World health organization has divided influenza into six stages and three periods this is done to globally prepare people. All the phases from 1 to 6 offer a wide coverage on the process of the influenza pandemic from the time a new virus subtype is shown signs in animals to the time it spreads to infect people.
Interpandemic period: it has two phases
Phase 1: in this phase, there is no possible threat of a new virus subtype in humans globally. The risk groups such as the medical professionals receive seasonal influenza vaccination (centers for disease control and prevention, 2005).
Phase 2: as in phase 1no a new virus subtype has been deducted in humans. However, a new virus subtype is circulating in animals and is presenting a substantial risk of infection to humans (centers for disease control and prevention, 2005).
Pandemic alert period: has three phases
Phase 3: in this phase, there are few cases of isolated of people infected with a new influenza virus subtype (centers for disease control and prevention, 2005). However, the virus is noncommunicable to other humans. In this phase, emphasis is placed on preventing the spread of the virus to humans. Antiviral drugs and vaccines are researched and developed in preparation for the influenza outbreak.
Phase 4: in this phase, the outbreaks are few with cases of human-to-human transmission being very minimal mostly affecting the people who are in contact with the infected people. The virus is not widespread
Phase 5: a larger number of human beings are infected but the virus subtype is still localized found in small sections, showing that the virus is becoming increasingly adapted to humans. In this phase, the virus is not fully communicable.
Pandemic period
Phase 6: “in this phase the risk of transmission increases in the general population. There is a substantial spread and sustained transmission of the new influenza virus subtype which then develops into a pandemic virus” (centers for disease control and prevention, 2005)
Evidence based practice is vital in finding nursing solutions. It is based on empirical studies and use of available published resources to give answers to existing clinical questions. In this project, the model used is the Stetler Model. Here, the evidence based practice in the field of nursing is based on five major steps which include; the preparation stage, validation stage, comparative evaluation or decision making stage, the translation or application stage and the evaluation stage (Keele, 2011).
The preparation stage entails identifying the problem and validating the same with the available evidence. In this case, the issue at hand is the morbidity and mortality due to influenza especially among the vulnerable group. Those under observation are the elderly people above 65 years. The project is aimed at finding out whether the influenza vaccine helps in the reduction of morbidity and mortality due to the influenza infections among the vulnerable groups particularly the elderly. Research has shown that the use of the influenza vaccine is quite significant in the reduction and elimination of flu infections and mortality among the vulnerable groups (Mazurek, 2010).
The second stage is the validation stage. The stage involves the critiquing and synthesis of the empirical and non-empirical evidence using the evidence table. The evidence of low quality is left out at this stage and incase there is no evidence, the whole process stalls at this stage. Evidence has shown that there is a close link between the issuance of the influenza vaccination and reduction in morbidity and mortality due to flu. The journal entitled ‘Clinical Infectious Diseases’ shows that vaccination against influenza plays a significant role in the reduction of influenza especially among the vulnerable groups. Those who were not vaccinated against flu were prone to numerous infections and reduced performance at the workplace during the influence seasons. Those who were vaccinated were however less prone to these conditions as they were more resistant to the infection. This project is aimed at proving this hypothesis hence advocate for increased vaccination among the vulnerable groups if the hypothesis is proved right (Young, 2003).
Observed rate.
Outcome
Among vaccinated participants
Among unvaccinated participants
Those with Influenza related illnesses
16
25
Clinical visits with influenza related illnesses
4
9
Those who use antibiotics prescribed for Influenza
4
7
The third stage entails comparative evaluation and decision making. At this stage, the findings are synthesized cumulatively and decisions made concerning the evidence to be used and that which should not. In case the available evidence is invalid, one can decide to carry out individual research. In this case, the evidence found indicates that vaccinating people has much benefit as it helps in the prevention and control of morbidity and mortality due to influenza infection. The evidence shows that those who were vaccinated were much resistant to the infection as fewer cases of influenza related infections were reported in comparison to those who were not vaccinated. This shows the significance of vaccination in controlling influenza. Very few of the vaccinated needed to go for clinical check-ups or used influenza medication (Houser, 2010).
The fourth stage entails translation and application. Here, the decision is made concerning the level of application whether individual, group or if it is to be done at the organizational level. Here, the proposal is done and the implementation strategy is laid. A pilot project might be done at this stage. In this case, the evidence will be applied at group level where the participants are divided into two groups, those that are vaccinated and those that are not. They are then monitored to determine whether the vaccine is effective in the control of influenza. The final stage is the evaluation stage. The evaluation that is done at this stage is either the formative or summative. In the given case, the evaluation is aimed at proving that vaccination is critical in the control or prevention of influenza (Hammersley, 2007).
Implementation plan
This study takes place in a hospital setting. The subjects under study are the elderly patients above 65 years at mission hospital based in California. They are put into two groups, those who are vaccinated against influenza and those who are not. The two groups are then observed over some time to determine the difference between the vaccinated and non-vaccinated in relation to the influenza related illnesses. The project is supposed to take a span of two months. It is supposed to take place between the month of November and December 2012. This period is has been chosen as it is the time when flu is quite rampant among the population (Prohaska, 2012).
The first two weeks will involve getting the subjects’ names and grouping them accordingly. They are put into two groups. The third and fourth week will involve vaccination of the members of one group while the other is not vaccinated. The fifth and sixth week is for observation, recording as well at testing the participants for the influenza virus. It also entails comparing the findings with the hypothesis. The last two weeks will involve the evaluation of the findings, conclusion and the issuance of the appropriate recommendations (Louise, 2008).
