Sunday, July 25, 2010

The return of communicable diseases

There was a story today in the NYT Health section regarding people contracting Dengue fever in the Florida Keys. In recent weeks, there has been much discussion of the alarming rate in which Pertussis (Whooping Cough) has spread in California and other parts of the country. This is concerning for me and should be for all healthcare providers in all settings (prehospital, emergency departments, outpatient clinics, acute care/inpatient, etc). Many communicable diseases have previously been eradicated with vaccinations and have not been an issue for decades. Unfortunately, many of us would be unable to recognize many of these diseases; especially those such as dengue fever with vague, nondescript sympotomolgy.

So what does this all mean? The resurgence of communicable diseases requires education for all healthcare providers that may potentially come in contact with infected individuals. Ensuring vaccination to diseases such as pertussis and measles is also important to protect your own health. Both of these efforts are especially important for both EMS and emergency department staff (paramedics, EMTs, nurses, physicians, NPs, CNSs, patient care techs, etc) that have first contact with patients.

Education is perhaps the single most important step we can take for both ourselves and our patients.
  1. Know what, if any communicable diseases have been reported in your geographic area or region. The CDC, WHO and local health departments have free information for both healthcare providers and the laypublic.
  2. Many state health departments send memos to hospitals and EMS systems to alert providers the status of various diseases in the region. These memos are a great resource, providing information on symptoms, transmission, incubation period, disease course and priorities for treatment.
  3. Look for teachable moments: Encourage high-risk populations to vaccinate their children and themselves, use cough-etiquette and perform good hand-hygiene.
  4. Educate your colleagues: share the information you recieve and promote personal safety practices such as hand-hygiene.

Taking a proactive rather than reactive approach may help to reduce the incidence of these deadly diseases.

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