Epidemiology Exercise - Essay Example

Epidemiology Exercise Epidemiology Exercise: Tuberculosis the causative agent and if it is a virus, bacterium, parasite, or fungus. Tuberculosis is caused by a bacterium called Mycobacterium tuberculosis. The bacteria mostly attack the lungs though it can attack any body parts like brain, spine and kidney (CDC, 2014). 2) Describe the mode of transmission. (How is disease spread?) Is it a direct or indirect transmission? If indirect, name fomite or vector. TB is transmitted indirectly from an infected person to uninfected person through contaminated air. The TB bacterium is released into the air when an infected person, who has either TB disease of the throat or lungs, sneezes, coughs, sings or speaks (CDC, 2014). All individuals who get into contact with the contaminated air would inhale the contaminated air and eventually get infected (CDC, 2014). 3) Incubation/Communicable Period a) What is the usual incubation period? (average or range) Incubation period of TB ranges from 4-6 weeks (CDC, 2014). The pathogen is a sluggish dividing bacterium that may stay dormant for several years before becoming active. In addition to this, the length of tuberculosis incubation differs from individual to individual depending on the person’s risk factors. However, within six weeks of exposure to Mycobacterium tuberculosis, an infected individual develops early stages of TB in the lungs that have no symptoms (CDC, 2014). 4) Describe the clinical signs and symptoms of the disease or condition: 140 Symptoms and signs of TB depend on the part of the body infected by the bacteria. Primary infection of TB may resolve on its own as individuals develop immunity between 6-10 weeks after infection (CDC, 2014). In case the immunity is weak, TB may progress and stretch all over the lungs or other organs. Such patients may develop signs and symptoms like; weight loss, fever, fatigue, cough and loss of appetite (CDC, 2014). Symptoms and signs for TB in the lungs include coughing for almost a month, coughing of blood, painful breathing, chest pain and pain when coughing (CDC, 2014). Occurrence of extra signs depends on where TB is developing (CDC, 2014). For instance, if TB develops in the lymph nodes, the patient may have swollen glands on the neck and under the arms. In case it affects the joints and bones, the patient develops swellings and pains around hips and knees. Lastly, Genitourinary TB results into pain in the flank as well as frequent urination accompanied with pain plus blood in the urine (CDC, 2014). 5) How is the disease diagnosed? (Method used to make a positive diagnosis: e.g. screening tests? Blood tests? Cultures? Patient history? Relative signs and symptoms?) Tuberculin skin test is done by injecting a fluid in skin under the lower fraction of the arm. After about two days, the part injected with the fluid is examined (CDC, 2014). A hard, raised swelling indicates the presence of TB. Blood test for TB is done to determine how immune system reacts to the presence of TB causing bacterium (CDC, 2014). Patients with latent TB infection have the TB bacteria but cannot infect others or show signs of the disease. The bacterium is inactive form and if not cured, it may result in TB. Medications used for diagnosis of latent TB include rifampin (RIF), isoniazid (INH) and rifapentine (RPT) (CDC, 2014). TB can be treated through taking various drugs for 6-9 months. Drugs used for treatment of full-blown TB are ethambutol (EMB), isoniazid (INH), pyrazinamide (PZA) and rifampin (RIF). It is important for patients to finish their medication or else the disease may reoccur again (CDC, 2014) 6) a. Is there a drug treatment for this disease? Yes __yes__ No ____ If yes, give the name of the medication and state whether it is an antibiotic, antiviral, antiparasitic drug, etc. The antibiotics used for treatment of TB includes; ethambutol (EMB), isoniazid (INH), pyrazinamide (PZA) and rifampin (RIF). They may be given orally as pills or through injections. Similarly, corticosteroid may be administered among children to reduce inflammation cases (CDC, 2014) b. Are there any other treatments prescribed for this disease to alleviate symptoms? (e.g.: bed rest, push fluids, cool mist vaporizer, over the counter fever reducers) 100 If proper nutrition is observed, a patient can reduce symptoms and risks of TB. TB patients should avoid suspected food allergens like; eggs and cheese as well as chemical food additives. Patients should also take foods high in iron and B-vitamins (CDC, 2014). A patient diet should include a multivitamin and a trace of minerals like; calcium, zinc and magnesium. There are some herbs which can speed up the healing process. They include aged garlic for immune-stimulating and antibacterial properties. Others