NURS 4327001 Population Focused Health

Introduction:

H1N1 pandemic outbreak was first detected in the United States in 2009 which posed the greatest pandemic threat to the courtiers placed in the international border (cdc.gov., 2018). The centre of disease control suggested that it was Avian influenza A (H5N1) which posed greatest threats worldwide.  It was first discovered in April 15, 2009, in the United States, detected in the 10-year-old patient and widespread in the North American lineage.  The study suggested that close association of the infected pig causes infection. The outbreak was detected in the international borders when 12 cases of human infection was reported where 5 of them were in direct contact with the infection, six of them close to the pig and one of them were unknown. After the declaration of a pandemic on June 11, all 50 countries were under pandemic threat. In addition, an estimated 74 countries had reported confirmed laboratory infections in 2009. The outbreak was found to cause increase in the rates of summer infection in northern hemisphere, and increased activity levels during the winter months in this region of the world. Young children, pregnant women and individuals of all age, suffering from lung cancer and comorbidities were found to be at an increased risk of severe illness. Some of the countries included District of Columbia, Puerto Rico and Virginia Island. The widespread of the infection also reported in San Diego and imperial country (Cdc.gov., 2018). Confirmed deaths that occurred due to the outbreak in European union and EFTA, Africa, North America, South America, Southeast Asia and Australia and Pacific islands were 2290, 116, 3642, 3190, 393, and 217, respectively (ECDC, 2010). The cluster of the infection also found in the high school of Kansas which is Midwestern part of United States.

Discussion:

Analysis of the epidemiological determinants and risk factors:

The widespread influenza infection posed threat in the different countries which was first detected in California in 10 years old boy and the second infection was detected the130 miles away from the location of the first infection in 8 years old patient. Centre for disease control and prevention suggested that the epidemiological determinants of the influenza outbreak were infected swine since 12 cases of human infection that was reported in 2009 exhibited the direct contact with infected swine .human to human spread of swine was rarely documented but epidemiological study showed that human to human transmission was taken place which causes the disease (Qualls et al., 2017).  The identified risk factor of associated disease was that the viruses were resistant to two potential antiviral drugs such as amantadine and rimantadine (Chidgzey et al., 2015). A study by Fumanelli et al. (2016), suggested that in the case of influenza infection, potential risk factors are morbid obesity, the chronic liver disease where the immunosuppressant were used. The children, as well as pregnant women, were at higher risk of developing the infection caused by influenza flu (Chidgzey et al., 2015)

The route of the transmission of the disease: 

 As discussed by Jombart et al. (2014), the H1N1 flu infections common viral infection that can be deadly especially for the high-risk group such as children. According to Croucher and Didelot (2015), the flu attacks the lungs, throat, and nose of young children, older adults as well as older adults who have a weak immune system. The route of transmission is infected person who coughed and sneeze, they spray the tiny drops of the virus into the air. In the current context of influenza, the route of transmission was infected swine. In the current outbreak, the reported 12 cases of human infection were taken place due to direct exposure to the infected swine in the different part of the country (Dalziel et al., 2018).  Based on the primary epidemiological data demonstrated that human to human transmission is identified in many cases and viruses have the ability to cause the community-level outbreak.

Outbreak impacted the community:

Influenza places a significant socioeconomic burden on individuals, families, and society. Influenza outbreak mostly would affect the household with young children, pregnant women as well as individuals with chronic disease (Rodriguez-Morales et al. 2016). As reported in the outbreak of 2009, transmission of the infection causes severe influenza-like illness and deaths in Mexico, especially in high schools of California along with the population with chronic disease. The pregnant women were suspected for the high risk of developing seasonal influenza. The report suggested that 71% of hospitalized patients had one or more underlying chronic medical conditions (cdc.gov., 2018). The reported deaths of the infection were in between 22 months to 57 years old. The hospitalization observed in the 13% of the population where individuals were 50 years or more than 50 years to 57%. Therefore, as discussed before, it would impact the young children of the high school who would be at close contact with the infected swine (World Health Organization., 2017).  As discussed by Agoti et al. (2017), the household with larger families are a higher risk of developing the disease. The outbreak would increase the hospital admission, especially for the infected individual. The outbreak would hinder the schooling of children and thereby, closing the high school would manage the impact. An outbreak would impact local government sectors since the preventive measures would be taken to manage the outbreak of influenza. The vulnerable population also include the lower income class of the community who would fail to seek the health care assistant due to high health care expenditure.  Families lack adequate resources to protect their own health would be affected by the outbreak (Dalziel et al., 2018). The health care would directly impact since the preventive cost of each infected individual is high.  A health care professional would follow the framework of mange and prevention of influenza outbreak, especially health professionals from the emergency department (Dalziel et al., 2018). It would affect the local governing bodies and federal government and governance framework, as well as policies, would be followed for limiting the outbreak. The community would be managed by providing critical care along with flu care nurses and practitioner as well as other health care staffs.

