Epidemiology in Infection Risk Management

This presentation discusses the epidemiology of infectious diseases and how to manage infection risks. It focuses on the outbreak of tuberculosis in Auckland, New Zealand, and the surveillance strategies used to control it. The presentation also highlights the characteristics of people that contributed to the occurrence of the outbreak and the relationship between research and health interventions.

Epidemiology in Infection Risk Management
Author
Institution

Introduction
• Microorganisms such as bacteria, viruses,
parasites or fungi cause infectious disease and
can spread within individual and consequently
to a large population.
• In New Zealand there have been incidences of
infectious disease outbreak in various parts as
discussed.

The infectious organism responsible for the outbreak of disease
• The Mycobacterium tuberculosis bacterium causes the
Tuberculosis.

The infectious organism responsible for the outbreak of
disease
• The Mycobacterium tuberculosis bacterium causes the
Tuberculosis.

Specific population in the geographical area
in which the outbreak of the disease has
occurred
• Tuberculosis outbreak has occurred in the
population of Auckland city, New Zealand.

Patterns of disease transmission during the
outbreak
• Tuberculosis is spread through, sneezing,
coughing or sneezing (Wenger et al. 2005). The
bacteria are then carried into the air and people
nearby breathe them through their mouth and
noses.
• These droplets are produced by people with
laryngeal or pulmonary Tuberculosis. People
suffering extra pulmonary tuberculosis alone
are unable to transmit the infections to others.

• Meanwhile, people suffering latent tuberculosis are
also not infectious. Bovine tuberculosis is
transmitted from the cattle that are infected to
humans by taking unpasteurized contaminated
milk or milk products.

Characteristics of people that contributed to the
occurrence of the outbreak
• There are various factors that contribute to the
spread of tuberculosis disease. Generally, people
with the risk of developing tuberculosis are
classified into two categories.
• The people who have been recently affected by the
Tuberculosis bacteria, and those with a weakened
immune system due to medical condition
(Littleton, Park, Herring & Farmer 2008). People
with Auckland that contributed to the outbreak of
the tuberculosis disease

• People who have immigrated from other places in the world with high
incidences of tuberculosis this is given that there is the high number
of immigrants people moving to the Auckland city (DeRiemer Chin,
Schecter & Reingold 2002).
• The Auckland population has a group with high rate of Tuberculosis
transmission people with HIV infections. HIV weakens the immune
system and people suffering it has a high risk of developing
tuberculosis
• The Auckland population lives in a place that is highly congested and
this posed a risk of disease transmission (Hobbs, Moor, Wansbrough
& Calder 2002). Because of this factor one person might have resulted
to spread of disease to several people and hence the outbreak.
• Also, the majority of people living in the Auckland city have less
economic status. This is also a major risk factor that led to the
outbreak of the disease. This is because of poor health care access and
poor living conditions.

Epidemiological data outlining the course of the outbreak in the
selected area
• In Auckland city, the increasing high proportion of the tuberculosis is
derived from foreign-born people. Migration of people from the high
tuberculosis occurrences countries is the major cause of tuberculosis
in New Zealand (Das, Baker & Calder, 2006).).
• Of all those people who develop tuberculosis, a quarter of them
develop within the year of migration. The quarter of them mostly the
refugees enters the country probably with the disease.
• The rate of local tuberculosis reactivation and transmission of the
disease is steadily declining, except for the New Zealand born Pacific
and Maori people under the age of 40. The immigration of people
with Tuberculosis in New Zealand is significantly contributing factor
to the increased statics in Auckland city.
.

The table below shows the risk factor of immigrants living in Auckland city, New
Zealand.
Risk factor cases Total %
Not born in New Zealand 221 289 76.5
Current residence with person born
outside New Zealand
219 261 76.2

Country Year and Source Cases of overseas-born %
New Zealand 2005
2000
1995
76.3
55.6
47.5
Australia 2003
1994
82.7
66.4
• The table above illustrates a high number of
undiagnosed people entering New Zealand and
consequently resulting in a high number of
immigrants people with Tuberculosis in the
Auckland city.

