Category: Infectious Disease

Meanwhile, Kathleen A. Alexander and others identified different factors that contributed to the most recent Ebola outbreak, during their paper called “What Factors Might Have Led to the Emergence of Ebola in West Africa” (2015). Some of their identified factors were the potential infection due to the consumption of dead apes, meteorological factors could have help in the spread of the disease, seasonal influences of forage and wildlife as potentially increasing during the contacts between wildlife species, the used of traditional healers instead of doctors, poor sanitation, migration, and poor education (Alexander & others, 2015).

Taking in consideration all the information above I believe, the lack of education, traditional healers, poor sanitation, lack of safe food sources, and migration are the main factors that contributed to the most recent Ebola outbreak. These can be divided as sociological, socioeconomic and environmental factors. The continued reliance in traditional healers will continue as this event is a deeply rooted cultural belief. Something like this will be difficult to change in a society. Migration and education as socioeconomic factors tell us that people would continue to move in hopes to escape the disease and/or in hope to get a better job to provide for their families. Environmental factors such as poor safe food sources and sanitation would only continue to allow for a faster spread of diseases throughout the country.

Immediate public health challenges that I envisage as a result of the Ebola outbreak are the concise and direct definition of Ebola outbreak throughout the region and the correct method of communication to the countries adjacent to the source of the outbreak. By identifying, communicating, and controlling the information of resources, we can stop the spread of the outbreak. Another immediate public health challenges would be the identification of first responders to a future outbreak.

Delayed public health challenges that I envisage as a result of the Ebola outbreak are training and education of a designated first responder team throughout the local population, coordination between the health departments of the adjacent countries, ensure complete reporting was completed for the previous outbreak as it would provide accurate data of where your weak points or hotspots for a future outbreak. Eventually, surveillance training would have to be done with all the health departments which was involved in the previous outbreak and work their way outward to ensure we can prevent another outbreak. And finally, population education in methods of prevention, maybe educating them on the factors mention above such as migration during an outbreak, season of possible outbreak that coincide with the local wildlife and the reliance of the use of healer versus medicine.

Infectious diseases are becoming chronic, especially in developing countries due to their aging population and their malnutrition. Gaetan Gavazzi & others in their study of Aging and Infectious Diseases in the Developing World (2004), stated that developing countries are having difficulty with their adding population due to their medical advances and their malnutrition. Their concern is that with the population having a longer expectancy of life elderly population is more susceptible to infections. Some of these infectious diseases are respiratory tract infections, diarrheal diseases, tuberculosis, malaria, and AIDS. Malnutrition can also be a person since a person of low weight but, malnutrition is referred as a person who doesn’t eat the correct among of food and/or source of food. This could lead to the populations to develop chronic diseases which can lower or disrupt their immune system allowing for infectious diseases to take place (Gavazzi & others, 2004).

Immunity for malaria among the elderly population have being seen to be low compared to the younger population. A study has shown that P. falciparum is severe in the elderly population. In a publication called “Malaria in the returning older traveler,’ Allen and others (2016), reported that higher risk of adverse outcomes has been noted in the elderly population (Allen & others, 2016). Another example for infectious diseases that can be considered chronic in developing countries are the multiple sources which can cause an infectious diarrhea. Some of these sources of infection are vibrio cholerae, shigella, salmonella, and campylobacter, noroviruses, rotavirus, giardia, and cryptosporidium. Diarrhea has been a label as the second most important cause of death by the WHO (Gavazzi & others, 2004).

Strategies that I can recommend to developing countries to prevent these two infectious diseases of becoming are case definition, expedient communication, and education in food safety, vector control and water protection. Taking malaria into consideration first, vector control and water protection should be a national campaign plan to address all the population in order to prevent future outbreaks of malaria. Education should be targeted to ensured everyone can protect their water source causing an immediate reduction of the vector responsible for malaria.

Dealing with an infectious diarrhea would be a more undertaking as it can be caused by many sources. First, the developing country would need to prepare a plan to educate their national health department in order to be able to regulate their specific areas. Eventually, the population would need to be educated with food safety at the vendor level. By this, I mean the local shop who sales bread, meat, and milk. During my travels throughout Africa, I often responded to my Sailors having developed diarrhea for consuming food at those local shops. After I had visited the local shops and talk to them about food safety, they would often either like me or asked me to vacate their shops. For those that asked me to stay, after I explained the importance of food safety, I could see a grim in their faces as they could understand how dangerous it could be consuming infected food. At a national level, departments of health at developing countries need to adapt the WHO case definitions for infectious diseases as well as to their communication’s plans address at the International Health Regulations. It is at this level of government that education for food safety, vector control and water protection should be documented and track in order to prevent future outbreaks and reduce the infectious diseases that are becoming chronic diseases.

Yes, vaccines are an important tool in fighting infectious diseases that could help us to prevent, control and/or eradicate diseases like smallpox. Benefits to an individual include pre-exposure to diseases reducing the individual from ever acquiring the disease in the first place by developing antigens. Some of these infectious diseases include hepatitis A and B, measles, varicella, yellow fever, and rabies. For society, benefits include the prevention of deaths, a decrease in incident rates, and a decline in mortality rates. Some vaccines have been able to assist us in the prevention of stillbirths, cancers, and pneumococcal diseases (WHO, 2008). Vaccines are an important method of survivability, specially to those of us in the military that are involved in traveling the world and expose to numerous of infectious diseases.

Despite the advancement in the manufacture and supply of vaccines, why do you think that the immunization rates are so varied across the world and as a public health professional what strategies do you suggest improving the rates and access to vaccines?

In my opinion, immunization rates are varied across the world due to a few reasons; one is the vaccine supplies, and another is the cost of vaccines. According to Vanderslott & Roser, on their paper called Vaccination many countries, as much as one third have had vaccine supply issues. Some of the reasons for the shortage include engineering problems, inadequate stockpile, and/or companies leaving the market. Cost of vaccines had numerous reasons to be affected. Of these reasons one that have been documented is the development of new vaccines. This can cause that the manufacturing company leaves behind a less profitable vaccine for a more profitable vaccine, causing a high cost for the newly develop vaccine as well as a shortage of the old vaccine. As newly develop vaccines are becoming more available and are developed by more companies, supplies start to become more available and cost becomes lower as their patent protection is over (Vanderslott & Roser, 2013).

A strategy that I would suggest improving the rates and access to vaccines is to develop a comprehensive plan at a national level but manage at the very lowest level possible. An example of this is how the military provide immunizations to its service members and families. The guidance received from the top-level officials from the military is to provide immunizations regularly such as hepatitis A and B vaccines, as well as influenza in a yearly basis. Other immunizations are required to service members and their families depending to the region or country that they are stations. All that guidance is followed at the local level by the Public Health Directorate of Military Treatment Facilities (MTF). Each MTF’s is required to communicate to each Commanding Officer of the immunization’s status of his/her service member. My current job involves tracking over 10,000 service members’ immunization status, the coordination of a vaccine request and the planning to ensure vaccines are always available.

We accomplish all of these by ensuring each unit has a representative that track immunizations status of his/her specific unit. Then, vaccine requests are sent to me for review, and the MTFs provide the immunizations based on our monthly requests. The leadership of each command receives the information status each week and ensure service members are available to receive their immunizations.

In the Navy, each MTF follows the Chief of the Bureau of Medicine and Surgery, BUMEDINST 6220.12B, Medical Surveillance and Notifiable Event Reporting Instruction, which provides specific guidance for us to address and outbreak on infectious diseases. This surveillance program is tracked by using a computer program called Electronic Surveillance for the Early Notification of Community-based Epidemics (ESSENCE). ESSENCE is tracked on a workday basis, or during holidays and times of WHO/national alerts are issue. This computer program collects its information from laboratory results as well as from patient visits recorded in our electronic database, Armed Forces Health Longitudinal Technology Application (AHLTA).

If a positive laboratory result or probable case is identified, a medical event report is completed and reported to higher echelons for recording and notification to local or state health department notification. Some of the infectious diseases reported are amebiasis, anthrax, biological warfare agent, botulism, cholera, dengue fever, E. coli 0157:H7, encephalitis, hantavirus, hemorrhagic fever, legionellosis, malaria, measles, meningococcal, pertussis, Q fever, rabies, smallpox, tuberculosis, tularemia, typhoid fever, typhus fever, yellow fever, and any undiagnosed outbreak. Notification to any of these must be made within 24 hours (BUMEDINST 6220.12, 2009).

If an infectious diseases’ outbreak takes happens, the Operational Naval Instruction 3500.41 takes placed as a guidance to deal with the outbreak. Each MTF is required to have a Public Health Emergency Officer (PHEO), which he or she would be required to manage, report and advice installation Commanders on how to deal with the situation (OPNAVINST 3500.41, 2018). An example of the PHEO’s job is during the H1N1 Pandemic it was his job to coordinate the vaccine supply’s administration and distribution of the vaccine to everyone. Other responsibilities include the coordination between him, and the Public Affairs Officer so as to provide accurate information to our community.

A recommendation that I would give to my current base Commander would be to do base wide pandemic exercises, something that I was able to be a part of in my last command. It would involve the cooperation and work between all the base services such as military policy, emergency services, and emergency room and public health directorate staff. As I currently live in the desert of California, a base-wide event that could provide training to all his service members would be a contamination of our portable water source. Due to high temperatures everyone drinks more water than those station in a colder region or base.

Another training that I would recommend is something I also did in my last command, Immunization Shot Exercise. In a three-day event, we coordinated with all the units located in the same base, and with military police, and family members in order to vaccinate between 8,000 to 9,000 personnel and family members. Here with a population size of over 10,000 active service members and an estimated 20,000 family members, this would be a more time consuming but given the fact that it is always a hassle to track marines to report for their flu immunization, this could be a great benefit to our readiness.

