Prevention & Health Protection I

Question 1

What is an Infectious Agent?

Answer 1

Pathogens/microorganisms - invade the body, cause infection, and make you sick (bacteria, virus, fungi)

Question 2

What is a Reservoir?

Answer 2

• where the germ lives and grows
• can be on a person (in respiratory tract) or on equipment, environment, food

Question 3

What is the Portal of Exit?

Answer 3

• how the pathogen leaves its reservoir
• can be through sneezing, coughing, diarrhea etc,.

Question 4

How is an infection spread? (mode of transmission)

Answer 4

• the germ can spread by hands or equipment (ie, in air by coughing or contact w/ body fluids and blood)

Question 5

How does the pathogen infect someone new? (Portal of Entry)

Answer 5

• can be through eyes, mouth, hands, open wounds, tubes put into body (ie. catheter)

Question 6

What is a Susceptible Host?

Answer 6

People who are at higher risk of infection bc

1) they are unable to fight infection

3) people living congregate living centres
- elderly living in care homes

Question 7

How to break the link of infection?

Answer 7

• Breaking the link at any point in the chain stops the transmission

○ Infectious agent: immunization where possible, hand surface hygiene

○ Reservoir: hand and surface hygiene, water surveillance programs

○ Portal of exit: coughing/sneezing into a tissue (followed by hand hygiene), hand hygiene after using the washroom and before touching food/drink

○ Mode of transmission: hand hygiene, use single-use or dedicated devices, wearing a mask, staying home when sick, wearing gloves

○ Portal of entry: wearing gloves, covering cuts/wounds, wearing masks and goggles, practicing good feeding tube and catheter hygiene

○ Susceptible Host: hang hygiene, vaccination, mask wearing

Question 8

Pre-Colonial Perspectives of China and India

Answer 8

• reports of individual’s being inoculated using variolation in 1500’s
• could have began as early as 200 BCE

Question 9

Pre-Colonial Perspectives of Africa

Answer 9

• variolation was practiced before the 1700’s (Kenya, Ethiopia, Libya, Mali, Sudan)
• origins are difficult to determine due to impacts of colonialism

Question 10

Pre-Colonial Perspectives of West Asia and Middle East

Answer 10

• Physician: Abü Bakr Muhammed - 1st to identify measles and smallpox as 2 different diseases
• variolation was practiced w/in Ottoman Empire

Question 11

How was the 1st injectable vaccine developed?

Answer 11

• Dr.Edward Jenner
• inoculated an 8 yr old w/ pus from a patient w/ cowpox
  RESULTS:
• boy was only mildly sick
• no signs of illness

Question 12

What is Pus?

Answer 12

• fluid composed of dead white blood cells (immune cells), dead tissues, and dead pathogen
• Can help the body form an immune response

Question 13

History of Vaccines
(pretty sure i dont need to know this)

Answer 13

1) Sarah Nelmes (milkmaid) - infected w/ cowpox

2) James Phipps - inoculated w/ cowpox from Nelmes

3) Phipps - becomes ill w/ mild case of cowpox

4) Scabs are collected from smallpox patient

5) Phipps - inoculated w/ scabs of smallpox

6) Phipps - unaffected + protected from smallpox

Question 14

Examples of Vaccine Preventable Diseases

Answer 14

• Measles
• Mumps
• HPV
• Hep A
• Meningococcus
• Pertussis
• Diphtheria
• Rubella
• Tetanus
• Polio
• Hep B
• Pneumococcus
• Varicella (Chicken pox)
• Haemophilus Influenza B

Question 15

Provincial Government Vaccine Responsibilities

Answer 15

• Administration and delivery of health services
• Purchasing vaccines for publicly funded programs
• Design and maintenance of immunization registries, surveillance and monitoring, professional education, and engagement
• Setting immunization targets; planning, design, implementation, and evaluation of immunization programs

Question 16

Federal Government Vaccine Responsibilities

Answer 16

• Regulation of vaccines
• Bulk procurement (ownership) of publicly funded vaccines
• Vaccine safety monitoring
• Vaccine recommendations
• Vaccine coverage assessment
• Immunization awareness and promotion

Question 17

Role of a School Nurse

Answer 17

• type of public health nurse that works closely with, and in schools
• 1 significant role is the promotion of childhood immunizations.
• Immunizations are required in most jurisdictions for children to attend school or daycare. Known as: Immunization of School Pupils Act (ISPA) , in Ontario
• If a child is missing immunization, the PHN would communicate with the parents and liaise b/w the school and parents to support the health of the child.

Question 18

What is the process of vaccine administration?

Answer 18

• Before a vaccine can be administered in Canada, Health Canada will evaluate the vaccine to ensure it:
  a) prevents diseases;
  b) shows no safety concerns
• Once a vaccine is approved, the Public Health Agency of Canada will work w/ Health Canada to monitor safety and effectiveness
• The monitoring process requires collaboration from the public, vaccine industry, healthcare professionals, and public health authorities

Question 19

Why might people be vaccine hesitant?

Answer 19

• fear/anxiety
• misinformation
• health literacy barriers
• distrust of the medical system (ie. due to past experiences w/ medical system or government conspiracy theories
• NP’s say ‘vaccine hesitant’ instead of ‘anti-vaxxer’

Question 20

How do SDOH impact vaccine uptake?

Answer 20

SDOH’s important for vaccine uptake
1) Policy and Law
2) Data & Surveillance
3) Evaluation & Evidence Building
4) Partnerships & Collaboration
5) Community Engagement
6) Infrastructure & Capacity

• SDOH’s highlight where a resource limitation, or resource investment can impact the landscape in how likely vaccines are to be uptaken
• When working with certain populations (ppl who are underhoused, incarcerated), partnerships and collaboration is key

Question 21

Tips for Navigating Vaccine Hesitancy

Answer 21

• Validate the client’s concerns (BUT, do correct misinformation)
• Throughout the conversation, use a non-judgemental, calm tone and body language.
• Respect client autonomy.
• Reflect on why individual may be hesitant and empathize.
• Be honest about the risks and benefits.
• Be open to answering any questions.
• Understand that you won’t be able to win them all; if we can’t get them on board with prevention, try to do harm reduction
  ○ Ex. of Harm Reduction - remind clients when to stay home when sick, to wear masks, practice good hygiene
• Always end conversation reminding client that they can seek resources from the public health unit/medical clinic
  ○ this improves communication and reinforces trust and collaboration

Question 22

Why do higher-income countries (Canada/US) not see a high disease burden compared to burden of causes (CV/Stroke) lower-income countries?

Answer 22

• Neocolonialism and political tensions that arise lead to weakened public infrastructure and resource distribution networks
• Racism
• Unequitable resource distribution

Question 23

____________________ is 1 of the greatest burdens of disease in _______________ countries.

Answer 23

Infectious disease, low-income

Question 24

How to we achieve global health equity?

Answer 24

• we must address the needs of most marginalized (to empower us all)
• approach interventions with collaborative, culturally mindful, and emancipatory mentality
  ○ nurses serve as knowledgeable agents, sharing knowledge to the community to self-determine how it applies to them, and supporting community decision, needs, & goals

Question 25

Examples of Interventions to Achieve Gloval Health Equity

Answer 25

• Vaccine re-distribution banks
• Culturally congruent health promotion campaigns
• Investment in water and waste management infrastructure
• Investment in education and training