Clinical Epidemiology and Decision Making - Essay Example

?Clinical Epidemiology and Decision Making Case Study Introduction and Background The onset of floods in various parts of the world is marked by physical devastation including which includes economic loss by damaging property, agriculture and livestock. Moreover, there are serious health concerns as a result of this calamity which may escalate to catastrophic proportions if the epidemic is allowed to spread. One such health problem is Mold which is a special type of fungus. Although molds are present in the environment as microscopic cells, they need moisture to grow which essentially means that these organisms thrive in the presence of excess moisture at the onset of a flood. These spores thus need water or moisture to germinate and flood provides them the ideal environment to grow. Molds if inhaled can cause allergic reactions that affect the respiratory tract. Other illnesses include sinus congestion, sore throat and breathing problems. The health risks can be more for children and elderly people as well as people with low immune systems. Mold can also have severe implications on structural strength of buildings as well which may compound the problem in flood stricken areas. The field of clinical epidemiology suggests that general practitioners must consider facts based on population based studies of diseases and base their treatment and design preventive measures on these measures. Clinicians may use these statistics towards better patient care. In this paper we attempt to explore how clinical epidemiology may be beneficial to guide and deal with detection, prevention and treatment of mold in flood hit areas. It is pertinent to note that mold may appear soon after the flood and may carry on until there is moisture. For this reason it is important that the rehabilitation process may not be started unless all moisture dries out. For the purpose, the health practitioners treating the disease need to be advised before and immediately after the floods about the types of molds in the area as well as the extent of illness in the area. Also, the health practitioners need to know about the medical facilities that they would have as well as chalk out a method to deal in case that it takes the form of an epidemic. These practitioners need to be told that they must not look to test every individual due to resources constraints and would be better served to look for symptoms. 2. Types of Molds Evidence from clinical epidemiology suggests that there are three types of molds that can affect people in the aftermath of a flood. These are mentioned below: i. Allergenic These types of molds are the least damaging as they affect only those individuals that are already weakened by illness or disease and a have a weakened immune system. Although these molds are present all year, they thrive in areas where the moisture content is significantly high. This essentially means that these types of molds can exist in the aftermath of a flood. These molds result in sneezing and cause allergic reactions. Thus they do not have life threatening affects unlike other types of molds that might result in severe respiratory problems including congestion of the windpipe and choking. Mold spores are examples of allergenic molds. ii. Pathogenic This type of mold may cause respiratory tract infections. For persons with a weakened immune system, this may result in severe illness and may be possibly life threatening. However, healthy individuals may develop hypersensitivity but do not incur infection. This is why it is imperative that children and elders are guarded against this type of a mold infection. The bipolaris mold is one example of a pathogenic mold. The mold may manifest itself as mycotic keratitis and sinusitis etc. This type of a mold can affect both immune-competent as well as immune-compromised individuals with different repercussions. iii. Toxigenic The most devastating strain of mold produces myotoxin which can cause some seriously undesirable health problems. This is an extremely toxic strain of mold which may not only affect the respiratory tract but also lead to cancer. One example of this type of strain is the black mold which may result in serious life threatening illness. Examples of some fungal species that can produce myotoxin include Aspergillus, Trichderma etc. Like other forms of fungi, these also grow rapidly in the presence of moisture and therefore appear during floods. Such types of molds suppress the immune system. This results in a making the patient unable to fight any disease which might prove potentially life threatening. 3. Mold Detection and Prevention It is advisable that after the incidence of floods in a certain area, testing might not be the most plausible alternative. It would be prudent as well as effective to investigate the presence of mold in the area by taking into account the physical presence of mold. This is crucial as mold testing is certainly not economically feasible in flood hit areas as a number of people would be susceptible to it. People may be advised to take preventive measures such as using the respirator to prevent inhaling mold. The use of an N95 and N100 type respirator is strongly recommended. Also, use of rubber gloves as well as abstaining from eating or drinking in the contaminated area would help preventing the disease. It is also important that apart from these preventive techniques, efforts must be made to ensure that moisture is not allowed to develop. This is of particular importance after flood is alleviated. Another measure that can be adopted is to remove and relinquish the use of contaminated utensils and materials. In case there are no obvious signs of mold on kitchen utensils, it is important that they are cleaned before use to ensure that the spores are wiped off. This technique may not be able to eliminate mold altogether nor would be able to kill it. The Government should consider supplying the HEPA vacuum pump so that it can be employed to remove contamination. Using the HEPA pump though very effective may not be economically feasible. Its use is therefore limited by availability and economic constraints. Also, these utensils must be disinfected so that the mold that is present may be removed. It is imperative that mold contamination is not allowed to spread. In the event of flood, moisture is present in abundance and thus the focus should be on damage control since complete elimination of mold may not be possible. In all the techniques mentioned above, emphasis is more on prevention and controlling the epidemic rather than eliminating mild altogether since the source cannot be removed. In this context it is imperative to be patient as far as rehabilitation is concerned so that all moisture dries up. Also people might be cautioned to use antiseptics and other cleaning agents with care. 4. Talking Points for the Pennsylvania Health Department The Pennsylvania health department may debate over the type of mold that is present in the flood affected areas. This is of particular importance since this is what generally affects both the precautionary methods that need to be taken as well as the treatment. The Pennsylvania Health Department may also include deliberations over what prevention techniques to adopt. Also it is important to discuss how to control the mold infection from spreading across the affected community by adopting special procedures mentioned above. This would include a debate on how to mobilize resources to control both the spread as well as treat patients who have already contracted the illness. These three discussion points are critical to control the disease as well as ensure minimal life loss. 5. Type of Study to be Used With a lot of statistical data already available with regards to development of various types of molds, it would be advisable to adopt an approach which could consolidate upon existing literature. In doing so clinicians may be advised to follow the meta-analysis approach. By doing so, clinicians may be able to explore hidden elements in contemporary research to the benefit of other people. This may also be effective in providing an assessment of how heterogeneity of population would affect the diagnosis and treatment of disease. Also, biases and limitations in other studies may be detected to enable clinicians find better ways to solve existing problems. However it is important that this technique is used to assist original research by clinicians and randomized controlled clinicians tests may be employed both to test validity of previous literature as well as look for possible solutions. 6. Conclusion Mold infections may assume the form of an epidemic if proper preventive methods are not adopted. It is important that the potential life threatening hazards are recognized at an early stage and resources mobilized to prevent the disease from spreading. It is also imperative that an appropriate mix of various preventive measures is used to help control the spread as well as growth of molds. Also, after the type of mold prevalent in an area is detected, appropriate medical support needs to be provided to the patients in time to ensure smooth recovery and limit the effects of the disease. References “Dealing with Mold Problems after a Flood”. (2012). Minnesota Department of Health. Retrieved from http://www.health.state.mn.us/divs/eh/emergency/natural/floods/mold/mold.html Last, J.M. (1988). What is Clinical Epidemiology. Journal of Public Health Policy. Vol 9. No. 2, 1988. Retrieved from http://www.jstor.org/pss/3343001 Chakrabarti, A. (2011). The Emerging Epidemiology of Mold Infections in Developing Countries. US National Library of Medicine National Institutes of Health. Retreived from http://www.ncbi.nlm.nih.gov/pubmed/21799406 “Advanced Mold Inspections”.(No Date). AMI Environmental Testing. Retrieved from http://advancedmoldinspections.com/types_of_mold.html#More_On_Pathogenic_Molds Ioannidis, J.P. (1999). Pooling Research Results: Benefits and Limitations of Meta-Analysis. US National Library of MedicineNational Institutes of Health Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/10481815 Read More