UNIT II : GLOBALLY EMERGING

AND
RE-EMERGING INFECTIOUS
DISEASE

Prepared by: Vanessa C.

Malolos, RN
 Understanding Emerging and Re-emerging
Infectious Diseases
EMERGING
Emerging infections is defined as newly diagnosed or
previously unknown infections. This may include new or drug-
resistant infections whose incidence in humans has increased
within the past two decades or whose incidence threatens to
increase in the near future.

RE- EMERGING

Re-emerging infections are defined as secondary to the

reappearance of a previously eliminated infection or an
unexpected increase in the number of a previously known
infectious disease.
 For an emerging diseases to become established at least two events have occur
(1) The infectious agent has to be introduced into vulnerable population and
(2) The agent has to have the ability to spread readily from person- to – person and
cause disease

A factor that is especially important in the re-emergence of diseases is antimicrobial

resistance - the acquired resistance of pathogens to antimicrobial medications such as
antibiotics. Bacteria, viruses, and other microorganisms can change over time and
develop a resistance to the drugs used to treat diseases caused by the pathogens.
Therefore, drugs that were effective in the past are no longer useful in controlling disease.

Another factor that can cause a disease to re-emerge is a decline in vaccine coverage, so
that even when a safe and effective vaccine exists, a growing number of people choose not
to become vaccinated.
A. Nature of Infectious Disease

Pathogens

Microorganisms that are capable of causing disease.

A true pathogen is an infectious agent that causes disease

in virtually any susceptible host. Opportunistic pathogens
are potentially infectious agents that rarely cause disease
in individuals with healthy immune systems.

Diseases that cause by opportunistic pathogens typically

are found among the groups such as elderly.
 What is disease?

The term “disease” refers to conditions that impair normal tissue

function.

Infectious Disease?

An “infectious disease” is a disease that is cause by the invasion of a

host by agents whose activities harm the host’s tissue (that is they
cause disease) and can be transmitted to other individuals (that is, they
are infectious)
The terms “infection and “diseases”
are not synonymous

An infection results when a pathogen invades

and begins growing within the host.

Disease results only if and when , as

consequence of the invasion and growth
of a pathogen, tissue function is impaired.
 Case of the Corona Viruses
• SARS-CoV
• MERS-CoV
• SARS-CoV-2
(Which cause the diseases SARS, MERS,
and Covid-19)

Emerging diseases
Influenza
sample

Meningococcemia, Avian Influenza or

bird flu A (H1N1) virus infection
INFECTIOUS DISEASE MODEL

PAT
T HO
HOS GEN

DISEASE

ENVIRONMENT
8
 HUMAN PATHOGEN TRANSMISSION

Infection caused by Infection caused by

Airborne Transmission Contact and Feces

Infection caused by Infection caused by

Contaminated water Pathogens in blood stream
and tissues
 MODE OF TRANSMISSION

MODE OF TRANSMISSION

INDIRECT
Transmission
DIRECT
Transmission Vehicle borne

Direct Contact Vector borne

• Mechanical Propagative
Droplet Infection • Biological Cyclo-Propagative
Contact with soil
Airborne Cyclo-Developmental
Inoculation into skin or mucosa • Dust
• Droplet nuclei
Trans-placental (vertical)
Formite Borne
Unclean hands and finger
 TYPES OF COMMUNICABLE DISEASE
Depending upon source:

Intestinal Surface Infection

Infection Infection

Respiratory
Infection Arthropod Borne Sexually
Infection Transmitted
Disease
 B. INFECTION DISEASES THAT
THREATEN GLOBAL HEALTH SECURITY

What Global security?

Global health security is the existence of strong and resilient

public health systems that can prevent, detect, and respond
to infectious disease threats, wherever they occur in the
world. The Centers for Disease Control and Prevention (CDC)
works 24/7 to protect the health, safety, and security of the
American people and fight global health threats worldwide,
so we don’t have to fight them here at home.
INFECTION DISEASES THAT THREATEN GLOBAL HEALTH SECURITY

HIV/AIDS

H1N1 Swine influenza

Polio, Ebola,Zika

Covid-19
CDC strengthens capabilities in these four core areas to fight top
global health security risks:

 Surveillance systems to quickly catch outbreaks before they spread

 Laboratory networks to accurately diagnose diseases and identify

new pathogens.

