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Disease & prevention > Case 3 > Flashcards

Case 3 Flashcards

1
Q

What is an emerging infection?

A

When disease is caused by an orgnism that is:
- newly identified and not known previously to infect humans or:
- has changed susceptibility to an anti-infectious drug.

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2
Q

What is a re-emerging infection?

A

When disease is caused by an infectious organims previously known to infect humans that has re-entered human populaitons or changed in epidemiology.

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3
Q

What is an epidemic?

A

Unexpected increase in # of disease cases in a specific geographic area. Doesn’t have to be contagious

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4
Q

What are some diseases that are epidemics?

A
  • Yellow fever
  • Smallpox
  • Measels
  • Polio
  • Obesity rates
  • West Nile fever
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5
Q

What is a pandemic?

A
  • When disease’s growth is exponential = growth rates skyrockets and each day cases grow more than day before.
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6
Q

What is an endemic?

A

When a disease is consistently present but limited to a particular region => disease spread & rates are predicatable.

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7
Q

What is risk measured in?

A
  • Probability of death
  • Expected life years lost
  • Deaths per person exposed
  • Per hour of exposure
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8
Q

What is risk?

A
  • Probability that an unfortunate event occurs during a stated period of time, or results from a particular challenge.
  • Can never be reduced to 0.
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9
Q

What is absolute risk?

A

Probability of an event in a population

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10
Q

What is relative risk?

A

Ratio of the risk of an event among the exposed to the risk among the unexposed

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11
Q

**What is attributive risk? is this correct?

A

the porportion of the incidence of a disease in the population (exposed and nonexposed) that is due to exposure.

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12
Q

What is risk perception?

A
  • People’s judgements & assessment of hazards that might pose immediate or long term threats to their health & wellbeing.
  • Involves people’s beliefs & feelings within their social and cultural context. Particular risk/hazard means different things to different people and different things in different contexts.
  • Need to understand risk perception for effective risk communication.
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13
Q

*What is risk judgement?

A
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14
Q

How can risk judgement be evaluated?

A

In terms of consistency & accuracy

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15
Q

What does evaluating consistency mean?

A

Asking logically related questions and comparing answers (e.g. do risk estimates increase with increases in the number of exposures or time period?).

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16
Q

What does evaluating accuracy mean?

A

Asking questions that can be compared to risk estimates.

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17
Q

What is risk communciation?

A

way in which information about risk is communicated to various people and groups (e.g. public, healthcare organisations, ggd, etc)

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18
Q

What are the 2 components of risk assessment?

A
  1. Risk estimation
  2. Risk evaluation
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19
Q

What is risk estimation?

A
  • Relies on scientific activity & judgement.
  • Statistics about past harmful events can be used to predict both size & likelihood of future harmful events.
  • Involves identifying health problem, hazard responsible & quantifying exposure in a specific population.
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20
Q

What is risk evaluation?

A
  • relies on social & political judgement.
  • process of determining importance of identified hazards & estimated risks from point of view of those individuals or communities who face risk.
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21
Q

how does herd immunity impact the spread of infectious disease?

A
  • Key concept for epidemic control & is important to protect those who cannot get vaccinated.
  • # of people need to be vaccinated before reaching herd immunity depends on disease.
  • R # has to be below 1 to achieve herd immunity.
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22
Q

What is herd immunity?

A

only a proportion of a population needs to be immune (through overcoming natural infection or through vaccination) to an infectious agent for it to stop generating large outbreaks.

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23
Q

What is the role of vaccination for herd immunity?

A
  • effective vaccine = safest way to reach herd immunity

Why? Because:
* allocation can be specifically targeted to highly exposed populations (those most at risk) (e.g. healthcare workers or elderly)
* deaths can be prevented by first targting highly vulnerable populations.

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24
Q

What are the types of emerging infectious diseases?

