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Prevention of Communicable Diseases. by Dr. TK Au of UHS MBChB, MRCP(UK), DPD(Cardiff), DCH(Syd). Communicable diseases. Definition: diseases that can be transmitted and make people ill Statutory notifiable diseases

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prevention of communicable diseases
Prevention of Communicable Diseases
  • byDr. TK Au of UHS
  • MBChB, MRCP(UK), DPD(Cardiff), DCH(Syd)
communicable diseases
Communicable diseases
  • Definition: diseases that can be transmitted and make people ill
  • Statutory notifiable diseases
    • According to the law, a doctor has to notify the Department of Health when he/she has the reasons to suspect his patient is suffering from the disease
    • Eg. Chickenpox, tuberculosis, avian flu, SARS
communicable diseases1
Communicable diseases
  • Diseases that can cause outbreak in institutions
    • Influenza-like illness
    • Acute gastroenteritis
    • Hand, foot and mouth disease (HFMD)
    • Acute conjunctivitis
contact transmission
Contact transmission
  • Through direct body contact with the infected persons
  • Indirect through contact with objects contaminated by infective agents, eg sharing towels, combs and clothes
  • Example
    • Hand, foot, mouth disease
    • Acute conjunctivitis
    • Head lice
    • Scabies
    • Chickenpox
droplet transmission
Droplet transmission
  • Inhale or contact of droplets expelled from the sick during sneezing, coughing, spitting and speaking
  • Subsequent touching of mucous membranes of the mouth, nose and the eyes with hands contaminated with infective agents
  • Eg. Influenza, common cold, pneumonia
air borne transmission
Air-borne transmission
  • The infective agents float in the air for some time
  • Enter the body through the respiratory tract
  • E.g. Chickenpox, measles, pulmonary tuberculosis
food water borne transmission
Food/water-borne transmission
  • Through ingestion of contaminated food or water, or use of contaminated utensils
  • E.g. Viral gastroenteritis, cholera, hepatitis A
break the chain
Break the Chain

Early Detection, Isolation, and Treatment of patients

Disinfection

X

X

Build up Personal Immunity by Immunization and Healthy Lifestyle

Good Personal and Environment & Food Hygiene

personal hygiene
Personal Hygiene
  • The most important part of infection control as many diseases are transmitted through contact or droplet
  • Hand hygiene
  • Cough etiquette
hand hygiene when
Hand Hygiene – When?
  • Before touching the eyes, nose and mouth
  • Before eating or handling food
  • After using the toilet
  • When hands are contaminated by respiratory secretions, e.g. after coughing or sneezing
  • After touching public installations or equipment
    • e.g. escalator handrails, elevator control panels or door knobs
  • Before and after visiting hospitals
  • After making contact with animals or poultry
  • After handling garbage
hand hygiene how
Hand Hygiene – How?
  • Handwashing with soup and water
    • When hands are visibly soiled
    • When hands are likely contaminated with body fluid
      • e.g. after using the toilet, after coughing or sneezing
  • Use of 70-80% alcohol-based hand rub
use of 70 80 alcohol based handrub
Use of 70-80% alcohol-based handrub
  • Apply a palmful of handrub
  • Use at least 20s to rub all surfaces of hands and fingers
  • Until the hands are dry
personal hygiene1
Personal Hygiene
  • The most important part of infection control as many diseases are transmitted through contact or droplet
  • Hand hygiene
  • Cough etiquette
  • Other
cough etiquette
Cough Etiquette
  • Cover both the nose and mouth with tissue paper when coughing or sneezing
  • Do not spit
  • Wrap up sputum with tissue paper and discard it into garbage bin with lid or flush it away in the toilet
  • Wash hand immediately
  • Put on a surgical mask if you have respiratory infection symptom
environment hygiene
Environment hygiene
  • Regular cleansing and disinfection
  • Maintain good indoor ventilation – open windows widely
  • Keep worktops n the kitchen clean
  • Cover garbage bins
  • Wrap up rubbish properly before discarding it into garbage bins
  • Empty garbage bins at least once a day
  • Do not keep pets like dogs, cats, or birds in hall
to stop perpetuation of communicable diseases
To stop perpetuation of communicable diseases

