Intro & Emergency Preparedness Flashcards
What are the 2 main components of public health?
- Disease prevention through surveillance and healthy behaviors
- Deals with populations of people, not individuals
What is a comprehensive science with broad spectrum coverage and many definitions?
Public health
According to the American Public Health Association, what 2 things is public health?
- Prevention
2. Policy development and population health surveillance
Who analyzes the effect on health of genetics, personal choice, and the environment in order to develop programs that protect the health of your family and community?
Public health professionals
What is the science of protecting and improving the health of communities through education, promotion of healthy lifestyles, and research for disease and injury prevention?
Public health
What are the 2 ways the US public health system is distinct from other parts of the health care system?
- Primary emphasis is preventing disease and disability
2. Focuses on population rather than individual health
How many pillars is the foundation of public health based on and how many categories is it categorized into?
6 pillars, 3 categories
Which category of public health emphasis the tools and science of public health, including epidemiology and statistics?
A
Category B of public health focuses on health science research and investigation…what 2 components fall within this category?
- Biomedical sciences
2. Environmental health sciences
What is the emphasis of category C of public health?
- Social and medical care system
1. Social and behavioral science
2. Health care administration, medical care system
What are the core areas that compose public health?
- Infectious diseases*
- Environmental health*
- Biostatistics*
- Behavioral science/Health Education
- Epidemiology*
- Health Services Administration/Management
- Maternal and Child Health
- Nutrition
- International/Global Health
- Public Health Policy*
- Public Health Practice/Laboratory Practice
What did the Chinese develop around 1000BC that involved inhaling dried crusts from smallpox lesions?
Variolation (first example of immunization)
What did Edward Jenner develop in the 1820s and what did it protect against?
The cowpox vaccine to protect against smallpox
What 2 aspects of public health were demonstrated in the black death in Europe that occurred in the 14th century?
- Quaratine
- Destroying source of infection (burning the cities destroyed rodent infestations)
What did John Snow do in London that was another early example of public health?
He identified the source of the cholera epidemic in London as being from a contaminated water well
In the 20th century, where did the focus of public health shift to?
Chronic diseases
What are 2 chronic diseases that receive a lot of focus from a public health perspective?
- Cancer: Smoking/Lung CA
2. Heart Disease: Diabetes/Obesity
In developing countries, where is the focus of public health?
Infectious diseases (Malaria, TB, Cholera in Haiti)
What “new” infections have returned to the US that are receiving attention in public health?
AIDS (1980s), SARS, H!N!, MRSA, Salmonella, Listeriosis
What
- Contains recommendations to reduce vulnerability
- Partners with local/state health departments, medical and public health professionals, federal agencies
The 2000 CDC developed strategic plan to address the threat of biological or chemical terrorist attack
What are 5 recommendations to reduce vulnerability?
- Preparedness planning
- Detection and surveillance
- Laboratory analysis
- Emergency response
- Communication systems
What are the 4 levels addressed by emergency preparedness plans?
- National
- State
- Local
- Tribal
What 2 places can current emergency preparedness plans be found?
- Department of homeland security: National response framework (FEMA guide to all-hazards response)
- CDC
What are the CDC’s 5 key focus areas for emergency preparedness?
- Preparedness and prevention
- Detection and surveillance
- Diagnosis and characterization of biological and chemical agents
- Response
- Communication
What key focus area focuses on developing public health guidelines, support, and technical assistance, including self-assessment tools?
Preparedness and prevention
Which key focus area deals with integrated surveillance for reporting of illnesses from biological and chemical terrorism utilizing ERs, medical personnel, and poison control centers?
Detection and surveillance
What was created to help with diagnosis and characterization of agents that has the capability of testing for biowarfare agens and a rapid-response and advanced technology laboratory that provides 24-7 diagnostic confirmation and reference support?
Multilevel laboratory response network for bioterrorism (LRNB)
How many levels are in the multilevel laboratory response network for bioterrorism and what do they do?
4 levels that link clinical labs to public health agencies
Which level of the laboratory response network contains public health and hospital labs with low-level biosafety?
Level A: Early detection
Which level of the laboratory response network includes state and local public health labs and serves for agent isolation and presumptive testins?
Level B
What types of labs are included in level C laboratory response network for advanced and rapid detection?
State/federal labs and academic research labs
advanced testing- RFLP
Level D of the laboratory response network is the highest level of containment with specialized federal labs, what biosafety levels are associated?
3 and 4
What key focus area involves epidemiologic investigation, medical treatment, prophylaxis, and initiation of prevention or environmental decontamination?
Repsonse
What involves
- Rapid notification and information exchange
- Dissemination of diagnostic results and information
- Coordination of emergency response activities?
State of the art communication system that will support disease surveillance
How many more times toxic is sarin than cyanide?
