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• Preventive medicine

  The practice of healthcare to improve patient well-being with the goal of ultimately preventing disease, disability, and death
• Primordial prevention


  • Preventing the risk factor (e.g. for hypertension, preventing abnormal elevations of blood pressure in normotensive individuals)
• Primary prevention


  • Preventing disease before it ever occurs by preventing exposures to hazards, altering unhealthy/unsafe behaviours, and increasing disease resistance (e.g. immunization)
• Secondary prevention


  • Detecting and treating disease/injury early to slow its progress and implementing programs to return people to their original health and function to prevent long-term problems (e.g. cervical cancer, breast cancer, STDs)
• Tertiary prevention


  • Helping people manage ongoing health problems and disabilities to improve their ability to function and quality of life
• Disability


  The restriction or lack of ability to perform an activity in the manner or within the range considered normal for a human being
• Impairment


  Any loss or abnormality of psychological, physiological or anatomical structure or function
• Infectious disease


  Disorders caused by organisms such as bacteria, viruses, fungi or parasites that can live in and on our body, and under certain conditions may cause disease
• Some infectious diseases can be passed from person to person, transmitted by insects or other animals, or contracted by consuming contaminated food or water
• Cholera

  A sudden illness that happens when a person accidentally ingests (swallows) Vibrio cholerae bacteria, which infect the intestines and lead to severe diarrhea and dehydration
• Factors involved in cholera


  • Agent (V. cholerae)
  • Host (affects both males and females, all ages, more common in those with reduced gastric acidity)
  • Environment (poor environmental cleaning, infected water/drinks, infected meals, lack of education, poor quality of life)
• Incubation period


  The process of development, 2 hours to 5 days for cholera
• Modes of cholera transmission

  • Convalescent carrier (clinically healed but still capable of transmitting)
  • Chronic carrier (asymptomatic carrier)
• Signs and symptoms of cholera

  • Dehydration
  • Vomiting
  • Loss of skin elasticity
  • Nausea
  • Muscle cramps
  • Hypotension
  • Cardiovascular shock
  • Concentrated urine
• Laboratory diagnosis of cholera

  1. Stool examination using rubber catheter or rectal swab

  2. Stool culture to identify V. cholerae
• Prevention and control of cholera

  1. Early diagnosis of cases

  2. Cholera notification

  3. Immediate medical care

  4. Treatment based on severity (mild dehydration vs severe dehydration)

  5. Antibiotics

  6. Ensuring safe and clean water supply

  7. Promoting hygienic food

  8. Proper disposal of excreta

  9. Handwashing

  10. Disinfection

  11. Chemoprophylaxis

  12. Immunization

  13. Health education
• SARS (Severe Acute Respiratory Syndrome)


  A viral respiratory disease caused by a coronavirus, characterized by high fever, dry cough and troubled breathing
• Factors involved in SARS

  • Agent (SARS coronavirus)
  • Host (humans, animals)
  • Environment (travel, healthcare services)
• Incubation period


  1. 7 days for SARS
• Modes of SARS transmission

  • Infected droplets
  • Contaminated fingers
  • Infected discharges
  • Contaminated objects
• Signs and symptoms of SARS


  • Cough
  • Shortness of breath
  • Sore throat
  • Running nose
  • Chills
  • Fever
  • Headache
  • Loss of appetite
  • Muscle pain
  • Diarrhea
  • Pneumonia
• Laboratory diagnosis of SARS

  1. Presence of one or more signs of lower respiratory tract disease (cough, breathing difficulties, shortness of breath)

  2. Fever of at least 100.4°F

  3. Radiographic evidence of pneumonia

  4. No alternative diagnosis
• Prevention and control of SARS

  1. Identification of suspected, probable and confirmed cases

  2. Timely and accurate reporting to authorities

  3. Infection prevention measures (covering mouth when coughing, handwashing, glove use, proper disposal of tissues)

  4. Personal protective equipment for healthcare workers
• SARS


  Severe acute respiratory syndrome
• The patients experiences influenza - like symptoms including: fever, malaise, headache and vagari's (sudden sensation of cold) in the first week of illness
• No individual symptoms have proved specific however the most commonly recorded is a history of fever
• SARS treatment should be established and reported to the local authority in order to take effective action
• Timely and accurate reporting helps in achieving control of SARS
• Precautions


  1. Cover mouth when coughing and using tissue to store the secretions

  2. Wash hands after touching respiratory secretions, infected materials or dirty items and products

  3. Dispose of tissues following use in the nearest waste receptable
• Once the SARS suspicion index occurs, the required infection prevention measures must be triggered and required personal protective equipment (PPE) worn
• Both individuals entering the area must use mask, usage of traditional precautions (ie hand hygiene), usage of long-sleeved gowns, gloves and safe eye protection for patient or environmental touch, Placing surgical masks over prongs of nasal oxygen
• SARS patients should be separated
• According to the epidemiological record (2003) provided by WHO, each patient has been shown to infect an average of 3 others with the disease transmitted by direct touch
• Patients should be isolated for the time during which maximum virus excretion occurs during the course of the disease, which is estimated to be approximately 10 days per case
• Disinfection


  1. Use domestic detergent to clean floor and surfaces, and then use household bleach to rinse floor and services

  2. Pay attention to all sides of beds, head ends, bed side rails, lockers, doors, pull push door handles, trolleys, taps and sinks

  3. Use designated cleansing tools like cloth mops and buckets for isolated areas
• Screening of the cases, suspected cases and probable cases
• The travelers should be screened to prevent the migration of SARS cases to other areas
• No uniform therapy for serious Acute Respiratory Syndrome - Cov
• It can easily be confused with other lung - related diseases, so patients are usually provided: Broad- Spectrum Antibiotics, Anti-viral agents, Immuno- modulatory treatment, Supportive treatment
• Broad-Spectrum antibiotics

  Antibiotics acting on major groups of bacteria, gram +ve, gram -ve or any wide range of bacteria that cause a disease