Influenza Case Study

Influenza Case Study

Communicable diseases entail those conditions that can be passed from one passion to the other via physical contact with infection agent or person, sexual intercourse, fecal-oral transmission or even droplets. In all the instances, such development becomes a public health concern and the nurse in charge together with other related agencies are tasked with the duty of protecting the public. As claimed by Maurer & Smith, (2012), the community health nurse uses the nursing process to provide care for the community to determine and manage such conditions in the community. The epidemiology of influenza is vital in determining the state of the condition globally that influences the preparedness by various agencies on its management. This article dwells on the epidemiology of the virus and various aspects that are connected to the disease thus making it easy to plan for its surveillance and control.

Influenza is a viral disease that develops when an individual is infected by type A or B viruses. The viruses are passed to humans and can lead to the epidemic cases of flu. Influenza A can be further divided according to the genes that are present in the protein surface to come up with various sub-types. According to Yang et al., (2015) the communicable disease can be caused multiple types and subtypes of the virus that are always in circulation in the periods of flu season. The infected individuals manifest with various signs and symptoms which can include headaches, body or muscle aches, sore throat, and stuffy nose. Others include diarrhea and vomiting which are common in children compared to adults with the condition.

Since the virus is harbored by livestock and can reside within the environment, influenza can be passed to humans through various means. One can be via coming into contact with objects that are contaminated with the fomites. It can also via man- man infection from individuals that have contracted the virus. Humans can also get the virus via inhalation of the virus through aerosols. Yang et al., (2015) alludes that influenza is a contagious condition. The virus can be passed to healthy individuals by infected individuals early enough prior to the symptomatic period. This situation makes it hard to contain since immediately one gets sick, he or she begins to spread the virus. Being a zoonotic condition, the virus can be passed from livestock to human during their interactions. According to Mondiale de la Santé & World Health Organization (2017), the infections may also erupt from being exposed to infected animals such as exposure in the poultry farms, paying a visit to the market where birds are exchanged, through de-feathering as well as having mortality cases of birds in the nearby areas.

Fox, Miller & Meyers, (2017) also claims that besides the human transmission, other ways through which an individual can get the virus is through livestock reassortment occurrences. This transmission is usually evident in the cases where the virus is contained within livestock such as the swine where it might reside in its inactive form for years. The virus may then be passed to cause illness among the humans, and this type of transmission has been the one responsible for the pandemic events seen in the years March 1918, April 1957, May 1889 and July 1968. The other epidemic instances that occurred in 1977 and 2009 were due to a lab escapee and a human-derived variant respectively.

Being a contagious disease, influenza is best controlled by social distancing and isolation of the affected individuals to prevent transmission of the virus via the droplets to other healthy individuals. Individuals can also get prophylaxis treatment to curb them from contracting the disease. The infected individuals benefit from antiretroviral drugs such as oseltamivir as eluded by Mondiale de la Santé, O., & World Health Organization, (2017). The antiretroviral medication has a significant impact in containing the disease, especially when given from the day onset to about four days. The outcome of the treatment is even better when initiated early enough before the disease gets to its advanced stages. It is also significant to identify the condition early enough for the precautionary measures to be taken as this would prevent transmission. In other surveillance strategies, the evaluation of the livestock, humans and wild birds by various public health organizations are critical ways of approaching the transmission of the virus.

The communicable and contagious nature of influenza virus makes it a reportable condition since a single case can act as a beginning of an epidemic. The determined case is considered an outbreak and measures ought to be taken into account to confine the virus to prevent it spreading to other areas. The case then can be reported to the disaster management unit which in collaboration with the Center for Disease Control and Prevention (CDC) and World Health Organization (WHO) would work towards containing the disease via their response teams.

Determinants of health and their contribution towards development of influenza

In a particular community, the health of individuals is pegged on various factors. These factors come together to form the surrounding and circumstances that the individuals are subjected to thus forming the determinants of whether they are healthy or not at any particular time (Braveman & Gottlieb, 2014). Despite individuals being in contact with the issues that affect their lives, they are usually not able to directly manipulate most of the health determinants that affect them. This realization puts validity the inappropriate nature of various people in blaming other people for poor health or even giving credit to those having good health. The various health determinants encompass the following:

Physical environment – the surrounding has various contributors to good health. These include the surrounding communities, safe roads, clean water, clean air, healthy work environment, and houses. The conditions within a work setting are also vital for the health of a worker. Environments that contain fomites can also lead to contraction of diseases such as influenza. Farmers who interact with livestock and poultry in their workplace are also at risk of developing influenza. Influenza is also linked to seasons such as spring and summer (Fox, Miller & Meyers, 2017). Such seasons are vital aspects to consider while taking precaution in its prevention. The seasons increase the extent of the pandemic situation as well as the probability of transmitting the virus to other healthy individuals. Other environmental conditions that are related to the virus entail humidity and the school calendar period that are both considered to spearhead the transmission of the illness.

