NRS 428 Epidemiology Paper
NRS 428 Epidemiology Paper
NRS 428 Epidemiology Paper Sample
NRS 428 Epidemiology Paper
Infection refers to the lodgment and multiplication of a microorganism in the tissues of a host. A communicable disease can be transmitted from one person to another. The five modes of transmission of communicable diseases include contact, airborne, vehicular, vectors, and inoculation. The purpose of this paper is to describe Botulism and apply the concepts of epidemiology and nursing to research the disease.
Description of the Communicable Disease
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Botulism is poisoning caused by Clostridium botulinum toxin that affects the peripheral nerves. Botulism is categorized as foodborne, infant, and wound botulism. Foodborne botulism is associated with the consumption of canned foods (Rao et al., 2021). Infant botulism is caused by neurotoxins produced by bacteria in the infant GIT mostly at 1-6 months. Wound botulism is caused by toxins produced in contaminated wounds.
The symptoms of foodborne botulism begin to manifest 12 – 36 hours after ingestion of toxin-contaminated food. The patient presents with the following signs and symptoms: Nausea, vomiting, dizziness, tinnitus, diplopia, dysphasia, dysphagia, dyspnea, and muscle weakness of the neck, limbs, and respiratory system (Rao et al., 2021). Initial symptoms of infant botulism include constipation and a weak cry. As the disease progresses, infants have flaccid paralysis and respiratory arrest (Dilena et al., 2021). Wound botulism is clinically similar to food-borne botulism, although GIT symptoms are less prominent.
The major complication of botulism is respiratory failure, which leads to death. Patients with botulism are managed in a high-dependence unit. A tracheostomy is performed and a mechanical respirator is used. Cleansing enemas are administered to remove unabsorbed toxins from the colon and botulinum autotoxin serum is given and repeated after two to four hours (Rao et al., 2021). The WHO (2018) found botulism to have a low incidence. However, it tends to have a high mortality rate if there is no prompt diagnosis and treatment. The fatality rate is 5-10% of total cases. Wound botulism has a mortality rate of about 10%.Wound botulism is more common in females, but foodborne botulism has no sexual tendency.
Reportable Disease
Botulism is a reportable disease in the U.S. Healthcare providers are required to promptly notify the state health department of suspected cases. Laboratories are also obliged to notify the state health department of all confirmed cases (Centers for Disease Control and Prevention [CDC], 2021). The State health departments use the National Notifiable Diseases Surveillance System to report confirmed cases to the CDC.
Social Determinants of Health
The Social Determinants of Health (SDOH) associated with botulism is neighborhood and physical environment. Foodborne Botulism is associated with environmental factors, especially from food contaminated with C. botulinum spores. Besides, food preserved in conditions that favors the growth of C. botulinum and production of botulinum toxin leads to the disease outbreak (Rasetti-Escargueil et al., 2019).Infant botulism is also primarily from the environment, especially household dust.
Epidemiologic Triangle
Clostridium botulinum is a large stout gram-positive rod with parallel sides and rounded ends with oval terminal or subterminal spores. It is sluggishly motile by a few peritrichous flagella and is non-capsulated. C.botulinium can anaerobically grow on Blood agar, Egg Yolk Agar, MacConkey agar, and Reinforced Clostridial Agar (Rawson et al., 2023).C.botulinium produces botulinum toxin under anaerobic conditions, which inactivates proteins that regulate the release of acetylcholine, blocking neurotransmission at the peripheral cholinergic synapses.
Humans usually ingest C botulinum spores, but germination of the spores does not occur in the intestines without the favorable conditions. The environmental conditions required for the germination of the spores include an anaerobic environment, amino acid, low acidity, specific salt and sugar concentrations, and temperatures of 37F-99F (Rawson et al., 2023).Foodborne botulism occurs when food contaminated with botulinum spores (from the soil) is kept warm and in tightly covered containers for many hours. The organisms multiply in warm anaerobic environments, especially in protein-rich foods. When such food is contaminated, clostridium botulinum multiplies and starts producing toxins (Rawson et al., 2023). The contaminated food may appear spoiled (greenish) and emit an offensive odor. Once a person eats this food, they may suffer a mild illness that requires no medical treatment or a rapidly fatal illness terminating in death within 24 hours.
