Answers to questions on the spread and control of diseases

Answers to questions on the spread and control of diseases List and discuss briefly major public health strategies for communicable disease control. Choose five communicable diseases and discuss what public health strategies will be appropriate in each case. Major Public Health Strategies for Communicable Disease Control The main public health strategies to control communicable diseases include all measures designed to prevent or reduce the incidence, prevalence and consequences of disease (WHO 1984). These measures are included in primary health care and involve participation of community, support from different government, public and private sectors and coordination between these sectors (WHO 1978). The control measures are directed against reservoir or sounce of infection, the root of transmission and susceptible host ( people at risk). i) Controlling Reservoir of Infection. It includes early diagnosis or detection of cases or carriers, notification of disease, isolation, treatment and quarantine. ii) Interrupting Transmission of Disease . This is done by interrupting direct transmission and indirect transmission of infective agent from patient and carrier to susceptible host by changing some part of man’s environment. The public health strategies to achieve this includes clean water supply, improving sanitation, proper cooking and refrigeration, improving personal hygiene, controlling vectors and proper handling of secretions and excretions of humans and animals. iii) Protection of Susceptible Host or Patient at Risk This includes active immunization, passive immunization, combination of active and passive immunization and prophylaxis by drugs. iv) Other measures that have interrupted transmission of many diseases in developed countries include legislation for integrated and effective public health programs, improved quality of life and better education. Surveillance follows control measures. Five Communicable Diseases and Public Health Strategies to Control them 1-Chickenpox is acute highly infectious disea se caused by varicella zooster virus (VZV) usually in children. It spreads by airborne particles and direct contact. The control strategies are notification, isolation of cases for six days after the rash appears, disinfection of articles soiled with secretion from nose, mouth and skin and using gloves and face mask while attending patient. Antiviral drugs are effective if used in first 24 hours of appearance of skin rash. Human varicella zoster immunoglobulin is given to contacts and immunocompromrised. A live attenuated vaccine is available and used in US and some other countries for children at one year of age. 2-Measles is acute highly infectious disease of childhood caused by a myxovirus. The control strategies include routine vaccine coverage of all children at 9 months and 4 years of age using live attenuated vaccine. Catch up vaccination is done for children who miss out. Successive generations of children are vaccinated. Isolation in initial stages of incubation period and disinfection of articles can help control spread. Notification to local health authorities, epidemiological investigation and health education are also necessary. 3-Diphtheria is caused by corynebacterium diphtheriae and affects upper respiratory tract. Control includes early detection of cases and carriers, notification, isolation in the hospital, and treatment of cases by diphtheria anti-toxin and carriers by erythromycin. Contacts are given booster dose of anti-toxin if they have not received in last two years and surveillance of close contacts is done for several weeks after exposure. On community bases the effective control is achieved by active immunization of diphtheria vaccine at age of six weeks, ten weeks, fourteen weeks, and booster doses sixteen to twenty-four months and five years.