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Communicable Diseases: Influenza Analysis Through the Lenses of Determinants of Health and the Epidemiological Triangle

Introduction

The influenza virus, also colloquially known as “the flu,” is one of the most widespread diseases in the world. It is comprised out of several strains that share similarities based on their structure, biology, and effects on humans but differing in responsiveness to treatments and other factors (Wang & Tao, 2016). The disease is highly adaptable, with new mutations appearing every year. Some strains of the virus can use humans and animals as carriers. This adaptability is what makes vaccination against influenza so difficult – a new vaccine is required every year.

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Symptoms of the disease include a runny nose, a sore throat, high fever, loss of appetite, and general weakness of the body. Although treatable, it still manages to cause over 250,000 deaths worldwide every year (Wang & Tao, 2016). The victims are typically found among the poor, the elderly, children, and other vulnerable populations. The period of elevated infection for influenza usually occurs in autumn and winter, when low temperatures, high moisture, and lack of vitamins make humans more vulnerable to the disease (Wang & Tao, 2016). Worldwide epidemics usually occur between October and February. Although vaccines are used as primary prevention tools against influenza, nurses can also have a significant influence on the spread of the disease every year. The purpose of this paper is to examine influenza by analyzing it through the lenses of determinants of health and the epidemiological triangle.

Disease Description

The disease is caused by an influenza virus, which is a highly contagious airborne microorganism. Influenza is typically followed by symptoms similar to a common cold, which is why they are often confused with one another. Some of the most common symptoms include high body temperature (38-39 degrees Celsius/ 100-102 degrees Fahrenheit), cold sweats and shivers, headaches, body fatigue, coughing, and sneezing, as well as joint pains (Wang & Tao, 2016).

The disease attacks the upper respiratory systems, which is why it is often confused with the common cold. It is transmitted by air, though it can also be found on surfaces and in food near an infected person. Some strains are known to be carried and transmitted by animals as well. The disease is perfectly treatable and does not usually require hospitalization. However, a lack of treatment and general neglect of the patient can result in serious complications, such as pneumonia and even death. The treatment usually involves antiviral drugs such as Tamiflu, Relenza, and Paracetamol. Other measures include providing the patient with plenty of warmth, rest, and a warm drink in order for the immune system to overpower the virus on its own.

Due to the high adaptability of the virus, all demographics are potentially exposed to influenza. However, it causes the highest morbidity to individuals with weakened immune systems, such as young children and the elderly (Wang & Tao, 2016). Other vulnerable populations include individuals living under the poverty line and patients suffering from immunodeficiency. Although the disease is perfectly treatable in home conditions, it should be reported if the patient belongs to one of the vulnerable groups or if the symptoms did not subside within 2-3 days of treatment.

Influenza and the Determinants of Health

Any disease can be analyzed using five broad determinants of health. The purpose of these determinants is to help shape the responses to a health problem based on various important socio-economic and biological factors. Five determinants of health are as follows (Wang & Tao, 2016):

  • Policymaking. Since influenza is a world endemic, various countries are addressing the issue on a policy-making scale. In Europe, all health workers are obligated by law to undergo yearly vaccination in order to protect their patients. In the US, however, vaccination for medical workers remains voluntary.
  • Social factors. Social standing and economic position play a significant role in the spread, morbidity, and mortality rates of the disease. As it stands, patients living below the line of poverty are more vulnerable to the disease due to poor living conditions, constant exposure to the cold environment, and the necessity to work while sick.
  • Health services. The availability of vaccines and off-the-counter drugs to treat influenza largely determines a population’s capabilities of handling the disease. In poorer countries, where widespread vaccination is not practiced, yearly epidemics of influenza are a regular occurrence.
  • Individual behavior. Chances of contracting influenza as well as the morbidity of the disease are often determined by individual behavior. Wearing masks in public places during influenza outbreaks and treating the disease as soon as the first symptoms appear to help reduce sickness and overall exposure for the patients and those around them.
  • Genetics. Although there is speculation about predisposition to influenza being determined by genetics, the available academic data is incomplete and disorganized, with no solid correlation between influenza and genetics established in any of the available academic studies.

Based on the analysis presented above, it is possible to single out three major health determinants that affect influenza and its epidemiology the most. These factors include government activity, the socio-economic status of the patients, and the availability of health services.

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The Epidemiological Triangle

The epidemiological triangle comprises three parts: the host, the agent, and the environment. Some methodologies also add the dimension of time to be accounted for, effectively making it a rectangle or a square. According to the Centers for Disease Control and Prevention (CDC) (2016), humans remain the primary hosts for influenza due to being creatures capable of contracting, spreading, and enduring a full-blown infection. Other animals, such as chickens, swine, and cows, are also capable of carrying and transmitting influenza. The susceptibility of a human host to influenza is determined by their immune system. The weaker the immune system – the more vulnerable the host becomes. Patients with immunodeficiency are at extremely high risk of contracting influenza.

Major environmental factors include geographical influences, climate, socio-economic environment, and exposure to other hosts. Schools, hospitals, and other public spaces present an inherent environmental risk, as influenza spreads very quickly in confined environments. Exposure to animals is an important factor, as some strains use animal carriers to spread the infection. These include the H1N1 virus, colloquially called the swine flu, and the H5N1 virus called the bird flu (Wang & Tao, 2016). Healthcare workers are at risk of contracting influenza due to frequent contact with human (and sometimes animal) carriers of the disease.

