1. Presented by: DR /Amira Yahia Communicable Diseases

2. Introduction Communicable Diseases are the major causes of morbidity and mortality. Main causes of morbidity and mortality in emergencies are diarrheal diseases, acute respiratory infections, measles, and in areas where it is endemic malaria. 6/28/2016

3. Introduction Every disease has certain weak points susceptible to attack and the basic approach in controlling diseases is to identify these weak points and break the weakest links in the chain of transmission. This requires sound epidemiological knowledge of the disease (Frequency- Distribution in place, person and time- causation )

4. Introduction There are many methods to control transmission of communicable diseases. The choice of method will depend upon many factors; availability of proper tools, and technique.

5. Definitions Communicable Disease is one that can transmitted from one person to another and it is caused by an infectious agent that is transmitted from a source or reservoir to a susceptible host directly or indirectly. Infectious diseases is one that caused by infectious agent.

6. Transmission of Infectious Agents Transmission refers to any mechanism by which an infectious agent is spread from a source or reservoir to a person: 1.Chain of transmission: – Reservoir. – Mode of transmission. – Susceptible host.

7. Transmission of Infectious Agents 2.Epidemiological trait: - Agent - Environment - Host

8. Six Factors furthering the process Agent Reservoir Portal of exit Mode of transmission Portal of entry Susceptible host

9. Cont…. Host person/animal that affords subsistence to an infectious agent under natural conditions Carrier person/animal that harbors a specific infectious agent in the absence of discernible clinical disease and serves as a potential source of infection.

10. Cont… Fomite Contaminated substance (not necessarily a reservoir) serving as an intermediate means of transport for an infectious agent Reservoir Anything (living or inert) in which an infectious agent lives and multiplies in such a manner that it can be transmitted to a susceptible host

11. Cont… Vector is invertebrate animal capable of transmitting an infectious agent to vertebrates. Virulence is the ability of an infectious agent to cause severe or fatal infections.

12. Chain of Transmission Reservoir Routes of Transmission Susceptible host

13. Man 1=Case:-case can be prevented and controlled by 1-Identification:- --presentation:- This involves signs and symptoms of this disease. --Lab finding :- Diagnostic test, or physical examination --complications That may arise due to this disease. Reservoir

14. Case 2-Treatment 3-Isolation:- (type of isolation required) this needs to determine period of communicability 4 -Health education:- About -S&S of complication -treatment compliance. Man

15. carrier 2=carrier:- 1-Types of carrier -by type.healthy carrier.incubatory carrier.convalescence carrier -by portal of exit.respiratory carrier.GIT carrier. GUT carrier 2-active detection.Household surveillance for early detection of disease Man

16. Reservoir 3-health education concerning special hygiene and avoid risk factors 4-Quarantine :- this needs to know Incubation period of the disease.

17. Animal(Reservoir) Case -Identification -Treatment -Isolation -Extermination Carrier - Type - Active detection - Quarantine - Extermination

18. Soil (Reservoir) Disinfection

19. Mode of transmission - Direct :-- 1.Direct contact 2.Vertical transmission 3.Droplet infection 4.Animal bite transmission 5.Contact with soil

20. Indirect 1.Air-borne 2.Vehicle borne 3.Vector-borne transmission 4.Fomite –borne 5.Hand –borne

21. Susceptible host Man 1- The individual at risk Systemic diseases Surgical patients Immunocompromised individuals Genetic based Organ transplant Chemotherapy Radiotherapy HIV infection

22. Cont…. 2-health education :- about vaccination and preventive measures 3-immunization :- if available. 4-prophylaxis :- 5-special protective measures :- 6-legislation :-

23. Susceptible host Animals 1- At risk 2- Prophylaxis 3- Special protective measures

24. Emerging Infectious Diseases Emerging infectious diseases are diseases that have appeared for the first time or that have occurred before appeared in populations where they have not previously been reported.

25. Reemerging Infectious Diseases Reemerging infectious diseases are familiar diseases caused by well- understood organisms that were once under control or declining but now are resistant to common drugs or gaining new footholds in the population and increasing in incidence.

