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07 - Pathology: Public Health and Medicine


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Difference between Medicine and Public Health
Medicine = concerned about individual patient

Public Health = concerned about the public - both those with an infection and those without infection
The routine collection, analysis, interpretation and distribution of critical data
Surveillance in which the healthcare provide or lab is the initiator and the health department receives reports of disease as they occur
Passive Surveillance
Surveillance in which the Health Department is the initiator and the organiztion receiving info takes DIRECT action in collecting info
Active Surveillance
Uses of Passive Surveillance
1. monitoring background disease/trends
2. looking for key disease indicators
3. looking for increased incidence of disease
Times when Active Surveillance is used
1. in response to and outbreak
2. seeking epidemiological links
3. seeking source of outbreak
4. controlling outbreak
Advantages of Active Surveillance
1. identify more cases
2. Better quality data
3. more timely
4. useful in specific time-limited circumstances
Disadvantages of Active Surveillance (2)
1. Time-consuming
2. Costly
Reportable diseases must be reported to the local board of health within _______
24 hours
Diseases must be reported within 4 hours when it is: (4)
1. highly infectious (rubella, SARS)
2. doesn't depend on lab tests (smallpox)
3. when others are known to be exposed
4. other important info not available to labs (travel history)
Reportable agents that must be reported within 4 hours and must send an isolate

Primary source of data for Passive Surveillance
Lab data
Direct Effects of Vaccine-Preventable Disease Investigation
1. control/prevent further disease
2. vaccinate susceptible contacts
3. vaccination prevents 2nd generation cases
Vaccine given to children that lowered the incidence drastically
Haemophilus Infuenza Type B (Hib)
Separation/restriction of movement of persons who are ill to prevent transmission of disease
Separation/restriction of movement of person who are NOT ILL but who have been exposed to infection to prevent transmission of disease
Isolation ususally takes place in what setting?
Quarentines usually take place in this setting
Home or designated facility
Back in the day, being Quarantined was likened to...
Torture, exile, and death
When are Isolation and Quarantine indicated?
when a person or group of people has been exposed to a highly dangerous and contagious disease
How are people separated in Isolations and Quarantines?
Exposed "well" are separated from "ill cases"
How long does Quarantine last?
Only as long as necessary to ensure that quarantined persons do not become ill - use incubation period of disease as a guide
Who has the POWER to isolate and quarantine to protect public health?
Amendment that reserves powers to isolate and quarantine
10th Amendment
Who is responsible for the public health matters within their boundaries?
States (governor)
When does the Federal Authority step in to Isolate and Quarantine?
1. International importation of disease
2. Interstate spread of disease
3. certain Indian Lands
4. Prisons, hospitals (federal reservations)
Disease government is really dealing with now to try and prevent
Infectious TB
The CDC indicates that it is the government's goal to use its authority only in this incidence.
if an individual poses a threat to public health and refuses to voluntarily cooperate with a request to quarantine
When was the last time the FEDERAL government used an involuntary quarantine?
1963 with smallpox case
The CDC uses this act to monitor and temporarily detain individuals suspected of carrying or being exposed to disease
Public Health Service Act
Maximum penalty for violation of the Public Health Service Act
$1000 fine
One year in prison
Federal Law requires the reporting of ill passengers on ______________
international conveyances
8 CDC Quarantine Stations
NYC, Atlanta, Florida, Chicago, LA, SF, Seattle, Hawaii
When usually does the Federal Government step in?
when a person in one state has traveled to another state with a Quarantined disease
Measures the CDC may take for Community Containment (6)
1. isolation/quarantine
2. "snow days"
3. restrictions on group assembly
4. cancellation of public events
5. closure of mass public transit
6. restriction of non-essential travel
Community containment is more likely to be applied to _____
small # of exposed persons in focused settings
Small pox cases are isolated for how long?

Pneumonic Plague?
18 days after exposure or 14 days following successful vaccination

72 hours after initiation of antibiotics
Viral Hemorrhagic Fever is isolated for how long?
watch for fever and symptom for 21 days for persons exposed to blood, secretions from infected person
Do Public Health Investigations get to acquire Private Health Information (name,address, etc of patient)?
Is Confidentiality a legal requirement and KDHE policy?
Yes, must confirm you are faxing to a confidential fax, stamp envelopes as "confidential", no identifying info when emailing

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