Since influenza is an airborne disease, the infected moisture particles launched into the air during a sneeze or a cough serve as primary agents for spreading the disease. This factor can be reduced by practicing some of the basic hygienic procedures, which include covering the orifices during sneezes and coughs and washing hands. According to CDC (2016), such basic practices can have a major influence on the dynamics of the disease.

The last factor to consider is the period of incubation and the symptomatic period for influenza. According to Banning (2013), the virus undergoes changes and stops being infectious within a week of infecting a host. Symptoms of the disease, however, can exist within a person two-three weeks. Understanding the cycles of infection is important for the purposes of controlling the spread of the disease.

The Role of the Community Health Nurse

The community nurse is one of the primary healthcare agents that has an influence on the spread and severity of the disease. Some of the roles of a nurse include case finding, reporting, data collection, data analysis, and conducting follow-up investigations in their area before reporting these findings to the CDC (CDC, 2016). It helps create a wholesome picture of the outbreak and plan the intervention according to the needs of the affected populations. Accurate risk assessment and tracking the progress of interventions have a significant effect on the morbidity of the disease within the community. For example, data provided by community nurses help evaluate the effectiveness of the yearly vaccine administered to the population. Without these reports, researchers and vaccine producers would have to operate blindly, which has the potential to significantly reduce the effectiveness of vaccination efforts.

Another important role of a community nurse in the struggle against influenza is the education of the population. Due to a lack of information, many vulnerable population groups are unable to tell the difference between influenza and the common cold. They do not know that antibiotics are useless against influenza, as the disease is caused by viruses and not bacteria. In addition, uninformed individuals tend to underestimate the dangers presented by influenza. Many influenza-related deaths in young adults and patients aged between 27-45 occurred due to their determination to whether the disease “on their feet” rather than taking a week off and facilitate proper treatment (Banning, 2013). Therefore, it is important for a community nurse to ensure everyone understands how the disease spreads, what interventions are available, and what dangers influenza poses to the human body.

CDC and Influenza

The CDC stands for Centers for Disease Control and Prevention. It is a major federal agency dedicated to the promotion of health, education of the local populations, and improving prevention and preparedness efforts in the USA (CDC, 2016). Its goal is to improve the overall public health of the nation. Combating communicable diseases such as influenza is one of the major activities on their agenda. The CDC works in close partnership with all major healthcare organizations in order to monitor and record outbreaks of chronic and infectious diseases. It funds and sponsors various research efforts aimed at studying the disease and developing new methods of prevention and treatment.

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In addition to funding and coordinating nursing efforts in the USA, the CDC analyzes the information provided and develops strategies for the treatment of various diseases, with extra attention given to various indigenous and vulnerable populations (CDC, 2016). In addition, the agency engages in policy-making and advocacy in order to promote healthcare. Lastly, the official site of the CDC provides important information to anyone performing research on diseases, teaching many people how to test for the disease and how to avoid spreading it to others. CDC has a wide mandate over the number of issues it can address and is considered to be the primary statistical information bank in the country.

Global Implications of Influenza

Due to the high levels of adaptability of the influenza virus, it is unlikely for humanity to get rid of it in the nearest future. Instead, all efforts should be dedicated to mitigating the effects of the virus on vulnerable population groups. Although relatively harmless, an untreated epidemic of influenza can cause the loss of human lives and a severe decline in the quality of life. In addition, influenza is a gateway disease to other dangerous afflictions, such as pneumonia and bronchitis. World Health Organization (WHO) acknowledges the dangers an uncontrolled epidemic of influenza poses to underdeveloped and poor countries (WHO, 2016). The Global Influenza Program (GIP) was initiated to provide member states with strategic guidance, coordination, resources, and technical support in order to prepare the existing health systems against seasonal, zoonotic, and epidemical influenza outbreaks (WHO, 2016). This program finds great success in Africa, Asia, and the Middle East.

Conclusions

Influenza is one of the most widespread viruses in the world. It is highly adaptive, and vaccines against it need to be renewed on a yearly basis. At the same time, it does not pose a major threat to society, as the major symptoms subside after 3-7 days if the patient is provided with medicine, rest, and warmth. At the same time, vulnerable populations, such as children, the elderly, and the poor, are in greater danger from influenza than the rest due to weaker immune systems, contagious environments, and the lack of knowledge about the disease. CDC, WHO, and other organizations work closely with community healthcare organizations in order to have an accurate picture of the most recent outbreaks and epidemics. Community nurses play an important role as frontline healthcare agents. They provide important data that helps coordinate strategic efforts, guide research, and evaluate the effectiveness of implemented vaccines.

References

Banning, M. (2013). Influenza: Incidence, symptoms and treatment. British Journal of Nursing, 14(22), 1192-1197.

Centers for Disease Control and Prevention (CDC). (2016). Seasonal influenza. Web.

Wang, Q., & Tao, Y. J. (Eds.). (2016). Influenza: Current research. Norfolk, UK: Caister Academic Press.

World Health Organization (WHO). (2016). Influenza vaccine viruses and reagents. Web.

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StudyCorgi. (2022) 'Communicable Diseases: Influenza Analysis Through the Lenses of Determinants of Health and the Epidemiological Triangle'. 19 March.

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