BlessWorld Foundation International

Affecting the World Through Health
A Global Health Initiative

Public health interventions in disease outbreaks



Human history is littered with horrors of disease outbreaks ranging from as far back as the Justinian plague to the recent Ebola outbreaks. These outbreaks could be global- known as pandemics like the 1918 influenza pandemic; or localized involving a large part of a continent-known as epidemics  like the 14th century bubonic plague that almost wiped out half of Europe. Most of these outbreaks are caused by viruses but some are also caused by bacteria and parasites. These infectious agents are mostly communicable, spreading quickly by air like influenza; localizing in body fluids like blood and saliva e.g. HIV or travel via vectors like mosquitoes as in the case of Zika virus and malaria parasite. Given the death toll from these outbreaks as evidenced by the fact that the bubonic plague claimed more lives than the First World War, it is important to understand why they happen and how to prevent, control or manage their occurrence.

There are several reasons that account for outbreaks. Firstly, infectious agents can become resistant to already available treatments and vaccines, something known as antimicrobial resistance. They do this by several forms of genetic adaptations like the antigenic shifts and drifts seen in influenza virus. Also, some infectious agents can create conditions for spread of other agents as exemplified in the resurgence of TB due to HIV. Secondly, environmental modification such as climate change can cause spread of pathogens via vectors from a resistant human population to a vulnerable population like the increasing incidence of dengue fever in the United States. Additionally, increased population pressure could lead to movement to uninhabited areas which results in exposure to newer pathogens and vectors. Improper waste disposal and sanitation practices could also lead to increased spread of these agents. There are also cases of biological warfare like the US anthrax attack in 2001. Finally, the higher rate of globalization and human travel can lead to a faster spread of these diseases before they can be controlled.

Most outbreaks are caused by novel agents or known agents which are resistant to already available modes of treatment. Consequently, they often constitute a public health emergency. With threats to health care givers and patients In hospitals, hospitalized care is paralyzed leaving public health prevention practices as the only safe and reliable method of control and prevention. Widespread education and awareness programs about disease symptoms, route of spread and vectors- if any, are important for identification and prevention of disease outbreaks. As stated in SDG goal 4, the importance of the environment to heath should be stressed to reduce the rate of climate change. More so, better sanitation practices would reduce the rate of spread. Government must also place strict restrictions to immigration, especially people from known affected areas and also quarantine if needed until effective treatments are discovered. There is really nothing to do about genetic adaptations but to keep on researching and providing drugs and vaccines to cover resistant organisms. Sadly, outbreaks will keep occurring probably because it is an evolutionary and survival mechanism for these organisms but we must also fight for our survival by being prepared and ready to control them.

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