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Chapter 13
Infectious Disease Prevention
and Control
Copyright © 2016 by Elsevier Inc.
Issues in Public Health Nursing:
Infectious Disease Prevention and
Control
Min is part of a team of public health nurses that
specializes in surveillance, screening, and treatment of
communicable diseases.
“What I love best?” he says. “That’s hard to pinpoint. I
like being part of an emergency team called in to
respond to unique cases; I like feeling like I may be
helping to save not just one patient’s life but many if we
can successfully diagnose, isolate, and contribute to a
larger surveillance and response effort.”
Copyright © 2016 by Elsevier Inc.
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Objectives
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Discuss the current impact and threats of
infectious diseases on society.
Explain how the elements of the epidemiologic
triangle interact to cause infectious diseases.
Provide examples of infectious disease control
interventions at the three levels of public health
prevention.
Explain the multisystem approach to controlling
communicable diseases.
Copyright © 2016 by Elsevier Inc.
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Objectives (Cont.)
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Discuss the factors contributing to newly
emerging or re-emerging infectious diseases.
Define the bloodborne pathogen reduction
strategy and universal precautions.
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Historical and Current Perspectives
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Early 20th century leading causes of death
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Respiratory diseases (e.g., tuberculosis [TB]) and diarrheal
diseases were major killers.
Infectious disease still a leading cause of death in
children worldwide; second-leading cause of death
overall
Current concerns
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HIV
Pneumonias and influenza
Vancomycin-resistant Staphylococcus aureus (VRSA) and
methicillin-resistant S. aureus (MRSA)
Severe acute respiratory syndrome (SARS)
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Transmission of
Communicable Diseases
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Agent, host, and environment
Modes of transmission
Disease development
Disease spectrum
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Epidemiologic Triangle
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Change in any one
of these may cause
disease transmission
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Modes of Transportation
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Vertical
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Parent to offspring
Horizontal
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Person-to-person
Four routes
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Horizontal Transmission
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Person-to-person
Four routes
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Direct/indirect
• Such as sexual contact = direct
• Clothing, toys, and the like = indirect
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Common vehicle
• Infected host to susceptible host
• Via food, water, body fluids
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Airborne
Vectorborne
• Arthropods
Copyright © 2016 by Elsevier Inc.
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Quick Recall
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Transmission of a disease via contact with an
infected person’s saliva is an example of
which mode of transmission?
A. Direct transmission
B. Indirect transmission
C. Vectorborne transmission
D. Common vehicle transmission
Copyright © 2016 by Elsevier Inc.
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How’d You Do?
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Transmission of a disease via contact with an
infected person’s saliva is an example of
common vehicle transmission.
Copyright © 2016 by Elsevier Inc.
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Disease Development
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Exposure and infection are not automatic.
Infection
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Disease
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Possible pathologic or physiologic reaction
Incubation period
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Entry and development of agent in a host
Time between invasion and first signs/symptoms
Communicable period
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Interval in which agent may be transferred from one
person to another
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Disease Spectrum
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Broad: from subclinical to severe or fatal
Endemic
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Epidemic
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Constant presence of a disease in one group
Occurrence beyond normal expectancy in one region
or community
Pandemic
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Epidemic occurring worldwide
Affects large populations
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Surveillance of
Communicable Diseases
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Elements of surveillance
Surveillance for agents of bioterrorism
List of reportable diseases
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Surveillance of
Communicable Diseases (Cont.)
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Elements of surveillance
Surveillance for agents of bioterrorism
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Syndromic surveillance systems
Early Aberration Reporting System (EARS)
List of reportable diseases
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National Notifiable Disease Surveillance System
(NNDSS)
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Emerging Infectious Diseases
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Emerging factors
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Societal events
 Health care
 Food production
 Human behavior
 Environmental
 Public health
 Microbial adaptation
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Examples of Emerging Diseases
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Prevention and Control of
Communicable Diseases
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Primary, secondary, and tertiary prevention
Role of nurses in prevention
Multisystem approach to control
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Prevention and Control of
Communicable Diseases (Cont.)
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Goal
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Prevention
Role of nurses
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Reduce prevalence
Immunizations
Surveillance
Teaching controls
Prevention
Screening and treatment
Multisystem approach to control
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Imbalance between human host and environment
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Agents of Bioterrorism
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Anthrax
Smallpox
Plague
Tularemia
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Vaccine-Preventable Diseases
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Routine childhood immunization schedule
Measles
Rubella
Pertussis
Influenza
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Novel influenza A H1N1 (2009)
Avian Influenza A (H5N1) (1997)
Copyright © 2016 by Elsevier Inc.
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Foodborne and Waterborne Diseases
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Role of safe food preparation
Salmonellosis
E. coli
Waterborne disease outbreaks and pathogens
Copyright © 2016 by Elsevier Inc.
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Vectorborne Diseases
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Lyme disease
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Rocky Mountain spotted fever
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Usually occurs in the summer in rural and suburban
areas of the northeast, mid-Atlantic, and north-central
states, particularly Wisconsin and Minnesota
Most commonly occurs in the southeast, Oklahoma,
Kansas, and Missouri
Tick-borne diseases
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Prevention and control
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Diseases of Travelers
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Malaria
Foodborne and waterborne disease
Diarrheal disease
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Zoonoses
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Rabies (hydrophobia)
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Highest case fatality rate of any known human
infections, essentially 100%
Best protection remains vaccinating domestic animals
(dogs, cats, cattle, and horses)
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Parasitic Diseases
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Intestinal parasitic infections
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Parasitic opportunistic infections
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Greater concern in developing countries
Pinworm most common helminthic infection in United
States, usually in schools, institutions or overcrowding
More frequent or severe in immunocompromised
Control and prevention
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Early diagnosis
Improved hygiene and vector control
Education and environmental improvements
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Health Care-Associated Infections
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Transmitted or developed within a hospital or
other health care setting
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Clients
Health care workers
Visitors
Anyone who has contact with a hospital
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Universal Precautions
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Response to HIV transmissions during health
care procedures (1985)
CDC policy recommendations for all health
care settings
Copyright © 2016 by Elsevier Inc.
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Issues in Public Health Nursing:
Infectious Disease Prevention and
Control
“I can’t see myself shifting to any other role in public
health nursing,” Min says. “The combination of
surveillance and reporting keeps me in collaboration with
the larger public health system, while responding to our
particular patients in crisis is the right balance for me.
“And when we succeed in not only saving a patient but
reducing prevalence of a deadly communicable disease,
there is nothing more rewarding.”
Copyright © 2016 by Elsevier Inc.
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