Download Guidelines for Preparing PowerPoint® Presentations

Survey
yes no Was this document useful for you?
   Thank you for your participation!

* Your assessment is very important for improving the work of artificial intelligence, which forms the content of this project

Document related concepts

Pandemic wikipedia, lookup

Transcript
Part IV
Provision of Public Health
Nursing to Vulnerable Populations
Copyright © 2008 Delmar. All rights reserved.
Chapter 20
Populations with
Infectious and Communicable Disease
Copyright © 2008 Delmar. All rights reserved.
Contributing Factors
• Institute of Medicine (IOM) 1992 report
Emerging Infections: Microbial Threats to
Health in the United States
– Emerging infectious diseases
– Increasingly present infectious diseases
– Identified six important factors in disease
emergence and reemergence
3
Copyright © 2008 Delmar. All rights reserved.
Six Factors
1. Changes in human demographics and
behavior
2. Advances in technology and industry
3. Economic development; changes in land
use
4. Commerce
5. Microbial adaptation
6. Deterioration in the public health system
4
Copyright © 2008 Delmar. All rights reserved.
Models of Transmission
• Epidemiological triangle and the chain of
transmission
– Agent-host-environment
• Agent and reservoir
– Biological agents
• Fungi, parasites
• Bacteria, viruses
5
Copyright © 2008 Delmar. All rights reserved.
Models of Transmission
• Agent and reservoir
– Reservoir
• Human, animal, environment
6
Copyright © 2008 Delmar. All rights reserved.
Models of Transmission
•
•
•
•
Infectivity
Pathogenicity
Virulence
Antigenicity
7
Copyright © 2008 Delmar. All rights reserved.
Models of Transmission
• Modes of exit
– Respiratory
– Gastrointestinal
– Urinary and reproductive system
• Mode of entry to a new host is often the same as
the mode of exit from the reservoir
8
Copyright © 2008 Delmar. All rights reserved.
Models of Transmission
• Modes of transmission (Table 20-1)
– Direct person to person
– Common vehicle
– Vectors
9
Copyright © 2008 Delmar. All rights reserved.
Types of Host Immunity
•
•
•
•
•
Natural
Acquired
Passive
Active
Herd
10
Copyright © 2008 Delmar. All rights reserved.
Levels of Prevention
• Leavell and Clark (1958) Preventive
Medicine for the Doctor in His Community
–Three levels of prevention
1. Primary
•
•
•
Education, immunizations
Chemoprophylaxis, universal precautions
Protective clothing, barrier protection
11
Copyright © 2008 Delmar. All rights reserved.
Levels of Prevention
• Three levels of prevention
2. Secondary
•
•
•
•
Screening
Disease management
Treatment
Directly observed treatment (DOT)
3. Tertiary
•
•
Management of complications
Prevention
12
Copyright © 2008 Delmar. All rights reserved.
Common Infectious
and Communicable Diseases
• Foodborne and waterborne disease
– Food intoxication
• Shellfish, mushrooms, bacterial growth, mercury
– Food infections
• Trichinosis, Salmonellosis
• Escherichia coli, Toxoplasmosis
• Hepatitis A, Parasites
13
Copyright © 2008 Delmar. All rights reserved.
Prevention
• Five keys to safer food:
1.
2.
3.
4.
5.
Keep clean
Separate raw and cooked
Cook thoroughly
Keep food at safe temperatures
Use safe water and raw materials
14
Copyright © 2008 Delmar. All rights reserved.
Vectors
• Disease carriers
– Animals, insects, birds
•
•
•
•
•
Malaria
Anthrax
Brucellosis
Mad Cow
Avian Flu
15
Copyright © 2008 Delmar. All rights reserved.
Lyme Disease
• Most common vector-borne disease
– White-tailed deer
– Bull’s-eye skin lesion
• Red spot at the site of bite, followed by spreading
rings of inflammation as infection progresses
• Develops 3-30 days after tick bite
16
Copyright © 2008 Delmar. All rights reserved.
Lyme Disease
• Symptoms
– Fatigue
– Headache
– Fever
– Stiff neck, joint pain
– Muscle aches
– Enlarged tender lymph nodes
17
Copyright © 2008 Delmar. All rights reserved.
Lyme Disease
• Treatment: 10-14 days of penicillin or
tetracycline
– Left untreated can progress to Stage II
• Neurological and cardiac symptoms
– Stage III
• Months to years of ongoing attacks
– Arthritis and arthralgia
18
Copyright © 2008 Delmar. All rights reserved.
Rocky
Mountain Spotted Fever
• Vector
– Dog and wood ticks
• Atlantic and western south central region
19
Copyright © 2008 Delmar. All rights reserved.
Rocky
Mountain Spotted Fever
• Occurs 4-6 hours after bite
• Incubation period 3-14 days
– Maculopapular rash on extremities, palms of
hands, soles of feet
– Antibiotic therapy required
20
Copyright © 2008 Delmar. All rights reserved.
Malaria
• Vector
– Infected mosquito
• Tropical and subtropical area
• Travelers should use mosquito repellent
– Use mosquito nets while sleeping