References

1. Alexander, K. A., Sanderson, C. E., Marathe, M., Lewis, B. L., Rivers, C. M., Shaman, J., . . . Eubank, S. (2015). What Factors Might Have Led to the Emergence of Ebola in West Africa? PLOS Neglected Tropical Diseases, 9(6). doi:10.1371/journal.pntd.0003652
2. Allen, N., Bergin, C., & Kennelly, S. (2016). Malaria in the returning older traveler. Tropical Diseases, Travel Medicine and Vaccines, 2(1). doi:10.1186/s40794-016-0018-9
3. Andre, F., Booy, R., Bock, H., Clemens, J., Datta, S., John, T., . . . Schmitt, H. (2008). Vaccination greatly reduces disease, disability, death and inequity worldwide. Bulletin of the World Health Organization, 86(2), 140-146. doi:10.2471/blt.07.040089
4. BUMED INSTRUCTION 6220.12. (2009, February 12). Retrieved July 20, 2019, from https://www.med.navy.mil/sites/nmcphc/Documents/policy-and-instruction/bumed_inst_6220-12B.pdf
5. Factors that contributed to undetected spread of the Ebola virus and impeded rapid containment. (2015, September 22). Retrieved July 20, 2019, from https://www.who.int/csr/disease/ebola/one-year-report/factors/en/
6. Gavazzi, G., Herrmann, F., & Krause, K. (2004). Aging and Infectious Diseases in the Developing World. Clinical Infectious Diseases, 39(1), 83-91. doi:10.1086/421559
7. Nyenswah, T., Engineer, C. Y., & Peters, D. H. (2016, June 2). Leadership in Times of Crisis: The Example of Ebola Virus Disease in Liberia. Retrieved July 20, 2019, from https://www.tandfonline.com/doi/full/10.1080/23288604.2016.1222793
8. OPNAV INSTRUCTION 3500.41. (2018, November 19). Retrieved July 20, 2019, from https://www.secnav.navy.mil/doni/Directives/03000 Naval Operations and Readiness/03-500 Training and Readiness Services/3500.41A.pdf

The strong relationship between malnutrition and infection was originally described by Scrimshaw et al. (47). From this framework, much investigation was done in this area and there is a total agreement among authors that mortality is significantly more elevated in undernourished child compared to healthy ones. The study by Man et al. (48), which included a large population of hospitalized Gambian children, clearly illustrated the relationship between undernourishment, characterized by lower weight relative to age, and higher mortality indexes associated with many infectious diseases.

One-third of the world’s population is infected with M. tuberculosis, the main agent that provokes death among infectious diseases (49, 50). This infection is particularly influenced by undernutrition and is a major cause of morbidity and mortality in developing countries where PCM is also prevalent (51). Furthermore, malnutrition as an important risk for tuberculosis has also being reinforced by findings in experimental models (52). Similarly, undernutrition may also affect the clinical outcome of tuberculosis (53). A recent meta-analysis suggested that low serum vitamin D levels are associated with higher risk of active tuberculosis (54). It is important to emphasize that tuberculosis is a typical condition whose evolution, characterized by a chronic inflammatory process, accentuates undernutrition and causes a typical cachexia. This has been partially attributed to IgG1 antibodies, that up-regulate TNF-α and IL-6 (proinflammatory cytokines), but not to IL-10 (anti-inflammatory cytokines) (55). Emergence of highly virulent drug-resistant strains of M. tuberculosis has been largely attributed to a combination of poorly implemented drug regimen and coinfection with HIV. It has been suggested by Prentice et al. (56) that malnutrition may contribute to the appearance of resistant M. tuberculosis strains (57).

Even though effective vaccines are licensed for measles, it continues to cause death and severe disease in children worldwide. Complications from this viral infection can occur in almost every organ or system including pneumonia, croup and encephalitis. Among other factors, malnutrition and vitamin A deficiency increase complication rates (58). There is experimental evidence that vitamin A supplementation in children is associated with a reduction from 23 to 30% in mortality risk and attenuation in disease severity (59). For this reason, the World Health Organization recommends administration of an oral dose of vitamin A to children with measles that live in vitamin A deficiency areas (60).

Malnutrition and intestinal parasitism share a similar geographic distribution, with the same individuals experiencing both diseases simultaneously (61). The coexistence between undernutrition and nematode infection involves two causal pathways, malnutrition that augments susceptibility to infection and the infection itself that leads to a more accentuated undernutrition (62). Intestinal nematodes may provoke malnutrition because they cause anorexia and a variety of pathophysiological responses in the gastrointestinal tract such as vomiting, diarrhea and malabsorption. Together, these alterations deleteriously affect the host ability to get enough nutrients from the diet (63). Parasites that clearly affect the nutritional status are soil transmitted helminths, Giardia duodenalis, Entamoeba histolytica, coccidia and Schistosoma sp. (64).

There is also a general consensus that PEM is associated with greater malaria morbidity and mortality in humans (65). Supporting this observation, controlled clinical trials of either vitamin A or zinc supplementation indicated that these nutrients can substantially reduce clinical malaria outbreaks (66, 67). Opinions regarding the effect of certain micronutrients, as iron, for example, are still contradictory (68, 56).

Noma is an opportunistic infection promoted by extreme poverty that evolves rapidly from a gingival inflammation to mutilating orofacial gangrene. Even thought it can be observed worldwide, it is much more common in sub-Saharan Africa. It results from very complex interactions among malnutrition, infection and compromised immunity, and is very frequently preceded by malaria, measles and severe necrosating ulcerative gingivitis (69).

Microorganisms are small living organisms that you are unable to see without a microscope. They live inside of the host (endoparasites). There are five main types of microorganism’s; bacteria, fungi, protozoa, viruses and parasites. Microorganisms are also known as pathogens and are around us daily, in every environment. There are different shapes and sizes and can survive in various habitats. They can cause disease by attacking and invading the body of their host. Reproducing and causing damage, allows our body to react, increasing our symptoms of infection. They can enter our bodies through cuts or breaks in the skin or by a lumen for example our mouth or genital openings.

Bacteria is unicellular and a prokaryotic cell. They can replace their cells adding to their population, sharing DNA via binary fission. A chromosome divides into two, replicating into identical daughter cells. Our body contains a lot of probiotics that are harmless and beneficial for our bodies to help our immune system fight diseases. Lactobacillus are found in some yogurts and are naturally found in the intestine, they are resistant to digestive enzymes therefore they decrease gastrointestinal problems like irritable bowel syndrome. There are many types of bacteria that can cause different infectious diseases, here are some examples; Spherical shaped bacteria are called cocci, a chain of cocci is known as streptococcus and can cause puerperal fever. Treponema is a spiral formed bacterium that causes syphilis, a sexually transmitted disease. Rod-shaped bacteria are known as Bacilli, this causes salmonella. This is associated with food contamination therefore to prevent having salmonellosis we need to ensure we are following the correct food handling practices for example, keeping raw food away from cooked and using different clean utensils for each. Professionals advise to drink fluids to keep hydrated as this usually lasts around one-week. When the body is under threat by bacteria, it naturally removes the invading cells. It does this by a process called phagocytosis, this is when phagocytes swallow up the infection to prevent illness however bacteria have a capsule, a polysaccharide layer that surrounds the pathogen and protects the cell from being engulfed. This structure allows the bacteria to have more time to invade and reproduce, making it harder for the body to eliminate the cells. Bacteria also have hair like structures on their cell wall, which is composed of protein, this is called Pilus. Pili helps create a strong bond between the bacteria and the host cell. They allow it to attach to surfaces and contaminate, spreading disease.

Fungi are heterotrophs and a eukaryotic organism. There is a variety of fungi E.G. moulds and mushrooms, you can visibly see these with the naked eye however you can only see yeast with a microscope. Most fungi reproduce by creating spores via mitosis and spraying them out, letting them flow freely in the environment. We can inhale spores and due them being tiny they are able to gain access to our lungs, or they can fall on us. If they pass our bodies natural primary and secondary defences, they can cause diseases such as chronic fatigue syndrome or cancer. There are many benefits of fungi, E.G. Yeast is used in bread to make it rise. It is also used in prescription drugs like antibiotics to fight against bacteria’s that is attacking human tissue. Trichophyton is fungi that causes athletes foot and ringworm. Fungus succeeds in warm, moist environments E.G. skin infections are usually in particular parts of the body such as in the groin area, armpits or feet. To prevent athletes’ foot, you should ensure your feet are always clean and dry, wear open/loose shoes. There are also various anti-fungal creams available to treat the infection.

Protozoa are unicellular, prokaryotic cell’s that multiply in their human host cell, causing serious infectious disease. Humans are infected with protozoan that feed from the blood by arthropod vector. There are a number of protozoan, one example; Sporozoa, a complex life cycle that involves both asexual and sexual reproduction. Plasmodium attacks and destroys red blood cells (RBC) in mammals and causes malaria. Protozoa eats Haemoglobin and changes it into Haemozoin, toxic material that causes fever like symptoms such as headaches and aching joints. Each protozoa has pseudopod, this is to allow the microorganism to move around through the bloodstream for maximum invasion.

Viruses consist of nucleic acids. Genetic material replicates new viruses containing information needed to invade the host cell’s DNA. The genetic material is surrounded by a protein coating that penetrates the host whilst protecting genetic material this is known as the capsid. There are numerous types of viruses that are different shapes and sizes. An example of a virus is Acquired Immune Deficiency Syndrome (AIDS) or Human Immunodeficiency Virus (HIV) these diseases are spread when bodily fluid passes through the mucous membrane into our bloodstream during unprotected sex. Once the virus has passed our non-specific defence systems, it attacks our immune system. Our immune system releases clusters of differentiation 4 (CD4) to fight infection and eliminate the virus however viruses also use CD4 to replicate. Transcriptase is an enzyme from CD4 also known as T-lymphocytes helper cells which HIV uses to adapt its RNA into DNA. A drug called Nucleoside reverse transcriptase inhibitors (NRTIs) can prevents the enzyme converting RNA. Protease is also an enzyme however this is to breakdown protein chains which creates the virus, protease inhibitors (PIs) block the enzymes preventing the protein chains from breaking down. HIV has icosahedral or helical structure, the virus is enclosed by a lipid bilayer membrane which forms an envelope surrounding. When viruses are budding, the bilayer is formed. The capsid and envelope are vital for viruses to attach and enter the host cell. They also help with releasing the capsid content to create new viral particles, which helps with the transmitting genetic material from one cell to other cells.

Prions are infectious proteins that gather in the brain and cause permanent damage to nerve cells. This causes brain damage and deteriorates gradually in both humans and animals. An example of the disease caused by prion is Creutzfeldt-Jakob disease (CJD). There is no specific drug that can treat CJD. There has been test done on mice however evidence and research are not strong enough to try on the human body. This disease is not curable and causes the brain to shrink therefore it has been said that once you get symptoms of this disease it is fatal within twelve months.

As well as microorganisms there also can be macro-organisms. These are parasites that are visible and can be categorised as endoparasites or ectoparasites. Examples of macro-organisms are head lice, mites that spreads scabies, tapeworms and ticks that transmits Lyme disease. Ticks that carry the disease thrive in grass and wooded areas. They must be attached to our skin for around 36 to 48 hours to get into our bloodstream. You can prevent being infected by Lyme disease by removing the tick slowly with tweezers and applying antiseptic in the affected are. Lyme disease is caused by bacteria and can be treated by taking antibiotics such as amoxicillin. After treatment, symptoms like aching joints can occur this is known as post-treatment Lyme disease syndrome (PTLDS).

