Public Health Triumphs: Smallpox and Polio Eradication

Introduction to Health and Health Care in the U.S. Public Health, Part 2 Lecture a This material (Comp 1 Unit 8) was developed by Oregon Health & Science University, funded by the Department of Health and Human Services, Office of the National Coordinator for Health Information Technology under Award Number 90WT0001. This work is licensed under the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by-nc-sa/4.0/.

Public Health, Part 2 Learning Objectives - 1 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) 2

Public Health, Part 2 Learning Objectives - 2 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) 3

Communicable Disease (CD) Communicable: those diseases that result from organisms such as bacteria, protozoans, fungi, and viruses To control infectious diseases: Clean water and better sanitation Antimicrobial therapy 4

Public Health Triumphs New infectious diseases will continue to emerge Two of the brightest triumphs of public health are encouraging: Smallpox Polio 5

Public Health Triumphs: Smallpox Contagious and often fatal; caused by a virus that has been around for thousands of years 1796 Edward Jenner Discovered milkmaids who had caught cowpox did not catch smallpox 1800 Smallpox vaccination began in the U.S. 1949 - Last case of smallpox in the U. S. 6

Smallpox, continued 1966 International Smallpox Eradication program established 1977 Last naturally occurring case in the world, Somalia 1977 Worldwide eradication of smallpox following global vaccination program 7

Smallpox: Current State Routine vaccination against smallpox was stopped after the disease s eradication Other than laboratory stockpiles, the Variola virus has been eliminated from the world 8

Smallpox: A Terrorism Concern? CDC 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 Vaccination within 3 days of exposure will completely prevent or significantly modify smallpox for most U.S. has stockpiled vaccine it is a live vaccine to a related virus 9

Public Health Triumphs: Polio History - evidence of polio in an Egyptian stone engraving over 3,000 years old Virus mainly affects children <5 years of age. Spread by contact or by ingestion of fecal contamination in food or water 10

Polio, continued Highly infectious, the virus invades the nervous system Up to 95% of people may not have symptoms, those who do can have severe effects including paralysis 1955: Salk polio vaccine licensed. Rapid eradication in industrialized countries 11

Polio: Current State Polio has been effectively eliminated in industrialized countries, but still a risk in other countries World Health Organization (WHO) continues its efforts toward global eradication of polio 12

Public Health Communicable Disease Prevention Activities State and local health department activities include: Monitor incidence of CDs Investigate outbreaks Intervene/treat populations Report data to CDC 13

Federal Prevention Activities 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 during outbreak responses 14

Simplified Case Study: Food Poisoning Outbreak Investigation - 1 Public Health receives laboratory reports positive for foodborne pathogens Public Health Epidemiologists investigate Samples sent to Public Health Laboratory Fieldwork determines many of the patients ate at a company picnic 15

Simplified Case Study: Food Poisoning Outbreak Investigation - 2 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 16

Simplified Case Study: Food Poisoning Outbreak Investigation - 3 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 17

Communicable Disease Topics Animal- Related Diseases Food- Related Diseases Sexually Transmitted Diseases Water- Related Diseases Health Care- Related Infections and Issues Bioterrorism Agents/ Diseases Childhood Diseases HIV/AIDS Insects and Arthropod- Related Diseases Emerging Infectious Diseases 18

Sampling of Communicable Diseases: Animal Related 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 19

Sampling of Communicable Diseases: Food Related E. coli O157:H7 Bacterial infection usually traced to food contaminated with cow feces. Can lead to very severe health outcomes, including death Public health responses: monitoring, interventions, outbreak investigation, education on prevention 20

Sampling of Communicable Diseases: Sexually Transmitted Gonorrhea Bacterial infection transmitted by sexual contact or during birth. Can lead to permanent health problems. Public health responses: monitoring, interventions, outbreak investigation, education on prevention and treatment 21

Sampling of Communicable Diseases: Water-Related Cryptosporidiosis Microscopic parasite, ingested by drinking water contaminated with animal or human feces Some public health responses: monitoring, outbreak investigation, education on water treatment 22

Sampling of Communicable Diseases: Health Care-Related Methicillin-resistant Staphylococcus Aureus (MRSA) Bacteria resistant to certain antibiotics, in health care 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 23

Sampling of Communicable Diseases: Childhood Diseases 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 24

Sampling of Communicable Diseases: HIV/AIDS 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 25

Sampling of Communicable Diseases: Emerging 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 26

Public Health, Part 2 Summary Lecture a Communicable diseases Public health outbreak investigations 27

Public Health, Part 2 References Lecture a References Nationally Notifiable Infectious Conditions - United States 2010. (2010). Retrieved January 31, 2017, from Centers for Disease Control and Prevention - Office of Surveillance, Epidemiology, and Laboratory Services website: https://wwwn.cdc.gov/nndss/ 28

Introduction to Health Care and Public Health in the U.S. Public Health, Part 2 Lecture a This material was developed by Oregon Health & Science University, funded by the Department of Health and Human Services, Office of the National Coordinator for Health Information Technology under Award Number 90WT0001. 29