Public Issues (Unit 4) Flashcards
Historical Landmarks in Public Health
Quarantine
Sanitation
Immunization
Isolation of people with a disease or possible contact with a disease from healthy people (Was practiced in ancient times)
Quarantine
History of Quarantine
In the wake of one of history’s most devastating epidemics of bubonic plague, the Byzantine emperor Justinian enacts a law meant to hinder and isolate people arriving from plague-infested regions.
Black death of the 14th century:
Venice established the first formal system of quarantine, requiring ships to lay at anchor for 40 days before landing. (“Quarantine” comes from the Latin for forty.)
583
The Council of Lyons restricts lepers from freely associating with _______
1179
The Third Lateran Council decrees living arrangements for lepers and how their necessary _____ from society is to take place.
1200
Europe now has some 19,000 leprosaria, or houses for leper patients; France alone boasts roughly 2,000.
healthy persons
separation
Cholera epidemic of 1854-5
_____ proved cholera was spread through the town water pump.
The water was _______by an underground sewer near the well.
John Snow is called the father of epidemolgy.
John Snow
contaminated
Waste materials were _________ to be washed down the drains after a rain
Diseases such as ____ and ____ were common during these times
disposed of in alleyways
typhoid and cholera
IN 1738: With smallpox and yellow fever threatening to strike New York, the City Council sets up a….
quarantine anchorage off Bedloe’s Island (home of the Statue of Liberty today). The island becomes a quarantine station for contagious passengers and crew from arriving ships.
Plague Doctors
-tended to plague patients only
-Doctors early form of PPE long pointed beak mask probably containing herbs
-long coat and gloves which completely covered their body
-Carried stick to keep distance
Early attempts at sanitation was _______ to collect wastewater which emptied directly into a river or other body of water
drainage ditches
In 1979, smallpox has been officially _____ from the world (no place where smallpox exist)
eradicated
Immunization:
During 18th century _____ killed one in 10 children, _______ inoculated patients with cow pox and it prevented them from getting smallpox.
smallpox
Edward Jenner
It outlines ways of collectively working together in times of ________
health emergencies.
he public health system includes
Public health agencies at state and local levels
Healthcare providers
Public safety agencies
Human service and charity organizations
Education and youth development organizations
Recreation and arts-related organizations
Economic and philanthropic organizations
Environmental agencies and organizations
Role of Public Health:
Assessment-
Monitor health status to identify and solve community health problems
Diagnose and investigate health problems and health hazards in the community
Assurance-
Enforce laws and regulations that protect health and ensure safety
Link people to needed personal health services and assure the provision of health care when otherwise unavailable
Assure competent public and personal health care workforce
Evaluate effectiveness, accessibility, and quality of personal and population-based health services
Research for new insights and innovative solutions to health problems
Policy/ Development-
Inform, educate, and empower people about health issues
Mobilize community partnerships and action to identify and solve health problems
Develop policies and plans that support individual and community health efforts
It a code of conduct which can help
prevent and control health threats, and provide a public health response without interference from international trade and traffic.
__________ was issued in 1969, and revised in 2005
International Health Regulations
GOARN stands for
Global Outbreak Alert and Response Network
Dumping of Toxic Chemicals
In 2006, 500 tons was unloaded from a cargo ship and dumped a various sites in Cote d’ Ivoire, West Africa
8 deaths 69 admitted to hospital, with many more with health issues
Concern over contamination of water and food.
ChemiNet
Chemical Incident alert and Response System
WHO established it in 2002
Was setup to respond to environmental health events which might impact international health
Coordinates resources to respond to chemical incidents,
Also monitors for the release of chemicals, and assists in recovery.
what is GOARN?
Initiated by WHO in 2000
Was setup to ensure countries have rapid access to resources and experts.
Includes the collaboration of over 200 institutions from over 60 countries
The network coordinate the expertise and skills to respond to outbreaks of international importance.
Provides ongoing surveillance and monitoring for future outbreaks
Global Polio Eradication Initiative
The organization that is responsible for the surveillance of many vaccine-preventable diseases, and its goal is to eradicate Polio
Currently, only 2 countries, Afghanistan and Pakistan has on going cases of polio, 26 other countries experience outbreak due to importation from other countries
New Health risk in 21st Century
Bioterrorism
Anthrax Letters
In 2001, lethal anthrax spores were placed in letters in the U.S. mail
22 people were infected, 5 of them dies.