Health services – the manner through which the population accesses and utilizes the healthcare services are all determinants of the effort placed by both the entire population as well as the related health agencies in curbing and controlling the influenza virus which in the end affects health. With influenza being a contagious condition, the earlier one determines the disease or seeks treatment, the better they can get treatment and prevent advancement of the disease as well as prevention of passing the virus to others. It is important for an individual to seek medical intervention within two days of infection for appropriate containment of the virus (Mondiale de la Santé & World Health Organization, 2017). In the case where an infected individual does not seek treatment or is not able to get access to the healthcare services, the chances of mortality as well as the severity of the infection are relatively high.

Education – individual with low education or less knowledgeable is linked to being less informed towards the prompt identification of illnesses, a prompt reaction in case an illness occurs, going for check-ups to determine presence or absence of disease as well as less concerned with healthy living (Braveman & Gottlieb, 2014). These factors predispose the individuals to poor health, stress and lower self-esteem to confront situations.

Genetic composition – the coded traits that are passed from one generation to the nest are key health determinants as they influence the healthiness of siblings, the probability and predisposition to develop certain conditions as well as the overall lifespan of individuals. In consideration of influenza virus, there occurs a heterosubtypic immunity stemming during the early periods of childhood that comes about due to instances of infections of the novel H5N1 and H7N9 as was evident in China (Fox, Miller & Meyers, 2017).

Support system – the social support that exists for an individual or a community determines their health status. The support may be in the form of friends, family, support groups, organizations, the community as well as agencies (Braveman & Gottlieb, 2014). The existence of agencies such as World Health Organization as well as Center for Disease Control and Prevention has enabled the surveillance and containment of influenza viruses in various epidemic areas. Other determinants under this aspect include the beliefs and cultures that the family and community members subscribe to. This determination is associated with the fact that the beliefs and values affect the use of health services among the members hence affect their lives depending on their practice.

Gender differences – the health disparity that comes about with gender can be associated with the hormonal differences as well as body composition regarding muscles and fat distribution. The male to female ration of persons that are affected by the influenza virus favors the females despite the fact that this number being dependant on the age (Mondiale de la Santé, & World Health Organization, 2017). For persons that are less than age ten, the ratio is at 1 to 0.9. Above this age, the ratio however changes.

Epidemiologic Triangle and its relationship with Influenza

The epidemiologic triangle is a traditional model that is used to illustrate infectious disease (Szklo & Nieto, 2014). It is a model used in science to explain the origin of various diseases in various environments. The triad composes of agent, environment and the host which form the aspects to determine the occurrence of a condition in any setting.

The host is the organism which in most instances is humans or animals that are at risk of getting the illness by getting exposed or harboring the disease-causing organism. Szklo & Nieto (2014) reiterates that the host can either be a carrier to spread the illness or be the organism that can get sick upon exposure to the virus. The hosts for the care of influenza are human beings that develop illness upon infection by the virus and have the potential of spreading it to other during both the asymptomatic and symptomatic periods of the disease. Livestock and birds also harbor the virus and can pass it human beings in the events of reassortment. Upon infection, the hosts have multiple reactions determining the impact that the virus has on them.  According to Fox, Miller & Meyers, (2017), the children who get infected with novel H7N9 and H5N1 develop immunity against the condition. This is however different with adults who suffer from the infection instead of immunity. These differences are also similar to the symptoms of vomiting and diarrhea that are only common among children and not adults.

The agent is the causative organism of the illness. For influenza disease, the disease-causing agent is the influenza type A and B viruses. The virus infects the upper respiratory system to cause the disease. The activities by the virus lead to various symptoms that are apparent to the illness.

The environment refers to the conducive situations and surroundings that mark the external factors to the host which allows transmission as well as the establishment of the virus after transmission (Szklo & Nieto, 2014). In this case, the influenza virus survives and is virulent during the school calendar and the humid periods. In the hosts, the virus dwells in the body fluids hence able to be transmitted through the saliva droplets that come out in the times of sneezes and coughs making it contagious.

