Disease transmission occurs from person to person through direct contact such as shaking hands, sexual contact, or exposure to bacteria released in mucous by coughing or sneezing. Sharing of hypodermic needles transmits disease from one user into the bloodstream of the recipient. Ingestion of contaminated food passed amongst groups of people and contact with human fecal material are other person-to-person modes of bacterial and viral transmission. Decreasing the incidence of disease transmission can take place in the following ways: Hand-washing removes bacteria that is transferred to mucous membranes, the portal for bacteria and viruses.
In a randomised, controlled study involving 300 households in Pakistan, conducted over a period of one year, study results showed a 53% decrease in pneumonia in children under the age of 5 when hand-washing with plain soap was performed regularly (Luby et al. , 2005). Hand-sanitizing dispensers placed in schools and workplaces are being used more often and do not require extensive installation or maintenance costs. The use of this design of hand-washing system in a public place is most likely not feasible due to theft of the dispensers and higher cost of maintenance.
Washing hands with water only, without using soap, is not as effective at reducing bacteria and viruses from hands. Alternatives, such as using hand-washing devices similar in design to public water fountains, require study to assess public response. The public would require evidence that the health benefits, if any, outweigh the expense of water maintenance and product costs. Disease transmission through sexual contact can be controlled by the use of condoms, sexual abstinence and sexual satisfaction through non-invasive means.
A social stigma is attached to providing detailed sex education to anyone, particularly young people who are about to become sexually active, which impairs education about this form of disease transmission. In an attempt to overcome this stigma, educators view the physical process of disease transmission through sexual contact as a component of general health education and have incorporated this in the school curriculum of most North American schools. In a 1995 study of 598 adults (323 male and 275 female), 21% reported using a condom each time they had sexual intercourse over a period of 30 days (Zenilman et al. , 1995).
Education and social acceptance that disease is transmitted through sexual contact may increase use of condoms and aid in decreasing this type of disease transmission. Needle-sharing amongst the illicit drug-using population contributes to disease transmission. It has been estimated that millions of people are infected with hepatitis B, hepatitis C and human immunodeficiency virus every year as a result of unsafe needle-sharing practices (Kane, Lloyd, Zaffran, Simonsen, & Kane, 1999). Needle exchange programs have been established in many cities throughout the world with varying degrees of success.
Longitudinal studies would contribute to understanding how such clinics are used by the population they are trying to assist, and would potentially yield information to assist with future improvement. Blood transfusions are another means of disease transmission. In developed countries measures have been in place for a number of years to screen blood for disease prior to transfusion. In developing nations, screening methods in hospitals and medical clinics need to be part of the medical regimen to aid in prevention of this type of disease transmission.
Evaluation of spatial use also aids in preventing disease transmission. The public domain and the private domain are quite different and the importance of these differences becomes clear when examining disease transmission from person to person (Cairncross, Blumenthal, Kiolsky, Moraes, & Tayeh, 1996). Education and awareness of how infectious disease transmission occurs in the home establishes the formation of good hygiene habits that become a way of life for the occupants, will last their lifetime, and be passed on to future generations.
In summary, hand-washing with soap remains the best method of interrupting the transmission cycle of infectious disease between people. This simple and low-cost method of infectious disease prevention requires continued emphasis by public health workers. In conjunction with this, the issue of providing and maintaining clean and disease-free drinking water and wash water to all citizens is the cornerstone of eradicating infectious diseases and should be included in public education programs.
Methods to prevent spread of infectious disease can be communicated to the public using television and the internet. Public awareness of any health issue changes the public health environment to one of public knowledge rather than ignorance. This change fosters further change to improve public health, and new processes of disease prevention are born.
Refernces
Cairncross, S. , Blumenthal, U. , Kiolsky, P. , Moraes, L, Tayeh, A. (1996). The public and domestic domains in the transmission of disease. Tropical Medicine & International Health,1(1), 27-34.