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unit 13 > Communicable diseases > Flashcards

Communicable diseases Flashcards

1
Q

What has Public Health England been replaced with?

A

UK Health Security Agency
Office for Health Improvement and Disparities.

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2
Q

Define communicable disease

A

Illness caused by infectious microbes normall bacteria or viruses that spread from one individual to another via contact with a contaminated object e.g surface, bite or air droplet

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3
Q

What is the key difference between what a communicable and non-communicable disease are?

A

Communicable - spreads, caused by infective agents or pathogens, highly infectious or rely on vectors. Examples - TB, COVID-19. Can not be inherited. Tend to be acute

Non-communicable - does not spread, caused by allergy, illness, malnutrition, combination of environmental or genetic factors. No infectious agent. Examples include cancer, rickets. Can be inherited. Tend to be chronic

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4
Q

What are the key difference in the management of communicable and non-communicable disease?

A

Communicable - conventional methods, antibiotics etc. Prevent further spread by wearing masks, PPE, hand hygiene, isolation of infected individuals

Non-communicable - conservative or surgical treatment, precautino through regular check ups, maintain proper diet, daily exercise, taking proper sleep and rest.

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5
Q

What is the epidemiological triad of infectious disease?

A

Agent of infection - the pathogen
Environment - mechanism of transmission or reservoir
Host - susceptible to infection

These can all be linked by a vector - acts as a intermediate for survival and transmission.

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6
Q

What are the different stages in the chain of infection?

A

Agent of infection - virus, bacteria parasite etc
Mechanism of transmission - water born, air droplets etc
Portal of entry - cuts in skin, mucous membranes
Susceptible host - influenced by lifestyle, genetics, risk factors
Reservoir of infection - replicates and survives
Portal of exit - vomit, diahorrea.

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7
Q

Define pathogenicity

A

The power of an infective agent to cause disease
Pathogenic or not.

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8
Q

Define virulence of a microbe

A

The ability to produce severe pathological reactions
Measured by the rate of clinical to subclinical disease and the case fatality rate
Describe a property, how nasty, the disease caused by pathogenic microbes is.

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9
Q

Define dose of infection (inoculum)

A

Inoculum - amount of mircobe given to a patient.
MID - The size of the population of the microorganism required to cause disease.
Higher probability of severe disease with higher dose infection.

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10
Q

Define viability of the organism (resistance)

A

The ability of an organism to surive outside the host body.
Ability to persist during transmission between hosts.
A viable organism is living and able to reproduce.

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11
Q

How does spore formation affect viability of an organism?

A

Spore formation - maintains viability for a long period in unfavourable environmental conditions
Spores - resistant to death in harsh environmental conditions, dormant bacteria with minimal metabolism or respiration.

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12
Q

What is meant by the antigenic power of an organism?

A

The ability of an organism to stimulate the immune system to produce antibodies or antitoxins with subsequent immunity
Measured by second attack frequency (second occurrence of same pathogen in individual)

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13
Q

What is second attack rate?

A

The probability that an infection occurs within susceptible individuals within a specified time after close contact with infected individual.

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14
Q

What is meant by the ease of communicability of an organism?

A

Measured by the second attack rate
Indicates the number of secondary cases likely to occur within the range of the incubation period following exposure to a primary case
Often given as a percentage of the susceptible population.
May be represented by the R-value - which is the number of people that an infected individual is expected to pass the disease on to.

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15
Q

How can we break the chain of infection at the reservoir stage?

A

Ensure environmental sanitation
Disinfection and sterilisation
Water hygiene methods - filtering
Employee health in healthcare environments - using antivirals/antibiotivs when appropriate

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16
Q

How can we break the chain of infection at the portal of exit stage?

A

Hand hygiene
Control of excretions and secretion
Trash and waste disposal effectively

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17
Q

How can we break the chain of infection at the mean of transmission stage?

A

Isolate infected individuals
Ensure correct food handling
Airflow control (ventilation in hospitals)
Standard precautions - PPE when taking bloods etc
Sterilisation of surfaces/fomites
Hand hygine

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18
Q

How can we break the chain of infection at the portal of entry stage?

A

The aseptic technique when handling clinical examinations/material e.g blood
Catheter care - insertion technique and replacement when/if needed
Wound care - wear waterproof plaster, clean around the area,
Examples - bed nets, covering skin to prevent entry through skin or mucous membranes, using insect repellents

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19
Q

How can we break the chain of infection at the susceptible host?

