01-08A - Introduction To Healthcare and Public Health in The US - Unit 08 - Public Health Part 2 - Lecture A

Introduction to Healthcare and Public
Health in the US
Public Health (Part 2)
Lecture a
This material (Comp1_Unit8a) was developed by Oregon Health and Science University, funded by the Department of Health
and Human Services, Office of the National Coordinator for Health Information Technology under Award Number
IU24OC000015.
Learning Objectives
2
Give examples of and explain the general program
categories of public health, including communicable
disease, chronic disease, terrorism response, and
environmental public health (Lecture a)

Discuss the activities and achievements of public health
in the realm of communicable disease (Lecture a )

Compare and contrast the different types of terrorism
and the different public health responses (Lecture b )

Describe chronic disease activities and achievements of
public health, and the work of public health in the realm
of environmental health hazards (Lecture c )
Health IT Workforce Curriculum
Version 3.0/Spring 2012
Introduction to Healthcare and Public Health in the US
Public Health, Part 2
Lecture a
Communicable Disease (CD)
3
Lecture a
Communicable (also infectious or transmittable)
diseases are those that are a result of organisms such
as bacteria, protozoans, fungi, and viruses entering the
body
Control of infectious diseases has been mainly due to
clean water and better sanitation examples are the drastic
reduction of typhoid and cholera, scourges of the early 20th
century
antimicrobial therapy examples are control of infections such
as tuberculosis and sexually transmitted diseases (STDs)
Public Health Triumphs
Although there continue to be new
communicable diseases (see emerging
infections, later in this unit), and there is no
shortage of existing diseases that are a
continued struggle control (such as tuberculosis,
STDs, drug resistant infections, others), two of
the brightest triumphs of public health are
encouraging -
Polio
Smallpox
4
Lecture a
Public Health Triumphs: Smallpox
5
Lecture a
Contagious and often fatal, smallpox is caused by a virus that has
been around for thousands of years
1796 Edward Jenner discovered that milkmaids who had caught
cowpox did not catch smallpox
1800: Technique of smallpox vaccination introduced into the US
1949 - Last case of smallpox in the United States
1966 - International Smallpox Eradication program established
1977 - Last naturally occurring case in the world, Somalia
1977 - Worldwide eradication of smallpox following global
vaccination program

Public Health Triumphs:
Smallpox Current State
6
Lecture a
Routine vaccination against smallpox among the general public was
stopped after eradication
Other than laboratory stockpiles, the variola virus has been
eliminated from the world
A valid terrorism concern?
CDC has a detailed plan to protect Americans against smallpox
as a biological weapon: includes the creation and use of special
teams of health care and public health workers to immediately
control spread of the disease
Vaccination within 3 days of exposure will completely prevent or
significantly modify smallpox for most
US has stockpiled vaccine it is a live vaccine to a related virus,
vaccination involves repeated pricking of skin with a two-pronged
needle
Public Health Triumphs: Polio
7
Lecture a
History - evidence of polio in an Egyptian stone engraving over
3,000 years old
Virus that mainly affects children <5 years of age. Spread by contact
or by ingestion of fecal contamination in food or water
Highly infectious, the virus invades the nervous system. While up to
95% of people may not even have symptoms, those that do can
have severe effects including paralysis
1955: Salk polio vaccine licensed. Rapid eradication in industrialized
countries
Current: Polio has been effectively eliminated in industrialized
countries, but still a risk in other countries
World Health Organization (WHO) continues its efforts at global
eradication of polio