For this project to be effected, there are a number of resources that are needed. For instance, two qualified nurses who would help in the training and administering of the appropriate vaccine in the right way and in the right dosage. There also needs to be the typically intramuscular influenza vaccine (flu shot), syringes, record books and pens. Two computers are needed for effective storage and analysis of the collected data. The patients under study are divided into two groups where one is vaccinated and the other left out. The two groups are then observed over time for flu related morbidity and mortality. The same is recorded and analyzed. In this case, the independent variable is the vaccination from flu while the dependent variable includes influenza related symptoms and mortality due to the infection. Influenza tests are also carried out and results recorded for evaluation and analysis. Tables and chats are drawn so as to compare the morbidity and mortality among the two groups (Overholt, 2011).
Before carrying out this research, there needs to be training on the symptoms of influenza, the type of vaccine to be used and the normal response to the vaccine. The training will help in ensuring that the right dosage for the vaccine is administered using the right methodology. In this case, data are collected in the form of writing notes and tallying particularly via observation and clinical influenza tests. The influenza related infections are observed and tests done for the subjects in the two groups. The number of deaths due to influenza is also recorded. The findings are put in tables and charts and graphs are plotted for ease in analysis and comparison (Dixon, 2001).
The facilitators are trained to ensure the vaccine is administered in the right way and findings are recorded. The adverse effects need to be noted so as to avoid confusing them with the influenza symptoms. The whole research is supposed to cost about $2500. Two computers are supposed to be purchased at a cost of $250 each. The flu shot vaccines with the syringes would cost $500. Traveling and accommodation would cost about $750for the two months period. The stationary and other minor expenses are estimated at $ 250 while the two hired professional nurses are supposed to be given an allowance of $250 each. Most of the cost is however supposed to be covered by the institute. The research is therefore cost effective. After implementation, the research findings would be analyzed and if the findings tally with the hypothesis, then the same would be presented to medical associations and the concerned government ministries and institutions so as to ensure that vaccination among the vulnerable groups is advocated for and carried out so as to control influenza. Incase the findings prove otherwise, then the same would be stopped and appropriate research done so as to find the most effective ways of controlling influenza (Williams, 2007).
Evaluation process
In this case, secondary analysis is used. Existing evidence and research findings are analyzed to prove the hypothesis that influenza vaccine is important in the control of influenza. This method is used because it is less expensive and the researcher gets a deeper insight into complex issues. Comparison, summarizing and comparison are made easier. Data are also obtained via clinical trial or experiment. One group is vaccinated and the other left out and they are observed over time. The observation and recording method has also been used. The two groups are observed over two months and the findings recorded for analysis. This is important because the researcher gets firsthand information that is not subjected to biases (Soule, 2012).
The findings are supposed to help in determining whether vaccination is significant in the control of influenza. The morbidity and mortality due to influenza are observed and recorded. If the morbidity and mortality rate is higher in the non vaccinated group, then the study will have achieved its objective by proving that vaccination is important in the control of influenza. Observations are also made on the adverse effect and whether they have any effect on the intake of the vaccine.
The findings from the two groups are tabulated in relation to the occurrence of influenza related infections in the two groups. The number of those who die due to influenza related infections is recorded and tabulated. The participants are also tested for influenza at intervals to determine whether they have caught the influenza virus or are free from it. This makes the analysis credible and reliable. The findings are also compared to other researches that have been done before hence improving its validity. The findings would be crucial while advising medical practitioners, the relevant government ministries and individuals on the importance of vaccination on control of seasonal influenza especially among the most vulnerable groups (Reed, 2011).
If the results are not positive, then the appropriate step would be to do qualitative analysis of the effectiveness of vaccination in the prevention of influenza. Existing literature on the effect of vaccine on the prevention of influenza should be reviewed. A different study will to be done on a different group and using other variables so as to get the desired results. The findings of this practice would be vital for future research as they would form a basis for further research. This would act as secondary data for those who carry our research relating to this topic.
References
Dixon, M. (2001). Practical Guide to Primary Care Groups and Trusts. New York: Radcliffe Publishing.
Hammersley, M. (2007). Educational research and evidence-based practice. New York: SAGE.
Houser, J. (2010). Evidence-Based Practice. New York: Jones & Bartlett Publishers.
Keele, R. (2011). Nursing Research and Evidence-based Practice: Ten Steps to Success. Delhi: Jones & Bartlett Publishers.
Louise, M. (2008). Introduction to Public Health. Seydney: Elsevier.
Mazurek, B. (2010). Evidence-Based Practice in Nursing & Healthcare. London: Lippincott Williams & Wilkins.
Overholt, E. (2011). Evidence-Based Practice in Nursing & Healthcare. London: Lippincott Williams & Wilkins.
Prohaska, T. (2012). Public Health for an Aging Society. Maryland : JHU Press.
Reed, P. (2011). Nursing Knowledge and Theory Innovation. New York: Springer Publishing Company.
Soule, B. (2012). Best Practices in Infection Prevention and Control. London: Joint Commission Resources.
Williams, M. (2007). Comprehensive Hospital Medicine: An Evidence-Based And Systems Approach. Seydney: Elsevier.
Young, D. (2003). Fundamentals of Nursing Research,. London: Jones & Bartlett.
The spread of influenza is a major cause of mortality and morbidity throughout the world. Influenza vaccine is an effective treatment to prevent the vulnerability of the disease. This paper presents what is influenza vaccine is, its use, the benefits of the influenza vaccine, and the risk factors due to the vaccination.
Influenza Vaccine
The first incidence of influenza was reported in the 16th century and the etiological causes of influenza were discovered in 1933. The various flu pandemic in history is Asiatic flu, Spanish flu, Asian flu, Hong Kong flu, swine flu, etc. “Vaccination is the process of administering weakened or dead pathogens to a healthy person or animal, with the intent of conferring immunity against a targeted form of a related disease agent.” (Science reference, 2009, Vaccination, para.1).
