EPIDEMIOLOGY AND NOSOCOMIAL INFECTIONS

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Presentation transcript:

EPIDEMIOLOGY AND NOSOCOMIAL INFECTIONS CHAPTER 15 Copyright © 2012 John Wiley & Sons, Inc. All rights reserved.

Infectious Disease Spread What is Epidemiology? Where, when and how of disease in populations Promotion of a healthier society Incidence Number of new cases Prevalence Number of existing cases in any stage of disease Copyright © 2012 John Wiley & Sons, Inc. All rights reserved.

Epidemiological Terms Morbidity Ill effects suffered by individuals with disease Mortality Deaths Copyright © 2012 John Wiley & Sons, Inc. All rights reserved.

Diseases in Populations Endemic (b) Disease with constant presence Epidemic (c) High incidence in a short time in a region Pandemic Global disease epidemic Sporadic (a) Occasional occurrence Often imported due to air travel Copyright © 2012 John Wiley & Sons, Inc. All rights reserved.

Disease Spread Common Source Outbreak Individuals exposed to the same contamination Propagated Epidemic Spread from person to person Types of epidemiologic study Descriptive Analytical Experimental Copyright © 2012 John Wiley & Sons, Inc. All rights reserved.

Reservoirs of Infection Human Disease sufferers Those in incubation, convalescence Inapparent infections Animal (Zoonoses) Waste Contaminated meat, poultry Animal products (hides, feathers) Sick animals Non-living Soil and water Copyright © 2012 John Wiley & Sons, Inc. All rights reserved.

Portals of Entry Skin Thick Waterproof Tight cellular junctions Some worms, fungi Mucus membrane Simple epithelium Thick mucous layer Parenteral route Injections Punctures, bites, incisions Copyright © 2012 John Wiley & Sons, Inc. All rights reserved.

Portals of Exit Waste products Secretions Blood/pus Milk Copyright © 2012 John Wiley & Sons, Inc. All rights reserved.

Modes of Transmission Contact Vehicles Vectors Direct Indirect Droplets less than 1m Vehicles Food Water Air (droplets more than 1m) Blood Vectors Mechanical Biological Copyright © 2012 John Wiley & Sons, Inc. All rights reserved.

Challenges Carrier status STDs Education?? Zoonoses Vaccination challenges Disease Cycles Immunity is not a constant over time Herd Immunity % immunity needed varies with the disease Copyright © 2012 John Wiley & Sons, Inc. All rights reserved.

Controlling Disease Transmission Isolation Hospitals Quarantine Public exposed to potential pathogens Immunization Vector Control Insect or rodent population control Copyright © 2012 John Wiley & Sons, Inc. All rights reserved.

Public Health Organizations Centers for Disease Control (CDC) Federal agency Public educational mission Epidemiology center World Health Organization (WHO) International agency Notifiable Diseases Infectious diseases harmful to community health 63 diseases as of 2011 Nationally Notifiable Infectious Diseases Copyright © 2012 John Wiley & Sons, Inc. All rights reserved.

Nosocomial Infections Exogenous versus Endogenous Contributing factors Patient susceptibility Microbial virulence Chain of transmission Copyright © 2012 John Wiley & Sons, Inc. All rights reserved.

Exogenous Transmission Copyright © 2012 John Wiley & Sons, Inc. All rights reserved.

Controlling Transmission Universal Precautions Use good hand-washing techniques Careful personal hygiene Single use packaging wherever possible Sterilization/disinfection of shared equipment Minimizing invasive procedures Surveillance Antibiotic use Copyright © 2012 John Wiley & Sons, Inc. All rights reserved.

Bioterrorism Airborne human pathogens Anthrax Toxins Ricin Agricultural bioterrorism Foot and mouth disease Control measures Copyright © 2012 John Wiley & Sons, Inc. All rights reserved.