NRS 428 Epidemiology Paper GCU
Grand Canyon University NRS 428 Epidemiology Paper GCU.-Step -By-Step Guide
This guide will demonstrate how to complete the Grand Canyon University NRS 428 Epidemiology Paper GCU. assignment based on general principles of academic writing. Here, we will show you the A, B, Cs of completing an academic paper, irrespective of the instructions. After guiding you through what to do, the guide will leave one or two sample essays at the end to highlight the various sections discussed below.
How to Research and Prepare for NRS 428 Epidemiology Paper GCU.
Whether one passes or fails an academic assignment such as the Grand Canyon University NRS 428 Epidemiology Paper GCU. depends on the preparation done beforehand. The first thing to do once you receive an assignment is to quickly skim through the requirements. Once that is done, start going through the instructions one by one to clearly understand what the instructor wants. The most important thing here is to understand the required format—whether it is APA, MLA, Chicago, etc.
After understanding the requirements of the paper, the next phase is to gather relevant materials. The first place to start the research process is the weekly resources. Go through the resources provided in the instructions to determine which ones fit the assignment. After reviewing the provided resources, use the university library to search for additional resources. After gathering sufficient and necessary resources, you are now ready to start drafting your paper.
How to Write the Introduction for NRS 428 Epidemiology Paper GCU.
The introduction for the Grand Canyon University NRS 428 Epidemiology Paper GCU. is where you tell the instructor what your paper will encompass. In three to four statements, highlight the important points that will form the basis of your paper. Here, you can include statistics to show the importance of the topic you will be discussing. At the end of the introduction, write a clear purpose statement outlining what exactly will be contained in the paper. This statement will start with “The purpose of this paper…” and then proceed to outline the various sections of the instructions.
How to Write the Body for NRS 428 Epidemiology Paper GCU.
After the introduction, move into the main part of the NRS 428 Epidemiology Paper GCU. assignment, which is the body. Given that the paper you will be writing is not experimental, the way you organize the headings and subheadings of your paper is critically important. In some cases, you might have to use more subheadings to properly organize the assignment. The organization will depend on the rubric provided. Carefully examine the rubric, as it will contain all the detailed requirements of the assignment. Sometimes, the rubric will have information that the normal instructions lack.
Another important factor to consider at this point is how to do citations. In-text citations are fundamental as they support the arguments and points you make in the paper. At this point, the resources gathered at the beginning will come in handy. Integrating the ideas of the authors with your own will ensure that you produce a comprehensive paper. Also, follow the given citation format. In most cases, APA 7 is the preferred format for nursing assignments.
How to Write the Conclusion for NRS 428 Epidemiology Paper GCU.
After completing the main sections, write the conclusion of your paper. The conclusion is a summary of the main points you made in your paper. However, you need to rewrite the points and not simply copy and paste them. By restating the points from each subheading, you will provide a nuanced overview of the assignment to the reader.
How to Format the References List for NRS 428 Epidemiology Paper GCU.
The very last part of your paper involves listing the sources used in your paper. These sources should be listed in alphabetical order and double-spaced. Additionally, use a hanging indent for each source that appears in this list. Lastly, only the sources cited within the body of the paper should appear here.
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Sample Answer for NRS 428 Epidemiology Paper GCU
Epidemiology is the scientific study of how frequently diseases occur in different groups of people and why. It is based on two fundamental assumptions. Firstly, it assumes the occurrence of the disease is not random because several factors concomitantly influence the likelihood of developing the disease (Stover et al., 2021). Further, it assumes the study of populations facilitates the recognition of the causes and preventive factors analogous with the disease. Communicable diseases refer to infectious diseases caused by different microorganisms such as bacteria, viruses, fungus, and parasites that can be spread directly or indirectly from one individual to another. Many infectious diseases can be transmitted via bites from insects, while others are caused by ingesting contaminated substances such as food or fluids. Although several infectious diseases pose serious health risks to communities, HIV can never be underestimated. The purpose of this paper is to discuss HIV and apply epidemiology and nursing research concepts to this communicable disease.
Description of HIV as Chosen Communicable Disease
HIV is a retrovirus that destroys cells of the human immune system (mainly CD4-positive T-cells and macrophages), which are the cellular immune system’s critical components, and kills or impairs their role. Infection with this virus results from the progressive depletion of the immune system, leading to immunodeficiency (UNAIDS, 2021). The Human Immunodeficiency Virus comprises two strands of RNA, 15 types of viral proteins, and a few proteins from the last host cell it infected, all surrounded by a lipid bilayer membrane. There are two categories of HIV, HIV-1 and HIV-2. HIV-1 can be found worldwide, but HIV-2 is almost exclusively limited to West Africa. HIV-1 is transmitted more easily than HIV-2(UNAIDS, 2021). The advanced level of HIV infection is acquired immunodeficiency syndrome (AIDS). AIDS is determined by developing certain malignancies, conditions, or other acute continuing clinical indications. HIV-1 infection progresses more rapidly to AIDS compared to HIV-2.
Causes of HIV
A virus causes HIV through sexual contact or blood. In addition, transmission can occur from
mother to child during pregnancy, childbirth, or breastfeeding. When the virus enters the blood, it destroys the white cells that provide the body with the ability to fight infections and disease (UNAIDS, 2021).
