important measure of disease prevention and managing (Vaccines, 2017). Surveillance allows proper reporting of infection incidences. Infection investigation done in accordance of CDC definition, can allow effective identification of the prevalent diseases, and thereby formulate a control. Major infectious diseases of concern and their relevant etiology and epidemiology. Influenza: Also called the flu is caused by influenza virus. This ailment is characterized by symptoms like fever, sore throat, runny nose, muscular pains, coughing, and fatigue. Flu can be caused by different strains (A, B or C) of the Influenza virus. Flu cases in Australia are mostly caused by strains A and B. Out of these 2, only Influenza A is known to have caused pandemics. The spread of the virus can be in 3 different ways: direct transmission (when mucus from the infected person directly contacts the mucosa of the healthy person), airborne transmission (caused by inhaling droplets of moisture containing the virus), and through contaminated objects/ vehicles. Children are generally more prone to infection than adults. Estimates show that an average of 13,500 hospitalizations and 3,000 mortalities in Australia each year due to influenza. The worst affected are the patients suffering from chronic conditions like lung disease, asthma, cardiac disease, kidney disease, blood disorder, obesity and endocrine dysfunction (Colds and flu statistics, 2017). Surveillance reports from Australia in 2017 also provide the following information: The infections reached its peak activity in mid August. The confirmed cases of infection, reported to NNDSS (National Notificable Diseases Surveillance System) being 2.5 times compared to last year. The currently dominant strain of influenza virus, prevalent in Australia is the type a strain. The highest incidence of infection have been found among adults aged 80 and above, and the second highest incidence among children between 5 to 9 years. Even though in 2017 the number of mortality cases due to influenza showed an increase and is consistent with the rise in the reported cases and not necessarily due to an increased severity of the disease (List of notifiable conditions | Queensland, 2017). The Commonwealth Department of Health and Ageing estimated a total of 231,645 laboratory confirmed cases of influenza in Australia in 2017 (till November) (Immunisation Coalition, 2017). Figure 1: Statistics for Influenza in Australia; source: (Immunisation Coalition, 2017) Dengue: This disease is spread by mosquitoes, and caused by the Dengue Virus pathogen. The typical symptoms associated with the disease are fever, headache, nausea and painful joints. The symptoms can often develop into acute symptoms that are life threatening like hemorrhagic fever, bleeding, low platelet count, leakage of plasma, and shock that can cause acute low blood pressure (Centers for Disease Control and Prevention, 2017). A sudden onset of fever is a characteristic of dengue. Infection course can be divided into three discrete phases: febrile, critical and recovery. During the first phase- the febrile phase, a high fever occurs (typically above 40 degree Celsius) associated with muscular pain and headache lasting for a week. Nausea and vomiting are also common apart from rashes and flushed skin. The fever can be biphasic, and shows frequent relapse. The critical phase starts as the fever goes down, and there can be leakage of plasma from the blood vessels which can last for a couple of days, causing fluid accumulation in the thoracic and abdominal cavities and can also cause dehydration, loss of fluid, reduced blood to organs, and bleeding from the Gastro Intestinal tract. A dengue shock can ensure due to these conditions, and can be fatal. The recovery phase occurs next, and is evidenced by the reabsorption of the fluids back into the circulatory system. The improvement can be associated with a lowered heart rate, itching and peeling of the skin. A fluid overload can also occur due to the increased volume of blood, and can affect the brain causing seizures. The disease is spread by the mosquito Aedes aegypti, and the virus has 4 different strains (1, 2, 3, and 4). Infection with one strain of the virus can cause immunity to only that strain, thereby still exposing the individuals to infections by the other strains in the future ("Department of Health | Australian Influenza Surveillance Report and Activity Updates", 2017). The mosquitoes bite by the day, and the disease has an incubation period of 3-14 days. The majority of the mosquito borne disease in Gold Coast is caused due to the salt marsh mosquitoes. Freshwater bodies created due to heavy rainfall also provide the ideal breeding grounds for the mosquitoes. High tides exceeding 1.6m in the Gold Coast Seaway also triggers the breeding of the mosquitoes, thereby increasing the prevalence of mosquito borne diseases ("City of Gold Coast | Mosquitoes", 2017). However, reports from January 2017 shows a record high number (in 20 years) of reported cases of dengue in Australia (Butt, 2017) Currently, the mosquito causing dengue is only found in the North, Central and Southwest Queensland. Outbreaks have occurred each year in Queensland, and the outbreaks generally