DISEASE CONTROL AND PREVENTION

Disease
y Any harmful change that interferes with the normal

appearance, structure, or function of the body or any of its parts y A disorder in humans, animals, or plants with recognizable signs and often having a known cause


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Center for Disease Control and Prevention

y U.S. Department of Health and Human Services y Altlanta, GA (HQ), 1946 y Preventing and controlling disease y Promoting environmental health y Health education

CDC 24/7: Saving Lives. Protecting People, Saving Money

VISION-MISSION
y [V]Health ProtectionHealth Equity y [M]Collaborating to create the expertise,

information, and tools that people and communities need to protect their health through health promotion, prevention of disease, injury and disability, and preparedness for new health threats.

CDC 24/7: Saving Lives. Protecting People, Saving Money

FUNCTION
y CDC seeks to accomplish its mission by working with y partners throughout the nation and the world to  monitor health,  detect and investigate health problems,  conduct research to enhance prevention,  develop and advocate sound public health policies,  implement prevention strategies,  promote healthy behaviors,  foster safe and healthful environments,  provide leadership and training.

CDC 24/7: Saving Lives. Protecting People, Saving Money

CORE VALUES
y Accountability y Respect y Integrity

CDC 24/7: Saving Lives. Protecting People, Saving Money

PLEDGE
y To be a diligent steward of the funds entrusted to it. y To provide an environment for intellectual and personal

growth and integrity.

y To base all public health decisions on the highest quality

scientific data, openly and objectively derived. institution.

y To place the benefits to society above the benefits to the

y To treat all persons with dignity, honesty, and respect.

CDC 24/7: Saving Lives. Protecting People, Saving Money

Center for Disease Control and Prevention

COMPOSITION 5 OFFICES
y Public Health

y Office of the Director, y National Institute for

Occupational Safety and Health, y Center for Global Health

y y

y y

Preparedness and Response; State and Local Support Surveillance, Epidemiology and Laboratory Services Noncommunicable Diseases, Injury and Environmental Health; and Infectious Diseases
l , v

CDC

/ :

L v s. r

CDC Director

y Thomas R. Frieden,

MD, MPH


Director, Centers for Disease Control and Prevention Administrator, Agency for Toxic Substances and Disease Registry

Advisory Committee to the CDC Director

y PURPOSE
 

Section 301 (42 U.S.C Section 241) Section 311 (42 U.S.C Section 243)

1.

conduct, encourage, cooperate with, and assist other appropriate public authorities, scientific institutions, and scientists in the conduct of research, investigations, experiments, demonstrations, and studies relating to the causes, diagnosis, treatment, control, and prevention of physical and mental diseases, and other impairments; assist States and their political subdivisions in the prevention of infectious diseases and other preventable conditions, and in the promotion of health and well being; and train State and local personnel in health work

2.

3.

Advisory Committee to the CDC Director

y FUNCTION: y Recommends ways to prioritize CDCs activities,

improve results, and address health disparities

y Provides guidance to help CDC work more effectively

with its various private and public sector constituents to make health protection a practical reality

Advisory Committee to the CDC Director

y James Nicholson

Baird, Jr., MD


y Nisha D.


Botchwey, PhD
Assistant Professor, Urban and Environmental Planning and Public Health, University of Virginia, Charlottesville, Virginia

President, Stillwater Solutions, LLC, Columbus, Ohio

y Dileep G. Bal,


MD, MS, MPH

District Health Officer Island of Kauai, Hawaii

y Sanford R.

y Vivian Berryhill  President and Founder, National Coalition of Pastors Spouses, Olive Branch, Mississippi

Climan, MBA, MS


President, Entertainment Media Ventures, Inc., Burbank, California

y Suzanne Frances

Delbanco, PhD


Executive Director Catalyst for Payment Reform

Advisory Committee to the CDC Director

y

Thomas Farley, MD, MPH



Kelly J. Henning, MD


New York City Health Commissioner New York, New York

Director, International Health Programs Bloomberg Foundation New York, New York

David W. Fleming, MD


Director and Health Officer for Public HealthSeattleKing County Bainbridge Island, Washington

Mary Kelly


Alan Greenberg, MD, MPH



Executive Vice President, Merchandising and Category Management, Shoppers Drug Mart, North York, Ontario

Professor and Chair Department of Epidemiology and Biostatistics George Washington University School of Public Health and Health Services Washington, DC

Debra R. Lappin, JD


Senior Vice President, B&D Consulting, LLC, Washington, D.C.