Symptoms
The symptom of HIV varies and is determined by the phases of infection. Several people infected with HIV may manifest flu-like symptoms a few weeks after the entry of the virus. The likely symptoms at the acute stage may include fever, headache, skin rash, sore throat, and painful mouth sore. Similarly, swollen lymph glands, especially on the neck, muscle aches, joint pains, and diarrhea may manifest. In addition, the person could also manifest coughs, weight loss, and night sweats (UNAIDS, 2021). As the pathogen mutates in the blood and destroys the white cells at the symptomatic stage, the following symptoms may manifest Pneumonia, herpes zoster, thrush or oral yeast infection, fatigue, and fever. Furthermore, when the virus progresses to the stage of AIDS, the mentioned symptoms would manifest to be persistent and severe (UNAIDS, 2021).
Mode of Transmission
The predominant mode of HIV transmission is through unprotected sexual contact with an infected partner. In addition, exposure of broken skin or wound to infected blood or body fluids. Similarly, transfusion with HIV-infected blood is another avenue for transmission (Stover et al., 2021). Moreover, when an individual is injected with contaminated objects like needles and unsterilized syringes or razorblades, the virus is likely to be transmitted. Furthermore, transmission can also occur from mother to child during pregnancy, birth, or breastfeeding (UNAIDS, 2021).
Complications
People infected with HIV who do not get proper treatment for HIV/AIDS develop a wasting syndrome accompanied by diarrhea, fever, and chronic weakness. In addition, individuals are likely to develop neurological complications as the virus reduces mental functioning. The difficulty includes kidney disease, such as the inflammation of kidney filters that remove excess fluid and waste from the blood to the urine. Similarly, there is the liver complication (UNAIDS, 2021).The other common infectious complications related to or due to HIV comprise Pneumonia that causes severe illness. The difficulty of thrush or candidiasis causes inflammation on various body parts, i.e., the mouth, tongue, and esophagus. Similarly, the other problematic condition is Tuberculosis, especially in developing countries(Mahy et al., 2021).
Treatment
HIV has no cure but can be controlled through antiretroviral therapy. The treatment entails taking medicine that lessens the viral load in the blood. The medicine for HIV therapy is called antiretroviral (UNAIDS, 2021).The treatment involves a combination of everyday medications that prevent the virus from multiplying. The treatment aids protect the CD4 cells, keeping the immune system strong enough to combat infection and disease. The ART lowers the viral load and reduces the chance for transmissions from one person to another ((Mahy et al., 2021).
Demographic- Prevalence
The global prevalence of HIV, according to UNAIDS (2021), estimates that about thirty-eight million people living with HIV. Women accounted for fifty-three percent of the number, while men accounted for forty-seven percent. Furthermore, two million are children between zero to nineteen years of age. In addition, data indicate that women aged fifteen years up to twenty-four years globally acquire HIV. Furthermore, Sub-Saharan females account for sixty-three percent of the newly acquired HIV infection. Women accounted for fifty –three percent. Similarly, in 2020, 1.5 million people contracted HIV globally (UNAIDS, 2021).
According to the UNAIDS report, the most affected populace with HIV is from developing countries. For instance, in 2020, east and southern African countries had twenty-seven million people infected with HIV, accounting for fifty-five percent of global infection. Moreover, Asia and Pacific regions had six million people infected, accounting for fifteen percent of global infection. In addition, western and central Africa had five million infected, accounting for thirteen percent. Moreover, North America and Central Europe had two million, accounting for six percent of the global infection prevalence (UNAIDS, 2021).
Reporting of HIV
The primary object for reporting is for public health authorities to know where several diseases are found in a population. The information helps them take steps to mitigate the spread of infectious diseases and safeguard the community’s health. Further, it ensures linkage of care for any newly infected patients or continuation of care for earlier diagnosed patients(Stover et al., 2021). Moreover, timely monitoring presents trends in the epidemic and secures proper funding for local treatment and prevention services.HIV is a reportable condition that medical practitioners and pathology services must notify within five days of diagnosis to the HIV is reported only to the HIV/AIDS Surveillance Program at the Department of Public Health.
Determinants of Health and Explanation of How Determinants Contribute to Disease Development
Social health factors are the conditions in which people are born, grow, live, work and age. The social determinant includes factors like socioeconomic status, education, neighborhood, physical environment, employment, social support networks, and access to health care(Stover et al., 2021) The social factors of health can influence a person’s likelihood of acquiring HIV through influences on improper behavior, limited access to preventive measures, and limited access to healthcare providers or testing sites.
Studies show that abuse drugs such as alcohol, cocaine, marijuana have exacerbated the risk of HIV infection. Similarly, the use of drugs leads to confinement. The individuals under detention are reported to be engaging in unprotected sex leading to a high rate of HIV infection. Further, the social-economic status has contributed to the prevalence of HIV. The economically poor are more likely to get into unwarranted behaviors, e.g., indulging in commercial sex, thus risking and enhancing the infection of the virus (Mahy et al., 2021). Economically vulnerable women experience the scarcity of health-related resources in poor, under-served communities or villages where access to health care and condoms are not readily available(Mahy et al., 2021). These compounding social health determinants extrapolate the prevalence and the risk of acquiring the virus.