Influenza vaccination is an effective method in the prevention and eradication of the influenza virus that causes these various flues. Some people have a higher risk of infecting influenza and the people who are supposed to take vaccine each year are children whose age is from 6 months to 18 years, children who have a high risk of severe diseases, and the caregivers of the people who are affected by influenza. Some people must get vaccination each year. They are those who are above 50 years old, those who have chronic lung and heart illness, those who suffer from sickle cell anemia, caregivers of patients who are affected by these diseases, those who have low immunity power, and pregnant women. Around 36,000 people die in the United States due to influenza per year and most of them are old people. The researchers have framed some approaches to mitigate the death rate of old people due to influenza. The different approaches are: make sure that all the old people are getting a vaccination, provide vaccination identifying the riskiest old people, and use antiviral drugs more aggressively among the old people.
Benefits of influenza vaccination
Influenza is a major cause of morbidity and mortality throughout the world and vaccination against influenza brings more benefits to people. Infection of influenza causes people to spend more cost on health care and low level of productivity. But vaccination helps people to reduce health care costs and helps not to lessen productivity. People are protected from the flues after two weeks of vaccination. There are five benefits of vaccination. They are “it reduces the number of episodes of upper respiratory illness by 25 – 34%; it reduces days of sick leave from work due to upper respiratory illness by 32 – 43%; it reduces work absenteeism due to illness by 36%; it reduces physician office visits for upper respiratory illness by 34 – 44%; it reduces antibiotic use for influenza-associated illnesses by 25%.” (Economical benefits of influenza vaccination, 2009, Five reasons to provide influenza vaccination, para.1).
Vaccination is an effective treatment to prevent the pandemic of influenza and it manages to prevent 70 to 90 percent influenza incidence among healthier people who are below 65 years old. “In addition among healthy working adults, influenza vaccination reduces episodes of upper respiratory or influenza-like illnesses from all causes by 25 – 34%, associated work loss by 32 – 43%, physician visits by 34 – 44%, and antibiotic use for influenza-associated illnesses by 25%.” (Clinical benefits of influenza vaccination, 2009, Healthy adults aged <65 years, para.1). Among children, whose age is from 1 to 15, vaccination is successful to prevent influenza-related respiratory diseases and also it helps in the prevention of secondary infections such as infection from the family members, atmosphere, etc. Recent studies indicate that vaccine does not affect pregnant women causing any damage to the fetus and making any harm to the reproductive health of the women.
Risks and Side effects
Most of the people who receive vaccination have no side effects other than small pain at the site of injection and low fever for some days. There is a chance of showing allergic reactions in some people who get the vaccination. Swine flu vaccine used in 1971 had shown Guillain-Barre syndrome among children but this incident is rare among adults. Some people are restricted from receiving the vaccine due to their health conditions. They are people who have a strong allergic reaction whenever they take chicken and egg protein, those who have severe fever or disease, people who have experienced a strong allergic reaction in the previous influenza vaccination, and people who had been paralyzed because of the Guillain-Barre syndrome which is an auto-immune disease that affects the peripheral nervous system. Injection of vaccination may affect mild fever, small pain, swelling, redness, and soreness around the part of the body where the vaccine is injected. Children who have been injected with the vaccine have often experienced severe headaches, muscle pain, vomiting, pain in the stomach, running nose, cough, etc. “The steady escalation in the number of vaccines administered has been followed by an identical rise in the incidence of auto-immune diseases (rheumatoid arthritis, subacute lupus erythematosus, psoriasis, multiple sclerosis, asthma) seen in children. While there is a genetic transmission of some of these diseases, many are probably due to the injury from foreign protein particles, mercury, aluminum, formaldehyde, and other toxic agents injected in vaccines.” (Doubleday, 2001, Other dangerous from vaccines, para.4). Though there was no incidence of swine flu, the use of swine flu vaccine among American farmers was reported and they hesitated to take the vaccine since it killed several animals. After a few months of vaccination among human beings, cases of serious nerve injuries were reported.
Conclusion
This paper presents the various perspectives on the influenza vaccination such as what is the influenza vaccine, what are the benefits out of taking the influenza vaccine, and what are the risk factors due to the injection of influenza vaccination.
Reference List
Clinical benefits of influenza vaccination: Healthy adults aged <65 years. (2009). Solvay- Influenza.com. Web.
Economical benefits of influenza vaccination: Healthy adults younger than 65 years: Five reasons to provide influenza vaccination. (2009). Solvay- Influenza.com. Web.
The frequent re-emergence and fast spread of diseases across the world is a serious issue of concern among health practitioners. As such, the epidemiological approach is gaining interest among scientists. Epidemiological studies as depicted in an article by Kelland revealed that H7N9 bird flu is a fast spreading and evolving disease that requires special attention given its potential high risk of human pandemic. Besides, every disease has got a natural history which needs to be well understood.
Epidemiology
Unlike the conventional approaches in the medical field, which concentrate more on the study of disease processes in affected persons with the aim of finding a cure for the disease, epidemiology focuses on finding the reason why individuals are infected by a disease and how the frequency of the disease can be reduced (Ray, 2010). Epidemiological approach is anchored on the belief that the frequency at which a disease occurs in a population depends on an interaction of different factors and determinants and that possible manipulation of the interacting factors and determinants can reduce disease frequency (Ray, 2010). The approach’s ultimate goal is to connect the outcomes with the predictors and provide clues as to possible causes of the outcome by examining various factors that are associated with the disease.
Kate Kelland wrote an article in Routers on bird flu in which he puts together views from different scientists. Kelland (2013) focuses on the population of China, specifically on the deaths caused by bird flu. The article reviewed specific investigations on the possible transmission of the virus from person to person. This was advised by the case which was reported in a person that did not report any contact with poultry.
From the findings of his article, H7N9 bird flu is a disease that Chinese people need to be wary of given its contagious ability. Findings from different researchers presented in Kelland’s article confirms that the disease is not only capable of jumping between people but is also evolving into new strains hence poses a high risk of human pandemic. Kelland concludes by calling for hygiene campaigns and the closure of live poultry markets to curb the spread of the disease.
