Communicable Disease Control - Carter Center
LECTURE NOTESFor Nursing StudentsCommunicable DiseaseControlMulugeta AlemayehuHawassa UniversityIn collaboration with the Ethiopia Public Health Training Initiative, The Carter Center,the Ethiopia Ministry of Health, and the Ethiopia Ministry of Education2004
Funded under USAID Cooperative Agreement No. 663-A-00-00-0358-00.Produced in collaboration with the Ethiopia Public Health Training Initiative, The CarterCenter, the Ethiopia Ministry of Health, and the Ethiopia Ministry of Education.Important Guidelines for Printing and PhotocopyingLimited permission is granted free of charge to print or photocopy all pages of thispublication for educational, not-for-profit use by health care workers, students orfaculty. All copies must retain all author credits and copyright notices included in theoriginal document. Under no circumstances is it permissible to sell or distribute on acommercial basis, or to claim authorship of, copies of material reproduced from thispublication. 2004 by Mulugeta AlemayehuAll rights reserved. Except as expressly provided above, no part of this publication maybe reproduced or transmitted in any form or by any means, electronic or mechanical,including photocopying, recording, or by any information storage and retrieval system,without written permission of the author or authors.This material is intended for educational use only by practicing health care workers orstudents and faculty in a health care field.
Communicable Disease ControlPrefaceThis lecture note was written because there is currently nouniformity in the syllabus and, for this course additionally,available textbooks and reference materials for healthstudents are scarce at this level and the depth of coverage inthe area of communicable diseases and control in the higherlearning health institutions in Ethiopia. The author hopes thatthe material will, to some extent, solve this problem. Although,this lecture note is prepared and intended for use primarily fornursing students, other health science students and healthprofessionals can use it. After using this material, students areexpected to be able to: describe the epidemiology and scope of communicablediseases in Ethiopia and factors involved in thetransmission of communicable diseases; identify the preventive and control measures of each ofthe communicable diseases; play an active role in the prevention and control ofcommunicable diseases; organize and implement effective health education oncommunicable diseases, and; participate in teaching junior staff and significant others inhealth courses on managing patients with communicablediseases.i
Communicable Disease ControlIn order to accomplish the above objectives, efforts have cable disease outline of nursing students, including:epidemiology of communicable diseases in Ethiopia; definitionand descriptions of the transmission, prevention and control ofcommunicable diseases, air-borne diseases, vector-bornediseases, sexually-transmitted diseases, zoonotic diseases,and food-borne diseases (food poisoning and infection). Thelast chapter has a brief description of nursing principles in themanagement of communicable diseases.Specific learning objectives and review questions have beenset for each chapter. Moreover, each disease has beendiscussed in terms of its definition, infectious ccriteria,treatment, nursing care (for some diseases) and preventionand control methods. Important words or phrases in the texthave been defined in the glossary. References used havebeen also listed at the end.ii
Communicable Disease ControlAcknowledgmentsI am highly indebted to acknowledge The Carter Center Ethiopia Public Health Training Initiative (EPHTI), AddisAbaba, for its magnificent contribution in the preparation ofthis useful lecture note in terms of logistics and administrativesupport. I am also indebted to my students, to whom I ble disease control course, and whose interestand participation have sustained my motivation during thearduous writing of this material.I would like to express my deep appreciation to Dr. TadesseAnteneh for his advice, encouragement, and support in thepreparation of this lecture note.My deep appreciation also goes to Ato Keneni Gutema, AtoArega Awoke and S/r Addisalem Yilma, for their constructivecomments and suggestions on an earlier draft and for takingtime out from their busy schedules to read it.I would like to acknowledge Ato Abraham Alano and AtoYared Kifle, who reviewed the final draft and gave meinvaluable comments and suggestions.Last but not least my thanks also go to W/t Yiftusra Abebeand W/t Tigist Ayele who have assisted me in accomplishingall of the secretarial work of this text.iii
