Transcript What is a Communicable Disease?

Responding to Communicable
Diseases
Dr. Cheryl Anderson
National RAP Conference, Vancouver ,
February 20, 2007
What is a Communicable Disease?
Sickness caused by transmission of an
infectious agent to a susceptible host
Infectious agents include:
 Viruses
 Bacteria
 Protozoa
 Worms
How do humans get infected?
TRANSMISSION of infectious agents to
Susceptible Human Host occurs in variety of
ways, including:
 Touching/biting/kissing
 Sexual intercourse
 Droplets from sneezing, coughing, spitting
 Airborne particles, e.g. TB
 Mother to fetus during pregnancy
 Injections of contaminated blood
Does every exposed host get sick?
The Healthy host may not get sick or may have a
mild response to infection:
 TB – 90% of infected never get sick
The human host may become a carrier capable
of infecting others without ever getting sick
 Hepatitis B and C
How many people die from Infections?
Globally 1/3 of premature deaths are infectionrelated – mostly in poor countries:
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Diarrheal disease – 2-3 million deaths yearly
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Malaria – 2-3 million deaths yearly
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TB – 2-3 million deaths yearly
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HIV – more than 4 million deaths in 2005
Why poor countries?
 Poor nutrition
 Poor living conditions
 contaminated water
 no sewage
 crowded or no housing
 Poor or non-existent health care –
preventative & curative
What Prevents Infections?
Public Health Infrastructure
 Sewage systems
 Safe food
 Safe water
 Housing codes
 Vector control, e.g. mosquitoes
Personal Prevention strategies
 Good nutrition
 Immunization
 Hygiene
 Protective coverings
 Condoms
 Mosquito nets
 Disinfestation/Disinfection
 Avoid exposure
Medical interventions & infection control
 Isolation of sick person e.g. TB
 Prophylactic treatment of contacts
 Early detection and treatment
 Direct Observed Therapy (DOT) for TB
 Ensures completion of therapy
 Reduces development of resistance to treatment
 Infection control in hospitals/facilities
What puts refugees at risk?
Increased exposure to diseases endemic to
 Country of origin
 Refugee camp or transit country
Poor public health infrastructure
Poor nutrition
Poor immunization rates
Crowded housing
Poor or non-existent health care
How does CIC protect the Public’s Health?
Immigration Medical Examination screens for:
 HIV, Tuberculosis, Syphilis
Medical Surveillance Post Landing by Public
Health for:
 Inactive tuberculosis
 Treated positive syphilis serology
If HIV positive, immigrant advised to contact
clinic specializing in HIV following entry into
Canada
Who is at risk for TB in Canada?
Tuberculosis (TB) in 2005
 Total cases 1616 (5.0/100,000)
 Canadian born cases 519 (2.0/100,000)
 Aboriginal cases 308 (26.8/100,000)
 Non-Aboriginal cases 211 (0.9/100,000)
 Foreign born cases 1016 (14.8/100,000)
 Rates in top 3 source countries in 2004
China – 101/100,000
India – 168 /100,000
Philippines – 293 /1000,000
Reducing risk of infection/illness
Food Security and Nutrition
 Means and access to healthy food
 Canada Food Guides
Food Safety
 Instruct on proper storage and preparation
Appropriate Housing
Reducing Risk of Infection
Personal hygiene
Immunizations
Avoiding exposure
Protective coverings
 Condoms
Reducing Risk of Illness when Infected
Early detection and treatment
 Examples – HIV, TB
Healthy living
 Exercise, good nutrition, sleep
 Avoiding harmful substances, e.g. nicotine
How do settlement workers stay healthy?
 Healthy lifestyle – exercise, nutrition, sleep,
etc.
 Immunizations
 Personal hygiene
 Medical follow-up if:
 Asymptomatic but known exposure; or
 Symptomatic for early detection/treatment
Public Funded Immunizations (Canada)
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Diptheria
Tetanus
Pertussis (whooping cough)
Polio
Haemophilus influenzae type b
Hepatitis B
Measles, Mumps, Rubella
Varicella (Chicken Pox)
Meningococcal C conjugate
Penumococcal conjugate
Influenza (Flu)
Information Sources:
BC Health Files. Ministry of Health. www.gov.bc.ca
Canadian National Report on Immunization. Canada Communicable
Disease Report Supplement Vol32S3 Nov, 2006. Public Health Agency
of Canada.
Citizenship and Immigration Canada: Facts and Figures 2005.
www.cic.gc.ca
Country Profiles on Tuberculosis, World Health Organization. www.who.int
Health Canada: Eating Well with Canada’s Food Guide, 2007. www.hcsc.gc.ca
Heymann, David L., Editor. Control of Communicable Diseases Manual,
Official Report to American Public Health Association, 18th Edition, 2004.
Tuberculosis in Canada 2005. www.publichealth.gc.ca/tuberculosis
BC Health File Topics - www.bchealthguide.org/healthfiles/index.stm
Sneezes and Diseases Handbook http://www.vch.ca/public/communicable/docs/sneezes_diseases.pdf