Special Considerations or Notifications
If a healthcare provider suspects a patient has botulism, they should call the state public health department immediately and contact CDC if there is no response. If clinical findings indicate botulism, the clinician or health facility should ask for an antitoxin immediately and initiate therapy when it is available. If the antitoxin is administered early in the course of the illness, it inhibits disease progression and shortens the duration of botulism. For infant botulism, healthcare providers or facilities should instantly make contact with the Infant Botulism Treatment and Prevention Program (IBTPP) at the California Department of Public Health for a free clinical consultation (CDC, 2021). Besides, The IBTPP offers additional consultation and information-sharing with state and local health departments
Importance of Demographic Data
Demographic data refers to information on a population’s size, growth, and distribution. It provides a foundation for understanding a community’s health as it is currently, where it previously was, and where it is headed. Besides, demographic data is a powerful tool for tracking changes in populations’ health status over time and identifying the health needs and strengths of a community (Berg, 2018). This guides community health planning, healthcare decision-making, policy development, and allocation of healthcare resources. Furthermore, demographic data is essential in community health since it helps to improve the quality of care for all individuals. This is because demographic data helps to identify and tackle differences in care for specific populations in the community. In addition, it guides in identifying the populations in the community that do not achieve optimal interventions (Berg, 2018). Demographic data helps to evaluate if the healthcare system is providing culturally competent care to the community and establish additional patient-centered services.
Role of the Community Health Nurse
The community health nurse (CHN) has various roles in primary, secondary, and tertiary prevention of botulism. In primary prevention, the CHN has a role in health education, mainly good food practices in food preparation (Rasetti-Escargueil et al., 2019). This is by encouraging people to serve meals immediately after they are prepared to prevent the growth of organisms and keep food covered to keep off dust and rodents. In secondary prevention, the CHN has a role in identifying the source of botulism. The CHN has a risk assessment role, which entails differentiating the type of disease outbreak, that is, natural, accidental, or potentially deliberates (WHO, 2018). Besides, the CHN has the role of effectively administering appropriate treatment to patients affected by botulism. The CHN’s role in tertiary prevention includes providing supportive care to patients who have developed complications like generalized paralysis and requiring prolonged intubation and mechanical ventilation (Rao et al., 2021). The CHN can incorporate the Christian worldview when working with patients affected by botulism by helping them contain the disease source to prevent similar disease outbreaks in the future.
National Agency or Organization that Addresses the Disease
The CDC Botulism Consultation Service is a national agency that addresses botulism in the US. It offers clinical consultations on suspected cases of all types of botulism apart from infant botulism. The agency distributes antitoxin for non-infant botulism. (CDC, 2021). Moreover, the Botulism Consultation Service offers expert guidance to health providers and helps in collecting epidemiologic and medical information for suspected botulism cases reported in the U.S.
Global Implications
Botulism outbreaks occur worldwide and are usually a fatal illness. Fleck-Derderian et al. (2018) found that 58% of botulism outbreaks occurred in the U.S., 12% in Canada, 13% in Europe, 12% in Asia, and 6% in Africa. Outbreaks are more common in areas with high consumption of home-canned foods and non-commercially processed foods. The WHO has been working with national and local authorities in other countries to control botulism outbreaks at their source.
Conclusion
Botulism is caused by C. botulinum toxin and is categorized as foodborne, infant, and wound botulism. Death may occur from sudden respiratory paralysis and airway obstruction. It has a low incidence but is highly fatal if not diagnosed and treated early. The CHN has a role in health education, risk assessment, treatment, providing supportive care, and controlling the source of botulism.
References
Berg, S. (2018). Improve health equity by collecting patient demographic data. American Medical Association, 15.
Centers for Disease Control and Prevention. (2021, October 6). National botulism surveillance. https://www.cdc.gov/botulism/surveillance.html
Dilena, R., Pozzato, M., Baselli, L., Chidini, G., Barbieri, S., Scalfaro, C., Finazzi, G., Lonati, D., Locatelli, C. A., Cappellari, A., &Anniballi, F. (2021). Infant Botulism: Checklist for Timely Clinical Diagnosis and New Possible Risk Factors Originated from a Case Report and Literature Review. Toxins, 13(12), 860. https://doi.org/10.3390/toxins13120860
Fleck-Derderian, S., Shankar, M., Rao, A. K., Chatham-Stephens, K., Adjei, S., Sobel, J., … & Pillai, S. K. (2018). The epidemiology of foodborne botulism outbreaks: a systematic review. Clinical infectious diseases, 66(suppl_1), S73-S81.