A
  • HIV/AIDS infections
  • Nipah virus
  • SARS
  • MERS
  • COVID-19
  • Lyme disease
  • Escherichia coli (E. coli)
  • Hantavirus
  • Dengue fever
  • West Nile virus
  • Zika virus.
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25
Q

What is zoonoses?

A

infections in animals transmitted to humans.

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26
Q

What are vector-borne diseases?

A

Infections transmitted by bite of infected arthropod species, such as mosquitoes, ticks, triatomine bugs, sandflies, and blackflies.

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27
Q

**What are the most important emerging infectious diseases?

A

Zooneses & vector-borne diseases

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28
Q

**Why are zoonoses & vector-borne diseases the most important emerging infectious diseases?

A
  • Co-evolution with specific rodent speicies whose contact iwht humans has increased a s aresult of modern environment and human behavioural factors.
  • farming, keeping domestic pets, hunting and camping, deforestation, other ytpes of habitat destruction all create opportunitites for such infectious agents to invade human hosts.
29
Q

What are the causes of re-emerging infectious diseases?

A
  • Microbial evolution
  • zoonotic encounters
  • environmental enroachment
  • AMR
  • Globalisation
  • War
  • Vaccination rates dropping
  • climate relatded e.g. El Nino/Southern Oscillation (ENSO) phenomennon is associated with resurgences of cholera and malaria.
30
Q

What are types of re-emerging infectious diseases?

A
  • Malaria - DDT use => abandonment of other mosquito-control porgrammes & mosquito now resistant to DDT
  • TB
  • Cholera
  • Influenza
  • Pneumococcal disease
31
Q

Why has TB re-emerged?

A
  • Immune deficiencies of people with AIDS & this increases risk of latent Mb. TB infections becoming active & contagious.
  • Inadequate courses of anti-tb therapy = emergence & spread of drug resistant and multi-drug reisstant strains = more expensive treatment.
  • disease of poverty, associated with crowding and inadequate hygiene. Continuing expansion of global populations living in poverty makes tb more difficult to control.
32
Q

What is becoming a new problem with regards to newly emerging infectious diseases?

A

Infectious agents associated with chronic diseaes E.g associations of hep B & C with liver damage.

33
Q

How is the impact of new & re-emerging infectious diseases on human populations affected?

A
  • By rate & degree to which they spread across geographical areas.
  • depending on movement of human host or of the vectors or reservoirs of infections.
  • travel has an important role in bring people into contact with infectious agents.
34
Q

What are deliberately emergin ingections?

A

those that have been develop by man, usually for nefarious use.

35
Q

What is the burden of mortality and morbidity associated with infectious diseases?

A

falls most heavily on people in developing countries espeically infants and children.

36
Q

What are infections that don’t transmit from humans to humans?

A
  • Rabies –> is a zoonotic infection that commonly occurs after the bite of a rabid animal.
  • Only transmitted from human to human through non-sterile medical procedures, blood transfusion and organ transplants.
37
Q

What are infections with limited human-to-human transmission?

A
  • Monkeypox: transmission among humans through direct contact with infectious droplets.
  • Ebola virus: short incubation period, infection leads to rapid progression to disease with a severe and often fatal outcome that limits the potential for contact of infected humans with others.
38
Q

Why do some infections have limited human-to-human transmission?

A

Some zoonotic infections in humans are able to initially transmit from person to person but unable to sustain transmissibility.

39
Q

**What are infections with sustained transmission?

Check. ifit is correct influenza in this category

A
  • Influenza virus
  • HIV - Has a long incubation (latent) period during which it is difficult to clinically detect.
40
Q

Briefly explain the influenza virus

A
  • RNA viruses that cause seasonal human epidemics of influenza are highly unstable genetically and mutate frequently during replication.
  • 4 types of influenza viruses: A, B, C, D.
  • Types of influenza A viruses: bird flu & swine flu.
41
Q

What causes infectious diseases to (re-)emerge?