A vector is a living organism that bite their host cell (human or animal) as they need organic material for survival. Vector borne diseases are infections caused by pathogens, vectors only transport the disease they do not have the disease themselves. Once they have bitten you, they infect you with the parasite their carrying, delivering the DNA from the pathogen into the human body. Some examples of vectors are; tape worm, mosquito and houseflies. Vectors transmit various diseases for example houseflies cause dysentery due to the bacteria they carry. Dysentery is a worse case of diarrhoea however pus and blood are present and can cause stomach irritation. It is most known in warm deprived countries like Africa, this is because the parasite can spread easily due to Poor hygiene, for example; people may consume water that is contaminated with human or animal urine and feces. In severe cases medical assistance may be needed where oral dehydration solutions will be provided.

Another example of a vector is mosquitoes. They are the most common vector and can cause malaria. This is also more common in hotter countries. To prevent this disease, you can receive an appropriate vaccination. A drug called ‘Chloroquine phosphate’ is preferred to treat malaria however most bugs that causes malaria are resistant to chloroquine, therefore will not kill the parasite, allowing it to spread the infection. However, artemisinin-based combination therapies are more reliable as it is more than two drugs that work on the parasite in different ways to ensure it kills the disease. Research states that future treatment is being investigated as the malaria parasite is resistant to the majority of antimalarial drugs.

There are several ways we can transmit disease. The most common way is contact, there are two types, direct and indirect. Direct contact is where an infected person physically touches another person. E.G. sexual contact could transmit genital herpes which is a sexual transmitted infection caused by a virus entering the mouth, genitals or anus. This can be prevented by using contraception such as condoms. Indirect contact is where there is no human contact but contact with contaminated surfaces. Other diseases which can be transmitted are chicken pox, measles and common colds. We can prevent being infected by these diseases by disinfecting areas regularly.

Droplet infection is another way disease can be transmitted. Coughing and sneezing spread microorganisms such as viruses and bacteria which other people inhale. Scarlet fever and meningitis are diseases that are contagious from the droplets. We can prevent these illnesses by covering our mouth and nose when coughing and sneezing and following the recommended hand washing procedure, thoroughly drying to prevent recontamination.

Our body has natural barriers to prevent infectious diseases entering the body. There are two levels of our non-specific defences, these include our external barriers for examples our skin protects the inside of our bodies, obstructing pathogens. If pathogens do enter our bodies passing the external barrier, we also have physical barriers internally for example protease and hydrochloric acid in the stomach help breakdown the illness. If the pathogen is strong enough to pass the first line of our non-specific barrier, we have a second line immune response. This is the complementing system that helps activate the inflammation encouraging phagocytes to attach to the infection (when the pathogen has entered our tissues). Phagocytes are our natural cell eater that destroy the pathogen by eating and removing it from our body.

The specific immune system uses antigens to identify foreign cells. Once they have recognised the cell, they then invade the pathogen and remember the cells to destroy them faster in future infections. T-lymphocytes (T-cells) and B-lymphocytes (B-cells) are white blood cells (WBC) and individually fight a specific antigen. T-cells have receptor proteins on its surfaces. They only have one binding site, Antigens, to create antigen-receptor complexes. B-cells creates immunoglobulin to bind to an antigen.

B cell is stimulated when its attaches Antigen-presenting cells (APC) to a helper T cell, it starts to split. These separating B-cells are known as plasma cells, they secrete antibodies. Proteins attach to the antigens on the pathogen, so macrophages understand it needs to be destroyed.

The immune system consists of antibodies that are produced in the tonsils and thymus. WBC defend our body from infectious disease, fight infection and destroy the pathogen causing it. Bone marrow is containing of connective tissue and lipids. RBC, WBC and platelets are created in the bone marrow and is made up of red and yellow marrow too. This is often be found in long bones like legs.

The lymphatic system transports nutrients and lymph fluids. The lymphatic system is vital for the immune system because the lymph nodes sieve lymph fluid as it passes through collecting pathogens so lymphocytes can destroy them. Damage blood cells are removed from the blood by the spleen which also helps the body cleanse and remove waste products.

On a global scale, the public health sector is built on prioritizing diseases that majorly contribute to the leading causes of morbidity and mortality. In the spectrum of accountable diseases, infectious diseases caused by Aedes Aegypti, which is the principal vector among the species family, has the widest ever recorded distribution and is notably responsible for Yellow Fever, Dengue, Chikungunya and Zika virus. Infectious diseases caused by Aedes Aegypti range from how they progress clinically, presenting with severe flu- like illnesses that affect all age groups, to complications that can result in end-organ failure and ultimately death. This literature review will support the urgency for critical assessment of vector control and preventative measures with respect to the discussed diseases and highlighting the causative factors that are leading to the expansion of these diseases internationally through lack of effective mosquito control, globalization and urbanization. Future control of outbreaks is greatly dependent on preparedness and education on preventative measures that needs active participation from both the government and the public.

Introduction

Aedes Aegypti for centuries was known as the “most dangerous animal in the world” as it has been hypothesized that out of the approximate 3500 mosquito species, this particular vector has contributed immensely to human suffering and the death toll. The historical evolutionary course of Ae. Aegypti started from its ancestral root in West Africa and was introduced into the New World about 550 years ago through the European slave trade (Powell, Gloria-Soria & Kotsakiozi, 2018). The timeline and dissemination of this vector continued to the Mediterranean region, when ships from the New World were returning to their European ports of origin between 1800 and 1950. Subsequently, in 1869 when the Suez Canal opened, Aedes Aegypti made its way into Asia in the 1870s, then Australia in 1887 and the South Pacific in 1904 (Powell, Gloria-Soria & Kotsakiozi, 2018).

Although strong evidence has established that Africa is the Ancestral home of the vector species, there is still no detailed understanding or timeline established as to when this wild species became domesticated. The wild population of Ae. Aegypti uses tree holes and natural pockets of water as breeding sites for larvae and non-human mammals as a blood source, whereas the domesticated form began using human generated water containers and humans as blood source (Powell, Gloria-Soria & Kotsakiozi, 2018). More than transition, this overlap in co-existing environments was a major hallmark in the spread into the tropical and subtropical world and the source of the transmitted infectious diseases it carries globally. To differentiate the two forms of the species, a subspecies classification was implicated, for the ancestral African type named Ae. aegypti formosus and outside Africa, the domesticated form named Ae. aegypti aegypti (Powell, Gloria-Soria & Kotsakiozi, 2018). The infectious diseases caused by the Ae. Aegypti vector has many different routes of distribution due to varying causative and transmission factors, that will be further discussed in detail.

Epidemiology & Transmission

Yellow Fever

Yellow fever virus, a flavivirus, is an acute viral hemorrhagic disease that continues to be prevalent in Africa, Central and South America, even after the introduction of vaccination. This mosquito-borne illness is responsible for an estimated 200,000 cases annually and 30,000 deaths per year, with Africa accountable for 90% of these cases (Mutebi & Barrett, 2002). Africa, along with Central and South America have similar factors, which contributes to the incidence rate, however, there is a high density of A.Aegypti mosquitoes in close proximity of unvaccinated individuals yet Central and South America has a lower rate of transmission. (Mutebi & Barrett, 2002). South America has a higher level of immunity amongst its residents compared to Africa because they have implemented campaigns for vaccination programs during outbreaks, leading them to have better control of their transmission (Barnett, 2007). Another contributing factor as to why South America shows lower transmission rate is due to limited contact between the infected monkeys, that are the host of the virus, in the forest canopy and the human population. By taking the precautious steps towards limiting and preventing exposure, South America has better outcomes (Barnett, 2007).

Dengue

Dengue fever, along with its more severe forms, dengue haemorrhagic fever and dengue shock syndrome are caused by 4 serotypes of the dengue virus (DENV-1, DENV-2, DENV-3 and DENV-4) (‘Epidemiology | Dengue | CDC’, 2019). Dengue virus, a flavivirus, is transmitted between humans mainly by the Aedes Aegypti mosquito but in some cases it was found to be transmitted from an infected mother to her fetus or through blood transfusions. This highly infectious disease is said to have originated 800 years ago in Africa and was passed down to humans by monkeys. Many factors are said to have played a role in the dissemination of the virus, one of the main ones being transportation of army forces and cargo between almost all continents during the second world war (‘Epidemiology | Dengue | CDC’, 2019). Over the years, there has been uncertainty in the pattern of incidence, which accounts for being one of the most common arboviral diseases with almost 40% of the population living in an area with a high risk of dengue virus transmission. There are about 100 million infections recorded every year. Of this, there are 500,000 haemorrhagic fever cases recorded and almost up to 22,000 deaths each year (‘Epidemiology | Dengue | CDC’, 2019).

The disadvantage of the dengue virus from the beginning of its discovery was the ability to captivate and control the disease in a given area, starting from 1970, when the virus was recorded in just 9 countries. However, it is now an endemic in 100 countries around the globe and it is highly prevalent in Central and South America, Africa and Southeast Asia. The World Health Organization has reported an increase of almost a million infected individuals in three regions between 2010 to 2015, with reported outbreaks in Europe specifically in France and Croatia in 2010 and in the Madeira Islands of Portugal in 2012 (Bhatt, et al., 2013). Several risk factors contribute to the development of the dengue fever including living in tropical and subtropical regions such as Mexico, Brazil, Philippines, Thailand and many other countries of Latin America and Southeast Asia (Bhatt, et al., 2013). Studies has indicated that young children are more susceptible to developing the disease due to incomplete development of their immune system, implying that age is also a risk factor. Males were also found to be more commonly affected than females, however the reason for this gender difference has not been thoroughly investigated (Bhatt, et al., 2013).

Chikungunya

The Chikungunya virus (CHIKV) is dominant in continents such as Africa, Asia and the Indian subcontinent, with an estimated 3 million infections occurring each year. Chikungunya was first identified in 1952, in West Africa with low level activity associated with heavy rainfalls contributing to the increasing mosquito population. There have been periodic outbreaks documented in Asia and Africa beginning in 1960, which was followed by several decades of inactivity (Zeller, Bortel, & Sudre, 2016). However, in recent years, there has been re-emergence occurring in areas where there has been no previously transmitted activity such as Europe, Caribbean and South America, as well as re-appearance in India following an absence of viral activity for 32 years. The largest documented outbreak occurred in 2005 on the island of Reunion located in the Indian Ocean, with an estimated 266,000 cases out of a total population of approximately 770,000 (Borgherini, et al., 2007). The next year, India encountered approximately 1.25 suspected cases. The irregularity of these epidemic outbreaks caused by the disease has made it difficult to predict a pattern of behaviour, however it has been suggested that chikungunya follows a similar pattern as dengue, especially in the United States subtropical regions, which helps navigate investigations during outbreaks.

