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Transcript of Emerging Infections
Have never occurred in humans before
Have occurred but only in a small, isolated population
Have occurred in history but now is a distinct infectious agent
Previously a major health issue either globally or in a certain country but is now becoming a relevant health problem again Contagion: How Do You Avoid Something That’s Everywhere? “CDC’s mission, simply put, is to keep Americans safe and healthy where they work, live and play. Scientists and disease detectives work around the world to track diseases, research outbreaks, respond to emergencies of all kinds, and use what they learn from this work to develop and advocate public health policies that strengthen America’s health and resilience” (CDC, 2011). Part of the United Nations system
“It is responsible for providing leadership on global health matters, shaping the health research agenda, setting norms and standards, articulating evidence-based policy options, providing technical support to countries and monitoring and assessing health trends” (WHO, 2013). International Health Regulations (IHR) Part of World Health Organization (WHO)
It’s purpose is to help the global population prevent and respond to public health risks that are acute in nature and have the possibility to cross over borders and threaten other communities.
It requires countries to report disease outbreaks and public health events Online source that monitors disease outbreaks globally and has real-time surveillance of emerging threats
Team is made up of researchers, epidemiologists and software developers from Boston Children’s Hospital
Free to the public via or a mobile app called "Outbreaks Near Me"
Examples of Emerging infections Norovirus; What is it? Norovirus is often times called the “stomach flu” or “food poisoning”.
The CDC estimates that 20 million cases of acute gastroenteritis are caused by norovirus. That means that on average 1 in 15 Americans gets infected each year.
According to the CDC the norovirus causes over 70,000 hospitalizations and 800 deaths each year in the U.S.
Signs and Symptoms
Norovirus usually lasts only 1-2 days. How is it Spread? The virus spreads from person to person. Unlike the flu, the norovirus is much more contagious.
It spreads quickly in crowded environments such as daycare, cruise ships, restaurants, hotels, and schools.
Those infected with norovirus should not prepare food while sick or for 3 days after recovering from their illness.
Foods can be infected in the same way as humans or through their preparation. How is it Treated? Unlike the flu there is no vaccine to prevent the norovirus. There is also no drug to take to cure the norovirus. But there are simple precautionary measures you can take to avoid getting sick. The most important of them being hand hygiene. Also carefully wash fruits, vegetables, and seafood.
Make sure to clean and disinfect contaminated surfaces by using a bleach-based household cleaner
Immediately remove and wash clothing or linens that may be contaminated with vomit or stool Trends in Norovirus Norovirus is contagious throughout the year, but is most commonly spread during the winter months. According to the CDC, when there are new norovirus strains norovirus illnesses occur 50% more in that year.
This was the case in 2006, 2007, 2009, possibly 2013. Figure 1: Outbreaks of Acute Gastroenteritis, 30 States, January 2007 through April 2010. (December 10, 2012). Retrieved February 21, 2013 from http://www.cdc.gov/features/dsnorovirus/figure1.html Figure 2: Setting of 1,518 Confirmed Norovirus Outbreaks, U.S., 2010-2011. (December 10, 2012). Retrieved February 21, 2013 from http://www.cdc.gov/norovirus/trends-outbreaks.html Figure 3: Known Causes of Foodborne Illness Outbreaks, U.S., 2006-2010 (December 10, 2012). Retrieved February 21, 2013 from http://www.cdc.gov/norovirus/trends-outbreaks.html Norovirus: The New Strain Leading cause of epidemic gastroenteritis in the United States
Belong to the family Caliciviridae
Divided into 5 genogroups (GI through GV), further divided into 34 genotypes
Human disease caused GI and GII noroviruses; most outbreaks caused by GII.4 strains New GII.4 strains emerge every 2–3 years
March 2012 new GII.4 strain identified in Australia
GII.4 Sydney causing acute gastroenteritis outbreaks in multiple countries, including the US
In the United States, GII.4 Sydney strain appears to have replaced the previously predominant strain GII.4 New Orleans
Not known to be more virulent then other similar strains of GII.4 identified The New Strain Timline September–December 2012, 141 (53%) of the 266 norovirus outbreaks reported to CaliciNet were caused by GII.4 Sydney
September 2012: 4 (19%) out of 21 outbreaks caused by GII.4 Sydney
October 2012: 22 (46%) of 48
November 2012: 70 (58%) of 120
December 2012: 45 (58%) of 77 Most of the outbreaks resulted from direct person-to-person transmission; 72 reported outbreaks (51%)
29 (20%) of the reported outbreaks were foodborne
Only one outbreak reported (1%) was waterborne
Transmission mode was unknown in 39 (28%) of the outbreaks
Long-term–care facilities and restaurants were the most frequently reported settings How did GII.4 Sydney spread Emerging Infections to "Watch out for" National Institute of Allergy and Infectious Diseases released list of emerging and re-emerging infections
Group I: Pathogens newly recognized in the past two decades
Group II—Re-emerging pathogens
Group III—Agents with bioterrorism potential Divided into 3 different categories
Category A Priority Pathogens: pose the highest risk to national security and public health
Category B Priority Pathogens: second highest priority organisms/biological agents
Category C Priority Pathogens: include emerging pathogens that could be engineered for mass dissemination in the future Influenza: What is it? Contagious respiratory illness that is caused by the influenza viruses
Affects the nose, throat and lungs
Can either by mild or severe or can sometimes be fatal
Spreads through by coughing, sneezing, or talking Signs and Symptoms Fever
However this does not apply to everyone
Runny or stuffy nose
Muscle or body aches
May have vomiting or diarrhea Periods of Contagiousness Can pass the flu on to someone before you know you’re sick, while you’re sick and ever after you’re are sick
Most healthy adults can infect others 1 day before symptoms develop and up to 5 – 7 days after becoming sick
The people who are most at risk (children, elderly, pregnant woman, or people with weakened immune systems) may possibly be able to spread the flu for an even longer period of time H1N1 (Swine Flu) In 2009 caused a worldwide pandemic
Now it’s a seasonal flu virus that also affects pigs
Cannot get it by handling improperly cooked pork or pig products
Symptoms are similar to that of the seasonal flu
Best way to protect yourself – flu vaccine H5N1 Avian Flu (H5N1 Bird Flu) It’s a highly pathogenic flu virus that has caused serious outbreaks in domestic poultry
H5N1 does not usually infect humans, nearly 600 human cases have been reported from 15 countries since 2003
Rare but most cases usually occurred in people who had recent contact with sick or dead poultry that were infected with H5N1 viruses
60% died of their illness
Usually does not spread from human to human Treatment If diagnosed with the flu it is important to stay home and follow HCP’s recommendations
Can treat flu symptoms without medication
OTC meds may improve symptoms but will not make you less contagious
Antiviral medications to make your illness milder and prevent serious complication
oseltamivir (Tamiflu), zanamivir (Relenza), amantadine (generic), and rimantadine (Flumadine)
Work best if taken within the first 2 days of getting sick
Antibiotics may be prescribed if your flu has become a bacterial infection
Prevention: Influenza Vaccine Influenza Vaccine Effectiveness The Influenza vaccine effectiveness can vary from year to year and among different age and risk groups.