SARS
In 2003 first new severe disease reveled our vulnerability
It can spread person to person, with no vector
Incubates silently for more than a week,
Mimics symptoms of other diseases
Takes heavies toll on hospital staff and kills10% of those infected.
Can easily spread through air travel
Global Public Health security
Partnerships must exist amongst countries to achieve this.
All countries need to
implement the IHR (International Health Regulations),
Cooperate in the surveillance and outbreak alert and response
Openly share knowledge, technologies and materials
Increase training for public health personnel
- In the 21st century, describe why infectious diseases pose a greater threat to the global population.
-climate change
-increased global travel and urbanization (rapid spread across border)
-bioterrorism (anthrax)/inventions of other biochemical weapons
- What in the role of GOARN?
-coordinating international responses to disease outbreaks and public health emergencies
-facilities resources fast and experts in affected areas
-preventing spread across borders
- In history, there are 3 major landmarks in public health that is still very relevant today. Describe the impact of the following public health landmarks at their time in history and their importance to today’s public health.
-Quarantine (isolation of ppl with disease, reduced spread of COVID, at the time prevented epidemics such as plague, saved lives)
-Sanitation (snow created during cholera outbreak, clean water ad proper waste disposal preventing spread, and is used in healthcare all the time now)
-Immunization (reduced deadly disease almost eradicated stuff like polio and smallpox, still kids are given it save lives prevent illness)
example of Epidemic
Ex. AIDS in Africa or AIDS in intravenous drug users
- separation and restriction of movement who are not ill but who may have been exposed to infection, in order to prevent further transmission of disease.
Can involve close contact with ill person, such as family, social events, airplanes, health care workers.
If an entire community is quarantined, it is called cordon sanitaire
Quarantine
- Why is it crucial to have collaboration between donor and recipient countries?
-ensures that resources are allocated effectively and efficiently
-donor countries provide funding, expertise and tech while recipient countries offer local knowledge which promotes sustainability
- WHO established the ChemiNet in 2002. Why was it established?
-To enhance global cooperation and coordination in responding to chemical incidents and emergencies
-Chemical Incident alert and Response System
Coordinates resources to respond to chemical incidents,
Also monitors for the release of chemicals, and assists in recovery.
- Enforcing borders controls is not effective way to stop the spread of disease in today’s world. How can the spread of disease be prevented?
-promoting vaccines
-bettering global surveillance systems to detect outbreak
-educate on safety, washing hands
-investing in health programs and centres
a disease that occurs in a certain place or group of people
Polio in Afghanistan
Endemic
affects more than the expected number of cases of disease occurring in a community or region during a given period of time. A sudden severe outbreak within a region or a group.
Epidemic
refers to the sudden increase in the number of cases of a disease
outbreak
- contacting all people that was in contact with a person who has tested positive to ensure all precautions are taken to prevent the spread of the disease
Contact tracing
example of Pandemic
Ex. H1N1 COVID 19
Note: WHO- World Health Organization
ex of outbreak
Ex. Many residents in a nursing home getting sick with a flu virus.
ebola outbreak
Phases of an Pandemic
WHO has identified 6 phases of a pandemic, subdivided into 3 periods.
Inter pandemic Period- Phases 1 and 2
Pandemic Alert Period- Phases 3, 4 and 5
Pandemic Period- Phase 6
An epidemic (a sudden outbreak) that becomes very widespread and affects a whole region, a continent, or the world.
Pandemic
Ability of a virus to move from poultry to wild birds and back again, or to other species (humans, pigs)
Relay transmission
- separation and restriction of movement of people who are ill with an infectious disease.
Isolation
- maintaining a distance of 2m or 6ft between you and other people.
Social distancing
-Minor genetic changes in virus
-Reason why flu vaccines must be reformulated every year for the seasonal flu.
Antigenic drift
Interpandemic Period:
Phase 1-
Phase 2 -
Phase 1
Informs us no animal influenza virus is currently detected in humans.
If virus is present in animals, risk of human infection is low
Phase 2
No animal influenza detected in humans
A animal influenza virus is circulating and increases the risk of human infection
WHO goals and responses during Phases 1 and 2
Goal
Strengthen global, national and local preparedness
Minimize risk of transmission to humans
Responses
Improve farming practices
Enhance animal surveillance
Investigate suspect cases
Pandemic Alert:
Phase 3 -
A group or cluster of people is affected by a strain of influenza that is not caused by person to person transmission.
