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N4127
Exam II Infectious Disease Prevention & Control
| Question | Answer |
|---|---|
| What are the problems with communicable disease? | Nature and scope of diseases have changed. Reemergence of old diseases. New diseases have emerged. Antibiotic resistant strains. |
| In the 1900s, what was the leading cause of death in U.S? | Communicable diseases |
| In the 2000s, what contribute to the reduction of communicable diseases? | Improved nutrition and sanitation, vaccines, and antibiotics. |
| As porple nowlive longer, what have replaced infectious disease? | Chronic diseases |
| Has infectious disease vanished? | No! |
| Infectious disease still persist as what? | The number one cause of death worldwide |
| In the twenty-first century, what has infectious disease become? | A means of biologic terrorism |
| Wolrwide, what is the leading killer of children and young adults? | Infectious disease |
| How would you descrine the economic effects of infectious disease? | Staggering! |
| What is the objectives of healthy people 2020 with regards to immunization & infectious disease? | Preventable through universal vaccination. Preventable through targeted vaccination. Infectious diseases and emerging antimicrobial resistance. Vaccination coverage and strategies. |
| What is the U.S national vaccine plan? | The nation’s roadmap for a 21st century vaccine and immunization enterprise. |
| What does the U.S national vaccine plan include? | Strategies for advancing vaccine research and development, financing, supply, distribution, safety, global cooperation, and informed decision-making among consumers and health care providers. |
| What does the 2 phases of the National vaccine plan consist of? | A strategic plan with overall goals and objectives to achieve over a 10-year period, and an implementation plan with measurable outcomes and processes to achieve the goals of the plan. |
| Name the chain of infection? | Agent. Reservoir. Portal of exit. Mode of transmission. Portal of entry. Susceptible host. |
| Explain the Epi triangle of communicable disease? | Communicable diseases occur as a result of interaction between a host (person), infectious agent (bacteria), and environment (contaminated food, water)—epidemiological triangle |
| What are Agent Factors? | Infectivity. Pathogenicity. Virulence. Toxicity. Invasiveness. Antigenicity. |
| What are the 4 main categories of infectious agents that can cause infection or disease? | Bacterias, Fungi, Parasites, & Viruses. |
| Define Infectivity? | The proportion of persons exposed to an infectious agent who become infected by it. |
| Define Pathogenicity? | The ability to produce a disease in a host. Or the degree to which a pathogen debilitates its host. |
| Define Virulence? | (1) The case mortality rate of an infection. (2) The extent to which a pathogen harms its host. |
| Define Toxicity? | The degree to which a substance can harm humans or animals. |
| Define Invasiveness? | The Ability of a organism to spread beyond its introduction site and become established in new location where it may provide a deliterious (bad) effect on organisms already existing there. |
| Define Antigenicity? | The ability of a substance to trigger an immune response in a particular organism or person. |
| What are host factors? | Host resistance. Immunity (Natural or acquired) Active or passive. Herd immunity. Infectiousness. |
| Define Host Resistance? | The ability of a host to resist or withstand disease or infection. |
| Define Immunity? | State of being resistant to a disease, particularly an infectious one. |
| Define natural or aquired immunity? | Innate or genetically inherited immunity. Immunity gotten through exposure to the infectious agent, toxin, or vaccine |
| Define passive immunity? | Temporary host immunity that comes from immunoglobulins passed from mother to child or by the transfer of antibody or from an immune donor (passive immunity). |
| Define active immunity? | Immunity gotten when the body builds its own antibodies that then provide protection against toxic or infectious agents. |
| Define herd immunity? | The resistance of a group of people to invasion and spread of an infectious agent. |
| Define Infectiousness? | A measure of the Potential ability of an infected host to transmit the infection to other host(s). |