The natural History of the Avian Influenza
Avian influenza (H5N1) is a viral disease of the birds and rarely infects humans. The first known infection of H5N1 in humans was recorded in Hong Kong, China in 1996 (Sonnberg, Webby and Webster, 2013). Its widespread re-emergence about a decade ago posed a great threat to global public health as it quickly spread to parts of Europe, Africa and Asia (Sonnberg, Webby and Webster, 2013). The disease has since then become of great importance due to its economic implications and potential threat to public health given its high fatality rate. The avian influenza is not well understood since it is still an emerging disease.
The major predisposing factors associated with infections of the H5N1 in humans is exposure to infected poultry, whether dead or alive, as well as exposure to contaminated surfaces, more so in and around poultry houses (Sonnberg, Webby and Webster, 2013). However, there has been suspicion on consumption of raw or undercooked poultry as a risk factor, but no link has been established so far.
The incubation period of the H5N1 virus is considered to range from eight to seventeen days. The disease, in its initial stages, presents flue like symptoms including fever, diarrhea, chest pains and abdominal pains (Sonnberg, Webby and Webster, 2013). The symptoms, however, progress rapidly and by the fifth day patients mostly present severe respiratory distress and bleeding from nose and gum.
Currently, vaccines are being used to prevent the disease in high risk areas. The symptoms are however very severe in humans, and require very urgent attention whenever a person is exposed. Failure to check and control the infection at an early stage often leads to fatalities.
References
Kelland, K. (2013). New china H7N9 bird flu cases ‘signal potential winter epidemic.’ Routers. Web.
Ray, M.M. (2010). Introduction to epidemiology. London: Jones and Bartlett Learning.
The N1H1 virus also called the swine influenza is a disease of the respiratory system that has its cause in infection by type influenza, which affects pigs and is a frequent occurrence in humans (Siegel, 2009). As much as the virus is not common to humans, there have been sporadic cases of infection by the pN1H1 virus with most of such cases occurring in persons that have direct contact with pigs. Some of the most recent outbreaks of this type of influenza have occurred in Asia, which has raised a concern about the possibilities of a human-human mode of infection. Swine influenza spreads just like any other type of influenza; through liquid droplets, which get airborne as a result of sneezing or coughing. Another mode of infection could be touching places that have the live virus and then touching the nose, mouth, and eyes (Smith et al., 2009). The first case of the pandemic of Influenza A in America happened in 2009 after the initial identification of the traits of the disease in a 10-year-old child who came from California (Jhung, 2011).
The article described the epidemiology of the disease following the 2009 outbreak in the US. The researchers of the case used methods of research in writing their findings. The authors conducted their research using secondary data, which was an extraction of statistics from the CDC (Hesse-Biber, 2010). However, there is an element of the use of primary data in the report especially concerning the developmental stages of the virus. Most of the data that they collected concerned the use rates of infection and the effects of the disease. As such, the data provided useful information concerning the worst affected regions of the country and their levels of prevalence. Another method that gave the findings used in writing the article involved laboratory experimentations, which presented information concerning the stages of development of the disease. The experiments were made possible by the data collected from the first cases of infection, which were also a part of the primary methods (Hesse-Biber, 2010).
The research used statistics of the geographical as well as temporal disease patterns that related to the epidemic. This type of statistics gave findings concerning the regions of the country that had the highest levels of infection of the virus and the patterns of disease (Jhung, 2011). The research also considered the features of pH1N1 virus attacks, which were the basis of the countermeasures that the CDC and the government used it. There were also statistics concerning the extreme cases that resulted in the hospitalization of patients, deaths, and the effects of the disease on pregnancies. Finally, the statistics used in the report also concerned the approximated overall burden of the infection.
The findings of the research were broad-based considering that they delivered conclusions of a number of facts that concerned both the 2009 epidemic and the nature of the virus. First, the findings indicated that the pandemic happened in two separate waves, which varied from the standard pattern of the virus season. The virus had a limited effect on persons of 65 and above years, which made the overall rates of household attacks and the disease burden to be lower than the assumptions held during planning. Therefore, the 2009 pandemic indicated that there were sparing health complications on older adults and severe effects on the children. Prior attacks and seasonal influenza had most of their deaths (90%) of the hospitalized cases in people older than 65 years (Jhung 2011). The findings of the research gave valuable information on the need for preparedness for the epidemic because of the unpredictable patterns of the outbreak.
In collusion, the research provided useful information that could be used in increasing the levels of preparedness for the possible outbreaks of the pH1N1 virus. The writing of the report utilized data from both primary and secondary sources with statistics concerning four elements of the case. First, the geographical as well as temporal disease patterns, and then the features of pH1N1 virus attacks, the severity of the infection, and the overall disease pattern. There were two significant findings of the research, the first, indicated that the epidemic happened in two waves that were different from prior infections. The second finding of the study was that the disease was less severe to people above the age of 65 than it had on children and younger adults.
References
Hesse-Biber, S. N. (2010). Mixed methods research: Merging theory with practice. Guilford Press.
Jhung, M. A., Swerdlow, D., Olsen, S. J., Jernigan, D., Biggerstaff, M., Kamimoto, L., & Finelli, L. (2011). Epidemiology of 2009 pandemic influenza A (H1N1) in the United States. Clinical Infectious Diseases, 52(suppl 1), S13-S26.
Siegel, M. (2009). Swine flu: The new pandemic. New York: John Wiley & Sons.
Smith, G. J., Vijaykrishna, D., Bahl, J., Lycett, S. J., Worobey, M., Pybus, O. G., & Rambaut, A. (2009). Origins and evolutionary genomics of the 2009 swine-origin H1N1 influenza A epidemic.Nature, 459(7250), 1122-1125.
Influenza is one disease that is of significant public health concern in the United States. Consequently, a lot of information on the disease is available on local, state and national websites. These sites provide information on the condition including how to take care of patients affected. Relevant local, state, and national websites were assessed to determine the Hawaiian Influenza status. A table on the content of these websites was created. This essay describes and summarizes the findings of the national, state, and local government on their coverage of influenza.