The Epidemiologic Triangle
The Epidemiologic Triangle is a tool that researchers employ in addressing the three constituents that contribute to the spread of infections or disease. The triple components comprise an external agent, a susceptible host, and an environment that brings the agent and host together (Mahy et al., 2021).The triangulation of HIV (causative agent) refers to factors and attributes of the virus that concomitantly aids its infection and spread on the host. Firstly, the nature of the subtype of the HIV Virus determines the extent of infection and spread. Studies show that HIV-I is easily transmitted due to its biological and chemical characteristics. To underscore, HIV-1 RT is a heterodimer composed of p66 and p51 subunits, with p66 harboring two functional, active sites: an N-terminal RNA- and DNA-dependent DNA polymerase and a C-terminal RNase H that digests the RNA component of RNA–DNA hybrids (De Almeida et al., 2021). Due to its nature, HIV -1, therefore, binds more efficiently and faster than HIV 2 with the receptor molecule CD4 on the cell surface.; thus having a higher capability to infect and spread rapidly. Similarly, the other exacerbating factors include having a sexually transmitted infection (STI) such as syphilis, herpes, chlamydia, gonorrhea, and bacterial vaginosis that enhance chances for infection.
The host triangulation characterizes the host (human) factors as those that help enhance infection and spread the virus. The factors include having unprotected sex, having a frequent change of partners or having sexual activity for financial gain, peer pressure, drug and substance abuse (Hershow et al., 2019). These behaviors aid in enhancing HIV infection and spread. Similarly, urban health studies have found that poverty and unemployment, vacant buildings, and high crime rates are concomitant with an increased risk of HIV infection. The Social economic factors such as lack of access to care, discrimination, stigma, homophobia, and poverty enhance higher rates of HIV infection. Studies from cosmopolitan and urban areas indicate that poverty, unemployment, and high crime rates increase the risk of HIV infection and spread (Hershow et al., 2019). In addition, viral load increases in the infected occur for reasons such as not taking antiretroviral medication consistently due to lack of access to ART.
Special Consideration
There are special considerations or notifications for the community regarding the triangulation of HIV. Communities affected by HIV usually do risky behaviors, including sexual activities without protection and sharing paraphernalia that contribute to HIV infection. HIV education can aid learners in schools and the community develop and maintain safer behaviors and reduce stigma and discrimination towards people affected by and living with HIV (Hershow et al., 2019).
Role of the Community Health Nurse and Importance of Demographic Data
Nurses play vital roles in educating patients about HIV, providing support for treatment adherence, and assisting with navigation of care delivery. APRNs, further, are positioned to provide ART directly, consistent with their state practice authority.The community health nurse has professional technical skills and knowledge that the community populace may not have; thus, the nurse has the role in ensuring the quality of community-based care(Stover et al., 2021). They form a significant component in delivering quality HIV services, including counseling, adherence support, development of a referral framework, and dissemination of information. They also have the role of reporting and HIV data collection.
Demographics are essential since they offer an exhaustive comprehension of a population’s various features. The provided information is particularly vital to government organizations and institutions for making crucial policy decisions concerning the people(Stover et al., 2021). Similarly, demographics data is critical as it gives the health authorities andpopulace information they need to strategies and implements future investments and services; data from sources such as the CDC and the US Census aids in determining where assistance programs need to be directed (UNAIDS, 2021)
National Agency or Organization That Works to Addresses Communicable Disease
The USAID is one of the major federal agencies that implement the PEPFAR core mandate. The USAID’s Office of HIV/AIDS reinforces country-led efforts to combat the complex challenges of HIV in over fifty countries around the globe. The agency avails global leadership in developing projects and plans of actions that amplify impact. Similarly, it reinforces country-led programs and policies while at the same time administering USAID’s elaborate health and development skills and particularized HIV/AIDS technical capability(Stover et al., 2021). Further, the organization applies research, technology, and change to encourage cost-effective, sustainable, and judicious integrated HIV/AIDS interventions.
ALSO READ: NRS 428 Topic 1 DQ 1 Explain the role of the community health nurse in partnership with community stakeholders for population health promotion
Global Implication of HIV
Notwithstanding the existence of treatment that can manage and mitigate the progression of HIV viral transmission, the virus remains a major leading cause of death and a health risk to millions globally. HIV is non-endemic; it is widespread globally. Different countries have put various strategies to mitigate the infection surge among their population. Techniques like the use of male and female condoms are encouraged by various governments. Further, voluntary medical male circumcision is agitated across the globe to minimize the chances of infection. (UNAIDS, 2021).Moreover, many countries use antiretroviral drugs to prevent mother-to-child transmission, pre-exposure prophylaxis, post-exposure prophylaxis, and treatment as prevention. Similarly, sex and reproductive health services are used to inform the population on the crucial knowledge that helps reduce infection of the virus (Stover et al., 2021).
Conclusion
HIV is a retrovirus that destroys cells of the human immune system, specifically the CD4-positive T-cells and macrophages. There are two types of HIV, namely HIV-1 and HIV-2. HIV-1 can be found worldwide. In addition, the infection is non-endemic but widely spread. Further, it is caused by a virus that enters the blood and impairs the white cells. Moreover, the primary mode of HIV transmission is through contact with infected blood body fluids. In addition, people infected with HIV who do not get proper medication for HIV/AIDS develop diarrhea, fever, and chronic weakness. In addition, they are likely to develop complications like neurological malfunction, kidney, and liver, among others. UNAIDS 2021 report reveals that about thirty-eight million people live with HIV, of whom women are the majority with infection. Similarly, regionally, the Sub-Saharan countries lead with an infection of about twenty-seven million, accounting for 53% of the world infection as of 2020. Moreover, the condition is modifiable to the health authorities to help mitigate the spread of infectious diseases and safeguard the community’s health.