Zika Virus

Zika Virus, is a less commonly discussed disease, amongst the group of diseases caused by the Aedes Aegypti, such as dengue and yellow fever. The name “Zika” comes from the Zika forest in Uganda where the virus was first isolated back in 1947. From the 1960s to 1980s, rare sporadic cases of human infections were found across Africa and Asia, typically accompanied by a mild illness (or illnesses) (Plourde & Bloch, 2016). Very few cases of Zika Virus were brought forward up until, the first reported outbreak of Zika Virus in 2007. Subsequently, in 2013 and 2014, epidemics of Zika virus infection occurred in French Polynesia, New Caledonia, Cook Islands, and Easter Islands. Up until this time, the virus was only found in areas close to equatorial belt in Africa and Asia, however, this belief changed in 2015, when the first recorded outbreak in the Americas and more currently in Brazil occurred, indicating the dissemination of the disease to more areas (Petersen, et al., 2016). The Brazil Ministry of Health estimated around 440,000-1,300,000 suspected cases of Zika virus infection in December 2015. To date, a total of 86 countries and territories have reported evidence of mosquito-transmitted Zika infection. (Petersen, et al., 2016).

Zika virus is mainly transmitted by the bite of the female Aedes Aegypti mosquito, however it can also be transmitted vertically from a mother to her fetus, as well as sexual transmission, from infected men to their partners. It was found that when the zika virus was isolated in semen samples, there was a significant increase in the virus compared to blood and urine samples. The CDC recommends that men that travelled to areas where the virus is endemic should avoid sexual intercourse and wait a minimum of six months before attempting conception. Until now, there has been no recorded case of an infected female transmitting the virus to her sexual partner.

Climate is the pattern of atmospheric conditions over a long period of time. Also can be described as the atmospheric conditions that prevail in a given region over a period of time. This includes not only the average weather but also values of climatic conditions that prevail at extreme ranges, their variability, and the frequency of various occurrences. These climatic elements include solar radiations, temperature, humidity, precipitation, atmospheric pressure and wind in terms of speed and directions. Therefore climate change is the variation of global and regional climates over time. These changes can be caused by processes internal to the earth, external forces or human activities.

Vector is an agent that delivers a pathogen or other biological materials from one place to the other. It’s a vehicle that only helps in transportation of infectious materials. Vectors do not cause the disease but act a significant role in the transmission of a disease. Although vectors can transmit pathogens to both animals and plants, our main focus will be those that transmit to animals.

Vectors can be categorized into two classes:

• Mechanical vectors

This is a type of vectors that act as transport vehicle only, whereby the infectious agent does not depend on the vector in any part of its cycle. In fact, most of these agents can be transported by any vector without making any major difference.

• Obligate hosts

This is a class of vectors that plays an important role in the pathogens life cycle. The insect is needed by the pathogen to complete some of its developmental stages before it is transmitted to its final host eg mosquito from a genus Anopheles is specifically required by Plasmodium malariae to complete parts of its development.

Most vectors are bloodsucking insects such that the transportation of the pathogen may be through a direct route.

Infectious diseases are illnesses that result from a disease-causing organism getting into a hosts body and the organism causes reactions toward the host tissues either due to the presence of the agent or the toxins they produce. They can also be called transmissible diseases. Infectious diseases can be caused by either bacteria, virus, fungi or parasites. Oftenly infectious diseases are through contact with infected people, animals, vectors, parasites or ingestion of contaminated food.

The ecology of vector-borne diseases is one of the complex scenarios to address since climate is always a major factor to be considered due to its influence in disease transmission cycles and disease occurrences. Vectors involved in vector borne diseases are very sensitive towards climatic changes and surrounding environmental factors. This could be due to; vectors and hosts survival, reproduction, development and distribution; pathogen development, replication, and transmission; geographical range of pathogens, vectors, and hosts; human behavior; disease outbreak frequency, onset, and distribution.

The complexity of these interactions is an indication that the effects of climatic changes and the nature and extent of non-climatic factors vary by disease and by location. A disease with well-known transmission cycles can be affected very differently by climate change.

So far, we cannot deny that in the last 150 years, the climate has changed. The levels of carbon dioxide and methane gases in the atmosphere has increased at an alarming rate. The earth’s temperature has risen and if no efforts are done to reduce the amount of greenhouse gases in the atmosphere, global temperature is expected to rise more rapidly by the end of the 21st century. This will make it hard for animals and plants to adapt toward the heat changes. Sea levels have risen with up to 8 inches, ocean acidification has increased by 30% and we can’t fail to admit that in the last 2 millenniums, we have experienced intense rainfall, flooding, typhoons and in some areas extreme lack of rain. All these changes pose a risk toward infectious diseases.

Environmental temperature is one of the factors that affect life and transmission of diseases. Temperature has an effect on the distribution of vectors. As the temperature continues to rise, insects in low latitudes may find new habitats in mid and high latitudes. Some vectors of Malaria, African triponomiasis, plague, and dengue have distributed to wider ranges mostly into areas of high latitudes. Also, the temperature has been observed to have the potential to restrict disease distribution. A good example is Aedes aegyptia, a mosquito vector for yellow fever and dengue fever. The experiment shows that larvae of these species perish when the temperature passes 34 degrees and adult could not survive temperature above 40 degrees. As global warming increases, vectors such as A. aegypti may get extinct. Low temperatures also provide optimum conditions for the spread of infections such as Influenza. Also, long hours of sunshine has been observed to act synergetically with temperature during Cholera periods to create favorable conditions for the multiplication of Vibrio Cholerae in the aquatic environment.

Humidity is another factor with a great impact on pathogens. Pathogens of airborne infectious disease such as Influenza tend to be responsive in humid conditions. Their survival rates of water-borne infections near water surfaces are getting narrower due to the drying of surface water. A number of hosts have shown a tendency to respond to humidity positively. Humidity of lower than 60% shortens the lifespan of mosquitos that cause malaria while those that cause West Nile fever and dengue fever migrate toward non-traditional regions when high temperatures are coupled with dry spells.

Many vectors have been found to be positively affected by rainfall. Larval development of mosquitoes is usually accelerated by rainfall while their adults breeding sites could be limited by drought. Also, excessive rainfall may have a catastrophic impact on the mosquito population by sweeping away their breeding grounds. Drying of river beds allows accumulation of organic matter that provide Culex a vector for West Nile fever breeding grounds. During rainy seasons, number of Chorela cases are usually high and this is associated with the increase in fecal materials stirred up by rain.

Wind is also a key factor in the spreading of airborne diseases. Bacteria, fungi, and viruses are easily transported across dust particles reaching hosts easily According to Chen et al.,2010, the presence of desert dust during Asia Dust Storms (ADSs) are associated with increased concentration of cultivatable bacteria, fungi, and fungal spores. Also, Influenza during ADSs was higher than normal days. Wind also has a dual effect on vectors affecting vectors for malaria both negatively and positively. Strong winds reduce bitting mosquitos and also extend their flight distances.

Climate change may have contrasting effects on both pathogens and vectors thus disease outcomes may be different but what we are sure is outcomes that favor the survival of vectors and spread of infectious diseases no matter how small they are, may be catastrophic. This continues to pose a health risk to a human in relation to infectious diseases. Efforts toward reducing vulnerability should be adopted at either scientific or social level because the rate at which climate change is taking place demands an urgent action globally.

Introduction

Every country is susceptible to potential outbreaks of large scale diseases. These infectious diseases cause a multiplicity of problems, specifically extreme numbers of death with those afflicted. Diseases like SARS, HIV/AIDS, and Ebola have claimed the lives of many, but what if we could predict the spread of new infectious diseases? That is the purpose of this paper. Mathematics will be used to map how diseases could spread, as well as determining the susceptibility of infection in certain regions. The basic reproduction number of diseases will be calculated, followed by how said disease will spread throughout specific areas. By doing so, a plan of action can be established when the next pandemic arises. This plan encompasses providing greater amounts of vaccinations to those regions more susceptible, as well as ensuring an effective first response and containment.

In my lifetime, I have seen the outbreak of various diseases all over the world. Most notably, Ebola. I thought the outbreak of Ebola had been minimized, but upon watching the news I saw that it is still prevalent in the Democratic Republic of the Congo (WHO). I then wondered if there was a method to model the spread of the disease. Doing some research, I learned of the SIR model. A model of how diseases spread, along with a region’s susceptibility has the potential to save lives and reduce the hospitalization of many. This type of advancement in determining the spread of infectious diseases can provide intel that has the possibility of eradicating disease epidemics altogether.

The mathematics that will be involved in this study are various topics in calculus, such as differential equations. Specifically, the SIR model will be used. Statistics, algebra, and functions will also be used in modeling the spread of diseases.

Investigation

The SIR model, as created by Kermack and McKendrick (MathWorld), calculates an estimated number of people that could be infected by a contagious disease in a specific area’s population. This model also has the capability of determining the recovery time necessary for patients within that selected area. The name SIR is an acronym for the variables used in this model: S refers to the number of susceptible people, I refers to the number of people infected, and R refers to the number of people who have recovered from the illness (MathWorld).

Variables

• The SIR model represents disease epidemics over a period of time thus making time the independent variable t, measured in days in this investigation (Smith and Moore).
• The SIR model divides the total population, N, into three classes which act as the dependent variables (Smith and Moore):

o represents the number of susceptible individuals to the disease

o represents the number of infected individuals

o represents the number of recovered individuals

The rate of change of the variables must be assumed in this investigation (Johnson).

• A constant population size must be assumed. The population size must be large and hold a stable number of people which excludes births, deaths, and immigration. No one can be added to the susceptible group, and the only way to leave this grouping is by becoming infected.
• Homogenous mixing must be assumed. Everyone has equal probability of encountering another and therefore face the same probability of exposure of disease by those already infected.
• A fixed fraction of recovery per day must also be assumed. For example, if the average infection duration is two days, it can be assumed that on average ½ of the infected population recovers each day.