Information Overlap
The websites selected had significant information overlap. These websites discussed influenza and provided information to any individual that opened the pages. First, all the three websites defined the condition, including making a description of the epidemiological characteristics of this disease. The local website made a thorough description of the health condition and the different ways that people may be affected (‘Flu Epidemic Hits Hawaii?’ 2015). On the other hand, the state website made a less detailed description of influenza (‘Hawaii State Department of Health’, 2015). The national website provided the most detailed description of the condition (Hawaii, 2015).
The three websites selected discussed the prevalence of influenza in the State of Hawaii. This description was the other overlap in the website content. In addition, the three websites contained information on the areas that are more affected and the measures in place to prevent the spread of the disease in the event of an epidemic. Aside from the provision of data on the prevalence of the condition, the other overlap in the information provided was the available medical interventions such as medicines and vaccinations (‘Flu Epidemic Hits Hawaii?’ 2015). These websites contained information on the influenza vaccine development that is taking place in the country.
Structure between Levels of Governments
The three levels have functional overlap as indicated. However, each level has a defined function. The local level is involved in the monitoring of individuals in the society and ensuring that a diagnosis of the condition is made before it spreads to another area. The state level of the disease prevention formulates policies aimed at keeping the disease in check (‘Hawaii State Department of Health’, 2015). The state website provides information that is useful in the assessment of the impact of influenza on the region. On the other hand, the national website indicates that this level of disease prevention mainly focuses on policy implementation and financing of programs aimed at primary prevention (‘Hawaii’, 2015).
Functions of Each Level
The three levels of the control of influenza are evident in the structure of the websites and their content. The local level of influenza control serves to monitor the presence of the condition in the community. Individuals working at this level have direct contact with the vulnerable population and the affected patients. On the other hand, the state is involved in the monitoring of the general health of the population and ensuring that the nation is free of the disease. State policies are focused on preventing the disease and ensuring that the population is not affected (‘Hawaii State Department of Health’, 2015). Hawaii’s government has the role of preventing the entry of sick patients undetected. The national government formulates policies that affect the control of the condition. These policies include the preparedness for future epidemics and funding (‘Hawaii’, 2015).
The local health agency website indicates that this level of disease prevention is involved in the dissemination of information to patients and the healthcare providers (‘Flu Epidemic Hits Hawaii?’ 2015). This information is important in the event of suspected cases such as those in Hawaii. On the other hand, the state agencies provide surveillance on the condition and map out the areas affected (‘Hawaii State Department of Health’, 2015). This level also provides the necessary information for the prevention of the condition. The national level of influenza monitoring and control indicated by the website also serves to prevent the spread of influenza and provide information on the condition.
Working Together
Despite the different levels of prevention of influenza being evident, local, state, and national departments work together on different parts of the prevention program. First, these levels work together in the monitoring of this health condition. The local authorities and agencies collect information on the patients and forward it to the state agencies and the national organizations. The information is used to plan and influence the existing health policies.
There is collaboration between the three levels of influenza prevention in Hawaii. While the national health agencies monitor the condition in other parts of the world, the state agencies prepare for any cases that may develop. In addition, the local health agencies in Hawaii actively participate in the management of suspected patients and enforcing national and state policies on influenza (‘Hawaii State Department of Health’, 2015). Therefore, these levels collaborate in the prevention of any epidemic and ensuring that the nation stays free of influenza. Public and community health may be defined as the maintenance of wellbeing of a society or community. Public health focuses on the prevention of diseases in the community.
References
Flu Epidemic Hits Hawaii? (2015). Web.
Hawaii State Department of Health Disease Outbreak Control Division: Influenza Surveillance Report. (2015). Web.
Influenza has been a major cause of death among the general population and vaccination has been vital in the prevention of flu related illnesses. Various studies have been carried out to determine whether the administration of the influenza vaccine affects the mortality rate of patients who die of flu related complications. Different researchers have used different methodology and variables in such studies. According to Beyer different research techniques consider different variables hence making comparison of the outcome difficult (Beyer, 2006). Another factor that poses a challenge is the fact that influence is defined differently by different people.
The research methods used in this case include the case studies. In this particular case, the criterion for the subject to be included in the study is for one to be above 65 years. The research methodologies used in this case include qualitative and quantitative research techniques. In the qualitative research technique, the study utilizes secondary data from the various studies that have been carried out to determine the significance of vaccination in the prevention of influenza (Halloran, 1997).
In this study terms like ‘side effects have been avoided and instead, there is the use ‘adverse event,’ ‘normal response’ and ‘chance happening,’ so as to avoid the misconception that the vaccination might harm the users hence negatively influencing the uptake of such vaccines. The other keywords used in this study include efficacy and efficiency where the former refers to the effect of the intervention on the study while the former refers to the effect that the intervention has on the given clinical situation.
By employing the qualitative research technique, reports and reviews have been used, for instance, the review on immunity to flu which tries to explain the reason as to why the influenza virus is transmitted and the precautions that should be taken before the distribution of the vaccine so as to restraint the virus from being transmitted.
The quantitative technique has also been used. The study focused on a subject that encompasses people above 65 years. The techniques used have various strengths and limitations. For the qualitative method, a person can get new insight and a better understanding of a given phenomenon and in this case, it entails the effect of vaccination on reducing the mortality rate due to flu infections. It enables a person to provide a detailed description of the phenomenon which might otherwise be complex. The qualitative method is usually done in the phenomena’s natural habitat hence producing more realistic results, unlike other techniques that might be done in the laboratories.
This method is holistic, unlike the quantitative method where the population is subdivided into groups that might not represent the phenomenon under study (Basu, 2005). In this case, the subjects are studied without restrictions or manipulation so as to produce certain results. This method is non-intrusive hence giving room for subjects that cannot be studied using the quantitative method to be studied without intrusion. It has limitations too as it relies on already researched data and may be biased depending on the researcher’s findings. The population under study is usually uncontrolled and the results found might be influenced by other factors that the researcher might not be aware of. It is also not easy to find replicated results (Carrat, 2007).