 Workforce development of frontline staff to identify, track, and

contain outbreaks at their source

 Emergency Management systems to coordinate response efforts

when crises occur
 EPIDEMIOLOGY OUTBREAK

Epidemic or outbreak refers to an occurrence of

more cases of disease than normally expected
within a specific place or group of people over a
given period of time;
 Outbreak preparedness

To respond effectively to outbreaks, it is essential to be prepared.

 Formation of a multisectoral outbreak control team (OCT), with roles and

responsibilities designated for each team member;

 Development of outbreak response plans (including reactive vaccination strategies

where appropriate) for each priority epidemic-prone disease;

 Development or updating (if necessary) of standard line-list forms for data

collection during an outbreak;

 Development and distribution of standard treatment protocols for key diseases,

with strategies for training of staff;

 Calculation of potential attack rates for epidemic-prone diseases, where possible;

 Pre-positioned stockpiles of essential treatment supplies to initiate outbreak control (e.g.
oral rehydration salts, intravenous fluids, vaccination material, personal protective
equipment, transport media for samples, water purification supplies and information leaflets
on preventive measures for health staff or the community;

 Procurement of laboratory sampling materials for the priority diseases, and identification of
a competent laboratory for confirmation of cases;

 Identification of potential sites for isolation and adequate treatment of patients, or for extra
capacity in the event of a surge in cases (e.g. a cholera treatment center);

 Implementation of relevant prevention tools based on the risk assessment of diseases (e.g.
indoor-residual spraying of dwellings and distribution of long-lasting insecticide-treated nets
to prevent malaria outbreaks).
 IMPLICATION TO HEALTH CARE
Implications for healthcare fitted into 11 categories:

1. Individualize care plan-Strategies to improve medication taking should take into

account a patient’s individual concerns and issues. This includes all suggestions
that call for personalization of management.
2. Address practical barriers for the individual - Specific, practical barriers that
apply to an individual should be explored and tackled. This includes barriers such
as forgetfulness, lack of routine, difficulty obtaining treatments and social isolation.
3. Adopt a patient-centered approach- This refers to clinicians taking a more
holistic approach, allowing them to understand the perspective of the individual
taking medications, including their ideas, concerns and expectations.
4. Increase clinician involvement- Clinicians should spend more time with
patients to discuss medications.
5. Ensure long-term follow up- The patient should be followed up and seen on
more than one occasion to support their medication taking behavior.
6. Promote self-management- Those taking medications should themselves be
encouraged to take a more active role in decision-making and monitoring.
7. Increase family or carer involvement- Patient experiences of medication-
taking would be enhanced if there was greater involvement of family members
or carers.
8. Improve patient education- Strategies should focus on providing individuals
with more information to support them to make decisions about whether or not
to take medications.
9. Address system barriers- Medication-taking could best be optimised by
making changes at the health system broadly. This may include improvements to
the healthcare setting but may also include broader suggestions including
overcoming geographical and financial barriers.
10. Increase access to non-prescribing clinicians- Individuals should have
access to a healthcare professional other than the prescriber (usually a
physician). This includes pharmacists, nurses and other healthcare worker roles.
11. Improve staff training- Healthcare staff involved in medication provision
need training to improve their ability to support those taking treatments. It
includes a variety of improvement areas such as prescribing guidelines,
counselling about treatments options and communication skills.
 Nurses Role and
Responsibilities during
Epidemic Detection,
Control and Prevention
 The vital role of nurses is undeniable. Nurses not only
provide critical care to patients in need, but they also
serve as agents of change, advocating for patients and
promoting improvements across health systems.

Nurses play a vital role during infectious disease

outbreaks. Nurses are on the front line whenever any
crisis develops, whether it's a local outbreak or a
pandemic. Whenever infectious disease outbreaks occur,
the role of nurses is to lead the way in providing safe,
effective care even under stressful circumstances.
Because nurses work on the front lines. They stand in an excellent position
to rapidly identify communicable diseases and spot infectious pathogens
early.

Nurses in Public and Community Health Clinics

Public and community health centers give marginalized communities access
to healthcare. People with limited funds, lack of insurance, or language
barriers rely on these clinics to deliver their primary care.