Communicable Disease ControlTable of ContentsPrefaceiAcknowledgementiiiTable of ContentsivList of FiguresixAbbreviations and AcronymsxCHAPTER ONE: INTRODUCTION11.1 Learning Objectives11.2 Epidemiology and Scope of Communicable2Diseases in Ethiopia1.3 Epidemiological Terms and DefinitionsReview Questions47CHAPTER TWO: DEFINITIONS, DESCRIPTIONS8OF THE TRANSMISSION, PREVENTION ANDCONTROL OF COMMUNICABLE DISEASES2.1 Learning Objectives82.2 Communicable Diseases82.3 Chain of Disease Transmission92.4 Carrier and Its Types152.5 Time Course of Infectious Diseases152.6 Levels of Prevention162.7 Communicable Disease Control19Review Questions22iv
Communicable Disease ControlCHAPTER THREE: ORAL-FECAL TRANSMITTED23DISEASES3.1 Learning Objectives233.2 Introduction233.3 Feces Mainly in Water243.4 Feces Mainly in Soil423.5 Direct Contact With Feces56Review Questions61CHAPTER FOUR: AIR-BORNE DISEASES624.1 Learning Objectives624.2 Introduction624.3 Common Cold634.4 Measles654.5 Influenza684.6 Diphtheria704.7 Pertusis734.8 Pneumococcal Pneumonia764.9 Meningococcal Meningitis794.10 Tuberculosis814.11 Leprosy87Review Questions91CHAPTER FIVE: ARTHROPOD OR92INTERMEDIATE VECTOR-BORNE DISEASES5.1 Learning Objectives92v
Communicable Disease Control5.2 Introduction925.3 Mosquito-borne Diseases935.4Flea-borne Diseases1065.5Louse-borne Diseases1115.6Snail-borne Diseases116Review Questions126CHAPTER SIX: SEXUALLY TRANSMITTED122DISEASES6.1Learning ancroid1336.5Lymphogranuloma Venereum1356.6Herpes chomoniasis1436.10 HIV/AIDS146Review Questions150CHAPTER SEVEN: ZOONOTIC DISEASES1517.1Learning Objectives1517.2Introduction1517.3Food of Animals1527.4Animal Bite Diseases169vi
Communicable Disease Control7.5Direct Contact Diseases1727.6Animal Reservoir Diseases177Review Questions187CHAPTER EIGHT: FOOD-BORNE DISEASES1888.1Learning Objectives1888.2Introduction1888.3Staphylococcal Food w Questions198CHAPTER NINE: NURSING RESPONSIBILITIES IN199THE MANAGEMENT OF COMMUNICABLEDISEASES9.1Learning Objectives199Review Questions205Glossary206References211vii
Communicable Disease ControlList of FiguresFig. 3.1 The five “Fs” which play an important role infecal-oral diseases transmissionFig. 3.2 Transmission and life cycle of EntameobahistolyticaFig. 3.3 Transmission and life cycle of Giardia lambliaFig. 3.4 Transmission and life cycle of AscarislumbricoidsFig. 3.5 Transmission and life cycle of TrichuristrichuriaFig. 3.6 Transmission and life cycle of EntrobiusVemicularisFig. 3.7 Transmission and life cycle of StrongyloidesStercolarisFig. 3.8 Transmission and life cycle of HookwormsFig. 5.1 Transmission and life cycle of MalariaparasitesFig. 5.2 Transmission and life cycle of W. bancroftiand Brugia speciesFig. 5.3 Transmission and life cycle of SchistosomaspeciesFig. 7.1 Transmission and life cycle of Taenia soliumand Taenia saginataFig. 7.2 Transmission and life cycle of LeishmaniaparasitesFig. 7.3 Transmission and life cycle of T.b.rhodesiense and T.b. gambienseviii243336444750525496100119154179183
Communicable Disease ControlAbbreviations and AcronymsAFBAcid Fast BacilliAIDSAcquired Immuno-Deficiency SyndromeBCGBacillus of Calmate-GuireinBidBies in dies (two times a day)B. Sc.Bachelor of Science degreeC0Degree CelsiusCNSCentral Nervous SystemCSFCerebro-spinal fluidCTComputerized TomographyDECDiethylcarbamazin CitrateDOTSDirectly Observed Treatment Short courseGITGastro-intestinal TractHIVHuman Immuno-deficiency VirusIgMImmunogloblin M.IMIntramuscularIUInternational UnitIVIntravenousKgKilogramMOHMinistry of HealthMRIMagnetic Resonance ImagingOPVOral Polio VaccinePOPer os (per mouth)PTBQID Smear Positive Pulmonary TuberculosisQuadris in dies (four times a day)ix
Communicable Disease ControlSTDSexually Transmitted DiseaseSTISexually Transmitted IllnessTBTuberculosisTidTries in dies (three times a day)URTIUpper Respiratory Tract InfectionUSAUnited States of AmericaWHOWorld Health Organizationx