Rasetti-Escargueil, C., Lemichez, E., & Popoff, M. R. (2019). Public health risk associated with botulism as foodborne zoonoses. Toxins, 12(1), 17.https://doi.org/10.3390/toxins12010017
Rao, A. K., Sobel, J., Chatham-Stephens, K., &Luquez, C. (2021). Clinical Guidelines for Diagnosis and Treatment of Botulism, 2021. MMWR. Recommendations and reports: Morbidity and mortality weekly report. Recommendations and reports, 70(2), 1–30. https://doi.org/10.15585/mmwr.rr7002a1
Rawson, A. M., Dempster, A. W., Humphreys, C. M., & Minton, N. P. (2023). Pathogenicity and virulence of Clostridium botulinum. Virulence, 14(1), 2205251. https://doi.org/10.1080/21505594.2023.2205251
World Health Organization. (2018, January 10). Botulism. WHO | World Health Organization. https://www.who.int/news-room/fact-sheets/detail/botulism
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Assessment Description
The purpose of this assignment is to discuss concepts of epidemiology and apply nursing theories and research to a communicable disease. Refer to “Communicable Disease Chain,” “Chain of Infection,” and the CDC websites, all located in the topic Resources, for assistance when completing this assignment.
Choose a communicable disease topic from the resources mentioned above or you may select one from the list below:
Chickenpox
Tuberculosis
Influenza
Mononucleosis
Hepatitis B
HIV
Ebola
Measles
Polio
E. coli
Salmonella
Listeria
Hepatitis A
SARS-CoV-2
Monkeypox
Dengue
Botulism
Norovirus
Write a paper (1,000-1,500 words) in which you apply the concepts of epidemiology and nursing to research a communicable disease. Refer to “Communicable Disease Chain,” “Chain of Infection,” and the CDC websites, located in the topic Resources, for assistance when completing this assignment.
Describe the chosen communicable disease, including causes, symptoms, mode of transmission, complications, treatment, and the demographic of interest (mortality, morbidity, incidence, and prevalence).
Explain why this is a reportable disease. Provide details about reporting criteria.
Describe the social determinants of health and how those factors contribute to the development of the chosen communicable disease.
Discuss the epidemiologic triangle as it relates to the communicable disease you have selected. Include the host factors, agent factors (presence or absence), and environmental factors.
Identify any special considerations or notifications for the epidemiologic triangle (community, schools, or general population).
Explain the importance of demographic data to community health.
Describe the role of the community health nurse in primary, secondary, and tertiary prevention through tasks such as case finding, reporting, data collection, analysis, and follow-up. Provide an example of how Christian worldview can be integrated by a community health nurse when working with a population impacted by the communicable disease selected.
Identify at least one national agency or organization that addresses the communicable disease chosen and describe how the organizations contribute to resolving or reducing the impact of disease.
Discuss a global implication of the disease. How is this addressed in other countries or cultures? Is this disease endemic to a particular area? Provide an example.
A minimum of three peer-reviewed or professional references (i.e., professional health organizations like CDC, WHO, OSHA, DHS) is required.
Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center.
This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.
You are required to submit this assignment to LopesWrite. A link to the LopesWrite technical support articles is located in Course Resources if you need assistance.
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Epidemiology Paper – Rubric
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Rubric Criteria
Total125 points
| Criterion | 1. Unsatisfactory | 2. Insufficient | 3. Approaching | 4. Acceptable | 5. Target |
|---|---|---|---|---|---|
| Description of Communicable Disease
Description of the chosen communicable disease, including causes, symptoms, mode of transmission, complications, treatment, and the demographic of interest. |
0 points
Description of the chosen communicable disease, including causes, symptoms, mode of transmission, complications, treatment, and the demographic of interest, is not present. |
6.56 points
Description of the chosen communicable disease, including causes, symptoms, mode of transmission, complications, treatment, and the demographic of interest, is present, but lacks detail. |
6.91 points
Description of the chosen communicable disease, including causes, symptoms, mode of transmission, complications, treatment, and the demographic of interest, is present. |
7.79 points
Description of the chosen communicable disease, including causes, symptoms, mode of transmission, complications, treatment, and the demographic of interest, is detailed. |
8.75 points
Description of the chosen communicable disease, including causes, symptoms, mode of transmission, complications, treatment, and the demographic of interest, is thorough. |
| Reportable Disease
Explanation about why the disease is reportable, including details about reporting time, whom to report to, etc. |
0 points
Explanation about why the disease is reportable, including details about reporting time, whom to report to, etc., is not present. |
6.56 points
Explanation about why the disease is reportable, including details about reporting time, whom to report to, etc., is present, but lacks detail. |
6.91 points
Explanation about why the disease is reportable, including details about reporting time, whom to report to, etc., is present. |
7.79 points
Explanation about why the disease is reportable, including details about reporting time, whom to report to, etc., is detailed. |
8.75 points
Explanation about why the disease is reportable, including details about reporting time, whom to report to, etc., is thorough. |
| Social Determinants of Health
