- Occurs in conjunction with population level interventions aimed at controlling disease. - Confidential notification and identification of exposed persons. - Clients are encouraged to notify partners and close contacts - If client prefers not to do this, then nurse visits or call to encourage contact testing.

Communicable diseases Flashcards by ashley Hassler

Communicable disease

Illness that is caused by an infectious agent by transmission of that agent, from a person, animal or inanimate reservoir to an infected host.

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Which of the following is NOT a communicable disease:
HIV
Salmonella
Shingles
Rocky mountain spotted fever

Shingles

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Definition of disease surveillance

The systematic collection and analysis of specific health data for use in public health.

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Purpose of disease surveillance

Monitoring and improving health. Also assessing the status of public health and plan programs as well as evaluate interventions.

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Uses of disease surveillance

Estimate magnitude of problems
Determine geographic distributions
Detect epidemics and define problems
Monitor changes in infectious agents
Evaluate control measures

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Ex: Vampire facials leading to 2 cases of HIV; why is this important?

Knowing where to track things from!

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How long does it take a virus to reach in major city in the world?

36 hours

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Data Sources

Mortality and Morbidity reports
Notifiable disease reports both state and federal
Nurses and other public health workers required to report specific diseases.
Specialized disease registries (tumor boards)
Reporting of communicable diseases in MT (list)

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Does the incidence of STI’s increase or decrease in the winter months?

Decrease; less people sexually active; spikes in august, as semesters start up!

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**Roles of the public health nurse

-Reporting
-Working with health care providers in the community
-Investigation of case reports
-Identify factors that contribute to disease outbreaks and occurrences.
-Communicating with populations about disease risks and preventative measures.
Educating the public about prevention: safe food prep, water borne illnesses, parasites

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Two broad MAJOR roles of the public health nurse summarized.

Preparation and prevention

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How and who do we report to?

The local health department who then reports to the state.

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Reporting and privacy?

Maintained, goal is for the greater good of the population.

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**Contact tracing

The PHN needs to notify all persons who may be associated with an outbreak to prevent spread throughout the community.

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*What does contract tracing require?

Tact, good critical thinking skills, the ability to not personalize anger or insults and a clear focus on the goal of keeping a community free of disease.
* Partner notification

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Partner notification

Occurs in conjunction with population level interventions aimed at controlling disease.
Confidential notification and identification of exposed persons.
Clients are encouraged to notify partners and close contacts
If client prefers not to do this, then nurse visits or call to encourage contact testing.

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Partner notification and confidentiality

NEVER reveal the source patient

- May need to be creative with follow-up and visit people privately in bars and clubs where they frequent.

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When attempting contact notification and finding that the partner is out of county, who do you contact?

The county nurse.

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Food borne illnesses basics

Common
Costly
Preventable
Underreported
Public health priority

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Who investigates food borne outbreaks?

Nurses and sanitarians

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What is an important part of prevention regarding re-occurrence?

EDUCATION

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Food born Illnesses: Causes

Can be bacterial, viral or parasitic; can be chemical contamination.
Common causes: Campylobacter, Salmonella, cyclospora, E-Coli

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Food borne Illness: Campylobacter (which animal associated)

Poultry; incidence rising

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Food borne Illness: Salmonella (which animal associated)

Poultry/eggs; incidence stable

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Food borne illness: Cyclospora (which animal associated)

Produce; incidence increasing

Salmonella: Bacterial/viral/ or parasitic?

Bacterial

Salmonella: Transmission

Food derived from infected animal or contaminated by FECES of infected animal or person

S/S of salmonella

Sudden headache, ABD pain, diarrhea, nausea, occasional vomiting, almost always fever

2 carriers of salmonella

Animals/reptiles

Hosts of salmonella

Raw undercooked meat, poultry, uncooked eggs, unpasteurized milk/dairy

Campylobacter: Etiology

Bacterial

Campylobacter: Hosts

From birds;

What season is campylobacter most common?

Summer

Campylobacter: S/S

diarrhea (may be bloody), ABD pain/cramping, FEVER within 2-5 days of EXPOSURE. Can be spread to bloodstream and be deadly in immune compromised.

Campylobacter: Diagnosis and treatment

Dx: Stool culture Tx: Symptoms, in severe cases: ABx such as azithromycin, fluoroquinolones

In severe cases of campylobacter what ABx will be used to tx?

Azithromycin or fluoroquinolones

What can causes campylobacter (environment/host)?

Raw, uncooked poultry, unpasteurized milk

T/F Campylobacter is a very fragile organism and is killed by freezing and exposing to oxygen

True

Clostridium perfringens: Etiology

Spore forming gram + bacteria; can grow in areas of little or no oxygen.

Clostridium perfringens: Where is it found?

Raw meat and poultry especially. Dried and precooked foods; large quantities of food kept warm for a long amount of time.

Clostridium perfringens: S/Sx

Usually no fever or vomiting; diarrhea and ABD cramps over 6-24 hours after infected. NO transmission from infected person to another

T/F clostridium perfringens is transmitted from person to person.

