Etiological Research: Evidence-Based Medicine - Coursework Example

Order 304197 ETIOLOGICAL RESEARCH: EVIDENCE-BASED MEDICINE Introduction The United s of America has an alliance of Public Health Organizations. This is made up of appropriate professionals in the Department of Health and Human Services, The Centers for Disease Control Prevention, and the Institute of Medicine. The individual group has been allocated specific public function. The Department of Health and Human Services is tasked to account for the project called Healthy People 2010. The Centers for Disease Control Prevention is assigned to explain the Public Health Infrastructure. Finally, the Institute of Medicine is assigned in the area of application of scientific and technical knowledge for public health (Gostin, 2002). Thus, the professional coalition could readily prepare the public by initiating the conduct of an etiological research which is evidence-based medicine, given a legitimate report on the existence of a virulent, totally new strain of influenza virus in a foreign country, and the risk of transmission within 3 months,. Body To verify the existence of a virulent, totally new strain of influenza virus in the United States of America, etiological research, an evidence based medicine (Jenicek, 2002) should be initiated. The process begins with surveillance. For efficiency purposes, the alliance of Public Health Organizations can very well adopt the Syndrome Reporting Information System, SYRIS, (Appendix) platform which is currently employed by the Department of Health officials in Lubbock, Texas. The information system runs on any internet linked device such as cell phones, iPods, laptops, etc. Physicians, health care givers, nurses, and laboratory technicians’ inputs critical information in less than a minute. Because Syndrome Reporting Information System is completely in accordance with the Centers for Disease Control and Prevention, CDCP, protocols on electronic reporting systems, the mapping features make available for an on the spot map update and response to queries (Zelicoff , and Bellomo, 2005). Consistently, surveillance which is the initial accurate observation will provide evidential records on fluctuations of hospitalized cases as well as the type of infections. These evidential records can be drawn from hospitals’ microbiology laboratory reports (Mims, Dockrell, Goering, Roitt, Wakelin, and Zuckerman, 2004). For example, keeping an eye on AH1N1 victims on a regular basis for proteins found on the surface of the virus or antigens which were identified to be hemagglutinin, H, and neuraminidase, N, as the existence of a virulent, totally new strain of influenza virus have been reported in respiratory care units of hospitals in Mexico. Subsequently, direct assessment of identified victims should be done to confirm cases of infections. Finally, autopsy reports, hospital staff records, and survey results on discharge victims should be assessed (Mims et al, 2004). Epidemiology and Microbiology research ensues when surveillance reports benchmarked epidemic. Initial informational clinical data should be gathered along the following epidemiologic indicators: 1) number of infected victims; 2) date of hospital admission; 3) date of infection development; 4) geographical locations of victims as epicenter; 5) medical management team description; and 6) medicinal treatments given (Mims et al, 2004).. Simultaneously, the standardized Microbiology laboratory operations initiate by taking specimens from the individual victims. The individual specimens will be cultured in-vitro and in-vivo. As soon as the microorganisms have formed characteristic colonies, isolation as well as characterization of the pathogen will follow. In cases where the isolated pathogen is consistently found in all the victims’ specimen, then, clinically the problem is confirmed (Mims et al, 2004). This substantiation may then be submitted as a report to the Centers for Disease Control and Prevention, Infectious Diseases Department by encoding in the SYRIS platform. In a minute or less, all interlinked devices will have the update. In the intervening time, epidemiologic study will proceed to ‘fingerprint’ the pathogen isolate and further investigate and draw concrete data on: 1) the phenotypic characteristic similarity to or difference from recorded strains; 2) whether the pathogen will reproduce the same strain in a setting other than the epicenter of the epidemic; 3) antibiotic susceptibility patterns; and 4) biotyping by serotyping or the novel method called molecular typing using pulsed field gel electrophoresis (Mims et al, 2004). The determination of phenotypic characteristic similarity to or different from recorded strains can initially be done by simply referring to recorded information. Nonetheless, the isolated pathogen must be further tested if it will grow and reproduce in an alternative setting. Subsequently, the isolated pathogen must be tested for antibiotic susceptibility pattern which can be done in a diagnostic laboratory through standard broth microdilution, diffusion or paper disk, or automated instrument to determine preliminary evidence on the interaction between antibiotics and the isolated pathogen in a secluded manner, from which results will most likely give an idea on the appropriate therapy that will be given to the victims (Mims et al, 2004). After the antibiotic susceptibility blueprint of the isolated pathogen have been established, biotyping the isolated pathogen will be done to distinctively characterize the microorganism. This can be done either through serotyping, Bacteriophage typing, Bacteriocin typing, or molecular typing. Serotyping is very important despite being classical and expensive because monoclonal reagents application to the isolated pathogen would reveal capsular antigenic structures similar to hemagglutinin and neuraminidase in the recent H1N1 virus strain that emerged. On the other hand, Molecular typing techniques is critical in the 21st century emergency responses as the process brings about speedy characterization of the DNA of the isolated pathogen. Characteristic DNA of an isolated pathogen can then be the basis for formulation of an antibiotic drug and a vaccine. The specific drug can then be employed to manage infected victims, while the vaccine can be introduced to prospective victims as a precautionary measure, thus preventing further transmission of the pathogen (Mims et al, 2004). With the conclusive clinical diagnostic findings, informational data may be transmitted to the CDCPIDD through SYRIS. This will be for further evaluation of the results by other experts in the field who are at hand, online. This is also to certify the evidence as sufficient, and to some scale, pertinent to the theory laid before the research was initiated (Jenicek, 2002). Moreover, this will also systematically inform all the members of the alliance of Public Health Organizations so that each department can do the necessary preparations for the upcoming health risk. In a situation where the totally new strain of influenza virus is not selective in terms of victims of infection, and that the mode of transmission is through respiratory droplets or direct contact then people who often congregate in venues like schools, churches, offices, factories, and homes are the most likely host who would be at risk of catching the flu. After the Department of Health and Human Services, the Centers for Disease Control Prevention and the Institute of Medicine confirm that tracking is completed, then, preventive action must be taken. Completed tracking would mean that the isolated pathogen has been accurately typed, the characteristics are well defined, the mode of transmission is known and reservoirs are recognized (Mims et al, 2004). Vaccination is the best medical option against viral infection. So, as soon as the Institute of Medicine will confirm the forthcoming public health risk, government should provide the funding for manufacturing of the required supply. In the event that only 50 % of the demand will be supplied, then basic hygiene should be observed as an alternate. In certain cases where about 1% mortality is experienced, chances are high that the recipient of the vaccine is an immunocompromised host that have received active vaccines. Hence, prudence must be taken along vaccinations of immunocompromised host even when the vaccine is of passive type (Mims et al, 2004). On the other hand, the Department of Health and Human Services and the Centers for Disease Control Prevention should initiate an extensive, saturative, information drive on the basics of precautions and preventions especially to the immunocompromised host, and to those who refuse vaccination. Basic defensive measures include sanitation, proper personal hygiene, disinfection, and sterilization (Mims et al, 2004). Conclusion Etiological research which is evidence-based medicine is apt for the current century need; where of essence is speed and accuracy. Reference Centers for Disease Control and Prevention, Morbidity and Mortality Report: Recommendations and Reports. Addressing Emerging Infectious Disease Threats: A Prevention Strategy for the United States. April 15, 1994, Vol. 43, No. RR-5 http://www.cdc.gov/mmwr/PDF/rr/rr4305.pdf rets: 6/14/09 CDCP. Organizational Chart. http://www.cdc.gov/about/organization/pdf/cdcOrgChart.pdf rets: 6/14/09. Gostin, L. O. (Ed.). (2002). Public Health Law and Ethics: A Reader. Berkeley, CA: University of California Press. Jenicek, M. (2002). Foundations of Evidence-Based Medicine. New York: Parthenon Publishing. Mims, Cedric, Hazel M. Dockrell, Richard V. Goering, Ivan Roitt, Derek Wakelin, and Mark Zuckerman. (2004). Medical Microbiology. 3rd ed. London: Mosby. Zelicoff , Alan P., Michael Bellomo. (2005). Microbe: Are We Ready for the Next Plague? American Management Association. Appendix Source: Janicek, 2002 Read More