Category: Flu

The 2009 Novel Influenza A (H1N1) pandemic brought to the forefront the critical issues of disaster preparedness and planning. Influenza pandemics often portend a political, humanitarian, social, and economic crisis if managed poorly. The essence of this assertion is that an influenza outbreak is an unpredictable and recurrent event (Jhung et al., 2013). As such, Nelson et al. (2007) have argued that advanced preparedness and adequate planning are essential to mitigate the impacts of influenza pandemics. Nonetheless, these efforts require the input of everyone in the community. Both national and international guidelines have provided the framework for addressing these issues adequately (McCormick et al., 2009). The state of Tennessees response to the H1N1 pandemic has provided valuable lessons for future practice.

The health and disaster management agencies should form collaborative linkages to respond to pandemics efficiently (Barrios et al., 2012). No single organization can respond to a pandemic independently considering the practical issues involved in disaster management. In addition, an effective reaction to emergencies requires the mobilization of massive resources (Nelson et al., 2007). Interagency collaboration is essential to build sufficient capacity. Emergency response mechanisms achieve their intended goals when agencies utilize their resources and knowledge base collectively (Barrios et al., 2012). The health administrators in Tennessee understood the value of cooperation by deploying the services of the Tennessee Emergency Management Agency (TEMA).

Each of the agencies involved in the multidisciplinary team should have explicit roles to avoid a conflict of interest. The best strategy to achieve this goal entails the delegation of duties depending on the resources and specialty of each organization (McCormick et al., 2009). For instance, the Department of Health (DOH) and TEMA assumed the leading role during the H1N1 pandemic in Tennessee. On the one hand, DOH had the resources, expertise, and contacts to address public health issues because of its background in health matters. On the other hand, TEMA would have addressed the security and logistic concerns since it had developed expertise in these areas over the years.

The agencies involved in emergency response should ramp-up resources in a progressive manner depending on the magnitude of the situation (McCormick et al., 2009). According to Barrios et al. (2012), the deployment of resources should follow a rational plan to prevent the incidences of overutilization. An influenza pandemic often expands in scope and magnitude as the virus spreads. It is illogical to deploy all the resources at once during the initial stages of outbreak. Such an action may constrain the capacity to respond to a fully blown situation in the future (McCormick et al., 2009). The authorities at Tennessee abdicated TEMAs lead role to DOH after realizing that the pandemic would not increase in severity based on the initial assessment.

The development of efficient communication channels is essential to coordinate interagency efforts during a pandemic (Nelson et al., 2007). Interagency collaboration mechanisms are often complicated because the organizations involved have conflicting interests. These agencies may move in different directions without a clear chain of command (McCormick et al., 2009). The state of Tennessee ensured efficient communication by within the team through the establishment of the State Health Operations Center (SHOC). The principal function of SHOC was to act as a conduit for coordinating and disseminating information between the state authorities and their partners. This was an integral task because Tennessee has a hybrid public health system.

A two-way communication and collaboration between authorities and the public is an elemental strategy to dispel fear. The deleterious social and health effects of pandemics usually cause anxiety among community members (McCormick et al., 2009). The residents look to their local leaders to provide timely and accurate information. In the same vein, the contagious nature of pandemics requires the delivery of risk planning and reduction information (Nelson et al., 2007). Nelson and his colleagues have identified risk communication as one of the essential aspects that keep the local communities apprised of the risks and prevention measures. The Tennessee health authorities worked closely community leaders to prevent an explosive spread of the virus. For instance, these authorities engaged with school administrators on the issue of school closures.

Health authorities and their partners should work closely with the media during a pandemic. Media channels play a significant role in reducing the risk of cross-transmission. The media serves as the primary source of information for the masses (Nelson et al., 2007). Conversely, speculative and sensationalized reporting can increase anxiety and fear. As such, the disaster management team should keep the media informed to avoid these challenges (McCormick et al., 2009). The senior public health officials in Tennessee held conferences and briefs with representatives of media organizations. The authorities also participated in talk shows on both the radio and television to respond to the concerns of the public. These correspondences facilitated the dissemination of crucial information.

The emergency response team should use the established guidelines and protocols to minimize the spread of pandemics. National and international protocols provide best practices based on scientific evidence (Barrios et al., 2012). According to McCormick et al. (2009), these standards should inform the development of strategies that are necessary to counter the emergency. For example, Tennessee relied on policy updates from the CDC to determine the closure of schools. Conversely, some of these provisions may not address unique circumstances considering the unpredictability of emergencies. Health authorities should instead revise these guidelines based on the situation on the ground (Barrios et al., 2012). Tennessee adopted this strategy when one school reported a positive diagnosis after the CDC had relaxed its school closure policy.

The implementation of the pandemic response should consider legal and ethical issues relating to the distribution of scarce resources. Health agencies face the challenge of prioritizing the distribution of the vaccines, medications, and beds in intensive care units (Thomas, Dasgupta, & Martinot, 2007). Tennessee experienced a shortage of vaccines because of delays in production and distribution. In addition, the state recorded a surge of patients at the Le Bonheur Childrens Hospital due a severe outbreak among children. These challenges require the emergency response team to develop both implicit and explicit measures to rationalize the distribution of vaccines and antiviral drugs (Coleman, 2009).

First, Influenza pandemic has the potential to overwhelm the medical system. Jhung et al. (2013) have asserted that the overutilization of the emergency department imposes an immense stress on hospital resources. Consequently, Barrios et al. (2012) have demonstrated that patients who need urgent care desperately may leave the hospital without receiving any medical attention. Health facilities and departments should develop rational patient care pathways to ensure that only deserving patients utilize the emergency services. Le Bonheur Childrens Hospital addressed the surge at the surge at the facility by redirecting patients to hospitals with low capacity. This plan would not have succeeded without efficient triaging and communication.

The development and implementation of public health education and promotion is essential to minimize the spread of pathogens. Although vaccines and antiviral offer protection, they do not provide a cure (Thomas, Dasgupta, & Martinot, 2007). The execution of public health countermeasures reduces the risk of exacerbation significantly. The emergency response team should work with the local authorities, the media, and other partners to educate the public about the modes of influenza transmission (Coleman, 2009). For example, the interdisciplinary team should distribute information fliers and pamphlets, as well as establish a call centre where people can get accurate information (Nelson et al., 2007). One of the major challenges of vaccinations is the low rates of compliance because of religious or philosophical reasons. Health education can benefit defaulters and minimize the risk of exposure (Thomas, Dasgupta, & Martinot, 2007).

Secondly, the contagious nature of pandemics may necessitate the use of restrictive measures (quarantine, travel restrictions, and social distancing). Nonetheless, these strategies raise fundamental questions regarding human rights and liberties (Barrios et al., 2012). Health authorities should communicate effectively to justify the use of quarantine and other containment strategies instead of making unilateral decisions. Thomas, Dasgupta, and Martinot (2007) have indicated that health authorities carry the legal mandate of ensuring that disease containment measures do not stigmatize or harm the affected individuals. The health authorities should ensure that the affected individuals have full access to essential goods and services to prevent human suffering (Barrios et al., 2012).

