A notifiable disease is any disease that should be communicated to all the relevant government authorities to make it possible for them to monitor and give the early warnings of the possible occurrence of the disease. For the livestock diseases, there exist some laws that require that the infected livestock is destroyed once there is a notification of the disease. There are also important regulations for the reporting of both livestock and human diseases. For specific diseases, especially those that are highly infectious, reporting is crucial in controlling and preventing the spread of the particular disease (Australian national notifiable diseases and case definitions, n.d)
In the majority of places, both the local and state officials must report the occurrence of the disease. Every state has its list of notifiable diseases which is dynamic and can be either removed or added depending on the existing public health needs. The International Health Regulations has the duty of coming up with the internationally reportable diseases concerning the regulations of the World Health Organization. Each state is also required to communicate the occurrence of cases of yellow fever, cholera place and other diseases that need quarantine and are of international concern (Notifying Infectious Diseases, n.d).
Contact tracing helps in the primary. Secondary and tertiary prevention (Field Epidemiology Manual, n.d). In the primary prevention, contact tracing plays a crucial role in ensuring that the contacts are diagnosed, properly treated and taken care of. In the secondary prevention, contact tracing helps in ensuring that there is no progression of the disease among the exposed individuals. In tertiary prevention of the diseases, severe outcomes that may arise from the disease are prevented (Field Epidemiology Manual, n.d). The main aim of Public health is to ensure that there is a reduced transmission of the disease. Pre-test contact tracing is performed when the exposed persons are at high risk and when the time used to wait for the laboratory results may cause severe effects to the exposed individuals. Post-test contact tracing is performed after diagnosis to help reduce the mental, social and emotional impact on the contacts. Principles of contact tracing are similar for all diseases but are different in the duration taken during follow up and the number of times the monitoring sessions are taken (Contact Tracing, 2015).
According to the World Health Organization, the monitoring process can be divided into three steps; contact identification, contact listing, and contact follow up. During contact identification, contacts are known by finding out about an individual’s activities and the roles and activities of those that were around them during and after the onset of the disease. Contacts include those who have had contact with an infected individual, friends, health care personnel, family members and colleagues. Contact listing involves listing those who have had contact with the infected individual as a contact. During this stage, every contact that has been listed is told of his or her status and what is required of them, how to prevent the spread of the disease as well as the importance of ensuring that they get treatment once the symptoms appear. Isolation or quarantine can be undertaken for high risk contacts. Contact follow up involves constant follow up to monitor the signs and symptoms of the diseases (Contact tracing, 2017)
The Northern Territory guideline indicates that Contact Tracing should involve coordination among all the staff from the Centre for Disease Control as well as the community health workers and hospitals (Control, 2016). The Victoria guideline is not clear on the major players that should be involved in the contact tracing process. However, it has indicated that contact tracing for exposed patients and staff should be conducted by the occupational and prevention units of the hospital (Department of Health & Human Services, 2016).
Secondly, the Northern Territory guidelines indicate that contact tracing should be conducted by identifying the contacts that are at high risk of acquiring infections followed by the ones with a low risk so that the community can achieve a rate of the infection that does not exceed the background rate (Control, 2016). On the hand, the Victoria guidelines is more confined to the hospital setting where it indicates that the health care workers that are exposed should be identified, offered counseling and followed up while the exposed patients who have been discharged from hospital should be offered counseling and followed up too (Department of Health & Human Services, 2016). The healthcare staff who have been exposed to an infected person and do not require follow up should be reassured of their safety.
Thirdly, the Northern Territory guidelines groups contacts as either high risk, medium risk or low risk which is not present in the Victoria guidelines. The high-risk group includes all the relatives that have had prolonged and frequent contact with the infected person. The medium risk group includes all the people who have had less contact with the infected person, and the low-risk group includes individuals that have had contact with the infected person in places such as schools and social environment. Fourthly, the Northern Territory guidelines indicate that children and people with pre-existing disease conditions such as HIV and immunosuppression are more vulnerable to Tuberculosis (Control, 2016). The Victoria guidelines, on the other hand, does not indicate the individuals that are at risk of acquiring the disease (Department of Health & Human Services, 2016). Lastly, the Northern territory guidelines have indicated that the information on the infectivity of the index case should be obtained from the index case an can be categorized into high, medium, low and negligible. However, this is not present in the Victoria guidelines (Control, 2016).