start when an individual is infected with the virus while travelling overseas, and thereby introducing the pathogen into the country ((Faddy, Viennet, Flower McBride, 2017). As per WHO there were 662 laboratory conformed cases of Dengue in Australia, as of July 31st, 2017 (World Health Organization, 2017). This shows a reduction in the reported cases compared to previous years. Figure 2: Reported cases of Dengue; source: (World Health Organization, 2017) Infectious disease health services capacity and critical control points The health services for Infectious disease control ensure proper prevention of communicable diseases and prevent disease outbreaks. The service policies provide critical control points to check the outbreaks/spread of disease by analyzing the mode and path of infection. These control points are: Immunization: This is the process of aiding an individuals immune system to recognize a pathogen or immunogenic, building an immune memory of it. Immunization saves approximately 2-3 million lives every year from preventable diseases like diphtheria, tetanus, rubella, polio, mumps, pneumococcal diseases, tetanus, Pertussis, measles, hepatitis B and Haemophilius influenza type B. The vaccination program can involve strategies like: vaccination for all children, documentation of all vaccinations, free vaccinations and revaccinations incase of outbreak of diseases (Immunization, 2017). In addition, compulsory vaccination can also be implemented against certain diseases that shows prevalence. Screening: It allows identification of individuals who have been infected or exposed to the pathogen. It allows the treatment to be commenced in a timely manner, manage the co morbidities with more affectivity, help to reduce high risk behaviors for the disease, identify the necessity for any compulsory treatment plans. A quick and successful identification can also lower the rate of transmission thereby improving the success rate of disease management. Legal Framework and Mandatory Disclosure Laws: Penalizing non compliance to public health orders or for behaviors that can cause risk to public health allows prevention of activities that can jeopardize health of the public, and ensure personal responsibilities related to health. The laws also ensure compliance by healthcare providers to adhere to the strict protocols and methods that can foster well health of the population, and prevent outbreaks (Chen, Levonyan, Reinhart Taksler, 2014). Isolation/Quarantine: In case of serious outbreaks, it is often challenging to identify the correct source and the carriers. Due to this evacuation and closure of public places can be helpful to stop the spread of the disease. A proper quarantine protocol, combined with decontamination practices can ensure the safety of the people, in particular the economically vulnerable (Drazen et al., 2014). Role of transport access in affecting risk of infectious disease transmission: Infectious diseases can be transmitted by various methods, and therefore public health services aims to minimize transmission of the diseases. Enteric diseases can spread through water or food, and contamination of water supplies can result in diseases like diarrhea, jaundice and cholera. Diseases like Dengue, Malaria, Yellow Fever or Zika Virus are spread by mosquitoes. Prevalence of mosquitoes can hence be associated with prevalence of the diseases borne by them. Similarly, diseases like Influenza can be spread by direct or indirect contact, or by mucosal discharge, as does common cold and small pox. As we understand that a huge influx of people are likely to occur during the commonwealth games, 2018, there will be an elevated risk of retransmission of diseases during that time. Overcrowding can also elevate the risks of influenza spreading out of the country and diseases like Dengue and Zika entering the country from foreign individuals (Rahman, Harley Plummer, 2017). Therefore it is of utmost importance that the mode of transmission of these diseases be understood clearly, and proper precautionary and intervention measures be used to prevent their outbreak or to contain them. Preventing access to the vehicles of the disease can in effect prevent the spread, and ensure the continued protection of public health and foster a general well being among the public. References: Butt, C. (2017).Dengue fever cases hit 20-year high in Australia.The Sydney Morning Herald. Retrieved 13 November 2017, from https://www.smh.com.au/national/health/dengue-fever-cases-hit-20year-high-in-australia-20170112-gtqq5b.html Centers for Disease Control and Prevention. (2017). Symptoms and what to do if you think you have dengue.Centers for Disease Control and Prevention, Atlanta, GA: https://www. cdc. gov/dengue/symptoms. Chen, D. L., Levonyan, V., Reinhart, S. E., Taksler, G. B. (2014).Mandatory disclosure: Theory and evidence from industry-physician relationships. Working paper, mimeo. City of Gold Coast | Mosquitoes. (2017).Goldcoast.qld.gov.au. Retrieved 15 November 2017, from https://www.goldcoast.qld.gov.au/environment/mosquitoes-4095.html Coast fully sick as flu numbers soar (2017).Coast fully sick as flu numbers soar.Goldcoastbulletin.com.au. 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