A
  • AMR has an effect → if you cannot treat a disease, it will re-emerge.
  • Globalization
  • War
  • Closer contact between humans and animals.
  • Vaccination rates - if drop (e.g. measels) a disease will make a comeback.
42
Q

What is the susceptibility of the host determined by?

A
  • Genetic / inherent susceptibility
  • immune protection (vaccines, past exposure to disease)
  • Cell tropism
  • Demographics and behaviour (international travel/trade/recreational, sex, occupational, antibiotic misuse
43
Q

What is the susceptibility of the agent determined by?

A
  • Genetic diversity
  • Genetic evolution & change
  • infectivity
44
Q

What is the susceptibility of the environment determined by?

A
  • Animal exposures
  • climate and weather
  • economic development / land use
  • poverty and social ills
  • wars, famines, natural disasters
  • lack of public health infrastructure
  • lack of political will
45
Q

What is one health?

A

an integrated, unifying approach to balance and optimize the health of people, animals and the environment

see image

46
Q

What is the purpose of the one-heath model?

A

to show interdependence of several factors which drive the appearance and transmission of EIDs.

i think?

47
Q

What are the potential outcomes when an infectious organism (re-)emerges in human populations?

A
  • Some don’t transmit from humans to other humans
  • Some have limited human to human transmission, with the potential to re-emerge when the conditions are favourable.
  • Others emerge, spread widely = endemic.
48
Q

What factors influence the transmission of an infectious organism to and among humans?

A
  • Type of organism
  • Incubation period (time from exposure to infectious organism to clinical disease and infectiousness)
  • Clinical outcomes
  • Mutations
  • Human genetics.
49
Q

What factors influence (re-)emergence of infectious diseases?

A
  • Weakend public health infrastructrue
  • failure of safety/regulations
  • population shifts
  • climate change
  • public health consequence of civil disturbance, human displacement and natural disasters
  • Human behaviour: occupation, mistrust & misnformation
  • deliberate use to cause terror or harm
  • anti-microbial drug resistance
50
Q

How does a weakened PH infrastructure influence the (re-)emergence of infectious diseases?

A
  • Decreased investment in public health
  • Worsened by poverty in lower-resourced countries where competing priorities for development & suboptimal access to healthcare & sanitation.
  • Deficient infrastructure = lack of strong public health practices that can prevent emergence of infectious diseases or prepare communities to respond to them should they emerge.
51
Q

How does failure of safety/regulations influence the (re-)emergence of infectious diseases?

A
  • Blood transfusions source of infection.
  • Food borne outbreaks
52
Q

How do population shifts influence the (re-)emergence of infectious diseases?

A
  • Population growth = increase disease transmission.
  • Rural-urban migration = crowded living conditions and inadequacy of water and sanitation systems and other basic infrastructure.
  • Uncontrolled urbanisation with overcrowded and substandard living conditions in slum areas.
53
Q

How does anthropogenic activities or climate change influence the (re-)emergence of infectious diseases?

A
  • Deforestation that disrupts natural habitats of animals and forces animals searching for food in closer contact with humans
  • Climate changes
  • Climate extremes e.g. excessive rainfall or drought = displace animals and bring in closer contact with human settlements, or increase vector breeding sites.
54
Q

How does civil disturbance, human displacement and natural disasters influence the (re-)emergence of infectious diseases?

did i word this question correctly?

“Public health consequence of civil disturbance, human displacement and natural disasters”

A
  • War, conflict, etc = crowded, unhygienic and impoverished living conditions = hightens risk of emergence & re-emergence of infectious diseases.
  • Impact of war, conflict or natural catastrophe e.g. earthquakes = destruction or weakening of health systems with diminished capacity to detect, prevent, and respond to infectious disease outbreaks.
55
Q

How does human behaviour influence the (re-)emergence of infectious diseases?

