The incubation period for chicken pox is 2-3 weeks (Bishop,P et al. 2010), this is the contagious time before the signs and symptoms start showing, which means the nurse’s daughter, was past the infectious period of the disease. The nurse’s daughter could have had the virus for over a week, and exposed her mother to it during this time. If the nurse developed symptoms a few days after getting Variable Sister Ammunition, she had already contracted the virus before ammunition injection had been administered, thus not able to prevent chickenpox in this case.
Question 1: B Pregnant woman are at high risk of severe disease/complications if they do not have immunity to chickenpox (Department of Health – Victoria, 2007). If Variable infection in contracted during the first trimester of pregnancy, there is a small risk of miscarriage (Department of Health – Victoria, 2007). Clinical manifestations of contracting the virus during pregnancy include limb hyperplasia and cortical atrophy of the brain and growth retardation. (Department of Health – Victoria, 2007).
Question 1: C There is an infection control issue for other staff have not been unmissed, and to had chickenpox virus in the past, they may now have become infected from their co-worker. The best way to handle the situation is reduce the risk to other employees by testing those who have been in contact with the infected nurse to see if they have been infected. If they have been infected, those staff members will need to be withdrawn from the workplace until their incubation period has passed.
Variable sister specific mucilaginous should be offered to the population at risk. This would include any staff or patients who were in contact with the nurse during the time she was in the incubation period. Question 1: D It’s hard to detect an outbreak such as the one presented, as with incubation periods, a person is exposing a pathogen to others without knowing that they themselves have it in the first place, making this type of situation impossible to avoid completely.
Implementing detailed staff training on occupational health and safety should be conducted, to ensure all staff know what the protocol is for when they are infected, or others they work with are infected to ensure future outbreaks are dealt with as quickly and efficiently as possible. When exposure to a substance which can cause disease cannot be avoided, immunization is commended as a control measure to prevent illness for staff. (Alberta Human Services – 2009) A staff immunization program should be put in place, for all who have not been minimized against viruses they are likely to come in contact with in their workplace.
This will decrease the likeliness of this situation in the future. Question 2: A Impetigo is highly infectious, pus forming, skin infection caused by staphylococci bacteria, streptococci bacteria or both. The symptoms include single or many blisters filled with pus which leaves a red, raw look when broken. Skin lesions on the face, legs or arms that spread. A rash which can begin as a spot, that when scratched spreads to other areas of the body (Bishop,P et al. 2010 IPPP). After the blisters rupture and form scabs, new blisters can develop either in the same area or in different locations which can ooze highly contagious fluid. Department of Health – Victoria, 2007) Question 2: B There are two main forms of Impetigo. The non-bilious form caused by staphylococci (incubation period of 4-10 days), and/or Group A streptococci (Incubation period of 1-3 days), which is characterized by small vesicles on the skin that can rupture easily and release fluid. The non-bilious form of Impetigo break down to form honey-clouded crusts. (Bishop,P et al. 2010 IPPP-376) The bulbous form is caused mainly by the microorganism staphylococci erasures, which are larger and has clear fluid which later becomes yellow.
The bulbous form of Impetigo develops brownish crusts after vesicles rupture. (Bishop,P et al. 2010 IPPP-376) Question 2: C Timothy developed impetigo from his insect bites. The scratching of the bites caused transmission of the organism to close other bites or broken skin which caused the Impetigo to spread. It is most likely that he picked up the agrarianism from attending preschool for the first time, as there was a large range of new microorganisms causing Timothy to be a susceptible host.
Question 2: D Impetigo is extremely contagious, and can easily spread to another person if the fluid from the blisters comes in contact with an open area on their skin (Pumped Health. 2010). In Timothy’s preschool it could be spread from some of the fluid getting on toys, furniture or even hands, and then coming into contact with another child. Children like Timothy are more at risk of developing impetigo, especially if their skin has already been injured y cuts or abrasions, irritated or y having skin problems like eczema (Department of Health – Victoria, 2007).
Question 2: E Preventing the spread of the infection within the preschool should be their top priority, and they should be monitoring children who look as if they have any contagious rashes or sores. Any washcloths used to wash a child who has any type of lesion on their skin should not be used on any other children, and a new washcloth should be used each time skin is cleaned (Pumped Health 2010). Preschool staff should be mindful of doing routine surface cleaning/ decontamination of tables and toys with disinfectant should be done on a daily axis due to risk of contamination.
An Increase in the importance of hand washing with antibacterial soap after using bathrooms, before meals, after play time should be increased to help prevent the spread of germs. Question 3: A Phagocytes is a vital part of the bodes second line of defense for immunity, to help protect the body from disease. It is one type of indications (a process in which a substance gains entry into a cell without passing through the cell membrane), where the material the cell is taking in solid particles, such as virus, bacteria or worn-out cells.