References
De Almeida, S. M., Rotta, I., Tang, B., Vaida, F., Letendre, S., Ellis, R. J., & HNRC Group. (2021). IgG intrathecal synthesis in HIV-associated neurocognitive disorder (HAND) according to the HIV-1 subtypes and pattern of HIV RNA in CNS and plasma compartments. Journal of Neuroimmunology, 355, 577542. https://doi.org/10.1016/j.jneuroim.2021.577542
Hershow, R. B., Gonzalez, M., Costenbader, E., Zule, W., Golin, C., & Brinkley-Rubinstein, L. (2019). Medical providers and harm reduction view on pre-exposure prophylaxis for HIV prevention among people who inject drugs. AIDS Education and Prevention, 31(4), 363-379. https://doi.org/10.1521/aeap.2019.31.4.363
Mahy, M. I., Sabin, K. M., Feizzadeh, A., & Wanyeki, I. (2021). Progress towards 2020 global HIV impact and treatment targets. Journal of the International AIDS Society, 24, e25779. https://doi.org/10.1002/jia2.25779
Stover, J., Glaubius, R., Kassanjee, R., & Dugdale, C. M. (2021). Updates to the Spectrum/AIM model for the UNAIDS 2020 HIV estimates. Journal of the International AIDS Society, 24, e25778. https://doi.org/10.1002/jia2.25778
UNAIDS (2021) epidemiological estimates.https://aidsinfo.unaids.org
Sample Answer 2 for NRS 428 Epidemiology Paper GCU
Influenza is a highly contagious respiratory disease caused by influenza viruses. It is commonly referred to as flu. It is a cause of pandemics and epidemics, although it is not so contagious as the common cold. There are many influenza viruses, each causing its disease; some are very similar but different. The symptoms include fever, cough, sore throat, and coryza. Influenza can cause mild to severe illness in people of all ages. The condition, which is particularly quick and vigorous, has been observed to catch people during the fall and winter frequently. Reports indicate that millions of cases are reported worldwide during an epidemic season each year. Therefore, there is a need to prevent the disease. Vaccination is the most appropriate strategy to handle this health challenge. It helps to prevent the spread of the disease during its reach. Hence, according to the local healthcare department’s recommendation, people should seek vaccination yearly. This paper aims to describe influenza in terms of specific demographics, how various determinants of health contribute to its development, and the epidemiology triangle. Similarly, it will focus on the community health nurse’s role, the importance of demographic data, the national organization that works to address the disease, and the global implication.
Comprehensive Description of a Communicable Disease and the Demographic of Interest
Influenza is caused by influenza viruses infecting the upper respiratory tract. The viruses are classified as influenza A and B (Darricarrère et al., 2021). Each type causes distinct disease patterns, but both are capable of causing severe illness and death in young children, older adults, and people with other underlying health conditions who lack immunity to the virus (Kim & Chang, 2018). Influenza A viruses are further divided into subtypes based on the genetic makeup of their hemagglutinin (HA) and neuraminidase (NA) protein subunits (Kim & Chang, 2018). Hemagglutinins comprises H1 and H3 on the surface of the virus. These proteins help the virus bind to sialic acid molecules on host cells, thus allowing the virus to attach to them and enter through the cell membrane. Once inside a cell, the virus replicates and infects another cell by attaching itself to sialic acids on this new host cell. The H1 protein is responsible for causing symptoms such as fever, chills, coughing, sneezing, and sore throat (Kim & Chang, 2018).
The H3 protein does not have these symptoms; however, it helps spread infection from one person to another through coughing or sneezing. Influenza B viruses are further divided into subtypes based on the genetic makeup of their PB1 and PA protein subunits (Kim & Chang, 2018). Influenza is a highly contagious disease that spreads quickly from person to person, household to household, school to school, and workplace to workplace. In general, influenza is spread through direct contact with respiratory secretions such as coughing, sneezing, or droplets expelled from a sick person (Boktor et al., 2021). It can also be transmitted from objects and surfaces contaminated with infected respiratory secretions, such as doorknobs and phones. Also, it occurs through touching things like toys and books that have come into contact with infected surfaces. Most people recover from influenza within a week. However, some people develop complications such as pneumonia or even death if they contract influenza while they have underlying health problems such as asthma or diabetes. Preventing flu is more accessible than treating it once it spreads (Kim & Chang, 2018). Vaccination can prevent infection with many types of flu virus; nevertheless, not all flu vaccines work equally well for everyone (Mameli et al., 2019). Also, vaccination should be done early in the season when the highest risk exists for developing severe illness from flu virus infection.
Influenza is a reportable disease for the U.S. Public Health Service (PHS). It is when one can be tested for influenza and reported to the local or state health department or hospital as appropriate (Morabia, 2020). A person who has had an influenza-like illness and presents to the health care provider with a fever, cough, or other respiratory symptoms should report within 24 hours after the onset of symptoms. If the patient cannot contact a health care provider or hospital within 24 hours, it is necessary to call a local or state health department or hospital at once and ask them to accept the report (Morabia, 2020). Also, the patients should contact their public information office to confirm if they would accept reports from a specific area code phone number.
