Download Population Health Curriculum for Health Professionals

Emerging Infectious
Diseases
Dorothy Cumbey, Ph.D., RN
Director of Quality Management
Health Services
Jerry Dell Gimarc, MA
Senior Planner
South Carolina Department of Health and
Environmental Control
AHEC
SOUTH
CAROLINA
Developed as part of an
Enhanced AHEC Community
Partnership for Health
Professions Workforce and
Educational Reform project
funded by the Health
Resource and Service
Administration (HRSA)
SOUTH
CAROLINA
AHEC
At the completion of this
module you will be able to
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describe how the public health system
can be mobilized to address emerging
issues or threats to the public’s health
identify roles and responsibilities of
different components of the public
health system in confronting health
challenges
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CAROLINA
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Objectives, Continued
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describe the linkages needed within
the public health system to
effectively address these challenges
discuss health care needs of
individuals and communities in the
future
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CAROLINA
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OBJECTIVES
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Describe the public health approach
to emerging issues.
Identify roles and responsibilities of
public health system components.
Describe linkages needed to address
challenges.
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CAROLINA
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What Are Emerging
Infectious Diseases?
These are human illnesses
caused by microorganisms or
their poisonous byproducts and
having the potential for occurring
in epidemic numbers.
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CAROLINA
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Why are we concerned about
Emerging Infectious Diseases?
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These diseases:
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Pose a threat to all persons
regardless of age, sex, lifestyle,
ethnic background, or
socioeconomic status
Cause suffering and death
Impose a financial burden on
society
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CAROLINA
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Trends in Death Caused by Infectious
Diseases in the United States, 1900-94
Click for larger picture
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Economic and Societal Impact of
Some Infectious Diseases
Economic and Social Impact of
Some Infectious Diseases
Click for larger picture
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Emerging Infectious Diseases
include conditions that
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emerge as a new infectious
process
re-emerge as drug resistant
forms
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CAROLINA
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Microbial Adaptation
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Mechanisms of genetic diversity
Respond to changes in physical
and social environment.
Epidemiologic triangle
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Host
Environment
Agent
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CAROLINA
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New Emerging
Infectious Diseases
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Human Immunodeficiency Virus
(AIDS)
Lyme disease
Ebola fever
Hantavirus Pulmonary Syndrome
West Nile encephalitis
Legionnaire’s disease
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CAROLINA
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Drug Resistant Diseases
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Malaria
Multiple drug resistant
tuberculosis
Bacterial pneumonias
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CAROLINA
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How Are Infectious
Diseases Acquired?
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Inhalation
Ingestion
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Food, water, soil
Percutaneous inoculation
Mucous membranes
Blood and body fluids
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CAROLINA
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Origin of Emerging
Infectious Diseases
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Changes in environment (technology
and industry)
Economic development
Population growth or migration
Human behavior
International travel and commerce
Microbial adaptation
Breakdown in public health measures
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CAROLINA
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Discussion Time
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Identify some changes that may
contribute to the rise of
infectious diseases.
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Target Areas for Preventing
Emerging Infectious Diseases
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Drug resistance
Food borne and water borne diseases
Vectorborne and zoonotic diseases
Diseases transmitted through
exposure to blood and body fluids
Chronic diseases caused by infectious
agents
Vaccine development and use
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CAROLINA
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Drug Resistance
The emergence of drug resistance
in bacteria, parasites, viruses, and
fungi is reversing medical advances
of the previous 50 years.
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CAROLINA
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Drug Resistant Diseases
More Examples
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S. aureus in Japan and UK, 1997
HIV endemic in NY
Problems in South Carolina
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Streptococccus pneumoniae
Vancomycin resistant Enterrococcus
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CAROLINA
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Examples of Multi-State Food-borne
Outbreaks in the US 1994-1997
Year Organism
#States Food Source
1994 Shigela flexneri
2
Green onions, probably
contaminated in Mexico
1994 Listeria
monocytogenes
3
Milk, contaminated after
pasteurization and shipped
interstate.
1995 Salmonella
enteriditis
41
Ice cream premix hauled in trucks
that had previously carried raw
eggs.
1996 Cyclospora
cayetanensis
20
Raspberries from Guatemala,
mode of contamination unclear
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CAROLINA AHEC
Examples of Multi-state Food-borne
Outbreaks in the US 1994-1997
1996
Escherichia
coli O 157:H7
3
Unpasteurized apple juice, probably
contaminated during harvest.
1996
Norwalk virus
5
Oysters contaminated before harvest.
1997
Samonella
infantis
2
Alfalfa sprouts, probably contaminated
during sprouting.
1997
Cyclospora
cayetanensis
18
Raspberries imported from Guatemala,
mesclun lettuce, and products
containing basil.
1997
Hepatitis A
4
Strawberries from Mexico distributed
through USDA Commodity program for
use in school lunches
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CAROLINA AHEC
Vectorborne and Zoonotic
Diseases
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Influenza
Creutzfeldt-Jakob Disease
“Mad Cow Disease”
Lyme Disease
Rabies
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CAROLINA
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Vectorborne and Zoonotic
Diseases
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West Nile Viral Encephalitis
Malaria
Ebola fever
Hantavirus pulmonary syndrome
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Diseases Transmitted Through
Exposure to Blood and Body Fluids
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Human Immunodeficiency Virus
Hepatitis
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A, B, C, D, E
NANE
SEN-V
Bacterial pathogens
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Other Target Areas
for Prevention
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Chronic Diseases Caused by
Infectious Agents
Vaccine Development and Use
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Populations Particularly
at Risk
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People with impaired host
defenses
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Pregnant women and newborns
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Travelers, immigrants, refugees
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Bioterrorism as an Emerging
Infectious Disease Threat
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Intentional dissemination of
disease
Infectious and toxic agents
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viruses, bacteria, toxins, fungi
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Public Health Approach to
Emerging Infectious Diseases
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Surveillance
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Epidemiology for early diagnosis
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Early response to outbreaks and
changing disease patterns
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Public Health Approach
continued
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Public Health Laboratory support
for rapid and accurate diagnosis
Rapid Communication links to
private providers and hospitals
Communication to public
Education about prevention
and/or early detection
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CAROLINA
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CASE STUDY
Foodborne Illness
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Health care provider report
Epidemiologic investigation: Epi Team
Early Response: Consultation
Laboratory support for diagnosis
Rapid communication to health care
provider/hospital
Communication to public
Education
AHEC
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CAROLINA
DISCUSSION
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What is your role in addressing
emerging infectious diseases?
 Prevention
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Education
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Detection
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CAROLINA
AHEC
Your role in the prevention of
emerging infectious diseases
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Best practices
Antibiotic use
Food preparation
Control exposure
Awareness of risk
Behavior change
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CAROLINA
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Your role in education about
emerging infectious diseases
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Stay informed
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CDC Web Pages
MMWR on Web
EID Journal
Educate patients/family/friends
Know resources - who to call
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CAROLINA
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Your role in detection of
emerging infectious diseases
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Participate in surveillance activities
within your clinical setting
Be alert for “clues”; assess risk
Know your resources - who to call
for consultation
Report to local health department
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CAROLINA
AHEC
Summary
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Shifts in the environment, human
behavior and microorganisms can
cause new diseases to emerge
We share responsibility to identify,
minimize or avoid these situations
SOUTH
CAROLINA
AHEC