include astralagus for treatment of TB and arsenicum album for chest pain and coughs (CDC, 2014) 7) Is this disease considered a nationally notifiable disease reportable to the Centers for Disease Prevention and Control (CDC)? Yes ______YES___ No _______ 8) Is there a vaccine available for this disease to protect humans? a. Yes ___YES______ No ________ b. If yes, what is the immunization schedule? (Number of doses, how far apart, ages recommended for vaccinations) In the US, BCG is only considered for selected people who meet given conditions. However, whenever it is administered for infants who are below 12 months, it is advised to give them 0.05 ml of the BCG vaccine. On the other hand, for infants above 12 months and adults, the experts recommend to give them 0.10 ml of the vaccine (CDC, 2014). There is no age gap recommended for BCG vaccination. In most cases, it is considered if the individuals in question are at a higher risk of contracting the disease. For example, children below 16 years coming from regions that TB is widespread or have been close to someone with pulmonary TB may be vaccinated. Healthcare officials under the age of 35 should be vaccinated against TB if they constantly handle TB patients. Others to be vaccinated include prison staff members dealing with prisoners, veterinary officials and homecare givers. These individuals can be vaccinated at any time regardless of their ages as long as they are at a risk of contracting the disease (CDC, 2014) B. Host Factors 1) What internal factors or behaviors could increase the host’s risk for getting this disease? (For example, lifestyle behaviors, hereditary factors, strength of immune system) HIV and AIDS infection is a risk factor for TB disease. It is important for HIV patients to seek early preventive mechanisms before contracting the disease. Alcoholism and smoking are other lifestyles that can easily lead to TB (CDC, 2014). This is because; they lower immune system and also lead to clustering. Smoking leads to reduced phagocytic capability of alveolar macrophages and limited clearance of mucosal secretion. Other factors include malnutrition and diabetes (CDC, 2014) C. Environmental Factors Describe any external factors that could increase the host’s risk for getting this disease. For example: vector, fomite, crowding: are you more likely to contract this disease if you live in close conditions like dorms or prisons or at the gym? Does an unsanitary water supply, low SES, certain occupations (exposure) increase the person’s susceptibility? Increased population and air pollution are the major risk factors in developing of TB. Over populated regions that have, infected persons are likely to infect others since it is an airborne disease. Polluting air using coal and other chemicals reduces immune system of individuals thus exposing them to TB (CDC, 2014). Socioeconomic and behavioral factors could also hasten the contraction of TB. Most people suffering from TB in developing countries come from ghettos, rural areas and poor backgrounds because such individuals are exposed to overcrowding, poor living conditions and do not get immunized when they should (CDC, 2014) D. Distribution Patterns – Describe the patterns of distribution of the disease in terms of person, place and time. i) What “person” factors are important in this disease/condition? What do the statistics say? Is it more common in women or men, the elderly or the young, certain ethnicities, low SES? Most blacks in USA are at a greater risk to be infected with TB compared to other communities (CDC, 2014). This is partly due to economic and behavioral factors that expose them to this disease. In addition to this, health disparities in the country limit their accessibility to vaccination and quality healthcare. Children below 15 years are also prone to TB due to weak immune system and exposure from infected parents (CDC, 2014). Correctional facilities such as drug rehabilitation centers and prisons report high cases of TB due to overcrowding. Lastly, TB is also more common among the aged. Most of those diagnosed with TB in USA are above 65 years (CDC 1). 1) What “place” factors, if any, are important in this disease/condition? Does prevalence of disease/condition differ from one region/country to another? Is it more prominent in certain climates? According to a research conducted between 1971 and 2006 showed that South Africa, Cameroon, India, Hong Kong, Kuwait, Spain, Japan, Mongolia, UK, Ireland and Russia are more prone to TB than other countries of the world (CDC, 2014)A seasonal pattern of TB is mostly experienced in spring and summer seasons. The reason explaining TB cases are predominant during spring and summer seasons are not known. However, this could be due to; indoor activity, exposure to sunlight, change in healthcare seeking behaviors and immune functioning (CDC, 2014) E. Describe how frequently this disease occurs in the U.S. using incidence and/or prevalence rates/numbers. 