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Introduction to Health Care and Public Health in the US: Public Health
Part 2
Audio Transcript
Slide 1
Welcome to Component 1: Introduction to Health Care and Public Health in the
U.S.: Public Health, Part 2. This is Lecture(a).
The component, Introduction to Healthcare in the US, is a survey of how healthcare
and public health are organized and services are delivered in the US.
Slide 2
The Objectives of Public Health, Part 2, are to:
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give examples of and explain the general program categories of public health,
including communicable disease, chronic disease, terrorism response, and
environmental public health,
discuss the activities and achievements of public health in the realm of
communicable disease,
compare and contrast the different types of terrorism and the different public
health responses, and
describe chronic disease activities and achievements of public health, and the
work of public health in the realm of environmental health hazards.
Slide 3
This lecture will discuss Public Health and communicable diseases.
Communicable diseases can also be termed infectious or transmittable diseases. They
are caused by organisms such as bacteria, protozoans, fungi, or viruses entering the
body. The control of infectious diseases can mostly be traced to two advances. First,
better sanitation and clean water, which have brought many diseases, even typhoid and
cholera, under control. Second, antimicrobial therapy – the arsenal of medical
treatments against infectious diseases has expanded greatly through the discovery of
agents such as penicillin.
Slide 4
New communicable diseases continue to appear – the “emerging infectious diseases” –
and probably always will. Other diseases continue to evade good control, such as
tuberculosis, drug resistant infections, and so forth. But it is encouraging to consider
some more details of two of public health’s brightest triumphs, and how these once
fearsome diseases were brought under control: polio and smallpox.
Health IT Workforce Curriculum
Version 3.0/Spring 2012
Introduction to Healthcare and Public Health in the US
Public Health, Part 2
Lecture a
This material (Comp1_Unit8a) was developed by Oregon Health and Science University, funded by the Department of Health and
Human Services, Office of the National Coordinator for Health Information Technology under Award Number IU24OC000015.
1
Slide 5
Smallpox virus has been sickening populations for thousands of years. In 1796 Edward
Jenner discovered that cowpox conferred immunity to smallpox upon milkmaids. In
1800 the technique of smallpox vaccination was introduced into the US, and a century
and a half later, the US was declared free of smallpox. The International Smallpox
Eradication program was established in 1966, and by 1977 the global vaccination
program had effectively eradicated the disease.
Slide 6
Routine general vaccination against smallpox was discontinued after eradication of the
disease. The virus has been eliminated from the earth, with the exception of some
laboratory stockpiles. Are these stockpiles a matter of concern for terrorism risk? The
CDC has detailed plans to protect the US in the case of a smallpox weapon, the plans
include deploying teams of medical and public health workers to stop the spread, using
stockpiled vaccine.
Slide 7
Polio is another disease that has been a threat for thousands of years – there is
evidence of polio in an Egyptian stone engraving more than 3000 years old. Polio virus
mainly affects children under 5 years of age, and is spread by fecal contamination of
food or water. The highly contagious virus invades the nervous system: the vast
majority of those infected are not seriously affected, but for those that are the symptoms
are severe, including paralysis. In 1955 the Salk polio vaccine was licensed, and
currently polio has been effectively eliminated in industrialized countries. However, it still
poses a risk in other countries, and the World Health Organization continues to strive for
global eradication.
Slide 8
Public health at the state and local level work to prevent communicable disease in the
population through a combination of monitoring and surveillance, outbreak investigation,
interventions/treatments, and reporting of data to CDC. Federal level activities by CDC
include gathering national data, managing national prevention and surveillance
programs, distributing funding, and collaborating in outbreak responses.
Slide 9
Outbreak investigations can take many forms and be quite complex. This slide
illustrates a fictional – and very simplified – outbreak investigation of a food poisoning
incident. In our fictional example, public health first learns about the incident by receipt
of laboratory reports positive for foodborne pathogens. Epidemiologists investigate the
report, sending additional samples to the public health laboratory to be more closely
identified. The epidemiologists trace the illness to a company picnic; questionnaires and
statistical analysis identifies the problem as a dairy product served at the picnic. Yet
Health IT Workforce Curriculum
Version 3.0/Spring 2012
Introduction to Healthcare and Public Health in the US
Public Health, Part 2
Lecture a
This material (Comp1_Unit8a) was developed by Oregon Health and Science University, funded by the Department of Health and
Human Services, Office of the National Coordinator for Health Information Technology under Award Number IU24OC000015.
2
more investigation reveals the product was contaminated at the dairy due to a sanitation
issue. A product recall is issued, and the dairy fixes the problem that led to the
contamination. Public health utilizes the data gathered and lessons learned to help
prevent future problems.
Slide 10
This listing of some communicable disease topics gives a good idea of the diversity
involved. We’ll look at a few of these in more detail.
Slide 11
Rabies is a good example of an animal-related disease. A fatal infection results when
the virus is introduced into breaks in the skin (commonly by an animal bite). Public
health responses include monitoring for incidents, managing treatment, and
encouraging prevention by pet vaccinations. A serious food-related disease is caused
by E. coli O157:H7. Incidents are usually traced to food contaminated with cow feces,
and can be very severe. Public health responds by monitoring, assisting in
interventions, investigating outbreaks, and providing education for prevention.
Gonorrhea is an example of a sexually-transmitted disease. This bacterial infection can
lead to permanent health problems. The public health response includes monitoring,
interventions, investigation of outbreaks, and education on prevention and treatment.
Slide 12
The parasite Cryptosporidiosis causes one example of a water-related disease. The
parasite is ingested by drinking contaminated water. Public health responses include
monitoring, investigation of outbreaks, and education on water treatment. MRSA can
cause a healthcare-related disease, if it is introduced in a healthcare setting by visitors
or providers. Public health responses include monitoring, investigation of outbreaks, and
education for both patients and providers. Chickenpox is an example of childhood
disease; this highly contagious viral infection is spread by coughing, sneezing, or
contact. Public health response includes monitoring, intervention (vaccination), outbreak
investigation, and education on vaccination.
Slide 13
The human immunodeficiency virus (HIV) can lead to acquired immune deficiency
syndrome (AIDS). The public health response includes monitoring of disease and
treatments, outbreak investigation, and education on prevention and testing. Emerging
infectious diseases, mentioned earlier in this unit, continue to appear. One example is
Dengue infection, endemic (native) to many popular tourist destinations in Latin
America, Asia, and Puerto Rico, this mosquito-transmitted disease is appearing more
often in the US states. Public health response includes monitoring, outbreak
investigations, and education on avoidance and on mosquito control.
Health IT Workforce Curriculum
Version 3.0/Spring 2012
Introduction to Healthcare and Public Health in the US
Public Health, Part 2
Lecture a
This material (Comp1_Unit8a) was developed by Oregon Health and Science University, funded by the Department of Health and
Human Services, Office of the National Coordinator for Health Information Technology under Award Number IU24OC000015.
3
Slide 14
This concludes Lecture (a) of Public Health, Part 2. In summary, the topic of
communicable diseases is discussed in detail, using notable examples including
smallpox and polio. Public health disease outbreak investigations are discussed using a
simplified food poisoning incident.
Slide 15
Reference Slide, Lecture (a)
No audio
Health IT Workforce Curriculum
Version 3.0/Spring 2012
Introduction to Healthcare and Public Health in the US
Public Health, Part 2
Lecture a
This material (Comp1_Unit8a) was developed by Oregon Health and Science University, funded by the Department of Health and
Human Services, Office of the National Coordinator for Health Information Technology under Award Number IU24OC000015.
4