500
What are the initial symptoms of sarin poisoning?
Runny nose, dyspnea, constricted pupils
What is the progression of sarin poisoning?
- Difficulty breathing, nausea, drooling
- Loss of bodily functions, coma, respiratory paralysis
- DEATH
What type of terrorist attack was the sarin gas attack in Tokyo?
Overt
What type of terrorist attack is
- A quick effect of terrorism
- Has more plans in place due to more concern historically
- Elicit immediate response from police, fire, EMS personnel?
Overt
What are 2 types of attacks that are a quick effect of terrorism?
- Bombings
2. Chemical attacks: Agents absorbed via skin or inhalation with immediate/obvious symptoms
What were the 2 given examples of covert terrorist attacks?
- Rajneeshee bioterror attack (salmonella in salad bar)
2. Anthrax to US Senate offices
What is a covert attack?
There is a delay between exposure and onset of illness….Incubation with no immediate threat
Who identifies victims of a covert attack?
Physicians or other primary health-care providers
What is another exmaple of a covert attack?
When smallpox released, patients don’t present until 2nd week with flu-like symptoms, then develop rash and death
What type of attach has a short window of time between the first cases and second wave?
Covert
What 3 things do public health individuals need to do if a covert attack is suspected?
- Determine if attack occurred
- Identify organisms
- Prevention strategies
What enhances bioterrorism-related education and training for health-care professionals?
Communication programs to deliver information
What 4 things can be done to enhance epidemiological capacity to detect and respond to biological attacks?
- Support development of diagnostic tests
- Establish surveillance for microbial strains
- Supply reagents to public health agencies
- Encourage research on antiviral drugs and vaccines (stockpile appropriate ones)
How many categories are bio-warfare agents classified into?
3
What biowarfare agents
- Are easily disseminated or transmitted between people
- Have high mortality rates, potential for major public health impact
- Might cause public panic and social disruption
- Require special action for public health preparedness?
Category A: High priority agents
What are the 2 features of category C bio-warfare agents?
- Have availability, are easily produced and disseminated
2. Have POTENTIAL for high morbidity and mortality rates
What category of bio-warfare agents
- Are moderately easy to disseminate
- Have moderate morbidity and low mortality rates
- Require enhancements of CDC’s diagnostic capacity
Category B
How are all category A agents transmitted?
Respiratory or blood
What are 6 examples of category A agents?
- Anthrax (Bacillus anthracis)
- Botulism (Clostridium botulinum toxin)
- Plague (Yersinia pestis)
- Smallpox (variola major)
- Tularemia (Francisella tularensis)
- Viral hemorrhagic fevers
Filoviruses [e.g., Ebola, Marburg]
Arenaviruses [e.g., Lassa, Machupo])
What category of agents are the following diseases?
1. Brucellosis (Brucella species)
2. Epsilon toxin of Clostridium perfringens
3. Food threats (e.g., Salmonella, EHEC, Shigella)
4. Glanders (Burkholderia mallei)
5. Melioidosis (Burkholderia pseudomallei)
6. Psittacosis (Chlamydia psittaci)
7. Q fever (Coxiella burnetii)
8. Staphylococcal enterotoxin B
. 9Typhus fever (Rickettsia prowazekii)
10. Viral encephalitis (VEE, EEE, WEE)
11. Water threats (e.g., Vibrio cholerae, Crypto)
Category B
What encompasses category C agents?
Emerging Infectious Diseases
- Nipah virus
- Hantavirus
- Tick-borne hemorrhagic fever viruses
- Tick-borne encephalitis viruses
- Yellow fever
- Multidrug-resistant TB
Who can help enhance awareness of chemical terrorism?
EMS, police, firefighters, physicians, nurses
What is important to supply for the public during and after a chemical attack?
Educational materials
What 3 things can be done to help detect and prevent chemical attacks?
- Develop and provide bioassays for detection and diagnosis
- Enhance epidemiologic capacity for detecting and responding
- Stockpile chemical antidotes
Types of Chemical Agents?
- Nerve agents
- Blood agents
- Blister agents
- Heavy metals
- Volatile toxins
- Pulmonary agents
- Dioxins, furans, PCBs
- Explosive nitro compounds
- Flammable liquid and gas
- Poison gas, liquid, solid
- Corrosives
Sarin, soman, VX?
Nerve agents
Blood agents?
Hydrogen cyanide
Arsenic, lead, mercury?
Heavy metals
Volatile toxins?
Benzene, chloroform
Pulmonary agents?
Chloride, vinyl chloride
Ammonion nitrate?
Explosive nitro compounds
Gasoline, propane?
Flammable liquid and gas
Poison gas, liquid, solid?
Cyanides, nitrites
Corrosives?
Nitric acid, sulfuric acid