Advisory Committee to the CDC Director

y

Jonathan T. Lord, MD


Eduardo J. Sanchez, MD, MPH



Chairman of the Board and Chairman of Compensation Committee for DexCom Inc, Fisher Island, Florida

Vice President and Chief Medical Officer Blue Cross and Blue Shield of Texas

Kenneth D. Mandl, MD, MPH



John Reese Seffrin, PhD



Associate Professor, Harvard Medical School, Director, Intelligent Health Laboratory, Children s Hospital Informatics Program, Boston, Massachusetts

Chief Executive Officer, American Cancer Society, Inc., Atlanta, Georgia

M. Cass Wheeler


Sara Rosenbaum, JD


Private Consultant, Walburg, Texas

Chair, Department of Health Policy Harold and Jane Hirsh Professor of Health Law and Policy George Washington University Washington, DC

Similar Agencies
y Centre for Health Protection (CHP), Hong Kong y Chinese Center for Disease Control and Prevention, China y European Centre for Disease Prevention and Control y y y y y y y y y

(ECDC), European Union Health Protection Agency (HPA), United Kingdom Hellenic Centre for Diseases Control and Prevention, Greece Institut de veille sanitaire (IVS), France Istituto Superiore di Sanit (ISS), Italy Instituto de Salud Carlos III (Spain), Spain Public Health Agency of Canada (PHAC), Canada Robert Koch Institute, Germany Epidemic Intelligence Service World Health Organization (WHO)

Principle of Disease Control & Prevention

Principles of Disease Control and Prevention

1. y y

Diagnosis Disease diagnosed and treated immediately Necessary to prevent spread of infection

2. Notification y y

Health authority informed Preventive measures are done to control spread of disease

Principles of Disease Control and Prevention

3. Isolation y y

Infected patient isolated at hospital or home Period of isolation dependent on communicability of disease

4. Treatment y y

Given to infected patient and carrier of infection Uninfected individuals may be given treatment as well

Principles of Disease Control and Prevention

5. Quarantine y y

Isolation of normal and healthy persons until incubation period is over Ex. International travelers who may be potential carriers of a disease

6. Investigation y Assessment of people and infected areas y Findings confirmed by laboratory tests

Principles of Disease Control and Prevention

7. y y 8. y y y

Disinfection Disinfection of excreta and articles used by infected patient Done during the phase of infection, recovery, and death Blocking of Transmission Water borne infection prevented by boiling water and milk Air borne infection prevented by wearing masks, isolation of patient, dust control, air disinfection Insect borne diseases use of insecticides

Principles of Disease Control and Prevention

9. Immunization y y

Easy method to prevent communicable diseases Ex. Small pox, tuberculosis, measles, poliomyelitis

10. Health Education y

Public informed regarding the importance of maintaining clean environment

Periodic Health Exam

y Preventive practices have significantly reduced the

morbidity and mortality associated with several common medical conditions

y Periodic Health visit is an important opportunity for

the delivery of clinical preventive services

y Health maintenance needs to be considered at every

visit

Level of Prevention
y PRIMARY y SECONDARY y TERTIARY

Primary Prevention
y Disease is stopped before it starts y Reducing or elimination risk factors for a health

problem
y Vaccinations, chemo-prevention, and counseling are

types of primary prevention

y Depends on the persons age and risk profile

Secondary Prevention
y Disease is detected and treated early y Before symptoms are present, thereby minimizing

adverse outcomes
y Screening programs

Principles of Screening (WHO)

1. 2. 3.

The condition should be an important health problem There should be a treatment for the condition Facilities for diagnosis and treatment should be available There should be latent stage of the disease There should be a test or examination for the condition

4. 5.

Principles of Screening (WHO)

6. 7.

The test should be acceptable to the population The natural history of the disease should be adequately understood There should be an agreed policy on who to treat The total cost of finding a case should be economically balanced in relation to medical expenditure as a whole a once and for all project

8. 9.

10. Case-finding should be a continuous process, not just

Screening Tests

y Early diagnosis leads to improved clinical outcome. y The cost, accuracy, and acceptability of the screening

test are adequate for the population to be sceened.

Tertiary Prevention
y An existing, usually chronic disease is managed to

prevent further functional loss.



E.G.: people with diabetes focuses on tight control of blood sugar, excellent skin care, and frequent exercise to prevent heart and blood vessel disease

y Providing supportive and rehabilitative services to

maximize quality of life

y Preventing complications among people with

disabilities

Level of Prevention
y PRIMARY prevention  Monthly self breast examination with a young female patient y SECONDARY prevention  Screening mammography y TERTIARY prevention  Prevent the progression of breast cancer, such as chemotherapy

Major components of Preventive Medicine

1.

Vaccination to prevent infectious diseases

2. Screening programs 3. Chemo-prevention 4. Counseling aimed at helping people make healthy

lifestyle choices

Health Maintenance Evaluation

y Identifying risk factors in ones personal and family y y y y

health history Performing a focused exam, as appropriate Obtaining needed screening tests at the right intervals Encouraging people to choose healthy lifestyles to maximize their health This checkup can occur during an office visit devoted to health maintenance or may be covered during an office visit for other concerns