Determinants of Health and Explanation of How Determinants Contribute to Disease Development
The social conditions in which one is born lives, and ages significantly impact the spread of influenza. These social determinants are responsible for how the disease affects the body and the people’s health experiences (Seligman etal., 2021). These factors include access to health care services, public safety, and the availability of resources that satisfy everyday needs, such as safe housing and food (Social Determinants of Health, 2018). Besides, they include the availability of resources and the patient’s capacity to access medical care, and many other circumstances might improve one’s health, including but not limited to employment, education, and social support.
Like many other diseases, social factors in health influence the frequency of influenza-related mortality and the harm that impacts economic growth. Researchers have discovered a connection between the improvement of social elements and the prevention of influenza outbreaks. For instance, if the economy were to improve, more people would have access to vaccinations, which would help reduce disease prevalence (Fell et al., 2017). Additionally, it would be beneficial in providing researchers with more adequate resources to undertake studies to comprehend the nature of the disease and stop its spread. Therefore, strengthening the economy is essential to easing the burden of this illness on the population. Lack of educational possibilities may also affect how the disease is handled because it is more likely to cause adverse conditions if people are unaware of how to take it (Fell et al., 2017). Given that the infected persons might not be aware of the associated symptoms and the use of preventive actions, it could be fatal because it would spread exceptionally quickly.
Epidemiologic Triangle (Host Factors, Agent Factors, and Environmental Factors
According to Fell et al. (2017), the four components of the epidemiological triangle are time, host, environment, and agent. The numerous influenza virus strains related to the illness are linked to the illness’s epidemiological triangle and attack the upper respiratory system. Fell et al. (2017) reveal that influenza viruses use animals as carriers and have a quick mutation rate. This aspect demands that new vaccines be continuously produced each year. The most susceptible individuals to this illness are those with immunological deficiencies (Tanner et al., 2021). Because there are not enough environmental health determinists, health professionals are also at risk of contracting the disease. The sickness’ causal agent, moisture from infected individuals, is responsible for its transmission. According to Fell et al. (2017), influenza has an incubation and a symptomatic period between 5 and 7 days. After this period, there is the likelihood that the disease will stop being infectious to the host. However, the host may experience the symptoms for up to 14 days.
Role of the Community Health Nurse and Importance of Demographic Data
Community health nurses should contribute to researching influenza. They are responsible for collecting and reporting influenza statistics to CDC, just like many other communicable illnesses (Grohskopf et al., 2018). This information is essential for the CDC to accurately assess the sickness and develop workable tactics to stop its spread. Community health nurses also help the general public’s awareness of the illness. They can develop public relations strategies, campaigns, and studios to increase awareness. Through a greater understanding of the illness and its risks, these initiatives may seek to reduce the spread of the disease (Grohskopf et al., 2018). In addition, community health nurses can be at the forefront of promoting and advertising the program in society during immunization campaigns to ensure it reaches the public.
Similarly, nurses are responsible for providing patients with medical care to encourage healthy lives and stop the spread of disease. In addition to providing medical care to the ill, they can provide educational programs with advice on how to stop the spread of the illness by choosing healthy lives (Grohskopf et al., 2018). Community health nurses can assist the health departments in setting up screening procedures and immunization cases of influenza outbreaks. Also, they can offer the general public personal protective equipment to keep them from catching the disease.
National Agency or Organization That Works to Addresses Communicable Disease
Over the years, World Health Organization (WHO) has been at the forefront of addressing the effects of influenza. According to Ly et al. (2017), WHO was established on 22nd July 1946 as a United Nations office focusing on solving global influenza and other medical issues. It has successfully reduced the flu through practical measures, a significant contributing component. The group focuses on changing some of the mechanisms that regulate all pandemics caused by the disease. Because of its dedication to improving public health and wellbeing, the organization has conducted extensive research on preventing sporadic influenza outbreaks and spreading the virus from animal to human. One instance was the 2009 H1N1 influenza A test conducted in Mexico. The introduction of a Pandemic Influenza Control (PIP) structure in the same year led to significant advancements in treating the condition. The system was intended to increase availability and significantly respond to the influenza epidemic. WHO works with its administrative bodies to create organizations for delivering impact populace training programs. The organization released the Global Influenza Strategy 2019–2030 on 11th March 2009 to protect the entire world’s population from influenza (Ly et al., 2017). According to Ly et al. (2017), the organization suggested using flu antibodies throughout the Northern Hemisphere’s 2019–2020 flu season. In addition, it has the Global Influenza Program, which aims to provide strategic direction, activity coordination, and technical support based on the threat from all types of influenza.
Global Implication
Influenza is a leading cause of global mortality and morbidity rates today. According to Ly et al. (2017), besides death, the disease has significant effects that cause major burdens towards the limited resources in the world. Therefore, the global implications of influenza are far-ranging and impact many industries. The economic costs of the pandemic have been staggering, with estimates placing them at $11.2 billion in the United States alone (Putri et al., 2018). These costs can be attributed to lost productivity, increased medical care expenses, travel disruptions, and even death. Similarly, in the last few decades, influenza viruses have evolved to overcome many antiviral drugs used to treat them. It has led to an exploding number of cases, with about 5-10% of adults and 20-30% of children worldwide becoming ill (Ly et al., 2017). These statistics contribute to between 3 and 5 million cases of influenza and nearly 1 million fatal cases worldwide (Ly et al., 2017). The World Health Organization (WHO) estimates that more than 200 different types of influenza A virus are circulating globally at any time. Vaccines or antiviral drugs do not recognize the majority of these types. Each year, the WHO publishes recommendations for countries on preparing for and responding to pandemic influenza outbreaks. These recommendations include using vaccines and antiviral drugs as their countries’ healthcare systems require. On the other hand, the influenza B virus is an endemic species to specific regions and does not spread globally. According to Ly et al. (2017), influenza B cases are reported in India and China.