Goals and responses During Phases 3
Goal- to characterized new virus subtype and contain virus
Response
Consider culling and vaccinating animal source (kill all of them)
Isolating human infections
Use of antivirals
Pandemic Alert
Phase 4
Small clusters resulting in limited spread from person to person, causing local outbreaks in communities
Goals and responses during Phase 4
Goal- contain virus and delay spread
Response
Continue containment; restrict travel, quarantine, use of antiviral medications
Speed up vaccine development
Pandemic Alert:
Phase 5 -
Human to human spread(outbreaks) has occurred in at least two countries in one WHO region
Suggesting virus is better adapted to humans, but not fully transmissible
Goal and responses During Phases 5
Goal- contain and delay spread to avert pandemic and to gain time to implement pandemic measures
Response
Continue containment, antiviral medications
Restrict travel
Consider community containment if necessary
Pandemic period:
Phase 6 -
Considered the true “pandemic phase” with community level outbreaks in at least one other country in a different region that was originally noted in phase 5
Virus is widespread and containment measures is no longer effective
Pandemic starts to subside with decreasing number of cases and possibly good vaccine coverage
Goals and responses during Phase 6
Goal- to minimize impact of pandemic
Response
Continue containment, isolation and/or quarantine as needed
Continue to administer antiviral medications as per priority groups
Immunize when vaccines comes available
Actively monitor high- risks areas
Infection levels drop below peak levels and spread has slowed down
Post Pandemic Peak Period
WHO Action Plan During Post Peak Period
Plan and coordinate for resources for possible future waves
Continue surveillance to detect future waves
Continue to update the public
Evaluate the effectiveness of the measures taken
Rest, restock, and rebuild essential services
Infection levels drops to level normally seen for the regular seasonal influenza
Post Pandemic Period
WHO Action Plan During Post Pandemic Period
Review lessons learned and share experiences
Replenish resources
Evaluate all interventions implemented
Evaluate the response of the health system to the pandemic
Developed by the Pandemic Influenza Committee of the Public Health Agency of Canada
Canadian Pandemic Influenza Plan
The committed included experts in:
Infectious disease
Public health
Emergency response
Epidemiology
Laboratory diagnostics
goal of the plan
To minimize serious illness
To minimize number of deaths
To minimize societal disruption among Canadians
Plan details
Include disease surveillance
Public health measures
Vaccine development, production and use
Emergency response, health services
Strategies for using antiviral medications
Outlines roles and responsibilities of all levels of government
Possible priority list is under review because of ethical dilemmas it poses
Stockpiling medications (has come under criticism)
How you can help stop the spread of Influenza?
Handwashing
2 metre rule- stay 2 m away from people who are sick
Cover nose, mouth when sneezing
Wear masks within 2 m of sick people
Wear gloves if caring for sick people
Keep social interactions at a minimum
Follow community public health measures- don’t travel, or go to mall
If a deadly virus is discovered and starts to spread worldwide, what action to you expect your government to take to keep you protected?
-letting us know more quickly (inform)
-masks
-quarantine
-stop travels
What actions would you take if a deadly virus is identified in the GTA?
-stay at home
-wear mask
-social distancing
Should a health care worker be forced to work with patients who are infected with a deadly virus?
-shouldn’t be forced, up to them, but they may lose job, it is their job but should be given proper protection
What century did the Bubonic Plague (The Black Death) take place
Occurred in the 14th to the 17th century)
what outbreak Killed 25 million (wiped out 50% of Europe’s population)
Bubonic Plague (The Black Death)
Symptoms included vomiting blood, diarrhea, respiratory failure, headache, swollen lymph glands, red spots on skin which turned black(painful)
Bubonic Plague (The Black Death)
How was bubonic plague spread?
Was spread through bites from infected rodents, fleas, and lice.
Still cases of buboic plague reported today, which can be treated with antibiotics (T/F)
TRUE
when did Russian Flu Pandemic
occur
Occurred in 1889-90
What is Russian flu viral strain?
