Epidemiology of Influenza Example Essay
Influenza is a viral pathogen that attacks the human body respiratory system. The virus is introduced into the body through contact with saliva that contains the virus on the mucosal membranes around the mouth and nose. Influenza virus can also be transmitted through aerosol droplets found in the air inhaled. The virus is categorised into four major groups; A, B, C and D. Human influenza A and B are responsible for the seasonal flu (CDC, 2019). However, influenza A type causes severe flus that are often classified as global epidemics due to its ability to mutate into new strains that spread and multiplicate faster. “A(H1N1) pdm09 virus,” is an example of type A influenza that cause global pandemic flu in the spring of 2009. Influenza C causes other mild conditions in humans while D mainly causes illnesses among livestock.
Influenza virus type A is further divided into subtypes according to the two proteins in the cell wall of the virus: neuraminidase (N) and hemagglutinin (H). The two proteins have a variety of subtypes with hemagglutinin having 18 while neuraminidase has 11. Common colds caused by influenza A are mainly the combination of A(H1N1) or A(H3N2). The influenza viruses in type A can be further subdivided based on genetic clades and sub-clades of the individual strains (CDC, 2019). Unlike influenza A, type B is not divided into subtypes. Instead, it is classified into two major lineages: B/Victoria and B/Yamagata. However, the two lineages can be classified into clades and subclades like influenza A. The rate of mutation for both genetic and antigenic properties in this type of influenza is slower compared to the A virus. Therefore, influenza B is considered more manageable compared to influenza A.
Causes of influenza Flu
The influenza virus is airborne. Humid air droplets released into the atmosphere by virus positive persons through coughing, sneezing, or talking remain suspended until they come into contact with a surface (CDC, 2018). Sometimes the surface is the human body. When the infectious air molecules land on the mucus membranes of the upper respiratory system or mouth of human being they cause flu. The virus can also be obtained from surfaces contaminated with saliva droplets of infected persons. As mentioned earlier, there are different types of influenza, thus they cause different types of flu. Some are mild that they resolve without medical intervention while others are lethal.
Risk Factors
Every human being can contact influenza and develop its symptoms. However, some people are at a higher risk compared to others. An active immune system recognises foreign bodies in the system and initiates mechanisms to render them harmless. Depending on the type of pathogen, an effective immune system may clear the foreign bodies from the system before the individual realises through symptoms. In other cases, a person develops symptoms that subside without taking any medication. However, a weak immune system is easily overwhelmed during a fight with pathogens thus severe symptoms that sometimes progress and become complications. Therefore, persons with weak immunity are at higher risk of contracting the influenza virus than other members of the general population (Magdaleno, 2019) A weak or ineffective immune system could be caused by various factors including improper nutrition, medications like antihistamines, and conditions like HIV.
Persons with pre-existing respiratory conditions like chronic obstructive pulmonary disease (COPD) are at a higher risk of influenza. COPD symptoms exacerbate those of influenza thus making the individual more critical. Influenza triggers an immune reaction on the respiratory system that initiates increased production of mucus. Excessive production of mucus blocks the airways hence breathing difficulties which are a major symptom in COPD. Children below 6 years are also at a higher risk of developing flu since their immune system is still weak to form a strong resistance towards the virus (Magdaleno, 2019) Senior citizens with 65 years and above are also at a higher risk of developing the flu due to compromised immunity which occurs with advancement with age. Pregnant women or those who have recently given birth have a physiologic low immunity that makes them vulnerable for more severe symptoms of flue if the virus enters their system. Morbid obesity is another risk factor since the nutritional disorder lowers both leucocytes and cell-mediated immune response increasing chances of a pathogen thriving in the system. Other chronic conditions like kidney disease, heart disease, asthma, diabetes and liver disease are also risk factors of influenza.
Symptoms of Influenza
Flu majorly affects the respiratory system though in severe cases other systems can be impacted. Once the virus is detected in the body, the immune system triggers various responses to fight the pathogen. One of the responses is increase production of mucus along the surfaces of the respiratory system. The mucus in most instances is thick thus blocking the airways. Consequently, patients present with difficulty in breathing, persistent coughs and blocked sinuses. Fever is also a common feature of flu which is a product of the inflammation process that takes place when the immune system tries to get rid or supress of the virus. Persons with flu also experience headaches and felling light headed which is caused by poor oxygen saturation to the brain. Persons with influenza also feel tired and lethargic (Magdaleno, 2019). Those two symptoms are attributed to ineffective breathing pattern that results to limited oxygen available for transport to vital organs like the brain. Chest pains are also common to persons with flu since they use accessory muscle while breathing as the body tries to compensate the oxygen imbalance.
