Question

Peter travels the world in his position on the advance team for the secretary of state. He has likely visted as many 20 different countries in 12 months' time and is frequently in area where infectious diseases are far more common than in his home country , the Untied States. Using the CDC and the WHO as your resource , plan a strategy to keep Peter healthy.

1. What vaccination are necessary for Peter?

2. Is there any prophylactic treatment or medications?

3. What other precautionary measures might be taken?

4. What economic and political factors are considered here?

Answer 1

CDC and WHO FRAMEWORK

CDC framework was developed for improving ability to prevent known infectious disease to recognize and control highly dangerous and newly emerging threats. There are 3 critical elements in these efforts to keep a person safe.

a) Strengthen public health fundamentals includes infectious disease surveillance, lab detection and epidemiologic investigation

b) Identify and implement public health interventions

c) Develop an advanced policies to prevent, detect and control infectious disease.

As per WHO guidelines, motivate participant in prevention and control measures, encourage to take proper action which includes immunization, safe water supply and sanitation, get help from specialized services, food safety, ensure diagnosis includes clinical interpretation and physical examination, inform the expected outcome, provide treatment free of charge.

VACCINATION FOR INFECTIOUS DISEASE

Infectious disease caused by pathogenic microorganism such as bacteria, virus, fungi. Vaccines, that improve immunity to a particular disease and one of most cost-effective method in health and economic development. Immunization can prevent death associated diseases like polio, measles and pneumonia.

1. Tuberculosis- DOTS therapy (Directly observed treatment short course). BCG vaccine in childhood

2.Five doses of diphtheria, tetanus and polio vaccines ensure long term protection

3. If 65 years or older, should be routinely receive a single dose of pneumococcal polysaccharide vaccine for pneumococcal meningitis

4. Annual influenza vaccine should be received

5. For young adults who are unprotected should receive measles, mumps, rubella dn meningococcal C.

6. Antiretroviral combination therapy for HIV/AIDS

7. Long lasting, insecticidal-treated mosquito nests, seasonal malaria chemoprevention, effective case management and indoor residual spraying for malaria.

8. Other vaccinations for underlying medical conditions included Hib, influenza A and B for viral infection of respiratory tract, Hep B immunoglobulin, pneumococcal vaccines.

9. Dukoral cholera vaccine (oral)

10. Anthrax vaccine

11. Diphtheria toxic for diphtheria

12. Hepatitis A vaccine for infection in the liver caused by hepatitis A virus

13. Japanese encephalitis caused by flavivirus ( mosquito-borne viral encephalitis)- JE-VAX and "Green Cross" vaccine

14. Meningococcal meningitis- MenC conjugate vaccine

15. For diphtheria, pertussis, tetanus- DPT vaccine

16. Polio for poliomyelitis

17. Rabies (viral encephalomyelitis) - HDCV( Human Diploid Cell Vaccine) and PCEC ( Purified chick embryo cell rabies vaccine)

18. Small pox vaccine

19. Tick-borne encephalitis: FSME-IMMUN virus

20. Kyasanur forest disease ( Yellow fever vaccine for yellow fever and dengue fever)

PROPHYLACTIC TREATMENT

For blood borne infectious disease :

1. Hep B virus- Hep B immunoglobulin within 48 hours

2. Hep C virus- none available

3.HIV- Tab. Tenofovir 300mg once daily with emtricitabine 200mg

For viral infectious disease :

1. Hep A virus- Hep A vaccine within 2 weeks of exposure

2. Varicella zoster virus- varicella vaccine within 5 days of exposure

3. Influenza- influenza vaccine only for unvaccinated persons

4. Rabies- should be given as early as possible in days 0,3,7 and 14 postexposure

For bacterial infectious disease :

1. Streptococcal A infection- Single dose of penicillin G Benzathine

2. Invasive meningococcal infection- Ciprofloxacin 500mg orally ( single dose)

3. Leptospirosis- Doxycycline

4. Pertussis- Azithromycin 500mg in day 1, 250mg for 4 days

5. Tetanus- TT and single dose of tetanus immunoglobulin (250units IM)

6. Tuberculosis- Isoniazid plus Vit B6 for nine month if more than or equal to 5mm induration in tuberculin skin test or interferon assay is positive

PRECAUTIONARY MEASURES

1. Immunization

2. Screening of have been infected or exposed to an infectious disease

3. Compulsory diagnosis and treatment

4. Limit contact with infectious persons.

ECONOMIC AND POLITICAL FACTORS

1. The government should support whoever is in need during epidemic period. Get the support from other countries if cannot be controlled.

2 Rule out the causes and take prevention measures.

3. Social media is powerful to transfer the information.

4. National efforts to be taken to prevent transmission of HIV and other sexually transmitted disease

5. Penalty for those who fail to follow the public health laws.

6. Provide awareness program.