Other diseases in several African nations exhibit symptoms similar to those of influenza. Due to the disease’s limited surveillance, they become confused (Ly et al., 2017). High poverty levels and weak health systems are present in various African nations, especially in the Sub-Saharan region. Similarly, the countries face significant obstacles brought on by illnesses like HIV and malaria, which change the focus of financial issues (Ly et al., 2017). The world must work together to address these issues and raise the region’s health standards. For instance, the CDC has significantly contributed to reducing malaria in Kenya through various programs.
Conclusion
Influenza is a contagious disease that spreads through contact with respiratory secretions, doorknobs, phones, and toys that have come into contact with infected surfaces. Vaccination can prevent infection with many flu viruses, but not all vaccines work equally well. A person with influenza-like symptoms should contact a health care provider or hospital within 24 hours. They can also get their public information office to confirm if they would accept reports from a specific area code phone number. The social conditions in which one is born lives, and ages significantly impact the spread of influenza. These social determinants include access to health care services, public safety, and the availability of resources that satisfy everyday needs, such as safe housing and food. The four components of the epidemiological triangle are time, host, environment, and agent. Influenza viruses use animals as carriers and have a quick mutation rate, and the most susceptible individuals are those with immunological deficiencies. Community health nurses are responsible for collecting and reporting influenza statistics to the CDC, helping to develop public relations strategies to increase awareness of the illness, and providing medical care to patients to encourage healthy lives and stop the spread of disease. The World Health Organization is a United Nations agency that works to address infectious diseases. It has successfully reduced the flu through practical measures and created organizations to deliver impact training programs. Influenza is a leading cause of global mortality and morbidity rates today. It has significant effects that cause major burdens towards the limited resources in the world and has cost the United States $11.2 billion. The WHO estimates that more than 200 different types of influenza A virus are circulating globally at any time. It recommends that countries use vaccines and antiviral drugs as their healthcare systems require. African nations face significant obstacles due to illnesses like HIV and malaria, which change the focus of financial issues. The world must work together to address these issues.
References
Boktor, S. W., Hafner, J. W., & Doerr, C. (2021). Influenza (Nursing).
Darricarrère, N., Qiu, Y., Kanekiyo, M., Creanga, A., Gillespie, R. A., Moin, S. M., … & Nabel, G. J. (2021). Broad neutralization of H1 and H3 viruses by adjuvanted influenza HA stem vaccines in nonhuman primates. Science Translational Medicine, 13(583), eabe5449. doi: 10.1126/scitranslmed.abe5449
Fell, D. B., Bhutta, Z. A., Hutcheon, J. A., Karron, R. A., Knight, M., Kramer, M. S., … & Savitz, D. A. (2017). Report of the WHO technical consultation on the effect of maternal influenza and influenza vaccination on the developing fetus: Montreal, Canada, September 30–October 1, 2015. Vaccine, 35(18), 2279-2287. https://doi.org/10.1016/j.vaccine.2017.03.056
Grohskopf, L. A., Sokolow, L. Z., Broder, K. R., Walter, E. B., Fry, A. M., & Jernigan, D. B. (2018). Prevention and control of seasonal influenza with vaccines: recommendations of the Advisory Committee on Immunization Practices—United States, 2018–19 influenza season. MMWR Recommendations and Reports, 67(3), 1. doi: 10.15585/mmwr.rr6703a1
Kim, Y., & Chang, K. O. (2018). Protein disulfide isomerases as potential therapeutic targets for influenza A and B viruses. Virus research, 247, 26-33. https://doi.org/10.1016/j.virusres.2018.01.010 Get rights and content
Ly, S., Arashiro, T., Ieng, V., Tsuyuoka, R., Parry, A., Horwood, P., … & Arima, Y. (2017). Establishing seasonal and alert influenza thresholds in Cambodia using the WHO method: implications for effective utilization of influenza surveillance in the tropics and subtropics. Western Pacific Surveillance and Response Journal: WPSAR, 8(1), 22. doi: 10.5365/WPSAR.2017.8.1.002
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Sample Answer 3 for NRS 428 Epidemiology Paper GCU
Chickenpox which is also known as Varicella is a viral disease that is extremely contagious, especially among children and is characterized by an early eruption of vesicles and papules, mild constitutional disturbances and fever. It was until the late 19th century that physicians were able to distinguish chickenpox varicella from smallpox. However, in the 16th century, Giovanni Filippo made the first description of chickenpox. In 1767, William Heberden came up with a demonstration differentiating chickenpox from smallpox. Rudolf Steiner conducted further investigations and in 1875, reported that chickenpox was caused by an infectious agent, as Von Bokay made the first observation that varicella zoster is different from herpes zoster in 1909 (Adams et al., 2017). In 1954, Thomas Weller isolated the causative agent, varicella virus and Michiaki Takahashi went ahead to make the first live attenuated vaccine for the virus in 1972.
