10:832:240 Chapter Notes - Chapter 12: Bloodborne, Isoniazid, Vector Control

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Chapter #12: Communicable Diseases
I. Overview
What are the determinants of selected communicable diseases?
What are the key concepts concerning prevention, transmission, and treatment?
What are the costs and consequences of communicable diseases?
What are examples of successful interventions?
What are the key challenges to future efforts?
II. The Importance of Communicable Diseases
Cause 31% of deaths and 40% of DALYs in low- and middle-income countries.
Disproportionately affect the poor.
Enormous economic consequences.
Relevance to MDGs.
Much of the burden of communicable diseases is avoidable, many can be prevented or treated.
III. Key Terms, Definitions, and Concepts
Communicable Disease-Transmission- Animal-animal, animal-human, or human-human.
Communicable disease synonymous with infectious disease.
Includes infectious and parasitic diseases.
Case- An individual with a particular disease.
Case Fatality Rate- The proportion of persons with a particular condition (cases) who die from
that condition.
Control (Disease Control)- Reducing the incidence and prevalence of a disease to an
acceptable level.
Elimination (of Disease)- Reducing the incidence of a disease in a specific area to zero.
Emerging Infectious Disease- A newly discovered disease.
Eradication (of Disease)- Termination of all cases of a disease and its transmission globally.
Parasite- An organism that lives in or on another organism and takes its nourishment from that
organism.
Reemerging Infectious Disease- An existing disease that has increased in incidence, spread to
new place, or has taken on new forms.
Transmission paths for communicable diseases:
Foodborne: Salmonella, E. coli.
Waterborne: Cholera, rotavirus.
Sexual or Bloodborne: Hepatitis, HIV.
Vector-borne: Malaria, onchocerciasis.
Inhalation: Tuberculosis, influenza, meningitis.
Nontraumatic Contact: Anthrax.
Traumatic Contact: Rabies.
Different control measures:
Vaccination.
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Mass chemotherapy.
Vector control.
Improved water, sanitation, hygiene.
Improved care seeking, disease recognition.
Case management (treatment) and improved caregiving.
Case surveillance, reporting, and containment.
Behavioral change.
IV. The Burden of Communicable Diseases
V. The Costs and Consequences of Communicable Diseases
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Constrain health and development of children, affecting schooling and adult productivity.
Strong stigma and discrimination associated with HIV, TB, and others such as leprosy.
Limit productivity and income of adult workers.
Costs of treatment burden families.
High rates of communicable diseases reduce investment in a country’s development.
VI. The Leading Burdens of Communicable Diseases
The Burden of Emerging and Reemerging Infectious Diseases:
Examples of emerging infectious diseases:
SARS, China (2002).
MERS, Arabian Peninsula (2012).
Examples of reemerging infectious diseases:
Cholera, Peru (1997).
Ebola, West Africa (2014).
Truly global threats and “a perpetual challenge.
Zoonoses (infection spread from animals to humans) cause of about 60%.
Key factors include microbial adaptation and change, climate, changing ecosystems,
international travel and commerce, and war.
578 outbreaks in 132 countries from 1998–2001.
Antimicrobial Resistance:
Resistant forms of disease can emerge or reemerge when bacteria, parasites, and viruses are
altered through mutation, natural selection, or the exchange of genetic material among
strains and species.
Examples of drug resistance:
HIV, any first-line drug.
MRSA, beta-lactams.
In 2013, about 480,000 people globally developed multidrug-resistant TB.
There is resistance to all malaria drugs.
Factors contributing to development of drug resistance include increasing use of drugs,
poor prescribing and dispensing practices, inappropriate use, failure of patients to take
correct dosages, and counterfeit drugs.
The Consequences of Emerging and Reemerging Infectious Diseases:
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