| Give example of infectious and noninfectious organisms? | Ebola has an increased infectiousness. Leprosy has decreased infectiousness (noninfectious) |
| What is an environment? | All that is external to the human host |
| What are environmental factors? | Factors that facilitate the transmission of an infectious agent. |
| Environmental factors are also called what? | Extrinsic factors |
| Extrinsic factorsinfluences what? | The existence of agents, exposures or susceptibility to the agent. |
| Transmission of Infectious Agents? | Any mechanism by which an infectious agent is spread from a source or reservoir to a person. |
| Why are agents of transmission of infectious disease important fot nurses to know? | For prevention and treatment. |
| Name modes of transmission? | Direct. (Direct contact, Direct droplet). Indirect. (Vector, Fomites). Vertical transmission. Airborne. (Droplet nuclei, Dust). Fecal-Oral. Common vehicle. |
| Define horizontal transmission? | person-to-person spread of infection. |
| Explain Direct transmission? | A mechanism in which the infectious agent is transferred directly into the body via touching or biting or kissing or sexual intercourse or by droplets entering the eye or nose or mouth. |
| Explain Indirect transmission? | Spread of infection via a vectors or formites. |
| What is a Vector? | A carrier. |
| What is the best way to understand a Vector? | Is to recall its origin meaning of the word Latin which means a "bearer." |
| Give an example of vector | Mosquitors. A vector that carries malaria parasite. |
| What is parasitology? | The study of parasitic organisms |
| Describe Fomite? | A physical object that serves to transmit and infectious agent(s). |
| Give example of fomites? | Comb, Dust particules, Food, Water, & Blood products. |
| Airborne? | Is via aerosols or droplet nuclei come in contact with wounds or mucous membranes, inhaled. |
| Fecal-oral? | entrance of feciece into mouth.Can be direct or indirect |
| Explain some Common Vehicle? | The transportation of infectious agent from an infected host to a susceptible host via water, food, milk, blood, serum or plasma. |
| Define Vertical transmission? | The passing an infection from parent to offspring through sperm, placenta, milk, or contact in the vaginal canal at birth. |
| Infection refers to what? | Refers to the entry, development, and multiplication of the infectious agent in the susceptible host. |
| Disease refers to what? | The outcome of infection. |
| Define the term Incubation period? | This is the time interval between invasion by an infectious agent and the first appearance of signs and symptoms of the disease. |
| Define Communicable period? | This is the time interval during which an infectious agent may be transferred directly or indirectly from an infected person to another person. |
| Define Endemic? | Disease that is present in a community at all times but in relatively low frequency. Something that is endemic is typically restricted or peculiar to a locality or region. |
| Define An epidemic? | A sudden severe outbreak within a region or a group. Or greater than normally expected occurrence of disease. Or occurrence of disease in an area that is clearly in excess of what is expected. |
| Define pandemic? | This occurs when an epidemic becomes very widespread and affects a whole region, a continent, or the entire world. |
| Give an example of pandemic? | SARS. Avian flu. |
| What is surveillance | A systematic collection, organizing, & analyzing current, accurate, and complete data for a defined disease condition. |
| What do nurses do with information gathered from surveillance? | This is promptly provided to those who need it for planning, implementation, and evaluation of disease prevention and control programs. |
| Name 3 Surveillance of Communicable Diseases? | National Surveillance System. Surveillance for Agents of Bioterrorism. Emerging Infectious Diseases. |
| Who monitors the National Surveillance System? | The CDC (Center for Disease Control & Prevention) |
| List some agents of Bioterrorism? | Anthrax. Smallpox. Plague. Tularemia. |
| Agents like to be used in bioterrorism? | Those having the potential for both high mortality and easy dissemination. |
| Discuss Anthrax? | An acute disease caused by spore-forming bacterium Baccillu anthracis. It manifests in Cutaneous, GI or respiratory/inhalational |
