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Welcome to Unit 6

Communicable Diseases

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APA Format

When to cite in-text source citations• Any idea that is not your own

• Data or information accessed from a source• Statistics (ie: prevalence, incidence, mortality, morbidity)

• Tables/charts that includes data from other sources• Personal interviews/communications

• Information learned from a video, seminar, conference etc

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APA Format

When to reference a source

• Any source that is provided within a paper must be referenced with the exception of personal

communications.

• Information provided in tables and charts also need to be referenced

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APA Format

How to cite a personal communication:Personal communications (includes interviews,

letters, memos, telephone conversations)

(A. Dickerson, personal communication, April 22, 2010)

Or

A. Dickerson (personal communication, April 22, 2010)Personal communications are cited within the a paper, but are not

referenced on the reference page.

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APA Format

Why would personal communications be used?

For the purposes of this class, personal communications may be helpful to:

• Obtain information from a local public health agency for a paper or assignment

• Interview a person who has personal experience with an infectious disease.

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APA Format

How to reference sources in APA format

• Journal articles with one author

Geiger, H.N. (2009). The psychological effects of nicotine

addiction. Journal of Professional Public Health

Practictioners, 18(6): pp. 297-321.

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APA Format

Journal article with more than one authorGeiger, H.N., Bennett, T.R., Dole, S., Raisin, V.N.,

& Tipper, G. (2010). Breaking the

psychological addition. Journal of Drug

Addictions, 6(21): pp. 322-337.

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APA Format

Referencing Journal Articles: Things to Remember

• The first line of each reference begins at the margin and all other lines are indented 8 spaces.

• Author’s last name, first and middle initials, in order as they appear in the article.

• Only the first letter of the first word of the article title is capitalized and the first letter of the first word after a semicolon: (ie:

Psychological addictions: How they are broken).• All sources on the reference page are doubled spaced

• The name of the journal and the volume number are placed in Italics (ie: American Journal of Public Health,

16(5).

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APA Format

In-text citations of journal articles• Can appear several ways: to introduce information

• After the information is presented.

Example:According to Geiger et al (2010) the psychological addiction to nicotine

takes much longer to overcome than physical addiction does.

Or

The psychological addiction to nicotine takes much longer to overcome than physical addiction does (Geiger, Glum, Daily & Jones, 2010).

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APA Format

Things to keep in mind when citing journal articles:• Authors and year of publication are cited (not name of the journal

article).• If you quote information from a journal article, the page number is

also provided, for example (Geiger, Glum, Daily & Jones, 2010, p. 59).

• Authors are listed as they appear in the journal article• The citation is included within the sentence (.? ! Appear after the

citation). • If no date is provided in the journal article, citation would appear:

(Geiger, Glum, Daily & Jones, “n.d.”).

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APA Format

How to reference a web site:• Author’s last name appears first, year of publication, title

of article, date retrieved, from, provide web site address.

Example:

Sherman, P.D. (2010). Emerging infectious diseases in the

21st century. Retrieved April 21, 2010, from

http://www.cdc.gov/emerginginfectiousdiseases.

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APA Format

How to reference a web site articleIf there is not author or year of publication

provided:Centers for Disease Control and Prevention. (2010).

Emerging infectious diseases in the 21st century.

Retrieved April 17, 2010, from

http://www.cdc.gov/emerginginfectious.

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APA Format

Things to keep in mind when referencing web sites:

• Author name (s) appear first, if no author, the name of the web site appears first.

• Never use the initials of a web site in the reference (or in-text). (ie; CDC, WHO)

• If no year of publication is provided, type, “n.d.” where the year of publication would appear.

• Only the first letter of the first word of the article is capitalized and the first letter of the first word after a

semicolon.• Always provide the full web site address, not just the

home page of the web site (ie: http://www.cdc.gov )

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APA Format

How to cite a web site• Can be cited several ways: Before the information is provided, or

after the information is provided:

Example

According to the Centers for Disease Control and Prevention (2010), there were many serious infectious diseases that emerged throughout the 21st century.

Or

There were many serious infectious diseases that emerged throughout the 21st century (Center for Disease Control and Prevention, 2010).

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APA Format

How to reference a book• Author (s) first (last name, first and middle initials)

• Year of publication• Title of the book (italicized with only the first letter of the first word of

the title capitalized and the first letter of the first word after a semicolon capitalized)

• City and state of publication• Name of publisher

Example:

Riegelman, R. (2010). Public health 101: Healthy people – healthy

populations. Sudbury, MA: Jones and Bartlett.

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Communicable Diseases

What is a communicable disease?

“any condition which is transmitted directly or indirectly to a person from an infected person or

animal through the agency of an intermediate animal, host, or vector, or through the inanimate

environment”.

Helpful Terminology

Antibodies: infection fighting proteins produced by white blood cells that fight bacterial infections.

Antibiotics: medicines that help fight bacterial infections.

Immune system: body system for fighting infections.

Helpful Terminology

Immunization (vaccination): specific substance containing weakened or killed pathogens given to build resistance to A given infection.

Infection: condition caused by pathogenic material in the body.

Exposure: coming into contact with A pathogenic material.

