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Public Health > Health protection > Flashcards

Health protection Flashcards

1
Q

Information needed to notify communicable disease

A

Severity: Morbidity, fatality, etc..

Transmissibility: Potential, route, sources, infectiousness

Contacts: Susceptibility/resistance among contacts, number, nature

Control measures: That would prevent transmission, availability/evidence

Special circumstances: e.g. age, pregnancy, occupation that increase risk of case

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2
Q

Definition of incubation period

A

Time between inoculation and becoming symptomatic

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3
Q

Latent period

A

Time between inoculation and becoming infectious

Caution if latent < incubation –> infective while asymptomatic

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4
Q

Infectious period

A

Time during which patient is capable of infecting others

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5
Q

Pathogenicity definition

A

Ability of organism to cause disease

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6
Q

Virulence definition

A

Severity of illness caused by organism

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7
Q

Interventions to reduce person-person transmission

A

Reduce infectiousness: Treatment, hygiene

Limit contact: Quarantine, isolation, advice

Reduce susceptibility of contacts: PPE, PEP, immunisation, Tracing/screening

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8
Q

Interventions to reduce indirect transmission

A

Source decontamination

Vector source control

Zoonotic animal cull/movement ban

Source shutdown (restaurant, factory)

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9
Q

Presentation of CO poisoning

A

Nausea, vomiting, confusion

Lethargy, flu-like symptoms

Headache, dizziness, syncope

Tachypnoea, metabolic acidosis, respiratory failure

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10
Q

Normal carboxyhaemoglobin concentration

A

1-3% in non-smokers

5-10% in smokers

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11
Q

Information to collect for suspected CO poisoning

A

New appliances?

CO alarm?

Who else at home? esp. pregnant, extremes of age, heart conditions

Any communal areas they have been in recently?

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12
Q

Actions to take for CO poisoning

A

100% O2 until asymptomatic and normal COHb levels

Contact local Health Protection Team

Advise not to use new appliances + contact HSE/Gase Emergency Helpline

F/U at 1-2months

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13
Q

Rationale for post-exposure chemoprophylaxis in meningococcal disease

A

Eradication of carriage of invasive meningococcal strain

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14
Q

At-risk period for secondary cases of meningococcal disease

A

7 days is highest risk period

Chemoprophylaxis should be given within 24h

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15
Q

Definition of close contact for antibiotic prophylaxis in meningococcal disease

A

Prolonged contact during preceiding 7d

Boy/girlfriend

Household contacts, shared dormitory, shared kitchen

Contact with large-droplet respiratory secretions within 24h (incl healthcare workers)

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16
Q

Vaccination guidance after meningococcal case

A

Close contacts: Vaccination unless serogroup-immunised within preceding 12mo OR MenB case

Give full recommended vaccination to case if not already immunised (don’t re-immunise)

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17
Q

Meningococcal cases requiring public health action

A

Clinical: Septicaemia, mengingitis, other invasive disease

AND

Lab: G-ve diplococci OR N. meningiditis organisms or DNA from sterile site

OR

evidence of bacterial infection and N. meningiditis likely source (PH/microbiologist advice)

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18
Q

Timings for measles symptoms

A

7-21d (typically 10-12d) incubation period

2-4d prodromal phase: fever, cough, conjunctivitis

7d maculopapular, nonitchy rash

19
Q

Infectious period for measles

A

4d before and after rash onset

Extremely infectious (respiratory droplets)

20
Q

Ideal samples for measles testing

A

Oral fluid is ideal sample

Mouth viral swab if not possible

Serum IgM/IgG to assess contact immunisations status

21
Q

Factors increasing risk/likelihood of measles

A

Recent international mass gathering

Epi link to confirmed measles case or visit to area with known circulation

Not fully immunised

Local community with low vaccination rate

Adolescents/young adults (fewer similar disease presentations)

22
Q

Individual info to be collected for notifying measles

A

Travel Hx - incl. GP/A&E visits

Vaccination Hx

Epi link to outbreaks

Ethnic/cultural background (Esp if low vacc community)

Signs, symptoms, lab results

23
Q

Which contacts should be traced following measles case?

A

Household contacts

>15min in closed, confined space (e.g. classroom)

Face-to-face contact of any length

24
Q

Priority groups for measles contact tracing?

A
  1. Immunocompromised
  2. Pregnant or infant <12mo
  3. Healthcare workers
  4. Healthy contacts
25
Q

Post-exposure treatment for measles contacts

A

MMR vaccination and serum IgG testing

Consider IgG for immunocompromised individuals

26
Q

Presentation of O157 E. Coli

A

Mild non-bloody diarrhoea

Bloody diarrhoea

HUS (ESP <5YO)

27
Q

Incubation period for O157 E. Coli

A

3-4 days

28
Q

Sources of O157 E. Coli

A

Faeco-oral transmission from infected animal excreta:

  • Water: drinking/vegetables
  • Meat: during slaughter, if not properly cooked; contact with other raw meat
  • Direct: E.g. farms, petting zoos
  • Human-human: esp in nurseries, primary schools due to prolonged contact, immature immune systems, poor personal hygiene
29
Q

Indications for faecal culture in acute diarrhoea (bloody or non-bloody)

A
  1. Vulnerable: <16y, >60y, pregnant, frail, immunocomp
  2. Recent travel abroad
  3. Bio plausible contact to O157/ part of outbreak
  4. Severe/protracted illness
30
Q

What to avoid in O157 management

A

Antibiotics - higher risk of HUS

Anti-motility, opioids, NSAIDs

31
Q

Active vs passive surveillance

A

Passive: Relies on routine data collection, cheap but incomplete coverage

Active: Surveillance team reaches out to labs/clinicians/patients to collect data e.g. during outbreaks

32
Q

Sentinel surveillance

A

Centres with high probability of seeing cases identify and notify the disease as routine to pick up trends

33
Q

Enhanced surveillance

A

Collection of additional info if disease suspected (e.g. TB routine info not enough)

34
Q

Definition of epidemic

A

Occurence of illness/health-behaviour in a population in excess of normal expectancy

Interchangeable with outbreak

Pandemic = global epidemic

35
Q

Case fatality definition

A

Proportion of cases that are fatal within a given time period

36
Q

Definition of cluster

A

Cases in a similar time/place where an epidemiological link is possible but unconfirmed

37
Q

Basic reproduction number

A

Average number of secondary cases from a single index case in a totally susceptible population

Affected by: Rate of contact, probability of transmission, duration of infectious period

38
Q

Effective reproduction number (R)

A

Average number of 2ry cases in a population with a mixture of susceptible/unsusceptible individuals

R= R0x where x is the fraction of the population that is susceptible

39
Q

Herd immunity threshold

A

Proportion of population that needs to beimmunised to make disease stable in population (i.e. R=1)

1- 1/R0

40
Q

Attack rate

A

Number of new cases/population at risk

within specified time

41
Q

Secondary attack rate

A

Number of cases among contacts/Number of contacts

Within one incubation period

42
Q

Point source epidemic curve

A

All cases appear within one incubation period

e.g. food poisoning at wedding

43
Q

Continuous source epidemic curve

A

Abrupt start within one incubation period

Continuous source = prolonged, high level of cases

44
Q

Propagated epidemic curve

A

Waves occuring within average incubation period - increasing until susceptible population falls or intervention measures succeed

Public Health (7 decks)

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