Since the population is fixed and there are no outside influences that inflict death, the total of the number of people susceptible, infected, and recovered is equal to the total population. Thus, the equation below is derived:

There are two parameters relating to this model, and where both . is defined as the rate of contact between infected and susceptible persons and is defined as the rate of the duration of recovery. Both variables are impacted by the duration of the disease for those recovered, or D, and the mortality rate for those who die per day, or M (Modelling Infectious Diseases).

• is found using the equation, , where the mortality rate is divided by the number of susceptible individuals. It represents the rate at which a disease travels from a susceptible person to that of an infected person due to contact. , where 0 implies no infection rate and 1 implies a total infection rate. For example, if the mortality rate of a population is 50% and the number of susceptible individuals is 10, then the rate of infection or is
• is found using the equation, , where 1 is divided by the duration of the disease. An infected person can only recover once during the duration of an illness, thus verifying the equation. For example, if the duration of the disease is 5 days, then the recovery rate is .

The SIR model uses a system of three differential equations (Smith and Moore):

• where represents the rate of change of those susceptible to a disease over time. Susceptibility to the disease is determined by the number of susceptible and infected individuals, and the rate of infection. Once infected by the disease, the individual leaves the susceptible group therefore showing the proportional decrease between susceptibility () and infection (I).
• where represents the rate of change of those infected by a disease. Infection is determined by the number of people susceptible and infected, as well as the rate of recovery from a disease. shows the same inverse relationship as . The greater the population of I shows a greater decrease in the population of S.
• where represents the rate of change of those recovered from a disease over time. The recovery rate is dependent on the population of I because in order to recover, one must become infected first. As v

Using these equations, it can be determined that This shows that there is no net change in the total population meaning that the total population is constant.

Dengue Fever in the Philippines

Dengue is an easily transmittable disease originating in mosquitoes. There are an estimated 390 million dengue infections recorded each year globally, with most cases occurring in the tropical destinations of the world (WHO). Dengue fever is transmitted by the bite of an infected Aedes mosquito. Those infected will experience high fever, migraines, pain behind the eyes, joint and muscle pain, fatigue, nausea, vomiting, rash, and mild bleeding (WedMD). The first documented dengue fever epidemic was in the 1950s in the Philippines and Thailand (WHO). My extensive reading about and learning of the processes required to complete the SIR model will be applied to the Dengue Fever epidemic in order to gain an understanding of this model while utilizing an example.

The population of the Philippines in the 2014 will be considered in relation to the Dengue Fever epidemic (WHO). According to data from the WHO, the total population of the Philippines in 2014 is N=100,102,249, the infected population is I=121,580, deaths due to Dengue is 465, and mortality rate is 0.44. To find R, you must include both those who have died and those who have recovered seeing as both groups have achieved permanent immunity.

As seen in the graph above, there is a large drop in the susceptible group beginning at 17 days. The susceptible group began as a significant portion of the total population of the Philippines in 2014 and falls below half the total population after a duration of 32 days as reaches 50,000,000 people. After 52 days, levels off and remains at 20,000,000 susceptible individuals. Conversely, begins an increase after 17 days. levels off in tandem with after 52 days and remains at 80,000,000 recovered individuals. This shows an inverse relationship between the susceptible group and the recovered group. As the number of recovered individuals increase, the number of susceptible individuals decrease. Once exposed to and recovered from the disease, the individual has built up an immunity therefore not rendering them as susceptible. For , an increase in the infected number of individuals begins at day 17. A positive slope can be seen from day 1 to day 34, where the number of infected individuals reaches its maximum at about 18,000,000 people. After day 34, decreases to approach 0 between days 34 and 61. The decreasing trend of line works simultaneously with increase in line By creating this graph, I was able to see the relationship between the different variables, and successfully use differentiation to model the spread of Dengue fever on the Philippine population over the span of 60 days.

Wanting to further analyze the data, I individually graphed the susceptible, infected, and recovered groups. I then used polynomial regression to find a line of best fit for the data to then formulate an equation.

The shapes of the susceptible, infected, and recovered group graphs had a strange shape to me. I researched and I learned that the graphs take the shape of a sigmoid or logistic curve (Weisstein). Logistic functions use the equation (Balkew). Learning this, I realized my equations do not resemble the parent function. The limitations in Excel’s trendlines led me to come up with incorrect equations. Graphing the lines individually ended up providing me little to no information.

Conclusion

The SIR model is useful in the medicinal field. Not only does it estimate the spread of diseases within a certain population, but also dictates the recovery rate of said population. This can be used to determine necessity of vaccinations and the devising of plans to handle disease epidemics in specific areas. Through this exploration I realized the necessity of modeling data to provide advantages in the medical field. The information I gathered should be shared with the governments of countries who are prone to disease outbreak so they can take precautionary measures by way of vaccinations and health care. The model is widely used by scientists, but it holds many limitations. The model works under unrealistic assumptions like each individual will have an equal number of encounters with others in the population. In terms of tracking real-life epidemics, that is not the case. There is not an equal probability of everyone in the population encountering one another, thus there is greater room for error within the model’s estimates.

The main purpose of this essay is to discuss influenza and what is the mode of action and risk factors for the older person and how to prevent the spread of infection in a residential aged care facility. This essay will discuss the risk assessment needed for a person who suffering from influenza and what nursing care is required following cultural safety and how multidisciplinary team help to assess the patient. Influenza spreads very quickly, and it may lead to severe mortality and morbidity in the residential aged care facility.

Influenza caused by the influenza virus and is the most common and highly contagious respiratory disease. Influenza spreads anywhere and can cause seasonal outbreaks. The main symptoms of influenza are high fever, cold, runny nose, headache, body ache, and loss of appetite. (Bullock & Manis, 2014). People over the age of 65 are more vulnerable to get influenza because of low immunity and, chronic condition such as respiratory, endocrine, and chronic cardiac disease, renal failure, and sometimes, it creates complications and may lead to death. Three different types of virus infect humans, which are type A, B, and C, but only type A and B mainly causes major influenza outbreaks. There are three subtypes of influenza A such as H1, H2, and H3 but only H1, and H3 cause seasonal influenza in humans (Ghebrehewet, Macpherson, & Ho, 2016).

Influenza is transmitted via three modes, such as contact, droplet, and airborne transmission. In contact transmission, infectious particles are transferred to the mucous membrane to the upper respiratory tract by touching the patient or through break skin or person comes in contact of a susceptible host with a contaminated object such as needles or sharps. In droplet transmission, when an infectious patient sneeze or cough, they generate a large particle, and it travels up to 1 meter and comes in contact with a susceptible host. Large droplets deposited in upper airways can directly entre the recipient’s mouth via droplet infection (Tang et al., 2014). Airborne transmission occurs when virus carried on dust particles or in small respiratory droplets become aerosolized when infected person talks, coughs, sneeze, and laugh (Crisp, Taylor, Douglas & Rebeiro, 2013).

Older people are more likely to get an infection due to chronic conditions such as diabetes, chronic obstructive pulmonary disease, cardiac arrest, and low immunity. Older people may decline in their physical functions, for example, mobility due to influenza. Influenza is the most common infection that causes death in an aging society (Shobugawa, Fujiwara, Saito & Kondo, 2018).“World health organization (WHO), one billion people are infected, and around 500,000 people die from influenza each year” (Ghebrehewet, Macpherson, & Ho, 2016, p.1). Research shows that the efficacy of the influenza vaccine is less in older people than younger adult due to their chronic condition (Yang et al., 2017).

Residential aged care is a more vulnerable place to spread a virus due to older age and chronic diseases. All staff responsible for providing care to residents should control and prevent the spread of infection. First step to reduce the spread of germs is hand hygiene. It is essential to perform hand hygiene before touching a resident, before a procedure, after a procedure, after touching a resident and after touching the resident’s surroundings and use alcohol-based hand rub (Sundal, Aune, Storvig, Aasland, Fjeldsæter, & Torjuul, 2017). It is necessary to use personal protective equipment (PPE), such as gloves, apron, mask, and goggles, to prevent the potential spreading infection. The purpose behind using gloves is to reduce the spread of infectious agents that may carry on hands. Aprons are used to protect against contamination. Face masks and goggles are used to protect a care worker’s mouth and nose from exposure to infectious agents through splashing vomits (Akagbo, Nortey, & Ackumey, 2017). It is important to clean frequently touched hard surfaces, such as doorknobs, bedside tables, light switches, tabletops and wall areas around the bathroom with detergent followed by a disinfectant solution to prevent spreading infection (National Health and Medical Research Council, 2013).

Nursing home are more vulnerable places to the spread of influenza because of increased contact between people. A person who struggles with their activities of daily living (ADL) are more prone to get infected. In the nursing home, residents and care workers are more susceptible to infectious agents. Mainly, the care worker’s hands are a possible source of transmission of contagious agents to residents (National Health and Medical Research Council, 2013). Patients who required precautions should be isolated in a single-patient room, and staff needs to perform hand hygiene’s five steps with using PPE such as gloves, gown, mask, goggles to prevent contact with the contaminated patient’s environment. Try to restrict the visitors during the period of an outbreak to prevent further spreading of infection. (Gothenburg & Barron,2016). Staff should wear PPE when they enter a room and take off the PPE when they leave the room and, dispose it in a clinical waste box, and perform the hand hygiene (Baek et al., 2014).

It is essential to perform Mr. Holden’s risk of assessments such as pressure injury, falls risk assessment, pain assessment, and fluid balance chart because he suffers from influenza. A pressure injury can be caused by many factors such as age, poor nutrition, mobility, and faecal and urine problems (Han, Kim, Hwang, Lee, & Song, 2018).To prevent the risk of pressure injury, inspect skin every day and reposition every two hours, maintain skin integrity, hydration and prevent from shear and friction. Document skin assessment using a validated assessment tool such as Water low and Bardon assessment tool to communicate between health professionals (Crisp, Taylor, Douglas & Rebeiro, 2013). The second assessment is falls risk assessment, and many factors are affected to mobility, medication, nutritional status, gait and balance abnormalities, frailty, and medical condition (Kwan & Straus, 2014). Falls risk assessment tool was developed to do a quick assessment for those people who are at high risk falls and it is used in hospitals and residential aged care facility by healthcare workers (Crisp, Taylor, Douglas & Rebeiro, 2013).

