07 - Pathology: Public Health and Medicine
Terms
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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
- 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
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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
-
Anthrax
Meningococcemia
Pertussis
Plague
SARS
TB
*P-STAMP* - 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
- Isolation
- Separation/restriction of movement of person who are NOT ILL but who have been exposed to infection to prevent transmission of disease
- Quarentine
- Isolation ususally takes place in what setting?
- Hospital
- 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?
- Police
- 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
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$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)
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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)?
- Yes
- 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