Communicable Diseases

Us:- Waled Amen Moh

Head department, Community
Health Nursing
UMST
 Introduction
• Communicable Diseases are the major
causes of morbidity and mortality.
• Main causes of morbidity and mortality in
emergencies are diarrheal diseases, acute
respiratory infections, measles and in
areas where it is endemic malaria.
 Introduction
• Other communicable diseases that have
also in the past caused epidemics
amongst population affected by
emergencies are meningococcal disease,
tuberculosis and typhus.
• Malnutrition and trauma are additional
causes of illness and death amongst
populations affected by communicable
diseases.
 Definitions
• Communicable Disease is one that can
transmitted from one person to another
and is caused by an infectious agent that
is transmitted from a source or reservoir to
a susceptible host.
• Infectious diseases is one that caused
by infectious agent.
• Outbreak
• o occurrence of new cases of a disease clearly in excess of the
• baseline frequency of the disease in a defined community over a
• given time period
• o point source outbreak: an outbreak due to
• exposure of a group of people to a noxious influence that is
• common to the individuals in the group
• • the exposure is brief and essentially simultaneous, resultant
• cases all develop within 1 incubation period of the disease
• o propagated outbreak: an outbreak where there are multiple
• exposures over a period of time, from host to host
• (directly or indirectly), resulting in cases that are not within
• 1 incubation period
• Epidemic
• occurrence, in a community or region, of a group of illnesses of a
• similar nature in excess of normal expectancy
• Endemic
• habitual presence of a disease or agent within a geographic area
• based on the usual prevalence of a given disease within such an area
• Pandemic
• an epidemic which is worldwide in distribution
• Host
• person/animal that affords subsistence to an infectious agent
• under natural conditions
• Carrier
• person/animal that harbors a specific infectious agent in the
• absence of discernible clinical disease and serves as a
• potential source of infection
• Fomite
• o contaminated substance (not necessarily a reservoir) serving as
• an intermediate means of transport for an infectious agent
• Reservoir
• o anything (living or inert) in which an infectious agent lives and
• multiplies in such a manner that it can be transmitted to a
• susceptible host
• Vector
• o invertebrate animal capable of transmitting an infectious agent
• to vertebrates
• Virulence
• o ability of an infectious agent to cause severe or fatal infections
• IMMUNITY
• o active
• • altered organism or its product induces a host to produce
• antibodies (e.g. natural measles infection or live vaccine)
• o passive
• • protective antibodies produced by another host which are
• introduced into susceptible persons (e.g. natural transplacental
• IgG from mother to infant)
• o inherent
• • endogenous production of antibody
• o herd
• • expression used to describe immunity of a group or community
• • resistance of a group to an infectious agent based on the
• immunity of many individuals in the group
• • implies transmission interruption when < 100% of group is
• immune due to separation of few susceptibles
 Transmission of Infectious
Agents
Transmission refers to any mechanism
by which an infectious agent is spread
from a source or reservoir to a person.
– Reservoir.

– Mode of infection.

– Susceptible host.
 Six Factors furthering process
• Agent
• Reservoir
• Portal of exit
• Mode of
transmission
• Portal of entry
• Susceptible host
 Reservoir

Man
Case=1:-case can be prevented and controlled by
-:Identification-1
-:presentation--
.This involves signs and symptoms of this disease
-: Lab finding--
Diagnostic test, or physical examination
complications--
.That may arise due to this disease
 Man Case
Treatment-2

-:Isolation-3
this needs to determine communicability period
-:Health education-4
About
S&S of complication-
treatment-
 Man carrier
-:carrier=2
Types of carrier-1
by type-
healthy carrier.
incubatory carrier.
convalescence carrier.
by portal of exit-
respiratory carrier.
GIT carrier.
GUT carrier .
active detection-2
Household surveillance for early detection of disease.
 Reservoir
health education-3
concerning special hygiene and avoid risk
factors
-: Quarantine-4
this needs to know Incubation period
 (Animal(Reservoir
• Case • Carrier
- Identification - Type
- Treatment - Active detection
- Isolation - Quarantine
- Extermination - Extermination
(Soil (Reservoir

• Disinfection
 Mode of transmission
--: Direct-
2. Direct contact
3. Vertical transmission
4. Droplet infection
5. Animal bite transmission
6. Contact with soil
 Indirect
1. Air-borne
2. Vehicle borne
3. Vector-borne transmission
4. Fomite –borne
5. Hand –borne
 Susceptible host
Man
the at risk individual -1
Systemic diseases
Surgical patients
Immunocompromised individuals
Genetic based
Organ transplant
Chemotherapy
Radiotherapy
HIV infection
-: health education-2
about vaccination and preventive measures
-: immunization-3
.if available
-: prophylaxis-4
-: special protective measures-5
-: legislation-6
 Susceptible host