Early Detection, Isolation, and Treatment of patients

Disinfection

X

X

Build up Personal Immunity by Immunization and Healthy Lifestyle

Good Personal, Environment & Food Hygiene

build up immunity
Build up Immunity
  • Vaccination
    • Tuberculosis (BCG vaccine)
    • Hepatitis A & B
    • Diphtheria, Pertusis, Tetanus
    • Measles, Mumps, Rubella
    • Chickenpox
    • Pneumococcal
    • HPV
    • Others – before travel
  • Healthy lifestyle
build up immunity1
Build up Immunity
  • Healthy lifestyle
    • Enough rest/sleep
    • Regular exercise
    • Balanced diet
    • Maintain a normal body weight, i.e. BMI 18.5-23
    • Do not smoke
to stop perpetuation of communicable diseases1
To stop perpetuation of communicable diseases

Early Detection, Isolation, and Treatment of patients

Disinfection

X

X

Build up Personal Immunity by Immunization and Healthy Lifestyle

Good Personal, Environmental, Food Hygiene

bleach
Bleach
  • Active ingredient: sodium hypochlorite (次氯酸鈉)
  • Action: denatures protein in virus, bacteria and fungus
  • Pros: Works quickly, widely available, low cost
  • Cons:
    • Irritates mucous membranes, skin and airway
    • Decomposed under heat or light
    • Reacts readily with other chemicals
use of bleach tools and equipment
Use of Bleach – Tools and Equipment
  • Cleansing tools: brush, mop, towel, spray can and bucket
  • Cleansers/disinfectants: bleach and water
  • Measuring tools: tablespoon and measuring cup
  • Protective gear: mask, rubber gloves, plastic apron and googles (recommended)
use of bleach procedures
Use of Bleach - Procedures
  • Keep windows open, ensure good ventilation
  • Wear protective gear
  • Use COLD WATER for dilution
    • hot water decomposes the active ingredient of bleach
  • Bleach with 5.25% sodium hypochlorite
    • 1 in 99: mixing 10ml of bleach with 990ml of water, for general household cleaning
    • 1 in 49: 10ml of bleach with 490ml of water, disinfect surfaces or articles contaminated with vomitus, excreta and secretion
use of bleach procedures1
Use of Bleach - Procedures
  • Rinse disinfected articles with water and wipe dry
  • Cleansing tools
    • soak in diluted bleach for 30mins
    • rinse thoroughly before reuse
  • Wash hands with liquid soap, dry hands with a clean towel or disposable towel
use of bleach precautions
Use of Bleach - Precautions
  • If bleach gets into the eyes, immediately rinse with water for at least 15 minutes and consult a doctor
  • Bleach should not be used together or mixed with other household detergents
    • Reduce effectiveness
    • If mixed with acidic detergents -> toxic gas
  • Bleached should be stored in a cool and shaded place
    • Undiluted bleach liberates a toxic gas when exposed to sunlight
disinfection
Disinfection
  • Regular cleansing and disinfection of
    • Rooms, kitchen, toilets, bathrooms
    • Door knobs and lift buttons
    • Frequently touched surfaces – furniture, computer keyboards
  • For obvious contaminants e.g. respiratory secretions, vomitus or excreta
    • Wipe away with disposable towels
    • Disinfect the surface and neighboring areas with appropriate disinfection
      • Non-metalic surface – 1:49 bleach
      • Metalic surfaces – 70% alcholol
to stop perpetuation of communicable diseases2
To stop perpetuation of communicable diseases

Early Detection, Isolation, and Treatment of patients

Disinfection

X

X

Build up Personal Immunity by Immunization and Healthy Lifestyle

Good Personal, Environmental, Food Hygiene

early treatment
Early Treatment
  • Seek and follow medical advice immediately if you feel unwell
early isolation
Early Isolation
  • Stay at home and do not attend school if your doctor tell you to do so. This is usually when one is
    • Febrile (Ear temperature ≥ 38˚C)
    • Suffering from chickenpox, hand-foot-mouth diseases, measles, certain form of tuberculosis
  • Minimize contact with other people as far as possible. Avoid group activities.
  • Maintain good personal hygiene
  • People with respiratory infection symptoms and their close contacts should wear surgical mask
early detection
Early Detection
  • Inform the Hall Management if you suspect that there is clustering of diseases, e.g.
    • Gastroenteritis
    • Influenza-like illness
    • Hand-foot-mouth disease
    • Acute conjunctivitis
summary
Summary
  • Chain of Propagation of Communicable Diseases
  • Break the Chain
    • Good personal, environment and food hygiene
      • Hand washing and alcohol handrub
    • Build up immunity by vaccination and healthy lifestyle
    • Disinfection
    • Early detection, isolation and treatment of patients
references
References
  • Infection Control Corner, Centre for Health Protection
    • http://www.chp.gov.hk/en/guideline_infection/346.html
  • Hand washing video, fromthe University of Leicester
    • http://www.youtube.com/watch?v=sjpWwjzCbrw
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