Complications
Flu can resolve by itself after some few days for people with strong immunity. However, in some cases the symptoms are quite severe that one may require medical interventions. Failure to seek medical interventions during such instances or poor management results into complications of influenza. Pneumonia is one of the complications of flu where the air sacs of one or more lungs are filled with fluid. The fluid impairs gaseous exchange that the patient ends up with dangerously low levels of oxygen in their blood system. Other complications of influenza include ear and sinuses infection that the patient may start producing fluids in the ears. Myocarditis which is the inflammation of the heart can also occur in unmanaged cases of influenza (CDC, 2020). Severe cases of influenza can also cause of the bran (encephalitis) which is a life-threatening situation. Organ failure can also occur both in the kidney and the lungs when gaseous exchange is severely impacted. Flu can also trigger extreme immune response known as sepsis which is a life-threatening condition since it can easily damage vital organs.
Treatment of Influenza
Mild and moderate flu do not require medication to treat, instead home remedies are used to clear the infection. Some of the home remedies is eating foods rich with vitamin C to boost immunity. Patients also take plenty fluids to replace fluid lost due to fever thus preventing hydration. Taking enough rest reduces fatigue and oxygen demand thus control of symptoms. However, in severe cases, health care providers administer antiviral agents that to produce a synergistic effect on the body’s immune response towards the virus. Zanamivir, oseltamivir, baloxavir and peramivir are some of the drugs used in management of influenza (Kotey et al., 2019). Oxygen therapy is also used for patients with difficulty in breathing and with less than 90% oxygen saturation. Cases of severe dehydration due to fever are managed by infusing fluid to rehydrate. Patients are also given analgesic to relief headaches, chest and muscle pains.
Demographic of Interest
According to Centre of Disease Control and Prevention, influenza A (H1N1pdm09) and A (H3N2) were quite predominant in the seasons from 2018-2019. CDC estimates of the period indicated that 35.5 million U.S citizens were sick with influenza. 16.5 million sort for medical intervention for the same. 490,600 of those who went to health facilities were hospitalized and 34,200 lost their lives to influenza. The results of the study analysis indicated that children between 0-4 years had the highest numbers of disease rate while senior citizens made up the lowest. On the contrary, mortality rate was highest (48.7) among the age group of 65 years and above while in children between 0-4 years it was 1.4. The age group between 0-4 years had the most hospital visits among all age groups (8,419.3) due to influenza while the senior citizens had the least visits (3,282.4). Surprisingly the rate of hospitalization was highest among the senior citizens compared to any other age group (532.9) (CDC, 2020). Influenza is not a reportable disease.
Epidemiologic Triangle
Flu is caused by the various types of influenza mentioned earlier. Human beings are the host of influenza A, B and C while livestock are the host of influenza D. The communicable disease is transmitted through air when one breathes in humid air droplets containing the virus. It can also be transmitted through toughing contaminated surfaces then toughing the mouth nose or eyes. For one to contract influenza, they have to been in a close range with someone with the virus. The carrier must release the agent into the air or the surface through talking, coughing or sneezing.
Role of Community Health Nurse in Influenza
Community health nurses (CHN) has a role to play in prevention and control of influenza. The main responsibility is educating member of the public about the communicable disease, symptoms, management and how to prevent themselves from contacting the virus. CHNs should influence members of the community towards practicing proper hygiene measures like covering the mouth when coughing or sneezing. They should also understand the essence of hand washing that will help eliminate possible pathogens that they may have come into contact with including the influenza virus. Health diet and nutrition should also be part of the education. They should know that eating food rich in vitamin C enhances their immunity. On the other hand, unhealthy feeding leads to conditions like diabetes and morbid obesity that increases their risk of developing a flu. Community members should also be taught home remedies and the need to seek medical advice if the symptoms persist (Kotey et al., 2019). CHNs should collect data on influenza to keep track of the disease within the community. Analysis of the data obtained can also be used as a toll to measure effectiveness of the education done to the public.
