Discuss about the Communicable Diseases for Cough and Sough Throat.
A communicable disease is any infectious disease that can be directly transmitted from one person to another or one host to another through contact with a person or affected host. The transmission can also be indirect by the means of a vector. Some of the communicable diseases can spread from one person to another while other may spread from an animal to a person. However, others may be spread through the body fluids and through the air as well. Some of the communicable diseases such as influenza may have lethal or mild symptoms. However, their control and prevention are basically based on the public health work including vaccinations especially for the kids and the young adults. In addition, proper hygiene such hand washing every time after leaving the toilet or before handling any food substances is highly recommended to prevent the germs from causing any harm. Other protective way include practicing protected sex and consuming safe and clean food (Marshall et al., 2009).
Influenza causes about half a million deaths worldwide yearly with the highest record of influenza cases recorded in the 1918 where over 50% of the world’s population was affected an over thirty million people in the whole world because of the disease. Due to the fact that vaccines were very expensive and were not produced quickly in order to respond to the epidemic in time, other antiviral drugs that reduced the strength of the disease were used. The influenza disease can be caused by three different viruses including the influenza A, influenza B and the influenza C and most of the disease symptoms include cough, sough throat, running nose and fever, vomiting, headache among others (Fenichel, Kuminoff & Chowell, 2013).
Planning for Influenza
What was Initially Planned?
The level of preparedness for influenza in Australia was of serious concern in the past decade through increased awareness campaigns to adapt to the emergency responses implemented. In relation to this, a good planning framework had been put in place in all the governmental sectors to adapt to the influenza disease. For example, in 2005, the Australian Health sector put in place a national pandemic influenza plan which integrated the different scientific policy developments. Three years later, the Australian Health Management Plan for Pandemic Influenza (AHMPPI) generated a nationally accepted strategic framework to guide the pandemic preparedness and response activities (Bishop, Murnane & Owen, 2009).
What Actually Happened?
Due to the fact that the Australian government had put in place a pandemic plan, it was therefore in good position to put in place actions that respond to the influenza disease. AHMPPI was used by the AHPC in the implementation of actions adapted to understand how the disease evolved. Coming up with the new PROTECT phase showed that the nation was very flexible to respond to the health system. The protect phase was developed and put in place in June 2009 with the main aim to and provide care to the vulnerable groups and avoid severe outcomes. The system phases were basically for the consistence in the national operations. On the other hand, the governing bodies such as the jurisdiction were seriously negatively impacted during the implementation of the public health actions despite the fact that it was legitimate phasing nationally and the purpose was not clear though. In mid 2009, the National Health and Medical Research Council (NHMRC) also invited those who had research proposals for the planning to control the pandemic (Gordon et al., 2012).
Planning for the pandemic is very necessary since it has become threat to the health system of the nation. On the other hand, the influenza disease has a great negative impact on the social and economic components of the society and therefore, the World Health Organization is working hard enough to ensure that all countries have a draft of a work plan for the preparedness of the disease. Even though it’s quit uncertain of the next pandemic outbreak, there is high likelihood of influenza outbreak very soon due to the fact that it has always been experienced in at least every century. Planning for the disease is very necessary since the magnitude of the next outbreak is not clearly known to the expertise. However, it’s predicted to be very mild causing very serious health problems as those experienced in 1918. If the nation is sufficiently prepared, then the number of the reported cases of the pandemic will drastically reduce as well as improving the health sectors and other critical infrastructure by the government (Brachman, 2003).
It was therefore recommended that integration and high flexibility during the influenza planning to adapt to the responses in the areas where the disease was so severe was one of the best way to handle the pandemic. Naming and identifying all the public health control measures was also another remedy through the development of the decision support documents though this strategy was pulled back by the legislation and the communication processes. Gradual checking of the health advisory groups in terms of their operation before the pandemic occurs was also suggested in all the government processes. Finally, generation of a research plan that met the needs of the public health response in the affected areas as well as funding the investigation processes within and outside the nation (Rashid et al., 2015).
Surveillance of the Pandemic
What was Initially Planned.
Surveillance of a pandemic is the continued and systematic data collection and analysis by the public health officials and for dissemination to the public in order to get their responses about a pandemic for proper and sound decision making. The national government and all its bordering territories all cooperated together to provide a common surveillance image to make the whole public informed and the decision makers aware of the pandemic. On the other hand, there was documentation of all the clinical pictures for the public for appropriate decision making. However, it was the role of the health care sector to information and warning about any outbreak or severity warnings (Newman et al., 2010). Researchers and other policy makers therefore had to collect analyze and report the analyzed data for informed decision making by the public and the government. Due to the data collected, the government therefore felt the urge for routine and occasional influenza surveillance in the whole country for easy elimination during the breakout of the pandemic. In 2009, the nation came up with a computer based reporting system (NetEpi) that was used during the multi-jurisdictional outbreaks before the pandemic was experienced. Despite the continued influenza surveillance, it was not possible to identify each and every case but just a few that were used as models by the health practitioners and the whole community at large (Tay et al., 2013).
