C10 Diseases Pathogens rev2 (S)

Introduction to Diseases & Pathogens

Focus of the session: Preventing disease transmission and understanding infection control in healthcare environments.

Exposure Risks in Healthcare

Healthcare Worker Stats:

• Approximately 5.6 million healthcare workers in the U.S. face the risk of exposure to bloodborne pathogens, including HIV (Human Immunodeficiency Virus), HBV (Hepatitis B Virus), and HCV (Hepatitis C Virus). These workers are often involved in direct patient care or manage biological materials, which increases their exposure risk.

OSHA Standards:

• The Occupational Safety and Health Administration (OSHA) has established standards to safeguard healthcare workers against exposure to blood and other potentially infectious materials. Employers are required to implement various safety measures, including employee training and proper use of personal protective equipment (PPE).

Tuberculosis in Malaysia

Reported Cases:

• In Malaysia, the number of reported tuberculosis cases was significant: 22,710 cases in 2012 and 24,071 cases in 2013, resulting in 1,597 deaths. The state of Sabah in Malaysia reported the highest incidence of these cases, highlighting a critical area for public health intervention.

Control Measures:

• To combat tuberculosis, the BCG (Bacillus Calmette-Guérin) vaccination is administered, especially in high-risk groups. Comprehensive screening and diagnostic efforts, coupled with public awareness campaigns, are also critical components of tuberculosis control efforts.

Learning Objectives

• Understand the pertinent laws and regulations governing healthcare practices.

• Identify and characterize significant diseases of concern in healthcare settings.

• Recognize and implement effective methods to prevent disease transmission among healthcare workers and patients.

Laws and Safety Regulations

OSHA 1994 Act:

• The OSHA Act mandates that employers provide a safe working environment, ensuring compliance with safety standards to mitigate risks associated with biological hazards.

Biological Hazards:

• Employers are legally required to take appropriate measures to reduce exposure to bloodborne pathogens and uphold workplace safety protocols.

Pathways of Disease Exposure

Common Exposure Routes:

• Exposure can occur via needlestick injuries, cuts from contaminated sharps (needles, blades), and contact with mucous membranes (eyes, nose, mouth) exposed to infected fluids.

Transmission:

• Pathogen transfer can occur in both directions; infected individuals can spread pathogens to others, and non-infected individuals can also inadvertently carry pathogens to susceptible populations.

Chain of Infection Components

1. Infectious Agent: Pathogen that can cause disease.

2. Reservoir: Natural habitat where pathogens live and multiply (humans, animals, environment).

3. Means of Exit: Route by which the pathogen leaves the reservoir (e.g., respiratory secretions, blood).

4. Mode of Transmission: How the pathogen is transferred (direct, indirect, airborne, vector-borne).

5. Means of Entry: How pathogens enter a susceptible host (e.g., skin breaks, respiratory tract).

6. Susceptible Host: An individual who is at risk of infection.

Transmission Modes:

• The modes of transmission include direct contact, indirect contact through intermediate objects, airborne transmission via droplets, and vector-borne transmission through organisms like insects.

Pathogen Types

Categories of Pathogens:

1. Viruses: Require a host cell to reproduce (e.g., Hepatitis, HIV).

2. Bacteria: Microscopic organisms capable of significant disease (e.g., Tuberculosis, Staphylococcus infections).

3. Fungi: Include organisms like yeasts and molds causing infections (e.g., Ringworm).

4. Protozoa: Single-celled organisms often transmitted through water or food (e.g., Malaria).

5. Parasites: Complex organisms that depend on hosts for survival and can cause various diseases.

Bloodborne Pathogens

Definition:

• Bloodborne pathogens are infectious microorganisms in human blood that can lead to disease and are a significant concern in healthcare settings.

Conditions for Transmission of Disease:

• Several criteria must be met for disease transmission to occur:

  1. Presence of the pathogenic organism in sufficient quantity.

  2. The susceptibility of the host.

  3. Appropriate route of entry, such as through open wounds or mucous membranes.

Infectious Diseases of Concern

Key Diseases:

• Important diseases to be aware of include:

  • Herpes: Can cause severe health issues especially in immunocompromised individuals.

  • Meningitis: Inflammation of protective membranes covering the brain and spinal cord; can be bacterial or viral.

  • Tuberculosis: Chronic disease with serious public health implications.

  • Hepatitis: Including HBV and HCV, which can lead to liver damage and are major health concerns.

  • HIV: Leads to AIDS, severely compromising immune system function.

Concerns:

• Each of these diseases poses potentially severe consequences for both individuals and public health systems if transmitted within healthcare settings.

Hepatitis Overview

Hepatitis B (HBV):

• This virus is transmitted through contact with infected blood and body fluids. Symptoms may include jaundice, fatigue, and abdominal pain. Although there is currently no cure, effective management practices exist, including vaccination for prevention.

Hepatitis C (HCV):

• Similar transmission to HBV but lacks an available vaccine. Preventative measures focus on avoiding exposure and promoting awareness of safe practices.

Human Immunodeficiency Virus (HIV)

• This virus causes Acquired Immunodeficiency Syndrome (AIDS) which severely compromises the immune system, making individuals more susceptible to infections and diseases.

Statistics:

• As of 2002, over 816,000 cases of HIV were reported in the United States alone, indicating the importance of prevention, management, and awareness campaigns.

Symptoms:

• Common symptoms include fever, unexplained weight loss, and swollen lymph nodes. However, many individuals can remain asymptomatic for years.

Treatment:

• No cure exists currently, but antiretroviral therapy can manage the virus effectively and improve quality of life for individuals living with HIV.

Tuberculosis Information

Definition:

• Tuberculosis is caused by the bacterium Mycobacterium tuberculosis and is primarily spread through airborne particles from coughs or sneezes.

Symptoms:

• Key symptoms of tuberculosis include a persistent cough lasting three weeks or longer, fever, night sweats, and unintended weight loss. Awareness of these signs is crucial for early diagnosis and treatment.

Management:

• Infection control in care settings involves using PPE, promoting respiratory hygiene, and isolating patients as necessary to prevent further transmission.

Infection Control Strategies

• Healthcare settings should establish and maintain a comprehensive respiratory protection program and adhere strictly to universal precautions designed to minimize the risk of exposure.

• Regular cleaning and disinfection of all equipment and areas that may come into contact with infectious materials is essential for maintaining hygiene standards.

Exposure Control Plans

• Proactive plans must be implemented, educating healthcare professionals about risks and the necessary protective measures (PPE) to support safety in their workplace.

Summary of Key Concepts

• Compliance with laws and regulations regarding workplace safety is paramount. A thorough understanding of infections and the recognition of significant diseases of concern enable healthcare practitioners to implement meticulous preventive measures effectively, ensuring both staff and patient safety.

Additional Diseases of Concern

• Other diseases, such as Dengue fever and Leptospirosis, may also impact healthcare settings. Awareness and proper management strategies for these diseases enhance overall healthcare safety, particularly in endemic regions.