The third assessment is pain assessment, and many factors affected to the pain such as sleep disturbances, impaired mobility, decreased appetite, constipation, falls, and cognitive impairment. Nurses play a crucial role in pain assessment, and as a nurse, it is essential to assess how pain is affecting their ADLs (Gregory, 2015). There are three ways of measuring pain self-reports, physiological, and behavioral changes. To assess pain, the main pain assessment tool is used Wong-Baker faces pain scale and Abbey pain scale (Crisp, Taylor, Douglas & Rebeiro, 2013). The fourth assessment is a fluid balance. Water is essential for the body; therefore, enough fluid balance is necessary to maintain metabolic processes. A subsequent level of fluid imbalance can cause a severe effect. Appropriate use of fluid balance monitoring is required to determine hydration. A decline in urine output may indicate symptoms of renal failure. If a person reduces their fluid intake shows changes in consciousness level, gastrointestinal-related problems (Pinnington, Ingleby, Hanumapura, & Waring, 2016).

Nurses need to be aware and respect the Aboriginal culture and provide a humble environment and patient-centered care. As a nurse, consider involving Aboriginal patients and their families in decisions regarding their care. As a nurse, we need to be aware of a patient’s cultural and spiritual, emotional, physical wellbeing (Department of Health, 2014).

As we know, Mr. Holden is underweight, and he had influenza, and it reduces his appetites. It is essential to involve a dietitian to review him. Dietitian provides information related to nutrition and diet. It is essential to involve a dietitian to review him. By involving dietitians, it plays an important role to increase food intake and reduce the risk of developing malnutrition in older adults. It is essential to communicate between dietitians and chef successfully to reduce malnutrition (Farrer, Sasanelli, Matwiejczyk, Yaxley, & Miller, 2019). Consider involving a physiotherapist, who helps Mr. Holden with mobility because he is unsteady while walking. A physiotherapist provides treatment through massaging and exercise. Physiotherapists provide treatment for people suffering from physical problems caused from injury, diseases, illness, due to aging. Physiotherapists aim to improve the quality of life by improving mobility, alleviating pain, improving balance, and to build strength (Baert, Gorus, Guldemont, Coster, & Bautmans, 2015).

The main purpose of this essay is to focus on influenza and how it is transmitted through contact transmission, droplet transmission, and airborne. Older people are more likely to get an infection due to chronic conditions such as diabetes, chronic obstructive pulmonary disease, congestive heart failure, renal failure and low immunity. Hand hygiene is an essential factor to prevent spreading infection as well as it is necessary to use personal protective equipment (PPE) such as apron, gloves, mask, and goggles to avoid spreading flu and cross-contamination. As a nurse, we need to be aware of and respect the patient’s culture and consider involving them in decisions regarding their care. This essay also includes the involvement of other health professionals, such as dietitians and physiotherapists.

Reference

1. Akagbo, S. E., Nortey, P., & Ackumey, M. M. (2017). Knowledge of standard precautions and barriers to compliance among healthcare workers in the lower manya krobo district, ghana. BMC Research Notes, 10(1), 432-432. https://doi.org/10.1186/s13104-017-2748-9
2. Baek, J. H., Seo, Y. B., Choi, W. S., Kee, S. Y., Jeong, H. W., Lee, H. Y., … Kim, J.W. (2014). Guideline on the prevention and control of seasonal influenza in healthcare setting. The Korean journal of internal medicine, 29(2), 265–280. https://doi.org /10.3904/kjim.2014.29.2.265 mn.
3. Baert, V., Gorus, E., Guldemont, N., De Coster, S., & Bautmans, I. (2015). Physiotherapists’ perceived motivators and barriers for organizing a physical activity for older long-term care facility residents. Journal of the American Medical Directors Association, 16(5), 371-379. https://doi.org/10.1016/j.jamda.2014.12.010
4. Bullock, S., & Manis, E. (2014). Fundamentals of pharmacology (4th ed.). Frenchs Forest NSW, Pearson: Australia.
5. Crisp, J., Taylor, C., Douglas, C., & Rebeiro, G. (2013). Potter & Perry’s Fundamentals of Nursing – Australian Version (4th ed.). Chatswood, NSW. Mosby.
6. Department of Health, (2014). Providing culturally appropriate palliative care to Aboriginal and Torres Strait Islander peoples: Australian government.
7. Farrer, O., Sasanelli, L., Matwiejczyk, L., Yaxley, A., & Miller, M. (2019). The role of dietitians in residential aged care: How do cooks and chefs perceive their contribution? Australasian Journal on Ageing, 38(2), 85-90. https://doi.org/10.1111/ajag.12584
8. Ghebrehewet, S., Macpherson, P., & Ho, A. (2016). Influenza. BMJ, 355, 1-10. https://doi.org/10.1136/bmj.i6258
9. Gothenburg, E. W., MD, & Barron, M. A., MD. (2016). Isolation precautions in the inpatient setting. Hospital Medicine Clinics, 5(1), 30-42. https://doi.org/10.1016/j.ehmc.2015.08.004
10. Gregory, J. (2015). The complexity of pain assessment in older people. Nursing Older People, 27(8), 16-21. https://doi.org/10.7748/nop.27.8.16.e738
11. Han, S., Kim, Y., Hwang, J., Lee, J., & Song, M. R. (2018). Predictors of hospital‐acquired pressure ulcers among older adult inpatients. Journal of Clinical Nursing, 27(19-20), 3780-3786. https://doi.org/10.1111/jocn.14600
12. Kwan, E., & Straus, S. E. (2014). Assessment and management of falls in older people. Cmaj, 186(16), E610-E621. https://doi.org/10.1503/cmaj.131330
13. National Health and Medical Research Council (2013). Australia guidelines for the prevention and control of infection in healthcare. Retrieved from https://www.nhmrc.gov.au/about-us/publications/australian-guidelines-prevention-and-control-infection-healthcare-2019
14. Pinnington, S., Ingleby, S., Hanumapura, P., & Waring, D. (2016). Assessing and documenting fluid balance. Nursing Standard, 31(15), 46-54. https://doi.org/10.7748/ns.2016.e10432
15. Shobugawa, Y., Fujiwara, T., Tashiro, A., Saito, R., & Kondo, K. (2018). Social participation and risk of influenza infection in older adults: A cross-sectional study. BMJ Open, 8(1), e016876-e016876. https://doi.org/10.1136/bmjopen-2017-016876
16. Sundal, J. S., Aune, A. G., Storvig, E., Aasland, J. K., Fjeldsæter, K. L., & Torjuul, K. (2017). The hand hygiene compliance of student nurses during clinical placements. Journal of Clinical Nursing, 26(23-24), 4646-4653 https://doi.org/10.1111/jocn.13811
17. Tang, J. W., Gao, C. X., Cowling, B. J., Koh, G. C., Chu, D., Heilbronn, C., . . . Li, Y. (2014). Absence of detectable influenza RNA transmitted via aerosol during various human respiratory activities -experiments from Singapore and Hong Kong. Plos One, 9(9), e107338-e107338. https://doi.org/10.1371/journal.pone.0107338
18. Yang, L., Nan, H., Liang, J., Chan, Y. H., Chan, L., Sum, R. W. M., . . . Suen, L. K. P. (2017). Influenza vaccination in older people with diabetes and their household contacts. Vaccine, 35(6), 889-896. https://doi.org/10.1016/j.vaccine.2017.01.004

Travel is a major factor when it comes to the spread of infectious diseases. Throughout history, there have been many examples of why traveling and migration have played a major factor in spreading very infectious diseases. In this essay, I’ll be explaining the consequences of traveling during an outbreak, how it relates to our world right now during the COVID-19 pandemic, and the history and examples of previous pandemics to support my claims.

The consequences of traveling during an outbreak are beyond the person traveling. It can also affect the destination’s population, ecosystem, etc., and cause the disease to spread further. In the past when humans traveled and explored the world, they brought their genetic makeup, immunity from past infections, cultural preferences, customs, behavioral patterns, among other things to the place they landed on. Microbes, animals, and other biologic life also accompanied them. This means that diseases that a certain group of people are immune to can also be brought to the place traveling and be transferred to the second group of people that haven’t built up immunity to it yet. This will lead to many members of that second group getting the same disease. Because of their weak immunity to it, it’ll be harder for them to recover from it and many would die because of that. In the next paragraph, I’ll explain examples of this exact situation in the past.

In the past, there have been many cases where outbreaks have started when people began to travel. One example is when Europeans came to America and smallpox and measles ravaged Native American communities. As I explained before, the travelers (Europeans) had built up an immunity to those diseases before coming to the Western Hemisphere, so when they made contact with the new group of people (the Natives), they had no immunity to it. Which led to more than 70 percent of the Native population dying throughout the Americas. Even a century after their initial contact with Europeans, different groups of Natives were becoming infected. The spread usually stayed in one area around New York, but during the years 1756-57, it spread to Ohio Valley. This was because Native fighters that were recruited to fight for the French against the British during the Seven Years’ War contracted the virus. When they came back they infected their communities. Another example is the Native Hawaiians when Captain Cook came. His crew brought things like STD’s which spread quickly. There was also a plague in 1803 that is thought to be yellow fever. It killed up to 175,000 Hawaiians which split their population in half. In 1848, measles and pertussis made their way to Hawai’i via missionary ships, killing another quarter of the population. By 1920, after multiple waves of diseases, there were less than 24,000 Hawaiians.

Bringing it back to the Hawai’i we live in now, we have 17 deaths from the Corona Virus pandemic, which is a lot less than other states in America. This is because of the precautions that our government and Governor Ige put into place. Some major factors that helped us keep our deaths and cases low (compared to other places) are the stay-at-home order and the 14-day mandatory quarantine when you arrive in the islands. The mandatory quarantine was the first of its kind when introduced in the United States. It helps with traveling because, in 14 days, that’s usually when you’re able to see if you have symptoms or not. And if you’re asymptomatic then you’ll have testing done in that time.

In conclusion, when you look through history compared to now, you’ll find many reasons why traveling during outbreaks is bad and the impact that it has on others. Luckily, it seems like we’ve learned a bit from the past, and now that it’s repeated itself, it seems like most places are starting to learn and take the correct precautions to prevent more people from dying.

There are many factors that influence the transmission and contraction of infectious diseases. Some individuals are more vulnerable to infections, due to other serious health conditions or a weaker immune system. For instance, young children have not yet developed their immune systems. A common cause of immunodeficiency is poor nutrition. This is because great nutrition is needed in order to support the immune response. Moreover, lifestyle choices, for example, stress, has a negative impact on the immune system, and this supports the transmission of micro-organisms.

Environmental factors also have an impact on the transmission and contraction of infectious diseases. These factors include pollution, climate, sanitation and a vector presence. For instance, ticks behave as the vector for Lyme disease in the UK. Climate is a less obvious factor that influences the transmission of infection. For example, heavy rain is an environmental factor that causes flooding, resulting in a sewage overflow. This results in an increased chance of individuals developing a disease.