Tuberculosis has continued to be a disease of Public Health concern over the recent years. Although there have been reduced incidences of Tuberculosis, it remains to be a significant cause of mortality and morbidity worldwide. According to the World Health Organization, in 2013, an estimated 9million people contracted the disease while there were about 1.1 million deaths from the disease. The incidence of tuberculosis is relatively Low in Australia. For instance, in 2013, the Commonwealth Department of Health indicated that there were 5.5 cases per 100000 people (Tuberculosis notifications in Australia, 2013).
In 2014, there were 1339 Tuberculosis cases which represents a rate of 5.7 per 100000 population. Australia has managed to control the spread of disease since the mid-1980s, and hence reducing the incidence rate to an estimated 5 to 6cases per 100000 population. An estimated 1-2% of the annual notifications were for the diagnosed multi-drug resistance TB cases. The Aboriginal and Torres Strait Islander Population have a high TB prevalence that is around six times that of the non-indigenous population born in Australia. The Australians that are born overseas make up to 86% of the Tb notifications (Tuberculosis notifications in Australia, 2014). In 2015, the world health organization indicates that the incidences of TB were stable between 2006 and 2015. In 2016, the mortality rate from tuberculosis in Australia was approximately 0.2 cases per 10000 people. Although the mortality rate has fluctuated in recent years, it declined between the years 2002-2016 (Tuberculosis – World TB Day 2018, n.d).
The primary challenge in dealing with the disease in Australia is the fact that migration from neighboring countries leads to new cases of the disease. Another concern is the fact that the immediate neighbors of Australia such as Vietnam have new cases of extensively drug-resistant TB and Multidrug resistance TB (Tuberculosis – World TB Day 2018, n.d).
Tuberculosis is passed on from an infected person to a vulnerable person through airborne particles known as droplet nuclei whose diameter are 1-5 microns (Strauch, 2014). The infectious droplet nuclei are produced once a person who has laryngeal and pulmonary tuberculosis sneezes, coughs, sings or shouts. The droplet nuclei are tiny water droplets with bacteria and continue to stay suspended in the air up to many hours when the environmental conditions are favorable. Mycobacterium tuberculosis is only spread through breathing contaminated air and hence touching a surface cannot lead to its transmission (Department of Health & Human Services, 2015). Once a person inhales a droplet nuclei with the tuberculosis bacteria, it moves through the nasal passages or the moth into the upper respiratory tract. It then travels to the bronchi and finally to both the alveoli and lungs. Tuberculosis is highly contagious and can spread too fast if appropriate control measures are not taken (Mandal, 2018)
The high-risk groups include children aged 5 and below and people with immunosuppression. The high-risk group also includes people who have had prolonged, close and frequent contact with the infected person within three months before the diagnosis. This is around 8hours or more of cumulative physically close contact to the index case. The high-risk group also include the individuals living in the same household especially that which is poorly ventilated with the infected person (High-risk groups, n.d).
The people who spend more time with the infected person, as well as all the relatives, friends and workmates that have prolonged contact with the infected person, are also high risk groups (High-risk groups, n.d). This is because once the infected person either sneezes, sings, speaks or coughs, the people who are in the same room may breathe in the contaminated air and hence getting infected (Baxter, n.d). In this case, the classmates, close friends, and relatives of the infected student that have had increased contact with him or her are at high risk. The clinical circumstances that distant contacts or community members should present for testing for Tuberculosis include when they develop the symptoms of Tuberculosis or when they have had close contact with the infected person (THL, 2017).
Contacts were identified once they had had contact with the infected student who tested positive for TB. The infected student was also asked to explain their activities and the people that they interacted with or those that attended to them during the onset of the disease. Contacts in this context include friends, family members, healthcare providers and colleagues. Once the contacts were identified, they were added to the contacts list. Every contact that has been listed was then informed about his or her status, what actions they should take and the reason why they should receive timely care once they develop the symptoms of TB. They were also educated on how to prevent the spread of the disease and isolation and quarantine was performed for those high-risk contacts that are either in the hospital or at home (Steps in Contact Tracing, n.d).
