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PaSS Sem 4 > 2.1 Principles Of Communicable Disease Control And Outbreak Management > Flashcards

2.1 Principles Of Communicable Disease Control And Outbreak Management Flashcards

1
Q

What are the main routes of transmission of disease between people?

A 
Droplet spread 
Aerosol
Faecal-oral
Direct contact
Vector borne
Blood borne 
Fomites
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2
Q

Give examples of disease that spread via droplet or aerosol spread?

A

Influenzae
Measles
Meningococcal infection
COVID-19

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3
Q

Give some examples of faecal-oral route diseases?

A

Typhoid
E.coli.
Hepatitis-A

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4
Q

Give some examples of diseases that spread via direct contact

A 
Scabies 
Impetigo - topical staphylococcal skin infection 
Nits
Cold sore
STIs generally
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5
Q

Give some examples of vector borne disease transmission

A 
Malaria
Dengue
Lyme disease
Leptospirosis 
Rabies
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6
Q

Give some examples of diseases that spread via blood borne transmission

A

HIV
Hepatitis B
Hepatitis C

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7
Q

Give some examples of blood borne transmission

A

Receiving contaminated blood products
IV drug use
Transmitted during pregnancy / labour
Sexual contact

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8
Q

What is a fomite?

A

A non living object that transmits disease causing pathogens e.g door knobs or tap handles.

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9
Q

What is the epidemiological triangle?

A

A simple diagram showing the different factors that determines a diseases spreadability. Considers the agent itself, the host and the environment.
The agent is the disease causing thing such as the bug
The environment must by suitable for spread and facilitates the bug moving from the host to a new carrier.
The host is an ill person or asymptomatic carrier.

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10
Q

What is the chain of infection?

A 
Host
Person to person spread
Reservoir
Portal of exit
Agent 
Mode of transmission
Portal of entry 
Host
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11
Q

What measures can be used to kill or inactivate the agent at source?

A 
Antibiotics
Decontamination
Disinfection
Sterilisation
Heat treatment
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12
Q

What measures can be taken to interrupt the pathway of transmission?

A

Isolation
Environmental hygiene
Personal hygiene
PPE

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13
Q

What measures can be taken to protect the receptor host?

A

Isolation
Immunisation - of vulnerable, contacts, cocoon
Chemoprophylaxis

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14
Q

What are the key steps necessary for disease transmission?

A

Infectious agent
Source of infection
Available pathway for disease transmission
Population with susceptible people in it

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15
Q

What is an outbreak?

A

Two or more linked cases of an infection. May be Linked by time, place or person
Or
An increase in cases of a disease over and above the normal background rate of that disease

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16
Q

What is meant by a cluster of a disease?

A 
An observed (real or perceived) aggregation of cases
grouped in a single time period or setting and
suspected to be above the expected level. Not necessarily a proven link between the cases.
17
Q

How is an epidemic curve plotted?

A

Number of cases on the y axis

Time along the x axis

18
Q

What is a point source outbreak?

A

A single rapid rise in cases resulting in a peak. Followed by an equally rapid fall in cases. Implies that there is a single source of the infection that was expose to a large number of people over a short period of time

19
Q

Give an example of the causation of a point source outbreak

A

Food borne outbreaks associated with big events

20
Q

What is an extended outbreak?

A

When there is a more gradual increase of infections over time and a more gradual decrease. Flatter and wider curve than a point source outbreak. Longer lasting source.

21
Q

Give an example of a causation of an extended outbreak

A

A contaminated water source.

22
Q

What is a propagated outbreak?

A

Outbreaks where there is sustained person to person transmission. Many clusters occurring and outbreak lasts a long duration.

23
Q

What is meant by R0?

A

A basic reproduction number of the virus. Is an integral factor of the organism of the virus. Refers to given a 100% susceptible population, how many secondary cases would a primary case produce.

24
Q

What is meant by the R number?

A

The net reproduction number or the effective reproduction number
How many people is truth a case will go on to infect.

25
Q

What is a superspreader?

A

Someone who spreads the infection to a degree far more so than the r number

26
Q

What are the 9 steps of investigating an outbreak?

A
  1. Establish a case definition
  2. Confirm cases are real
  3. Determine background rate - is this really an outbreak
  4. Case finding (active)
  5. Describe cases in time, place and person - ask lots of questions
  6. Plot your epidemic curve
  7. Generate your hypothesis
  8. Test your hypothesis (usually with case control model)
  9. Generate conclusions
27
Q

When dealing with an outbreak, what procedures should be done whilst investigating to protect the population?

A

Take samples
Instigate control methods
Convene an outbreak control group
Communication

28
Q

When describing cases, what factors must be considered?

A 
Demographics
Symptoms and TIMING
Travel/Other exposures including food
Immunisations
Ethnic/Cultural/Religious Background
29
Q

What is the incident management team/ outbreak management team?

A

A multidisciplinary team than help investigate and control outbreaks.

30
Q

What group members should be included in an outbreak control team?

A 
Health protection specialist from local HPT 
Screening and immunisation team representative
Education representative
School nurse/ team leader
GPs
Local DPH
Local clinical commissions groups 
Communication leads
Acute trust representative
31
Q

What are the legal frameworks that help with control of infectious diseases?

A

Notifiable infections/agents
Control of Disease Act
Environmental Health Regulations
International health regulations

32
Q

At what point can you declare that an outbreak is over?

A

When there has been no new cases within twice the time of the incubation periods from the date of the last confirmed case.
Or
When the background rate of infection returns to normal/ below expected value

33
Q

What should be done when an outbreak is over?

A

Declare it as over
Debrief - both hot and cold
Contingency plan

34
Q

Notifiable diseases are not he only things that should be notified according to the law. What other things should be notified to the local council?

A

Any infection which presents, could present or could have presented significant harm to human health (for example, varicella zoster exposure in pregnant or immunocompromised people)
- Any relevant contamination (e.g. chemical or radiological) which presents, could present or could have presented significant harm to human health

35
Q

Whether a notification should be considered urgent or not depends upon a number of factors. What do you think these factors might be?

A

The type of disease - urgent if highly contagious. Need to put in control measures swiftly to reduce likelihood of outbreak

PaSS Sem 4 (4 decks)

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