– Prophylaxis can begin 4-6 weeks prior to
travel
21
Copyright © 2008 Delmar. All rights reserved.
Parasitic Diseases
• Tropical climates, underdeveloped
countries
– Lack of sanitation
– Insufficient primary care
– Inadequate access to medications
22
Copyright © 2008 Delmar. All rights reserved.
Parasitic Diseases
• Four groups of organisms:
1.
2.
3.
4.
Roundworms
Tapeworms
Flukes
Single celled organisms
23
Copyright © 2008 Delmar. All rights reserved.
Nosocomial Infections
• Acquired in a hospital setting
• May affect anyone who has contact with a
hospital
– Other patients
– Staff
– Environment
24
Copyright © 2008 Delmar. All rights reserved.
Respiratory Infections
• Tuberculosis
– Airborne pathogen
• Droplet nuclei
25
Copyright © 2008 Delmar. All rights reserved.
Respiratory Infections
• Symptoms
– Fever, cough, chest pains, fatigue
– Hemoptysis, weight loss
– Incubation period 4-12 weeks
26
Copyright © 2008 Delmar. All rights reserved.
Respiratory Infections
• Active cases begin 6-12 months after
infection
– Extrapulmonary
– Multi-drug resistant
• Isoniaid and Rifampin
27
Copyright © 2008 Delmar. All rights reserved.
Respiratory Infections
• Influenza
– Influenzia A, B, or C virus
– Occur annually
– Last 5-6 weeks
28
Copyright © 2008 Delmar. All rights reserved.
Respiratory Infections
• Small children and elderly most vulnerable
– Flu vaccine 70-90 percent effective
• Pneumonia
– Aspiration of virulent and nonvirulent
organisms
– Inhalation of toxic fumes
– Aspiration of stomach acids
29
Copyright © 2008 Delmar. All rights reserved.
Respiratory Infections
• Symptoms
– Upper respiratory tract infection
– Chills, fever, cough
– Chest pain and dyspnea
• Treatment
– Antibiotics
30
Copyright © 2008 Delmar. All rights reserved.
Hepatitis
• Hepatitis A
– Fecal-oral routes
– Vaccine available and provides protection
• Hepatitis B
– Blood borne pathogen
• Fatigue and right upper quadrant discomfort
• Treat with Interferon and Lamivudine
31
Copyright © 2008 Delmar. All rights reserved.
Hepatitis
• Hepatitis C
– Blood-borne infection
– Causes up to 10,000 deaths a year
– Interferon, Ribavirin
32
Copyright © 2008 Delmar. All rights reserved.
HIV
• Destruction of immune system
• Antibody test can confirm diagnosis
• Early detection better prognosis
– Elisa
– Western Blot
• Treatment
– Protease inhibitors, anti-retroviral drugs
33
Copyright © 2008 Delmar. All rights reserved.
HIV
• Role of public health nurse
– Promote prevention of spread of HIV through
education
• Venereal Warts
– HPV
• Gardasil
34
Copyright © 2008 Delmar. All rights reserved.
STDs
• Syphilis
• Gonorrhea
– Bacterial disease, purulent discharge with
painful urination
– Treatment
• Antibiotics
35
Copyright © 2008 Delmar. All rights reserved.
Bioterrorism
• Three categories of biological agents:
1. Category A highest risk
•
•
•
•
•
Easy spread
Can be transmitted person to person
High death rates
Public panic
Require special action
36
Copyright © 2008 Delmar. All rights reserved.
Category A
•
•
•
•
•
•
Anthrax
Plague
Smallpox
Botulinum toxin
Tularemia
Hemorrhagic fever
37
Copyright © 2008 Delmar. All rights reserved.
Category B
2. Category B second highest:
–
–
–
–
Moderately easy to spread
Moderate illness rates
Low death rates
Require specific enhancements of CDC’s
lab capacity
38
Copyright © 2008 Delmar. All rights reserved.
Category B
•
•
•
•
•
Q Fever
Brucellosis
Glanders
Melioidosis
Psittacosis
• Ricin toxin
• Typhus Fever
• Staphylococcal
Enterotoxin B
• Viral encephalitis
• Food and waterborne
diseases
39
Copyright © 2008 Delmar. All rights reserved.
Category C
3. Category C third highest priority:
–
–
–
–
Emerging pathogens
Easily available
Easily produced and spread
Potential for high morbidity and mortality
40
Copyright © 2008 Delmar. All rights reserved.
Category C
•
•
•
•
•
Napin virus
Hantaviruses
Tick-borne encephalitis viruses
Yellow fever virus
Multi-drug resistant Mycobacterium
tuberculosis
41
Copyright © 2008 Delmar. All rights reserved.
Managing Bioterrorism
• Plans in place for local response
• State and Federal agencies can assist
• U.S. Department of Homeland Security
42
Copyright © 2008 Delmar. All rights reserved.
Strategies for Nurses
• Often first to detect presence of illness
• Often manages the communicable disease
program for county
– Surveillance systems
– Nurse conducts case and contact follow up
– Communication skills
• Risk communication
43
Copyright © 2008 Delmar. All rights reserved.
Planning for
Pandemic Disease Events
• WHO Global Influenza Preparedness Plan
– Inter-pandemic
• Phase I and II
– Pandemic alert
• Phase III, IV, V
– Pandemic period
• Phase VI
44
Copyright © 2008 Delmar. All rights reserved.