Another method used in this study is the quantitative technique. The subject under study is usually restricted and controlled hence the aspect of confounding variables is minimized. It becomes easier to replicate the results. The use of random methods ensures objectivity as different samples are used and it is easier to identify a cause and effect relationship. The method gives exact measurements and it becomes easier to make inferences and evaluations of the phenomenon under study. The method has limitations too, for instance, the research is mostly carried out in a laboratory setting hence the difficulty in applying the findings in the real world. The subject of study is usually controlled and can be manipulated to achieve particular results. The main focus is on trends and norms rather than individual differences. Confound variables are present in spite of the subject being controlled (Debnath, 2009).
Internal validity is of great significance in this case. Here dependent variables are usually affected by alterations in independent variables. In this case, it is how much the mortality rate caused by flu is depended on the vaccination. This validity might however be affected by other factors like the history of the vaccine intake and changing the subject under study. There is a need to shield the subject from external influences. There is also the aspect of external validity which entails the aspect of the experimental results to apply in a general setting or across all the groups. In this case, the study is done on people above 65 years and its results should be applicable to people of various age groups in various settings s well as historical backgrounds across the population. Internal validity is therefore important in enhancing external validity (Chen, 2008).
Solution Description
This project targets people above 65 years to determine whether the use of the influenza vaccine has effects on the mortality rate for people who die of influenza. Two groups are studied in relation to the mortality rate due to the influenza-related infection among those who had been vaccinated and those to whom the vaccine had not been administered. The time frame for this study is between November and December 2012.
The intervention, in this case, involved grouping the subject under study into two groups. The vaccine is then administered to one group while the other is left out over a period in which these two groups are prone to influenza infections. The mortality rate for the members of these groups is then determined by recording the members who succumb to influenza-related infections. This is aimed at noting the effectiveness of the influenza vaccine in preventing influenza infection as well as reducing the deaths that are caused by this infection (Truax, 2007). The study is to be carried out between the month of November and October 2012 (Thresyamma, 2005).
This intervention is realistic as it is not expensive and complicated. The proposed solution is in line with the organizational culture as it entails the administering of the vaccine to a particular group which is a clinical requirement in the fight against influenza (Wagner, 2009). The vaccine is administered at this particular period so as to determine whether the annual vaccination of the given population might help in the reduction of influenza-related deaths. The community is usually encouraged to go for free or vaccination so as to prevent the spread of contagious illnesses particularly among the most vulnerable group and this study would come in handy in the aiding of the same. According to this research, it is expected that the number of those who die or are infected with influenza would be more for those who were not vaccinated against the disease in comparison to those to whom the vaccine was administered (White, 2004).
In this case, the 65-year-old people are divided into two groups. One group is vaccinated against the influenza virus and the other is not. They are then observed and the mortality rate among the two groups in relation to the infection is determined. In this case, some of the assumptions made are that the groups are prone to only one strain of the virus. It is also assumed that the results obtained can be replicated across the whole population irrespective of age, setting or historical background. It is also assumed that the vaccination used can be effective against all the strains of the influenza viruses that the population might be prone to (Brooker, 2007). The study is particularly restricted to a particular group for instance the elderly. The reality of the matter is that the virus does not target just one group as it might be in the case of herd vaccinations hence posing a challenge to the findings of such studies (Lugton, 2005).
This research is meant to ensure that the influenza vaccine is administered to the most vulnerable group so as to prevent the spread of the influenza virus and reduce the mortality rate due to its infection among this group. It will also improve patient-centered quality care, improve efficiency while administering the vaccination as it will be carried out annually particularly during the season when the infections are more and the right population would be targeted. The right vaccination will also be used while vaccinating people hence ensuring that the disease is put under control no matter the environmental changes or setting (Keegan, 2008). The medical community would also put more efforts in ensuring efficiency in the administration of the vaccination.
References
Basu, R. (2005). Total Operations Solutions. Oxford : Oxford University Press.
Beyer, W. (2006). Heterogeneity of case definitions used in vaccine effectiveness studies – and its impact on meta-analysis. Vaccine , 24, 6602.
Brooker, C. (2007). Foundations of Nursing Practice: Fundamentals of Holistic Care. New York: Elsevier Health Science.
Carrat, F. (2007). Influenza vaccine: the challenge of antigenic drift. Vaccine , 25.
Chen, R. (2008). Vaccine adverse events: causal or coincidental. Lancet , 611.
Debnath, R. (2009). Professional Skills in Nursing. New York City: SAGE.
Halloran, M. (1997). Study designs for evaluating different efficacy and effectiveness aspects of vaccines. Epidemiol , 789–803.
Keegan, L. (2008). Holistic Nursing: A Handbook for Practice. New Delhi: Jones & Bartlett Publishers.
Lugton, J. (2005). Palliative Care: The Nursing Role. New York: Elsevier Health Sciences.
Thresyamma, J. (2005). Fundamentals of Nursing. New Delhi: Jaypee Brothers Publishers.
Truax, D. (2007). The Nurse Practitioner in Long-Term Care: Guidelines for Clinical Practice. Longhorn : London.
Wagner, B. (2009). Modeling influenza epidemics and pandemics: insights into the future of swine flu. BMC Med , 7, 30.
White, L. (2004). Foundations Of Basic Nursing. Singapore: Cengage Learning.
Statins are a group of 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitors with anti-inflammatory and immunomodulatory effects that might control the host immune response to pandemic influenza virus infection. This class of drugs lowers cholesterol levels in people at the risk of cardiovascular diseases by inhibiting the enzyme HMG-CoA reductase (Fedson, 2006). This inhibition in the liver results in decreased cholesterol synthesis and also of the LDL (low-density lipoprotein) receptors which in turn lead to increased clearance of LDL from the bloodstream. In a case-control study by van de Garde and colleagues, they showed that there was a 50% decrease in pneumonia hospital admissions in diabetic patients administered with statins. Statins are divided into two categories: fermentation-derived and synthetic-derived (Fedson and Dunhill, 2006).