References

Barrios, L. C., Koonin, L. M., Kohl, K. S., & Cetron, M. (2012). Selecting nonpharmaceutical strategies to minimize influenza spread: The 2009 influenza A (H1N1) pandemic and beyond. Public Health Reports, 127, 565571.

Coleman, C. H. (2009). Allocating vaccines and antiviral medications during an influenza pandemic. Seton Hall Law Review, 39(4), 1111-1123.

Jhung, M. A., Epperson, S., Biggerstaff, M., Allen, D., Balish, A., Barnes, N., & Finelli, L. (2013). Outbreak of variant influenza A (H3N2v) virus in the United States. Clinical Infectious Diseases, 57, 17031712.

McCormick, L. C, Yeager, V. A., Rucks, A. C., Ginter, P. M., Hansen, S., Kazzi, Z. N., & Menachemi, N. (2009). Pandemic influenza preparedness: Bridging public health academic and practice. Public Health Representative, 124, 344349.

Nelson, C., Lurie, N., Wasserman, J., & Zakowski, S. (2007). Conceptualizing and defining public health emergency preparedness. American Journal of Public Health, 97(1), S9-S11.

Thomas, J. C., Dasgupta, N., & Martinot, A. (2007). Ethics in a pandemic: A survey of the state pandemic influenza plans. American Journal of Public Health, 97(1), S26-S31.

A review of report by Sara et al. (2012). Influenza Outbreaks at Two Correctional Facilities  Maine. Weekly, 61(13), 229-232.

This report investigated the emergence of influenza in a correctional surrounding in Maine which gave rise to severe cases of illness that led to one death, one admission at intensive care unit, and several other cases of influenza-like illness in staff members and inmates. Several reports were raised about the shortcomings of Correctional Medical Services in providing quality healthcare services to inmates and staff members. This report suggested certain measures to be implemented by correctional facilities in influenza control.

The Maine Center for Disease Control (2011) gave reports of a death case and an acute illness; both cases were connected with influenza. The Center for Disease Control (CDC) in addition, reported some cases of illnesses like influenza in inmates and staff members in two correctional facilities (facility A and facility B). CDC however, lacked basic resources and staff to effectively check the prevalence of these illnesses. The reported prevalence of multiple illnesses prompted the collaboration of the Maine Department of Corrections (DOC), Correctional Medical Services (CMS), and the Maine Center for Disease Control and Prevention (Maine CDC). The Maine DOC, CMS, and Maine CDC in collaboration carried out screenings in both inmates and staff members of both correctional facilities. Results from these screenings enhanced proper treatment and preventive measures against influenza.

Data were obtained from two correctional facilities (A and B) situated on distinct sites and operated by a single organizational structure. The collected data was obtained from an epidemiologic study on correctional facilities concerning the influenza eruption observed in the correctional facilities. The Correctional Medical Services and the Maine Department of Corrections assisted by the Maine Center for Disease Control and Prevention conducted epidemiologic research to collect the data. The data was however reported by Sara et al., (2012). Collected data was sourced from exploratory research and relevant scholarly journals. The data is quantitative.

The results demonstrated that partnership between correctional principals and public healthcare is important to subdue the challenges in controlling influenza outbreaks in correctional settings. The report also established that Correctional Medical Services did not have adequate resources and staff strength to tackle the influenza outbreak.

In the course of this report, several recommendations were made as regards influenza control. The report pointed out that correctional facilities should;

• Provide influenza vaccination to every staff member and inmate in the jails and prisons.
• Carry out enlightenment programs on respiratory etiquette and other health-related issues.
• Histories of vaccination of staff members and inmates should be documented.

Data collected in the report can be of relevance to policy development and program planning. Policy developers and program planners can learn from the report that collaboration with public healthcare can tremendously help in achieving medical goals. They can also see from the report that the provision of vaccines to its elements or members is crucial in preventing possible illnesses.

The results of the report conform to several other related types of research and share the same argument.

The study employed a good methodology in ascertaining the level of the outbreak in both facilities. The report, however, was restricted to influenza-like illnesses; it could have covered a wider range of illnesses that could breakout in correctional settings. The research is well exploratory; the findings of this report provide clear insight into the poor healthcare facility and resources of the CMS and the importance of collaboration between public health care and correctional principals. However, several limitations must be looked at in the interpretation of study results.

References

Center for Disease Control. (2011). Using antiviral medications to control influenza outbreaks in institutions. Web.

Sara R., Susan M., Stephen S., Carrie R., Peter S., & Joseph S. (2012). Influenza Outbreaks at Two Correctional Facilities  Maine. Weekly, 61(13), 229-232.

Equine influenza is a respiratory disease that is highly contagious to horses and other animals in the horse family. It is caused by numerous influenza subtypes, a virus comparable to but distinct from influenza viruses seen in other animals. Contact with sick horses and infected clothing, equipment, brushes, gear, and so on transmits the virus swiftly. When the illness strikes horses, it is known to cause considerable losses. Horses may not display the corresponding signs when affected by the disease. However, it is possible to prevent the spread of the virus by vaccinating the horses, treating the sick horses, and using any other preventive measure. The essay will discuss the effects, ways of transmission, and how to treat and prevent equine influenza.

Horses are affected by two varieties of influenza viruses that steadily circulate and produce seasonal flu waves, influenza A and influenza B with two varieties of influenza viruses that steadily circulate and produce seasonal flu waves, influenza A and influenza B. Influenza stresses the letters H and N are used to categorize viruses. Letters H and N stand for hemagglutinin and neuraminidase, correspondingly. These are both proteins on the worms external that help in the viruss raid of cells (Oladunni et al., 1657). Occasionally the bacteria exchange genetic data, acquiring original traits that human immune mechanisms have never seen before.

Equine fever is a viral infectious respiratory illness that spreads quickly among horses and has a short incubation period (1-3 days). It is transmitted by diseased horses coughing, filthy buckets, brushes, gear, and so on. Coughing horses volatilize the organism, which may spread the virus up to 150 feet and infect an entire barn in a matter of minutes (Blanco-Lobo et al., 933). Infectious horses may shed influenza for 14 days after being infected.

Finally, many horses are symptomless virus shedders, which means they are resistant and will not become sick; however, the virus may still multiply and transfer to other horses.

Because equine influenza respiratory indicators are comparable to other respiratory disorders, they cannot solely identify illness on clinical signs. The testing window is limited; the findings may be harmful if samples are analyzed very late in the diseases progression. Diagnostic testing facilities isolate viruses mostly from nose swab samples acquired from ill horses shortly after infection. Serum sample testing can also be used to make a diagnosis.

Equine influenza is a worm with severe penalties, but with proper immunization and biosecurity, supervisors may affect the outcome of infections. Shareholders, riders, handlers, and coaches can lessen the risk of sickness by succeeding the American Association of Equine Practitioners immunization recommendations (AAEP). Sticking to proper biosecurity follows, collaborating closely with the vets, and existence proactively (getting temperatures, separating horses) if they detect potential signs of illness. Working with your vet to ensure that horse(s) is on a suitable immunization regimen is critical.