False

Clostridium perfringens: Diagnosis and treatment

Dx: Stool culture Tx: Symptoms, rehydration, NO ABX

Are antibiotics utilized with clostridium perfringens?

T/F: Salmonella and campylobacter are most commonly identified causes BUT higher death rates with salmonella, listeria, and toxoplasma

True.

Botulism: 5 kinds

Foodborne (improper canning), wound, infant, adult intestinal toxemia, iatrogenic botulism

Botulism: Causes

Occur as a result of Neurotoxins

** T/F Botulism is completely PREVENTABLE with EDUCATION

True

When can babies start having honey?

At age 1

Botulism S/S

``` Double vision/blurred vision Drooping eyelids, slurred speech Difficulty swallowing Dry mouth and muscle weakness. **May lead to paralysis of respiratory center ```

Time range of botulism

Can occur as early as 6 hours and late as 10 days

Botulism diagnosis and treatment

Dx: History, diagnostics (XR, CR), occasionally blood test. Tx: Supportive if able, mechanical ventilation antitoxin

*** What are the special attention populations?

Babies and pregnant women

*T/F Most of the nutritional benefits of drinking raw milk are available from pasteurized milk without the risk of disease at comes with drinking raw milk

True

*T/F Raw milk made into other products like soft cheese, ice cream, and yogurt can still cause dangerous infections. When consuming these products, make sure they are made from pasteurized milk.

TRUE

*T/F Organic milk is safe to drink regardless of whether it has been pasteurized

False: Only organic milk that has been pasteurized is safe to drink.

*T/F Healthy animals can carry illness causing bacteria that can contaminate milk

True

*T/F Even dairy farms with very good safety practices can contain illness causing germs. And even if tests on a batch of a farm's raw milk come back negative, it is no guarantee that the next batch of milk will be free of harmful germs

True

Waterborne Illnesses

May be drinking water or recreational water

Which etiologic agent is the leading cause of outbreaks of diarrhea linked to water and the 3rd leading cause of diarrhea associated with animal contact in the U.S.

Cryptosporidium

Waterborne Illness: Giardia Risk factors

Drinking untreated water Childcare settings Exposure to someone with Giardia Travelers to countries with known giardia

Waterborne Illness: Giardia S/S

Diarrhea, gas, greasy stools that float, stomach cramping.

Giardia Diagnosis

3 stool samples collected on different days

What waterborne illness is this characteristic of? Diarrhea, gas, greasy stools that float, cramping.

Giardia

How do we treat Giardia?

Metronidazole/Flagyl

WHO key education with safe food handling

``` Keep clean Keep raw and cooked food separate Cook thoroughly Hold food at safe temperatures Use safe water and raw materials Do not cross-contaminate ```

Vectors

Transmitters Usually arthropods such as ticks and mosquitos Generally educate to limit risk of exposures and may eliminate certain vectors through measures such as spraying.

What is one way to educate about vectors in life?

Wear long sleeve shirts and pants mosquito netting

Malaria

A mosquito borne illness

S/S of malaria

``` Appear 10-15 days after exposure Fever HA Chills Illness can be severe leading to death ```

With malaria how long until symptoms begin to appear?

10-15 days

Who is at risk of malaria? Who is at higher risk?

1/2 of the worlds population Most deaths in sub-Saharan Africa Infants children, pregnant women, immunocompromised and children*****

Malaria prevention

Mosquito nets treated with insecticide could prevents deahts

West Nile Virus: Transmission

Via mosquito

The 4 D's of WEST NILE VIRUS***!!!!!

DEET Drain Water Dawn and Dusk Dress in long sleeves

The 4 D's: DEET, drain water, dawn & dusk and dress in long sleeves are associated with which vector associated illness?

West nile Virus

What is an example of a tick disease?

Rocky mountain spotted fever, lyme disease

How would we treat tick disease?

Treat the same as others and educate the same as others.

Will mosquitos and tick populations increase or decrease with climate change?

Will increase; projected a longer breeding season See an increase in malaria and denge Increase in mental health issues, more algae blooms

Zoonotics

Diseases which are spread from animals to humans

Zoonosis: Toxoplasmosis education

Cat litter; educate pregnant women

Examples of zoonotic illnesses

Brucellosis, Toxoplasmosis, leptospirosis, Rabies, hantavirus, chronic wasting disease

Zoonotic: Manifestation of Tularemia

Skin ulcer

Rabies

Virus that infects wildlife, esp bats, raccoons, skunks, and foxes in the US

How does rabies spread?

Spreads to people and pets when they are bitten or scratched causing FEVER, AGITATION AND DEATH.

T/F Rabies is 100% preventable with post exposure prophylaxis

True

T/F All three major groups of parasites depend on the host to survive

True

Parasites 3 major groups

Protozoa Helminths Extoparasites

How can we test for pinworms?

Scotch tape