Communicable disease control

Abstract

Communicable diseases pose a major threat to the public's health and have done so since the beginning of humankind. In today's world, such diseases are transmitted globally as the result of mobile populations, increased urbanization, and international travel. Communicable diseases can be transmitted through direct contact from one person to another or indirectly through contaminated objects (air, water, food) or a vector (animal or insect). Communicable diseases affect all types of people and have worldwide significance. Ideally, prevention of communicable diseases is accomplished through primary prevention methods such as utilizing mass media education campaigns, one-on-one education, and immunization. Knowledge of VPDs, the schedule of vaccinations, a community's immunization status, herd immunity, barriers to immunization coverage, planning and implementing immunization campaigns, adult immunizations, and the immunization needs of international travelers, immigrants, and refugees have been discussed. Health care workers need to practice universal precaution and the safe handling of infectious wastes to maintain worksite safety. Secondary prevention activities of screening and disease investigation are steps taken when primary prevention activities have failed. Tertiary prevention is needed to ensure additional people are not infected and those who are ill receive care and treatment. Ongoing disease transmission can be interrupted through treatment, isolation, or quarantine. Becoming familiar with the major communicable diseases affecting our nation is essential baseline information for community health nurses. TB, resurging since the 1980s, may be one of the biggest public health problems in the new millennium. Nurses must be aware of the populations at risk, how the disease is prevented, and the use of appropriate interventions during diagnosis and treatment. Issues compounding the control of TB are twofold: increasing infections with MDR strains, and the increasing number of people with TB and HIV/AIDS, making diagnosis and treatment more complicated. A second major disease, HIV/AIDS, was first identified in the 1980s. With the success of antiviral drugs, HIV/AIDS is becoming a chronic disease for clients in industrialized nations, with an average life expectancy of 10 to 15 years after diagnosis. Africa is deeply affected by the massive numbers of women and children who are HIV positive, without access to the life-prolonging drugs available to people in developed nations. STDs threaten the health and lives of millions of citizens. At greater risk are the sexually active, nonmonogamous. Control of STDs can be accomplished through effective screening, treatment, contact investigation, and aggressive public education. Several common STDs were discussed, including gonorrhea, syphilis, chlamydia, genital herpes, and viral warts. Hepatitis is more common than HIV, and can lead to life-threatening events, such as cirrhosis and liver cancer. Yet, these diseases do not garner the attention they need. Most of the public is unaware of the types of hepatitis, prevention, transmission, and treatment. Vaccines for two of the forms (hepatitis A and hepatitis B) are available. Influenza and pneumonia are "old" diseases that cause increased morbidity. These diseases cause the most morbidity and mortality in the frailest citizens-the immune compromised, very young, and the very old-although vaccines are available to prevent them. Smallpox (an eradicated disease) and anthrax have been identified as potential bioterrorism weapons. The community/public health nurse has several areas of responsibility in regard to bioterrorism. First, the nurse must know the signs and symptoms of potential infectious diseases used as weapons. Also, the nurse has a responsibility to the community to allay fears about bioterrorism and to provide information about prevention. Community/public health nurses use the nursing process in their important role with regard to all populations at risk for communicable diseases. Nurses concerned with communicable disease control must recognize who is at risk, where the potential reservoirs and sources of infectious disease agents are located, what environmental factors promote their spread, and what are the characteristics and vulnerability of community members and groups. Community health nurses must work collaboratively with other public health professionals to establish immunization and education campaigns, work to improve community communicable disease control policies, and develop a broad range of services for at-risk community members. Ethical issues in communicable disease control include enforced compliance, the justifiability of screening, preservation of confidentiality and privacy, and the avoidance of discrimination against infected people.