Pathogens

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Disease causing agents

includes bacteria ,viruses, fungus, protozoa, parasitic worms

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Pathogens

Virus

smallest agent of disease

can only grow and reproduce after infecting another cell

not truly “living”

Examples: cold, flu, polio, hepatitis, herpes, chicken pox, mumps, measles

Pathogens

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Bacteria

living cells that can grow and reproduce on their own

can live in & on the body without issue, when growing in the wrong place disease arises

Examples: pneumonia, tuberculosis, cholera, plague, typhoid fever, gonorrhea

Pathogens

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Fungus – from the plant world…very long complicated definition…ex. Athlete’s foot

Protozoa – single cell organism that can only divide in a host organism…

ex. malaria

Parasitic worms – yucky wormies ex. trichinella, tape worm

Diseases

Plague – killed 130 million people in the Middle Ages (bacterium)

Yellow Fever – 5000 people killed in Philadelphia in 1703 (viral - mosquitoes)

Smallpox – brought by Spanish explorers to the Americas. Killed at least ½ of the ENTIRE North & South American Indian populations. Later eradicated from the earth through vaccine (virus)

Diseases

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Influenza – killed 40-60 million people worldwide in 1918, including US, deadliest disease event in human history

Diseases

Why did the WHO decide to attempt to eradicate small pox? Reference Table 7-1

1. No known animal carriers

2. No chronic human carrier where disease lies dormant

3. Safe, effective vaccine is available

Modes of Transmission

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• Direct• Blood-borne or sexual – HIV, Hepatitis B,C• Inhalation – Tuberculosis, influenza, anthrax• Food-borne – E.coli, Salmonella,• Contaminated water- Cholera, rotavirus, Hepatitis A

• Indirect • Vector-borne- malaria, onchocerciasis, trypanosomiasis• Formites

• Zoonotic diseases – animal handling and feeding practices (Mad cow disease, Avian Influenza)

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Burden of Disease

What is meant by burden of disease in Public Health?

This is the impact a disease has on a specific area or population

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Tools to Address the Public Health’s Burden of Disease• Barrier protection including isolation and

quarantine.• Immunizations

• Screenings and Case findings• Treatment and Contact treatment

• Efforts to maximize effectiveness of treatment and prevent resistance

Barrier Protections & Immunization

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Screening for Disease

Purpose of Screening for Disease

• To test individuals who are asymptomatic (experiencing no symptoms) of a disease

• To catch a disease early on in the disease process.

• To reduce disability and deaths

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Types of Communicable Disease Screening Programs

• TB

• Syphillis

• Chlamydia

• Gonorheaa

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Four Criteria for Ideal Screening Program

1. The disease produces substantial death and/or disability

2. Early detection is possible and improves outcomes

3. There is a feasible testing strategy for screening

4. Screening is acceptable in terms of harms, costs and patient acceptance

Case Finding

Screenings linked to:

• Case Findings/Contact Tracing

• &

• Contact treatment

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What Is Case Finding or Contact Tracing?

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• Identification of individuals that may have had contact with infected individual.

Contact Tracing

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• For Syphilis, HIV, and AIDS patients– Interviewed, counseled by trained Disease

Intervention Specialists (DIS) – Partners are located and referred to the

health department for testing, additional counseling, etc.

• For other STDs, partner notification occurs by partner referral.

Who are Contacts?

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• Family• Friends• Students at school• Daycare children and workers • Co-workers• Sexual partners• Patients (for Healthcare workers)• Customers (for Food service workers)

TB Contact Tracing

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• April 1994

• Traveler-- multi-drug resistant TB

• Honolulu Chicago Baltimore

• Baltimore Chicago Honolulu

TB Contact Tracing

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• Health department identified contacts from passenger manifests on 4 flights– Questionnaire: TB risk factors– Skin testing (baseline then 12 weeks after

exposure)

TB Contact Tracking

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• Of 760 passengers and crew members– 6 (0.8%) Conversions (all on Chicago to Honolulu

flight)

• Contacts seated within 2 rows of the index case were 8.5 times as likely to have a positive skin test or conversion than those in the rest of the cabin.

• For conversions, preventive therapy offered and watch for signs of disease

TB

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• 2 billion people infected with microbes that cause TB.– Not everyone develops active disease– A person is infected every second globally

• 22 countries account for 80% of TB cases.– >50% cases in Asia, 28% in Africa (which also has the highest

per capita prevalence)

• In 2005, there were 8.8 million new TB cases; 1.6 million deaths from TB (about 4400 a day)

• Highly stigmatizing disease

TB

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• The number one single infectious disease killer• TB is not on the decline.

• One third of the world's population is infected with TB – In 1999 TB caused 8,000 deaths/day

The most deaths from TB in history

– 7- 8 million people become infected with TB/year

– 5-10 % of these people will develop active TB

– Between 1993 and 1996, TB increased 13 %

– TB accounts for more than 1/4 of all preventable adult deaths the developing world.

nfid.org/factsheets

TB

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• The number one single infectious disease killer• Someone is newly infected with TB every second !

– TB is the leading killer of women

– TB outranks all causes of maternal mortality

– TB creates more orphans than any other infectious disease

– TB is the leading cause of death among HIV-positive individuals

nfid.org/factsheets

TB & HIV

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• A third of those living with HIV are co-infected with TB– About 200,000 people with HIV die annually from TB.– Most common opportunistic infection in Africa– 70% of TB patients are co-infected with HIV in some countries in

Africa

• Impact of HIV on TB– TB is harder to diagnose in HIV-positive people. – TB progresses faster in HIV-infected people. – TB in HIV-positive people is almost certain to be fatal if

undiagnosed or left untreated. – TB occurs earlier in the course of HIV infection than many other

opportunistic infections.

Human Security concerns

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• Potential magnitude and rapid spread of outbreaks/pandemics. e.g. SARS outbreak– No country or region can contain a full blown

outbreak of Avian influenza

• Bioterrorism and intentional outbreaks– Anthrax, Small pox

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Interesting Exercise

Find out and record what you have been vaccinated against.

Include the following:

vaccine given

when (how old were you)

fights against what disease

THANK YOU!!

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