Fermentation statins are extracted from the process of oxidation of organic compounds using an ingenious electron acceptor, which is usually an organic compound. Examples of fermentation-derived statins are Lovastatin, Pravastatin and Simvastatin. Synthetically derived statins are prepared in the laboratory by purposeful execution of chemical reactions. Examples of synthetic statins are Atorvastatin, Cerivastatin, fluvastatin, pitavastatin and Rosuvastatin.
Influenza, also known as flu, is an infectious disease caused by RNA (ribonucleic acid) viruses of the Orthimyxoviridae family that affects mammals and birds. It is transmitted through the air by sneezes, coughs; through bird droppings; contact with infected body fluids such as saliva, feces, blood and nasal secretions; and contact with contaminated surfaces. Sunlight, disinfectants and detergent such as soaps inactivate influenza viruses that is why frequent hand washing reduces the risk of infection. It spreads through seasonal epidemics around the world that leave hundreds of people dead and the appearance of new strains (Fedson and Dunhill 2007).
For instance, in April 2007, a strain named ‘swine flu’ combining genes from pigs. Humans and bird flu evolved in Mexico, United States and has spread in many countries in every continent leading to the declaration by World Health Organization as an epidemic. Symptoms of flu include chills, fever, headache, coughs, sore throat, muscle pains and general discomfort. There are three types of influenza: influenza A which has one species and aquatic birds as natural hosts these include HINI, H2N2, H3N3, H5N1, H7N7, H1N2 and others; influenza B genus with one species and Almost exclusively infects humans; and influenza C which infects dogs, humans and pigs and cause severe illnesses and local epidemics.
Why statins?
In influenza pandemics, adequate supplies of affordable vaccines and antiviral agents are required and which are unavailable to most people in the world especially to the third world (Basler, 2007). I. Adequate supplies will also be a challenge due to concerns of antiviral resistance which will discourage stockpiling. This is the reason effective alternatives are explored such as generic agents that target the host immune response and pandemic virus are being explored.
Studies suggest that statins improve outcomes in pneumonia and bacteremia might be effective against influenza have conducted. These are informed by observations made on severe infections caused by type A H5N1, the 1918 Spanish influenza H1N1 and seasonal influenza A viruses which showed increased levels of several cytokines and chemokines, a response called ‘cytokine storm’. In 2005 Kruger et al carried out a retrospective cohort research that showed a significant survival benefit in bacteremia patients on statin therapy. However, doubts have been raised about the use of statins in the treatment of influenza although it has potential benefits.
One such study by de jong and colleagues (2006) presented details on virological findings on 18 patients with H5N1 and compared with the 8 people with seasonal influenza those with the H5N1 had higher serum cytokine and chemokine levels and high viral load in pharyngeal secretions and therefore the study concluded that the focus of clinical management should be on preventing the intense cytokine response by early diagnosis and effective treatment. This is because all 18 patients sought treatment at an average of 6 days after onset of symptoms.
Interest in immunomodulatory and anti-inflammatory agents for pandemic control focuses on statins, at least initially. Laboratory and clinical research by cardiovascular experts show that statins have high anti-inflammatory and immunomodulatory (pleiotropic) effects (Kruger et al, 2006). These emanate from statins’ modification of intracellular signaling cascades that cause multiplication of effects. This phenomenon is likened to ‘reducing the heat under a boiling kettle’. Heart failure progression can not be prevented only slowed down with therapies. Studies show that the use of statins in patients with coronary diseases prevents the subsequent attack of congestive heart failure( Anorld and Koning, 2006).
The hypothesis has been put forward that inhibition of HMGCoA reductase reduces cholesterol level and reduces the synthesis of mevalonate-derived molecules this way, downregulating cytokines and chemokines production activated in patients with heart failure. However, it has been suggested that cholesterol can be beneficial to heart failure patients in that cholesterol rich-lipoprotein can bind and detoxify bacterial lipopolysaccharide(LPS) which is highly produced in heart failure patients.
This shows two conflicting effects of statins. Van de Garde and colleagues found that in a case-control study, recent prescriptions for statins reduced hospital admissions by 50% in diabetic patients. In another study by Schlienger and co-workers, they showed that in a 30 days current prescription of statins the results were a 53% decrease of pneumonia 30 days mortality. In a different study, Majumdar and colleagues found that there were no beneficial effects of statins prescription and attributed the said benefits found in other studies to ‘healthy user effect’.
PPAR Agonist
Peroxisome proliferator-activated receptor (PPAR) is a fibrate gemfibrozil family of drugs that have been produced as generics in the developing world. PPAR Agonists have anti-inflammatory and immunomodulatory activities, which makes them potential treatment agents agonist influenza. In an experimental study with mice infected with H2N2 and treated with PPAR agonist mortality reduced significantly with 52%of control mice compared to 26% of those treated (Stacy, 2004). However, the study did not include the possible effects of treatment on virus replication or dissemination. Studies have also failed to show the direct antiviral effect of PPAR Agonist although it affects several intracellular pathways crucial for influenza viral replication and also they act synergistically to affect some of the pathways.
Combination therapy of PPAR agonists and statins in patients of diabetes mellitus and cardiovascular diseases show addiction. It is, however, safe and well-tolerated for a prolonged therapy of fibrates in adults which leads to the conclusion that short-term acute treatment of influenza would be acceptable if effective. Experimental studies so far are yet to show that treating H5N1 or the 1918 influenza H1N1 virus infections with antiinflammatory and the immunomodulatory agent is beneficial (Ooi et al, 2004). PPAR agonist findings of reduced mortality in influenza H2N2 in infected mice are of great significance. This indicates that improved outcomes of severe influenza virus infection could be done by modifying cell signaling. With an agent that is antiviral.
