Health Protection Flashcards
what is public health?
it is the science and art of promoting and protecting the health and wellbeing, preventing ill health and prolonging life through the organised efforts of society
what approach is the public health approach?
population based
what are the three domains of public health?
health improvement, health protection and healthcare public health
what comprises health improvement?
housing, employment, inequalities, education, family, community, lifestyles and surveillance and monitoring of specific diseases and risk factors
what comprises health protection?
outbreaks, emergency response, environmental health hazards, chemicals and poison, radiation and infectious disease
what comprises healthcare public health?
service planning, clinical effectiveness and efficiency, audit and evaluation, equity and clinical governance
what measures are in health protection?
interventions to reduce infections such as exclusion, screening and immunisation, advice, guidance and communication about risk, outbreak control and coordination
who carries health protection measures out?
PHE in UK or CDC in USA
what is PHE?
public health england was established in 2013 and has 8 offices outside of london and health protection team within these as well a local centre directors who are part of local healthcare system. It was set up with the mission to protect and improve the nations health and to address inequality, working with the national and local government, NHS, industry, academia and voluntary, public and community sectors.
what are healthcare protection teams?
they are based within PHE centres and provide specialist support to prevent and reduce the impact of infectious disease, chemical and radiation hazards and major emergencies
what are activities of HPTs?
local disease surveillance, maintaining alert systems, investigating and managing health protection incidents and outbreaks, delivering and monitoring national action plans for infectious diseases at local level, response to chemical and environmental hazards, and food and water and environmental labs
what classifies as acute responses?
response to individual cases and outbreaks and chemical incidents
what are notifiable infections?
they are the infections where there is legal responsibility to inform health protections teams - infection risk to public
what are some examples of notifiable disease?
encephalitis, anthrax, botulism, cholera, malaria, MMR, tetanus, scarlet fever, rabies, whooping cough, TB, yellow fever
what are three components of surveillance process?
surveillance, outbreak detection and epidemiological analysis on time person and place
what are the characteristic of whooping cough?
B pertussis is an exclusively human pathogen that is transmitted through close direct contact. The clinical presentation varies with age although those young unimmunised children will have more severe and older immunised have atypical mild infection. There are continual outbreaks, where vaccination is most effective way to prevent severe infection.
what is the pertussis vaccination?
the primary course is three doses of a pertussis containing product with an interval of one month between each dose given to the infant
what types of infection have airborne communication?
respiratory infections
direct - fecal oral
direct contact - STIs
what are public health measure to control factors?
clean water and sanitation awareness and health promotion access to healthcare vaccination diagnostics
what is vaccination for?
it is to reduce mortality and morbidity of vaccine preventable infections using vaccination strategy adapted to the epidemiology
what is the strategic im?
selective protection for the vulnerable
elimination using herd immunity
eradication
what is programmatic aim?
prevent: deaths infections transmissions clinical cases cases in certain age groups
what is reported annually in foodborne outbreaks?
trends and sources of zoonoses
zoonotic agents
antimicrobial resistance
foodborne outbreaks
what are food pathogens commonly associated with and what pathogens do these present with?
raw mean/poultry/eggs - salmonella or campylobacters
burgers or mince - e coli
rice - bacillus cereus
gravy or stews - clostridium perfringens
meat - staphylococcus aureus
soft cheese - listeria
how can fooborne pathogens work??
organism is ingested, invades and multiples a) in the intestinal lining or b)produces a toxin whilst in the intestinal tract
what are the most common symptoms of GI illness?
vomiting, abdo cramps and diarrhoea
how can infected persons be a source?
the pathogens are excreted in faeces - fecal oral route
what are symptoms of TB?
cough, fever, night sweats, weight loss, haemoptysis, fatigue
what is TB?
it is a bacterial infection caused by mycobacterium tuberculosis - typically affects the lungs but can be extrapulmonary - air droplet transmission over 8 hours
what are the two types of TB tests?
active TB test and latent TB test
what comprises an active TB test?
CXR, imaging, sputum smear microscopy, culture and rapid molecular tests
what comprises latent tests for TB?
screening, tuberculin skin test interferon gamma release assays
what is the purpose of screening?
look for potential source, find other active and latent cases and treat
what is needed when planning a outbreak control measure?
the infectious agent, the hosts, those exposed to the infectious agent, the mode of transmission, the symptoms and diagnostic tests, the incubation period and the infectious/communicable period, the virulence, the susceptibility, the transmission potential or reproductive number, the consequence and the known vaccines or treatmetns
what are hosts?
they are the people who carry the infection
why is the mode of transmission important to know?
so that you can break the cycle
why is it important to know the symptoms and diagnostic tests?
so that you can identify and confirm or rule out potential cases
what is the incubation period and why is it important to know this?
it is how long it takes for symptoms to occur after the exposure - can work out how long to monitor the suspected cases for
what is the infectious/communicable period and why do we need to know this?
it is the period of time which infection can be transferred in - work out the potential contacts at risk of exposure
what is the virulence and why is this of importance?
it is the ability to infect the host and how easy it is to transmit - this allows for an estimate of the likely spread
what is the susceptbility?
it is the vulnerability of the population and whether they have an natural or acquired immunity
why is the consequence important?
allows us to know the severity and therefore can plan the healthcare demand
why is it useful to know the known vaccines or treatments?
can prepare health care services
what is the reproduction number or transmission potential divided into?
the basic and the effective reproduction number
what is the basic reproductive number?
it is the expected number of secondary cases that are directly generated by a case
what is the effective reproductive number?
it is the same as the basic but takes into account the susceptibility in the population at risk
what is the mode of Covid-19?
it is mainly droplet infection - either direct from breathing in droplets from an infected person coughing or sneezing or indirect from touching something that the droplets have landed on and then touching eyes, nose or mouth for entry
how are coronaviruses spread in general?
from close sustained contact usually 15 minutes or longer within 2 metres of the infected person
what are the symptoms of Covid-19?
they are flu like making it hard to identify without a lab swab which is around 48 hours to do
what is the infectious and incubation period of Covid -19?
incubation is 14 days
infectious is unknown but can be infectious before get symptoms and after they have gone so are unaware of passing it on
is there susceptibility to covid-19?
very susceptible as new virus so no natural immunity
what is the reproduction number?
around 2-3
what is the consequence?
around 2% die - infects those immunocompromised or with high viral load such as in healthcare workers
what are the prevention measures of outbreaks in the UK?
self isolation, quarantine and lockdown, closing borders and case identification at borders, infection control measures
what is the risk of closing borders?
economical, citizens stranded, family and work commitments
what are the risks of identification of cases at the borders?
workers required, what to do with those who are infection, false reassurance if no symptoms, index of suspicion
how are infection control measures put in?
enforced or advice, there is the possibility of panic
what are the risks of self isolation and quarantine?
self isolation - how to monitor and enforces, compliance if no sick pay etc
quarantine - where and how to transport those who are, how many and for how long
what is containment?
it is isolation of cases - impact on services, contact tracing and quarantine of those exposed, shutting down key services, schools and gatherings
what are the issues of containment?
LT - depression and loneliness
