Health Risks on the Gold Coast

This assignment requires an in-depth analysis of potential health risks on the Gold Coast, Australia. The assessment should consider various factors such as prevalent infectious diseases like dengue and Zika, the influence of climate and weather patterns (e.g., Surfers Paradise forecast), tick-borne illnesses, and the availability of healthcare resources and preventative measures (e.g., immunization programs).

Running head: INFECTIOUS DISEASE PREVENTION AND MANAGEMENT
ANALYSIS OF THE RISK FACTORS FOR THE SPREAD OF INFECTIOUS DISEASE
IN THE GOLD COAST COMMONWEALTH GAMES, 2018
Name of the Student
Name of the University
Author Note

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Gold Coast environment in relevance to infectious disease
The XXI Commonwealth Games (2018) is scheduled in Gold Coast in Queensland,
Australia, and will be the fifth Commonwealth Game hosted by Australia. The game start on
April 4th, and has provisioned the accommodation of 6600 athletes and officials in the form
of an athletes village comprising of 1252 houses, 1170 apartments and 82 townhouses in
Southport. As a result, there will be an enormous influx of people (athletes, audiences,
dignitaries) in the city, and therefore increasing the chances of introducing infectious disease
into the community. If not checked and controlled properly, a potential outbreak scenario can
ensue due to the influx, and can jeopardize the public health as well as the health of the
visitors. It is therefore vital to identify the diseases most prevalent in the city, and the diseases
that can potentially be favored by the environmental conditions of Gold Coast. Identifying the
pathogenicity and etiologies of these communicable diseases can allow the implementation of
preventative measures to control disease outbreaks/spreads.
Gold Coast has a humid subtropical climate. The winters are warm (average of 25 to
29 degree Celsius) and hot and humid summers (average 23 to 27 degree Celsius with 106%
to 121 % humidity) (Surfers Paradise Forecast, 2017). This can provide a good sustainable
environment for different kinds of pathogens that exists or can be introduced to Gold Coast.
Currently, the Gold Coast environment has seen the prevalence of different types of
infectious diseases like diseases borne of contaminated food or water, diseases carried by
mosquito (like Dengue), Viral Zoonotic Disease (like Australian Bat Lyssavirus or Q fever),
Influenza, and infections (like meningococcal disease). Tick borne disease like Lyme disease
has shown several incidences in Australia (Tick Borne Diseases | Gold Coast Hyperthermia
Dr Craig Thompson – Integrative GP, 2017).

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Some of the more relevant diseases in Gold Coast are Mosquito Borne diseases (like
Dengue and Zika), and Influenza. As per Gold Coast Bulletin (August 26th, 2017), have
reported an increased number of Influenza infections, with teenagers between 10 and 19 years
being at the highest risk Statistics from Gold Coast Hospital Health Services shows a 20%
increase (520 cases in a week) in the incidence of Influenza (Coast fully sick as flu numbers
soar, 2017). Similarly Mosquito borne disease like Zika, have also been reported before.
Presumably the Aedes aegypti (Dengue mosquitoes) can pick up the Zika virus from an
infected traveler, and spread it (Zika virus | Queensland Health, 2017).
Infrastructure related to infection control and management
The infrastructure applicable to/ associated with Infection Control and Management
Plan (ICMP) enables better management of communicable diseases, and its treatment. The
infrastructure can be comprised of an Infection Prevention Team, Long Term Care Facilities
and Hospital Surveillance of Health Associated Contagion. ICMP is a standard design aimed
for reduction or prevention of infectious diseases in regards to healthcare services for
patients, healthcare professionals working in the facility as well as individuals who can get
infected in the facility. The declared healthcare facilities includes public hospitals, blood
banks, occupational therapists, dental clinic, pathology laboratories, podiatry clinic,
acupuncturists, specialist practice clinic, physiotherapists, speech therapists, pharmacies,
hyperbaric medicines, aboriginal healthcare services, dermatology service, pharmaceuticals,
nursing service, optometrists, correctional service, diabetes educators, radiological and
diagnostic imaging services, stem cell transplant service and Chinese medicines.
Infection control program involves components like basic measures for infection
control; education, training of healthcare workers; protecting the health of people through the
processes of immunization; health hazard identification and risks mitigation; conducting