A

Recognition of high risk patients - additional safety mechanisms e.g vaccines etc
Treatment of underlying diseases for example effective flu management to reduce risk of pneumonia, management of HIV to reduce risk of infection in AIDs.
Health education
Adequate personal hygiene
Sound nutrition
Immunixsation
Chemoprophylaxis

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20
Q

How can we break the chain of infection at the infectious agent stage?

A

Rapid and accurate identification of organsisms - targeted and effective treatment
Sourcing and linking cases to identify source of infection an dhow to eradicate

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21
Q

What is meant by control of a communicable disease?

A

Deliberate efforts to reduce disease or health problem burden such as mortality or morbidity to a very low level, normally until no longer a public health concern.

22
Q

What is meant by elimination of a communicable disease?

A

Termination of all modes of transmission to reduce the incidence of disease to zero
In a specific confined or local geographical space
Requires deliberate efforts and sometimes continuous intervention.

23
Q

What is meant by eradication of a communicable disease?

A

Termination of all modes of transmission of an infection
Extermination of the infectious agent worldwide

24
Q

What measured can we use to manage an infectious agent to prevent infection?

A

Sterilization
Disinfection
Antiseptics
Sanitisation
Ensure proper treatment of infected individuals

25
Q

What is sterilisation of a microbe?

A

Complete removal of all forms of living.infectious agents from a surface

26
Q

What is disinfection in terms of communicable disease?

A

A process that eliminate many or all pathogenic microorganisms, except bacterial spores on inanimate objects
Note normal/healthy commensals tend to remain.

27
Q

What is antiseptic in terms of communicable disease?

A

When disinfectants, normally at lower concentrations are used on the skin to removal all or many pathogenic microorganisms.
Chemical agents - stop or slow the growth of infectious agents on external surfaces such as skin.

28
Q

What is meant by sanitisation in terms of communicable disease?

A

The cleaning and disinfection of an area or an item using heat or chemicals to reduce the number of microorganisms to safe levels.

29
Q

What methods help prevent transmission of a disease?

A

Isolation of infected individuals
Decontamination of formties
Promote handwshing
Modify ventilation and air pressure of hospital rooms containing infectious patients
Control vector population (mosquito nets)
Environmental - sanitation of water, food and proper sewage handling.

30
Q

What methods targeting the reservoir of infection can be used to reduce transmission?

A

Identifying cases
Identifying carriers
Identifying animal reservoirs

31
Q

How can identifying cases of a condition help manage it?
(aka prevent transmission)

A

report to local authority and trace back to cause (the reservoir), ensure isolation or elimination of reservoir or appropriate treatment, often isolate over whole period of communicability and treatment, surveil for the longest incubation period - identify those at risk.

32
Q

How does identifying carriers of infection help manage the condition?

A

Carriers in community should be treated if needed
Should be isolated from work/others until organism eliminated (esp food handlers, child worker or carer)
Cost effectiveness depends on the proportion of carriers in the community to those affected and the sensitivity of their occupation.

33
Q

How is identifying any animal reservoirs of infection important in managing an infective condition?

A

Adequate animal husbandry
Immunisation of anmials
Treatment of infected animals or killing of infected animals
To prevent spread to humans or other species/animals

34
Q

What is meant by modelling of an infectious agent?

A

Using a range of data sources - from soft sources (twitter), clinical trials, lab experiments, epidemiological studies to death reports
Create a stasticial distribution of different disease aspects such as vulnerable population, effects etc
Filters into a model
Creates predictions on disease burden (QALYS), mortality, cost, threshold intervention coverage.
Can adjust policy control variables to predict effect on disease management.

35
Q

Why is creating a model of an infectious agent useful?

A

Allos to predict outcomes and behaviours
Can alter model variables particular those under policy control (such as length of isolation) to predict effect on the outcome
Leads to policy control variables for example understanding cost effectiveness of vaccination

36
Q

What people are involved in managing infections in hospitals?

A

Director of infection prevention and control (DIPC) - develop and implements plans for control, monitor and adjust policies organising training as needed - authirty figure and reports to board.
Infection prevention and control team - help healthcare workers and provide training on hold to limit spread on infection, advise on closure of wards and decision making during an outbreak, work with occupational health to protect health of workers and patients.