Role of Community Health Nurse in controlling Influenza

As a healthcare provider, the community health nurse is tasked with the role of conducting surveillance of the illness in collaboration with other public health organizations (Maurer & Smith, 2012). In monitoring, the nurse engages in activities such as health education concerning prevention strategies, early identification of symptoms and seeking medical attention for ill health. All the above moves are geared towards an early determination of the virus as explained by Edmonson et al., (2017). The nurse is a crucial player in the case finding as he or she engages in the assessment of symptoms of concern and curbing others from contracting the virus. The nurse then paves the way for laboratory tests to confirm the diagnosis.

The nurse communicates the information to the facilities of concern as well as the disaster management unit which mobilizes their team to dig into the issue. By working with the units, the nurse determines other exposed individuals to do an assessment. The community affected is also informed in the process to make them aware the situation and allow vigilance as well as taking precautionary measures to curb further spread. In so doing, they empower the community to engage in promotive activities as depicted by Maurer & Smith, (2012). Data is collected to determine the extent of the disease. Treatment is done with stable individuals discharged under follow-up of the community health nurse. A report is then prepared for determination of cases handled as well as for future references.

National Agencies or Organizations Addressing Influenza

World Health Organization – it handles various global health risks. In handling influenza, it came up with the tool for assessment of the risk of an influenza pandemic which has been instrumental in the prevention of transmission of the virus due to standard vigilance towards the determination of the condition (Mondiale de la Santé, & World Health Organization, 2017). In addition to the above contribution, WHO  came up with the criteria for assessing pandemics and the steps to take in managing the response teams which responding to such occurrences.

Global Implication of Influenza

Since China has reported several cases of influenza up to the year 2016, the nation has placed various measures to avert the situation (Wolf, 2017). The agricultural department resolved to an immunization program to cover the whole nation which was to see all the poultry sectors are covered since it formed the leading cause of the human transmission. The vaccination was done against the H7N9 virus for months thus preventing its transmission to humans.

Other regions such as cities of Frankfurt and London worked towards influenza preparedness thus being vigilant towards determining and arresting the condition. Due to the universal vulnerability in various parts of the world, global preparedness has turned to be the essential move to keep the whole world ready for any pandemic. Wolf (2017) claims that instead of setting screening at the entry points to countries, various management teams are working towards a quick response to the affected area.

Conclusion

Influenza is a contagious infection, and the whole globe is at risk of the virus. Based on the history of the pandemics, the entire healthcare team ought to be ready in managing the condition as well as preventing its development. With unique characteristics such as occurrence in the humid and school calendar periods as well as in the Northern Hemisphere, it is critical to use the history from the previous pandemics to strategize in curbing any occurrences. Its pattern of occurrence makes a significant element that community health nurses, as well as other agencies, can use for its surveillance. In so doing, the study of influenza epidemiology acts as a contribution to the medical team in both disease analysis and its surveillance. 

References

Braveman, P., & Gottlieb, L. (2014). The social determinants of health: it’s time to consider the causes of

the causes. Public health reports129(1_suppl2), 19-31.

Edmonson, C., McCarthy, C., Trent-Adams, S., McCain, C., & Marshall, J. (2017). Emerging

Global Health Issues: A Nurse’s Role. Online journal of issues in nursing22(1).

Fox, S. J., Miller, J. C., & Meyers, L. A. (2017). Seasonality in risk of pandemic influenza

emergence. PLoS Computational Biology13(10), e1005749.

Maurer, F. A., & Smith, C. M. (2012). Community/public health nursing practice: Health for

            families and populations. Elsevier Health Sciences.

Mondiale de la Santé, O., & World Health Organization. (2017). Human cases of influenza at the

human-animal interface, January 2015–April 2017–Cas humains de grippe à l’interface

homme-animal, janvier 2015-avril 2017. Weekly Epidemiological Record= Relevé

            épidémiologique hebdomadaire92(33), 460-475.

Szklo, M., & Nieto, F. J. (2014). Epidemiology. Jones & Bartlett Publishers.

Wolf, M. (2017). Knowing Pandemics: An Investigation into the Enactment of Pandemic

Influenza Preparedness in Urban Environments. Science & Technology30, 4.

Yang, Z. F., Mok, C. K., Peiris, J. S., & Zhong, N. S. (2015). Human infection with a novel

avian influenza A (H5N6) virus. New England Journal of Medicine373(5), 487-489.