Discussing Infectious Diseases
Infectious diseases, or communicable diseases as they are commonly known, are diseases that are caused by microbes such as bacteria, fungi, viruses and parasites. Infectious diseases continue to be a burden to the whole world, the current advancements being made in the field of medicine notwithstanding. They are among the leading major causes of human suffering, with ever high morbidity and mortality rates throughout the history of human beings (Jackson et al., 2021). This paper thus provides an analysis of a communicable disease, to be specific influenza, with a focus on its causes, symptoms, mode of transmission, complications and treatment. We also break down the demographics of at-risk populations, as well as the determinants of health, the epidemiological triad of the communicable disease and lastly, the role of the nurse practitioner in the management of the infectious disease.
Analysis of Infectious Disease
Influenza, or “the flu” as is commonly referred to, is a highly infectious respiratory illness that is caused by the influenza viruses. The disease occurs in mild to severe forms, with the severe forms in some cases resulting in hospitalization and ultimately loss of life. There exist three types of influenza viruses: type A, B and C (CDC, 2020). Influenza type A is responsible for moderate to severe respiratory illness among individuals of all age groups. Its infects not only humans but other animals as well. The influenza type A virus has been known to be perpetuated by wild birds in nature, more commonly the waterfowl.
Influenza type B generally causes milder forms of the flu as compared to type A, and has been known to primarily affect young children. Being more stable than influenza type A, influenza type B has less antigenic drift and consequently immunologic stability, hence why it only affects human beings. Influenza type C on the other hand is rarely reported to be a cause of human illness, which may be attributed to the fact that most cases are usually subclinical. Classical symptoms of influenza include sore throat, fever of an abrupt onset, headache, nonproductive cough, and myalgia. The fever is usually unique in its abrupt onset, such that the patient may at times recall the exact hour of onset. Additional symptoms of influenza include substernal chest burning, rhinorrhea, and ocular symptoms such as sensitivity to light and eye pain.
Complications that may arise due to influenza include pneumonia, Reye syndrome that primarily and almost exclusively occurs in children, and myocarditis. Pneumonia is the most common and frequent complication of influenza. The Reye syndrome is common in children taking aspirin, and primarily occurs in association with influenza type B. It presents in the form of confusion and severe vomiting, which may progress to coma as a result of swelling of the brain. Death due to influenza is usually reported in less than 1 per 1,000 cases of the virus (WHO, 2021). Management of influenza comes in two forms: vaccination and treatment. Two types of vaccines are available in the U.S.: the live attenuated influenza vaccine (LAIV) and the inactivated influenza vaccine (IIV) (Rockman et al., 2020). Following vaccination, the duration of immunity is usually less than a year. In terms of treatment, a number of antiviral medication are available. Four antiviral agents have been approved for use in the U.S.: rimantadine, amantadine, oseltamivir and zanamivir. The first two are however not often recommended since resistance has been documented in U.S. influenza isolates.
The populations most at-risk of contracting the influenza virus or developing severe disease and complications are children under the age of 59 months, pregnant women, the elderly, individuals with immunosuppressive conditions such as cancer and HIV, and individuals with chronic medical conditions such as chronic pulmonary and cardiac diseases. Studies have shown 5 to 7 outpatient visits related to influenza per 100 children every year (Jackson et al., 2021). The CDC reports that the number of influenza-associated deaths usually varies by influenza virus type and subtype, the year and age group. It is also reported that an average of more than 200,000 hospitalizations per year are influenza-related, with close to 37% occurring in individuals younger than the age of 65 (CDC, 2020). Nursing homes however experience attack rates as high a 60%, with fatality rates as high as 30%.
Determinants of Health
According to Healthy People 2020, determinants of health fall under social factors, policy-making, biology and genetics, individual behavior and health services. All these factors play an important role in determining influenza infection. Poor health outcomes usually arise as a result of the interaction between individuals and their environment. Physical and social aspects of the environment such as transportation options, quality schools, housing and neighborhoods, built and the natural environment, all determine if one is predisposed to the influenza virus or not. Homes and public places that are overcrowded and unhygienic also foster the spread of influenza.
In terms of biology and genetics, determinants that might predispose an individual to the influenza virus include: age, HIV status, inherited conditions or a family history of chronic conditions such as heart disease. Individual behaviors that may predispose one to the influenza virus include handwashing and use of cigarettes or any other drug that is inhaled. Handwashing prevents the spread of the virus from one person to another. Smoking on the other hand interferes with the integrity of the respiratory mechanisms. Availability of health services is also crucial in combating the influenza virus. Proper health services will ensure that individuals are immunized against the influenza virus as well as providing treatment options to those that contract the virus.
The epidemiologic triad of any infectious disease usually entails a host, a causative agent and the environment. As susceptible host refers to the human that can acquire the disease. With the determinants of health in mind such as biology and genetics, some individuals are more susceptible to the influenza virus than others are. For example, children under the age of 59 months and elderly individuals over the age of 65 are the most susceptible hosts for the influenza virus. The agent refers to the microbe that transmits the virus, which in this case is the Hemophillus influenza virus. The environment is the favorable conditions that promote the spread of the disease. Again, with the health determinants in mind, factors such as crowded environs and unhygienic surroundings foster the spread of the influenza virus.
Roles of a Nurse Practitioner
According to the American Association of Nurse Practitioners (AANP), the role of a nurse practitioner includes, but is not limited to, assessment; ordering, performing, supervising and interpreting diagnostic and laboratory tests; making diagnoses; initiating and managing treatment; coordinating care; counseling; and educating patients and their families as well as their communities (AANP, 2015). Relating these roles to the influenza virus, nurse practitioners play a very important role in the management of influenza. In terms of preventive and promotive services, nurses provide health education to patients, their families and communities on ways in which to prevent the influenza virus. These include handwashing, as well as cough and sneeze hygiene. They also provide vaccination services to children and adults (Wiley, 2016). Nurse practitioners also offer curative services, including administration of antiviral medication to patients infected by the influenza virus. Nurses also monitor infection trends for outbreaks, and report back to the health team with possible interventions for implementation.
American Association of Nurse Practitioners (2015). Scope of Practice for Nurse Practitioners. Retrieved from https://www.aanp.org/advocacy/advocacy-resource/position-statements/scope-of-practice-for-nurse-practitioners:
Centers for Disease Control and Prevention (2020). Epidemiology and Prevention of Vaccine –Preventable Diseases. Retrieved fro https://www.cdc.gov/vaccines/pubs/pinkbook/flu.html
Jackson, M. L., Scott, E., Kuypers, J., Nalla, A. K., Roychoudury, P., & Chu, H. Y. (2021). Epidemiology of Respiratory Syncytial Virus Across Five Influenza Seasons Among Adults and Children One Year of Age and Older—Washington State, 2011/2012–2015/2016. The Journal of Infectious Diseases 223:1, 147-156
Rockman, S., Laurie, K. L., Parkes, S., Wheatley, A., & Barr, I. G. (2020). New Technologies for Influenza Vaccines. Microorganisms 8:11, 1745.
Wiley, S. K. (2016). Nurses’ most important role this flu season: Get Vaccinated. National Library of Medicine, 46(10): 58-60. Retrieved from https://doi:10.1097/01.NURSE.0000494656.90248.0d
World Health Organization (2021). Influenza: Burden of Disease. Retrieved from https://www.who.int/influenza/surveillance_monitoring/bod/en/
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