Once the particle is recognized by receptors on the outside of a cell called a phagocyte, the plasma membrane extends outwards, which is called a pseudopodia and surrounds the particle into a vesicle called a phagocyte. Organelles called Lissome then attach to the phagocyte and release digestive enzymes to degrade ingested material. (Tractor, G et al. 2012 p. 76, 77) Question 3: B Inflammation is a common non-specific defense response that happens at the location of an injury or infection, which involves signs of swelling, redness heat and pain (Bishop,P et al. 2010 p. 142).
If you have a cut, inflammation is basically laid moving towards that cut (results in the swelling, redness and pain), which will bring in materials for repair like oxygen, platelets, and amino et al. 2010 IPPP). Due to fluid moving towards the cut it is going to help stop or slow the spread of pathogens, by making it harder for pathogens to move away from the area. With the fluid moving towards the area, its going to bring in other immune fighters, like compliment and other white blood cells. The main function of inflammation is to clear the injured site of foreign material or microbes preparing the area for repair (Bishop,p et al. 010 IPPP). Question 3: C Complement is part of our second line of defense that is made up of over 30 proteins circulating in our blood, that cause a series of reactions (phagocytes, cytolysis and inflammation) to help get rid of pathogens. (Tractor, G et al. 2012 p. 903) If a pathogen invades our body complements active Cob protein attaches to the outside of pathogen. If this happens, Cob can make the pathogen more appealing to phagocytes by a process called postposition (Tractor, G et al. 2012 p. 904).
Complement can create a membrane attack complex where proteins are inserted into the membrane of the pathogen resulting in cytolysis. Complement is stimulated mostly by antibodies and once an antibody finds a target, and binds onto that target, it can call in compliment to help destroy it. Question 3: D Antibody mediated immunity is the bodies way of killing bacteria that is still on the outside of the cell. If bacteria are floating around, white blood cells will find it and start to destroy/engulf it. The body contains T-Cells and B-Cells, which are capable of responding to a specific antigen.
In the presence of a foreign antigen, a specific B cell will become activated. When a B cell is activated; it will make Emory cells and more active cells. Active cells are called plasma cells, which will make and secrete antibodies, which circulate in the lymph and blood to reach the site of attack (Tractor, G et al. 2012 p. 900). Question 3: E Cell mediated immunity is part of the acquired immune system. It’s the body’s way of killing bacteria that is still on the inside of the cell, and begins with activation of T cells by a specific antigen.
ETC Cell (Cytosine T Cell) finds an infected cell. Infected cell has taken a little piece of whatever has infected it in the MIMIC protein and put it on its outside surface. The ETC Cell comes along and says ‘That’s the pathogen I’m looking for as well’ and the ETC Cell is then called activated. Activated ETC cells will make memory cells that will lay in wait for the next time this pathogen comes along, and will send out active cells, to go out and look for more infected cells (Tractor, G et al. 2012 p. 896). Question 4: A The preventive steps are the same if at work or at home.
You should keep your wounds that are draining, or have pus, covered with clean, dry bandages until healed. The bandages and taped used can be disposed of with your regular trash. You and anyone in close contact should wash their hands frequently with soap and water or use an alcohol-based hand rub (Centers for Disease Control and Prevention. 2010). Do not share personal items, including towels or clothing that may have had contact with infected wound or bandage and wash any sheets, towels or clothes that come in contact with area with water and laundry detergent, then use dryer to completely dry clothes.
You should also make sure you clean surfaces around your home or work that come into direct contact with your skin, to prevent the spread to others (Centers for Disease Control and Prevention. 2010). Question 4: B Stash and MRS. infections are treatable, with the help of your doctor. People should not attempt to treat the infection themselves, as it can worsen or spread the infection to others. The primary therapy for this type of infection involves incision and drainage. Antibiotic treatment should be given dependent on the susceptibility profile of the organism.
For severe infections, treatment may include surgical or antimicrobial interventions (Centers for Disease Control and Prevention. 2010). Question 4: C The signs and symptoms for MRS. will vary by the type and stage of the infection. Although healthcare facilities can cause more severe infections, such as bloodstream and surgical site infections, most MRS. infections are skin infections that are often red, swollen, painful pustules or boils with pus or other drainage (Centers for Disease Control and Prevention. 2010).
They can look like red, painful, swollen bumps or spider bites and can commonly occur at areas where there has been trauma to the skin, such as cuts and abrasions (Centers for Disease Control and Prevention. 2010). MRS. skin infections can commonly be located at areas of the body covered in hair, such as groin, armpit, buttock and he back of the neck (Centers for Disease Control and Prevention. 2010). Question 4: D The first important step is finding out the patient’s medical history, if they have had MRS. infection previously, or have recently come into contact with someone who has MRS..
