Preventive and control measures of communicable diseases

Dr. Senaka Herath

How to prevent disease spread

General considerations :
 Knowledge - chain of infection  Methods - single or multiple  Expenses  Cultural / religious aspects  Harmlessness  Multi-task group

Prevention phases
 Primary - the action taken prior to the onset of disease, which
removes the possibility that the disease will ever occur

 Secondary - action which halts the progress of a disease at its

incipient stage and prevents complications

 Tertiary - all the measures available to reduce or limit

impairments and disabilities

Primary prevention


Community measures
    

chlorination of the water supply inspection of restaurants immunization programs proper disposal of solid waste control of vectors and rodents

Personal / Individual effort

    

hand washing proper cooking of foods adequate clothing and housing use of condoms obtaining all of the available immunizations against specific diseases

Secondary prevention


Community measures
  

maintaining records of cases and notifiable diseases investigating cases and contacts Isolation, Quarantine

Individual effort
 

self-diagnosis and self-treatment with nonprescription medications diagnosis and treatment with an antibiotic or other physicianprescribed medicine Sensible use of antibiotics

Tertiary prevention

disease

impairment

disability

handicap

Chain of infection

Causative agent

Mode of transmission

Controlling the reservoir / Source

 Early diagnosis  Notification  Isolation  Treatment  Quarantine - Enforced isolation or restriction of free movement
imposed to prevent the spread of contagious disease

 Surveillance - Close observation of a person or group, especially

one under suspicion

 Proper handling of animals  Disinfection

Notifiable diseases
Group - A Cholera Plague Yellow Fever Group - B Acute Poliomyelitis / Acute Flaccid Paralysis Chicken pox Dengue Fever / Dengue Haemorrhagic Fever Diphtheria Dysentery Encephalitis Enteric Fever Food poisoning Human Rabies Leptospirosis Malaria Measles Meningitis Mumps Rubella / Congenital Rubella Syndrome Simple Continued Fever of over 7 days or more Tetanus Neonatal Tetanus Typhus Fever Viral Hepatitis Whooping Cough Tuberculosis

Controlling the transmission

 Contact
 Direct hand washing, safe sex, avoid bites  Indirect use own personal items (towel, tooth brush, comb etc.)  Droplet proper sneezing techniques

 Vehicle
 Airborne use masks  Waterborne boiling, filtering, purifying  Foodborne proper food and food handling

 Vector
 Mechanical avoid flies, roaches  Biological avoid mosquito / insect bites

Susceptible host
 Prevent exposure  Host defence mechanism immunization  Pathogenicity

Modes of HIV/AIDS Transmission

Modes of HIV/AIDS Transmission

 Sex
unprotected, penetrative oral, anal or vaginal Intercourse

 Mother to baby
pregnancy, delivery and breast feeding

 Blood and blood products

 Needles and other sharp objects

invasive procedures, drug addicts, tattoos

One cannot get HIV by

 kissing, hugging or shaking hands  mosquito or any other insect bites  sharing clothes, towels, cups and plates  toilet seats or swimming pools  working with an infected person in the same working place  living in the same house with an infected person

How to prevent AIDS

 Delay sexual activities until marriage.  Limit sexual activities to only one, faithful partner  Always use a condom properly: during sex with those other than

your faithful sexual partner

 Use only screened blood for transfusions  Use only sterilized needles and syringes  Strictly adhere to universal precautions

Universal precautions
1. Hand washing 2. Avoid contact with body fluids
Gloves (Do not reuse) Protective clothing Shield for rescue breathing

3. Disposal of infectious waste

Contaminated materials Used needles, syringes and other sharp objects Body waste

4. Clean-up 5. Accidental exposure

Recapping of syringes

Immunization

Dr. Senaka Herath

Immunization - definition

 Immunization is the process whereby a person is

made immune or resistant to an infectious disease

Classification
Immunization

Active

Passive

Natural

Artificial

Natural

Artificial

Live

Killed

Human

Animal

Active Immunization
 Live attenuated
 

Virus Bacteria

Measles, mumps, rubella BCG

 Killed
 

Virus Bacteria
  

Hepatitis B
Pertussis Tetanus Meningococcal

Whole Toxoid Polysaccharide

Passive Immunization
Human Immunoglobulin
 Specific


IM

Hepatitis B
Rabies Tetanus Varicella

IV

Cytomegalovirus (CMV)

Respiratory syncytial virus (RSV)

Passive Immunizationcontd
Human Immunoglobulin
 Non-specific


IM

Hepatitis A Measles

IV

Antibody deficiency disorders Idiopathic thrombocytopenic purpura (ITP) Kawasaki syndrome

Passive Immunizationcontd
Specific equine antibodies
   

Botulism antitoxin Diphtheria antitoxin Tetanus antitoxin Snake & spider anti-venom

Monoclonal antibodies


Anti-endotoxin antibodies

General Contraindications
 Moderate or severe illness with or without fever  Anaphylactic reaction to vaccine or vaccine constituent  Live attenuated vaccines for
  

Pregnant women Immuno-compromised / Immuno-suppressed individuals within 3-11 months of immunoglobulin administration

Invalid Contraindications
 Mild to moderate local reaction  Mild acute illness with or without low grade fever  Current antimicrobial therapy  Convalescent phase of illnesses  Prematurity and low birth weight  History of penicillin or other nonspecific allergies  Malnutrition

Expanded Programme of Immunization