Epidemiology Case Study - Research Paper Example

Epidemiology Case Study Caridad Center in Boynton Beach, Florida, is visited yearly by 7,000 low income families. Charlie Grove, one of the nurse practitioners, treated last winter a child, Pablo, who had swine flu symptoms. The preliminary diagnosis was confirmed through a nasal swab culture. The patient lives with multiple adult migrant workers and their children, and attends a school at which additional migrant children, besides local children, are present. Epidemiological Triangle According to the epidemiological triangle, changes in one of the elements of the triangle can influence the occurrence of disease by increasing or decreasing a person’s risk for disease (X.X. College of Nursing, 2012, sl.10). The epidemiologic triangle model is comprised of the agent, host, and environment in relation to health and disease. Moreover, “[a]ccording to this model, the agent, host, and environment can coexist” (Anderson & Mcfarlane, 2011, p. 44). It is when there is no balance among them that disease can take place. The following are the agent and hosts. The infectious agent in case of swine flu is virus H1N1, which is a subtype of influenza A virus, the latter being a common and much less harmful cause of flu among humans. Hosts are individuals that have contact to animal hosts of the H1N1 virus, such as pigs. Similarly, in case of avian flu, another strain of influenza A hosts were birds, as infections took place, “in or near known wintering sites for migratory birds” (Gilbert et al., 2006, p.1650). Moreover, individuals with low immune system levels can easily become hosts. Environment is crucial in transmission of the virus and incidence levels. According to Tellier (2006), “influenza viruses can be transmitted by 3 routes: aerosols, large droplets, and direct contact with secretions (or with fomites)” (p.1659). Thus, any crowded, unventilated area poses a high risk of an infection, given that the specific area is exposed to the virus. Moreover, unhygienic areas in developing countries can serve as a source of contagion through secretions. Since Tellier (2006) stated that H1N1 transmission should be compared to transmission of known human influenza viruses, it is safe to assume that windy weather propagates infections through aerosols (p.1657). Sale of infected pigs can transfer infections to a new area (Gilbert et al., 2006, p.1650). Complex Relationships between Epidemiological Triangle Components Since in this case the agent is type A virus, the transmission is dictated by its ability to spread like any other human influenza virus. Since the agent can spread through aerosols, it “can be carried over large distances, which may create a potential for long-range infections” (Tellier, 2006, p.1658). Moreover, if an infection takes place in a highly populated area, or unhygienic environments, transmission of the agent will take place on a large scale. That is, transmission takes place from an animal host onto a human host and then it spreads among humans. The infected area must thus be sealed off in order to prevent further infections, for even a wind can spread the virus to the uninfected areas. Contributing Factors in Pablo’s Infection Pablo was at a high risk of contracting the virus and becoming infected. His socio – economic status is the most important factor leading to the infection. First, according to Tellier (2006), immunity affects our resistance to the influenza viruses, since “we all have partial immunity against these viruses” (p.1660). Pablo’s immune system was most likely low due to inadequate diet arising from the poverty. Secondly, sanitation where Pablo lived with his family was poor; creating a ground for the transmission of the agent. Third, Pablo was enrolled in school, where other children of similar socio – economic background went as well. It is possible that the he contracted the disease in his classroom, or even from his parents. Pablo’s parents could have contracted the virus at work from an infected pig, or another worker. However, because of a weaker immune system, the incubation period in case of Pablo was shorter. Solutions / Prevention Levels There are three prevention levels. At the primary level, the intervention seeks to promote health, while preventing the occurrence of a disease, injury or disability (X.X. College of Nursing, 2012, sl.11). Then, there is the secondary level at which an infection already took place, thus aiming to detect the disease early in its progression, before clinical signs and symptoms become apparent, and treat it (X.X. College of Nursing, 2012, sl.11). Lastly, tertiary intervention seeks to limit disability and rehabilitate agents (Anderson & Mcfarlene, 2011, p.28). According to Anderson and Mcfarlane (2011), “[f]or the community health practitioner, the levels of prevention – primary, secondary, and tertiary – guide practice” (p. 28). Thus, since the health care practitioner already knows that the infection has taken place, Pablo must be treated at the tertiary level. He will be hospitalized, isolated and treated with medication known so far to be efficient at combating H1N1. Secondary intervention will take place at his school, among children’s parents and Pablo’s home; as well as where his family works. The rest of the nearby population, including the infected population, will also be treated at the primary level. They will be prescribed to increase hygiene and strengthen their immune system. Moreover, the animal hosts should be found and eliminated. It might be that new infections have already taken place, but the incubation period has not ended yet. Thus, everyone will be tested. Cultural barriers must be overcome. An educated member speaking the same language, or one of the workers, will be required to communicate with the migrants. This person is trusted, and so (s)he can make recommendations about hygiene and impose a quarantine. Otherwise, migrants could feel threatened and think they are being gathered for deportation. References Anderson, E. & Mcfarlane, J. (2011). Community as partner: Theory and practice in nursing (6th ed.). Philadelphia: Lippincott, Williams, & Wilkins. X.X. College of Nursing (2012). Concepts of epidemiology applications [PowerPoint slides, 1-16]. Retrieved from http://vizedhtmlcontent.next.ecollege.com/CurrentCourse/NUR%2007%20PP%20%20Epidemiology%20Revised.pptx Gilbert, M., Xiao, X., Domeneche, J., Lubroth, L., Martin, V. and Slingenbergh, J. (2006). Anatidae migration in Western Palearctic and spread of highly pathogenic avian influenza virus. Emerging Infectious Diseases, 12(11), 1650 – 1656. Retrieved from http://www.cdc.gov/ncidod/EID/vol12no11/06-0223.htm?s_cid=eid06_0223_e Tellier, R. (2006). Aerosol transmission of influenza A virus. Emerging Infectious Diseases, 12(11), 1657 – 1662. Retrieved from http://www.cdc.gov/ncidod/EID/vol12no11/06-0426.htm?s_cid=eid06_0426_e Read More