| Why is inhalation anthrax long considered as an extremely high potential of a single greatest biological warfare threat? | Because of its ability for aerosolization, the resistance to environmental degradation, and a high fatality rate. |
| What should nurses do in a threat of anthrax? | It should be reported promptly to the Federal Bureau of Investigation (FBI) and to local and state health departments. |
| Anthrax treatment? | Its sensitive to a variety of antibiotics, and immunization is available for those with exposure risk. |
| Discuss Smallpox? | Considered eradicated in U.S. since 1979, Stopped immunization since 1982. pockets of it still available. |
| Smallpox has been identified as one of the leading candidate for what? | Agents for bioterrorism |
| Why is smallpox identified as a leading agent for bioterrorism? | Because the susceptibility is 100% in the unvaccinated and the fatality rate is estimated at 20% to 40% or higher. |
| What is the vaccine for smallpox? | Vaccinia vaccine |
| Smallpox vaccine is available through whom? | CDC |
| It is important for health workers to disinguish what? | Smallpox fom chickenpox |
| Prevention efforts of smallpox is focussed on what? | The development of a new vaccine with fewer potential side effects. |
| Discuss plague? | Plague is a vectorborne disease transmitted by rodent fleas carrying the bacterium Yersinia pestis. |
| Initial signs and symptoms of plague are? | Nonspecific and include myalgia, malaise, fever, chills, sore throat, and headache; |
| As the plague disease progresses, what are the S/S? | Lymphadenitis commonly develops, producing the characteristic bubo. |
| Bubonic plague can progress to what? | Septicemic plague and secondary pneumonic plague, which creates human-to-human outbreaks. |
| Untreated cases of septicemic and pneumonic plague are? | Most often fatal, with a case fatality rate of 50% to 60%. |
| What is the treatment of choice for septicemic and pneumonic plague? | Streptomycin, with tetracycline and chloramphenicol as alternatives. |
| What can immunization do for bubonic plagues? | May confer some protection. |
| What can immunization for do for pneumonic plaque? | Nothing! |
| A bioterrorism attack would most likely do what with pneumonic plague? | Aerosolize plague, resulting in pneumonic disease and human-to-human transmission. |
| Discuss Tularemia? | It is a (rabbit fever, deer fly fever). its a zoonotic disease cased by the bacterium agent Francisella tularensis, |
| How is tularemia carried commonly? | By wild animals. Tularemia is not transmitted from person-to-person. |
| Common S/S of tularemia? | onset is sudden and may resemble influenza with high fever, myalgia, headache, nausea, and chills. Ulcerative lesions appear (buboes), which can cause confusion with plague. |
| What is the possible complication of tularemia? | Pneumonia |
| What are the treatment drug choice for tularemia? | Aminoglycosides or ciprofloxacin. |
| Any vaccine in the U.S. for tularemia | No! |
| What is considered the most likely scenario for use as an agent of bioterrorism? | Aerosolized tularemia with resulting pneumonic disease. |
| What are the 12 Vaccine-Preventable Diseases | Hepatitis A & B, diphtheria, tetanus, pertussis, measles, mumps, rubella, polio, Haemophilus influenzae, type B, meningitis, varicella (chickenpox), and Streptococcus pneumoniae, Influenza. |
| Vaccines are one of the most effective methods of what? | Preventing and controlling communicable diseases. |
| Give an example of diseases that controlled but eradicated through vaccines?. | Polio, diphtheria, pertussis, and measles |
| What have vaccines done in the field of medicine? | It has literally transformed its landscape over the course of the 20th century. |
| What is measles? | An acute, highly contagious disease caused by the rubeola virus. |
| How contagious is Rubella (German measles)? | Moderately contagious |
| How Rubella (German measles)transmitted? | Its through inhalation of/ or direct contact with infected droplets from the respiratory secretions of infected persons. |
| S/S of Rubella (German measles) in adults? | Several days of low-grade fever, headache, malaise, runny nose, and conjunctivitis before the rash appears. |
| What is Pertussis? | Whooping cough |
| What bacteria causes Pertussis? | Bordetella pertussis. |
| Bordetella pertussis is transmitted via what? | An airborne route through contact with infected droplets. |