Description of the social determinants of health and how those factors contribute to the development of the chosen communicable disease. |
0 points
Description of the social determinants of health and how those factors contribute to the development of the chosen communicable disease is not present. |
7.5 points
Description of the social determinants of health and how those factors contribute to the development of the chosen communicable disease is present, but lacks detail. |
7.9 points
Description of the social determinants of health and how those factors contribute to the development of the chosen communicable disease is present. |
8.9 points
Description of the social determinants of health and how those factors contribute to the development of the chosen communicable disease is detailed. |
10 points
Description of the social determinants of health and how those factors contribute to the development of the chosen communicable disease is thorough. |
| Epidemiologic Triangle
Discussion of the epidemiologic triangle as it relates to the communicable disease selected, including the host factors, agent factors, and environmental factors. |
0 points
Discussion of the epidemiologic triangle as it relates to the communicable disease selected, including the host factors, agent factors, and environmental factors, is not present. |
7.5 points
Discussion of the epidemiologic triangle as it relates to the communicable disease selected, including the host factors, agent factors, and environmental factors, is present, but lacks detail. |
7.9 points
Discussion of the epidemiologic triangle as it relates to the communicable disease selected, including the host factors, agent factors, and environmental factors, is present. |
8.9 points
Discussion of the epidemiologic triangle as it relates to the communicable disease selected, including the host factors, agent factors, and environmental factors, is detailed. |
10 points
Discussion of the epidemiologic triangle as it relates to the communicable disease selected, including the host factors, agent factors, and environmental factors, is thorough. |
| Special Considerations or Notifications
Identification of any special considerations or notifications for the community, schools, or general population. |
0 points
Identification of any special considerations or notifications for the community, schools, or general population is not present. |
7.5 points
Identification of any special considerations or notifications for the community, schools, or general population is present, but lacks detail. |
7.9 points
Identification of any special considerations or notifications for the community, schools, or general population is present. |
8.9 points
Identification of any special considerations or notifications for the community, schools, or general population is detailed. |
10 points
Identification of any special considerations or notifications for the community, schools, or general population is thorough. |
| Importance of Demographic Data
Explanation of the importance of demographic data to community health. |
0 points
Explanation of the importance of demographic data to community health is not present. |
7.5 points
Explanation of the importance of demographic data to community health is present, but lacks detail. |
7.9 points
Explanation of the importance of demographic data to community health is present. |
8.9 points
Explanation of the importance of demographic data to community health is detailed. |
10 points
Explanation of the importance of demographic data to community health is thorough. |
| Role of the Community Health Nurse
Description of the role of the community health nurse in primary, secondary, and tertiary prevention through tasks such as case finding, reporting, data collection and analysis, and follow-up, including examples of how Christian worldview can be integrated. |
0 points
Description of the role of the community health nurse in primary, secondary, and tertiary prevention through tasks such as case finding, reporting, data collection and analysis, and follow-up, including examples of how Christian worldview can be integrated is not present. |
7.5 points
Description of the role of the community health nurse in primary, secondary, and tertiary prevention through tasks such as case finding, reporting, data collection and analysis, and follow-up, including examples of how Christian worldview can be integrated is present, but lacks detail. |
7.9 points
Description of the role of the community health nurse in primary, secondary, and tertiary prevention through tasks such as case finding, reporting, data collection and analysis, and follow-up, including examples of how Christian worldview can be integrated is present. |
8.9 points
Description of the role of the community health nurse in primary, secondary, and tertiary prevention through tasks such as case finding, reporting, data collection and analysis, and follow-up, including examples of how Christian worldview can be integrated is detailed. |
10 points
Description of the role of the community health nurse in primary, secondary, and tertiary prevention through tasks such as case finding, reporting, data collection and analysis, and follow-up, including examples of how Christian worldview can be integrated is thorough. |
| National Agency or Organization that Addresses the Disease
Identification of at least one national agency or organization that addresses the communicable disease chosen, including a description about how the organizations contribute to resolving or reducing the impact of disease. |
0 points
Identification of at least one national agency or organization that addresses the communicable disease chosen, including a description about how the organizations contribute to resolving or reducing the impact of disease, is not present. |
7.5 points
Identification of at least one national agency or organization that addresses the communicable disease chosen, including a description about how the organizations contribute to resolving or reducing the impact of disease, is present, but lacks detail. |