Communicable Disease ControlCHAPTER ONEINTRODUCTION1.1Learning ObjectivesAt the end of this chapter, the student will be able to:-Describe the burden of communicable diseases inEthiopia.-Define epidemiology and epidemiological terminologies.-Identify the major communicable diseases that posehealth problems in rdimensions, namely the time course and cause. According tothe time course, they are further classified as acute(characterized by a rapid onset and a short duration), andchronic disease (characterized by prolonged duration).Based on the cause, diseases can be broadly categorized asinfectious, (i.e. caused by living parasitic organisms such asviruses, bacteria, parasitic worms, insects, etc.), or as noninfectious (which are caused by something other than a livingparasitic organism).However, most of the common diseases in Africa areenvironmental diseases (infectious) due to infection by living1
Communicable Disease s,because they spread from person to person, or sometimesfrom animals to people. They occur at all ages but are mostserious in childhood and they are to a great extentpreventable. In developed countries where they have beenprevented, other health conditions such as accidents anddegenerative diseases become the most common. Therefore,communicable diseases remain very important in developingcountries because: Many of them are very common Some of them are serious and cause death and disability Some of them cause widespread out breaks of disease orepidemics Most of them are preventable by fairly simple means. Poor socio-economic status of the individuals makes themvulnerable to a variety of diseases Low educational status Lack of access to modern health care service1.2 Epidemiology and Scope of CommunicableDiseases in EthiopiaDuring the past 70 years, there has been a dramatic fall in theincidence of infectious diseases, particularly in developedcountries. This is due to severeal factors including: Immunization2
Communicable Disease Control Anti-microbial chemotherapy Improved nutrition Better sanitation and housingIn less developed countries, however, especially in thetropics, infectious diseases continue to be one of thecommonest causes of death, particularly in children. Ethiopia,as part of the developing world, has two big health problems.These are: Infectious diseases (communicable diseases) 80% ofthese can be prevented by simple sanitary measures. Nutritional problemsThe magnitude of infectious diseases in Ethiopia can be seenfrom the 1993 E.C. MOH report. Accordingly: The top leading causes of outpatient visits were:-All types of malaria (10.4%)-Helminthiasis (6.7%)-Acute upper respiratory infection (6.5%)-Bronchopneumonia (5.5%)-Infections of skin and subcutaneous tissue (4.6%)-Dysentery (3.5%)-Tuberculosis of respiratory system (2.2%)-Sexually transmitted infection (2.2%)-Bronchitis, chronic and unqualified (1.9%)The top leading causes of admission were:-All types of malaria (14.8%)3
Communicable Disease Control -Pneumonia (8.9%)-Tuberculosis of respiratory system (7.8%)-Bacillary dysentery (1.6%)-Gastroenteritis and colitis (1.5%)-Meningitis (0.9%)The top leading causes of deaths were:-Tuberculosis of the respiratory system (10.1%)-Pneumonia (7.3%)-All types of malaria (4.6%)-Bacillary dysentery (2.2%)-Meningitis (1.5%)-Gastroenteritis and colitis (1.1%)-AIDS (0.8%)-Leishmaniasis (0.5%)Others, like yellow fever, acute febrile illnesses, rypanosomiasis, are the major public health problems in ourcountry.1.3Epidemiological Terms and DefinitionsEpidemiology- the study of the frequency, distribution anddeterminants of disease and other health related conditions inhuman populations, and the application of this study to the4
Communicable Disease Controlpromotion of health and to the prevention and control of healthproblems.Some of the components in the definition of epidemiology are: "Populations” Epidemiology focuses on the effects ofdisease on populations "Disease and health related conditions” Epidemiologyindicates that everything around us and everything we doaffects our health. "Frequency" shows that “epidemiology” is a quantitativescience (e.g. occurrence of illness is measured usingmorbidity rates). "Distribution" refers to the occurrence of disease byplace, person and time. r or not a person will get a disease.The causes of diseases are classified epidemiologicallyas:Primary causes - Factors that are necessary for a disease tooccur, and in whose absence the disease will not occur (e.g.infectious agents, vitamin deficiencies).1. Contributing, predisposing, or aggravating factors Risk factors whose presence is associated with anincreased probability that disease will occur/developlater(e.g. Poverty is the most powerful environmentaldeterminant in the disease occurrence, Habit of cigarette5
