Required Preparation: Read the textbook; review the power points before class. Read the assigned article, and be ready to discuss it in a group.
Learning Objectives:
- Review principles related to the occurrence and transmission of infection and infectious diseases.
- Describe the chain of transmission of infectious diseases.
- Apply the chain of transmission to describing approaches to controlling infectious disease.
- Review types of immunity, including herd immunity.
- Review principles of immunization and specify the immunization recommended for all age groups in the United States.
- Describe the legal responsibility for control of communicable diseases in the United States.
- Describe the chain of transmission and control for priority infectious disease.
- Identify nursing activities for control of infectious diseases at primary, secondary, and tertiary levels of prevention.
- Review principles related to the occurrence and transmission of infection and infectious diseases.
Key Terms: Knowing these terms will help you understand the concepts of this topic. communicable disease isolation mass screening mode of transmission zoonoses incubation period nosocomial infection outbreak endemic epidemic pandemic cross-immunity
Materials Needed for Class: This packet Today’s Activities: Lecture, group work with case studies
Study Questions:
Talk about the previous perspectives in communicable diseases. What happened in the last century to increase positive outcomes in community health? Talk about transmission of communicable diseases. Transmission depends on the successful interaction of three factors. What are they? What are the four main categories of infections agents that can cause infection?
Discuss the modes of transmission. What are the three examples of disease spectrum? How are communicable diseases tracked? What about emerging infectious diseases? What are some examples—and what was done about it? How are communicable diseases prevented and controlled? What is the role of the nurse? Talk about agents of bioterrorism. How are anthrax and smallpox contracted? Treated? How do they present? Vaccines are one of the most effective methods of preventing and controlling communicable diseases. What are these diseases? How do they present? How are they treated?
Food infection results from bacteria or viral or parasitic infection of food. Name some food- borne illnesses. What are food intoxications? Vector-borne diseases are transmitted by vectors. How are they treated? Prevented? Zoonosis is an infection transmitted from a vertebrate animal to a human. How is this prevented? Treated? Talk about hospital-acquired infections and universal precautions. Discuss disease surveillance. What are the uses? Purposes? Data sources?
What are nationally notifiable diseases? State notifiable diseases? What is the system used for this report mechanism?
Discussion Questions:
- Your college roommate went to bed not feeling well one night and early the next morning you had trouble arousing her. She was rushed to the hospital just in time to be effectively diagnoses and treated for meningococcal meningitis. The health department recommends immediate antibiotic treatment for everyone that was in close contact with your roommate. They set up a process to watch for additional cases to be sure an outbreak is not in progress. Fortunately, no more cases occur. You ask yourself: should your college require that all freshmen have the meningococcal vaccine before they can register for classes?
- As a health advisor to a worldwide HIV/AIDS foundation, you are asked to advise on ways to address the HIV and developing tuberculosis epidemics. You are asked to do some long- range thinking and to come up with a list of potential approaches to control the epidemics, or at least ways reduce the development of TB. The first recommendation to make is to forget about eradicating HIV/AIDS. How did you come to that conclusion?
- Your hometown of 100,000 is faced with a crisis as an airplane lands containing a passenger thought to have a new form of severe influenza that has recently gained the ability to spread from person to person through airborne spread. As the mayor of the city, what do you decide to do?
- You are a principal at a local high school. One of your top athletes is in the hospital with a spreading bacterial infection due to a staphylococcus bacteria resistant to all known antibiotics. The infection occurred after what appeared to be a minor injury during practice. As the principal, what do you decide to do?
Case Study # 1: A local university does not require proof of immunization from incoming students.
The university administration is afraid that requiring evidence of immunization will deter students from registering for courses. How might you go about convincing the administration that immunization status should be validated before students are allowed to register? You believe that all college students should receive a meningitis vaccination prior to enrolling. What do you believe would work better: 1) requiring the immunization before the student arrives at the college or 2) providing vaccinations to students upon arrival at college?
Case Study # 2: A Communicable Disease.
Jane is an 18-year-old college student. She lives in the dorm with her roommate, Sally. Shortly after Jane returned from Christmas vacation, she developed a fever and a rash. She didn’t feel too bad, but Sally persuaded her to see a doctor. Because it was Saturday, Jane went to the emergency department (ED) of the local hospital. The physician there made a diagnosis of rubella. Later that night, he and the nurses in the ED became very busy with victims of a multi vehicle accident. As a result, no one completed the health department form reporting Jane’s rubella until 2 days later.
By the time a community health nurse contacted Jane to complete a rubella case report, Sally and several other girls in Jane’s dorm had also developed rubella. Sally gave it to her boyfriend, who exposed those in his classes. One of the women in his English class is pregnant. Based on the information presented in the case description, what biophysical, psychological, physical environmental, sociocultural, behavioral, and health system factors are operating in this situation? What additional factors in these dimensions might influence the situation?
How might you assess for the presence or absence of these factors? What primary preventive measures could have been employed to prevent this situation? What primary prevention measures are appropriate at this point? What secondary and tertiary measures by the community health nurse are appropriate at this time? What roles will the community health nurse perform in dealing with this situation? What other public health personnel might the community health nurse collaborate with in addressing the situation? How would you evaluate the effectiveness of interventions in this situation?