Control of infectious disease

Question 1

What is the primary focus of the Public Health Vertical Module?

Answer 1

Control of infectious disease

Led by Dr. Simonette Mallard, Preventive & Social Medicine.

Question 2

What are the learning objectives of the course?

Answer 2

• Importance of communicable diseases from a public health perspective
• Principles of communicable disease surveillance and control
• Principles of immunisation as a population-based health strategy

Question 3

Who is known for tracing cholera cases during the 1854 London cholera epidemic?

Answer 3

John Snow

Question 4

What theory did John Snow discount while tracing cholera cases?

Answer 4

Miasma theory

Question 5

What significant action did John Snow take during the cholera outbreak?

Answer 5

Closed down the contaminated Broad Street water pump

Question 6

What practices did Māori use as controls for infectious disease?

Answer 6

• Sick, dead, and possessions kept separate (tapu)
• Hygiene & sanitation measures
• Separate toileting and food compost areas
• Leftovers not consumed
• Disposal of human bodily products
• Separate whare for birth period

Question 7

What impact did explorers and colonists have on Māori health?

Answer 7

Brought new diseases to which Māori had no immunity

Question 8

What was the percentage of deaths from infectious disease in the 1870s?

Answer 8

One-third of deaths

Question 9

What was the percentage of deaths from infectious disease by 2000?

Answer 9

Less than 7%

Question 10

What factors contributed to declining morbidity and mortality from infectious disease?

Answer 10

• Improved sanitation
• Baseline health
• Health care
• Clean water & food
• Living conditions
• Antimicrobials
• Vaccination
• Surveillance
• Legislation & regulations

Question 11

Which infectious disease remained the world’s leading single infectious disease killer in 2024?

Answer 11

Tuberculosis (TB)

Question 12

What legislation requires water suppliers to provide residual disinfection in pipe networks?

Answer 12

Water Services Act 2021

Question 13

What incident in Havelock North in 2016 was linked to contaminated water supply?

Answer 13

Outbreak of campylobacteriosis

Question 14

What was the result of the 2016 Havelock North water contamination?

Answer 14

• 8320 cases of campylobacteriosis
• 4 deaths
• 3 cases of Guillain-Barré syndrome
• 42 hospitalisations

Question 15

What is included in the immunisation schedule in Aotearoa?

Answer 15

• Tetanus + diphtheria + whooping cough (pertussis)
• Influenza
• Rotavirus
• Diphtheria + tetanus + whooping cough + polio + hepatitis B + Hib
• Pneumococcal disease
• Meningococcal B
• Measles + mumps + rubella
• Chickenpox (varicella)
• Human papillomavirus (HPV)
• Shingles

Question 16

What is the goal for childhood immunisation in New Zealand by 2030?

Answer 16

95% of children fully immunised at 24 months of age

Question 17

What is the Basic reproduction number (R0)?

Answer 17

The number of cases expected to be generated by one case in a susceptible population

Question 18

What does an R0 value of less than 1 indicate?

Answer 18

Disease won’t spread

Question 19

What is the herd immunity threshold formula?

Answer 19

p ≥ 1 – 1/ R0

Question 20

What is passive surveillance?

Answer 20

Collection of data on notifiable diseases, sentinel site surveillance, analysis of routinely collected data, environmental data

Question 21

What is active surveillance?

Answer 21

Contact tracing, outbreak investigation, environmental, zoonotic surveillance

Question 22

What does the Global Influenza Surveillance & Response System (GISR) do?

Answer 22

• Advises biannually on vaccine composition
• Acts as a global alert mechanism for respiratory viruses with pandemic potential

Question 23

What was the first influenza vaccine developed?

Answer 23

1942

Question 24

What is the estimated number of measles deaths globally in 2023?

Answer 24

> 100,000 deaths

Question 25

What does WHO advise biannually regarding vaccines?

Answer 25

Composition of vaccine for Northern & Southern Hemispheres

Question 26

What is one of the roles of WHO in relation to respiratory viruses?

Answer 26

Acts as a global alert mechanism for the emergence of respiratory viruses with pandemic potential

Question 27

Which respiratory viruses is the WHO expanding its surveillance to include?

Answer 27

* RSV * COVID-19

Question 28

What organization has been part of WHO GISR since 1989 on behalf of NZ MOH?

Answer 28

Environmental Science & Research (ESR)

Question 29

What is the purpose of swabbing patients with ILI at sentinel sites?

Answer 29

To test for various respiratory viruses

Question 30

Which viruses are tested by ESR’s National Influenza Centre?

Answer 30

* influenza * SARS-CoV-2 * RSV * adenovirus * enterovirus * metapneumovirus * parainfluenza * rhinovirus

Question 31

What type of data is sent to WHO GISR?

Answer 31

Data from ILI surveillance

Question 32

List some other ESR dashboards related to infectious diseases.

Answer 32

* Invasive pneumococcal disease * Meningococcal disease * Measles * Pertussis * STIs (syphilis, chlamydia, gonorrhoea) * Wastewater (COVID-19) * Notifiable diseases

Question 33

What are notifiable diseases?

Answer 33

Diseases that must be reported to the Medical Officer of Health

Question 34

Name one infectious disease that is notifiable under the Health Act 1956.

Answer 34

* Campylobacteriosis * Cholera * Cryptosporidiosis * Giardiasis * Hepatitis A

Question 35

What is the notification requirement for AIDS/HIV under the Health Act 1956?

Answer 35

Must not include identifying information

Question 36

What was declared a Public Health Emergency of International Concern (PHEIC) on January 30, 2020?

Answer 36

COVID-19

Question 37

What is the definition of a Public Health Emergency of International Concern (PHEIC)?

Answer 37

An extraordinary event constituting a public health risk to other States requiring a coordinated international response

Question 38

How many PHEIC declarations have there been so far?

Answer 38

8

Question 39

What is one control measure implemented to manage infectious diseases?

Answer 39

* Improved sanitation * Vaccination * Surveillance * Legislation & regulations

Question 40

What does the 2005 International Health Regulations require from Member States?

Answer 40

* Detect public health risks * Assess & Report to WHO events * Respond to public health risks

Question 41

What is the definition of an outbreak?

Answer 41

An epidemic limited to a localised increase in the incidence of a disease

Question 42

What are the three broad strategies used in pandemic planning?

Answer 42

* Mitigation * Suppression * Elimination

Question 43

What was the primary strategy used in New Zealand from March 2020 to late 2021?

Answer 43

Elimination

Question 44

What does mitigation in pandemic planning refer to?

Answer 44

Making the health system manageable and flattening the curve

Question 45

Fill in the blank: The Health Act 1956 grants special powers to the _______.

Answer 45

Medical Officer of Health

Question 46

What principle involves giving individuals the option to comply before issuing an order?

Answer 46

Voluntary compliance

Question 47

What is the principle of proportionality in infectious disease management?

Answer 47

Measures should be proportionate to public health risk

Question 48

What does the least restrictive alternative principle entail?

Answer 48

Applying the least restrictive measure that will achieve the objective

Question 49

What is the significance of the 2024 update to the International Health Regulations?

Answer 49

Defines pandemic emergencies with higher levels of alarm and commitment to solidarity and equity

Question 50

What is the purpose of the Aids Epidemiology Group (AEG)?

Answer 50

To report HIV and AIDS data to health providers and authorities

Question 51

What is the definition of a pandemic?

Answer 51

An epidemic occurring worldwide or over a very wide area affecting a large number of people