What is Disease?
According to Google, A disease is a particular abnormal condition that
negatively affects the structure or function of all or part of an organism, and
that is not due to any immediate external injury. Diseases are often known to
be medical conditions that are associated with specific signs and symptoms.
A disease may be caused by external factors such as
pathogens or by internal dysfunctions. For example, internal dysfunctions of
the immune system can produce a variety of different diseases, including
various forms of immunodeficiency, hypersensitivity, allergies and autoimmune
disorders.
Prevention of diseases - The goals of medicine are to promote
health, to preserve health, to restore health when it is impaired and to
minimise suffering and distress Prevention of a disease includes all these
three goals.
Levels of prevention-
Concerning the natural history of the disease, three levels of
prevention have been classified:
1. Primary prevention- It is the action taken before the onset of
disease. The intervention is taken at the prepathogenesis phase of the disease.
The interventions are-
a) Health promotion
b) Specific protection.
2. Secondary prevention - It is the action taken at the early stage of a
disease that halts the progress of a disease and prevents complications. The
mode of intervention is early diagnosis and treatment.
This intervention arrests the progress of the disease, restores health
and prevents irreversible damage. Also, it protects other members of the
community from acquiring the disease.
3. Tertiary prevention - It is the action taken after the disease has
advanced beyond the early stages. The intervention is by disability limitation
and rehabilitation. These measures minimise the suffering and help the patient
to adjust to the derangement of health.
Methods of Disease control-
In most countries, local health authorities conduct health protection
activities at a local level such as receipt of case notifications, and
investigation and control measures.
National health authorities tend to be responsible for data collation,
analysis, and dissemination for action (surveillance). They may also
support outbreak investigation and control, particularly if investigations
cross regional borders.
There will also be a variety of organisations at each level that
contribute to the efforts of the health protection team but whose primary
function is not health protection, such as local government at a regional or
sub-regional level, and food safety and veterinary health agencies at a
national level.
For a more detailed example, health protection arrangements in England
are discussed briefly below.
Public Health England (PHE) is an executive agency sponsored by, but
independent from, the Department of Health.
The Secretary of State for Health has the overarching duty for
protecting the health of the public, but in practice, this is discharged for
him by PHE through its health protection directorate and operations, which has
specialist health protection functions such as disease surveillance, laboratory
services, investigation and management of health protection incidents and
outbreaks.
PHE Structure
Health Protection is one of three
professional directorates within PHE. The directorate delivers health
protection services that maintain and deliver best practices to leading
international standards.
It is a source of expert advice and
operational support, and contributes actively to policy-making and
implementation in partnership with other PHE directorates and the Department of
Health, and externally with the National Health Service (NHS), local authorities,
and other agencies. The Health Protection directorate comprises several
specialist national teams:
1. Emergency Response and Preparedness
2. Centre for Radiation, Chemical and
Environmental Hazards (CRCE)
3. Field Epidemiology Service (FES)
4. Global Health
5. National specialist epidemiology and
intelligence
6. Public Health Strategy (for health
protection)
7. Health protection quality,
governance and service improvement
Some of these departments are located
centrally, others are integrated within local centres.
Sub-national/local Health Protection
Teams (HPTs) are organised within the Operations Directorate, which is
accountable for the delivery of PHE services across England. They work
closely with the Health Protection Directorate.
There are 24 local Health Protection Teams
(the most local level of PHE). The teams are further grouped into 8
sub-regional centres, and then 4 regions including London, which is an
integrated centre and region.
HPTs control the communicable disease
at a local level with support from the PHE Health Protection Directorate if an
incident affects a larger geographical area, is complex, or is of national
significance.
The Health Protection Team provides
specialist health protection advice as well as operational support on all
health protection matters to NHS trusts, local authorities, community health
services (including schools and social services), and the general public.
Increasingly, these functions are being
shared within centres between several teams to improve efficiency.
HPTs are staffed by CCDCs or CHPs
(Consultants in Communicable Disease Control, or Consultant in Health
Protection), Health Protection nurse and non-nurse background practitioners,
epidemiologists and admin support staff.
The HPT is responsible for the
following functions:
1. Surveillance and analysis of trends
in communicable disease
2. Liaison with key stakeholders
involved in the control of infectious disease
3. Prevention, investigation, and
control of health protection incidents including the prevention, investigation
and control of outbreaks and incidents involving communicable diseases,
chemical, radiological and other environmental hazards
4. Chemical, biological and
radiological incident planning and management
5. Provision of advice and support to
clinical commissioning groups (CCGs - healthcare commissioning organisations in
England), local authorities, hospital and primary care staff and the public on
health protection issues
6. Infection control advice and support
to nursing and residential homes and schools
7. Acting as the 'proper officer' in
relation to public health legislation
8. Advise clinical commissioning groups
(CCGs), the local commissioners of NHS services, on commissioning services to
prevent, control and treat infection
9. Support the development and implementation
of prevention and health promotion programmes
10. Teaching and training of local
health professionals in health protection
11. Liaison with local media outlets
regarding health protection incidents or outbreaks.
The local government is also charged
with planning for and responding to public health emergencies and incidents at
a local level; in practice, this entails emergency response planning in
cooperation with PHE and assuring their populations of the specialist functions
provided to them by PHE teams.
Environmental health support also sits
within local government. Due to differences in organisational
‘footprint’, each HPT will work in cooperation with several local governments.
This was a summary of how the government
prevent and try to control the epidemic or a pandemic.
Written By – Chavi Goel
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