Public Health Communicable Disease
Prevention Activities
8
Lecture a
State and Local Health Department activities include -
Monitor incidence of CDs
Investigate outbreaks
Intervene/treat populations
Report data to CDC
CDC activities include:
Gathering national data on infectious diseases
Managing national prevention and surveillance programs
Distributing funding and other resources
Collaborating with state and local public health in outbreak
response
Food Poisoning Outbreak Investigation
A Very Simplified Case Study
9
Lecture a
Following is an extremely simplified fictional outbreak investigation. Although the reality is
much more complex than this quick example, it does illustrate some of the steps that
public health takes in its unending efforts to safeguard the population.
Public Health receives laboratory reports for an enteric disease-causing organism
such as Salmonella or Shigella
Public Health Epidemiologists or disease detectives investigate the reports
Samples are sent to the Public Health Laboratory to be closely identified
Fieldwork determines that a significant number of ill patients ate at a company picnic
Questionnaires and statistical analyses identify the culprit as contamination in a dairy
product served at the picnic
Further investigation reveals a sanitation issue at the dairy has led to contamination
in their product
A product recall is issued
The dairy fixes the sanitation problem, and further tests show the product is now free
of contamination
Public health reviews and evaluates the study and how to help prevent further such
incidences
Data reported to CDC become part of the national data set
Communicable Disease Topics
10
Lecture a
Animal-Related Diseases
Bioterrorism Agents/Diseases
Childhood Diseases
Drug Resistant Infections
Emerging Infectious Diseases
Food-Related Diseases
Healthcare-Related Infections and Issues
HIV/AIDS
Insects and Arthropod-Related Diseases
Sexually Transmitted Diseases
Water-Related Diseases
Sampling of Communicable Diseases
11
Lecture a
Animal-related example Rabies
A fatal viral infection, caused when the virus is introduced into
breaks in skin (such as by an animal bite)
Some Public Health Responses: monitoring, managing
treatment, education for responsible pet ownership

Food-related example E. coli O157:H7
Bacterial infection usually traced to food contaminated with cow
feces. Can lead to very severe health outcomes, including death
Some Public Health Responses: monitoring, interventions,
outbreak investigation, education on prevention

Sexually transmitted diseases example Gonorrhea
Bacterial infection transmitted by sexual contact or during birth.
Can lead to permanent health problems.
Some Public Health Responses: monitoring, interventions,
outbreak investigation, education on prevention and treatment

(continued)
Water-related example Cryptosporidiosis
Microscopic parasite, ingested by drinking water contaminated with
animal or human feces
Some Public Health Responses: monitoring, outbreak investigation,
education on water treatment

Healthcare-related - example Methicillin-resistant Staphylococcus
Aureus (MRSA)
Bacteria resistant to certain antibiotics, in healthcare settings may be
introduced by visitors or by health care providers
Some Public Health Responses: monitoring, outbreak investigation,
education on prevention for both patients and health care providers

Childhood diseases example Chickenpox
Viral infection causing fever and itchy rash, highly contagious, spread by
coughing, sneezing, contact
Some Public Health Responses: monitoring of disease and
vaccinations, outbreak investigation, education on prevention through
vaccination
12
Lecture a
(continued)
HIV / AIDS The human immunodeficiency virus (HIV),
which can lead to acquired immune deficiency syndrome
(AIDS)
Viral infection transmitted by sexual or other body fluid contact
Some Public Health Responses: monitoring of disease and
treatments, outbreak investigation, education on prevention and
testing
Emerging Infectious Diseases example Dengue
infection
Viral infection, transmitted by mosquito. Endemic to Puerto Rico
and many popular tourist destinations in Latin America and Asia.
No vaccine or specific medication
Some Public Health Responses: monitoring of disease, outbreak
investigation, education on avoidance and mosquito control
13
Lecture a
Summary Lecture a
14
Communicable diseases
Public health outbreak investigations
Lecture a
References Lecture a
References
Nationally Notifiable Infectious Conditions - United States 2010. (2010). Retrieved December 6,
2011, from Centers for Disease Control and Prevention - Office of Surveillance, Epidemiology, and
Laboratory Services website: http://www.cdc.gov/osels/ph_surveillance/nndss/phs/infdis2010.htm
15
Lecture a

01-08A - Introduction To Healthcare and Public Health in The US - Unit 08 - Public Health Part 2 - Lecture A

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