Though vaccination is not a panacea, it is among the most effective existing defense against this condition. If an immunized horse becomes sick, the situation is milder, and vaccinated animals shed influenza for shorter times. A rise in events, along with an increase in horse movement, leads to epidemics of infectious illnesses such as equine influenza (Sacket al., 1185). Effective biosecurity strategies, methods to decrease pathogen spreading, and understanding of sickness symptoms are necessary safety precautions.

Finally, Equine influenza may infect both horses and humans. It is easily spread through direct contact with sick horses and can swiftly infect a significant number of horses in a single grazing area. Familiarize oneself with the approved indications of equine influenza and keep an eye out for them over the winter season. If you believe that you have the flu, have your veterinarian take suitable samples and submit them to a specialist laboratory for examination. Adequate measures and improved knowledge will help to keep this highly contagious respiratory ailment at bay.

Works Cited

Blanco-Lobo, Pilar, et al. A bivalent live-attenuated vaccine for the prevention of equine influenza virus. Viruses, vol. 11, no. 10, 2019, p. 933.

Oladunni, Fatai S., et al. Equine Influenza Virus and Vaccines. Viruses, vol. 13, no. 8, 2021, p. 1657.

Sack, Alexandra, et al. Equine Influenza virusa neglected, reemergent disease threat. Emerging infectious diseases vol.25, no. 6, 2019, p. 1185.

Description of the Pandemic

The influenza virus erupted in 1918 before it grew to be a pandemic. The causative agent was the H1N1 virus that was linked to avian descent. In the US, influenza was first diagnosed by military personnel in 1918. About one-third of the worlds population was infected with H1N1, and the death toll was estimated at over 50 million (Dolan 2). Unfortunately, San Francisco Bay Area was the first place in the US to declare social distancing following the influenza virus. Such consideration promoted historical fact-finding on how maintaining social distance slowed the transmission of H1N1. Efforts were made towards flattening the disease infection curve, which was essential in controlling influenza (Reshi 214). The federal government should adopt similar approaches to manage similar cases in the future, like the present coronavirus. However, developing a guideline to stop the H1N1 virus from being transmitted was a challenge due to limited literature and novelty.

The 1918 flu pandemic was distressing everyone with no defined path of treatment or prevention globally. It started as small outbreaks in San Francisco before spreading to other parts of California. The generally unfavorable conditions facilitated the shift from minor episodes of the virus to the epidemic. Similarly, San Francisco residents were warned of the rising influenza situation on the 10^th of October, 1918, but they placed little emphasis on the matter. Within a week, over 1600 more cases were reported, and more than 7000 at the end of the month (Dolan 4). The epidemic explosion along the Atlantic coast was expected because the conditions that facilitated its occurrence doubled. However, according to Dolan, the shift from a pandemic to an epidemic was unpredictable (8). Such anticipations explain the state-wide rise in cases of influenza.

Interventions Implemented to Address the Pandemic

The trend of influenza-related morbidity and mortality triggered fast-paced scientific research on the global public health issue. To mitigate the impact of the loss caused by influenza, the California health department set up various interventions to stop further transmission of the H1N1 virus within California, such as the use of face masks (Dolan 4). Such interventions included the rapid establishment of coordination to deliver operations, technical and strategic support to the partnerships, and channels that already existed. Most countries also scaled up their response operations and preparedness, for instance, boosting the preparedness for quick diagnosis and treatment, implementing awareness and health measures for travelers, and feasible infection control and prevention in hospitals (Dolan 6). Other interventions used were accelerating priority innovation and research towards the transparent global process to scale up and fast-track research.

Resistance, Barriers, and Challenges

The outlined intervention to curb the spread of the flu virus encountered various challenges. For instance, an antagonist group, Anti-Mask League, was created to contest the use of face masks due to potential health risks associated with prolonged use (Dolan 3). Improper commitment from the public impeded the achievement of targets aimed at combating H1N1 infection. The people have found it difficult to restrict movement or maintain face and eye protection wherever they go. Such laxity accelerated the spread of the virus in San Francisco. Mayor Breed showed concern over the November 1918 celebrations among San Francisco residents. People were allowed to remove their masks, leading to the second wave of H1N1. Improper communication between health professionals and the general public impeded fighting against influenza. For instance, the health department announced that the virus was virtually over, making people throw their masks away as they celebrate (Dolan 2). Such consideration allowed the return of public health measures to be contested.

What Could Have Been Done for Successful Intervention

Californias public health department was not successful in its advocacy to contain the H1N1 virus considering the rapid spread after implementing social distancing and face-mask interventions. A collaborative approach was required to combat the effects of the 1918 influenza virus in the population. The Mayor was not to permit the bear-faced liberation movements. Amid Californias anti-mask protest, people should have learned to wear masks in public places and observe social distancing. Public health advocacy was supposed to be helpful in California, especially in raising awareness and knowledge about the pandemic. Different people are involved, such as nurses, doctors, and other hospital staff, sharing patient information towards a modified treatment plan.

Even though they proclaimed the endemic to be virtually over, the health department could not have allowed celebrations without masks, increasing virus transmission. For instance, public gatherings of more than 50 people should have been discouraged in California. San Francisco residents needed to practice handwashing with soap and running water, avoid touching their faces, and take precautions while sneezing or coughing. People also could also avoid unnecessary movements, especially in and out of San Francisco, by imposing travel bans. Misinformation stems from knowledge gaps among Californias health department, with an inadequate understanding of the H1N1 virus and the ability to recur in the population. The health professionals needed more training and guidance on preventing the spread and eradicating the H1N1 virus.

Works Cited

Dolan, Brian. Unmasking History: Who Was Behind the Anti-Mask League Protests During the 1918 Influenza Epidemic in San Francisco? Perspectives in Medical Humanities, vol. 5, no. 19, 2020, pp. 1-23.

Reshi, Nissar. Management Strategies of COVID -19. COVID-19 Pandemic Update 2020, vol. 1, no. 5, 2020, pp. 214-221.

Introduction

The problem involves the policy surrounding flu vaccines in children under five years old and its effects in delay or refusal. Vaccine policy usually refers to a governments health strategy to manage herd immunity for its people (Jester et al., 2020). It has an advisory committee which provides information to states and assists in making an evidence-based decision on immunization mechanisms. The program is typically targeted towards specific individuals at risk as per their health vulnerabilities. One such disadvantaged group is children under the age of five years (Jester et al., 2020). The program is useful for the young generation because it reduces the spread of flues. It also offers direct protection to unvaccinated and high-risk persons. Such measures aim to eradicate or maintain the elimination of infections that can be prevented by vaccines. Furthermore, it seeks to achieve and surpass immunization coverage levels, which is globally recommended among young children.

Lack of vaccination within the specified age group under evaluation can lead to fatalities since their bodies immunity will be unprepared to combat invasions. As a result, the hospitals will be flooded with inpatients suffering from illnesses that could have been easily prevented if the right precaution had been taken. Others may equally succumb to the diseases leading to the loss of potential active members of the society shortly. However, the policy is mostly flawed and necessitates an adjustment to solve the underlying challenges. Yearly, the Center for Disease Control (CDC) issues recommendations and guidelines for the program to reduce childhood morbidity and mortality (Rizzo et al., 2018). However, some parents are hesitant to accept the advice because of such reasons as religion, medical, philosophical, or socioeconomic claims. The current government directives are flexible to accommodate the reservations of such parents or guardians. The resulting problem is the widespread non-compliance, which hinders the effectiveness of the vaccination objectives.