Clinical Implications
Large-scale clinical trials of lipid-lowering statins have led to a revolution in the management of atherosclerosis. Moreover, statins influence other cellular pathways that involve inflammatory, oxidative and thrombotic processes. The effects which beneficially modify the anthropogenic process are associated with the success of the trial (Kramer, 2005). Currently, the clinical benefits of statin therapy emanate from the lowering mechanism of low-density lipoprotein and will remain the focus of risk reduction approaches in clinical practice.
In the trials on statin therapy, beneficial effects have been demonstrated on rates of cardiovascular events and three statin lovastatin, pravastatin, and simvastatin were used in trials have shown beneficial effects on myocardial, stroke, revascularizations and mortality ( Mortenson et al 2006). Mortenson et al continue to say that community-acquired pneumonia and COPD patients can be protected with statins.
Future study recommendations
Future areas of study should focus on finding an agent with no anti-racial activity that would effectively modify steps in cell signaling. This agent would target the host’s response without attacking the virus (Peiris, 2007). Studies should also focus on identifying effective, inexpensive and universally available, one or more effective antiinflammatory and immunomodulatory agents (Majamdar, 2007).
Studies should also focus on how much low-density lipoprotein cholesterol should be lowered in long term trials in order to determine safety levels and generate such data (Palamara, 2005)
Research is also needed to understand the benefits of specific statins at the precise doses in particular patient groups of influenza virus (Chong and Sullivan, 2007).
Conclusions
In conclusion, statins are important in the treatment influenza virus due to their benefits demonstrated so far by the many trials done so far. Their benefits, which include reducing atherosclerosis, direct and indirect antioxidant effects, anti-inflammatory effects, inhibition of cardiac hypertrophy among other benefits. Does this mean we just grab simvastatin or any other statin on the first onset of influenza? Further studies are required to sufficiently link statins to the successes in morbidity and mortality demonstrated by current studies (Allison and Adel, 2005). However, with the imminent danger of a global pandemic where 85% of the world will not have meaningful access to pandemic vaccines or antiviral agents, the time to act is now on research to determine whether these alternative agents are useful or not.
In countries without these treatments, it is imperative to come up with new approaches to confront the pandemic (Stacy, 2004). They can support new research that studies existing agents that promise antiviral or inflammatory and immunomodulating activities. These can be identified among the existing agents which can be produced as generic and made affordable to people all over the world.
Table: Recent treatment with statins in patients hospitalized with pneumonia. Source: Majamdar et al, 2007.
References
Fedson, D.S. (2006) Vaccine development for an imminent pandemic. Why we should worry, what we should do. Hum Vaccin.2: 38-42.
Fedson, D.S and Dunnill, P. (2007). New approaches to confronting an imminent influenza pandemic. Perm J.; 111: 63-69.
Fedson, D.S and Dunnill P. (2007) From scarcity to abundance; pandemic vaccines and other agents for “have not” countries. J Public Health Policy.28; 32-40.
Basler, C.F, (2007). Influenza viruses: basic biology and potential drug targets. Infect Disord Drug Targets. 7:282-93.
Fedson, D. (2006). Pandemic influenza: a potential role for statins in treatment and prophylaxis. Clin Infect Dis 2006; 43: 199–205.
Peiris JS, de Jong MD, Guan Y. Avian influenza virus A (H5N1): a threat to human health. Crit Microbiol Rev 2007; 20: 243–67.
Jeffrey, G and Karen, M. (2006). The Bird Flu Pandemic: Can It Happen? Will It Happen? to Protect Yourself and Your Family If It Does. Thomas Dunne Books.
Stacey Knobler. (2005) The threat of pandemic influenza: are we ready? : workshop summary. Institute of Medicine (U.S.). Board on Global Health.
Alison,M and Adel M. (2005). Forum on Microbial Threats. National Academies Press.
Stacey Knobler. (2004). Learning from SARS: preparing for the next disease outbreak : workshop summary. Institute of Medicine (U.S.).
Kramer, M.A. (2005). Trends in Cholesterol Research. Nova Publishers.
Kruger P, Fitzssimmons K, Cook D, Jonnes M, Nimmo G, (2006). Statin therapy is associated with few deaths in patients with bacteremia. Intensive Care Med; 167:1655-79.
Scleinger RG, FedsonDS Jick SSJick H, MeirCR. (2006) Statins and risk of pneumonia:a population-based, nested case-control study. pharmacology; 27: 525-32.
Majamdar SR, Mc Alister FA, Eucharist DT, Pandwal RS, Marnie TJ, (2006). Statins and outcomes in patients admitted it hospital with community-acquired pneumonia: population-based prospective cohort study. BMJ; 333: 999-10.
de Jong MD, Simmons CP, Thanh TT, et al. (2006). Fatal outcome of human influenzaAH5N1) is associated with high viral load and hypercytokinemia.Nast Med; 12: 1203-02.
Chong CR, Sullivan DJ. (2007). New uses of old drugs.Nature;448: 645-46.
Arnold R, Koning W. (2006). Peroxisome proliferator-activated receptor-gamma agonists inhibit the replication of syncytial(RSV) in human lung epithelial cells. Virlogy; 350: 335 46.
Palamara AT, Nencion I, Aquilano K, et al. (2005). Inhibition of influenza/ virus replication resveratrol. J Infect Dig;191: 1719-29.
de Jong MD, Simmons CP, Thanh TT, et al. Fatal outcome of human influenza A (H5N1) is associated with high viral load and hypercytokinemia. Nat Med 2006; 12: 1203–07.
Ooi EF, Chew JS, Loh JP, Chua RC. (2006). In vitro inhibition of human influenza A virus replication by chloroquine. Virol J; 3: 39.
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 world’s 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 10th 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
California’s 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 California’s 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 California’s 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.
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.