Chickenpox Description
Chickenpox is an airborne infection that is caused by the varicella-zoster virus (VZV). The virus can be transmitted from an infected person through sneezing or coughing, and inhalation of the viral particles by a healthy individual. The disease can also be spread through inhaling or touching the virus particles that have been shed from the body. Consequently, the virus can be spread by indirectly being in contact with items which were in direct contact with active blisters. People who have never contracted the disease before and have not been vaccinated are at a high risk of acquiring the infection. The virus is considered contagious within a period of one to two days before the eruption of rashes and formation of scrabs from the blisters. Symptoms might take between 14 to 16 days to appear after exposure to the virus (Lo et al., 2019). The initial symptoms resemble the common colds, such as fever, running nose, malaise, and sore throat. Immediately after the occurrence of these symptoms, the red spot will start appearing on the body. The spots usually start appearing on the scalp and trunk before spreading outward. The mucous membrane can also be affected in addition to the spots being noted along the nasal passages and the mouth. The spots then develop into vesicles as elevated bumps with clear blisters that are teardrop shaped and turn rapidly within six to eight hours to crusty lesions (Lo et al., 2019). New spots will continue to develop as the old ones heal and disappear. It takes up to 5 to 6 days for new lesions to stop developing. However, all the crusts will start disappearing after about twenty days.
Intense itching is a common symptom of chickenpox that increases an individual’s irresistible urge to scratch and may lead to complications such as cellulitis which is a skin bacterial infection. Other complications that might result from chickenpox include pneumonia, invasive group A streptococcal infection, sepsis, necrotizing fasciitis, encephalitis and Reye syndrome (Driesen et al., 2015). Most of these complications are usually developed by individuals with a poor immune system. The diagnosis of chickenpox is based on symptoms such as rash and fever. In case, the physician needs confirmation of the diagnosis, the fluid from the lesion is taken to the lab, and cultured for about 5 to 10 days.
Chickenpox treatment is based on managing the symptoms of infectious diseases, such as itchiness and fever reduction, as most cases are usually uncomplicated and take about two to three weeks to resolve themselves. An antihistamine such as Atarax and Benadryl are mainly recommended for the management of pruritis (Lo et al., 2019). Wet compresses and topical treatment are used to provide immediate relief of the blisters as the fever is managed by non-steroidal anti-inflammatory drugs such as acetaminophen or ibuprofen. The use of aspirin is, however, contraindicated as a result of the complication of Reye’s syndrome. Given that chickenpox is a viral infection, antiviral agents such as valacyclovir, famciclovir, and acyclovir are recommended in managing the infection by reducing the intensity of the itching and speeding up the healing of the skin lesions with an overall outcome of shortening the duration of the infection. For maximum effectiveness of treatment, the patient should start medication therapy within 24 hours of the initial appearance of the first rash (Lo et al., 2019). Non-pharmacological measures include taking an adequate amount of fluids and electrolytes to prevent dehydration as a result of the infection. Frequent bathing and maintaining short fingernails among other hygienic traits are recommended as the most appropriate prophylactic measure of preventing the disease.
Chickenpox vaccine, Varivax was developed in 1955 and approved by the FDA the same year. The vaccine is administered to children above 1 year old. It has proven to be 90% effective in the prevention of infection by the virus (Hawker et al., 2018). However, for the individuals who might develop the infection even after being vaccinated, the symptoms are usually mild as compared to those who have never received the vaccine. The Varivax vaccine is also effective in protecting people against diseases such as shingles which is an extremely painful rash caused by the same virus, varicella-zoster, and lies dormant in nerve tissues around the brain and spinal cord in people with chickenpox and can easily be reactivated (Gemmill, Quach-Thanh, Dayneka, & Public Health Agency of Canada, 2016).
The manifestation of chickenpox is usually high among teenagers below the age of 15 years, with most cases among children between the age of 1 year to 4 years old. Before the vaccine was developed, varicella was the most common disease among most children mounting to about 4 million cases annually, with an average of 105 deaths, and hospitalization of over 10,500 patients. According to the CDC, more than 95% of adults in the United States, experience the infection at least once at some point in their lifetime (Lo et al., 2019). However, the development of the vaccine reduced the morbidity and mortality of the infection dramatically, with only a few individuals being affected with mild symptoms. Implementation of the two-dose vaccine for every child older than a year has greatly reduced the outbreak of the infection.
As of 2003, the healthcare system of the United States recommended that all the cases of chickenpox infection be reported (Giesecke, 2017). The CDC recommended three initial core variables that were based on the age, severity of the disease and the vaccination status of the patient. Additionally, it was also recommended that the demographic, epidemiologic and clinical data be reported together with information regarding the outcome of the infection to the patient. The CDC formulated varicella messaging guide to help in direct documentation of information regarding the infection by respective respondents.
Social Determinants of Health
The social determinants of health as defined by the Healthy People 2020 are the conditions within the environment in which individuals are born, raised, learn, play, work, worship and age that affect a variety of human functioning, health and general quality of life, in addition to their risks and outcomes. Some examples of social determinants of health that contribute to the development of chickenpox include access to healthcare and educational services, availability of resources, public safety and cultural believes among others (Lo et al., 2019). Research has also shown that personal behavior and genetic factors cannot fully explain the health disparities of infectious diseases on their own. Complex, overlapping and integrated social structures, and economic systems also need to be reviewed to be able to fully understand the morbidity and mortality of a given infectious disease (Currie, World Health Organization, & Health Behaviour in School-aged Children, 2012). People without medical health insurance covers, or who have a low income, tend to be at high risk of developing chickenpox infection as they may fail to seek medical attention on a regular basis due to the high costs. Consequently, language barrier or shortages in the distribution of the vaccine to certain communities might also contribute greatly to the development and spread of chickenpox infection. Individual who are also unable to acquire proper education might also fall as victims of the infections due to lack of knowledge on the importance of vaccinating their children at the right time, and the measures that they need to take when one of their loved ones are infected. Given that chickenpox is contagious, social structures comprising of high education and public awareness is recommended to equip community members of the preventive measures such as high hygiene to prevent the spread of the virus.
