What are epidemiological determinants?
In this task, you will analyze a recent global outbreak of a communicable disease. It must be an outbreak that has crossed international borders. You are asked to choose ONE of the following communicable diseases to address in your task:
� respiratory syndrome coronavirus
� meningococcal disease
You will be asked to describe the epidemiology and transmission of the outbreak. In addition, you will be asked to analyze the effect of the outbreak on your community at the systems level. And finally, you will be expected to discuss what actions would be appropriate for a community health nurse when confronted with an outbreak of pandemic proportions.
A1. Select ONE of the listed diseases and find a recentSPECIFIC OUTBREAK. These websites �The Centers for Disease Control and World Health Organization – are great resources to help you track down a global outbreak. Describe the specific details of the causative agent, geographical spread, hosts, mode of transmission, incubation and communicability periods, symptoms, mortality rate, morbidity characteristics of those affected, etc. Where appropriate you will provide specific data. The specific outbreak needs to be a documented outbreak with numbers of cases, dates, and other epidemiological data. It does need to be an outbreak that has crossed international borders. It does not need to be an outbreak in your specific community nor does it have to have entered the United States. See this link – https://www.cdc.gov/mmwr/preview/mmwrhtml/mm6236a5.htmfor an example of the kind of outbreak they are looking for. The evaluators really want a description that says, for example, � there were x number of confirm/suspected cases in country one for x number of days, from x month/year to xmonth/year, somehow the disease crossed international borders (identify travel, vector, refugees, etc. as the culprit). The disease then infected y number of individuals in the next country, for ynumber of days, from y month/year to y month/year.�
2. Analyze the EPIDEMIOLOGICAL DETERMINANTS of the outbreak. Once you have found a specific outbreak, you can discuss the epidemiological determinants of thisoutbreak more fully. What are epidemiological determinants? A determinant is anything that increases disease frequency in a population. Risk Factors and Transmission are both epidemiological determinants. However, you should discuss other determinants relevant for your outbreak here such as infectivity (how easily spread is it?), virulence (how deadly is it?), mode of transmission (Vector? Contact? Aerosol?), climate considerations (i.e. does the vector survive arid or cold temperatures?), antigenic stability (i.e. Influenza) and any other appropriate variable.
a. Discuss the national and international ROUTE OF TRANSMISSION of the disease causing the outbreak. See this WHO Transmission of Communicable Diseases on aircraft document. Discuss how the disease was spread geographically. Was air travel to blame? Migration? More local travel? Other? And then explain where it went over time.
b. Discuss any RISK FACTORS involved. Risk factors typically address the condition of the host (patient) and environment. Examples of risk factors would be age, occupation, immune-compromised status, unvaccinated status, lack of prior exposure to the disease, smoking, living in close quarters (i.e. military, prisons, college dormitories), vector exposure, etc.
3. If an outbreak occurred in your community, how would it affect the community at a SYSTEMS LEVEL? Include information on how the outbreak would affect the economy, schools, healthcare facilities, transportation. Predict the effect of an outbreak on the FUNCTIONING of your city/county. You will want to address additional things like hospital overflow, transportation issues, economic productivity, etc. Assume the worst case scenario. The evaluator is looking for a �logical discussion�. What would be the effect on schools? Would they need to close? Would government offices need to close, etc.? Would the hospitals have the staff to care for an outbreak? Could they handle the individuals coming to the clinics or put others at risk? Would it overburden the health system of the community, etc.?
4. REPORTING PROTOCOL. As a community health nurse, who would you report a new case to? Who would they report it to? Review this Chain of Command Example and p 531-2 in Foundations of nursing in the community: Community-oriented practice. What is your county� s reporting process? Your state legislature should have laws for the reporting of communicable diseases when suspected or actual. What does your Public Health Department, local and state level, indicate for reporting communicable disease?
5. Discuss two strategies (e.g., patient education strategies, community education strategies) that you would recommend to PREVENT AN OUTBREAK in your community. You may want to review the following, Infection, Don� t Pass it on! and https://www.cdc.gov/mmwr/preview/mmwrhtml/rr6204a1.htmSection