Policy Goal Establishment

The primary challenge affecting the policy is non-compliance from some community members; hence the solution will be a rectification of the problem. The scheme aims to encourage people to bring children under their care to go through flu vaccination. In an ideal state, every individual within the age group should gain access to the program and benefit equally. The perfect scenario will accommodate everyones varied perspectives while ensuring that the objectives of the stratagem are met. If it succeeds, then the tensions associated with the process will be eliminated since people feel that their autonomy and liberty are infringed upon.

The ethical objections and debate on mandatory vaccination protocols create multiple and interrelated dilemmas that make implementation difficult. Such concerns include contrasting family and religious beliefs and other human rights questions (Olson et al., 2020). As such, if the goal was achieved, the individual disagreement or rebellion towards the policy will be limited hence greater acceptance. Thus, it will result in a dramatic decline in child morbidity and spending on treating otherwise preventable infections. It is the desired outcome because of the fundamental roles of vaccines. They are primarily practical because they boost immunity against that particular flu and its associated symptoms, including asymptomatic carriers. Moreover, they protect individuals who have not gone through the process because of the reduced risk of exposure. Therefore, there is improved health among children under the age of five years, allowing them to survive to adulthood.

Policy Alternatives

Several alternatives can be adopted by authorities to achieve the desired goal and address the concerns. The solution generation process is focused on the individual challenges experienced or primary triggers of recalcitrance. The new scheme should make the program free and accessible to everyone that merits the age requirements. It originates from the reported claims of discriminatory action against some minority groups. The government can create incentives for private industries to manufacture the desired serums at a relatively low cost. Such means include creating tax breaks to stimulate fresh manufacturing plants and improvement of existing firms. It can equally take part in active partnership with private companies to further minimize production cost, hence making the program affordable to everyone (Savulescu et al., 2021). The approach will ensure that there is limited discriminative access in both socioeconomic and ethnic aspects.

Moreover, to tackle resistance, the alternative should focus on addressing contention issues and building a society with informed consent. Some of the beliefs that oppose the program are born from ignorance and misconceptions among people. It originates from the action of some states which provide legal representatives with a Vaccine Information Statement (VIS) with data on the general benefits and risks. The strategy hopes to help the guardians make decisions based on a scientific perspective instead of belief systems. The other means include increasing public awareness and general knowledge on inoculation. However, if the immunization is not done, numerous detrimental outcomes can happen, including childrens death. The no-change option can be considered because it will maintain the current environment.

Conclusion

The main challenge facing immunization policy for children under five years is the objection by some guardians. At this age, the children are most vulnerable because of their weak immune system. It is thus imperative to design new schemes that can solve the situation to save young lives. Alternative approaches include increasing the affordability and improving access to the serum. Additionally, the general public should be considerably informed to minimize the tensions that arise from the ethical debates. The shots are beneficial and are an excellent means of protecting the young population against severe infections.

References

Jester, B. J., Uyeki, T. M., & Jernigan, D. B. (2020). Fifty years of influenza A(H3N2) following the pandemic of 1968.American Journal of Public Health, 110(5), 669676. Web.

Olson, O., Berry, C., & Kumar, N. (2020). Addressing parental vaccine hesitancy towards childhood vaccines in the United States: A systematic literature review of communication interventions and strategies.Vaccines, 8(4), 590. Web.

Rizzo, C., Rezza, G., & Ricciardi, W. (2018). Strategies in recommending influenza vaccination in Europe and US. Human Vaccines & Immunotherapeutics, 14(3), 693698. Web.

Savulescu, J., Giubilini, A., & Danchin, M. (2021). Global ethical considerations regarding mandatory vaccination in children.The Journal of Pediatrics, 122. Web.

Influenza viruses can be categorized into three. These subtypes are named as A, B and C with A type viruses infecting humans, birds, horses, pigs and other animals. The natural hosts for these viruses are wild birds. A review of available substantiation on potential transmission of avian influenza indicates that A virus is a proofed cause of epidemic. Influenza B on the other hand are viruses found simply in humans. Studies indicate that compared to other types, influenza C viruses cause placid sickness in humans.

Influenza A viruses has various categories which are defined by the haemagglutinin (H) and neuraminidase (N) proteins existing on the virus surface. The H subcategories are epidemiologically vital, as they determine the capability of the virus to bind to and find their entry into the cells, where the virus then multiplies itself. The N subtypes on the other hand controls the discharge of new occurring virus from the cells. Research indicates that some subtypes have low capacity to cause ailment known as pathogenicity. Other subtypes have soaring pathogenicity. Human influenza A has various subtypes including H1N1, H1N2 and H3N2. These subtypes have brought a major epidemic in humans.

Avian influenza commonly known as bird flu is brought by avian influenza A viruses. It has its transmission usually taking place between birds. H5N1 a subtype of avian influenza A virus is very infectious amongst birds. In the few cases that the virus is transmitted from birds to humans, it can be a source of pneumonia, many organ failure and time and again death. According WHO, there had been over 200 cases of transmission to humans as at May 2006 accompanied by 115 deaths.

Research indicates that wild waterfowl are the usual carriers of all avian influenza A viruses. Most infected birds with the virus shows no symptoms, even when removing large amounts of infectious virus from their bodies. These highly infected birds act as carriers of the virus, and they transmit to other birds. The virus is typically passed from wild birds with low pathogenicity and then it mutates in domestic poultry.

The prevailing apprehension concerned with the HPAI H5N1 virus is that it may transform into a structure that is extremely communicable for humans and that transmits effortlessly from one person to another. Nobody will possess immunity for the epidemic because no one will have been open to it or come up with antibodies for it. For such an outbreak no prevention vaccine with assured effectiveness can be prepared in advance making it even more dangerous. Vaccines are being organized and kept in advance, hoping that they might match the epidemic strain of the virus. Research shows that a pandemic strain may exhibit distinctiveness of pathogenicity that might not be known without delay. Such alterations may possess effects for the effectiveness of control measures introduced during pre-pandemic development. Nevertheless, it is known that some proceedings, such as amplification of personal hygiene methods will cut down human-to-human conduction of the virus. This will assist in curbing or slowing the multiplication of the pandemic virus.

The type A (H1N1) virus known as the swine flu circulates and cause recurring influenza and in the past, very sporadically these viruses from swine have contaminated people. The virus is highly contagious just like the H5N1 virus. Originally, studies indicated that the virus had its origins from pigs but there is no substantiation that the present spread of virus is coming from the pigs. Avian flu and swine flu can be spread from one person to another. This happens when an infected person sneezes or coughs among non infected people. This is one striking characteristic between them. Research shows that there is strong likelihood that people may become contaminated by touching anything with flu viruses. Both influenza pandemics occurred when they emerged and got transmitted speedily across the globe mainly because there was no previous immunity against this virus in the past. This is a very common characteristic with the all influenza viruses.

