Chapter 26 Infectious Disease Prevention and Control Francisco S. Sy Susan C. Long-Marin Copyright © 2010, 2006, 2002 by Mosby, Inc., an affiliate of Elsevier Inc.

Introduction Worldwide concern about infectious diseases has increased with the rise of human migration As people move from one place to another, they bring their diseases, levels of immunity and resistance, and the viruses or bacteria they may harbor that have not emerged as diseases The topic is complex and includes study of a wide range and variety of organisms, the pathology they may cause, and their diagnosis, treatment, prevention, and control Copyright © 2010, 2006, 2002 by Mosby, Inc., an affiliate of Elsevier Inc.

Historical and Current Perspectives 1900: Communicable diseases were the leading causes of death in the United States By 2000: Improved nutrition and sanitation, vaccines, and antibiotics had put an end to the epidemics that once ravaged entire populations As people live longer, chronic diseases (heart disease, cancer, and stroke) have replaced infectious diseases as the leading causes of death Infectious diseases have not vanished – they are still the number-one cause of death worldwide New killers are emerging, and old familiar diseases are taking on different, more virulent characteristics Copyright © 2010, 2006, 2002 by Mosby, Inc., an affiliate of Elsevier Inc.

Transmission of Infectious Diseases Agent, host, and environment Modes of transmission Vertical transmission Horizontal transmission Common vehicle Vectors Disease development Disease spectrum Endemic Epidemic Pandemic Copyright © 2010, 2006, 2002 by Mosby, Inc., an affiliate of Elsevier Inc.

Surveillance of Infectious Diseases Surveillance: gather the who, when, where, and what; these elements are then used to answer why A good surveillance system systematically collects, organizes, and analyzes current, accurate, and complete data for a defined disease condition The resulting information is promptly released to those who need it for effective planning, implementation, and evaluation of disease prevention and control programs Surveillance for agents of bioterrorism Anthrax Smallpox List of Reportable diseases Varies by state Copyright © 2010, 2006, 2002 by Mosby, Inc., an affiliate of Elsevier Inc.

Emerging Infectious Diseases Emerging infectious diseases: those in which the incidence has actually increased in the past two decades or has the potential to increase in the near future Ebola virus Hantavirus pulmonary syndrome HIV/AIDS West Nile virus (WNV) Emergency factors Copyright © 2010, 2006, 2002 by Mosby, Inc., an affiliate of Elsevier Inc.

Prevention and Control of Infectious Diseases Primary prevention Preventing the incidence of disease before it happens Secondary prevention Preventing the spread of disease once it occurs Tertiary prevention Reducing complications through treatment and rehabilitation Role of nurse in prevention Control and teach about disease; screen for disease; treat persons with disease Multisystem approach to control Copyright © 2010, 2006, 2002 by Mosby, Inc., an affiliate of Elsevier Inc.

Vaccine-Preventable Diseases Routine childhood immunization schedule vaccinates children against 11 diseases: Hepatitis B, diphtheria, pertussis, measles, mumps, rubella, polio, Haemophilus influenzae, type B meningitis, varicella (chickenpox), and Streptococcus pneumoniae Copyright © 2010, 2006, 2002 by Mosby, Inc., an affiliate of Elsevier Inc.

Food- and Waterborne Diseases Ten golden rules for safe food preparation Foodborne diseases Salmonellosis Escherichia coli 0157:H7 Waterborne diseases Hepatitis A Cholera Typhoid fever Bacillary dysentery Copyright © 2010, 2006, 2002 by Mosby, Inc., an affiliate of Elsevier Inc.

Vector-Borne Diseases Vector-borne diseases: refers to illnesses for which the infectious agent is transmitted by a carrier (vector) Lyme disease Rocky Mountain spotted fever Prevention and control of tick-borne diseases Vaccine for Lyme disease recommended for those living in high-risk areas Copyright © 2010, 2006, 2002 by Mosby, Inc., an affiliate of Elsevier Inc.

Diseases of Travelers Those traveling outside the U.S. need to be aware of and take precautions against diseases they may be exposed to; may return to the U.S. with an “unplanned souvenir”; health professionals taking client history need to consider recent travel by the client Malaria Foodborne and waterborne diseases Diarrheal diseases Copyright © 2010, 2006, 2002 by Mosby, Inc., an affiliate of Elsevier Inc.

Zoonoses and Parasitic Diseases Zoonosis: an infection transmitted from a vertebrate animal to a human under natural conditions Rabies (hydrophobia) Parasitic diseases More prevalent in tropical climates and countries with inadequate prevention and control methods Intestinal parasitic infections Parasitic opportunistic infections Control and prevention of parasitic infections Copyright © 2010, 2006, 2002 by Mosby, Inc., an affiliate of Elsevier Inc.

Nosocomial Infections Nosocomial infections: infections acquired during hospitalization or developed within the hospital setting May involve patients, health care workers, visitors, or anyone who has contact with a hospital Universal Precautions: procedures to prevent exposure to blood-borne diseases Copyright © 2010, 2006, 2002 by Mosby, Inc., an affiliate of Elsevier Inc.

Nurses’ Role and Communicable Diseases Communicable disease prevention and control programs must move beyond providing drug treatment and vaccines Health promotion and education must be aimed at changing individual and community behavior Nurses play a key role in all aspects of prevention and control of communicable diseases Close cooperation with other members of the interdisciplinary health care team is crucial Mobilizing community participation is essential to successful implementation of programs Copyright © 2010, 2006, 2002 by Mosby, Inc., an affiliate of Elsevier Inc.