Communicable Disease Controlsmoking leads to lung cancer. Having multiple sexualpartners results in STI).Definition of other epidemiological terms:1. Epidemics - the occurrence of any health relatedcondition in a given population in excess of the usualfrequency in that population.2. Endemic - a disease that is usually present in apopulation or in an area at a more or less stable level.3. Sporadic - a disease that does not occur in thatpopulation, except at occasional and irregular intervals.4. Pandemic - an epidemic disease which occurs worldwide5. Disease - a state of physiological or psychologicaldysfunction.6. Infection - the entry and development or multiplication ofan infectious agent in the body of man or animal7. Contamination – presence of living infectious agent uponarticles8. Infestation – presence of living infectious agent on theexterior surface of the body9. Infectious - caused by microbes and can be transmittedto other persons.10. Infectious agent- an agent capable of causing infection6
Communicable Disease ControlReview Questions1. How do you compare the impact of communicabledisease in Ethiopia with that of the developed world?2. What are some of communicable diseases that createmajor health problems in Ethiopia?3. Define the following radic-Infection and infectious agent4. Why are communicable diseases very important inEthiopia?7
Communicable Disease ControlCHAPTER TWODEFINITION, DESCRIPTION OF THETRANSMISSION, PREVENTION ANDCONTROL OF COMMUNICABLEDISEASES2.1Learning ObjectivesAt the end of this chapter the student will be able to:-Define communicable municable disease transmission.-Identify the different levels of disease prevention.-Apply the different control methods of communicablediseases.2.2Communicable DiseasesThese are illnesses due to specific infectious agents or itstoxic products, which arise through transmission of that agent,or its toxic products from an infected person, animal orinanimate reservoir to a susceptible host, either directly or8
Communicable Disease Controlindirectly, through an intermediate plant or animal host, vectoror inanimate environment.2.3Chain of Disease TransmissionThis refers to a logical sequence of factors or links of a chainthat are essential to the development of the infectious agentand propagation of disease. The six factors involved in thechain of disease transmission are:a. Infectious agent (etiology or causative agent)b. Reservoirc. Portal of exitd. Mode of transmissione. Portal of entryf. Susceptible hosta.Infectious agent: An organism that is capable ofproducing infection or infectious disease.On the basis of their size, etiological agents are generallyclassified into: Metazoa (multicellular organisms). (e.g. Helminths). Protozoa (Unicellular organisms) (e.g. Ameobae) Bacteria(e.g.Treponema pallidum, Mycobacteriumtuberculosis, etc.) Fungus (e.g. Candida albicans) Virus (e.g. Chickenpox, polio, etc.)9
Communicable Disease Controlb. Reservoir of infection: Any person, animal, arthropod,plant, soil or substance (or combination of these) in which aninfectious agent normally lives and multiplies, on which itdepends primarily for survival and where it reproduces itself insuch a manner that it can be transmitted to a susceptible host.Types of reservoirs1. Man: There are a number of important pathogens that arespecifically adapted to man, such as: measles, smallpox,typhoid, meningococcal meningitis, gonorrhea and syphilis.The cycle of transmission is from human to human.2. Animals: Some infective agents that affect man have theirreservoir in animals. The term “zoonosis” is applied to diseasetransmission from animals to man under natural conditions.For example: Bovine tuberculosis - cow to man Brucellosis - Cows, pigs and goats to man Anthrax Rabies- Cattle, sheep, goats, horses to man- Dogs, foxes and other wild animals to manMan is not an essential part (usual reservoir) of the lifecycle of the agent.Animal . Animal Animal Human10
