Write a paper (2,000-2,500 words) in which you apply the concepts of epidemiology and nursing research to a communicable disease. Refer to “Communicable Disease Chain,” “Chain of Infection,” and the CDC website for assistance when completing this assignment.
Communicable Disease Selection
- Hepatitis B
Epidemiology Paper Requirements
- Describe the chosen communicable disease, including causes, symptoms, mode of transmission, complications, treatment, and the demographic of interest (mortality, morbidity, incidence, and prevalence). Is this a reportable disease? If so, provide details about reporting time, whom to report to, etc.
- Describe the social determinants of health and explain how those factors contribute to the development of this disease.
- Discuss the epidemiologic triangle as it relates to the communicable disease you have selected. Include the host factors, agent factors (presence or absence), and environmental factors. Are there any special considerations or notifications for the community, schools, or general population?
- Explain the role of the community health nurse (case finding, reporting, data collection, data analysis, and follow-up) and why demographic data are necessary to the health of the community.
- Identify at least one national agency or organization that addresses the communicable disease chosen and describe how the organizations contribute to resolving or reducing the impact of disease.
- Discuss a global implication of the disease. How is this addressed in other countries or cultures? Is this disease endemic to a particular area? Provide an example.
A minimum of three peer-reviewed or professional references is required.
Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center.
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The Epidemiology of Influenza
The impact of influenza on the global population is enormous. This applies to both individual well-being and the cost of economic opportunity. This is not even taking into account the lost man-hours of economic production. This is what drives the public’s desire for a universal influenza vaccination, particularly in light of the threat of a global pandemic (Jang & Seong, 2019; Phillipson et al., 2019; Paules & Fauci, 2018). Several investigations on the possibility and feasibility of developing a universal influenza vaccination have been conducted. However, this still remains to be a dream for epidemiologists as influenza is still an endemic viral infection that is yet to be mastered and fully controlled by a single vaccine. The purpose of this paper is to discuss the epidemiology of influenza as well as the global outlook of the viral infection.
Influenza or flu as it is commonly referred to is a viral infection of the upper respiratory tract that is caused by the Hemophilus influenzae virus. Particularly, the types of influenza viruses that cause flu are the ones designated as types A, B, and C. It is usually a seasonal infection that is more prevalent during the cold season but can affect anyone at any time too. According to epidemiologists, rampant seasonal outbreaks are mostly caused by the H. influenzae types A and B. The type known as type C is known to only cause mild outbreaks here and there and so it is not as virulent as the other two subtypes. Influenza is endemic in the general population and exists also on surfaces that can be touched and the virus transferred to the respiratory system (CDC, 2022b; Hammer & McPhee, 2018). Influenza is a very contagious infection and easily moves from one person to another through aerosols or respiratory droplets.
There are vaccines against the influenza viruses. However, it is significant to note that the vaccines only protect against the more virulent types A and B. They do not protect against the subtype C which has no vaccine so far. The subtype A is known by epidemiologists to also occur in different animals as a zoonotic infection. This means that zoonotic transmission to humans is also possible with the influenza subtype A. However, the influenza virus subtype B is known to only occur in humans (Hammer & McPhee, 2018). As stated above, both subtypes A and B infect humans and cause serious disease.
Influenza or flu usually causes mild symptoms but at times may be severe and even lead to death. This is dependent on the vaccination status and immune status of the person infected. For instance, children and the elderly with low immunity may easily suffer serious disease if they get infected by the flu virus. Characteristically there is usually a stuffy nose and rhinorrhea that is watery. This is usually but not always accompanies by a sore throat and fever. There may also be a cough and the patient may feel chills despite being febrile. The body may ache and there may also be a headache and a feeling of fatigue (CDC, 2022b; Hammer & McPhee, 2018). These symptoms do not all occur in everyone who has been infected with flu. Some people may exhibit some of the symptoms and others may not. A case in point is fever. It is not everyone that has flu that will present while febrile. This is a very important diagnostic point to note. As a matter of fact, some patients may even have diarrhea and vomiting when infected with the flu virus. These are however not common manifestations.