| How contagious is Bordetella pertussis? | It is highly contagious |
| How is Bordetella pertussis considered in the U.S? | Endemic. |
| Discuss influenza flu? | It is a viral respiratory infection. |
| How many type of influenza are there & name them? | 3 types of influenza viruses. Types A, B, and C. |
| Which types of influenza viruses are stable? | Typer A & B |
| Which type(s) of influenza virus are constantly changing? | Type A |
| Food borne diseases? | Food infection (Salmonellosis Gastroenteritis). Food intoxication (Botulism). |
| What is food infection? | Its an intoxication of foods from toxins produced by bacterial growth, chemical contaminants (heavy metals), and a variety of disease-producing substances found naturally in certain foods, such as mushrooms and some seafood. |
| When does food infection occur? | When there is production of toxins as a byproduct of normal bacterial life-cycle, such as staphylococcus aureus or clostridium perfringens. |
| When does foodborne botulism infection occur? | When a person ingests pre-formed toxin that leads to illness within a few hours to days. |
| Foodborne botulism is a what? | Public health emergency |
| Why is Foodborne botulism a public health emergency? | Because the contaminated food may still be available to other persons besides the patient to eat. |
| Infant botulism? | C. botulinum in their intestinal tract. |
| Wound botulism? | C. botulinum that secretes the toxin. |
| With foodborne botulism, symptoms begins when? | Within 6 hours to 2 weeks (most commonly between 12 and 36 hours) after eating toxin-containing food. |
| Symptoms of botulism includes? | Double vision, blurred vision, drooping eyelids, slurred speech, difficulty swallowing, dry mouth, muscle weakness that always descends through the body. |
| Why are persons who eat home-canned food adviced to consider boiling food @ high temperatures? | Because the botulism toxin is destroyed by high temperatures. |
| Where can instructions on safe canning food be obtained? | County extension services or from the US Department of Agriculture. |
| Why is honey prohibited for infants and children less than 12 months old | Because honey can contain spores of Clostridium botulinum and this has been a source of infection. |
| Who is honey safe for? | Persons 1 year of age and older. |
| Who recently are now asked to avoid eating honey? | Breast feeding mums. |
| Foodborne Diseases on the Rise | In the US, yearly, foodborne illness accounts for an estimated 76 million illnesses, 325,000 hospitalizations, & 5000 deaths. |
| Foodborne Disease: Measures of Protection or What are the Five keys to safer food ? | Keep clean. Separate raw foods and cooked foods. Cook thoroughly. Keep food at safe temperatures. Use safe water and raw materials. |
| What is the 1st five Golden Rules for Safe Food Preparation by (WHO) | 1. Choose foods processed for safety. 2. Cook food thoroughly. 3. Eat Cooked foods immediately. 4. Store cooked foods carefully. 5. Reheat cooked foods thoroughly. |
| What is the 2st five Golden Rules for Safe Food Preparation by (WHO) | 6. Avoid contact between raw foods and cooked foods. 7. Wash hands repeatedly. 8. Keep all kitchen surfaces meticulously clean. 9. Protect foods from insects, rodents, and other animals. 10. Use safe water. |
| What are some common Foodborne Diseases in the United States? | Salmonellosis. Campylobacteriosis. Listeriosis. Escherichia Coli 0157:H7 |
| What is Salmonellosis? | It is a bacterial disease. |
| Salmonellosis is characterized by what? | Sudden onset of headache, abdominal pain, diarrhea, nausea, sometimes vomiting, and almost always fever. |
| What is the typical onset of Salmonellosis? | Onset typically occurs within 48 hours of eating the contaminated food. |
| Where does outbreaks occur commonly? | In restaurants, hospitals, nursing homes, and children’s institutions. |
| What is the transmission route of Salmonellosis? | Its eating inadequately cooked food that comes from an infected animal or is contaminated by feces of an infected animal or person. |
| Name some foods most often associated with Salmonellosis outbreaks? | Meat. Poultry. & Milk. |
| Salmonellosis symptoms are usually gone after how long? | 1 week. |
| Can animals transmit salmonellosis to me? | Yes! |
| What are associated with handling raw poultry or eating raw or undercooked poultry meat? | Campylobacteriosis. |
