Case 1 Flashcards
What is public health?
art and science of preventing disease, prolonging life and promoting health through the organised efforts of society
What fields are associated with PH?
- Disease prevention
- Health promotion
- Health protection
Define disease prevention in the context of PH
Aimed at minimising the burden of diseases and associated risk factors through prevention efforts
Define health promotion in the context of PH
Enabling people to increase control over and improve their health through social and environmental interventions
Define health protection in the context of PH
Management of environmental, food, toxiocological and occupational safety
What is the difference between infectious, chronic, non-communicable diseases & communicable diseases?
CDs comprise infectious diseases such as tuberculosis and measles.
NCDs are mostly chronic diseases such as cardiovascular diseases, cancers, and diabetes
Why is there a transition from infectious to chronic diseases?
- Developments in society = changes in prevalence of risk factors.
- More chronic diseases = big issue for society e.g. obesity, hypertension, etc.
- Medical and scientific progress = improved detection/ screening/ treatment.
Why is cancer now the #1 death in NL when it used to be CVD?
- Incidence CVD decrease coz have better education, more awareness of lifestyle, CVD risk management in place than in the past. E.g. GP checkup every 6 months if have high BP, cholesterol, etc.
- Cancer increasing due to ageing population (age is huge risk factor)
Define primary prevention
Prevent disease before it develops & reduce risk factors. e.g. vaccination or ban on smoking (see image in doc)
Define secondary prevention
Early detection. ofdisease before suffering and disability (e.g. breast cancer screening)
Define tertiary prevention
Treat diagnosed disease to prevent further detoriation due to disease (e.g. management of diabetic complications)
**Define selective prevention
double check this
intervention that targets a sub-group of the population based on their specific characteristic that would make them susceptible and create a high-risk group. E.g. only selecting people who smoke (we don’t know symptoms) but based on certain characteristics e.g age, type of work, sex, etc that tend to smoke
**Define indicated prevention
double check if correct
focus on individuals at risk (screening). E.g. quit smoking then smokers are group at risk and you only want poeple who actually smoke (at risk)
What is universal prevention?
address an entire population (national, local, community, school, or neighborhood) with messages and programs.
Define a vaccine
Active immunity produced by vaccine. Immunity & immunologic memory similar to natural infection but without risk of disease.
More similar vaccine to disease = better immune response to vaccine
Define immunity
Ability of human body to tolerate presence of material indigenous to body and to eliminate foreign material.
Why has mortality due to infectious diseases decreased?
- Medical advances
- Access to health care
- Improved sanitation
Why are some infectious diseases still an endemic in some countries?
- e.g. polio
- due to conflict which stops vaccine programmes and increases the risk of polio.
Why can we eliminate diseases such as polio and smallpox but not diseases such as tetanus?
Because they only have a human reservoir (only human have the disease) but tetanus is everywhere (soil, animals, etc)
What is chain of infection?
Describes the infectious disease chain from reservoir through mode of transmission to host (see image)
E.g. malaria reservoir are human = spread thru vector (mosquito) and can infect another human
How do we know how many people we have to vaccinate in order to gain immunity of the population?
- Depends on how effective a virus/bacteria can transmit.
- This depends on contagiousness of pathogen and susceptibility of host.
What can you do with knowledge of the R0 value?
You know what vaccination coverage is needed to protect population against outbreak
What is R0?
R0 (basic reproduction number/rate) = contagiousness and transmissibility of infectious pathogens.
higher R0 = more contagious
How do we calculate the basic reproductive rate R0?
R0 = B * c * D
B = chance of transmission
c = # of newly infected/time
D = duration of infecitous period
When will an infection dissapear, become an endemic or epidemic?
Infection will:
* dissapear is R<1
* become endemic if R=1
* become epidemic if R>1
What is contagiousness?
The R0 value
What is susceptibility?
Personal immunity (had the disease in the past or vaccinated) & herd immunity
Why can’t immunocompromised people get vaccines?
is this true for all types of vaccines?
Because e.g. measels vaccine is a live-attenuated vaccine so it can cause a disease like measels.
Explain the basics of immunology
- Antigen in vaccine (part of virus/bacteria) = immune reponse = short term memory cells
- memory cells recognise antigen = quicker immune response = longer protection.
What are the types of immmunisation?
- Passive
- active
- live-attenuated
- inactivated
What is passive immunity?
Person is given antibodies to disease rather than producing them through own immune system.
Benefits & limitations of passive & active immunity
- Passive immunity= immediate protection but only lasts for few weeks/months
- Active immity takes several weeks to develop but long lasting
**What is active immunity?
Immunity you develop after beign exposed to an infection or from getting a vaccine
*Why MMR vaccine after 12 months of being born?
is this correct?
- Mainly young children at risk for MMR
- Up until 6 months of being born, protected by mother exposure.
- In case of outbreak vaccinated at 6 months but if no outbreak, vaccinated at 12 months.
Explain meningitis
- COVID measures (social distancing) reduce # of cases of meningitis
- Not everybody with the bacteria gets sick - many peple carriers but never get sick
What are the types of meningitis?
- MenA
- MenB
- MenC
- MenW
- MenY
What is vaccine hesitancy?
Delay in acceptance or refusal of vaccines despite availability of vaccine services.
What are some determinants of vaccine hesistancy?
- vaccine not needed/harmful
- religious beliefs
- distrust in health system
- past experience
- cost
- vaccination schedule
- mode of administration
- geographic barriers
- media
- reliability of vaccine
- Culture
What is a problem with the NIP in NL?
- last years decrease
- Have to give informed consent to inform RIVM if child is vaccinated = miscalculation of who/how many people vaccinated.
- prevention paradox - if don’t see disease, why vaccinate?
What is web 1.0 & web 2.0?
- Web 1.0 = bringing information out via internet & only experts were able to write and publish info
- Web 2.0 = more interaction through internet (facebook, blogs, etc) Put own input instead of only reading = misinformation
What is confirmation bias?
people’s tendency to process information by looking for, or interpreting, information that is consistent with their existing beliefs.
*What are the guidelines. forcommunication about vaccines?
Is this repeated in another case?
- Easily accessible
- Laymans language
- Natural frequencies e.g. 1 out of 10 instead of %
- visualisation
What is herd immunity?
When a significant proportion of a population becomes immune to an infectious disease & risk of spread from person to person decreases.
What is herd immunity?
When a significant proportion of a population becomes immune to an infectious disease & risk of spread from person to person decreases.
What does herd immunity depend on?
Contagiousness of the disease = R0
What are freeloaders?
People who do not participate in vaccination and depend on the others to be in the processs of herd immunity
How does PH & social media interact to inform the public on vaccinations?
- Risk communication approaches
- Misinformaiton can increase vaccine hesitancy
- Helps to raise awareness (e.g. cookies on peoples devices)
- Website should include visual aids to help explain better
Challenges of global immunisation?
- Introducing new vaccines
- financing new vaccines
- vaccine hesitancy