Introduction
The communicable illnesses chosen for the analysis are AIDS, influenza A, and rabies. The county chosen is Miami-Dade, FL (the ZIP-code is 33143). According to Miami-Dade County’s monthly report, 36 and 136 patients were registered with AIDS and HIV respectively in July 2017 (Florida Department of Health, 2017a). The surveillance of the diseases and their spread is described by the Florida Department of Health in yearly and monthly reports that also contain information about age groups, race, ethnicity, etc. For example, in 2015, the majority of the diagnosed cases of HIV (63) were related to 35-39 or 50-54 years old citizens. The racial/ethnic distribution shows that out of 473 cases, 227 and 208 were related to Black not Hispanic or Hispanic/Latino citizens respectively (Florida Department of Health, 2017a).
The surveillance on influenza cases is also presented on the Florida Department of Health’s website; according to it, four outbreaks were reported in weeks 35-36, and 172 outbreaks were reported since the start of 2016-2017 influenza season (Florida Department of Health, 2017b). The Department also informs that no pediatric deaths related to influenza in weeks 35-36 were reported (Florida Department of Health, 2017b). Vaccinations remain to be the most efficient way of preventing the pediatric population from the virus. Additionally, the Department does not recommend using the live attenuated influenza vaccine (LAIV) during the 2017-2018 influenza season because it was less effective in 2013-2014 and 2015-2016 (Florida Department of Health, 2017b).
The data provided on the spread of rabies shows that thirteen cases were registered in 2013; the majority of the animals with rabies were raccoons (six cases), whereas bats (three cases) and domestic animals (cats and dogs, one case each) were also reported to be suspect rabid animals (Florida Department of Health, 2017c). Despite the low levels of disease spread, the importance of prevention techniques is highly emphasized (no contact with wild animals, pets’ vaccination, hygiene after contact with non-vaccinated animals, etc.).
AIDS: Impact and Plan of Action
Active and passive surveillance is conducted to identify new cases of HIV/AIDS. Due to the growing effectiveness of programs that target the progression of HIV disease, the Department’s ability to report HIV incidence is affected as well; the surveillance of HIV infection was included in 1997 (Florida Department of Health, 2017a). The impact of HIV on the community can be addressed via fostering partnerships between businesses and labor units with regard to HIV/AIDS, decreasing discrimination and stigma levels, and promoting education and awareness of HIV/AIDS and prevention methods.
The Healthy People 2020 (2017) objectives are to reduce the number of new HIV diagnoses, the rates of transmission of HIV, and perinatally acquired HIV and AIDS, increase the proportion of individuals who know their serostatus, reduce deaths from HIV infection, etc. Katz et al. (2013) point out that stigma and discrimination adversely influence patients’ medication adherence and health outcomes. Therefore, not only treatment facilities that offer support for individuals with HIV and provide counseling to them are necessary but also community-wide interactions, lectures, and interventions that will spread the awareness are also needed to decrease HIV acquisition and transmission (Healthy People 2020, 2017). Physicians and nursing professionals need to promote routine testing for HIV among their patients, family, and colleagues. To improve community residents’ understanding of HIV, clinicians need to provide counseling to both adults and children to emphasize the importance of disease awareness. Additionally, faith-based organizations can also be helpful in providing spiritual and holistic help to religious individuals or anyone who expresses the need for it.
Influenza: Impact and Plan of Action
Influenza is a respiratory infection that is caused by various flu viruses (Influenza A is observed in this case). According to the Florida Department of Health (2017b), influenza can cause 36,000 fatal outcomes in people who got diagnosed with flu, and approximately 114,000 individuals with this diagnosis are hospitalized each year. Infectious diseases remain to be one of the leading causes of disabilities and death, and the lack of immunization leads to the increased disease spread. Vaccination can not only help save lives but also significantly reduce health care costs both of the state and households.
The Healthy People 2020 (2017) objectives for influenza include increasing the percentage of adults, children, healthcare personnel, and pregnant women that get an annual vaccination and increasing the number of laboratories that monitor influenza virus resistance. In order to complete these goals, clinicians need to discuss the importance of vaccination with patients, provide community-based resources (information or counseling) about vaccination and outcomes of influenza, and suggest the vaccination for those who do not get it annually or seasonally.
It is important to provide information about available health care facilities that can schedule flu vaccination for those who do not have it. Clinicians should support those individuals who vaccinate themselves and their children annually. An established surveillance system is an important component of an effective vaccination program, as it helps understand how counties and cities schedule vaccinations campaigns (e.g., prior to or during the outbreak) (Dwyer et al., 2013). The involvement of providers and hospitals in surveillance programs is also essential for the prevention of an outbreak. At the local level, however, clinicians can support facility-wide vaccinations of the personnel and investigations of influenza-like illnesses.
Rabies: Impact and Plan of Action
Rabies is a virus that can cause severe illness or 100% fatal outcome in humans and domestic animals. Florida Department of Health (2017c) emphasizes the importance of vaccination of domestic animals to prevent rabies’ spread and contamination. The majority of the cases registered during 1996-2016 surveillance indicate that raccoons, bats, and foxes (as well as cats) are among animals most likely to have rabies in Florida. Rabies does not only lead to fatal outcomes in humans and pets but also results in disabilities. Yousaf, Qasim, Zia, Ashfaq, and Khan (2012) point out that post-exposure preventive techniques can also be useful in addressing the issue.
Despite the small number of registered rabies cases in Miami-Dade County, FL, it is still highly dangerous to its residents as it can be transmitted from animals to humans; hospitalization and fatal outcomes directly influence health care costs for medical facilities and households. According to the Florida Department of Health (2017c), to prevent disease spread, individuals need to avoid contact with wild animals, vaccinate their pets and at-risk livestock, ensure revaccination if necessary, never feed wild or stray animals, and feed their pets indoors. If the pet was attacked by a wild or unvaccinated animal, it is obligatory to wear gloves when examining the animal’s wound so that the individual is not exposed to the saliva of the other animal. People with high-risk professions need to be provided with pre-exposure prophylaxis (rabies vaccines). The Healthy People 2020 (2017) objective on rabies includes increasing the number of states that use electronic data of animal surveillance to provide information for public health prevention programs from eight to fifty-two. Animal control in the community also needs support from healthcare facilities in raising awareness of the virus among community residents.
References
Dwyer, D., Barr, I., Hurt, A., Kelso, A., Reading, P., Sullivan, S., & Wang, D. (2013). Seasonal influenza vaccine policies, recommendations and use in the World Health Organization’s Western Pacific Region. Western Pacific Surveillance and Response Journal: WPSAR, 4(3), 51-59.
Florida Department of Health. (2017a). HIV surveillance.
Florida Department of Health. (2017b). Influenza.
Florida Department of Health. (2017c). Rabies.
Healthy People 2020. (2017). 2020 topics and objectives – objectives A–Z.
Katz, I. T., Ryu, A. E., Onuegbu, A. G., Psaros, C., Weiser, S. D., Bangsberg, D. R., & Tsai, A. C. (2013). Impact of HIV-related stigma on treatment adherence: Systematic review and meta-synthesis. Journal of the International AIDS Society, 16(3), 1-25.
Yousaf, M. Z., Qasim, M., Zia, S., Ashfaq, U. A., & Khan, S. (2012). Rabies molecular virology, diagnosis, prevention and treatment. Virology Journal, 9(1), 50-59.