26. Fundamental principles of Control of Communicable Diseases Rapid Assessment Prevention Surveillance Outbreak Control Disease Management

27. Modern Conditions that Favor the Spread of Infectious Diseases 1.Global travel 2.Globalization of food supply and centralization of food processing 3.Population growth, increased urbanization and overcrowding 4.Migration due to wars, famines, and natural disasters

28. Modern Conditions that Favor the Spread of Infectious Diseases 5.Irrigation, deforestation, and reforestation projects that alter habitats 6.Human behaviors, such as IV drug use and risky sexual behavior 7.Increased use of antimicrobial agents and pesticides 8.Increased human contact with wilderness habitats

29. Primary Prevention Increasing the resistance of the host Inactivating the agent Interrupt the chain of infection Restricting spread of infection – isolation – quarantine – segregation – personal surveillance

30. Secondary Prevention Activities targeted at detecting disease at earliest possible time to: – begin treatment – stop progression – protect others in the community

31. Tertiary Prevention Limits the progression of disability Treatment of symptoms and rehabilitation vary with each specific disease

32. Surveillance Surveillance is the ongoing systematic collection, analysis and interpretation of data in order to plan, implement and evaluate public health intervention.  Surveillance system should be simple, flexible, acceptable.

33. Outbreak Control An outbreak is occurrence of a number of cases of a disease that is unusually large or unexpected for a given place and time.  Outbreaks and epidemics refer to the one and same thing.  Outbreaks in emergency situations can spread rapidly giving rise to high morbidity and mortality rates.  Aim should be to detect and control the outbreak as early as possible.

34. Steps in the management of a communicable disease outbreak Preparation Detection Response Evaluation

35. Preparation for the outbreak Health coordination meetings Strong surveillance system Outbreak response plan for each disease Stocks of iv fluids, antibiotics and vaccines Plans for isolation wards Laboratory support

36. Steps in the management of a communicable disease outbreak Preparation Detection Response Evaluation

37. Detection of outbreak Surveillance system with early warning system for epidemic prone diseases. Inform ministry of health and WHO in case of outbreaks of specific diseases. Take appropriate specimens (stool, CSF or serum) for laboratory confirmation. Include case in the weekly report.

38. Steps in the management of a communicable disease outbreak Preparation Detection Response Evaluation

39. Response to the outbreak Confirm the outbreak Activate the outbreak control team Investigate the outbreak Control the outbreak

40. Steps in the management of a communicable disease outbreak Preparation Detection Response Evaluation

41. Evaluation Assess appropriateness and effectiveness of containment measures. Assess timelines of outbreak detection and response. Change public health policy if indicated. Write and disseminate outbreak report.

42. Global Disease Eradication Efforts Methods to accomplish the goal of eradication of diseases include: – immunization and vaccination – drug therapy – community training – health education – national disease surveillance efforts

43. Nurses’ Role Community health nurses play an important role with regarded to all population at risk for communicable diseases Nurses concerned with control of communicable diseases must Recognize who at risk. Where the reservoirs and source of infectious disease agents are located. What environmental factors promote the spread.

44. What comprise the characteristic of vulnerability of community member and groups-particularly those subject to intervention Community health nurses must work collaboratively with other public health professional to establish immunization and educational programs, to improve community infection control policies, and to develop abroad range of services to population at risk

45. References 1.Clement.I.2009, Basic Concepts of Community Health Nursing, Second edition, Bengalru: Jaypee Borther. 2.Spradley.B.W. 1996Community Health Nursing concepts and practice, 4 th edition. USA:library of congress catologing. 3.Stone.S.C.1998, Comperhensive Community Health Nursing, 5 th edition, USA:Nancy. L.coon. 4.Karem.H.C. Communicable diseases prevention,accessed on www.google.comwww.google.com 5.Kamalam.S.2005, Essentials in Community Health Nursing Practice, First edition, New Delhi: Jaypee Borther. 6.Omara.m.2007.Community Medicine.7 th edition, A.R.E.