H1N1 and H5N1 viruses were new virus when they emerged and little was known about them. Most people across the globe had no immunity to them. Based on evidence presented by history and scientific research, influenza pandemics can cause death of millions of people per outbreak. In both cases, there was no pandemic influenza vaccine at the beginning and there were no preparations for the virus. Characteristically, the percentage of deaths from past pandemics is estimated using statistical models and it is very high at the beginning. A more precise estimation of mortality from both pandemics was done using statistical models. The results showed that some groups of people appeared to be at higher danger of more complex or relentless infection these groups included the pregnant women, infants, and young children predominantly under age two years old.

This characteristic has not been proven for the H1N1 virus. However, lower respiratory tract (LRT) cells to which the virus attaches to are not known for humans^. It has been shown that H5N1 virus attached principally to type II pneumocytes, alveolar macrophages cells in the human LRT. This pattern was very closely seen in cat and ferret tissues. The results explain, partly, the localization and rigorousness of H5N1 virus in humans.

Studies conducted on transmission of avian influenza and swine flu indicated that both are transmitted by breathing of transferable droplets and by direct contact, and probably by indirect contact onto the upper respiratory tract or mucus membranes. The comparative effectiveness of the different routes of transmission has not been defined for both H5N1 and H1N1. H5N1 infections verification is regular with bird to human and environment to human and narrow, non persistent human to human transmission. Studies conducted in 1997 showed that disclosure to live poultry in a short time ahead of disease beginning was linked with infection in humans. However, there was no significant danger linked to eating or dressing of poultry products.

Other significant studies showed that many patients have had a past associated with direct contact with poultry for avian flu and direct contact with pigs for the swine flu. In both cases, the patients were either involved with treating a diseased animal or bird, mass culling of poultry, plucking and dressing of contaminated birds. Other studies suggested that handling infected ducks and utilization of its blood was a very strong method of infection. The incubation period of avian influenza (H5N1) is longer than that of swine flu (H1N1). Due to the survival of avian influenza (H5N1) in the environment, studies indicate that several other means of transmission are hypothetically possible.

Compared to other influenzas affecting the humans, avian flu and swine flu are potentially very dangerous. This is because very little is known about their manifestation. Avian flu exceeds other influenzas affecting the humans in terms of infection. The new viruses have also caused a lot of death and infection that are not usually viewed in influenza infections. Many deaths due to the avian and swine influenza have affected the younger people together with those who are potentially healthy. Both infections are more infectious in pregnant women, children and people with persistent lung infections.

References List

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Nicholson, RG, RF Webster & AJ Hay, Human influenza, Oxford University Press, Oxford, 1998.

Riel, VJ, ED Munster & GF Rimmelzwaan, H5N1 virus attachment to lower respiratory tract, Science Express, Chicago, 2006.

Stephenson, TR, Swine flu / H1N1:The facts, Jessica Kingsley, New York, 2009.

WHO, Avian influenza A (H5N1) in humans  interim infection control guideline for health care facilities, World Health Organization Publication, Geneva, 2006.

WHO, Infection control recommendations for avian influenza in health-care facilities, World Health Organization Publication, Geneva, 2009.

WHO, Review of latest available evidence on potential transmission of avian influenza (H5N1) through water and sewage and ways to reduce the risks to human health, Water, Sanitation Public Health and Environment, Geneva, 2006.

Introduction

The article did not give us a summary of discusses protection against influenza virus pathogenesis by pre-exposure to attenuated Bordetella pertussis. The authors rather introduce us to the history of virulent influenza which should have been dealt in the introduction page. The abstract also lacks an in-depth analysis on the attenuated Bordetella pertussis subject, and hence can not help a reader to ascertain the papers purpose. In another statement Rui et al (2010) state that Mass vaccination remains the most effective way to combat influenza (p.1). Here the article takes us back to the previous pathogenic studies that should have been mentioned in the literature review. In another analysis, Rui et al (2010) add that however, current vaccination strategies face the challenge to meet the demands in a pandemic situation (p.2). Again, the statement sounds like a conclusive analysis and does not succinctly communicate complex research ideas. In summary, an abstract should act as a patent application, where research ideas are first introduced to the reader (Wirsing 200; Tan & Skowronski 10).

Experimental Design

The information-gathering exercise did not present any variables to be measured at the end of the study. The article however did not indicate whether the study design was a controlled experiment, randomized experiments, statistical survey, natural experiment, or even an observed study. The experimental units presented here did not explain how participants were chosen.

Methods and Techniques

Research methodology did not indicate where blood samples were collected from and if any of the participants were indeed suffering from attenuated Bordetella pertussis (Weiss 37). It is evidenced that virulent influenza can have adverse effects on a persons life which could affect family and social life. Numerous studies in human and animal models have suggested that performing a test on the neonatal immune system in a mouse model is immature to effectively induce vaccine-mediated protective immunity (Wirsing et al 199; Siegrist 3332). Especially in severely influenza-induced pneumonitis, the production of Bordetella pertussis (BPZE1) response is essential to the development of the protective immunity to pertussis (Mills 1018). This is also reflected by the fact that significant amounts of BPZE1 specific are only produced after several months of vaccine-induced immunity with pertussis vaccines and can not protect the body during epidemics (Lu et al 5903).

Several studies have demonstrated the effectiveness of B. pertussis in inducing strong and long-lasting immunity as compared to vaccine-induced immunity (Wirsing et al 200). Furthermore, infections with B. pertussis induce measurable antigen-specific&these observations suggest that live vaccination administered through nasal route closely mimic natural B. pertussis and maybe the best alternatives over the currently available vaccines. There are currently many vaccination compositions to treat Bordetella infection but the immunogenic composition is not effective in treating influenza in human beings, or in cases where epidemic or rapid protective immunity is required (Wirsing 1326; Mielcarek 65).

Various types of vaccinating compositions mentioned in this article fail to address the problem of providing a vaccine or even an immunogenic composition that protects emergencies or even prior protection to newborn babies before they are of the age of six months. It is also evidenced that the production of immunogenic composition through genetic attenuation of a Bordetella strain such as B. pertussis diminishes pathogenicity while maintaining the ability to control and induce protective immunity. Here, the study fails to present inventions that would produce vaccines that induce protection after a single intranasal administration that is more superior to the protection provided by the current B. pertussis. This is yet another invention that should protect against infection with Bordetella pertussis, which was not seen after vaccine-induced immunity injection (Rui 2).

Rui and his colleagues article on B. Pertussis protection against severe influenza should present inventions that induce strong protective immunity against Bordetella infection and provide a vaccine composition that induces mucosal and systematic immunity. In another study, the present invention that induces a live attenuated Bordetella pertussis strain was given a single-dose nasal vaccine called BPZE1. Here Rui Li et al (2) argue that the BPZE1 vaccine can not only be used to vaccinate newborns but can be used to vaccinate mammals of any age in case of an epidemic. Rui et al (2010) article also state BPZE1-treated animals displayed markedly reduced lung inflammation and tissue damage, decreased neutrophil infiltration, and strong suppression of the production of major-inflammatory mediators in their bronco-alveolar fluids (p.2). Again, the research did not indicate any measurable device used to ascertain the validity of the results obtained. The data obtained to evidence remarkable improvement in lung inflammation are purely theoretical. With this regard, the research article and the outlined evidence are of no value and are viable for present application in fighting influenza.

