1. Discuss worldwide (in developed and underdeveloped countries)
the leading causes of death among children, adults, and older adults,
(Pgs. 287-290).
In the United States at the beginning of the twentieth century, infectious diseases were the
leading cause of death. In 1900 respiratory and diarrheal diseases were major killers.
Infectious diseases remain the leading cause of death for children and adolescents worldwide
and the second-leading cause overall, killing an estimated 8 million people a year. most
publicized infectious disease event of 2009 was the advent of a new strain of flu, novel
influenza A H1N1. 90% result from six causes: acute respiratory infections, diarrheal diseases,
malaria, and measles among children; and TB and HIV infection among adults.
• IID-1: Reduce, eliminate, or maintain elimination of cases of vaccinepreventable diseases.
• IID-12: Increase the percentage of children and adults who are vaccinated against seasonal
influenza.
• FS-1: Reduce infections caused by key pathogens transmitted commonly through food.
• HAI-2 Reduce invasive health care–associated methicillin-resistant Staphylococcal aureus
(MRSA) infections.
2. Discuss the transmission of communicable diseases using
the epidemiological triangle. Be able to apply examples, (Pgs. 290-292).
Agent, Host, and Environment
Agent Factor Four major categories of agents cause most infections and infectious disease:
bacteria (e.g., Salmonella and E. coli), fungi (e.g., Aspergillus spp. and Candida spp.),
parasites (e.g., helminthes and protozoa), and viruses (e.g., hepatitis A and B and HIV).
Host Factor A human or animal host can harbor an infectious agent. The characteristics of
the host that may influence the spread of disease are host resistance, immunity, herd
immunity, and infectiousness of the host.
Environment Factor The environment refers to everything that is external to the human
host, including physical, biological, social, and cultural factors.
Environment Factor The environment refers to everything that is external to the human host,
including physical, biological, social, and cultural factors.
3. Discuss Infectious Disease interventions based on the levels of
prevention. Be able to apply examples, (Pg 297)
There are three levels of prevention in public health: primary, secondary, and tertiary. In
prevention and control of infectious disease, primary prevention seeks to reduce the incidence
of disease by preventing occurrence, and this effort is often assisted by the government.
The goal of secondary prevention is to prevent the spread of infection and/or disease once it
occurs. Activities center on rapid identification of potential contacts to a reported case.
Contacts may be (1) identified as new cases and treated, or (2) determined to be possibly
exposed but not diseased and appropriately treated with prophylaxis.
Tertiary prevention works to reduce complications and disabilities through treatment and
rehabilitation.
Primary Prevention To prevent the occurrence of disease:
• Responsible sexual behavior
• Malaria chemoprophylaxis
• Tetanus boosters, flu shots
• Rabies pre-exposure immunization
• Safe food-handling practices in the home
• Repellants for preventing vector borne disease
• Following childhood immunizations recommendations, and “no shots, no school” laws
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, • Regulated and inspected municipal water supplies
• Bloodborne pathogen regulations
• Restaurant inspections
• Federal regulations protecting American cattle from exposure to bovine spongiform
encephalopathy (BSE)
Secondary Prevention To prevent the spread of disease:
• Immunoglobulin after hepatitis A exposure
• Immunization and chemoprophylaxis as appropriate in meningococcal outbreak
• Rabies postexposure immunization
• Tuberculosis screening for health care workers
• Sexually transmitted disease (STD) partner notification
• Human immunodeficiency virus (HIV) testing and treatment
• Quarantine
Tertiary Prevention To reduce complications and disabilities through treatment and
rehabilitation:
• Pneumocystis pneumonia (PCP) chemoprophylaxis for people with AIDS/ HIV stage III
• Regular inspection of hands and feet as well as protective footwear and gloves to
avoid trauma and infection for leprosy clients who have lost sensation in those areas
4. Discuss the Core Public Health functions, and provide examples
for each, (pages 5-9).
the core functions of assessment, assurance, and policy development.
The Core Functions Project (U.S. Public Health Service, 1994 [updated 2008]) developed a
useful illustration, the Health Services Pyramid (Figure 1-2), which shows that population-
based public health programs support the goals of providing a foundation for clinical
preventive services.
Vision: Healthy people in healthy communities
Mission: Promote physical and mental health and prevent disease, injury, and disability Public
health
• Prevents epidemics and the spread of disease
• Protects against environmental hazards
• Prevents injuries • Promotes and encourages healthy behaviors
• Responds to disasters and assists communities in recovery
• Ensures the quality and accessibility of health services
Essential public health services by core function Assessment
1. Monitor health status to identify community health problems
2. Diagnose and investigate health problems and health hazards in the community Policy
Development
3. Inform, educate, and empower people about health issues
4. Mobilize community partnerships to identify and solve health problems
5. Develop policies and plans that support individual and community health efforts Assurance
6. Enforce laws and regulations that protect health and ensure safety
7. Link people to needed personal health services and assure the provision of health care
when otherwise unavailable
8. Assure a competent public health and personal health care workforce
9. Evaluate effectiveness, accessibility, and quality of personal and population-based health
services
Serving All Functions
10. Research for new insights and innovative solutions to health problems
5. Discuss CDC’s reportable communicable diseases, (Pg. 293, Box
13-3).
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