| How many of Campylobacter can cause illness in human? | A very small number, < 500 |
| How many drops of Campylobacter from raw chicken can infect a person? | One! |
| Campylobacter organisms from the raw meat can then spread to where? | Other foods. |
| Larger outbreaks due to Campylobacter are usually associated with what? | The drinking of unpasteurized milk or contaminated water. |
| What is larger outbreaks due to Campylobacter not usually associated with? | With raw poultry or meat. |
| What is Listeriosis? | Is an illness caused by eating foods contaminated with a kind of bacteria, often found in soil or water, called Listeria monocytogenes. |
| Does everyone get infected with listeriosis? | No! |
| Who are at risk of getting infected with listeriosis? | Pregnant women and newborns, older adults, and people with weakened immune systems caused by cancer treatments, AIDS, diabetes, kidney disease, etc. |
| How can at risk humans be infected with listeriosis? | By eating foods that contain Listeria monocytogenes. |
| What is E. coli O157:H7? | Its one of hundreds of strains of the bacterium Escherichia coli. |
| Most strains of E.coli are what and where do they live? | Most strains are harmless and live in the intestines of healthy humans and animals. |
| Some harmless E.coli strains produces what? | Powerful toxin and can cause severe illness. |
| S/S of E.coli? | Bloody diarrhea, abdominal cramps, and infrequently fever. |
| Eating what can cause infection from E.coli? | Eating meat, especially ground beef, that has not been cooked sufficiently to kill E. coli O157:H7 can cause infection. |
| What other known sourses can cause infection from E. coli O157:H7? | Consumption of sprouts, alfalfa sprout, lettuce, salami, unpasteurized milk and juice, and swimming in or drinking sewage-contaminated water. |
| Mention some Recent Outbreaks with E. coli O157:H7? | Spinach outbreak 2006. Cookie Dough outbreak 2009. Salmonella outbreak linked to eggs in 2010. |
| Mention some of Waterborne Diseases? | Hepatitis A. Bacillary dysentery. Cholera. Typhoid fever. |
| How does water-borne pathogens usually enter water supply? | Usually through animal or human fecal contamination and frequently cause enteric disease. |
| What is the most publicized water-borne viral agent? | Hepatitis A |
| Name the most important water-borne bacterial diseases? | Cholera, Typhoid fever, and bacillary dysentery. |
| Which organism is specially problematic for municipal water? | Protozoa |
| Why is Protozoa specially problematic for municipal water? | Because they do not respond to traditional chlorine treatment as do enteric and coliform bacteria. |
| How does CDC define an outbreak of waterborne disease? | As an incidence in which 2 or more people experience similar illness after consuming water that epidemiological evidence indicates as the source of the illness. |
| What is Vectorborne Diseases? | Diseases Transmitted by vectors usually insects, either biologically or mechanically. |
| Give example of vectorborne disease? | West Nile Virus. Lyme disease. Rocky Mountain Spotted Fever. |
| With biological transmission, what is necessary for the developmental stage of the infectious agent? | A Vector |
| West Nile Virus is spread by? | Through a bite of infected mosquito |
| How do mosquito get infected with the west nile? | By feeding on infected birds. |
| When do people begin to develope s/s of west nile after being bitten? | 3 - 14 days |
| Explain mechanical transmission? | This is when the an insect contacts the infectious agent with its leg or mouth & carries it to thr host. |
| What percentage of people get no s/s after being bitten? | 80% of people have no s/s. |
| What percentage of people get s/s after being bitten? | 20% develop fever, HA, N/V, body aches, rash, swollen glands 1 in 150 develops serious illness. |
| How many develope serious illness after being bitten by by west nile mosquitoes? | 1 in 150 persons |
| How do you prevent west nile virus infection/ | Spraying for mosquitoes in the house and in certain zip code area. Shelby county does this. |
| What are disease of travellers? | Malaria. Food and Waterborne Illness. Diarrheal Disease. |
| What is zoonosis? | A disease Transmitted from a vertebrate animal to a human. |
| Give examples of zoonosis? | Rabies. Cat-scratch fever. Hantavirus. |
| Zoonosis mode of transmission? | Animal bites, inhalation, ingestion, direct contact, and arthropod intermediates. |