Social factors increase the chance of transmission and contraction of infectious diseases such as poor housing and poverty. For example, if a house is overcrowded, there is an increased risk to airborne infections. The infections that are more common in poor housing are respiratory infections and enteric diseases e.g. diarrhea. Migration and traveling are social factors that influence the transmission of disease as it results in a greater chance of individuals developing an infection. For example, Typhoid is only in high-risk locations such as Africa and the Indian Subcontinent. Nutrition influences the transmission of infection because if individuals have poor nutrition, they will be more vulnerable to infections but if they have great nutrition, they will be less chance of them developing and transmitting infections.

The transmission and contraction of infectious diseases can be influenced by social factors such as poverty. There are many infectious diseases that are more common to individuals who experience poverty. Evidence that supports this is from the source RESET, 2015 which states The three diseases most commonly linked to poverty HIVAIDS, Malaria, and Tuberculosis are the cause of six million deaths globally per year. This evidence demonstrates that poverty does have a serious influence on the transmission and contraction of infectious diseases. Moreover, this source states According to the Global Report for Research on Infectious Diseases of Poverty, poverty-related circumstances such as lack of food, shelter, security and social protection make people more vulnerable to infections, while affected populations are often unable to obtain even the most basic means of prevention and care. This clearly indicates that those from social class are more vulnerable and prone to developing infectious diseases, compared to those from upper-class who are wealthier. Poverty and poor housing can have a negative influence on the transmission and contraction of infectious diseases as poor housing can often consist of dampness and mold, causing respiratory problems. Additionally, this source states, According to UNICEF ‘malaria is truly a disease of poverty afflicting primarily the poor who tend to live in malaria-prone rural areas in poorly-constructed dwellings that offer few, if any, barriers against mosquitoes. This evidence indicates that individuals who live in poverty and in rural areas don`t have the resources and money they require to reduce the barriers and prevent them from being in contact with infected mosquitoes. This social factor negatively influences the transmission and contraction of infectious diseases as living in poverty consists of a lack of treatment and personal protective equipment (PPE). Evidence that supports this is from the World Economic Forum, 2020 which states, The global community must help LDCs expand PPE and technology for frontline workers, ensure an uninterrupted supply of essential medicines and equitable access to vaccines and medication. Without these resources and financial accountability, will seriously impact the transmission and contraction of infectious diseases such as Coronavirus within poor living countries e.g. Africa and South Korea. For instance, lack of PPE will increase transmission and contraction as it puts the public who live in poverty at a severely high risk of contracting this viral infection, possibly resulting in death.

On the other hand, to minimize this factor and reduce the risk of transmitting and contracting viral infections like this, more financial accountability needs to be provided to poverty-living countries. This will have a positive influence on society as it enables PPE to be provided, medical treatments to experiment and high-quality care to be given. This will reduce the rates of fatalities within poverty countries. This also suggests that living in poverty can influence the transmission and contraction of infectious diseases by poor nutrition. This is because those that live in poverty are more likely to eat unhealthy as the food is known to be cheaper. Evidence that supports this is from the source World Health Organisation which states Tuberculosis can be prevented by improving nutrition and can be treated with DOTS therapy. This can detect and cure disease in up to 95 percent of infectious patients, even in the poorest countries. This suggests that this factor can have a positive influence as good nutrition reduces the likelihood of the transmission and contraction of bacterial infectious diseases such as Tuberculosis. This factor can also have a positive influence as it`s a preventative measure to support the reduction of transmission and contraction of infectious diseases. This will minimize the likelihood of infectious diseases in the overall population, resulting in an improvement of overall health. Increasing the price of fast foods which are unhealthy and reducing the price of healthier foods such as fruits and vegetables would be a great preventative measure. This would encourage individuals within the public to spend less and eat healthier food which will be successful as it will benefit the overall health of the population. This would reduce the number of infectious diseases such as Tuberculosis and other diseases and problems such as Type 2 diabetes and obesity. Minimizing the transmission and contraction of infectious diseases would prevent individuals from experiencing heart disease and high blood pressure.

The climate is an environmental factor that influences the transmission and contraction of infectious diseases. Being in contact, for example, drinking contaminated water can expose individuals to waterborne infections. Contaminated water can be caused by a range of factors such as weather events or incorrect disposal of sewage wastes. Climate can influence the transmission and contraction of waterborne diseases such as cholera and poliomyelitis because if there is heavy rain, sewage overflow can cause these diseases. This is negatively influenced by this factor as some individuals in poorer countries have a lack of knowledge due to financial stability regarding the climate. For instance, without having any knowledge about the climate, the population in some countries doesn`t understand what the right or wrong disposal of sewage waste is. This then influences the transmission and contraction of water-borne diseases as individuals could be contaminating the water if disposed of incorrectly. Similarly, this environmental factor negatively influences the transmission and contraction of infectious diseases such as Cholera as micro-organisms thrive of cold conditions in order to support them with growth. This means that when bacteria grow in reservoirs of infections such as humans, this can influence the transmission and contraction by encountering food that`s been in contact with an infected individual and drinking contaminated water. In contrast, the climate can positively influence the reduction of transmission and contraction of infectious diseases by numerous ways. According to NHS, 2018 there are many factors that will help minimize the influence that the climate has on infectious diseases. This source states, to wash your hands with soap and water regularly, especially after using the toilet and before preparing food or eating, only drink tap water that’s been boiled or bottled water, and brush your teeth using bottled or boiled water. This evidence shows the importance of protecting all individuals from infectious diseases by carrying out these preventative measures daily, ensuring the levels of transmission and contraction is being reduced.

In contrast, the climate can influence the transmission and contraction of infectious diseases through vector-borne. Evidence that supports this is from the source Stanford University, 2019 which states, Mordecai`s research has found that warmer temperatures increase transmission of the vector-borne disease up to an optimum temperature. This clearly shows that the climate does influence the transmission and contraction of vector-borne diseases such as Malaria, as mosquitoes are more common in hot countries such as Asia and Africa. For instance, malaria is most likely to spread at 25 degrees Celsius (78 degrees Fahrenheit). This economic factor influences the transmission and contraction of infectious diseases as this is where vector-borne diseases occur the most. This climate condition has a negative impact on reservoirs of infection such as humans or vectors such as ticks because humans may be asymptomatic and therefore, show no symptoms of the infectious disease. This can have a severe impact on the human population as being asymptomatic means that there is no control of the infectious disease as it will be extremely difficult to identify when the transmission and contraction occur between humans and vectors. According to NHS, 2018 malaria is spread by Once you’re bitten, the parasite enters the bloodstream and travels to the liver…the parasites grow and multiply in the red blood cells…the infected blood cells burst, releasing more parasites into the blood… Each time they burst, you’ll have a bout of fever, chills and sweating. In addition to this, vectors such as mosquitoes can contract infectious diseases such as Malaria by biting an infected human (usually at dusk and dawn), and they can transmit this disease to other individuals. Malaria, however, cannot be transmitted directly from one individual to another. To minimize the transmission and contraction of infectious diseases within a warm climate, individuals should be aware of the risks regarding malaria prior to traveling and whether they will need prevention tablets. In order to do this, individuals should seek to a medical expert to gain advice and guidance regarding the different forms of tablets that they may be entitled to. Another factor that can have a positive influence on the transmission and contraction of infectious diseases such as Malaria is to gain access to resources that prevent mosquitoes from biting such as insect repellent and always seek to a doctor if individuals experience any symptoms of vector-borne diseases. Overall, this evidence demonstrates how the transmission and contraction of vector-borne diseases are influenced by warm climates.

Air pollution is another environmental factor that influences the transmission and contraction of infectious diseases. There is an association between air pollution and the transmission and contraction of infectious diseases because air pollution can contain harmful chemicals that have an influence on the growth of micro-organisms, enabling them to enter and spread around the body. Evidence that supports this is from the source Medical News Today, 2017 which states, New research suggests that air pollution may have an effect on human health by altering bacteria. It shows that black carbon, a major component of air pollution, dramatically changes how bacteria grow and form biofilms, which can affect their survival in the lining of airways and their resistance to antibiotics. This shows that the agent of infection, bacteria, is influenced by black carbon which is a harmful chemical produced by air pollution. This evidence suggests that air pollution influences the transmission and contraction of infectious diseases as it prevents the treatment that supports the infectious disease from working effectively. Moreover, this source states, According to the World Health Organisation (WHO), air pollution is the largest environmental risk factor for human disease. They estimate that in 2012, around 1 in 8 deaths worldwide were due to exposure to air pollution. This clearly demonstrates that air pollution can have a severe negative influence on the transmission and contraction of infectious diseases and have even resulted in death. This suggests that individuals who live in urban areas will have an increased chance of transmitting and contracting infectious diseases as this is where the most air pollution occurs. According to the source World Health Organisation, It is well documented that air pollution is a leading cause of human morbidity and mortality globally, and it can increase the risk of numerous diseases, including respiratory disease. Although air pollution is not the main cause of respiratory infections, it does have an influence on their transmission and contraction of them. Additionally, the agents that can cause respiratory infections are bacteria, viruses and fungi and this environmental factor, air pollution, influences the transmission of micro-organisms which individuals can then contract.

To minimize the transmission and contraction of infectious diseases in an area where there is a lot of air pollution, individuals should take fewer car journeys when they can, meaning that they should walk wherever possible. This will positively influence the transmission and contraction of infectious diseases because it will make a dramatic improvement of the overall health of the population and will, therefore, reduce the rates of transmission and contraction of infectious diseases. This would be successful as it ensures that not only humans are being benefitted, but the environment and economy too. According to The Guardian, 2016, The report linked polluted air to cancer, asthma, stroke, and heart disease, diabetes, obesity, and dementia, and calculated that NHS, business, and other costs in the UK came to more than £20bn a year. This indicates that minimizing the barriers that we face with air pollution, will put less pressure on both the government and individuals. This is because if people walk more and drive less, these infectious diseases can be prevented which will, therefore, have a positive influence on the transmission and contraction if infectious diseases within society. Moreover, this money that they`re providing to treat the diseases that air pollution is causing will be able to be provided to individuals who experience infectious diseases which cannot be prevented. Overall, air pollution does have a serious influence on the transmission and contraction of infectious diseases as it is causing an annual rise in morbidity rates, however, this can be prevented by taking journeys wisely and avoiding moving to busy areas e.g. London, as this will support and reduce the transmission and contraction of infectious diseases.

