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Block 9 Health and society lectures > Week 2 - Control Of Communicabke Disease Control - HS > Flashcards

Week 2 - Control Of Communicabke Disease Control - HS Flashcards

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Sociology 101 flashcards
1
Q

Why is infectious disease Important?

A
  • it’s a global burden
  • UK priorities :
    Health care associated infections - impact on health service delivery
    Antibiotic resistance
    New and emerging infections
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2
Q

Chain of infection

A

Infectious agent -> Host > portal of entry -> mode of transmission -> reservoir/environment

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3
Q

BInfectious agent/ pathogen has to be …

A
  • ability to reproduce
  • survival (incl environment )
  • Ability to spread
  • infectivity ( ability to cause infection also consider colonisation without infection )
  • pathogenicity (severity of the illness
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4
Q

Reservoir/environment has to be …

A
  • exposures - don’t forget relationship as a host issue
  • animals as reservoirs
  • other humans
  • water systems
  • environmental contamination
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5
Q

What kinds of modes of transmission are available?

A

1- respiratory spread
: droplet (3 feet)
: airborne(suspended particles)
: plus aerosolisation of water

2- ingestion 
  : direct consumption 
  : hand to mouth 
  : contamination from people (person to person spread) 
  : contamination from environment 
3- blood borne

4- sexual contact

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6
Q

The different portal of entries

A
  • mouth
  • nose
  • ear
  • genital tract
  • skin ( breakdown of barrier )
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7
Q

What host factors make them suspectible to infection from organisms ?

A
  • chronic illness
  • nutrition
  • age (the very young and the very old )
  • immunity (immune conditions ; chemotherapy; transplant etc)
  • lifestyle factors ( drugs, alcohol, sex , occupation , poverty, leisure activities )
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8
Q

Example of an outbreak of an Infectious disease

A

Measles outbreak in a prison

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9
Q

How did measles outbreak occur

A

: infectious agent (IA)
- measles is highly infectious (15 mins in the same room )
:Reservoir/environment (E)
- humans only ; crowded enclosed institution , lack of isolation facilities , the dinner queue
: mode of transmission (MOT)
- droplet spread , cough , sneezes
: portal of entry (POE)
- respiratory tract
: host (H)
- young adults most UK born but some non UK born , chaotic lifestyles not sure if immunised with MMR at birth ( no health records available)

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10
Q

How did it get controlled ?

A

Mass vaccination

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11
Q

Difficulties faces in controlling measles outbreak

A
  • long incubation period
  • consent
  • identification of new cases
  • isolation of cases
  • vaccination ( who pays and who does it in this setting )
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12
Q

Legionnaires disease outbreak in Stoke

A

:IA
- legionella
: E
- survives in amoebic sludge in water systems and can grow at certain temps
: MOT
- droplet or aerosois (showers, sprays, fountains, car washes , air conditioning , hot tubs etc )
: POE
- respiratory
: Host
- generally older people are vulnerable to infection with pre existing respiratory conditions

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13
Q

Food poisoning outbreak - E.coli in Germany

A 
\:IA
- E.Coli (usually O157) VTEC is ....
- high mortality and morbidity , haemolytic Uralemic syndrome 
\: E
- cattle guts, other animal reservoirs, soil survival 
\: MOT 
- ingestion ,person to person spread 
\: POE
- GI tract 
\:H
- babies and young children aged 5
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14
Q

Gonorrhoea outbreak in England

A 
\:IA
- gonorrhoea 
- high level antibiotic resistance - risk of untreatable infections 
\: E
- humans 
\: MOT 
- sexual contact 
\:POE
-genital  tract , pharynx 
\:H
- lifestyle risks , unprotected sex , number of patients , high risk MSN cohorts
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15
Q

Surveillance

A

Systemic collection, collation and analysis of data and dissemination of the results so that appropriate control measure can be taken

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16
Q

Measles outbreak

A
  • NOIDS (notice of intent to deny)
  • lab testing
  • public health , follow up all contacts

Problems : rashes look very similar not everyone notifies , lab test is not routinely available, lab test takes Time to come back - issue in example of offenders not wanting to disclose illness .

17
Q

Legionnaires outbreak

A
  • lab test
  • NOID
  • enhanced surveillance questionnaire
  • monitoring

Problems - presenting illness may be easily diagnosed as something else , test may not be done , test is not that great , need to confirm at a reference lab , clinical may not remember to notify , ESQ relies on recall ( recall bias ) , diffcult to complete.

18
Q

Food poisoning outbreak

A
  • NOIDS
  • lab tests
  • food complaints
  • syndromic survelliance
  • investigation if exceedances
  • enhanced survelliance questionnaires
  • outbreak specific questionnaires

Problems : mild cases don’t present, doctors don’t test. Recall bias for food eaten in the past , ingredients hard to identify , food distribution in the modern world is complex

19
Q

Gonorrhoea outbreak

A
  • GUM reporting (quarterly only at best)
  • relies on GUM notifying increases
  • lab tests to confirm organism and antibiotic resistance
  • reference lab to confirm
  • whole genome sequencing
  • enhanced survelliance

Problems : late identification , chaos of life , non attendance , non disclosure of partners , partners not being tested , sexual health promotion and target audiences , behaviour change diffcult

20
Q

Healthcare associated infections

A
  • Norovirus (viral gastroenteritis ) , Burden on hospitals
  • Carbapenemase producing organisms (CPO) - antibiotic resistance
  • MERs -CoV - novel or emerging infections ; hospital as the point of amplification
21
Q

Carbapenemase producing organisms (CPO)

A

Carbapenems are a powerful group of broad spectrum beta lactams antibiotics . Last effective defence against infections caused by multi resistant bacteria, such as some Strains of klebsiella pneumoniae and escherichia coli

Resistance to CPO had emerged and beginning to spread . New antibiotics needed to counter bacteria with this resistance and hospitals need good infection control to prevent their spread.

22
Q

Control of HCAI

A
  • hospital environmental hygiene ( incl isolation of cases )
  • hand hygiene
  • use of personal protective equipment (PPE)
  • safe use and disposal of sharps and
  • principles of asepsis

Block 9 Health and society lectures (11 decks)

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