Regular follow up was then performed on the contacts to check for the signs and symptoms of infection. Once they developed the signs and symptoms of TB, they were screened and offered extensive treatment to prevent the spread of the disease (Guidelines for the Investigation of Contacts of Persons with Infectious Tuberculosis Recommendations from the National Tuberculosis Controllers Association and CDC, n.d).
The index case can return to class after two weeks after treatment. This is because TB seizes to be infectious once the patients receive effective treatment (Ross, 2017). The community can know that they are safe from this source two weeks after the source has received treatment. This is because once the source has been treated for two weeks, the disease is suppressed to a level that is no longer infectious. Therefore, the community members should not stigmatize the infected people who have been properly treated.
References
Australian national notifiable diseases and case definitions. (n.d.). Retrieved from https://www.health.gov.au/casedefinitions
Baxter, S. (n.d.). Background. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK409247/
Contact Tracing. (2015). Encyclopedia of Public Health, 164-164. doi:10.1007/978-1-4020-5614-7_553
Contact tracing. (2017, May 10). Retrieved from https://www.who.int/features/qa/contact-tracing/en/
Control, C. F. (2016, May 01). Guidelines for the Control of Tuberculosis in the Northern Territory. Retrieved from https://digitallibrary.health.nt.gov.au/prodjspui/handle/10137/696
Department of Health & Human Services. (2015, October 08). Mycobacterial infections (tuberculosis). Retrieved from https://www2.health.vic.gov.au/public-health/infectious-diseases/disease-information-advice/tuberculosis
Department of Health & Human Services. (2016, January 13). Management, control and prevention of tuberculosis: Guidelines for health care providers. Retrieved from https://www2.health.vic.gov.au/about/publications/policiesandguidelines/tuberculosis-guidelines-2015
Field Epidemiology Manual. (n.d.). Retrieved from https://wiki.ecdc.europa.eu/fem/w/wiki/1245.contact-tracing
Government, N. T. (2016, December 15). Notifiable diseases. Retrieved from https://health.nt.gov.au/professionals/centre-for-disease-control/cdc-programs-and-units/notifiable-diseases
Guidelines for the Investigation of Contacts of Persons with Infectious Tuberculosis Recommendations from the National Tuberculosis Controllers Association and CDC. (n.d.). Retrieved from https://www.cdc.gov/mmwr/preview/mmwrhtml/rr5415a1.htm
High-risk groups. (n.d.). Retrieved from https://tuberkuloosi.fi/en/am-i-at-risk/high-risk-groups/
Mandal, A. (2018, August 23). Tuberculosis Transmission. Retrieved from https://www.news-medical.net/health/Tuberculosis-Transmission.aspx
Notifying Infectious Diseases. (n.d.). Retrieved from https://www.hpsc.ie/notifiablediseases/notifyinginfectiousdiseases/
Ross, E. (2017). Absence of a gut microbiome may be more common than previously thought ER — (Does it make more sense to say “Gut microbiomes may be less common than previously thought”?). Nature. doi:10.1038/nature.2017.22017
Steps in Contact Tracing. (n.d.). Retrieved from https://contacttracing.ashm.org.au/contact-tracing-guidance/steps-in-contact-tracing
Strauch, I. (2014, November 27). What Is Tuberculosis? Retrieved from https://www.everydayhealth.com/tuberculosis/guide/
THL. (2017, November 03). Tracing and identification of tuberculosis cases among risk groups to… Retrieved from https://www.slideshare.net/THLfi/tracing-and-identification-of-tuberculosis-cases-among-risk-groups-today-in-finlandeng
Tuberculosis – World TB Day 2018. (n.d.). Retrieved from https://www.health.nsw.gov.au/Infectious/tuberculosis/Pages/world-tb-day-2018.aspx
Tuberculosis notifications in Australia, 2013. Retrieved from https://www.health.gov.au/internet/main/publishing.nsf/content/cda-cdi3902f.htm
Tuberculosis notifications in Australia, 2014. (n.d.). Retrieved from https://www.health.gov.au/internet/main/publishing.nsf/Content/cdi4103-k
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