Data Analysis

As evidenced from a summary of inventions, descriptions of preferred B. pertussis vaccines, and claims, the present inventions provide a deleted Bordetella strain. This research also provides methods of protecting mammals against diseases caused by Bordetella strain pertussis comprising administering to said mammals in need of deleted gene.

Results and Methods

Construction of B. Pertussis BPZE1 that targeted three virulence factors; TCT, PTX, and DNT should have been analyzed using an unpaired Students t-test and the Kruskal-Wallis test followed by Dunns post-test and the differences measured at a certain variable scale to test the validity of the results. TCT is responsible for destructing ciliated cells in the trachea of the infected hosts (Heiss et al 177; Goldman & Cookson 187) involved in the influenza pathogens. Rui et al (5) also state that tracheal cytotoxins are generally broken down B. products of peptidoglycan in the cell wall of Gram-negative bacteria (Cookson et al 2224). Here, B. pertussis amp alone is inefficient in breaking down peptidoglycan products. This requires the replacement of ² pertussis AmpG with E. coli amps which would produce a strain of less than 1% residual TCT activity, an analysis that was overlooked in the research (Loch 130).

PTX is evidenced to be a major virulence factor in performing systematic effects of B. pertussis composed of enzymatic active moiety known as the S1, responsible for binding target cell receptors and one of the major important protective agents that inactivate toxins. Here, Lotch (1999) states that research on Allelic exchange should be first performed by deleting the ptx operon and inserting a mutated version (p.130). It evidenced that Allelic exchange removes the dnt gene although the role of DNT in the virulence of B. Pertussis is not certain as it has been identified as an important toxin.

In vitro studies of B. Pertussis BPZE1, Lotch (1999) evidences that the genetic alterations in BPZE1 are evidenced to affect the bacterial cell wall synthesis in terms of size and growth as well as the vitro growth rate at BPZE1. However, when compared with the parental strain BPSM, the studies did not show any differences between BPZE1 and BPZE1 in bacterial shape and size as evidenced by microscopic analysis. This comparison was important in determining whether the absence of alterations in the targeted toxins affect adherence properties of S. pertussis and the attachment rates of BPZE1 and BPSM using human pulmonary epithelial cells (131).

Here, the study did not also show significant differences in the adherence capabilities of either cell.

Attenuation of B. Pertussis BPZE1

The study where Balb/C mice were constantly infected with BPZE1 and colonization monitored over some time showed BPZE1 did manage to colonize in the lungs of mice although the results consistently lacked evidence to back this analysis. Also, studies with strains deleted genes did not provide data to support this analysis. Rui et al (2010) findings further state that

where lungs were examined for histological changes, inflammatory cell recruitment of 7 days after infection were reported to be associated with strong hypertrophy of the bronchiolar epithelial cells in (BPSM) and no changes were recorded in BPZE1-infected animals as the histology of the BPZE1 of infected mice that have received PBS instead of the bacteria. The B. Pertussis-induced inflammation was monitored for two months and the results indicated that the mutations introduced into BPZE1 resulted in drastic attenuation, but allowed bacteria to colonize in the lung (5).

Statistical Analysis

The BPZE1 challenge infection did not provide any figures of the bacteria that remained in the aPV animals. Also, Watanabe (2004) stated that the difference between the BPZE1 and the PV vaccinated mice bacterial load did not indicate any statistical significance in the mouse model intranasal administration (999). The frequency of infected population with (Watanabe 999) attenuated Bordetella pertussis are largely underestimated since the infections have been increasing over the last decades possibly because pertussis vaccines have been known to provide low or completely no protection against B. pertussis. The study did not introduce controls to be used in the study hence making conclusions drawn from the experiments unreliable and inconclusive. Additionally, data analysis using statistics figures also interpreted the results unconvincing.

Conclusion and Discussion

The mechanisms of protective immunity against B. Pertussis do not prove a clear conclusive analysis we can base our future research on. This is demonstrated in unclear evidence of the role of B cells and IFN-³ demonstrated in the mouse (Mills 594). Many features of the model system employed by the study can not be considered relevant. The virus used to infect the animals is a mouse-adapted strain of the human H1N1 virus and has not been carefully analyzed in previous studies. The research in BPZE 1 also evidences that vaccine-induced immunity with pertussis vaccines and can protect the body during epidemics, but there are relatively high production costs associated with treatment. The study also demonstrated evidence of Bordetella strains and growth conditions but Ag-induced IFN ³ secretion did not correlate with the duration of the bacterial growth and the age of the infected mouse. The B. pertussis used in the study was derived from B. Pertussis BPSM (Menozzi et al 1138) provided by Dr. N. Guiso that induces significant respiratory pathology contrary to previous investigations that have dwelt entirely on utilizing strains. Although a mouse model for the evaluation of pathogenesis and immunity to influenza sheds light on the possible underlying pathology responsible for driving the illness against severe influenza, it is important to note that the basis for susceptibility to the condition is multifactorial, and is likely to be significantly influenced by both, the viral strain as well as the pathogenic bacterial used in the study.

Works Cited

Cookson Belser, Cho H-L, Herwaldt, Goldman, Wilber. Biological activities and chemical composition of purified tracheal cytotoxin of Bordetella pertussis. Infect Immun. 57 (1989) :22232229

Goldman, Walsh., Cookson, Belser. Structure and functions of the Bordetella tracheal cytotoxin. Journal of Exp Clin Med. Suppl 13 (1988): 187-191.

Heiss, Flak., Lancaster, McDaniel., & Goldman, Wilber. Nitric oxide mediates Bordetella pertussis tracheal cytotoxin damage to the respiratory epithelium. Infect Agents Dis 2 (1993): 173-177

Locht, Camille., & Antoine, Rooijen. Bordetella pertussis protein toxins. Academic Press 5 (1999):130-146

Lu, Xue., Tumpey,Telugaukula., Morken, Zaki, Cox, Natalie., & Katz. Martin. A mouse model for the evaluation of pathogenesis and immunity to influenza A (H5N1) viruses isolated from humans. J. Virol. 73 (1999):59035911.

Menozzi. Farrar., Mutombo, Renauld., Renauld, Garigliany., & Gantiez, Camelline Heparin-inhibitable lectin activity of the filamentous hemagglutinin adhesin of Bordetella pertussis. Infect lmmun 62 (1994): 769-778. 14.

Mills, Higgins. Immunity to Bordetella pertussis. Microbes Infect 3 (2001): 655-677.

Mills, Higgins., Ryan Mielcarek., & Ryan, Mahon. A murine model in which protection correlates with pertussis vaccine efficacy in children reveals complementary roles for humoral and cell-mediated immunity in protection against Bordetella pertussis. Infect lmmun 66 (1998): 594-602.