Patient expressing complaints of a spider bite should raise suspicion of the infection (Centers for Disease Control and Prevention. 2010). An MRS. infection is commonly diagnosed using urine, blood, sputum or a skin sample of pus from a wound or biopsy material that is sent to a microbiology lab, S. erasures is grown on a Petri plate and the bacteria are exposed to different antibiotics, including nonmetallic. S. erasures bacteria that grow well when nonmetallic is in the culture are termed MRS., and the patient is diagnosed as MRS. infected. Davis, C. 201 1) Question 5: A Incidence of disease refers to new cases of disease. Incidence statistics are important in determining whether the number of new cases of the disease is increasing or decreasing which shows whether the outbreak is being contained. Incidence information is used to study risk to the population (Brat, H. 2009) Prevalence of disease refers to the total number of cases of disease that exist in he population either during a period of time or a specific point in time (Brat, H. 2009).
If a count of affected people is done one a particular day, it would include old and new cases therefore depending on the duration of disease; a single person may be counted more than once (Bishop,P et al. 2010 p 171) Incidence statistics reflect more accurately the occurrence and the rate of transmission of the disease, as incidence is a count of new cases, and prevalence is a count of the total cases Question 5: B A person might be pushed to migrate for many reasons, there could be political issues causing them to move for better security.
Poverty from lack of work resulting in a person needing to search work elsewhere to send money home, overcrowding which can cause poor living conditions. To seek out better access to care, such as access to hospitals or government assistance. The healthy migrant effect centers on the discovery that “first generation immigrants are often healthier then U. S born residents who share similar ethnic or racial backgrounds”(Finely, K. 2007), over time immigrant’s health diminishes due to adapting to the diet and lifestyle of the new location.
Studies on migrant’s health re impacted by the Healthy Migrant Effect, as to see if we can find a change in this pattern for immigrant’s health to maintain well balanced over time. Question 5: C Population at risk refers to a particular group of people that are specifically capable of coming down with or developing the condition/disease of interest. Egg, infectious diseases where there is specific immunization against the disease to protect the population, the people who have received the immunization will not be part of the population at risk.
Question 5: D There are four major steps necessary to investigate an epidemic, preparation, detection, response and evaluation (World Health Organization, n. D). Preparation involves outbreak response plans being put place for each disease, contingency plans for isolation wards in hospitals, health coordination meetings and stockpiles of appropriate antimicrobial, intravenous fluids and vaccines to be available in case needed. (World Health Organization, n. D) Detection involves taking clinical specimens for laboratory confirmation. World Health Organization, n. D) Response involves confirmation, investigation, confirming the diagnosis, counting the number of cases and determining the size of population, determining the at-risk population, formulate hypothesis for pathogen/source/ transmission, control and prevention measures specific for the disease (World Health Organization, n. D). Evaluation involves assessing the timeliness of outbreak detection and response, as well as assessing the appropriateness and effectiveness of containment measures (World Health Organization, n. ). Question 6: A would ask the students open ended questions to get valuable information for the investigation into the possible foddering illness. These questions would include; How do you believe you got ill? When did you eat the food? Where did you eat? What toppings were on your pizza? Who else were you eating with you? What did you have to drink? What were the similar items you and your roommate ate? How did your meal and drink differ from the people who didn’t get sick? If you took medication for symptoms, what did you take?
Have you been in contact with any animals in the last 24 hours? Question 6: B An outbreak in the community is referred to as, a higher number of reported cases then what is expected on the basis of previous reports during a non- epidemic time period within a given population (Bastard, K. 2000). During non-epidemic period of 5 days, Hospital A saw three patients with similar symptoms, yet were not associated with the university and during this period of outbreak there were 23 university students seen with associated symptoms.
The University Student Health Centre reported 20 students in one day with similar symptoms, when in a non-epidemic period there would typically see 1-2 students in a week. Therefore I believe that there has been an outbreak at the university. Question 6: C To narrow the range of agents that could be the cause of the students gastrointestinal illness, I would look into how long it took for the students to get kick after eating, as there are different Incubation Periods for different possible pathogens.
Another way to narrow the range of agents is to document the predominant signs and symptoms that the students are experiencing, and how long the symptoms lasted. Question 6: D In my discussion with the university officials would want to collect information that could be helpful to the investigation of the outbreak, and also negotiate cooperation with the officials to assure my investigation will run efficiently. Would discuss with them if they have had any issues in the past with similar asses, and where they think possible sources for diseases with the characteristics displayed would be, egg. Eater supplies, food sources and food conditions, living conditions for students, animal contact. Question 6: E Although I originally thought the pathogen was a parasite due to the students who were infected, eating at the main cafeteria which had a deli bar in its location – due to the incubation period for parasites taking longer than 24 hours (generally minimum of 2 days with parasites) (American Medical Association. 2004) it’s lead me to believe that this was less likely to be the reason for the outbreak.
Pathogen – Signs and symptoms among the infected students (Diarrhea, abdominal cramping muscle aches, headaches) are consisted with Nourish, a viral infection. With the outbreak happening in March, it fits into Norris’s’ more frequent occurring time period of October-April (INDICT. 2011). The symptoms commonly appear 1 -days after exposure to the virus, which fits the time frame the symptoms stated in the effected students.