What actually Happened.
The Communicable Disease Network Australia (CDNA) predicted the surveillance response and worked on the ways to adapt to the testing protocols and other requirements needed. To achieve this, they used the sentinel and the syndromic surveillance system in the follow ups of the pandemic. However, some cases were spotted within the country using the internet based system. On the other hand, the World Health Organization (WHO) and the Center for Reference and Research on Influenza also did some good and sound research and shared the information with the entire public and other health officers about the viruses of the influenza pandemic. Consequently, the territory health departments in collaboration with the national health officials on the patients admitted in the Intensive Care Units and other deaths that were recorded to have occurred from the pandemic (Kelly et al,. 2011). Some other information were also obtained from the Australia and New Zealand Intensive care society (ANZICS) and also the entry data in the hospital books obtained from the internet based systems in the Queensland (EpiLog).
To understand the occurrence of a disease, it is very critical to obtain an accurate pandemic surveillance information and data. Therefore more research work should be put in place for common agreements during the data collection processes for the pandemic especially in the bordering territories where the sentinel system could not be available. It was also noted that maintaining the internet based systems was quit hard since the reported cases increased day by day and therefore it was necessary for some states to develop and use personal and independent internet based systems (NetEpi). Following this decision by some states, a lot of data and information were lost by the state government since the national internet system was only capable of collecting the most important information and leaving out other minor information collected by the states. It was on the other hand so hard to access and interpret the jurisdictional reports of all the patients in hospitals every day since the data collected was purposefully meant for the jurisdictional surveillance (Bethel, Foreman & Burke, 2011). To establish the epidemiology of the disease, it was therefore of critical importance to complete all the work done in the previous years before the breakout of the contagious disease. There was increased need for the development of the emergency departments(ED) and other Intensive Care Units (ICU) for the seasonal surveillance of the influenza pandemic.
There should be increased number of health care officials who are well trained and specialized in the influenza disease control to help in the research of the outbreak especially at its early stages before it gets severe and affect a large population. An integrated approach should also be put in force for the jurisdictional and other territories to come up with common interest in controlling the pandemic other than independent states coming up with their own means of data collection and analysis on influenza. Finally, data collection, analysis and reporting of the finalized data should be done at the national level to provide a full surveillance plan (ANZIC Influenza Investigators 2009).
What was Initially Planned
The element of communication is very important in passing information to the general public on the benefits of proper hygiene as a means of lowering the spread of the influenza infection. This has been achieved by the Australian government through channels such as the national public campaigns against influenza to make the people knowledgeable as means of making positive future responses (Gray et al., 2012). The National Health Emergency Media Response Network (NHEMRN) was used in communicating important information between the national and the jurisdictional media responses. Even though there were great challenges in the communication channels such as the government websites and other telephone hotlines, they were highly used. The communication aspect was majorly used to pass the vital information to the policy makers and the general public as a whole together with the health specialists to aid in the information data collection and dissemination for informed decision making in a timely basis. The Council of Australian Governments was also developed through the government and the public communication strategy to help the health sector in making its decisions (Watkins, Barnett & Links, 2008). (AHMPPI on the other hand emphasized the benefits of communicating at the right time to the public and other important stakeholders about the pandemic for informed decision making.
What Actually Happened
In 2009, the Australian government came up with a national public communication campaign with the aim of passing the important information to the parents that vaccines for the children for the H1N1 were available and therefore immunization was highly encouraged. Promotion of proper hygiene practices was also encouraged through the communication channels and discouraging mythical approaches especially during the vaccination periods was also put on the forefront (Kumar et al., 2009). The government on the other hand came up with websites that shared the important information about the pandemic through advertisements before and during the outbreak of the disease (www.flupandemic.gov.au) created in late 2008. In addition to this, the Australian government also created a Health Emergency website to control the virus that was widely experienced in 2009 (www.healthemergency.gov.au). Other communication strategies developed included the telephone hotlines to provide customer services to the callers who had questions related to the pandemic as well as giving further information and what should be done in case of an outbreak. Social networking services such as facebook and twitter were widely used in conveying the essential information in addition to the spokespersons selected by the commonwealth and the jurisdictional bodies to pass the information (Bults et al., 2011)
Lessons Learnt and Recommendations
It was found to be of great importance to come up with a media specific outline to control the influenza disease through principles that guides the media management as well as coming up with other principles of communication within the health sector. Other development forums such as the National Health Emergency Media Response Network (NHEMRN) to run and manage all the public information campaigns for the pandemic were critical in creating awareness of the infectious disease.
