Health Education in terms of Epidemic

Policies in times of Epidemic/Activities of PHN in times of Epidemic:

1. Organize a team
2. Conduct an Epidemiologic Investigation (EI)
• A problem-solving approach that follows a scientific step
• Steps in Epidemiological Investigation:
1. a. Confirm diagnosis
• Determine 1st if greater population is affected by disease
• Example: Lanting Community=epidemic measles
1. 3000: Susceptible population
2. 1750: Affected population
2. b. Appraise the fact
• Use an empirical approach (the utilization of human senses)=naked eyes/sense of light, touch, smell & hearing
• PHN needs to get out & check for the victims
• Example: PHN’s sense of sight=saw the pathognomonic signs of measles→ koplik’s spot & rashes
3. c. Formulate hypothesis
• To make an intellectual guess based on theory, fact & generalization
• The problem is stated in hypothetical form using 2 Variables of Hypothesis:
1. Independent-refers to the cause
2. Dependent-refers to outcome/effect
• There should be an existing relationship between the 2 variables
• Example:
• Stated problem in hypothesis: Measles is caused by rubeola virus Dependent (outcome): Measles Independent (cause): Rubeola virus
4. d. Testing hypothesis
• To prepare an assumption which is always paired with stated hypothesis
• Assumption is the answer of the researcher to a stated problem. Assumption is the personal opinion of the researcher (pananaw) & does not need to be proven because it’s always true & correct
• Example: Lanting Community has poor environmental sanitation (es) which caused the measles
5. e. Draw a conclusion
• To draw a conclusion from the statement of problem & assumption to come up with a Nursing Diagnosis
• Example: Measles is caused by rubeola virus due to poor environmental sanitation
3. Collection of Specimen (optional)
• Optional because it is case to case basis
• Not done in measles epidemic
• Done in GIT diseases like Cholera caused by bacterial agent Vibrio cholera where it is identified in stool examination
4. Treatment
• RA 6675: providing drug of choice
• Example: Cholera-give Tetracycline but contraindicated to pregnant women & children below 8 years old so may give Penicillin like Ampicillin
5. Immunization
• Mass immunization for measles epidemic=”Ligtas Tigdas”, a DOH program
• Example: The mass immunization of all children in the community (6 months to 8 years old) with measles vaccine irregardless if a 9 month old baby has just received measles vaccine, he will still be given. No overdose will result but it’s prophylactic (Patak Polio) and not for treatment
6. Health Education-on personal hygiene
7. Environmental Sanitation
8. Referral
9. Recording & Reporting (R/R)-r.a. 3753: Vital Health Statistics Law
10. Evaluation & Reasearch
• Research evaluation was only started in 2001
• Year 1996-2000: Zero Polio Philippine Program
• In year 2000, there’s sudden mark decrement/decrease of polio cases
• In year 2001, suddenly there’s an increase incidence of polio because they don’t know the cause so they consider polio to be mutagenic
• 3 Strains of Polio:
1. Brunhilde
2. Leon
3. Lansing

Types of Epidemiological Investigation:

1. Descriptive: describes or defines the characteristic pattern or occurrence of epidemic as to where-place, when-date, time who-person
2. Analytical: determines what could have cause the occurrence of the disease
3. Interventional: therapeutic or experimental that determines the management/treatment for the victims of the occurrence of the disease
4. Evaluative:
• determines the efficacy of the management/treatment provided/procedure done
• Efficacy refers to effectivity (qualitative) and efficiency (quantitative)

Epidemiology is the pattern of occurrences & distribution of diseases, defects & deaths

1. Epidemic
• Greater than 50% of populations are susceptible or less immune individual
• Greater % of the population is affected by the occurring disease
• Example 1: Health worker reports that Community Lanting has an epidemic of measles affecting children less than 7 years old
• Total susceptible population: 3000
• Children affected by measles: 1750
• 3000 x 100=58% (more than 50% of susceptible population=epidemic
• Example 2: Epidemiological Chapter is regional
• Measles is considered epidemic if in:
• Year 2004=there are 15 cases
• Year 2005=there are 19 cases, because it exceeds the # of cases of previous year
2. Endemic-the disease occurs regularly, habitually, constantly affecting the population group
• 2 Local Endemic Diseases: where causative agent is available on those places
1. Schistosomiasis:
• Region V -Bicol (Sorsogon)
• Region VIII -Samar & Leyte
• Region XI -Davao
2. Malaria: Palawan & Mindanao-reasons why it’s prevalent
1. Forested areas
2. Surrounded by bodies of water
3. Sporadic
• The pattern of occurrence is on & off where:
• On=available causative agent
• Off=no available causative agent
• It’s intermittent (unpredictable) in occurrence
• Disease occurs only if there’s a susceptible host like in rabies
4. Pandemic-worldwide, international, universal, global in occurrence like in AIDS, Hepatitis B, PTB, measles, mumps, diphtheria, pneumonia
• SARS is categorized by WHO as an OUTBREAK only because out of 191 nations, 33 countries are reported to have it