Surveillance and current surveillance strategies
associated with your selected disease
Tuberculosis disease in New Zealand is a notifiable
condition. Notification of tuberculosis cases forms the
basis of follow up by the public health cases and
contacts and surveillance (Turnbull, 2003). Early cases
tuberculosis identification is the crucial to effective
control and management of the disease. The surveillance
strategy of the tuberculosis disease includes.
• Monitor the distribution and incidence of infections
and disease at both national and local levels.
• Identifying the risk factors to support intervention s
that aims at preventing tuberculosis

• Supporting the local management of identified cases,
screening and contact programmes.
• Monitoring the outcome and the process of disease
control and screening programmes, so that there can
be improvements (Pang, Harrison, Brearley,
Jegathesan & Clayton 2000).
• Monitoring the Antibiotic vulnerability of M.
tuberculosis and M. bovis to guide the appropriate
application of antibiotics.

Critically analyze and discuss the relationship between research and
health interventions
showing how research has influenced decision making and the choice
of interventions to
reduce the incidence of the selected disease within your selected
population and
internationally
• Tuberculosis is an infectious disease. However, its incidence can be
reduced. One of the main major factors that can influence the
reduction of tuberculosis is educating and creating awareness of the
disease to the people (Dye, Watt, Bleed, Hosseini & Raviglione 2005).
• It is evident that external factors act a major role in the spread of the
disease and not until when people aware of this external factor the
incidence will continue to increase. This applies to those who are
already infected and to those not. This awareness includes activities
such as covering mouth after a cough with a tissue when coughing,
sneezing, washing hand after sneezing or coughing.

• Moreover, those people who have HIV infections
should be monitored regularly as they are vulnerable to
tuberculosis because of a reduced immune system. The
research showed a high percentage of people having
HIV infections have been diagnosed with tuberculosis.
• It is of much significance for the people who are
migrating locally and internationally to be tested
tuberculosis (Elz et al. 2007). This is to avoid the
spread of disease from one place to another.
• Furthermore, it is essential to point out that in order to
reduce the spread of the disease it is good to adhere to
the medication.

References
DeRiemer, K., Chin, D. P., Schecter, G. F., & Reingold, A. L. (2002).
Tuberculosis among immigrants and refugees. Archives of
Internal Medicine. Retrieved from:
https://www.ncbi.nlm.nih.gov/pubmed/9554681
Dye, C., Watt, C. J., Bleed, D. M., Hosseini, S. M., & Raviglione, M.
C. (2005). Evolution of tuberculosis control and prospects for
reducing tuberculosis incidence, prevalence, and deaths
globally. Jama, 293(22), 2767-2775.
Elz, L., Schlegel, M., Weber, R., Hirschel, B., Cavassini, M., Schmid,
P., ... & Swiss HIV Cohort Study. (2007). Reducing
tuberculosis incidence by tuberculin skin testing, preventive
treatment, and antiretroviral therapy in an area of low
tuberculosis transmission. Clinical Infectious Diseases, 44(1), 94-
102.

Hobbs, M., Moor, C., Wansbrough, T., & Calder, L. (2002). The health
status of asylum seekers screened by Auckland Public Health in
1999 and 2000. The New Zealand Medical Journal (
Online), 115(1160).
Littleton, J., Park, J., Herring, A., & Farmer, T. (2008). Multiplying and
dividing: tuberculosis in Canada and Aotearoa New Zealand.
Retrieved from: https
://researchspace.auckland.ac.nz/bitstream/handle/2292/2558/
RALe_03.pdf;sequence=1
Pang, S. C., Harrison, R. H., Brearley, J., Jegathesan, V., & Clayton, A.
S. (2000). Tuberculosis surveillance in immigrants through health
undertakings in Western Australia. The International Journal of
Tuberculosis and Lung Disease, 4(3), 232-236.

Turnbull, F. (2003). The epidemiology and surveillance of
tuberculosis in New Zealand. Guidelines for
tuberculosis control in New Zealand, 1-30.
Wenger, P. N., Beck-Sague, C. M., Jarvis, W. R., Otten, J.,
Breeden, A., & Orfas, D. (2005). Control of
nosocomial transmission of multidrug-resistant
Mycobacterium tuberculosis among healthcare
workers and HIV-infected patients. The
Lancet, 345(8944), 235-240.