Animals
the at risk -1
prophylaxis-2
special protective measures-3
 Emerging Infectious Diseases
Emerging infectious diseases are diseases
that have appeared for the first time or that
have occurred before appeared in
populations where they have not
.previously been reported
 Reemerging Infectious
Diseases

Reemerging infectious diseases are

familiar diseases caused by well-
understood organisms that were once
under control or declining but now are
resistant to common drugs or gaining
new footholds in the population and
.increasing in incidence
 Fundamental principles of Control of
Communicable Diseases
• Rapid Assessment
• Prevention
• Surveillance
• Outbreak Control
• Disease Management
 Modern Conditions that Favor
the Spread of Infectious
Diseases
1. Global travel
2. Globalization of food supply and
centralization of food processing
3. Population growth, increased
urbanization and overcrowding
4. Migration due to wars, famines, and
natural disasters
 Modern Conditions that Favor
the Spread of Infectious
Diseases
1. Irrigation, deforestation, and
reforestation projects that alter habitats
2. Human behaviors, such as IV drug use
and risky sexual behavior
3. Increased use of antimicrobial agents
and pesticides
4. Increased human contact with
wilderness habitats
Prevention of communicable
diseases:-
Communicable diseases can be prevented
by appropriate preventive measures which
include:
• Good site planning
• Provision of basic clinical services
• Provision of appropriate shelter
• Clean water supply
• Sanitation
• Mass vaccination against specific diseases
• Regular and sufficient food supply
• Control of vectors
 Primary Prevention
• Increasing the resistance of the host
• Inactivating the agent
• Interrupt the chain of infection
• Restricting spread of infection
– isolation
– quarantine
– segregation
– personal surveillance
 Secondary Prevention

• Activities targeted at detecting disease

at earliest possible time to:
– begin treatment

– stop progression

– protect others in the community

• Examples of activities: case finding,

health screening, health education
 Tertiary Prevention
• Limits the
progression of
disability
• Treatment of
symptoms and
rehabilitation vary
with each specific
disease
 Surveillance
• Surveillance is the ongoing systematic
collection,analysis and interpretation of
data in order to plan, implement and
evaluate public health intervention.

 Surveillance system should be simple,

flexible, acceptable.
Outbreak Control
• An outbreak is occurrence of a number of
cases of a disease that is unusually large or
unexpected for a given place and time.
 Outbreaks and epidemics refer to the one
and same thing.
 Outbreaks in emergency situations can
spread rapidly giving rise to high morbidity
and mortality rates.
 Aim should be to detect and control the
outbreak as early as possible.
Steps in the management of a
communicable disease outbreak
• Preparation

• Detection

• Response

• Evaluation
Preparation for the outbreak

• Health coordination meetings

• Strong surveillance system
• Outbreak response plan for each
disease
• Stocks of iv fluids, antibiotics and
vaccines
• Plans for isolation wards
• Laboratory support
Steps in the management of a
communicable disease outbreak
• Preparation

• Detection

• Response

• Evaluation
Detection of outbreak

• Surveillance system with early warning

system for epidemic prone diseases.
• Inform ministry of health and WHO in
case of outbreaks of specific diseases.
• Take appropriate specimens (stool,
CSF or serum) for laboratory
confirmation.
• Include case in the weekly report.
Steps in the management of a
communicable disease outbreak
• Preparation

• Detection

• Response

• Evaluation
Response to the outbreak
• Confirm the outbreak

• Activate the outbreak control team

• Investigate the outbreak

• Control the outbreak

Steps in the management of a
communicable disease outbreak
• Preparation

• Detection

• Response

• Evaluation
Evaluation
• Assess appropriateness and
effectiveness of containment measures.

• Assess timelines of outbreak detection

and response.

• Change public health policy if indicated.

• Write and disseminate outbreak report.

Global Disease Eradication
Efforts
Methods to accomplish the goal of
eradication of diseases include:
– immunization and vaccination

– drug therapy

– community training

– health education

– national disease surveillance efforts

examples
7 diseases have – river blindness
been targeted for – Chagas’ disease
eradication in early
21st century:
– guinea worm
– polio
disease
– measles
– lymphatic
filariasis
– leprosy
Nurses’ Role
Community health nurses play an important role
with regarded to all population at risk for
communicable disease
Nurses concerned with communicable disease
control must
• Recognize who at risk
• Where the reservoirs and source of infectious
disease agents are located
• What environmental factors promote the spread
• What comprise the characteristic of
vulnerability of community member and
groups-particularly those subject to
intervention
• Community health nurses must work
collaboratively with other public health
professional to establish immunization and
educational programs , to improve
community infection control policies , and
to develop abroad range of services to
population at risk