Mode of Transmission
The influenza viruses are very contagious viruses and easily jump from one host to another. Transmission is characteristically by aerosol or droplets from infected persons that are coughing and sneezing (CDC, 2022b). This is the rationale for wearing a face covering at times of influenza outbreaks. They provide a physical barrier to prevent the virus in respiratory droplets from being inhaled by a healthy person. A sick person with influenza may also wipe their nose or sneeze into the palm of their hand and then rub the mucus onto surfaces such as door knobs and handles. When another person touches these and then touches their nose or mouth they will get infected with the influenza virus. For persons that are intimate, they may also get infected through actions such as kissing and exchanging saliva (CDC, 2022b; Hammer & McPhee, 2018). These are the most common ways in which the influenza viruses spread and are transmitted.
Incidence, Prevalence, and Mortality
According to Tokars et al. (2017), the incidence of influenza averages 8% but generally shifts between 3% and 11% depending on the season of the year. The patterns show that children under the age of two years and adults above the age of 65 years are the most affected. Added to these are those whose immunity has been compromised such as persons on chemotherapy or those with HIV (Hammer 7 McPhee, 2018; Tokars et al., 2017). On prevalence, the Centers for Disease control and Prevention approximates a figure of between 9 and 41 million cases (CDC, 2022c). Also, the mortality figure is placed by the CDC at between 12,000 and 52,000 deaths every year. Influenza is a reportable disease outbreak in many states and the reporting is done to the CDC at the time of diagnosis.
As much as flu appears to be a simple infection that usually wears off within days even without intervention, it can cause serious complications and even death. Some of the most common infections are sinusitis and otitis media. These are infections of the sinuses and the middle ear that more often than not are complicated by bacterial infection (CDC, 2022b; Hammer & McPhee, 2018). The other common complication is pneumonia that is often life-threatening especially for children and the elderly. Less common complications include myositis or an infection of the muscles with muscle tissue breakdown (rhabdomyolysis), sepsis, encephalitis, myocarditis, and multiple organ failure (CDC, 2022b; Hammer & McPhee, 2018). For patients with other respiratory conditions such as chronic obstructive pulmonary disease (COPD) or heart disease, an influenza infection will interfere with the management of these conditions and may cause an exacerbation of their symptoms.
The best strategy to prevent and control influenza is to get vaccinated first as a child and then as an adult by getting boosters (CDC, 2022a; Jang & Seong, 2019; Paules & Fauci, 2018; Phillipson et al., 2019). However, it is acknowledged that even those that are vaccinated may still get infected with flu. For this reason, the evidence-based practice or EBP intervention recommended by the CDC is the prescription of antiviral medications. These have the advantage of lessening the severity and duration of the symptoms.
Demography of Interest
The population demographics of interest as far as influenza is concerned are the elderly above the age of 65 years, children under the age of five years, and the immunocompromised (Tokars et al., 2017). These are the most vulnerable groups within the general population and it is them that need to be targeted by health promotion and education. Having said that, the most significant demographic amongst which the preventive intervention of immunization starts are the children under five years.
Social Determinants of Health (SDOH) and their Contribution to Influenza Infection
Social determinants of health or SDOH are conditions under which a person is born, grows in, ages in, and dies in (Powell, 2016). A number of social determinants of health are recognized and they influence the epidemiology of diseases within populations. One of them is low socioeconomic status (low family incomes). This influences flu infection in that the person or family may not afford antiviral medications and have no health insurance leading to complications. The other is poor sanitation and living conditions. This SDOH is tied to low socioeconomic status and facilitates the spread of flu. Under transmission above it has been observed that poor hand hygiene (lack of water) may lead to the virus being transferred to door handles and knobs where others touch them and get infected too.
Yet another SDOH is low educational achievement. This affects flu in that ignorance makes it difficult for the community to be educated and for them to quickly understand the implications of the condition. Last but not least is the SDOH of lack of access to quality healthcare services. Because of poverty, the affected population demographic will not be able to afford healthcare insurance such as provided for by the Affordable Care Act of 2010 (Kominski et al., 2017). This means extreme poverty as the ACA 2010 was meant to cushion poor populations.
Epidemiologic Triangle of Influenza as a Communicable Disease
The epidemiological triangle of influenza like any other communicable disease includes the host factors, the agent (virus) factors, and the environmental factors (Hammer & McPhee, 2018). The host factors for influenza include socioeconomic status, immunity status, and nutritional status amongst others. As already observed, an immunocompromised person will experience serious disease as opposed to a patient that is not. Having been vaccinated also makes a big preventive difference. With malnutrition (especially in children and the elderly), susceptibility to flu is high. Last but not least, poverty will mean that living conditions are poor and so spread of the virus will be fast due to factors such as overcrowding.