Viral strain- H2N2
Killed 1 million worldwide
Russian Flu Pandemic
Symptoms included fever, pneumonia, and traditional flu-like symptoms
Russian Flu Pandemic
Believed to have originated in ______, but spread rapidly through Europe the rest of the world
China
When did Spanish Flu Pandemic occur
Occurred in 1918-20
What is the viral strain of Spanish Flu?
Viral strain- H1N1
Killed 40 to 100 million worldwide (deadliest to young men between ages of 25-30)
Spanish Flu Pandemic
Killed more people than WWI.
Spanish Flu Pandemic
Originally misdiagnosed as cholera, dengue or typhoid
Spanish Flu Pandemic
Symptoms of what included bleeding from nose, ears, stomach or intestines
Spanish Flu Pandemic
Most deaths caused by ______ caused by the influenza
pneumonia
How did spanish flu spread?
Spread by person to person contact
Believed to have originated in _____, then towards Europe along trade/shipping routes and soldiers returning home from the war
Tibet
When did Asian Flu Pandemic occur
Occurred in 1957-8
What is the viral strain of Asian Flu pandemic
Viral strain- H2N2
Killed about 2 million(mainly elderly, children and pregnant women)
Asian Flu Pandemic
Symptoms included fatigue, aches and pains and fever that lasted for 2 weeks
Asian Flu Pandemic
How was Asian flu spread?
It was spread by person to person contact
First identified in _____, then detected in wild ducks in Southern China before mutating with the existing human flu strain
Far East
When did Hong Kong Influenza occur
Occurred in 1968-1969
What is the viral strain of Hong Kong Influenza
Viral strain- H3N2
Killed about 1 million worldwide (elderly was the hardest hit)
Hong Kong Influenza
Symptoms included high fever, joint pain, lack of energy, which worsen and lasted longer than the regular flu. Victims often bedridden for 2 weeks
Hong Kong Influenza
How was Hong Kong influenza spread?
It was spread by person to person contact(coughing sneezing)
False alarm pandemic
Fort Dix Novel Swine Influenza
‘Novel’ strain-one which humans have little or no immunity
Fort Dix Novel Swine Influenza
230 soldiers infected, 1 death
45 million vaccinated, some thought they overreacted
Fort Dix Novel Swine Influenza
First documented cases of human infection in Hong Chong recorded in 1997 and late case detected in Feb. 2017
Avian Flu(Bird Flu)
killed more than 60% of those who contracted the virus
Avian Flu(Bird Flu)
symptoms of avian flu
Symptoms are similar to the regular flu; cough, fever, muscle aches, sore throat
how was avian flu/bird flu spread
It is spread through contact with infected poultry or surfaces with secretions from infected birds. Person to person transmission is rare.
when did SARS(Severe Acute Respiratory Syndrome) occur
Occurred in 2002-3
A coronavirus
SARS(Severe Acute Respiratory Syndrome)
Killed almost 800 people worldwide, affected more than 30 countries
SARS(Severe Acute Respiratory Syndrome)
symptoms of SARS(Severe Acute Respiratory Syndrome)
Symptoms included high fever, headache, overall feeling of discomfort. Some experienced dry cough and respiratory symptoms. Most developed pneumonia
how was SARS spread
It was spread by person to person contact or contact with infected objects
when did H1N1(formerly called Swine Flu) occur
Occurred in 2009-10
Killed almost 18,000 people worldwide, affected over 214 countries
H1N1(formerly called Swine Flu)
Early cases of swine flu were reported in ____, which then spread to the rest of the world
Mexico
symptoms of H1N1
Symptoms are similar to the regular flu; cough, fever, muscle aches, sore throat, tiredness, headache
how was H1N1 spread?
It was spread by contact with an infected person, or touching infected objects and then touching mouth or nose
Began in 2019 in Wuhan China, currently active worldwide
Covid-19
name of COVID/varient
Novel coronavirus SARS-CoV-2
Genome of COVID 19 is made up of a single strain of ___
RNA
covid Has a more serious effect on ___ and people with underlying health issues
elderly
In Oct 2020, 41.3 million cases worldwide with 1.2 millions deaths. In Canada, 206,00 cases with 9800 deaths.