Influenza H1N1 being a serious threat to the Australian economy and society, a number of control measures have to be put in place to ensure the pandemic spread is drastically reduced. To achieve these objectives, a number of health care settings have been put in place including the nursing homes and other skilled personnel. Some of the strategies put in place to cub and reduce the spread of the disease include the public health measures and the border measures (Greer, 2013).
Restrictions were rapidly implemented in the Australian borders and its international airports. In the ports, several protocols were also imposed by the government to monitor the shipping activities within the country that would otherwise lead to the spread of the infectious disease. The strict border and ship cruising measures improved by greater percentage the health of the entire Australian population due to the delayed entry and reduced outbreak and spread of the virus. To achieve this, the government of Australia introduced rules that reduced the number of travelers who came from the influenza prone areas into the country and the few who had to travel to Australia had to undergo thorough screening to identify if they had already been infected (McAuley et al., 2007). The Australian government also implemented the quarantine Act 1908 that gave powers those involved in monitoring and reducing the disease spread especially in the Quarantine and Inspection Services where the immigrants had to show their Health Declaration Cards and other immunization documents upon arrival in Australia. Other measures adopted by the government include the implementation of the National Pandemic Influenza Airport Border Operations Plan indicating how all the legally binding parties will be operating to respond to the spread of the disease.
Lessons Learnt and Recommendations
It was wise to implement rapid border measures by the border agency officers who ensured that the airports and all other airlines met the standards and were free from the pandemic. For effective communication strategies, the government and all other involved agencies came up with a formal communication process between the airlines and all the airports in the country. There was therefore increased need to develop a cross-agency advice on health matters of those who worked in the airports and the airlines. To curb the spread of the pandemic influenza, an increased need for communication in the borders is of great significance. Operational protocols and other policy review should be seriously put in place (Rambaut et al., 2015).
Public Health Measures
For an appropriate management of the influenza outbreak, one need to first identify the affected or the susceptible individuals then separate them from the large group for special treatment to reduce the transmission of the disease. However, quarantine and isolation may be imposed to the affected individuals within the community. In addition, more concern should be put on the DELAY phase especially to individuals travelling to Australia through various health stages to establish if they are infected by the disease and as well establish ways of adopting and surviving with the affected individuals (Medlock, & Galvani, 2009).
Some of the methods adopted during the control of the pandemic influenza include passing of the personal hygiene messages conveying the major control measures of the disease such as coughing in the required manner as well as washing the hands after visiting the toilets or before handling any food substance. The public were also advised and given the guidelines in controlling the infection as well as being well informed on the possible occupational health hazards likely to occur due to exposure to the predisposing factor of the disease. Other methods for public information included the school exclusion and closures together with the wider community interventions such as counseling and reducing the aspects of public transport systems.
Lessons Learnt and Recommendations
Identification and imposition of quarantine or isolation was a major step in controlling the spread of pandemic influenza and therefore the health care workforce had the chance to properly study how the communicable disease is easily spread and its control measures. There was also serious need of using the antiviral drugs as well as reviewing all other policies to effectively reduce the pandemic outbreak. This was achieved through monitoring the guidelines set in controlling the disease as well as carrying out more research where little information was available. Childcare closure and the school policy reviews is also important in knowing how severe the disease is (Vaillant et al., 2008).
Influenza disease outbreak preparedness was a good step adopted by the Australian government. This lead to reduced number of death cases recorded since 2008 as compared to the highest number of deaths recorded in the 1918 that affected over forty million people with the highest number of deaths recorded in Australia of over half a million. Despite the fact that influenza was almost being declared a national disaster due to its widespread in the country, the government and other involved stakeholders have put great effort in controlling and reducing the spread of the pandemic and therefore Australia may be free of the disease with the continued efforts. The Australian communication and the public health sectors should be greatly supported in terms of finance and research work in ensuring the whole public is well informed of the pandemic to increase the level of preparedness.
ANZIC Influenza Investigators. (2009). Critical care services and 2009 H1N1 influenza in Australia and New Zealand. N Engl J Med, 2009(361), 1925-1934.
