Scenario question Part 1
Following an intentional biological attack, many different disciplines and agencies would become involved in the investigation. In a case which local water supply has been determined to have been intentionally contaminated with a disease agent, what disciplines/agencies (public health and otherwise) do you think would be involved in the investigation, and what might their roles be? Why would epidemiology be important?
The operative concept in this scenario is intentional. The established evidence is one highly suggestive of a terrorist attack. Therefore, besides public health intervention the department of homeland security officials must intervene for safety of citizens. Next human resource should be vigilant in alerting residents concerning water contamination along with public health education and promotion. The role of human resources specifically would involve assisting residents to access pure water supply either by distributing bottled water free of charge or at a low cost while public health tries to fix the problem through investigating the extent of the damage and areas which are most, least and not affected (Turnock, 2009).
Social service agencies ought also to be included in this surveillance strategy in case parents are severely affected, and children are left unattended due to parents who cannot cope with providing children the care needed during this disaster. As such, agencies like the Red Cross; helping hand and churches could volunteer child care services while public health is busy addressing the actual issue of a terrorist water contamination attack (Turnock, 2009).
Why would epidemiology be important?
Epidemiology investigates patterns, causes, diseases; health effects as well as disasters’ etiology. In this scenario epidemiology is very important because if this is a first time event collecting data would enable comparative analysis when second, third or fourth similar events occur. Lessons learnt from this event would anticipate outcomes in designing an appropriate disaster preparedness program as it pertains to biological water contamination (Foster & Agzarian, 2006).
Biomonitoring is essential to this epidemiological intervention since it measures the body burden of toxic elements. This analytical chemistry evaluates metabolites, which are often found in the blood and urine of persons who ingested or inhaled harmful substances. These scientists have the ability to identify and measure concentrations of both manmade and natural and manmade chemicals as it relates to parts-per-billion to parts-per-quadrillion levels (Foster & Agzarian, 2006).
Do you agree or disagree with the author of the Emerging Themes in Epidemiology article? Why?
Several discussions were articulated within the framework of Emerging Themes in Epidemiology. They ranged from ethical issues in public health epidemiology to current research practices. The article was written by Steven Coughlin (2006) highlighted Ethical Issues in Epidemiological research and public health practice. The author advanced arguments stating that if attention to ethical issues is made it can enhance planning, implementation, and success of many public health programs. Activities conducted as research projects related to health promotion and education could be more beneficial to the societies they target. It was further emphasized that public health ethics is compatible ‘with the prevention orientation of public health’ (Coughlin, 2006).
I agree with this theory of ethics attention in epidemiology because in every science ethics plays an important role in accessibility to service. Fundamentally, it must be understood that for any program to be accepted by a community ethical considerations regarding appropriateness, must be clarified first. Dignity must be maintained when conducting surveillance and persons must be assured of privacy/confidentially regarding data/information they provide health care professionals. There have been many issues recently and further in the past whereby breach of confidentiality occurred especially with the introduction of electronic health record data collection and storage devices. Therefore, these issues raised by the Emerging Themes in Epidemiology article are relevant to public health practice currently.
Coughlin, S. (2006). Ethical issues in epidemiologic research and public health practice.
Emerging Themes in Epidemiology 3(16), 1-10
Foster, G., & Agzarian, J. (2006). Reporting results of biomonitoring studies. Analytical and
Bioanalytical Chemistry 387 (1): 137–40
Turnock, Bernard J. (2009). Public Health: What It Is and How It Works, (4th Ed.). Sudbury,
MA: Jones and Bartlett
Review the Central Intelligence Agency's "Haiti Major Infectious Diseases"
report found in your Lesson Materials.
Hepatitis A is the Haiti disease chosen to be discussed in this section. It is caused by hepatitis A virus (HAV) and is often referred to as HAV. Precisely it emerges from the RNA virus group. Communicable conditions responsible for the spread of the virus include impure water supply and insanitary conditions. During the earthquake disaster in Haiti water pipes were damaged and fecal matter seeped into pure water supply circuits. This also created the potential for food contamination when food is cooked with infected water. Consequently, many Haiti contracted the virus which is transmitted through in water and food. Infected people show signs and symptoms of a very high fever, nausea, vomiting, jaundice, bile in the urine with a yellow discoloration in the conjunctiva, and general malaise. These symptoms usually prolong for about 6-9 months before subsiding (Centers for Disease Control and Prevention, 2003).
Prophylactic treatment includes vaccination. However, infected persons are encouraged to take large amounts of fluid to keep the liver functioning adequately because the virus attacks this organ. Importantly, there is no distinct treatment for hepatitis A because unlike hepatitis B it is curable. As such, depending on the severity of symptoms patients could be admitted to hospital to ensure that they receive enough rest for symptoms to resolve. Also, they are placed on a low fat diet and advised to avoid alcohol. Relapses could occur. Consequently as a prophylaxis patients are encouraged to eat a well balance; maintain hydration and ensure that they drink uncontaminated water or eat infected food (Centers for Disease Control and Prevention, 2003).
Discuss the epidemiology of the disease and its
Impact upon the public health of Haiti's populace.
Epidemiologists contend that the presence of HAV antibodies indicates that the person either had an infection in the past or is presently infected. Besides, Haiti there is a high incidence of hepatitis A among low income nations in low income regions inclusive of South Asia and Saharan Africa. Adolescents and children are mostly affected. However, a low prevalence is found among high income nations such as Australia, New Zealand, Western Europe, United States of America, Japan, Canada and Singapore. In 2010 Hepatitis A was responsible for 102,000 deaths globally, which is a marked increase from 99,000 in 1990 (Wasley, Fiore & Bell, 2006).
Current data pertaining to hepatitis A prevalence is Haiti is inconclusive since electronic database searches do not provide a comprehensive data on the issue. Therefore, it can be concluded that HAV seroprevalence in Haiti is obscure even though it is listed as one of Haiti’s Major Infectious Diseases. Public health authorities, however, studied neighboring territories in making an analysis of the Haiti hepatitis A epidemiology. Data from Central and South American countries were then applied. It was discovered that there was a 94.6% and 74.6% rate prevalence rates for Nicaragua and Brazil. An occurrence of 84% for persons over 20 years old and 46% incidence among children one to fourteen years of age was discovered in a study conducted in Peru (Wasley et.al, 2006).
Haiti is one of the poorest nations in the Caribbean region. As such, public infrastructure can be considered underdeveloped to cope with many of the diseases, which plagues the nation. Hepatitis is just one of public health challenges facing the nation after a devastating earthquake. Even though there are World Health Organization charters catering to the restoration of Haiti, these funds seem inadequate to deal with the numerous public health issues, which must be addressed during this period (Wasley et.al, 2006).
Centers for Disease Control and Prevention (CDC) (2003). Hepatitis A outbreak
associated with green onions at a restaurant--Monaca, Pennsylvania, 2003. MMWR Morb.
Mortal. Wkly. Rep. 52 (47): 1155–7.
Wasley, A. Fiore, A., & Bell, B. (2006). Hepatitis A in the era of vaccination. Epidemiol Rev 28: