The Community Health – SARS

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Table of Contents

Introduction
SARS Outbreak
Epidemiological Indicators of SARS
Analysis of Epidemiological Data on the Outbreak
Transmission Routes
Conclusion
Reference list

Introduction

Communicable diseases are infectious diseases transmitted from one person to another. One such disease is the Severe Acute Respiratory Syndrome (SARS) that had an outbreak in China in 2002. This paper will discuss issues regarding SARS out break, the epidemiological indicators, epidemiological data analysis, as well as modes of SARS transmission.

SARS Outbreak

There was an outbreak in China in 2002; country delayed in submitting the initial report to the World Health Organization (WHO). It was only after continued pressure and numerous cases that PRC notified WHO, and even so, the country disclosed information about the provinces of Guangdong only as it was believed that the disease had its origin there. This led to international criticism and the government changed its perspective, allowing the press to release information concerning the disease and conduct supervision (Wong and Zheng, 2005, p. 123).

Epidemiological Indicators of SARS

SARS is a viral disease and the virus responsible for its transmission is known as coronaviruses. The main epidemiological indicators are mortality, morbidity, and surveillance. According to Webb (2005, p. 77), Surveillance refers to “continuous assessment of the occurrence and distribution of diseases as well as other conditions of ill health, and their causes for effective control and prevention.” Surveillance entails gathering of information, analyzing it and interpreting relevant information and the subsequent dissemination of such information to the parties. Surveillance may be active, passive or sentinels systems. Mortality refers to number of death per certain period.

Infant mortality rate is mostly witnessed in the cases related to SARS; high infant mortality rate shows that the environmental conditions are unconducive and there are health needs that need to be addressed (Maurer and Smith, 2005, p. 165). Morbidity refers to an ill health incidence and it can be measured in several ways; morbidity rate shows a proportionate comparison of those people who are sick to the healthy ones.

Analysis of Epidemiological Data on the Outbreak

In data collection and analysis of SARS outbreak, there is a process to be followed in order to determine the cause and severity of the disease. First, an electronic patient database is kept in a central control position and all patients suspected to have the infectious SARS should be entered in the database; in the case of SARS, a SARSID (SARS Integrated Database) was created. After database creation, the case is defined and analyzed for clinical symptoms.

According to McLean (2005, p. 62), World Health Organization (WHO) defined the case in two ways; first, any person found after 1st November 2002 to have a cough, difficulty in breathing or high body temperature and had an exposure(s) ten days before onset of symptoms.

Second, anybody who had died after the same date had exposure before onset of symptoms, the cause of death was acute unexplained respiratory illness, and no autopsy was done. Clinical symptoms included presence or radiographic infiltrates after a chest x-ray, positive SARS-CoV, and autopsy results similar to pathology of RDS whose cause could not be established. The main symptoms include cough, high fever, headache, malaise, and diarrhea. In addition, the number of the deaths induced by the aetiological agent is established and it is known as case fatality rates. According to information released by WHO in 2003, SARS case fatality rate was 15% with high adult mortality as compared to infant mortality; the infectious period shows the period it takes an infectious agent to spreads prior to and after onset of symptoms (McLean, 2005.pg 62).

Transmission Routes

Respiratory droplets

This route is the most widely known mode of transmission. If an infected person coughs or sneezes and the droplets lands on mucus membrane of a healthy person, the healthy person is infected. Such membranes include the eyes, mouth or nose.

Direct contact

Direct contact with an infected person physically or direct contact with body fluids or respiratory secretions of the person also leads to transmission. Circumstances of direct or close contact include kissing, hugging, touching someone directly and so on.

Graphical Representation of Sars Out- Break.

Effect of SARS Outbreak on the Community

Outbreak of SARS would lead to psychological stress to the patients, health workers and even friends and relatives. The nature of the disease dictates isolation of patients that could eventually lead to lack of social support from friends and relatives who fear infection.

It would also lead to decline in economic growth since it would call for commitment of financial resources in paying hospital bills and purchase of necessary medical equipments. Human resource would also be affected since the sick will not work while others may die leading to reduced productivity. Moreover, investments by foreigners would also cut down since foreigners will not come in fearing infection.

Protocol for Reporting a Possible Outbreak

Reporting SARS possible outbreak after it has been confirmed would first involve verification to ascertain the truth. This would involve use of additional cases and use of past history data to compare the situation at hand and in the past. After verification, that information is reported to the health department immediately with specimen to support the report. The agent is then identified and a routine surveillance conducted. All concerned staff is informed to stay alert in case of additional cases. The cases are then categorized on bases of each person, place, and time and then obtained data is analyzed and reviewed to ascertain existence of a problem. If there is a problem, hypothesis testing is done to determine the root cause.

How to modify care of people with respiratory diseases in times of poor air quality

Poor air quality poses risks to patients suffering from communicable diseases such as asthma. To improve their care during such times, the following mechanisms can be utilized. Ventilation is most important at such a time, thus patients should stay in clean and well-ventilated rooms that are not congested. Use of strong scented air fresheners and conditioners should be avoided since this might induce sneezing.

The architecture of hospitals or rooms where such people are kept should be designed with a lot of care. Movement of air from one room to another may be caused by pressure that may be induced by natural forces such as wind and those airflows are sensitive to open doors or windows. Such airflows may alter the air pressure in other rooms thus reducing or reversing airflow directions. It is therefore advisable to keep their rooms’ doors and windows closed in order to reduce airborne concentrations.

The challenge in designing a ventilation system is in ensuing that each individual inhales only fresh air and no hazardous air is inhaled. This can be achieved in any of the three ways: first, contaminated air can be mixed with uncontaminated air, which aims to decrease the concentration of contaminated air by making it more pure. Another approach is that of dilution and it implies use of fresh air to dilute the contaminated air. Normally, ventilation is designed with at least 12 air exchanges. The final approach entails control of airflow in a way that air moves from health care workers to the sick. This approach dictates that exhaust vents and patients are close (Tang et al, 2006).

They should also be encouraged to cover their mouth when coughing and sneezing ensuring proper disposal of the sputum. Proper protective clothing should be used such as gowns and gloves. In addition, direct contact with body fluids and respiratory droplets should also be eliminated and use of filtered piece facemasks encouraged. Finally, they should be advised to maintain proper body hygiene and ensure that they wash their hands after getting into contact with any mucous fluid and before eating. This will reduce risk of infection to health workers taking care of them

Conclusion

Communicable diseases have no boundaries irrespective of age, gender, or geographical location. An outbreak of a disease such as SARS would have various costs both financial and psychological. Therefore, an understanding of the causes, mode of transmission and prevention would therefore be important in prevention and control.

Reference list

Maurer, F, & Smith, C, 2005. Community/public health nursing practice: health for families and populations. NY, Elsevier Health Sciences. Web.

McLean, A., 2005. SARS: a case study in emerging infections Oxford biology readers. NY, Oxford University Press. Web.

Tang, J. et al. 2006. Factors involved in the aerosol transmission of infection and control of ventilation in healthcare premises. Journal of Hospital Infection, 64(2): 100-114.

Webb, P., Bain, C., & Pirozzo, S., 2005. Essential epidemiology: an introduction for students and health professionals. Cambridge, Cambridge University Press. Web.

Wong, J., & Zheng, Y., 2004. The SARS epidemic: challenges to China’s crisis management. New Jersey, World Scientific. Web.

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