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AC1 (Izzy) > Week 4: communicable diseases > Flashcards

Week 4: communicable diseases Flashcards

1
Q

What is surveillance in communicable disease?

A

Surveillance = the ongoing systematic collection, collation, analysis and interpretation of data + dissemination of information ( to those that need it) in order that action may be taken.

Surveillance = information for action.

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2
Q

What 3 things are surveillance used for?

A
  • Provide warning ahead of an outbreak & monitor changes in the incidence of specific diseases
  • Allows monitoring of trends of particular diseases to allow planning
  • allows monitoring of the effectiveness of control measures
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3
Q

What surveillance systems exist?

A

1) notifications of infectious diseases –> lab notifications and other disease specific systems
2) primary care surveillance systems –> remote health advice (111), GP in and out of hours, RCGP (royal college of general practitioners) consultations, COVER (immunisation data)
3) secondary care surveillance systems –> ED syndromic surveillance

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4
Q

What are the notifiable diseases?

A

Make Acute Infections Be Taken Down Really Soon Lets YEET With Venom

Make –> Malaria, mumps, measles, meningococcal septicaemia

Acute –> Acute encephalitis/ meningitis/ poliomyelitis/ infectious hepatitis

Infections –> infectious bloody diarrhoea, invasive group A streptococcal disease

Be –> Botulism, brucellosis

Taken –> tetanus, tuberculosis, typhus

Down –> diptheria

Really –> Rabies, Rubella

Soon –> SARS, scarlet fever, small pox

Lets –> Leprosy, legionnaries

YEet –> Yellow fever, Enteric fever

With–> whooping cough

Venom –> Viral haemorrhagic fever

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5
Q

What are the agencies involved in communicable diseases?

A
  • Public health england
  • NHS england
  • CCG (clinical commisioning groups)
  • Primary care/ Community provider trusts
  • Acute hospital trusts
  • Local authorities
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6
Q

What is the role of PHE in communicable disease?

A

PHE has a statutory responsibility to take notifications of infectious disease and manage outbreaks/chemical or environmental incidents.

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7
Q

What is the role of NHS england in communicable disease?

A

NHS England –> should lead and coordinate the NHS response to large/ significant outbreaks

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8
Q

What is the role of clinical commisioning groups in communicable disease?

A
  • Support the role of NHS England and work with larger outbreaks/ commision community and acute trust providers to support smaller outbreak responses
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9
Q

What is the role of primary care/ community provider trusts in communicable disease?

A

To support outbreak investigation and management through taking samples (nasal/throat swabs/ blood sample/ stool sample etc), and organising treatment and prophylaxis (latter being either medication or vaccinations).

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10
Q

What is the role of acute hosptial trusts in communicable disease?

A
  • Provide microbiological advice regarding single cases of communicable disease/ outbreaks
  • In a hospital incident, direction of infection prevention and control (often microbiologist) leads outbreak management.
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11
Q

What is the role of the local authority in communicable disease?

A

Environmental health officers which support the investigation of certain communicable cases/ outbreaks which may have an environmental source e.g. GI infection, Legionella etc. Organise food questionnaires and stool samples in outbreak of GI disease, + insepction of food premises/ kitchen implicated, have the power to prosecute.

The director of public health (and teams) in local authority has statutory responsiblity to ensure there are plans in place to protect the health of the population and will support the outbreak response.

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12
Q

What are the three core factors in communicable disease?

A
  1. Agent –> is the organism that produces the infection (e.g. virus, bacteria, fungus, rickettsia, protozoa
  2. Host –> Host factors include age/ gender, SE status, ethnicity, lifestyle factors (drug use and sexual behaviour), level of inherent resistance & immunological status (immune suppression, previous exposure or vaccination)
  3. Environment –> environmental factors e.g. climate/ temp/ physical surroundings/ overcrowding/ sanitation/ availability of health services
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13
Q

Key definitions in communicable disease:

Infection/ colonisation

A

Infection/ colonisation = the entry and development or multiplication of an infectious agent on/ in the body of man or animals (not synonymous with disease)

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14
Q

Key definitions in communicable disease:

Communicable or infectious disease

A

Communicable or infectious disease: disease which occurs following direct or indirect transmission of an infectious agent or its toxic products.