Agent factors include virulence and dose. It has been observed above that influenza subtypes A and B are more virulent compared to subtype C. Therefore, a person will definitely get more serious symptoms when infected by either type A or B. by the dose is meant the quantity of virus that a person inhales to make them sick. The more the number of viruses inhaled, the higher the chances of more serious illness. On environmental factors; poor living conditions (dirt), lack of water, and overcrowding lead among the factors that favor the spread of influenza. Special considerations for the community, schools, and the general population concern the maintenance of proper hygiene and the wearing of face coverings for those who have flu.
The Role of the Community Health Nurse (CHN)
The role of the community health nurse in the prevention and management of flu is immense. To begin with, they are responsible for sensitizing the population and for delivering preventive health promotion and education. The CHN also participates in case finding especially since flu outbreaks would need to be reported to the CDC. Whenever cases are identified, the CHN finds out whether there are other cases within the community. The CHN also collects data about flu in the process of case finding and management. This epidemiological data that has been documented will then be used after analysis to plan for public health initiatives such as mass vaccinations. It is also the CHN that will make sure that cases are followed up including through home visitation for health promotion. Epidemiological data is therefore very important for communities because it is that very data that will be used to identify community needs and also to plan for any public health intervention.
The Role Played by the Centers for Disease Control and Prevention (CDC)
The Centers for Disease Control and Prevention (CDC) is a federal organization tasked with sensitizing the public and carrying out research aimed at prevention of illnesses and conditions. It is very instrumental in drafting policies geared towards the prevention and treatment of flu. For instance, the vaccination schedule that includes the influenza vaccine has been drawn by the CDC.
A Global Implication of Influenza
Influenza is an endemic viral infection in the world. It is present in almost every country and affects the same vulnerable populations as described previously. A global implication of influenza is that it causes sporadic outbreaks every now and then in different areas of the world. Management by other countries is no different to what has been done with the Covid-19 outbreak. That means mass vaccination, use of face coverings, handwashing, and social distancing.
Influenza or flu is a very contagious communicable disease caused by a virus. There are three subtypes of the influenza virus namely A, B, and C. The first two are more virulent than the last one and cause serious illness. The incidence of flu averages 8% and it leads to a significant number of deaths annually all over the world. Treatment of influenza is through antiviral medications that reduce the severity and duration of the symptoms. The CHN plays a crucial role in flu prevention, just as does the CDC in the United States.
Centers for Disease Control and Prevention [CDC] (February 17, 2022a). Child and adolescent immunization schedule. https://www.cdc.gov/vaccines/schedules/hcp/imz/child-adolescent.html
Centers for Disease Control and Prevention [CDC] (July 1, 2022b). Influenza (flu). https://www.cdc.gov/flu/index.htm
Centers for Disease Control and Prevention [CDC] (January 7, 2022c). Disease burden of flu. https://www.cdc.gov/flu/about/burden/index.html#:~:text=CDC%20estimates%20that%20flu%20has,annually%20between%202010%20and%202020
Hammer, D.G., & McPhee, S.J. (Eds). (2018). Pathophysiology of disease: An introduction to clinical medicine, 8th ed. McGraw-Hill Education.
Jang, Y.H. & Seong, B.L. (2019). The quest for a truly universal influenza vaccine. Frontiers in Cellular and Infection Microbiology, 9(344). https://doi.org/10.3389/fcimb.2019.00344
Kominski, G.F., Nonzee, N.J. & Sorensen, A. (2017). The Affordable Care Act’s impacts on access to insurance and health care for low-income populations. Annual Review of Public Health, 38. http://dx.doi.org/10.1146/annurev-publhealth-031816-044555
Paules, C.I. & Fauci, A.S. (2018). A universal flu vaccine is vital. Scientific American, 318(2). https://doi.org/10.1038/scientificamerican0218-8
Phillipson, J.E., Babecoff, R. & Ben-Yedidia, T. (2019). Is a universal influenza vaccine feasible? Therapeutic Advances in Vaccines and Immunotherapy, 7, 1–6. https://doi.org/10.1177/2515135519885547
Powell, D.L. (2016). Social determinants of health: Cultural competence is not enough. Creative Nursing, 24(1), 5-10. http://dx.doi.org/10.1891/1078-4518.104.22.168
Tokars, J. I., Olsen, S. J., & Reed, C. (2017). Seasonal incidence of symptomatic influenza in the United States. Clinical Infectious Diseases, 66(10), 1511–1518. https://doi.org/10.1093/cid/cix1060