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Module 5: Public Health Impact of and response to infectious diseases Infectious diseases appear from time to time, threatening the human race. The table below shows a few examples of infectious disease outbreaks in recent years to help students better understand the characteristics of infectious diseases and the common arguments for different types of questions on this topic. Global Impact of infectious diseases Suggestions on ways to manage infectious diseases Kong SARS epidemic Between February and June 2003, the Severe Acute Respiratory Syndrome (SARS) broke out in Hong Kong. The virus is mainly transmitted through close human contact. During the outbreak, 1,755 people were infected, of whom 299 died, including 8 medical practitioners. Lack of public health awareness Absence of vaccines High cross-border people mobility Damage to people’s health Increase in public health awareness Deployment of resources to tackle infectious diseases Better monitoring Strengthening education Providing resources World Health Organization (WHO) and governments Organizations Individuals Devising management policies Increasing public health awareness Monitoring the effectiveness of government measures Increasing personal health awareness Limited resources Barriers to the prevention of infectious diseases More updates Hong In late 2013, an epidemic of Ebola, a highly deadly infectious disease, broke out in various West African countries. Infected cases also emerged in countries such as the US and Spain. This acute infectious disease can transmit among humans through direct contact with infected persons’ bodily fluid or indirect contact with contaminated environment. The epidemic continued until 2015, and led to the deaths of more than 11,000 people. Background Causes of the spread of infectious diseases Ebola WHO and governments Uncooperative attitude of some governments Different situations in different countries Difficulties in changing people’s lifestyles and habits 2016 Hong Kong Educational Publishing Company 1 Avian flu Hong Kong AIDS Hong Kong MERS Global Global Zika virus The world’s first human case of avian flu was found in Hong Kong in 1997. Since then, infected cases have been found in Hong Kong from time to time. Individuals may contract the avian flu virus through close contact with infected wild birds and poultry (whether live or dead) or their droppings. The disease is transmitted through sexual contact and blood and from pregnant women to their babies. Infections in China are mainly related to drug abuse, prostitution, blood selling and sexual contact. It is estimated that over 10 million people have AIDS in China. There was a large-scale outbreak of the Middle East Respiratory Syndrome (MERS) in the Middle East in 2012. Imported cases appeared in Korea in 2015. Suspected cases were also found in Hong Kong. Infections are mainly caused by contact with animals (especially camels) and virus carriers. As of June 2015, 1,342 people from around the world had been infected with 513 deaths. In 2015, the Zika epidemic spread across Central and South Americas. In Brazil, the most affected area, there were over 1.5 million infections. It is suspected that the virus is linked to the surge in microcephaly (abnormal smallness of the head) among new-born babies in Brazil. The virus is transmitted to humans by Aedes mosquitoes. Human-to-human transmission may also occur by ways of blood transfusion and sexual contact. (Difficult to control people’s activities) Students can first grasp the common points listed on the far left column by looking at the local cases, before extending the reasoning to China and global cases at large. Students can freely add more examples to enrich this table. 2 Point Analysis Students can tackle questions on infectious diseases by examining the causes, impact, suggestions and challenges. There are common rules for various question types: Topic: Causes of the spread of infectious diseases Question Point Explanation type People lack public health awareness and have little knowledge on Lack of public health infectious disease prevention. In some places, people’s awareness lifestyles/traditional customs increase the risk of infection. Infectious diseases and virus continuously evolve. It takes time for Causes Absence of vaccines drugs and vaccines to be developed. It is not always possible for countries to obtain disease specific vaccines and drugs immediately. Cross-border mobility allows viruses to be carried around the world High cross-border people easily. This increases the chance of outbreaks and makes it harder mobility for governments to contain infectious diseases. Topic: Impact of infectious diseases Question Point type Damage to people’s health (negative impact on individuals) Impact Increase in public health awareness (positive impact on community) Deployment of resources to tackle infectious diseases (negative impact on society) Explanation Various infectious diseases damage the health of patients. For example, the avian flu causes fever, cough, sore throat, muscle pain and serious respiratory infection. Some diseases can cause failure of multiple organs and death. Often, people become more aware of the need to protect their health after an epidemic. They learn about measures to prevent diseases and change their lifestyles. When the risk of individual infection is reduced, the chance of cross infections is also lowered. The community’s ability to prevent epidemics is increased overall. In the face of infectious disease outbreaks, governments redistribute resources to improve the healthcare system’s capacity of response. This takes away some resources for other areas. Topic: Suggestions on ways to manage infectious diseases Question Point Explanation type Enhancing inspection of tourists from regions affected by Better monitoring an epidemic and putting infected persons in quarantine Releasing the latest health information to improve the Strengthening public’s epidemic prevention awareness and encouraging education people to adopt epidemic prevention measures Helping to improve the healthcare system of less WHO and Providing developed/affected regions by providing medical governments resources equipment and professional advice and assisting in drug and vaccine development Establishing cross-border health reporting mechanisms to Devising Suggestions report and assess epidemics to prevent their spread. management Adopting quarantine measures to prevent community policies outbreaks when necessary Increasing public Explaining the latest information about infectious diseases health awareness to the public and providing prevention guidelines. Organizations Monitoring the (For NGOs) Suggesting reform when they find loopholes effectiveness of in the government’s measures govt. measures Following the latest information about infectious diseases Increasing personal Individual and changing their lifestyles if necessary to minimize the health awareness risk of infection 2016 Hong Kong Educational Publishing Company 3 Topic: Challenges to the prevention of infectious diseases Question type Point Explanation Limited resources Challenges WHO and governments Uncooperative attitude of some governments Different situations in different countries Difficulties in change people’s lifestyles and habits Developing countries have limited medical resources because of their lower economic development level. To protect their own interests, some governments may not cooperate with other countries and international organizations in combating infectious diseases. Countries face different situations so they cannot support each other. Governments cannot forcefully change or monitor their people’s life constantly. Skill Transfer Topic: Explain the various roles played by the World Health Organization in handling infectious diseases. (6 marks) Skills for answering questions about ‘roles’ ‧ A role means the function performed by a stakeholder due to the stakeholder’s particular position. The roles played by stakeholders often end with ‘-or’ or ‘-er’ as in the right column below. The role of the WHO (stakeholder) is deduced from the causes and suggestions explained in the previous pages: Cause Suggestion / Method People’s lack of public health awareness Absence of vaccine Releasing the latest health information Assisting in drug and vaccine development Establishing cross-border health reporting mechanisms High cross-border people mobility Effective suggestions should respond to the causes. 4 Role of the WHO Educator Resource provider Policy formulator/ monitor Students are suggested to consider the role of the stakeholder before suggesting reasonable methods.