Mielcarek, Nathalie., Debrie, Sophie., Raze, Dominique., Bertout, Julie., Carine Rouanet, Amena Ben Younes, Colette Creusy, Jacquelyn Engle, Goldman, William., & Camille, Locht. Live Attenuated B. pertussis as a Single-Dose Nasal Vaccine against Whooping Cough. LoS Pathog. 2(7) (2006): 65.

Rui Li., Annabelle Lim., Meng Chee Phoon., Teluguakula Narasaraju.,Jowin, Peng Poh, Meng, Kwoon., Vincent , Chow., Camille Locht., & Sylvie Alonso. Attenuated Bordetella pertussis protects against highly pathogenic influenza A viruses by dampening the cytokine storm. American Society for Microbiology 5 (2010): 1-43

Siegrist ,Carine. Neonatal and early life vaccinology. Vaccine 19 (2001): 3331-33

Tan, Trindade., & Skowronski, Dowsky. Epidemiology of Pertussis. Pediatr Infect Dis J 24 (2005): S10-S18

Watanabe, Meng., Nagai, Mills. Whooping cough due to Bordetella parapertussis: an unresolved problem. Expert Rev Anti Infect Ther 2 (2004): 447-454.

Weiss & Goodman. Lethal infection by Bordetella pertussis mutants in the infant mouse model. Infect. Immun. 57 (1989): 3757-3764.

Wirsing von, KÌnig., Halperin, Riffelmann., & Mills, Guiso. Pertussis of adults and infants. Lancet Infect Dis 2 (2002): 744-750.

Introduction

People cannot ignore the fact that flu remains a worldwide burden that challenges human health and many social and economic aspects of life. The healthcare personnel are usually highly exposed to different respiratory pathogens due to the nature of their work. In most cases, immunization becomes a recommended preventive intervention for people of all ages, races, and genders that stops flu as shown in Figure 1 (Centers for Disease Control and Prevention, 2020). However, one should remember that vaccination may have both positive and negative outcomes, and in this presentation, the importance of the flu vaccine for healthcare providers will be discussed.

Stance

Healthcare workers have a variety of responsibilities in regard to their chosen jobs. They need to take care of patients, constantly improve their knowledge, communicate with colleagues, and promote collaboration throughout hospitals or other care facilities. When the moment to be vaccinated comes, all employees are obliged to agree. However, there are no laws and guidelines to receive this vaccine, just recommendations. Therefore, it is correct to say that healthcare staff do not need to receive the flu vaccine if they do not wish to get it.

Rationale

The reasons for not getting a flu vaccine vary, depending on personal, social, and even economic factors. Perceived risk is an opinion or belief about the vaccine, and if it is low, individuals choose specific behaviors. Besides, people deny any evident social benefits like extended financial rewards or increased self-perception. Some families may have negative memories about previous vaccination processes or inabilities to control the behaviors of other people. Finally, there are no clear rules that make vaccination an obligation because no guarantees that flu can be avoided are given.

Ethical Principles

There are four main ethical principles according to which healthcare workers must complete their tasks, namely autonomy, beneficence, non-maleficence, and justice. Each principle can be used either to support vaccination or to oppose this process:

1. Autonomy means respect for autonomous decisions, and if a person does not want to be vaccinated, it is normal to rely on this concept and prove human rights. Van Hooste and Bekaert (2019) admit that if an employee rejects vaccination, the fear of vaccines is fed. However, healthcare workers are responsible for making rational decisions, and if they do not want to do something, their choice must be respected.
2. Beneficence is a responsibility to behave for patient benefits and prevent harm. Several years ago, when no flu vaccines existed, healthcare workers were able to protect patients and help them. If simple rules of hygiene are followed (hand-washing or mask-wearing), vaccination may not be necessary.
3. Non-maleficence equals no harm to patients, like no killing, causing pain, or offending. The flu vaccine rejection has nothing to do with all these harms. Thus, it is allowed not to accept it mandatory but focus on other aspects that improve health care.
4. Justice promotes fair and appropriate treatment of healthcare workers in regard to other people. A flu vaccine is an independent decision that does not influence other peoples lives. Besides, if a healthcare provider rejects a vaccine and shares it with another person in need, it may be considered a just decision.

Theories and Evidence

Mandatory vaccination has its pros and cons, and the inability to demonstrate true attitudes toward this process results in low risk perception and other rationales for rejecting vaccines. The theory of planned behavior explains that human intention to do something is predetermined by their attitudes, subjective norms, and behavioral control (Corace et al., 2016). If those who impose vaccination neglect behavioral or normative beliefs but focus on control behaviors only, they can hardly achieve the desired outcome. At this moment, people report poor attitudes and no social benefits, which leads to rejection and negative attitudes. The risk perception attitude model proves that human actions depend on risk awareness and efficacy beliefs (Corace et al., 2016). If an employee has enough knowledge about a flu vaccine and rationally rejects it, there may be good reasons for this decision. The chosen framework supports the possibility to decline vaccination due to low risk perception. Finally, the power of presenteeism cannot be neglected because instead of being provided with time and resources to get well, many people have to continue working even with illnesses (Edmond, 2019). While this tendency exists, the effectiveness of flu vaccination is questionable. There are no grounds for specific laws and standards to introduce a flu vaccine as a safe obligation, which tells about its ambiguity.

Resolution

At the end of this presentation, three main arguments against flu vaccination help develop a resolution:

1. Healthcare staff should remember about all ethical principles to protect their rights;
2. As there are no laws and regulations concerning mandatory vaccination, a person is free to choose;
3. Until facilities face management shortages and poor behavioral control, a worth of vaccination is ambiguous.

References

Centers for Disease Control and Prevention. (2020). CDC seasonal flu vaccine effectiveness studies. CDC. Web.

Corace, K. M., Srigley, J. A., Hargadon, D. P., Yu, D., MacDonald, T. K., Fabrigar, L. R., & Garber, G. E. (2016). Using behavior change frameworks to improve healthcare worker influenza vaccination rates: A systematic review. Vaccine, 34(28), 32353242. Web.

Edmond, M. B. (2019). Mandatory flu vaccine for healthcare workers: Not worthwhile. Open Forum Infectious Diseases, 6(4).

van Hooste, W. L. C., & Bekaert, M. (2019). To be or not to be vaccinated? The ethical aspects of influenza vaccination among healthcare workers. International Journal of Environmental Research and Public Health, 16(20).

The study analyzes an article titled New Approaches for Influenza Vaccination of Healthcare Workers. Imperatively, the article focuses on the effectiveness of compulsory vaccination on healthcare workers (HWCs) as a strategy to minimize influenza infections and improve the level of vaccinations among HWCs in the United States. The article elaborates that influenza is among serious infectious diseases that have high levels of mortality. In the article, higher levels of mortality and infection transpire from the contact that HWCs have with patients. The main subject of the critique that the study highlights, is the relevance of the article in supporting the significance of mandatory influenza vaccination as a fundamental requirement among the HWCs in the United States. Furthermore, the point of view of the study is to review the effectiveness of the article in supporting seasonal influenza vaccination and its ability to minimize infections and improve service quality.