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routine activities and practices and effective work practices; surveillance; monitoring of
incidence; investigation of outbreaks; research and controlling infections in specific situations
(Poff, & Browning, 2014).
An Infection Control Committee acts as a forum for sharing information and allows a
multidisciplinary input and help, and should include representatives from a wide variety of
professions like management, healthcare workers, pharmacies, clinical microbiologists,
housekeeping, sterilization services, maintenance and training services. They should be able
to review and commend surveillance and prevention activities, identify scope of intervention
from surveillance data, promote better health practice and assess the existing practice
standards, ensuring proper training of staff in the domains of infection control and
management.
Quarantine Centers are applicable in conditions to stop further spread of the disease,
by isolating the infected cases from non infected individuals. The quarantine centers will
allow a safe study of the remedy and treatment, while ensuring safety for the population and
health workers (Drazen et al., 2014).
Vaccination protocols can allow preventative measures, providing protection to
healthcare providers and to public. The vaccines help to build up immunity against diseases,
and therefore is an important measure of disease prevention and managing (Vaccines, 2017).
Surveillance allows proper reporting of infection incidences. Infection investigation
done in accordance of CDC definition, can allow effective identification of the prevalent
diseases, and thereby formulate a control.
Major infectious diseases of concern and their relevant etiology and epidemiology.

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Influenza: Also called the flu is caused by influenza virus. This ailment is
characterized by symptoms like fever, sore throat, runny nose, muscular pains, coughing, and
fatigue.
Flu can be caused by different strains (A, B or C) of the Influenza virus. Flu cases in
Australia are mostly caused by strains A and B. Out of these 2, only Influenza A is known to
have caused pandemics. The spread of the virus can be in 3 different ways: direct
transmission (when mucus from the infected person directly contacts the mucosa of the
healthy person), airborne transmission (caused by inhaling droplets of moisture containing
the virus), and through contaminated objects/ vehicles. Children are generally more prone to
infection than adults.
Estimates show that an average of 13,500 hospitalizations and 3,000 mortalities in
Australia each year due to influenza. The worst affected are the patients suffering from
chronic conditions like lung disease, asthma, cardiac disease, kidney disease, blood disorder,
obesity and endocrine dysfunction (Colds and flu statistics, 2017). Surveillance reports from
Australia in 2017 also provide the following information:
The infections reached its peak activity in mid August. The confirmed cases of
infection, reported to NNDSS (National Notificable Diseases Surveillance System) being 2.5
times compared to last year. The currently dominant strain of influenza virus, prevalent in
Australia is the type a strain. The highest incidence of infection have been found among
adults aged 80 and above, and the second highest incidence among children between 5 to 9
years. Even though in 2017 the number of mortality cases due to influenza showed an
increase and is consistent with the rise in the reported cases and not necessarily due to an
increased severity of the disease (List of notifiable conditions | Queensland, 2017). The
Commonwealth Department of Health and Ageing estimated a total of 231,645 laboratory

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confirmed cases of influenza in Australia in 2017 (till November) (Immunisation Coalition,
2017).
Figure 1: Statistics for Influenza in Australia; source: (Immunisation Coalition, 2017)
Dengue: This disease is spread by mosquitoes, and caused by the Dengue Virus
pathogen. The typical symptoms associated with the disease are fever, headache, nausea and
painful joints. The symptoms can often develop into acute symptoms that are life threatening
like hemorrhagic fever, bleeding, low platelet count, leakage of plasma, and shock that can
cause acute low blood pressure (Centers for Disease Control and Prevention, 2017). A sudden
onset of fever is a characteristic of dengue. Infection course can be divided into three discrete
phases: febrile, critical and recovery. During the first phase- the febrile phase, a high fever
occurs (typically above 40 degree Celsius) associated with muscular pain and headache
lasting for a week. Nausea and vomiting are also common apart from rashes and flushed skin.
The fever can be biphasic, and shows frequent relapse. The critical phase starts as the fever

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goes down, and there can be leakage of plasma from the blood vessels which can last for a
couple of days, causing fluid accumulation in the thoracic and abdominal cavities and can
also cause dehydration, loss of fluid, reduced blood to organs, and bleeding from the Gastro
Intestinal tract. A dengue shock can ensure due to these conditions, and can be fatal. The
recovery phase occurs next, and is evidenced by the reabsorption of the fluids back into the
circulatory system. The improvement can be associated with a lowered heart rate, itching and
peeling of the skin. A fluid overload can also occur due to the increased volume of blood, and
can affect the brain causing seizures.
The disease is spread by the mosquito Aedes aegypti, and the virus has 4 different
strains (1, 2, 3, and 4). Infection with one strain of the virus can cause immunity to only that
strain, thereby still exposing the individuals to infections by the other strains in the future
("Department of Health | Australian Influenza Surveillance Report and Activity Updates",
2017). The mosquitoes bite by the day, and the disease has an incubation period of 3-14 days.
The majority of the mosquito borne disease in Gold Coast is caused due to the salt marsh
mosquitoes. Freshwater bodies created due to heavy rainfall also provide the ideal breeding
grounds for the mosquitoes. High tides exceeding 1.6m in the Gold Coast Seaway also
triggers the breeding of the mosquitoes, thereby increasing the prevalence of mosquito borne
diseases ("City of Gold Coast | Mosquitoes", 2017). However, reports from January 2017
shows a record high number (in 20 years) of reported cases of dengue in Australia (Butt,
2017)
Currently, the mosquito causing dengue is only found in the North, Central and
Southwest Queensland. Outbreaks have occurred each year in Queensland, and the outbreaks
generally start when an individual is infected with the virus while travelling overseas, and
thereby introducing the pathogen into the country ((Faddy, Viennet, Flower & McBride,
2017).