37
Q

What authorities are responsible for managing infections in the community?

A

The local authirty role is split into director of public health (focus on health in policy) and the environmental health team (sanitation, pollution, food poisoning), these are both part of the local health protection partnership
The NHS are also part of this partnership, identfy community priorities and create policy according to this.
NHS and LHPP are influenced by Public Health England.
PHH and the Director or public health can refer to the secretary of state for Health and Social care to influence nation guidelines or access funding.

38
Q

What are the standards for outbreak recognition and declaration?

A

Intitial investigation to clarfiy nature of outbreak should begin with 24 hours
Immediate risk assessment should be taken an updated as appropriate
Decision around declaring the outbreak should be made and recorded at the end of the initial investigation, should involve contact with outbreak control team

39
Q

What are the standards of care for managing outbreaks for the outbreak control team?

A

OCT should be heal as sson as possible and within 3 working days of decision to meat
All stakeholders should be represented at the meeting
Roles and responsibilities of OCT should be recorded and agreed
Lead organisation with accountability for outbreak should be agreed and recorded.

40
Q

What is the standard of management for outbreak investigation and control?

A

Control measures documented with clear timescales for implementation and responsibility
Cade definition agreed and recoded
Descriptive epidemiology undertaken and reviewed including key demographics, risks factors and severity of disease
Review risk assessment in light of newly appearing evidence
Analytical studies should influence decision making - reasons should be recorded.

41
Q

What are the standards of care for communication when managing a disease outbreak?

A

Communication stratergy agreed at first OCT meeting and reviewed throughout
Absolute clarity about outbreak lead at all times with appropriate handover.

42
Q

What are the standards of care for marking the end of an outbreak in infectious disease management?

A

Final outbreak report completed within 12 weeks of formal closure of the outbreak
Reports recommendations and lessons learnt reviewed within 12 months after formal closure of outbreak.

43
Q

Give a summary of the processes involved in outbreak management.

A

Incident notified
Initial response and investigation
Decide if outbreak should be declared
Is declared decide if OCT should be established
Both these decision should be reviewed as needed
Actions to take include - investigations into outbreak cause/patterns, control measures such as protecting those at risk and limiting spread and communication with media and members of OCT
End of outbreak declared
Write a final outbreak report and constructive brief on lessons learnt and goals moving forward.

44
Q

What are some national strategies being undertaken by NHS to help infection prevention and control?

A
  1. Optimise vaccine provision and reduce vaccine preventable diseases in England - focus on HPV in boys and flu vaccine uptake, work to modify NHS vaccination schedule
  2. Tackle antimicrobial resistance - ensure minor and low risk surgery remains sage, reduced AMR infections

Also guidance on hand hygiene, PPE, reducing occupational exposure for health care workers and guidance on managing patients.

45
Q

How would having a patient with hepatitis B (or other blood borne pathogen) influence clinical practise?

A

Need to understand routes of transmission in order to reduce risk to self and other patients (bodily fluids)
Design facilities to best treat patient and reduce risk of transmission
Consider patient environment
Understand and minimise risk of clinical procedures such as taking blood samples
Used PPE
Sanitisation of environment if fluids are spilt.

46
Q

Why are hospital acquired infection problematic?

A

Many susceptible individuals in close proximity in a hospital
AMR is a prominent issue
Potential for rapid spread

47
Q

What are the key differences between the management of infections in hospitals v community?

A

Hospital - tends to have better control, all health care staff take responsibility

Community - harder to control, blame game, only certain individuals or authority figures take responsibility.

48
Q

What is a notifiable disease?

A

A disease when registed medical professions have a statutory duty to notify the proper officer at their local council or local health protection team is suspected case of certain infections diseases.
Include: disease info, doctor info and patient info.
These diseases tend to have high morbidity, mortality or spread rapidly or a combination of all three.

49
Q

Give some examples of some notifiable diseases

A

Acute meningitis
Botulism
Cholera
Food poisoning
Tetanus
Smallpox
COVID-19

50
Q

Give some examples of some notifiable organisms

A

Clostridium botulinum
Ebola virus
Hepatitis A,B,C delta and E viruses
Influenza virus
Legionella spp
Salmonella spp

unit 13 (22 decks)

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