New Diseases

Introduction

A disease is a certain condition that affects an organism by weakening the body’s general functions and psyche; it is also affiliated with particular symptoms and signs. The factors that contribute to an organism having a disease may be intrinsic or extrinsic. Intrinsic factors originate within a host and could be caused by a disorder from that host, which compromises the processes of body organs or genetic features of the host. Extrinsic factors are when a host comes into contact with an entity from outside and it enters the host’s system. A disease that is infectious commonly called infectious disease results from pathogenic microorganisms that transmit straight directly to individuals by physical contact or indirectly spread when someone sneezes or coughs (Nii-Trebi 2017). There are numerous types of diseases but recently with modern society, there has been an elevation of infectious diseases emerging due to globalization, trade, urbanization, travel, and human spread into new regions. As a result, these factors contribute to the formation of new infectious diseases such as SARs, MERS, and COVID-19, which have spread and caused the loss of countless human lives.

Factors of modern human societies which enhance the risk of new infectious diseases appearing and spreading.

Urbanization

Urbanization is one of the modern human social factors that have contributed to the formation of emerging infectious diseases. It’s referred to as the expansion and settlement of individuals into urban surroundings and dates back to the 18th century of the industrial revolution. The industrial revolution was the epitome of urbanization, where individuals relocated to cities for the prosperity of improved education, increased income, and better overall health care. Now more than 54% of the world’s population is urbanized with even countries such as Asia and Africa expected to have rapid advancement and development. However, with urbanization comes complications as some urban areas still experience unacceptable housing, inefficient ventilation, contaminated water, and inadequate hygiene. These are all perfect environments for infectious diseases such as soil-transmitted helminth infections, respiratory infections, and SARS. Furthermore, with the discrepancy of economies and advances in different countries, the meaning of an urban area altered as urban housing in Africa may not be considered urban in America and more rural. With rural areas classified as urban, which is prevalent in more low-income countries, the infectious disease causes one of the most deaths (Neiderud 2015).

“A country that is a great example of how urbanization has enhanced the risk of new infectious diseases appearing and spreading is China. China covers the majority of the world’s population and has an essential role in the exchange of goods and services to other countries. In the past decades, China has experienced extensive economic growth, but this improvement to their economy comes at the risk of their environment and public health. The hasty rush of urbanization made China more prone to infectious diseases, and their health services were unable to improve to combat the emergence of new diseases. This is what allowed the spread of new diseases such as the coronavirus to appear and infect individuals in China and all over the world. Moreover, this is how urbanization in particular countries allows for the emergence of new infectious diseases to surface (Tong et al. 2015).”

Climate change

“Climate change is a very concerning matter in modern society as temperatures begin to rise, which causes warmer climates and extreme weather patterns; these weather conditions create a suitable condition where pathogens, hosts, and vectors can occur. Additionally, adjustments to the weather can facilitate the survival of particular infectious pathogens that cause diseases in humans. There is a possibility the changes in the weather could lead to new infectious diseases emerging as pathogen thrives in warmer weather, thus spreading and infecting humans. The numerous disease that arises from these fluctuations of weather could be vector-borne, water-bone, airborne and droplet-spread diseases. Vector-borne diseases come from sandflies and mosquitoes they are highly responsive to slight shifts to occasional and geographical distributions of weather. This means they are capable of spreading various diseases and what they spread could be modified due to the climate as it is known mosquitoes favor more humid environments to breed and spread. Water-borne diseases arise from inadequate sanitation and failure to provide clean drinking water, which is predominant in modern society. The inability to access clean drinking water and humidity in rural areas is a massive aspect of why waterborne diseases occur, which could also lead to new diseases emerging. Environmental factors are what contribute to airborne and droplet spread diseases, and these are magnified due to immense changes in climate (Dennis & Fisher 2018).”

“The weather in climate change such as floods, heatwaves, droughts, and storms that get amplified makes humans more susceptible to get infectious diseases. Heavy rains and storms can result in unsanitary sewer overflow and stoppage, as well as, excessive heat, which makes insects and rodents emerge, which are all factors that could cause the risk of new diseases to appear. Furthermore, depending on the country or region some are more vulnerable to infectious diseases than others as ways of countering these diseases are limited as climates modify. Climate change and its irregular weather patterns can amplify the materialize of certain new infectious diseases to spread to different areas and the rest of the world (Liang & Gong 2017).”

Migration/travel

“Migration can be defined as the process of individuals moving to certain areas with the objection of staying at their new location or seeking for another if not suitable. It is an essential part of human society as it allowed for the development of many countries and it is directed by political, socio-economic, and environmental factors. Migration has increased abundantly in the last decade as Western Europe, Spain, Russian, Ukraine, France, Italy, and Germany become one of the highest-migrated countries in the world (Castelli & Sulis 2017).” There have been positive aspects of migration as it has allowed for multiculturalism, diversity, trade, and economic growth in many countries. “Although this is the case it has also allowed for the spread of infectious diseases from all over the world as individuals move from one area to another. The movement from a new place to the next from rural areas or poverty can bring about new unknown diseases to certain countries, which can spread and cause an outbreak.

This correlates with travel as traveling has enabled individuals to move from all aspects of the world. However, traveling to rural countries has led to individuals bringing diseases back to their own country and even diseases that are new and had not been identified. This is the issue with modern travel as it is difficult to track who has been infected by what, and if so how to treat the infected individual (Torresi & Steffen 2017)”. This is how migration and travel have enhanced the risk of new infectious diseases occurring and spread as humans can transmit it to others all over the world.

Some modern diseases and how might they have been affected by these factors

Covid-19

“The coronavirus disease is also known commonly as COVID-19 is a highly contagious and pathogenic infectious disease resulting from extreme mild respiratory issues, which emerged from Wuhan, China. This is such as new infectious disease that its origins of it are unknown and there is no vaccination or anti-viral drug to treat the symptoms of cough, fever, and tiredness of the disease. However, it has been narrowed down to severely affect individuals who are old or have an underlying health issue such as asthma, diabetes, or a weak immune system. Nonetheless, this disease was never heard of until the spread of it by human societal factors such as urbanization and travel, which caused it to become an outbreak (Shereen at al. 2020).”

“The first case of the disease dated back to December of 18th of 2019 when an elderly individual was admitted to the hospital with flu-like symptoms, however, passed away due to the hospital’s inability to treat the disease. This has been an issue with China as its rapid urbanization has not allowed improvements into their health care systems, thus causing new infectious diseases like COVID-19 to occur and spread. Also, since the disease was treated like the flu individuals dismissed it, and this allowed it to spread from China to the rest of the world. The symptoms take a few days to occur and since there were so many individuals traveling to and from China it was able to transmit to the rest of the world quickly (Rothan & Byrareddy 2020).”

MERS

“MERS is another form of novel coronavirus that had a similar outbreak to COVID-19 with its first occurrence in 2015. MERS presents symptoms that are very similar to COVID-19 as individuals who are infected may experience coughing, fever, headache or shortness of breath, but is manageable due to extensive care to control any outbreaks of this disease. The disease was first occurred in the Middle East and caused about 539 deaths, and quickly become a threat to health globally as it soon spread to South Korea. The complication this time was that individuals with MERS were traveling from Middle Eastern Countries back to South Korea which allowed it to spread and cause the death of many citizens. Traveling individuals was the major issue with MERS and any other diseases as it allowed for it not to isolate just to the middle east (Kim et al. 2015).”

SARS

“SARS was discovered the earliest out of all the novel coronaviruses as the first cases were identified in Hong Kong of 2003. The viruses were thought to only affected animals at the time, however, this was later proven wrong with human cases developing as more than 8000 individuals become infected. The symptoms of this disease are very similar to influenza and individuals who had it would have experienced fevers, headaches, difficulty in breathing, and immense tiredness. The factors that caused this virus to appear and spread was the urbanization of China, which allowed the disease to transmit so fast, and on top of that the extreme climates of China amplified the occurrence of the disease as it becomes a global outbreak (Wong et al. 2015).”

Conclusion

This report demonstrates how modern human societal factors such as urbanization, climate change, travel, and migration can facilitate the emergence of new infectious diseases. Individuals in urban areas can cause diseases to spread quickly to one another, while migration and travel can cause diseases to spread all over the world. Also, climate change can amplify and cause disease to frequently appear and provide the essential environment for it to stay. The newly emerged diseases such as Covid-19, MERS, and SARS are the result of these factors, which have caused them to appear and spread to thousands of individuals all over the world.

References

1. Castelli, F. and Sulis, G., 2017. Migration and infectious diseases. Clinical Microbiology and Infection, 23(5), pp.283-289.
2. Dennis, S. and Fisher, D., 2018. Climate Change and Infectious Diseases: The Next 50 Years. Annals of the Academy of Medicine, Singapore, 47(10), pp.401-404.
3. Kim, K.H., Tandi, T.E., Choi, J.W., Moon, J.M. and Kim, M.S., 2017. Middle East respiratory syndrome coronavirus (MERS-CoV) outbreak in South Korea, 2015: epidemiology, characteristics, and public health implications. Journal of Hospital Infection, 95(2), pp.207-213.
4. Liang, L. and Gong, P., 2017. Climate change and human infectious diseases: A synthesis of research findings from global and Spatio-temporal perspectives. Environment international, 103, pp.99-108.
5. Neiderud, C.J., 2015. How urbanization affects the epidemiology of emerging infectious diseases. Infection ecology & epidemiology, 5(1), p.27060.
6. Nii-Trebi, N.I., 2017. Emerging and neglected infectious diseases: insights, advances, and challenges. BioMed research international, 2017.
7. Rothan, H.A., and Byrareddy, S.N., 2020. The epidemiology and pathogenesis of coronavirus disease (COVID-19) outbreak. Journal of autoimmunity, p.102433.
8. Shereen, M.A., Khan, S., Kazmi, A., Bashir, N. and Siddique, R., 2020. COVID-19 infection: origin, transmission, and characteristics of human coronaviruses. Journal of Advanced Research.
9. Tong, M.X., Hansen, A., Hanson-Easey, S., Cameron, S., Xiang, J., Liu, Q., Sun, Y., Weinstein, P., Han, G.S., Williams, C. and Bi, P., 2015. Infectious diseases, urbanization and climate change: challenges in future China. International journal of environmental research and public health, 12(9), pp.11025-11036.
10. Torresi, J. and Steffen, R., 2017. Redefining priorities towards graded travel-related infectious disease research. Journal of travel medicine, 24(6).
11. Wong, G., Liu, W., Liu, Y., Zhou, B., Bi, Y. and Gao, G.F., 2015. MERS, SARS, and Ebola: the role of super-spreaders in infectious disease. Cell host & microbe, 18(4), pp.398-401.