7.9 points
Identification of at least one national agency or organization that addresses the communicable disease chosen, including a description about how the organizations contribute to resolving or reducing the impact of disease, is present. |
8.9 points
Identification of at least one national agency or organization that addresses the communicable disease chosen, including a description about how the organizations contribute to resolving or reducing the impact of disease, is detailed. |
10 points
Identification of at least one national agency or organization that addresses the communicable disease chosen, including a description about how the organizations contribute to resolving or reducing the impact of disease, is thorough. |
| Global Implications
Discussion of a global implication of the chosen communicable disease, including how these are addressed in other countries or cultures. |
0 points
Discussion of a global implication of the chosen communicable disease, including how these are addressed in other countries or cultures, is thorough. |
7.5 points
Discussion of a global implication of the chosen communicable disease, including how these are addressed in other countries or cultures, is present, but lacks detail. Limited examples provided. |
7.9 points
Discussion of a global implication of the chosen communicable disease, including how these are addressed in other countries or cultures, is present. Examples provided. |
8.9 points
Discussion of a global implication of the chosen communicable disease, including how these are addressed in other countries or cultures, is detailed. Relevant examples provided. |
10 points
Discussion of a global implication of the chosen communicable disease, including how these are addressed in other countries or cultures, is thorough. Specific and relevant examples provided. |
| Thesis, Position, or Purpose
Communicates reason for writing and demonstrates awareness of audience. |
0 points
The thesis, position, or purpose is not discernible. No awareness of the appropriate audience is evident. |
6.56 points
The thesis, position, or purpose is unfocused or confused. There is very little awareness of the intended audience. |
6.91 points
The thesis, position, or purpose is discernable in most aspects but is occasionally weak or unclear. There is limited awareness of the appropriate audience. |
7.79 points
The thesis, position, or purpose is adequately presented. An awareness of the appropriate audience is demonstrated. |
8.75 points
The thesis, position, or purpose is clearly communicated throughout and clearly directed to a specific audience. |
| Development, Structure, and Conclusion
Advances position or purpose throughout writing; conclusion aligns to and evolves from development. |
0 points
No advancement of the thesis, position, or purpose is evident. Connections between paragraphs are missing or inappropriate. No conclusion is offered. |
6.56 points
Writing lacks logical progression of the thesis, position, or purpose. Some organization is attempted, but ideas are disconnected. Conclusion is unclear and not supported by the overall development of the purpose. |
6.91 points
Limited advancement of thesis, position, or purpose is discernable. There are inconsistencies in organization or the relationship of ideas. Conclusion is simplistic and not fully aligned to the development of the purpose. |
7.79 points
The thesis, position, or purpose is advanced in most aspects. Ideas clearly build on each other. Conclusion aligns to the development of the purpose. |
8.75 points
The thesis, position, or purpose is logically advanced throughout. The progression of ideas is coherent and unified. A clear and logical conclusion aligns to the development of the purpose. |
| Evidence
Selects and integrates evidence to support and advance position/purpose; considers other perspectives. |
0 points
Evidence to support the thesis, position, or purpose is absent. The writing relies entirely on the perspective of the writer. |
5.63 points
Evidence is limited or irrelevant. The interpretation of other perspectives is superficial or incorrect. |
5.93 points
Evidence is used but is insufficient or of limited relevance. Simplistic explanation or integration of other perspectives is present. |
6.68 points
Relevant evidence that includes other perspectives is used. |
7.5 points
Specific and appropriate evidence is included. Relevant perspectives of others are clearly considered. |
| Mechanics of Writing
Includes spelling, capitalization, punctuation, grammar, language use, sentence structure, etc. |
0 points
Errors in grammar or syntax are pervasive and impede meaning. Incorrect language choice or sentence structure errors are found throughout. |
5.63 points
Frequent and repetitive mechanical errors are present. Inconsistencies in language choice or sentence structure are recurrent. |
5.93 points
Occasional mechanical errors are present. Language choice is generally appropriate. Varied sentence structure is attempted. |
6.68 points
Few mechanical errors are present. Suitable language choice and sentence structure are used. |
7.5 points
No mechanical errors are present. Appropriate language choice and sentence structure are used throughout. |
| Format/Documentation
Uses appropriate style, such as APA, MLA, etc., for college, subject, and level; documents sources using citations, footnotes, references, bibliography, etc., appropriate to assignment and discipline. |
0 points
Appropriate format is not used. No documentation of sources is provided. |
3.75 points
Appropriate format is attempted, but some elements are missing. Frequent errors in documentation of sources are evident. |
3.95 points
Appropriate format and documentation are used, although there are some obvious errors. |
4.45 points
Appropriate format and documentation are used with only minor errors. |
5 points
No errors in formatting or documentation are present. |
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