Communicable Disease Control3. Non-living things as reservoir: Many of the agents arebasically saprophytes living in soil and fully adapted to livefreely in nature. Biologically, they are usually equipped towithstand marked environmental changes in temperature andhumidity.E.g.Clostridium botulinum etiologic agent of BotulismClostridium tetani etiologic agent of TetanusClostridium welchi etiologic agent of gas gangrenec. Portal of exit (mode of escape from the reservoir): Thisis the site throughwhich the agent escapes from thereservoir. Examples include: ry, cholera, ascariasis, etc. Respiratory: tuberculosis, common cold, etc. Skin and mucus membranes: Syphilisd. Mode of transmission (mechanism of transmission ofinfection): Refers to the mechanisms by which an infectiousagent is transferred from one person to another or from areservoir to a new host. Transmission may be direct orindirect.1. Direct transmission: Consists of essentially immediatetransfer of infectious agents from an infected host or reservoirto an appropriate portal of entry. This could be:11
Communicable Disease Controla. Direct VerticalSuch as: transplacental transmission of syphilis, HIV, etc.b. Direct horizontalDirect touching, biting, kissing, sexual intercourse, dropletspread onto the conjunctiva or onto mucus membrane ofeye, nose or mouth during sneezing coughing, spitting ortalking; Usually limited to a distance of about one meter orless.2. Indirect transmissiona.Vehicle-borne transmission: Indirect contact throughcontaminated inanimate objects (fomites) like: Bedding, toys, handkerchiefs, soiled clothes, cooking oreating utensils, surgical instruments. Contaminated food and water Biological products like blood, serum, plasma or IV-fluidsor any substance serving as intermediate means by whichan infectious agent is transported and introduced into asusceptible host through a suitab
Communicable Disease Control vi 5.2 Introduction 92 5.3 Mosquito-borne Diseases 93 5.4 Flea-borne Diseases 106 5.5 Louse-borne Diseases 111 5.6 Snail-borne Diseases 116 Review Questions 126 CHAPTER SIX: SEXUALLY TRANSMITTED DISEASES 122 6.1 Learning Objectives 12
Communicable Disease Management Page 6 of 14 3.2. Communicable diseases of concern Table 1 - Communicable Disease Definitions, Modes of Transmission, and Signs and Symptoms Disease Definition Transmission Signs & Symptoms Tuberculosis (TB) TB is an infectious disease that primarily affects the lungs, but it can attack almost any
Barry County: 330 W. Woodlawn Ave., Hastings MI 49058 Eaton County: 1033 Health Care Dr., Charlotte, MI 48813 Communicable Disease Phone Line: (269) 798-4152 (517) 541-2641 www.barryeatonhealth.org COMMUNICABLE DISEASE Linking Health Care Providers with Local Public Health CD Link: May 2018 Lyme disease is an increasingly important health issue
Pandemic Response Plan to form a Comprehensive Communicable Disease Management Plan . This plan was adapted (with permission) from Dr . Jan Olson and team’s comprehensive communicable disease management plan for the Molalla River School District, by the MESD School Health Services department in collaboration with district administration .
Training Sign-In Sheet Template Training Documentation Form . for Unit or Program-Specific COVID-19 Communicable Disease Plan . Program/Unit name: Date: Name Training Date Signature By signing this log, you confirm that you have been provided with training related to COVID-19 and your unit’s Communicable Disease Plan, that the content is .
The Economics of Non-Communicable Diseases in Indonesia report was written by Bloom, D. E., Chen S., McGovern M., Prettner K., Candeias V., Bernaert A. and Cristin S. 3 4 6 9 11 12. The Economics of Non-Communicable Diseases in Indonesia 3 Overview and purpose Non-communicable diseases (NCDs) have been
Prevention and Control of Communicable Diseases A Guide for School Administrators, Nurses, Teachers, Child Care Providers, and Parents or Guardians Department of Health and Senior Services Bureau of Communicable Disease Control and Prevention Jefferson City, MO 65102 (573) 751-6113 (866) 628-9891 e-mail: info@health.mo.gov
Communicable Disease Management in the Camp Setting Linda E. Erceg, RN, MS, PHN – October 2020 Purpose Statement Campers and staff arrive ready to participate in the camp program. When communicable illness strikes, it impacts that participation and changes the camp experience in unanticipated ways.
Institute (ANSI) A300 Part 7-2006 Vegetation Management standards and the International Society of Arboriculture best management practices. IVM has continued to evolve over the last decade, with examples of expanded emphasis of work on: 1) broad assessment of environmental impact, 2) building social awareness and responsibility; and 3) elevated focus on safety and reliability of service. The .