Role of CDC on Influenza
The CDC is one of the organisations that have addresses influenza through Influenza Division International Program (IDIP). The program works in collaboration with other parties like the World Health Organization and national health ministries to enhance the initiative towards prevention and control of influenza. The main goal of IDIP is to enhance evidence-based prevention and control of influenza globally (CDC, 2020). The department also focuses on creating awareness on effective communication of influenza-associated risks, and reduce the global impact of influenza caused by novel, seasonal and pandemic influenza viruses.
Therefore, the department has objectives that in different way help realise the main goal. The objective includes estimating economic impact of the disease, identifying risk factors and risk groups, supporting policy development of initiatives to increase influenza vaccination globally. The department also support countries develop epidemiological survey centres and labs for influenza which will increase reporting and data coverage. It is also the responsibility of the department to evaluate the effectiveness of influenza vaccines and methods employed to treat and control influenza. IDIP also enhances preparedness to support pandemics that may arise from influenza as well as infection control training.
Global Implications of Influenza
According to WHO (2019), influenza is a global health condition rather than a localised endemic. There are around 1 billion reported cased with 3-5 million being severe cases across the globe. As of 2019 there were 290 000-650 00 death cases of influenza related respiratory diseases worldwide. Being a global threat, the conditioned is addressed uniformly from all corners of the world. WHO initiated the Global Influenza Strategy 2019-2030 to provide nations with the framework on how deal with the condition holistically. Therefore, the focus of the initiative is to universal tools like antiviral drugs, vaccines, and treatment strategies that will benefit all nations in the fight towards influenza.
Conclusion
Influenza is a virus that takes different forms and causes respiratory conditions to human beings. The nature of some types of the virus like influenza type A have general characteristics that make them lethal compared to other strains (CDC, 2019). The pathogen causes symptoms like fever, coughing and difficulty in breathing when it enters the system. The symptoms can fade away with time or progress into complications depending with the immunity of the individual. All humans are susceptible to flu but others are at a higher risk due to personal characteristics. CHNs should ensure that members of the public embrace measures towards control and prevention of the disease.
References
Centers for Disease Control and Prevention (2018) How Flu Spreads https://www.cdc.gov/flu/about/disease/spread.htm
Centers for Disease Control and Prevention (2020) Estimated Influenza Illnesses, Medical visits, Hospitalizations, and Deaths in the United States – 2018–2019 influenza season https://www.cdc.gov/flu/about/burden/2018-2019.html
Centers for Disease Control and Prevention (2020) Influenza Division International Program https://www.cdc.gov/flu/international/program/index.htm
Centers for Disease Control and Prevention, (2019) Types of Influenza Viruses https://www.cdc.gov/flu/about/viruses/t)/ypes.htm
Centers for Disease Control and Prevention, (2020) Flu Symptoms & Complications
https://www.cdc.gov/flu/symptoms/symptoms.htm
Kotey, E., Lukosaityte, D., Quaye, O., Ampofo, W., Awandare, G., & Iqbal, M. (2019). Current and novel approaches in influenza management. Vaccines, 7(2), 53.
Magdaleno, L. (2019). Evaluating the signs and symptoms for influenza virus. Boletín de Malariología y Salud Ambiental, 59(2).
World Health Organization (2019) Global Influenza Strategy https://www.who.int/influenza/global_influenza_strategy_2019_2030/en/
Essay Instructions
Apply the concepts of epidemiology and nursing research to the communicable disease Influenza.
- Describe Influenza, including causes, symptoms, mode of transmission, complications, treatment, and the demographic of interest (mortality, morbidity, incidence, and prevalence). Is this a reportable disease? If so, provide details about reporting time, whom to report to, etc.
- Describe the social determinants of health and explain how those factors contribute to the development of this disease.
- Discuss the epidemiologic triangle as it relates to the communicable disease, Influenza. Include the host factors, agent factors (presence or absence), and environmental factors. Are there any special considerations or notifications for the community, schools, or general population?
- Explain the role of the community health nurse (case finding, reporting, data collection, data analysis, and follow-up) and why demographic data are necessary to the health of the community.
- Identify at least one national agency or organization that addresses the communicable disease chosen and describe how the organizations contribute to resolving or reducing the impact of disease.
- Discuss a global implication of the disease. How is this addressed in other countries or cultures? Is this disease endemic to a particular area? Provide an example.