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As per WHO there were 662 laboratory conformed cases of Dengue in Australia, as of
July 31st, 2017 (World Health Organization, 2017). This shows a reduction in the reported
cases compared to previous years.
Figure 2: Reported cases of Dengue; source: (World Health Organization, 2017)
Infectious disease health services capacity and critical control points
The health services for Infectious disease control ensure proper prevention of
communicable diseases and prevent disease outbreaks. The service policies provide critical
control points to check the outbreaks/spread of disease by analyzing the mode and path of
infection. These control points are:
Immunization: This is the process of aiding an individual’s immune system to
recognize a pathogen or immunogenic, building an immune memory of it. Immunization
saves approximately 2-3 million lives every year from preventable diseases like diphtheria,
tetanus, rubella, polio, mumps, pneumococcal diseases, tetanus, Pertussis, measles, hepatitis
B and Haemophilius influenza type B. The vaccination program can involve strategies like:
vaccination for all children, documentation of all vaccinations, free vaccinations and
revaccinations incase of outbreak of diseases (Immunization, 2017). In addition, compulsory
vaccination can also be implemented against certain diseases that shows prevalence.

8INFECTIOUS DISEASE PREVENTION AND MANAGEMENT
Screening: It allows identification of individuals who have been infected or exposed
to the pathogen. It allows the treatment to be commenced in a timely manner, manage the co
morbidities with more affectivity, help to reduce high risk behaviors for the disease, identify
the necessity for any compulsory treatment plans. A quick and successful identification can
also lower the rate of transmission thereby improving the success rate of disease
management.
Legal Framework and Mandatory Disclosure Laws: Penalizing non compliance to
public health orders or for behaviors that can cause risk to public health allows prevention of
activities that can jeopardize health of the public, and ensure personal responsibilities related
to health. The laws also ensure compliance by healthcare providers to adhere to the strict
protocols and methods that can foster well health of the population, and prevent outbreaks
(Chen, Levonyan, Reinhart & Taksler, 2014).
Isolation/Quarantine: In case of serious outbreaks, it is often challenging to identify
the correct source and the carriers. Due to this evacuation and closure of public places can be
helpful to stop the spread of the disease. A proper quarantine protocol, combined with
decontamination practices can ensure the safety of the people, in particular the economically
vulnerable (Drazen et al., 2014).
Role of transport access in affecting risk of infectious disease transmission:
Infectious diseases can be transmitted by various methods, and therefore public health
services aims to minimize transmission of the diseases.
Enteric diseases can spread through water or food, and contamination of water
supplies can result in diseases like diarrhea, jaundice and cholera. Diseases like Dengue,
Malaria, Yellow Fever or Zika Virus are spread by mosquitoes. Prevalence of mosquitoes can

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hence be associated with prevalence of the diseases borne by them. Similarly, diseases like
Influenza can be spread by direct or indirect contact, or by mucosal discharge, as does
common cold and small pox.
As we understand that a huge influx of people are likely to occur during the
commonwealth games, 2018, there will be an elevated risk of retransmission of diseases
during that time. Overcrowding can also elevate the risks of influenza spreading out of the
country and diseases like Dengue and Zika entering the country from foreign individuals
(Rahman, Harley & Plummer, 2017).
Therefore it is of utmost importance that the mode of transmission of these diseases
be understood clearly, and proper precautionary and intervention measures be used to prevent
their outbreak or to contain them. Preventing access to the vehicles of the disease can in
effect prevent the spread, and ensure the continued protection of public health and foster a
general well being among the public.

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australia-20170112-gtqq5b.html
Centers for Disease Control and Prevention. (2017). Symptoms and what to do if you think
you have dengue. Centers for Disease Control and Prevention, Atlanta, GA:
http://www. cdc. gov/dengue/symptoms.
Chen, D. L., Levonyan, V., Reinhart, S. E., & Taksler, G. B. (2014). Mandatory disclosure:
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Department of Health | Dengue Fact Sheet. (2017). Health.gov.au. Retrieved 13 November
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