| What is one well known zoonosis? | Rabies |
| Major carriers of rabies are? | Not dogs but but wild animals such as raccoons, skunks, foxes, and bats. |
| How rabies transmitted to humans? | Through an animal bite or scratch that passes on virus-carrying saliva. Transmission may also occur if infected saliva comes into contact with a fresh cut or intact mucous membranes. |
| The best protection for rabies is? | Vaccinating domestic dogs, cats, cattle, and horses. |
| Treatment for rabies? | None. No successful treatment for rabies. |
| What is a Cat Scratch Fever? | Bacterial disease caused by bartonella henslae. |
| What is a Hantavirus? | A deadly disease transmitted through infected rodents- thru urine, saliva, or droppings. |
| How human be infected by Hantavirus? | When they breathe in aerolized virus |
| How prevelent is Hantavirus? | Rare but potentially deadly virus. |
| What is the Primary Prevention for Hantavirus? | Rodent control |
| How is lime disease transmitted? | By ixodid ticks that are associated with white-tailed deer and the white-footed mouse. |
| Where is lime disease most prevelent? | Northeastern, north-central, and the Pacific coast states. |
| When doe line disease occur most? | It occurs most often in summer. |
| Rocky Mountain spotted fever is transmitted via/ | Tick vector |
| Rocky Mountain spotted fever occurs most often where? | In the Southeast and in Oklahoma, Kansas, and Missouri. |
| S/S of Rocky Mountain spotted fever? | Sudden onset of moderate to high fever, severe headaches, chills, deep muscle pain, and malaise. |
| When infected, what is important? | To start treatment as soon as clinical signs are present. |
| What is the best preventativemeaures to tick bite? | Wearing protective clothing when doing outside work and conducting a systematic assessment for ticks before going inside. |
| How long does it take for tick to start blood feeding on host? | 48 - 96 hrs. |
| Parasitic Diseases are? | diseases caused by parasites such as Helminths. Pinworms (enterobiasis). Protozoans. (Giardiasis Cryptosporidiosis) |
| describe Enterobiasis? | A a small thread-like “Pin worm" mainly infecting young children. |
| WHat does the femal pin worm do at night? | It emerges to the perianal region and lays some 10,000-15,000 eggs and then dies. |
| In the process of pin worm laying eggs, what deos it cause to the host? | Severe pruritis (itching) |
| Because of itching due to pinworm, what does children aften do? | They reinfect themself with the eggs inder their finger nails. |
| What has been recognized as one of the most common causes of waterborne disease in humans in the United States? | Giardiasis Giardia infection |
| Where does the Giardia live? | The parasite lives in the intestine of infected humans or animals. |
| Where can Giardia be found mostly? | In soil, food, water, or surfaces that have been contaminated with the feces from infected humans or animals. |
| How can Giardia be spread? | Eating uncooked food, contaminated water, swallowing feces of a person or animal infected with Giardia. Or swallowing Giardia picked up from surfaces (such as bathroom fixtures, changing tables, diaper pails, or toys). |
| Cryptosporidium parvum causes what? | Diarrheal disease mainly in infants and small children. |
| What is normal about Cryptosporidium parvum? | Usually self limiting |
| When and with can Cryptosporidium parvum be severe? | In immunocompromised individuals. |
| How do you prevent Cryptosporidiosis caused by Cryptosporidium parvum? | Early diagnosis and treatment, personal hygiene, safe sex practices, health education, vector control, improvement of sanitary control of food, water, and waist disposal. |
| What is Nosocomial Infections ? | Hospital aquired infection |
| How do we control communicable disease? | Remove, eliminate, or contain the cause or source of infection. Disrupt or block the chain of transmission. Protect the susceptible population |
| What is at the center of public & community health? | Prevention |
| Examples of prevention? | Education, immunizations, and screening. |
| What is the Role of the Nurse in Prevention? | Control, teach about, monitor, and treat persons with communicable disease. As a public health nurse we are always thinking about health promotion/disease prevention. |
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