Epidemics, Pandemics and the Protection of the Public (17) Flashcards

1
Q

Types of transmission

A

Direct, Indirect or Airborne

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2
Q

Direct

A

Direct - STIs, Scabies

Feacal-Oral - Viral GE

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3
Q

Indirect

A

Vector-borne - Malaria, Dengue

Vehicle-borne - Viral GE, Hep B

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4
Q

Airborne

A

Respiratory - TB, Legionella

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5
Q

Epidemic

A

Serious outbreak in a single community, population or region

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6
Q

Pandemic

A

Epidemic spreading around the world affecting hundreds of thousands of people, across many countries

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7
Q

Nasty diseases

A

Acute encephalitis, Leptospirosis, Ophthalmia neonatorum, Relapsing fever, Scarlet fever, Viral hepatitis

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8
Q

Vaccine preventable diseases

A

Acute poliomyelitis, Diphtheria, Measles, Meningitis and Meningococcal septicaemia, Mumps, Rubella, Tetanus, Whooping cough

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9
Q

Infectious diseases that can be controlled

A

Food poisoning, TB, Viral hepatitis

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10
Q

If you suspect a notifiable disease..

A

notify Public Health England asap

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11
Q

Influenza B

A

Sporadic outbreaks, children, prone to mutation, human virus

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12
Q

Influenza C

A

Mild symptoms, stable human virus

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13
Q

Influenza A

A
  • Can infect pigs, cats, horses, birds and sea mammals
  • Very prone to mutation (no proof reading mechanism)
  • Antigenic drift - flexibility causes seasonal epidemics
  • Segmented into 8 genes
  • Genes swapping occurs during co-infection with human and avian flu virus > antigenic shift
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14
Q

Haemagglutinin

A

Virus binding and entry to cells, 15 subtypes, immunity confers protection but only to specific subtype

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15
Q

Neuraminidase

A

Release of newly formed viruses from infected cells, 9 subtypes, immunity to subtype reduces amount of virus released from cells resulting in less severe disease

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16
Q

All 15N and 9N subtypes have been detected in

A

birds

17
Q

Seasonal Influenza

A

Every year ‘flu jab’

18
Q

Avian Influenza

A

Disease of birds H5N1, H7

mild disease in birds - ruffled feathers and depression

19
Q

Swine Flu

A

Disease of pigs

20
Q

Pandemic Influenza

A

Change/mutation in a flu virus to produce a new virus that can be transmitted easily between humans

21
Q

Pandemic flu will cause

A
  • High morbidity
  • Excess mortality
  • Social disruption
  • Economic disruption
22
Q

20th century pandemics influenza

A

1918 Spanish flu
1957 Asian flu
1968 Hong Kong flu

23
Q

What to expect from Pandemic Flu?

A
  • Incubation 1-4 days
  • Infectious from onset of symptoms - 5 days after
  • 10% infectious before symptom onset
  • Take 4-6 months before vaccine available
24
Q

Most seasonal influenza get..

A

Secondary bacterial pneumonia

25
Q

H5N1 causes

A

A primary viral pneumonia

26
Q

Controlling Avian Flu

A
  • Cull affected birds
  • Biosecurity and quarantine
  • Disinfecting farms
  • Control poultry movement
  • Vaccine workers
  • Antivirals for poultry workers
  • Personal Protective Equipment (PPE)
  • Reduce change of co-infection
27
Q

H1N1 is

A

Swine Flu

28
Q

Swine Flu

A
  • Human to human transmission
  • Sensitive to Oseltamivir and Zanamivir
  • Seasonal influenza vaccine not effective
  • People over 40 have some immunity
  • 474 deaths in UK
29
Q

Staff issues

A
  • Anxiety (unwilling to work)
  • Adequate protection
  • Access to antivirals
  • Risk to family
  • Child care
  • Segregation of staff
  • Redeployment of staff
  • Recycling of staff
  • Organisations sharing staff
30
Q

Vaccines

A
  • 6-10 months to develop
  • Limited availability - who first?
  • Two doses required for at risk groups
31
Q

Consequences of Measles

A

Measles encephalitis, thrombocytopenia, subacute sclerosing pan-encephalitis, death

32
Q

1 child with measles will infect … others

A

15

33
Q

MMR vaccine

A

12-13months and 3.5 years, single dose offers 95% protection, two doses >99%

34
Q

Wakefield Controversy (1998)

A

8/12 parents linked onset of behavioural problems with MMR, but parents were less clear about timing of abode symptoms (MMR linked to Autism)

35
Q

Issues with Wakefield Controversy

A

Bowel and behavioural pathologies may have occurred by chance, selection bias or lack of biological basis