The strengths evident in the article include its comprehensive argument on the strategies that various healthcare centers employ to encourage high rates of influenza vaccination from HWCs. The article highlights that the level of responsiveness from several HWCs is not encouraging, and thus, a number of healthcare centers introduce mandatory vaccinations to increase vaccination rates and minimize infections. According to Johnson and Talbot (2011), the level of responsiveness before mandatory vaccination was discouraging, but after its introduction, the rate increased significantly. In its discussion of the current strategies used on influenza vaccination, the article highlights the crucial nature of employing the strategies and combining them with mandatory vaccination. Some of the strategies that the article lists include early detection, adherence to ethical requirements provided by the healthcare centers, and extensive campaigns, which encourage voluntary influenza vaccination.

In asserting the essence of mandatory vaccination over other strategies, the article elucidates its pronounced changes and the related success. The article uses credible and realistic sources and data to explain the success attained by the approach in encouraging responsiveness to vaccination from HWCs in the country. Additionally, the article substantiates its argument by presenting a variety of criticism and explaining the reasons pertaining to why the strategy overrides them. Mandatory vaccination is a useful strategy in minimizing the level of infections that usually occur among HWCs and patients (Orient, 2012; Palache, Tainijoki-Seyer, and Collins, 2014). Therefore, the article is practical in the study of mandatory vaccination and its importance in the support of seasonal vaccination of influenza in the HWCs working in the United States.

Conversely, the article portrays a number of weaknesses that include its overemphasis on mandatory vaccination and low coverage on the effectiveness of other strategies. From the article, it is evident that the strategy of mandatory approach is dominant. The overemphasis accorded to the concept is a weakness as it limits the significance of the article, especially on the issues relating to the challenges occasioned by the strategy. Since mandatory approach is coercive and downplays the rights of HWCs, its overemphasis in the article is a weakness that makes it less relevant to several scholars in the medical field. Moreover, the article does not provide a good coverage on other important strategies, which may be practical in encouraging vaccination, while sustaining the rights and personal orientations of HWCs. Schmidt and Brown (2012) state that a good qualitative article needs to be credible, confirmable, dependable, and transferable. However, a review of the article reveals an absence of the four elements that are critical in every sound and well-balanced discussion.

In essence, other strategies such as campaigns, educational forums, and public reporting are very instrumental in encouragement of influenza vaccination among HWCs in the country. However, the article highlights the strategies and uses a small portion to discuss their application. The use of a small portion is relative to the size used by the article in its elaboration of mandatory vaccination. According to Rebmann, Wright, Anthony, Knaup, and Peters (2012), mandatory vaccination is coercive and overrides the autonomy of HWCs in decision-making. As a result, by focusing on mandatory vaccination, the article presents itself as unbalanced and irrelevant to many scholars, who advocate for employment and use of other strategies apart from mandatory vaccination.

The article is very important in the study of seasonal influenza vaccination among HWCs in the United States. Some of the merits associated with the article include its ability to advance concise and elaborate arguments on the significance of mandatory vaccination as opposed to other strategies that healthcare centers employ in the country. Conversely, the article presents some demerits that concern its overemphasis on mandatory vaccination and failure to comply with the four elements required in a balanced and well-designed analysis. The study highlights, that the article is relevant in application of mandatory vaccination strategy to increase the rate of vaccination, reduce the level of infections, and improve service delivery in healthcare centers in the United States.

References

Johnson, J., &Talbot, T. (2011). New Approaches for Influenza Vaccination of Healthcare Workers. Nosocomial and Healthcare-Related Infections, 24, 363369.

Orient, J. (2012). Mandatory Influenza Vaccination for Medical Workers: a Critique. Journal of American Physicians and Surgeons, 17(4), 111-117.

Palache, A., Tainijoki-Seyer, J., & Collins, T. (2014). The Link between Seasonal Influenza and NCDs: Strategies for Improving Vaccination Coverage. Health, 6 (1), 2724-2735.

Rebmann, T., Wright, K., Anthony, J., Knaup, R., & Peters, E. (2012). Seasonal Influenza Vaccine Compliance among Hospital-Based and Nonhospital-Based Healthcare Workers. Infection Control and Hospital Epidemiology, 33 (3), 243-249.

Schmidt, N., & Brown, J. (2012). Evidence-Based Practice for Nurses: Appraisal and Application of Research. Massachusetts: Bartlett Learning.

Introduction

The following analysis presents the next Americas flu outbreak challenge. The influenza pandemic that was reported in the last two years shook the entire globe with many people hospitalization cases reported in the United States. Many people lost their lives to the disease, and it was estimated that more than 1,280 children died (CDC 1). As a result of this pandemic, both the leading medical professionals and public health experts will make a public gathering in Washington, DC on 21 September to educate Americans on the impact of influenza and carry out immunization campaigns. This will help in reducing flu cases during the influenza season. In an attempt to shed some light on the 2011-2012influenza outbreak, the following research presents a discussion on seasonal flu.

Overview

The toll taken by flu in every season cannot be predicted with some levels of accuracy. Therefore, medical experts and public health professions advise that people who are over six months should be vaccinated every year in order to reduce the effect of the illness.

Seasonal Influenza Outbreak

According to research findings, flu viruses cause the seasonal influenza illness. This is a respiratory disease that is contagious in nature. And, it has been statistically proven that about 5 to 20 percent of those people who reside in the United States get the influenza infection every year. This is a matter of public health concern that requires urgent medical intervention, policy formulation and implementation. Recent research findings ascertain that cases of flu season are often common in the months of January and February (CDC 1). As a matter of an urgent intervention, flu vaccine can be the best influenza protection. This will help in protecting against flu complications, which include, but not limited to dehydration and pneumonia, among others. Seasonal influenza illnesses can last for more than one week, and in certain cases the duration lasts up to two weeks.

As discussed earlier, seasonal influenza illness is transmitted from the infected person to another individual through contact. This contagious respiratory disease causes mild and severe infections. According to healthcare reports, flu has been found to cause death (CDC 1). This deadly illness is frequent in the US during the winter seasons when the temperatures are extremely cold, and the peak is usually in the months of January and February. However, there are seasonal flu cases, which have been reported during the months of October and May. The research findings of the healthcare experts and medical professionals ascertain that the seasonal flu can be spread through sneezing. In fact, coughing contributes a lot to its spread. When such germs from influenza infected person land in ones nose or mouth, he/she stands a high risk of getting the infection. Seasonal flu complications are common among various groups of people. These groups include seniors of between 65 years and above, children who are below 2 years and people who are suffering chronic health illnesses (CDC 1).

In sum, the best way to protect someone from seasonal flu outbreak infections is to keep oneself healthy by observing daily healthcare steps. Some of the common seasonal flu complications include dehydration, bacteria pneumonia, sinus and ear infection. Often, people with chronic health illnesses are mostly affected and their conditions become worse. And, as discussed earlier, those people who get seasonal flu infection can last with it for two weeks. People whose immune systems are weak and children take a long time to heal from this contagious illness.

Work Cited

Center for disease Control and Prevention (CDC). America2s Next Flu Challenge. CDC Online Newsroom, 2011. Web.