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Environmental Health 10-27-10

Environmental Health 10-27-10 - Environmental Health...

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Unformatted text preview: Environmental Health Environmental Health Dr. George Van Orden Health Officer/Environmental Specialist Environment Environment Everything that affects a living organism Environment: Environment: The aggregate of all the external conditions and influences affecting life and development of an organism What is “The Environment” What is “The Environment” The sum total of our surroundings, biotic and abiotic Physical Chemical heat light Gravity Radiation Noise oxygen water Nutrients Toxic Biological plants animals bacteria Fungi Predators Pathogens Health Health Physical and mental well being; soundness; freedom from defect, pain or disease. Public Health Public Health Science and art of preventing disease, prolonging life and promoting health thru organized community effort. Community Efforts Include: Community Efforts Include: Sanitation of the environment Control of communicable diseases Education of individuals and groups Early diagnosis and prevention of disease Development of social machinery to insure everyone a standard of living which is adequate for maintenance of good health The early functions (1800’s) of The early functions (1800’s) of public health focused mainly on sanitation and nuisance. John Snow was an English physician and anesthesiologist. 1854 – John Snow (father of field epidemiology) conducted studies of cholera outbreaks to discover the cause (twenty years before the development of the microscope) and prevent its recurrence. John Snow John Snow Golden Square of London Developed spot map of cases Marked location of water pumps on spot map Developed relationship between clusters of cases and locations of the Broad Street pump. Removed the handle from the pump. Snow’s Contributions Snow’s Contributions Linked the cholera epidemic to contaminated water supplies. Used a spot map of cases and tabulation of fatal attacks and deaths. Golden Square Investigation Golden Square Investigation More cases clustered around pump A (Broad Street Pump) Residents avoided pump B because it was grossly contaminated. Pump C was located too inconveniently No cases occurred in a two block area just east of pump A. Brewery with a deep well on premises Workers received daily portions of beer Workers got their water from this well. None of the brewery’s employees contacted cholera John Snow Pub John Snow Pub Medical sciences Bacteriology Immunology Cancer Epidemiology Housing Nutrition Toxicology Environmental Science Over time the public health field Over time the public health field evolved (with a better understanding of the science) to include: The progressive (changing) The progressive (changing) nature of “public health” makes defining the functions and responsibilities of the health departments difficult. DEFINING THE RELATIONSHIP DEFINING THE RELATIONSHIP BETWEEN ENVIRONMENT AND PUBLIC HEALTH ENVIRONMENTORGANISMEFFE ENVIRONMENT CT Definition of Pollution Definition of Pollution Contamination of a medium (air, water, soil) with some form of matter or energy to an undesirable level. The level deemed undesirable is culturally determined or something which interferes with the intended use of a resource. Chemical, Physical, Biological Chemical, Physical, Biological components of the environment which affect organisms EXAMPLES EXAMPLES Sun light Temperature Oxygen Predators Parasites Weather Food Water Toxics Soil ingestion/contact air Environmental Health Environmental Health Public HealthEnvironmentPromote Health (regulates) If: If: ENVIRONMENTORGANISMEFFECT And: Public Health Environment Promote Health (regulates) Then: Would expect to see the absence of disease if public health is effective An example of how public health An example of how public health (environmental health) works using communicable disease. Environmental Health/Implementing Environmental Health/Implementing Controls Problem Identified in Community (Biological Causative Agent) Define Chain of Infection for Biological Agent Develop Control Strategy Epidemiology/surveillance Implement Control Evaluate Control Consider what is practical and cost effective Epidemiology FDU Norovirus Outbreak (March 2007) FDU Norovirus Outbreak (March 2007) Chain of Infection 397 people became ill ( 10.2 % attack rate) Epidemic Curve Age distribution Surveillance Notifications (NJDHSS and County Epidemiologist) Review Data (Epidemiological Investigation) Identify Source and Controls Implement Controls Through FDU Health Center Continue Surveillance to evaluate effectiveness of Control Measures Information to students and parents WASH HANDS!!!!!!! Recommend Isolation during period of communicability Infected foodhandlers??? Clean/disinfect fomites Separation – weekend and spring break Virus appeared to have been Virus appeared to have been highly contagious Testing confirmed Norovirus Group NEW VIRUS???? Pandemic Influenza Pandemic Influenza Things to Consider Things to Consider Social disruption may be widespread Being able to work may be difficult or impossible Schools may be closed for an extended period of time Transportation services may be disrupted People will need advice and help at work and home The 1918 influenza pandemic killed an The 1918 influenza pandemic killed an estimated 20­50 million people worldwide, including 675,000 in the United States. The pandemic’s most striking feature was its unusually high death rate among otherwise healthy people aged 15­34. This May 29, 1919 photograph showed rows of tents that had been This May 29, 1919 photograph showed rows of tents that had been set up on a lawn at Emery Hill in Lawrence, Massachusetts where victims of the 1918 influenza pandemic were treated. Novel Influenza A (H1N1) Novel Influenza A (H1N1) Spread from Mexico (Spring 2009) to US Surveillance Than to other countries (pandemic) In communities and schools Controls School closures (?) Panic Disease is a relatively mild form of influenza No resistance within the population Isolation in the home, distance (6 ft.), hand washing, fomites Antivirals, Vaccine Anatomy of the Influenza A Virus Anatomy of the Influenza A Virus Hemagglutinin (HA) Neuraminidase (NA) M2 Nucleoprotein (NP) M1 Polymerase (P) Proteins Adapted from: Hayden FG et al. Clin Virol. 1997:911-42. Surface proteins Key Viral Features Key Viral Features Hemagglutinin (HA) Site of attachment to the host cells Antibody to HA is protective Neuraminidase (NA) Help to release virions from the cell (spread) Antibodies to NA can help modify disease severity Avian Influenza – Influenza A (H5N1) Avian Influenza – Influenza A (H5N1) Influenza A (H5N1) virus – also called “H5N1 virus” – is an influenza A virus subtype that occurs mainly in birds, is highly contagious among birds, and can be deadly to them. H5N1 virus does not usually infect people, but infections with these viruses have occurred in humans. Most of these cases have resulted from people having direct or close contact with H5N1­infected poultry or H5N1­contaminated surfaces. Mechanisms of Antigenic Shift T IREC D 16 HAs 9 NAs Non-human virus Human Human virus virus Reassortant virus Items to consider at the municipal level Items to consider at the municipal level Local Surveillance – Quickly ID and report cases Prompt Case Investigation Isolation/Quarantine Public Education/Communication Identify clusters and suppress or slow down the spread Respiratory Hygiene Distribution of Antivirals (???) and/or vaccine Cost­Benefit Analysis Cost­Benefit Analysis PUBLIC HEALTH Cost of prevention vs. Cost of Disease Long­term benefit vs. short­term benefit Environmental Health Programs Environmental Health Programs Communicable disease surveillance and outbreaks Drinking water supplies Food supplies/inspections Septic systems Surface water surveillance Public bathing places Sanitary surveys Lead poisoning Watershed management Public health nuisance Youth camps Campgrounds Air pollution Contaminated sites Noise Hazmat response Institutional sanitation Rabies and other zoonotic diseases Vector control Weapons of mass destruction Other Public Health Programs Other Public Health Programs Hypertension and cardiovascular Cancer screening Immunizations Diabetes Infants and preschool children Childhood lead poisoning Improved pregnancy outcomes Health Education ...
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