Influenza is a serious infectious disease for many individuals. While most people will get “the flu” and recover swiftly, many individuals may develop serious complications from it. Some will even die as a result of the disease. Influenza tends to be most serious in individuals under the age of five and over the age of sixty-five. In addition, the disease is more likely to cause complications in individuals with pre-existing medical conditions, such as asthma, chronic bronchitis and cardiac disease. H1N1 was a strain of influenza that was particularly worrisome. The strain resulted in a pandemic in 2009. For this reason, public health officials took special precautions when dealing with influenza that year.
In the case study presented, the town was dealing with a significant increase in the incidence of influenza during 2009. At the time the information was originally presented, it was February of 2009. At this time, the disease was not considered a pandemic. The CDC did not identify cases of novel H1N1 until April of 2009. The first United States case of novel H1N1 was identified on April 15, 2009. The disease would not have been a reportable condition in February. Influenza was only a reportable condition in 2009 if it resulted in infant mortality (Hall-Baker, Groscelose, Adams et al, 2011).
International Health Regulations require diseases to be reported under specific conditions. In this situation, the public health director may choose to report the condition. The risk of international spread and international travel is not likely in this instance. However, the increase of 300% in an infectious disease is of concern. It may be reported under the instance that it is unusual and unexpected. The disease is not a serious event at this time (Global health—international health regulations, 2012). The local public health director should notify the CDC of a concern. In the case of individual reportable conditions, the physician may also notify the CDC. However, this is an aggregate condition, not an individual one.
The situation in Centervale is an epidemic. There are several notable concerns associated with this epidemic. First, the community lacks the proper herd immunity to combat the situation. Herd immunity refers to the immunity available to a community when a significant portion of the community is immune to the disease, normally as a result of vaccination. Children are in close contact with one another at schools and day cares. Herd immunity is especially necessary to protect individuals who cannot receive a vaccination for medical reasons. A significant portion of individuals did not receive the vaccination. This has resulted in ineffective herd immunity. In addition, individuals are contagious with the flu during the incubation period. This is the period when the disease is asymptomatic in the individual. Individuals tend to be social during these periods (Community immunity, 2013).
In addition, influenza may be spread through both direct and indirect contact. Direct contact occurs from person to person. A person may sneeze or cough and expel microbes. The microbes are then passed to another individual. Indirect contact occurs when an individual contaminates an inanimate object with the pathogen. Another person then touches the object and becomes infected after touching his or her mouth, nose, eyes or other opening. This is a common way for individuals to become exposed to influenza (Understanding emerging or re-emerging infectious diseases, n.d.).
Some individuals become carriers of infectious diseases. These individuals carry the infectious pathogen but show no signs or symptoms of the disease. However, they may still pass the disease onto other individuals. If the pathogen comes from an animal and can pass to humans, it is properly called a zoonosis. Influenza is often called “swine” or “avian” flu. This indicates the animal from which the disease originated. Epidemiologists work to determine if the disease was passed from an animal to a human. Often in these cases, large numbers of animals are slaughtered to end the source of the disease. The host is the person infected by the microbe or pathogen. Additionally, generation time is a crucial concept in infectious diseases. It does not, however, apply to viruses. Generation time in microbiology refers to the amount of time that it takes for a population of bacteria to double in size (Understanding emerging or re-emerging infectious diseases, n.d.).
An epidemic has occurred because a large percentage of the population was not vaccinated against the disease. Twenty-five percent of school-age children and fifty percent of the elderly did not receive the vaccination. The school-age children are not a high-risk group; however, they are a group that is in close contact with each other. In addition, many school-age children do not practice adequate hand washing. The children are also likely to share toys and other inanimate objects that can result in indirect contact. The elderly are a high risk population. They likely have co-morbidities that increase the risk of complications.
The epidemic needs to be controlled through effective vaccination of the population. In addition, a public health campaign needs to be conducted. This public health campaign needs to focus on several things. First, individuals should be instructed to wash their hands frequently. They need to be taught the proper method for hand washing as part of the campaign. Individuals should also be instructed to stay home from school, day care and work if they do not feel well. Day care workers should clean toys, doorknobs, desks and other shared items frequently.
They may be infectious with influenza at this point. They also need to be instructed to cover their mouths if they cough or sneeze. This should be done with a tissue or their arm. If they do cough or sneeze into their hands, they should wash their hands immediately. Furthermore, individuals need to be informed that they should avoid touching their hands to their mouth, eyes and nose. The campaign should be conducted immediately to end the spread of the disease. This will help to bring the epidemic under control.
- Community immunity. (2013, November 27). Vaccines. Retrieved November 27, 2013, from: http://www.vaccines.gov/basics/protection
- Global health—international health regulations. (2012, October 17). Centers for Disease Control and Prevention. Retrieved November 26, 2013, from: http://www.cdc.gov/globalhealth/ihrmaterial/ihrfaq.htm#general
- Hall-Baker, PA., Groscelose, SC, Adams, DA., Sharp, P., Anderson, WJ., Abellera, JP., Aranas, AE., Mayes, M., Wodajo, MS., Onweh, DH., Park, M., & Ward, J. (2011). Summary of notifiable diseases—United States, 2009. Centers for Disease Control and Prevention. Retrieved November 26, 2013, from: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5853a1.htm
- Understanding emerging or re-emerging infectious diseases. (n.d.). National Institutes of Health. Retrieved November 27, 2013, from: http://science.education.nih.gov/supplements/nih1/diseases/guide/understanding1.htm