Essay Assignment #2 Instructions For this assignment, you are to select one of the communicable diseases listed below. Tuberculosis Malaria Zika Ebola Hepatitis B Dengue Genital Chlamydia In your essay, you are to discuss the nature and key public health aspects of the disease that you have chosen. You should explain the burden that it represents for humans, how humans come to be infected, biological aspects of the infecting agent that are important in transmission and disease, and some of the most important recommended public health control measures to reduce the burden of disease. Finally, you should propose one or more recommendations to improve current prevention and control strategies for the disease. For some of the choices presented above, you will probably want to focus on the situation and issues presented by the disease in an international context. For others, a U.S. focus is more appropriate. While in general epidemiologic data are more available for U.S. populations than for populations outside the United States, you should be able to find adequate information for your paper on any of the conditions listed above. You should explicitly state the population focus of your essay; in other words, is your paper about Disease X in the United States, about Disease X globally, or about Disease X in a particular country. You are expected to obtain your information from reliable sources such as the U.S. Centers for Disease Control and Prevention, National Institutes of Health, National Library of Medicine, World Health Organization, or other scientifically reputable organizations; use of more than one source for the paper is required. Try to minimize use of secondary and lay media sources. As was the case for your first essay assignment, you are to: 1. Describe the agent and its key characteristics. What is the agent? What are key characteristics of the agent that influence its transmission, virulence, and the ease/difficulty of prevention and control? Is there a vector or intermediate host? If so, what are the characteristics of the vector or intermediate host? 2. Describe the disease. What are its major manifestations? How does the disease affect individuals who get it? You should describe the symptoms and signs of the disease so that an educated lay person would have a good sense of what the disease is and how it affects people after reading your description. If there are important complications or long-term sequelae of this communicable disease, these should be included in your description. Who is the disease most likely to affect (are there differences according to gender, age, racial/ethnic group, or other host characteristics?). Where is it common? Have there been important trends in occurrence over time? Are asymptomatic cases common and how do they affect the epidemiology and control of the disease? Is long- term/chronic infection an issue with this disease? If so, how does this affect the prospects for prevention and control? 3. Describe the epidemiology of the disease and mode of transmission. Discuss how the disease is transmitted in the population(s) that you selected and the impact of the disease. How is the disease transmitted, in general, and the most important modes of transmission in your chosen settings? What is the burden of this disease upon your population—how much of the disease is there (incidence/prevalence)? How much death and disability does the disease cause in your population? What is the case fatality rate? What are the economic or other costs? Are there groups or types of people that are more affected by this problem than others? Why are these group at a higher risk? How do people acquire the disease? In other words, how is it transmitted to humans? How likely is it that an exposed person will be infected? Are there factors that make transmission or less likely? Who is at particular risk? Try to relate the biological characteristics of agent and host to the epidemiology and transmission of the disease. 4. Discuss current recommendations for prevention and control of your selected disease. You are expected to identify and discuss the key aspects of current public health prevention and control strategies for your chosen disease in your chosen population of reference, including secondary prevention measures if these are relevant. Your discussion should be sufficiently detailed that a person previously unfamiliar with the recommendations would be able to understand them. You should try to relate recommended measures to biological and epidemiologic features of the disease that you have presented earlier in your essay. You should indicate if you believe that currently recommended measures are appropriate and likely to be effective, and why. 5. Finally, you should propose one or more recommendations toimprove current prevention and control strategies for the communicable diseases that is the focus of your paper. You should clearly explain how your recommended strategy would work and why you think it would work. If possible, relate your explanation about why the measure(s) that you are recommending would work back to the epidemiologic and biologic features of the disease. Your proposed measure(s) are expected to be plausible, feasible, and consistent with current principles of public health practice. You are encouraged to be creative in your proposal for improvement and an original discussion (i.e., your own words, not material copied from another source) is expected. While it is expected that you will obtain the background information for your essay from reference sources, a paper composed by cutting and pasting or a paper that consists mostly of quoted information is discouraged. Use your own words as much as possible. You are expected to summarize and distill a lot of important information into a logical, readable essay that could be used as a briefing paper or information summary for a busy public health professional. A satisfactory response to this assignment will typically occupy 4-6 typewritten double-spaced pages, excluding references and title page. The essay should be prepared in APA format with 1 inch margins, double-spaced, using an 11 or 12 point Times Roman or Calibri font. Be sure to include appropriate citations for information and ideas obtained from others. Your paper will be graded according to an essay grading rubric that will be posted on the course Blackboard Learn website. If your paper runs slightly over six pages, this will not be the basis for any deduction, but a paper in excess of 12 typewritten pages will be considered out of scope with these instructions. Your paper is expected to follow standard U.S. English grammar and spelling conventions, and failure to do so may result in deductions. Your paper will be graded according to the grading rubric that will be posted on the course Blackboard Learn website. Key elements for grading will be the extent to which your essay includes all of the elements outlined in the instructions above, shows logical connections between these elements, demonstrates critical analysis and synthesis of the material presented, presents original and creative recommendation(s), and follows these instructions.