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15
Q

Key definitions in infectious disease:

Contagious

A

Contagious : describes an infection spread by direct contact

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16
Q

What is transmission in infectious disease?

A

Transmission can be either through direct contact or indirect contact:

Direct transmission:

  • Touching (scabies), kissing (oral infections), sexual intercourse (HIV gonorrhoea, syphilis)
  • Droplet transmission (coughing/ sneezing e.g. measles, mumps, flu, meningococcal disease)
  • Vertical transmission (transplacental/during childbirth) - toxoplasmosis, rubella, herpes simplex, cytomegalovirus, HIV, hep B & C
  • Faeco-oral : campylobacter, salmonella, E.Coli, Hep A

Indirect transmission:

  • Vehicle borne (flu), inanimate objects, food, water, biological products
  • Vector borne (malaria), insect or living carrier (mosquitos) that carry disease from infected person to non infected person
  • Airborne (aerosols) e.g. TB and dust, Fungi and respiratory viruses
17
Q

Definitions:

Incubation period

Latent periods

infectious period

A

Incubation period –> time elapsed between initial exposure to pathogenic organism/ chemical or radiation and when symptoms and signs are first apparent

Latent period –> period between initial exposure to disease causing agent and onset of infectious disease (individual may now pass disease on to others)

Infectious period –> Time interval in which the host is infectious i.e capable of directly or indirectly transmitting the disease

18
Q

What are the different types of disease occurrence and explain each one?

(disease occurence = level of disease within a population)

A

Sporadic –> irregular pattern of disease, occasional cases at irregular intervals

Endemic –> persistent low or moderate levels of the disease

Hyperendemic –> a higher persistent level of the disease

Cluster –> occurrence exceeds the expected level for a given population and/or in a given geographical area and/or in a given time period (cases have a possible but unconfirmed link).

Epidemic/outbreak –> occurence exceeds the expected level for a given population and or in a given geographical area and/or in a given time period (same as a cluster but there is a highly probable or confirmed link between cases).

An outbreak is a localised epidemic and also practically defined as two or more linked cases or a single case of a rare or serious disease (e.g .rabies, diptheria, botulism, polio).

Pandemic –> an epidemic occuring worldwide over over a very wide area, crossing international borders and affecting a large number of people.

19
Q

What is the chain or transmission in communicable disesae?

A

In order for transmission of a communicable disease you need:

1) pathogenic microorganism
2) resevoir
3) a means of escape
4) mode of transmission
5) means of entry
6) host susceptibility

20
Q

How can we control the chain of transmission?

A

1) control the source (the resevoir and means of escape)
2) interrupt transmission (the mode of transmission/ means of entry)
3) Protect susceptible population by immunisation or chemoprophylaxis (host susceptibilty)

21
Q

Outline the steps to manage an outbreak

A
  1. Confirm or verfiy the diagnosis
  2. immediate control (e.g. barrier nursing, isolation in bay)
  3. convene an outbreak control team
  4. review epidemiological (time place and person) and microbiological information
  5. case finding
  6. definitive control measures
  7. descriptive epidemiology (epidemiological curves)
  8. analytical study (case or cohort)
  9. declare outbreak over - lessons learnt, prevention measures in place, ongoing monitoring
  10. communication - throughout
22
Q

What factors are involved in communicable disease when looking at autonomy vs population protection?

A

Autonomy vs population protection:

1) vaccination –> protect individual and population protection (herd immunity)
2) post exposure prophylaxis e.g. menigococcal disease –> chemoprophylaxis may protect individuals to some extent, but also eliminates nasal carriage in contacts so that they cannot pass it on to others
3) exlusion from work or school e,g, in case of E.Coli 0157 –> not allowed to return to work until clear stool samples
4) use of part 2A order legisalation –> to require investigation and detetnion of individual who poses a risk to the public.

AC1 (Izzy) (48 decks)

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