1) What is the incidence or prevalence (rates or numbers) for the most recent year that statistics are available? Over 9,945 people in the US were infected with tuberculosis in 2012. This gives a rate of 3.2 incidences per 100,000 persons (CDC, 2014). This shows the number have decreased by 5.4 % compared to earlier statistics. It is worth noting that, the TB cases reported in 2012 were the lowest ever recorded in the History of the United States (CDC, 2014). Identify whether the statistics describe incidence or prevalence. The statistics contain incidence. This is because; it contains the new cases that occurred in the United States in 2012 which were around 9,945 cases (CDC, 2014). 2) Are the statistics rates or raw numbers? The statistics are raw numbers and rates. This is because; they compare two variables. For example, they contain the total sum of TB patient per 100,000 people. The raw numbers are contained in the total sum of TB patients in the United States that is 9,945 (CDC, 2014). F. Natural Life History of the Disease If no vaccine was administered and/or no treatment was given, what is the natural life history of this disease including complications? Describe what happens in early and late pathogenesis periods of the disease. Remember, knowing the natural life history of a disease can help us identify primary, secondary and tertiary prevention strategies. 1) Pre-pathogenesis period (risk factors) During this period, a person may not realize he has TB unless he goes for a medical checkup. The patient feels normal because TB germs are not yet active (CDC, 2014). During the stage, an infected person cannot infect others. However, it would be appropriate to take medication in order to prevent TB from becoming active and eventually harming the body system (CDC, 2014). 2) Early Pathogenesis period (early signs and symptoms) During this stage, a patient may develop signs and symptoms of TB (CDC 1). The early signs of TB can easily be mistaken for other illness. However, it is important for individuals to seek medical attention in case they develop this signs; extreme fatigue or body weakness, lack of appetite, fever, repetitive chills and night sweats (CDC, 2014). 3) Late pathogenesis period (complications from advanced disease) If TB is not well treated, it can lead to various complications including death. Among the complications include; Pulmonary TB which leads to permanent lung damage. In addition to this, it may lead to life-threatening complications like severe pain, infection of the bones and joint destruction. It can also affect nervous system and the brains a condition called Meningeal TB. Lastly, it can lead to drug resistant TB that would keep on reoccurring in a patient life (CDC, 2014). II.CONTOL PLAN BASED ON LEVELS OF PREVTION Use your knowledge of the Natural Life History of your disease (pre-pathogenesis and pathogenesis periods) to develop primary, secondary and tertiary interventions) A. Describe a primary prevention measure that could be applied to this disease/condition. Primary prevention methods of TB include vaccination. The available vaccine for TB is bacille Calmette-Guérin (BCG) 9 (CDc, 2014). The vaccine is adequate for newborn babies and those exposed to TB patients. This is the sure way to eliminate TB as it ensures individuals are well protected for the rest of their lives. Another method is the use of environmental controls. This includes ventilation and ultraviolet lights. Ventilation allows free circulation of clean air, preventing the infection of TB in crowded areas (CDC, 2014). B. Describe a secondary prevention measure that could be applied to this disease/condition. Secondary methods for managing the disease are detection of latent TB in individuals. Those who turn out positive with LTBI are then treated to avoid LTBI from progressing to full blown or active TB (CDC, 2014). Those tested for LTBI include individuals such as healthcare officials, prisoners and nurses who are mostly exposed to the risk of TB infection (CDC, 2014). C. Describe a tertiary prevention measure that could be applied to this disease/condition. Tertiary Prevention methods include treatment of patients with TB. It includes identifying infected individuals who have active TB and subjecting them to proper treatment. During this stage, healthcare givers identify the infected parts of the body in order to understand the type of medication to give (CDC 2014). Work Cited Centers for Disease Control and Prevention (CDC) (2014). Basic Tuberculosis Facts. Retrieved from http://www.cdc.gov/tb/topic/basics/default.htm Read More