It is not possible to predict which flu viruses will dominate during a season. Flu viruses are constantly changing- this is called antigenic drift– they can change from one season to the next or even change within the course of one flu season.
Experts must choose which viruses to include in the vaccine many months in advance in order for the vaccine to be produced and delivered on time. Can the flu vaccine provide protection even if the vaccine is not a “good" match?
The answer is “Yes!” How Effective was this Years Flu Vaccine? The 2012-2013 influenza vaccine contained two A strains, H1N1 and H3N2, as well as a 2010 B strain.
The CDC is basing vaccine effectiveness for this season on 2,697 children and adults who are enrolled in the U.S. Influenza Vaccine Effectiveness Network from December 3, 2012 to January 19, 2013.
During this time, the effectiveness of the influenza vaccine was 56%. This finding was decreased compared to the first assessment, which found a vaccine effectiveness of 62% from December 3, 2012 to January 2, 2013. Have the CDC received reports of people who have gotten a flu vaccine and then tested positive for the flu? Do Flu Vaccines Work in People 65 years and older? Typically, the immune defenses become weaker as an individual ages, which places some individuals ages 65 and older at a greater risk of flu-related complications.
Individuals ages 65 and older account for about 65% of flu-related hospitalizations each year and about 90% of flu-related deaths.
Reported viral effectiveness estimates in people 65 and older have varied. In general, when overall viral effectiveness results are tracked by age, the flu vaccine seems to work less effectively in people ages 65 and older Should people over the age of 65 still receive the vaccine? Who has been most Severly Impacted this Flu Season? Individuals ages 65 and older have been most severely impacted by the 2012-2013 flu season.
As of February 9, 2012, more than half of flu-associated hospitalizations were reported to have occurred in adults 65 years of age and older.
Researchers have estimated that 90% of flu-related deaths occur in people 65 and older, and the flu is a major contributor to hospitalizations in seniors.
Some data from similar studies looking at flu seasons from years 1979 to 2001 estimate that as many as 60% of flu-related hospitalizations occur among people 65 and older.
How many children have died, this season, from the flu Are new flu viruses circulating this season? Flu viruses are constantly changing, so it's not unusual for new flu viruses to appear.
Most of the flu viruses that have been analyzed at the CDC are like the viruses included in the 2012-2013 flu vaccine.
However, some influenza B viruses that have been analyzed by CDC do not match the influenza B virus included in the 2012-2013 vaccine.
Does the flu vaccine work right away? Good News Bad News The good news is that the 2012-2013 vaccine provided 58% protection from the most common and most serious H3N2 strain for children 6 months to 17 years of age.
This season’s vaccine also provided 46% protection for those aged 18 to 49, and 50% protection for those aged 60 to 64. The influenza vaccine did not protect those individuals over the age of 65 as it should have.
According to the reports obtained by the CDC, the vaccine’s effectiveness for those over the age of 65 was a mere 9% Preventing Communicable Diseases Receiving the flu vaccine
Avoiding contact with those who are sick
If you are sick, STAY HOME!
Clean and disinfect all surfaces, including door handles
Avoid touching your face
Cover your mouth when sneezing or coughing
Avoiding crowded areas during flu season
Keep food out of the danger zone (40-140°F)
Avoid cross contamination when cooking
Keep pets away from food preparation area
Multivitamins Only Lysol Brand III is effective against Norovirus Not Lysol wipes! Hand Sanitizer: Helpful or Harmful Who are Susceptible to Communicable Disease? Elderly population
Low socio-economic status
Live in crowded housing, i.e. dorms, multi-family homes
Younger children and infants
Limited access to health care
Health care providers Use a hand sanitizer that is at least 60% alcohol
Does NOT kill all germs
Not effective when hands are visibly dirty
Not recommended in place of soap and water because it does not cut through grime
Creating a "SuperGerm"? Containing Triclosan
Read labels CAREFULLY Carefully wash fruits and vegetables
Cook shellfish thoroughly Prevention and Control of Outbreaks in the Health Care Settings Place infected patients on contact precautions and maintain until 48 hours after symptoms subside
Avoid long or artificial nails
Wash hands before and after any patient contact
Limit patient movements on and off the unit
Limit/Suspend unit activities during outbreaks
Clean and disinfect shared equipment And the Number one way to prevent the spread of disease..... Hand washing