Covid-19
In May ____, WHO declared Covid -19 no longer a global emergency, but still a health threat
2023
symptoms of COVID
fever (feeling hot to the touch, a temperature of 37.8 degrees Celsius or higher)
chills
cough that’s new or worsening (continuous, more than usual)
barking cough, making a whistling noise when breathing (croup)
shortness of breath (out of breath, unable to breathe deeply)
sore throat
difficulty swallowing
runny, stuffy or congested nose (not related to seasonal allergies or other known causes or conditions)
lost sense of taste or smell
pink eye (conjunctivitis)
headache that’s unusual or long lasting
digestive issues (nausea/vomiting, diarrhea, stomach pain)
muscle aches
extreme tiredness that is unusual (fatigue, lack of energy)
falling down often
for young children and infants: sluggishness or lack of appetite
Do you think Ontario is prepared to deal with a epidemic/pandemic at this time?
What concerns do you have regarding to being exposed to a deadly pandemic?
What actions would you take to prevent you and your family from being exposed to the outbreak?
In the Fort Dix outbreak, there was criticism that government over reacted by the mass vaccination, when a pandemic didn’t occur. Agree or Disagree?
Threats to Public Health include
Infectious Diseases
Hight Threat Pathogens
Antimicrobial resistance
Vaccine Hesitancy
Chronic Diseases
Environmental Factors
Climate Change
____ is constantly monitoring the strains of influenza in circulation and recommends which strains should be included in the yearly flu vaccine
WHO
Social factors that promote rapid spread of infectious disease
Global population growth
International travel
Poor sanitation
Lack of clean drinking water
Lack of healthcare facilities
The potential of pathogens is very ____, but WHO’s research and development (R&D) is limited
large
WHO’s ________ Team identifies diseases and pathogens that have potential to cause a public health emergency but lack effective treatments and vaccines.
R&D Blueprint
COVID-19
Crimean-Congo haemorrhagic fever
Ebola virus disease and Marburg virus disease
Lassa fever
ARE ALL ________
At present (2019), the priority diseases are:
bacteria, parasites, viruses and fungi now has the ability to ____ antibiotics, antivirals and antimalarial medicines
resist
what threatens to send us back to a time when we were unable to easily treat infections such as pneumonia, tuberculosis, gonorrhoea, and salmonellosis.
Antimicrobial resistance
Refusal to vaccinate when vaccines are available
Vaccine Hesitancy
The inability to prevent infections could seriously compromise surgery and procedures such as ________.
chemotherapy
Over 85% are ______ income countries
lower-middle
Threatens to reverse process in preventing certain diseases
Vaccine Hesitancy
70% of deaths worldwide is caused by diabetes, cancer and heart disease which are all ________
Chronic Diseases
Primary cause of air pollution is ______
burning fossil fuels
5 major risk factors cause the diseases
Tobacco use
Physical inactivity
Harmful use of alcohol
Unhealthy diet
Air pollution
Ex. Higher rates of diabetes in the______ populations due to inaccessibility/ cost of food in remote areas
First Nations
________ damage respiratory and circulatory system, causing diseases such as cancer, stroke and heart and lung disease
Microscopic pollutants
Some health problems can be associated with access to ________
proper food
_______ is biggest environmental risk to health, 9 out of 10 people breathe polluted air every day
Air pollution
Today the public health system is overwhelmed due to various factors. Identify some of these factors and describe what you can to help lessen the strain on the system.
Infectious Diseases
Hight Threat Pathogens
Antimicrobial resistance
Vaccine Hesitancy
Chronic Diseases
Environmental Factors
Climate Change
TO HELP: take mandatory vaccines, stay at home when exposed to illness, follow regulations on what items can be brought into the country and drink safe water not contaminated
Public Health measures to Protect the Public
Legislation
COVID 19 Emergency Response Act (2020)
Quarantines
Stay home when exposed or sick with illness
Vaccinations
Mandatory to attend school
Water chlorination
Chlorine added to drinking water to kill bacteria
Regulations of what items can be brought into the country
Many plants and animals are prohibited due to potential to bring in diseases
______ Cause death from malnutrition, malaria, and heat stress
Climate Change
Mosquito borne disease, 20% lethal, growing threat for decades
Longer rainy season and spreading to less tropical countries (Napal)
40% of world population at risk
Dengue Fever
Read the Article ‘Malaria migration’ and describe how bed nets are reducing the spread of malaria.
-The nets, treated with long-lasting insect repellent, have proven to be the most effective way to prevent malaria.
-protect while asleep
Read the article ‘Diabetes increase’ and describe why this a public health concern.