A
  • Occupation: farmers, people working with animals, vets, etc higher risk of obtaining and transmitting disease. Healthcare workers also at risk
  • Mistrust & misinformation: eg. safety of vaccines = less uptake of vaccines = re-emergence.
  • Deliberate use to cause terror or harm.
56
Q

How does AMR influence the (re-)emergence of infectious diseases?

A
  • AMR major public health problem because it threatens effectiveness of antimicrobials in combating infection.
  • Lack of effective antimicrobials= world back to pre-antimicrobial era where simple infections often = to severe outcomes & where effective measures to control spread of disease especially those for which there are no vaccines, would be lost.
  • AMR increases healthcare & other indirect costs as more expensive treatments are required and illnesses may be prolonged.
57
Q

What is AMR?

A

Anti-microbial drug resistance - susceptibility of infectious organisms to anti-infective drugs.

58
Q

When are anti-infective drugs used in human health?

A
  • Over or under-prescribing of antibiotics
  • Excessive demand for antibiotics by general population
  • Use of substandard drugs with inferior anti-infective drug content.
59
Q

When are anti-iinfective drugs used in annimal husbandry & agriculture?

A
  • Anti-infective drugs added to animal feed to promote animal growth.
  • Spraying on crops
60
Q

How does zoonoses occur?

A

Some of the organisms that infect animals freely circulate between animals & humans = opportunities for zoonotic infection with resistant organisms and for swapping or exchanging resistant genes = increasing speed with which anti-infective resistance evolves in both agriculture and human populations.

61
Q

How do diseases spread across the globe?

A
  • Travel in humans, insects, foods, animals (e.g. migratory birds, etc)
  • E.g. disease carrying mosquitoes travel in passenger cabin or luggage hold of jets to cause tropical infections in temperate countries when they feed on airport workers or those who live nearby.
62
Q

What can be done for the future of (re-) emerging diseases?

A
  • Better understanding of ecosystem & causative factors = enable** preventive actions** that reduce likelihood of disease emergence, especially infections at the animal/human interface.
  • E.g. encourage proper handling and distribution of livestock and maintenance of strict sanitation in markets where animals or animal products are sold that could be a source of infection.
  • Must have strong surveillance & preparedness, response protocols & mitigation systems.
  • Outbreaks must be detected rapidly & response must be timely & effective
63
Q

What is a benefit of surveillance systems?

A

Informs what public health actions are taken & reflects if those actions are effective.

64
Q

*Define surveillance & surveillance systems

A

Surveillance –> ongoing, systematic process of information collection, analysis, interpretation, visualisation, dissemination and connection to public health programmes.

Surveillance systems are organised networks of people and activities dedicated to managing and maintaining surveillance for specific conditions.

65
Q

*Define surveillance & surveillance systems

A

Surveillance –> ongoing, systematic process of information collection, analysis, interpretation, visualisation, dissemination and connection to public health programmes.

Surveillance systems are organised networks of people and activities dedicated to managing and maintaining surveillance for specific conditions.

66
Q

What is the goal of public health surveillance?

A

Provide infromation that can be usedf fo rhealth action by public health personnel, government leaders and the public to guide public health policy and porgrams.

67
Q

What does an effective surveillance system include?

A
  • Collection , reporting and consolidation of data
  • Routine analysis and interpretation of data
  • Feed-forward of surveillance data to decision makers
  • Feedback of surveillance data to those providing the data and other interested parties
  • Detection, evaluation and response to unusual patterns in the data and quality assurance.
68
Q

What is the purpose of public health surveillance?

A
  • Define public health priorities
  • Characterise disease patterns by time, place, person and disease characteristics
  • Detect epidemics, health problems
  • Monitor changes, measure trends of diseases, and health related events
  • Suggest hypotheses for further investigation
  • Estimate magnitude and scope of health problems
  • Guide and evaluate prevention and control programmes, including assessment of effectiveness and/or adverse consequences.
  • Facilitate planning, including projection of future trends and healthcare needs.

Disease & prevention (10 decks)

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