 

Hepatitis B Worldwide

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Characteristics of Hepatitis B

Hepatitis B is typically considered as infectious hepatitis attributed to the hepatitis B virus also known as HBV that has two levels; mainly acute and chronic. Acute hepatitis B talks about the commonly acquired viruses that attacked people notice signs merely 1 to 5 months after the disclosure to the disease. In a majority of individuals affected by acute hepatitis, the symptoms can manifest over weeks to months, and they are fully cured of the infection; even though, a few numbers of individuals are prone to developing a very intense and life-threatening kind of acute hepatitis referred to as fulminant hepatitis. On the other hand, the chronic hepatitis B is typically an infection with HBV that takes more than six months, and once the disease turns to be constant, it is likely to fade away completely (Brunetto et al. 2010). Many infected grown-ups can fight off the virus thus making them non-vulnerable to the infection as a low degree of adults infected with the HBV go on to acquire the chronic disease. Therefore, teenagers are at a higher risk of acquiring chronic infection as several infected teenagers are not able to clear the illness from their bodies and thus continues to receive the unceasing disease. Close to two-thirds of individuals infected with chronic HBV are typically chronic carriers who do not develop the symptoms; however, they keep the virus and can typically transmit it to other individuals. The other third develops active hepatitis that is considered as a disease of the liver that can be very intense.

Symptoms and Signs

Hepatitis B is typically a contagion that affects the liver, and it is attributed by the hepatitis B virus (HBV), and it is expected that close to 2.5 billion people globally have some symptoms of current or past hepatitis B infection. This incorporates close to 200 million chronic carriers and more than 500,000 deaths globally each year (Pérez-Alvarez et al. 2011). The hepatitis B germ reproduces in the liver cells; however, the illness itself is not considered as the primary source of the harm to the liver. Preferably, the existence of the disease alerts an impervious response for the body as it tries to fight the infection and heal from the damages. The impervious response leads to swelling and is likely to harm the liver cells significantly thus there does stability exist linking the safeguarding and vicious effects of the immune reaction to the hepatitis B disease. Since the contagion is in two phases, there are different signs and symptoms of every aspect that are typically acute and chronic. In the acute phase, close to 50 percent of the adults develop significant symptoms as the early signs are likely to be non-specific including fever and a flu-like sickness together with joint paints.

Some of the symptoms of acute hepatitis incorporate; loss of appetite or the urge to eat, constant fatigue, jaundice that is characterized by yellow skin and eyes, soreness in the upper right tummy as a result of the swollen liver. Notably, acute hepatitis affects the liver poorly thus making it difficult to function and this fatal status are referred to as fulminant hepatitis (Pérez-Alvarez et al. 2011). Patients suffering from fulminant hepatitis are typically at risk of having bleeding complications and coma due to the failure of the liver; thus, there is the need for liver transplantation evaluation. On the other hand, people infected chronic hepatitis acquire symptoms regarding the level of harm or destruction in the liver responsibilities. Therefore, the signs and indications of chronic hepatitis B depend on the level of damage caused to the liver as they vary from little to moderately severe signs and symptoms. A majority of people with chronic hepatitis B are still symptoms free for several years as the infected individual’s liver function blood test are average or slightly abnormal. Some individuals are likely to deteriorate and acquire inflammation or symptoms thus putting them at risk of acquiring cirrhosis.

Mode of Transmission

The hepatitis B virus is able to survive outside the human body for close to eight days and during this period; the virus is capable of still causing infection if it happens to enter into a person who is unprotected by the vaccine. In extremely endemic surroundings, hepatitis B is most frequently transmitted from mother to baby during the birth process, and this is known as perinatal transmission or via exposure to any infected blood. The development of chronic disease is viral in children contaminated from their mothers or prior to the age of 5years (Han et al. 2011). The illness is also spread through mucosal contact to contaminated blood and other body fluids such as saliva, menstrual, seminal and other vaginal fluids. Sexual spread of hepatitis B is likely to occur more so in unvaccinated males who engage in homosexuality and heterosexual people having several sex partners or contact with sex workers. The essential modes of diffusion of the virus are also likely to happen via the sharing or recycling of needles and other sharp objects either in a healthcare surrounding or between individuals who infuse drugs. Also, the contamination can happen during surgical, health check, and dental processes.