The Epidemiologic Triangle
The epidemiologic triangle is composed of three main aspects, the susceptible individual or host, the environment and the causative agent. The triangle is very crucial when analyzing the natural history of a particular disease. The information analyzed using the epidemiologic triangle is crucial especially when trying to prevent the spread of a contagious disease. For instance, controlling and preventing the spread of a contagious disease starts by identifying the weak points in the triangle to be able to eliminate the threat. This can be achieved by implementation of prevention activities in addition to enhancing the efforts of reducing the seriousness of the disease by considering variables such as severity of the disease, illness length, treatment costs, long-term and short-term effects of the disease, and the death risks as a result of the infection (Gershon, 2018). The epidemiologic triangle helps connect the link between the causative agent of chickenpox, which is the varicella-zoster virus, and the primary host who are the humans. It also displays the modes of transmission such as sneezing and coughing, which expose a healthy individual to respiratory droplets containing the virus, that cause infection upon inhalation. Consequently, the triangle provides a link between the times of the year when the outbreak of the infection is high. For instance, chickenpox outbreak fluctuates seasonally in temperate regions, with high cases during early spring and the months of winter. In the United States, high incidences of chickenpox occur within the months of March to May and lowest from September to November. With the above information, it is important for community members to be notified in case of an outbreak to put in place preventive measures to reduce the spread of the infection.
The Role Of The Community Health Nurse
Community health nurses play a significant role in promoting the health and lifestyle of members of a given community. It is required that all community health nurses must have basic information on communicable diseases, with a clear understanding of the causative agents, a period of incubation, modes of transmission, the symptoms of the disease, the preventive measures, and the available treatment options and care plan. Having this information will help the nurse focus more on the management of the symptoms of the infection while preventing its spread. Community health nurses are also required to conduct patient and community awareness on the importance of chickenpox vaccination, how it is transmitted, how to manage the symptoms at home and how to prevent the spread of the infection among community members. It is also the obligation of the community health nurse to identify chickenpox risk factors, and how to keep the community members safe from the disease. Given that chickenpox is a highly contagious disease, the community health nurse, will be required to make frequent reports using the guidelines provided by the CDC to analyze the progress of the infection, and come up with the necessary recommendation that can help reduce its morbidity (Harkness & DeMarco, 2016). With adequate information, the community health nurse will be able to assess the treatment options that have been used to manage chickenpox and their outcome from feedback provided by community members. As such, only productive methods will be reinforced in the future with better interventions to make sure that the disease does not cause future burden in healthcare.
National Agencies And Organizations Addressing Chickenpox
The World Health Organization (WHO) and the Centers for Disease Control and Prevention (CDC) are the main organizations which collect data and provide up to date information about chickenpox. The CDC has so far provided adequate information about presenting signs and symptoms of chickenpox, how it is transmitted, the causative agent, complications, prevention and treatment options, mortality and morbidity among others. The organization has also provided a kid-friendly fact sheet which provides information about the disease to children in a friendly and interesting manner (Lo et al., 2019). The WHO on the other hand provides the same information as the ones provided by the CDC in addition to travel risks, and measures to be taken when traveling to a chickenpox endemic area. Additionally, there are two main foundations for chickenpox, the National Shingles Foundation and the National Foundation for Infectious Diseases (NFID). The NFID, a nonprofit organization was developed mainly to help in creating public awareness and educate healthcare professionals on the causes, prevalence, treatment, and prevention of various contagious diseases such as chickenpox. The organization is aimed at promoting the health of individuals across the globe, through education. The National Shingles Foundation, on the other hand, is also a non-profit organization focused on fighting against varicella zoster virus through education and research.
The Global Implications of Chickenpox
According to the WHO, chickenpox is an extremely contagious viral infection that is distributed worldwide. The universal childhood varicella vaccination program was introduced and implemented in the United States in 1995 to help prevent chickenpox epidemic. The vaccine is currently available across the world, but it is only in a few countries such as Germany, Korea, Japan, and Australia where coverage rates have been extensively attained (Hirose, Gilio, Ferronato, & Ragazzi, 2016). In these countries, the vaccine has been able to attain significant outcome with a great reduction in morbidity and mortality rates as a result of chickenpox. Nonetheless, several countries still experience a shortage of the virus, such as the third world countries, making the disease still a worldwide epidemic. The global chickenpox burden is still very high, at 4.2 million severe cases, and 4200 deaths yearly.
Conclusion
The chickenpox burden was high before the varicella zoster vaccine was discovered in 1995. The disease burden, however, decreased by about 90% between 1995 to 2005. Currently, only a few cases of the disease are being reported. However, there is still a need for continued public awareness on the importance of the vaccine, and preventive measures that can be taken to prevent the spread of the disease. New treatment options have also been introduced which are helping patients suffering from the disease manage their condition. Chickenpox is a global epidemic and needs to be addressed with more seriousness to be able to curb the disease completely.
References
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