Bethel, J. W., Foreman, A. N., & Burke, S. C. (2011). Disaster preparedness among medically vulnerable populations. American journal of preventive medicine, 40(2), 139-143.
Bishop, J. F., Murnane, M. P., & Owen, R. (2009). Australia's winter with the 2009 pandemic influenza A (H1N1) virus. New England Journal of Medicine, 361(27), 2591-2594.
Brachman, P. S. (2003). Infectious diseases—past, present, and future. International journal of epidemiology, 32(5), 684-686.
Bults, M., Beaujean, D. J., Richardus, J. H., van Steenbergen, J. E., & Voeten, H. A. (2011). Pandemic influenza A (H1N1) vaccination in The Netherlands: parental reasoning underlying child vaccination choices. Vaccine, 29(37), 6226-6235.
Fenichel, E. P., Kuminoff, N. V., & Chowell, G. (2013). Skip the trip: Air Travelers' behavioral responses to pandemic influenza. PloS one, 8(3), e58249.
Gordon, D. L., Sajkov, D., Woodman, R. J., Honda-Okubo, Y., Cox, M. M., Heinzel, S., & Petrovsky, N. (2012). Randomized clinical trial of immunogenicity and safety of a recombinant H1N1/2009 pandemic influenza vaccine containing Advax™ polysaccharide adjuvant. Vaccine, 30(36), 5407-5416.
Gray, L., MacDonald, C., Mackie, B., Paton, D., Johnston, D., & Baker, M. G. (2012). Community responses to communication campaigns for influenza A (H1N1): a focus group study. BMC Public Health, 12(1), 1.
Greer, A. L. (2013). Can informal social distancing interventions minimize demand for antiviral treatment during a severe pandemic?. BMC public health, 13(1), 1.
Kelly, P. M., Kotsimbos, T., Reynolds, A., Wood-Baker, R., Hancox, B., Brown, S. G., ... & Irving, L. B. (2011). FluCAN 2009: initial results from sentinel surveillance for adult influenza and pneumonia in eight Australian hospitals. Medical Journal of Australia, 194(4), 169.
Kumar, A., Zarychanski, R., Pinto, R., Cook, D. J., Marshall, J., Lacroix, J., & Turgeon, A. F. (2009). Critically ill patients with 2009 influenza A (H1N1) infection in Canada. Jama, 302(17), 1872-1879.
Marshall, H., Ryan, P., Roberton, D., Street, J., & Watson, M. (2009). Pandemic influenza and community preparedness. American Journal of Public Health, 99(S2), S365-S371.
McAuley, J. L., Hornung, F., Boyd, K. L., Smith, A. M., McKeon, R., Bennink, J., ... & McCullers, J. A. (2007). Expression of the 1918 influenza A virus PB1-F2 enhances the pathogenesis of viral and secondary bacterial pneumonia. Cell host & microbe, 2(4), 240-249.
Medlock, J., & Galvani, A. P. (2009). Optimizing influenza vaccine distribution. Science, 325(5948), 1705-1708.
Newman, L., Stirzaker, S., Knuckey, D., Robinson, K., Hood, J., Knope, K., ... & Gajanayake, I. (2010). Australia's notifiable disease status, 2008: annual report of the National Notifiable Diseases Surveillance System. Communicable diseases intelligence quarterly report, 34(3), 157-224.
Rambaut, A., Pybus, O. G., Nelson, M. I., Viboud, C., Taubenberger, J. K., & Holmes, E. C. (2008). The genomic and epidemiological dynamics of human influenza A virus. Nature, 453(7195), 615-619.
Rashid, H., Ridda, I., King, C., Begun, M., Tekin, H., Wood, J. G., & Booy, R. (2015). Evidence compendium and advice on social distancing and other related measures for response to an influenza pandemic. Paediatric respiratory reviews, 16(2), 119-126.
Tay, E. L., Grant, K., Kirk, M., Mounts, A., & Kelly, H. (2013). Exploring a proposed WHO method to determine thresholds for seasonal influenza surveillance. PloS one, 8(10), e77244.
Vaillant, L., La Ruche, G., Tarantola, A., & Barboza, P. (2008). Epidemiology of fatal cases associated with pandemic H1N1 influenza 2009. Euro surveillance: bulletin europeen sur les maladies transmissibles= European communicable disease bulletin, 14(33), 127-136.
Watkins, R. J., Barnett, D. J., & Links, J. M. (2008). Corporate preparedness for pandemic influenza: a survey of pharmaceutical and biotechnology companies in Montgomery County, Maryland. Biosecurity and bioterrorism: biodefense strategy, practice, and science, 6(3), 219-226.