Hepatitis B occurrence is most in the World Health Organization (WHO) Western Pacific section and the WHO African area where 6.4 percent and 6.3 percent correspondingly of the adult inhabitants is polluted. As observed by Han et al. 2011, hepatitis associated mortality rate has been high with an average of 35 casualties per 150,000 people annually in western sub-Saharan Africa, Oceania and central Asia. Though, in total consideration, East Asia and South Asia still possess the utmost of hepatitis deaths with a totality of 55 percent. In these countries, people are exposed to various transmission procedures including the use of sharp objects due to the constant use of drugs where individuals share piecing objectives. Also, as part of the research conducted by the World Health Organization, a majority of hepatitis effects are in high-income nations and upper-middle-revenue nations that do not get growth support; thus, these assets will undoubtedly come from state wellbeing budgets.

Current Prevention Recommendations

The hepatitis B vaccination process is the primary way of preventing the global infection of hepatitis B as World Health Organization recommends that all teenagers should be subjected to hepatitis B vaccines as faster as possible after delivery more so in twenty-four hours. The few incidences of chronic HBV illness in teenagers with five years of age can be as a result of the prevalent use of hepatitis B vaccine. Internationally, in 2016, the approximated occurrence of HBV illness in the age group of one to five years was close to 2 percent as compared to 5 percent in the past vaccination period (Reddy et al. 2015). Also, the birth prescription should be given by two to three prescriptions to fulfill the main sequence thus making one of the following options suitable. The first option is a three-dose plan of hepatitis B injection with the initial prescribed amount being administered at delivery and the second and third administered at the same time as first and the third prescriptions of diphtheria, whooping cough and tetanus injections. The second option is typically a four-dose plan where a first delivery dose usually administered is followed by joint vaccine doses traditionally given with other subsequent baby vaccines.

The full vaccine sequence induces defensive antibody status in more than 98 percent of babies, teenagers and youthful adults. The safety goes up to 20 years and is most likely life-long; therefore, the World Health Organization does not approve the use of booster vaccinations for community who have received the three-dose vaccination plan. Also, all kids and youth younger than 18 years old and not formerly vaccinated ought to receive the treatment if they dwell in nations with a low or intermediate measure of disease prevalence. In 2016, the World Health Assembly came up with the primary international health section technique on viral hepatitis 2016-2020. The mechanism evaluates the significant function of worldwide health coverage, and the targets of the method are associated with those of the sustainable expansion objectives (Reddy et al. 2015). The process also has a plan of deleting viral hepatitis as a public wellbeing concern, and this is covered in the universal targets of lowering fresh viral hepatitis infection by 92 percent and lowering deaths as a result of viral hepatitis by 60 percent by 2030. The measures to be taken by nations and WHO Secretariat to fulfill these conditions are mentioned in the approach.

Recommendation

There is the need to conduct therapy process for people suffering from this ailment since the primary objective of therapy for patients with this sickness is to enhance survival and the quality of life through avoiding sickness progression and consequently hepatocellular carcinoma (HCC) growth. Moreover, the goals of antiviral rehabilitation process are to prevent mother to baby spread, hepatitis B reactivation and the prevention and cure of HBV-related extrahepatic manifestation. The level of achieving these goals relies on not only the timing of therapy during the process of the ailments but also on the phase of the sickness and the patient’s age when the treatment is started.

 

References

Brunetto, M. R., Oliveri, F., Colombatto, P., Moriconi, F., Ciccorossi, P., Coco, B., … & Cavallone, D. (2010). Hepatitis B surface antigen serum levels help to distinguish active from inactive hepatitis B virus genotype D carriers. Gastroenterology, 139(2), 483-490.

Han, G. R., Cao, M. K., Zhao, W., Jiang, H. X., Wang, C. M., Bai, S. F., … & Fang, Z. X. (2011). A prospective and open-label study for the efficacy and safety of telbivudine in pregnancy for the prevention of perinatal transmission of hepatitis B virus infection. Journal of hepatology, 55(6), 1215-1221.

Pérez-Alvarez, R., Díaz-Lagares, C., García-Hernández, F., Lopez-Roses, L., Brito-Zerón, P., Pérez-de-Lis, M., … & Forns, X. (2011). Hepatitis B virus (HBV) reactivation in patients receiving tumor necrosis factor (TNF)-targeted therapy: analysis of 257 cases. Medicine, 90(6), 359-371.

Reddy, K. R., Beavers, K. L., Hammond, S. P., Lim, J. K., & Falck-Ytter, Y. T. (2015). American Gastroenterological Association Institute guideline on the prevention and treatment of hepatitis B virus reactivation during immunosuppressive drug therapy. Gastroenterology, 148(1), 215-219.