Influenza, Tuberculosis, AIDS Prevention in Miami

Table of Contents

Epidemiological and Surveillance Data
Community Effects
Plan of Action
References

Epidemiological and Surveillance Data

Three population-based communicable illnesses have been chosen for analysis: influenza, tuberculosis, and AIDS. To obtain relevant and reliable epidemiological and surveillance data for Miami, Florida (zip code 33018), online resources were used; the Florida Department of Health publishes monthly reports concerning infectious disease services and disease control. According to the latest report (Epi Monthly Report, 2017), the Florida Department of Health is currently in need of influenza sentinel providers, i.e. health care providers who conduct surveillance for influenza-like illnesses and report the results to the Department so that, in combination with other surveillance data, the relevant authorities have a comprehensive picture of influenza incidence in every county and the country in general.

The report encourages more practitioners to become influenza sentinel providers and stresses that it normally takes less than 30 minutes a week to compose and send a report to the Department of Health concerning influenza-like illnesses surveillance. The report states that there were no novel strains of influenza in 2017 (or in two previous years) but also documents one case of pediatric death from influenza in 2017, while there were none in 2016 or 2015. Overall, the Centers for Disease Control (CDC), according to its most recent report (Weekly US map, 2017) classifies the influenza activity in Florida as sporadic, which is the second-lowest level of concern after no activity.

Concerning tuberculosis, nine cases were documented in May of this year, and overall, 24 cases have been reported in 2017. This is less than the number of reported cases for the same period of the previous year and the year before; the tuberculosis incidence rate in Miami-Dade County has been decreasing within the last three years. Concerning AIDS, 37 cases were reported in May 2017, and 152 cases were reported in 2017 overall. This is less than the number of reported AIDS diagnoses during the same period of the previous year; the largest number of cases were reported in 2016 and amounted to 209, and the smallest number of cases in the three years occurred in 2015.

Concerning the prevention and containment of influenza, the Department of Health is taking such measures as enrolling sentinel providers, and ten such providers are currently enrolled in Miami-Dade. Also, there is the syndromic surveillance system in place on the emergency-department basis. The community-level importance of monitoring influenza trends is justified by the fact that 15 to 40 percent of the population in the United States is affected by influenza every year, and it is estimated that approximately 36,000 people in the country die from the disease annually (Immunization and infectious diseases, n.d.). Concerning AIDS (Fact sheet 2012, 2012), the monitoring conducted by the Department of Health includes composing reports for different demographic groups based on such criteria as sex, race, and age.

Community Effects

Communicable diseases are especially suitable for being regarded from the community perspective because their effects extend most demonstrably from the individual level to the community level. A particularly relevant topic identified by the Healthy People 2020 initiative is immunization and infectious diseases, and the goal is to [i]ncrease immunization rates and reduce preventable infectious diseases (Immunization and infectious diseases, n.d., para. 1). Preventability is the key concept in this regard; it is recognized that large spending is required to address the effects of epidemics, which is why the efforts of the health care system should be aimed at preventing the spread of communicable diseases. Two directions are proposed by the Healthy People 2020 initiative: clinical and community-based. Both include the elements of education and the delivery of evidence to populations to promote healthy practices and engagement in effective self-care.

Influenza, along with pneumonia, is classified as an acute respiratory infection, which remains the eighth leading cause of death in the country. Due to the pattern of its transmission, the disease is responsible for affecting entire communities. One of the objectives set by the Healthy People 2020 initiative is to increase the percentage of people who are vaccinated every year against seasonal influenza, and many aspects of this objective are now considered achieved. Concerning tuberculosis, the objective of the initiative was to reduce the incidence rate to one new case per 100,000 people, and it is not currently achieved. What is recognized as particularly important in reducing the incidence rate is achieving a higher number of people diagnosed with tuberculosis who are eligible for curative therapy.

Concerning AIDS, its community threats have been identified in many studies, and several cases of AIDS crises, i.e. situations in which the incidence rates were remarkably higher than the capacity of the health system in a given region, are known. The Healthy People 2020 initiative currently has a separate set of objectives dedicated to HIV and AIDS, and several objectives are regarded as achieved today (HIV, n.d.). These include the reduction of new AIDS cases among adolescents and adults to 12.4 per 100,000 people and the reduction of perinatally acquired AIDS to 31 new cases.

Plan of Action

Concerning infectious decisions, the main plan of action proposed by the Healthy People 2020 initiative is promoting vaccination programs. These programs should particularly include home visits, requirements for school attendance, immunization schedules, family incentives, provider assessment, and immunization information distribution (Immunization and infectious diseases, n.d.). Concerning influenza vaccinations, in particular, the proposed actions include interventions with on-site, free, and actively promoted immunization sessions. Concerning tuberculosis, special attention is paid to its drug-resistant forms, and it is proposed that efforts should be applied to making diagnosis and treatment more accessible to the public. However, for AIDS, vaccination cannot be part of the measures aimed at reducing community risks; the actions proposed by the Healthy People 2020 initiative (HIV, n.d.) include such interventions as screening, risk reduction (e.g. interventions aimed at changing behaviors related to lifestyles and sexual activity), and promotion of protective behaviors.

Two particular areas that should be addressed as part of the plan of action are communication and infrastructure. The population of Miami should be more extensively informed on how communicable diseases are transmitted, what measures should be taken to reduce the risk of becoming infected, and what to do in case a disease is contracted. Information campaigns should be evidence-based and should not be limited to clinical settings but reach the general population through various media, including the Internet and social networking services. Concerning infrastructure, the providers of health care services should consider that a rapid spread of disease may impose additional burdens on the facilities, and it should be ensured that the system is prepared for such a scenario. Also, preventive measures should be incorporated into the health care system, too, including the work of the community preventive services task force.