Reporting protocol for the outbreak in the community:

When an outbreak occurs in the community, reporting is the crucial part of the management of the outbreak as well as the reduction of the global burden of the disease. By following International Health Regulations (1969), the world health organization’s designed a reporting framework for the communicable disease in the community. According to the world health organization’s when an outbreak about to occur in the community, first reporting protocol would be the identification of the disease that would cause a severe outbreak (World Health Organization., 2017). After identification, it is crucial to identify who would be at higher risk of developing the disease and their sociodemographic position, yearly income and house old situation. Therefore, health care workers would notify to local health authority about the communication disease that exists in the particular jurisdiction. The health care professional is required to notify identification data, affected individuals and age group, severity level (Lo, Mertz & Loeb, 2017). The health care professionals required to notify exposure date and time, suspected or confirmed etiologic of the communicable disease. Furthermore, they are also required to notice how the outbreak was identified as well as the other relevant background information related to the disease.

Strategies for prevention of the influenza outbreak in the community:

Traditionally, influenza virus has been thought to spread from person to person primarily through larger particle of respiratory droplet transmission. Therefore, preventing transmission of influenza virus and infectious agents within the health care setting requires a multifaceted approach (World Health Organization., 2017). Two strategies can be implemented in the health care setting for preventing the community outbreak. The first strategy would be patient education strategy for preventing the community outbreak. In order to educate the patient, it is crucial to provide information about influenza, route of transmission and exposure as well as who are at higher risk of developing the disease (Perry et al., 2016). The patient education strategy also involves initiative that would be taken by health care professionals to provide a basic education of the use of influenza vaccines, side effects of the vaccines and who should be vaccinated. This information would provide through arranging a session with the patients as well as family members and the information would be written pamphlet (Agoti et al., 2017). Yozwiak , Schaffner and Sabeti (2016), focused on the infected children and the elder population who will receive the education along with their family members for self-care during the period of infection. Moreover, basic health hygiene education should be provided to the patient and family members of the patient for managing the communicable disease.

  The second education strategy would community education strategy where the households of larger families and vulnerable individuals would receive the education about the information relevant to the communicable disease and preventive measures and basic nutritional sources and possible health care facilities for prevention (Groom et al., 2015). This education strategy would be provided by community stakeholders for each household.

Conclusion:

  Thus it can be concluded that the widespread influenza infection posed a threat to international borders in 2009 which infected a number of individual in California. The suspected route of transmission was exposure to infected swine and infected human to human contact. The vaccinations were provided to the patient for the managing the outbreak. The outbreak most affects vulnerable children, pregnant women, and patients with chronic disease. The reporting protocol would be collecting information about the infection and report it to the local authority. After reporting, the communicable disease outbreak would be prevented by patient education and community education.

References:

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cdc.gov. (2018). The 2009 H1N1 Pandemic: Summary Highlights, April 2009-April 2010. Retrieved from https://www.cdc.gov/h1n1flu/cdcresponse.htm

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Croucher, N. J., & Didelot, X. (2015). The application of genomics to tracing bacterial pathogen transmission. Current opinion in microbiology, 23, 62-67.

Dalziel, B. D., Kissler, S., Gog, J. R., Viboud, C., Bjørnstad, O. N., Metcalf, C. J. E., & Grenfell, B. T. (2018). Urbanization and humidity shape the intensity of influenza epidemics in US cities. Science, 362(6410), 75-79.

European Centre for Disease Prevention and Control. (2010). ECDC Daily Update – Pandemic (H1N1) 2009 – 18 January 2010. Retrieved from https://ecdc.europa.eu/en/healthtopics/Documents/100118_Influenza_AH1N1_Situation_Report_0900hrs.pdf.

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