The nurses working in public and community health clinics deliver care that:

 Prevents diseases
 Promotes and maintains health
 Educates patients about their health
 Diagnoses and treats illnesses and injuries
 Community Health Nurse Duties During Disease
Outbreaks
During a disease outbreak, nurses working in public and community health clinics
typically carry on with their regular duties. However, the way they do so may change
in efforts to limit disease spread and to protect their health and the health of their
patients.

For example, during a highly infectious pandemic such as COVID-19, nurses may:

 Screen patients for symptoms over the phone

 Conduct appointments, such as behavioral health appointments, remotely
 Nurses in Emergency Rooms
Emergency room (ER) nurses often treat patients with life-threatening health
conditions. By their very nature, emergency departments deal with the most urgent
health problems, delivering care to car accident victims, gunshot victims, and people
in cardiac arrest.

Specifically, triage includes the following:

 Determining if patients suffer from blocked or impaired airways

 Assessing if breathing is labored
 Examining circulation by checking for bleeding and the speed and rhythm of the
patient’s pulse
 Assessing the patient’s level of consciousness, pain, and muscle strength
 Determining the patient’s exposure to harmful materials or environments, such as
extreme cold or heat
 Nurses in Intensive Care Units
Intensive care nurses treat the most vulnerable and sick patients in a hospital or
clinic. In critical care units, patients aren’t always expected to survive. Intensive care
unit (ICU) nurses apply specialized knowledge to understand whether patients are
recovering or struggling to survive.

By adjusting fluids, medications, or therapeutic devices, such as ventilators, ICU

nurses strive to avoid complications and stabilize patients as they recover from
accidents, diseases, or surgeries.

ICU nurses contribute to decisions regarding:

 Which patients can be discharged to other units

 How to free up ventilators using other treatment techniques
 Which patients assessed as unlikely to recover should be taken off ventilators, so
they can be used for patients more likely to recover
 Nurses in Nursing Homes

The role of nurses in nursing homes spans a variety of duties. These nurses work in
both supervisorial and clinical capacities to ensure the well-being of their older
patients.

Other duties of nursing home nurses include the following:

 Monitoring patients’ hygiene

 Administering medication
 Checking patients’ blood pressure, temperatures, and heart rates
 Monitoring and treating their patients’ health conditions, such as Alzheimer’s
disease and diabetes
 Initiating treatment plans
 Telehealth Nursing During a Disease
Outbreak
The remote nature of telehealth nursing can make it an excellent resource during a
disease outbreak. Since it doesn’t require close contact, it can lower the risk of
spreading illness while still allowing patients to get the health services they need.

For example, a woman with mild flu symptoms who meets the requirement for self-
care at home can receive instructions about medication, rest, and signs to look out
for, without leaving home. In this way, the patient doesn’t risk exposure to disease
while being immunocompromised, and is still able to get care without exposing
others.
The novel coronavirus SARS-CoV-2 has dominated headlines in early 2020,
infecting people on six continents with the respiratory illness COVID-19. Nurses,
as ever, are on the job, providing direct care for people who develop COVID-19
and helping to prevent the spread of the virus by wearing appropriate personal
protective equipment (PPE) and following safety protocols.

Follow good nursing practices:

 Standard precautions and isolation.

 Hand hygiene.
 Proper PPE use.
 Quarantine and social distancing.
ROLE OF BIOMEDICAL RESEARCH
BIOMEDICAL RESEARCH

Biomedical research is the broad area of science

that looks for ways to prevent and treat diseases
that cause illness and death in people and in
animals. This general field of research includes
many areas of both the life and physical sciences.

Biomedical scientists study human physiology and the treatment or

understanding of disease. Biomedical research applies the principles of the
physical sciences to medicine. Most biomedical research is conducted by
physicians or biomedical scientists, but many studies are conducted by
biologists, chemists, physicists, and other medical and scientific
professionals.
 ROLE OF BIOMEDICAL RESEARCH IN PREVENTION

Utilizing biotechnology techniques, biomedical researchers study

biological processes and diseases with the ultimate goal of developing
effective treatments and cures.

Discovery of new medicines and therapies requires

careful scientific experimentation, development, and
evaluation.
 -Thank you-
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