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Public health approaches to infectious disease
This unit reviews the current global burden of infectious disease, the public health...
This unit reviews the current global burden of infectious disease, the public health strategies that are reducing the impact of some major infections and the challenges facing national and international organisations in preventing illness and death caused by bacteria, viruses and parasites.
By the end of this unit, you should be able to:
- Define and use, or recognise definitions and applications of, each of the glossary terms for this unit (LO1).
- Summarise the main features of the current global burden of infectious disease and the public health movement that has evolved to reduce its impact, emphasising the contributions of epidemiology, water quality, sanitation and hygiene, global infectious disease surveillance networks, and evidence-based interventions such as vaccination programmes (LO2).
- Use appropriate examples and interpret unfamiliar examples presented to you, to illustrate successful public health strategies that: use education to support behavioural changes that enable people to protect themselves, their children or other community members from infection; promote resistance to infection in the human host; isolate a source of infection to prevent it from being passed on; tackle an environmental source of infection (LO3).
- Consider a range of public health strategies, including unfamiliar examples presented to you, and identify the levels of prevention (primary, secondary, tertiary) involved in their implementation (LO4).
- Use or analyse examples of public health interventions to illustrate the importance of international and national prevention programmes, community participation and community health workers in controlling infectious disease (LO5).
- Describe the transmission cycle of the guinea worm (Dracunculus medinensis), identify features that facilitate its interruption, and discuss interventions that have been effective in preventing transmission of infection and in progressing the global dracunculiasis eradication campaign (LO6).
- Learning outcomes
- 1 The global burden of infectious disease
- 2 The public health approach
- 2.1 Threats to public health from urbanisation and industrialisation
- 2.2 Public health surveillance and response in a globalised world
- 2.3 Public health interventions
- 3 Levels of infectious disease prevention
- 4 Public health successes in controlling infectious disease
- 4.1 Vaccination revisited
- Current section: 4.2 The importance of hygiene
- 4.3 Community action against infectious diseases
- 5 The guinea worm eradication campaign
- 5.1 The human cost of guinea worm disease
- 5.2 Falling trends in guinea worm disease
- 5.3 The guinea worm transmission cycle
- 5.4 Eradication through community action
- 6 The Millennium Development Goals, infectious disease and public health
- Summary of the unit
- Questions for the unit
4.2 The importance of hygiene
In public health parlance, hygiene behaviour encompasses the wide range of actions taken by individuals to maintain a standard of cleanliness of their bodies, domestic environments and workplaces to prevent the transmission of infection. It includes all the personal actions associated with excretion and the disposal of human and animal waste and refuse, the washing of persons, clothing, implements and structures (e.g. floors, lavatories and latrines), the handling of domestic animals, and the preparation of food.
When clean water and sanitation were installed in London in the nineteenth century, the epidemics of cholera that had claimed thousands of lives rapidly came under control. However, typhoid fever continued to be a problem for several more decades. The eventual reduction in typhoid was ascribed to the increasing availability of piped water and soap inside domestic households, the safe disposal of waste water from houses, and the increasing social imperative for personal hygiene.
Name another infection that can be controlled by personal hygiene.
You might have thought of typhus, because frequent washing of the body and clothing reduces the frequency of its vector, the human body louse. Washing can also reduce the transmission of the mites causing scabies, an infectious inflammation of the skin.
Personal hygiene can also alleviate some of the suffering caused by secondary infections of inflamed tissues. For example, careful washing and drying reduces the secondary bacterial infections which often colonise the inflamed skin folds of people with elephantiasis resulting from the blockage of lymphatic vessels by filarial worms (Figure 10).
However, although personal hygiene is a matter for the individual, it also requires the provision of certain infrastructures (e.g. covered wells, water mains), the means to purchase certain goods (e.g. soap, domestic cleaning agents) and a culture that is supportive of personal, domestic and public cleanliness. These are all in short supply in the poorest parts of the world.