Prevention of communicable diseases
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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

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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


Chain of propagation of communicable diseases

Chain of Propagation of Communicable diseases


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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