Background Information

Question 1

What is the largest cause of child deaths globally?

Answer 1

Globally, infectious diseases, including acute respiratory infections, diarrhoea and malaria, along with pre-term birth complications, birth asphyxia and trauma and congenital anomalies remain the leading causes of death for children under 5.

In 2010 accounted for > 11 million deaths per year in LMICs.

https://www.who.int/data/gho/data/themes/topics/topic-details/GHO/child-mortality-and-causes-of-death

Question 2

What are the three main causes of communicable disease deaths in children and adolescents globally?

Answer 2

Enteric infections, lower-respiratory-tract infections and malaria accounted for 59·8% of the global communicable disease burden in children and adolescents, with tuberculosis and HIV both emerging as important causes during adolescence.

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(23)00860-7/fulltext

Question 3

What are the 8 reasons for why communicable diseases are still a significant public health issue in high-income countries.

Answer 3

1. **Globalisation **(rapid global spread e.g. COVID-19)
2. Re-emergence of old scourges (e.g. TB, measles)
3. Novel infections (e.g. SARS, COVID-19)
4. Evolution of existing pathogens leading to new risks (e.g. zoonotic disease threats, pandemic influenzas)
5. Resistance to therapeutic agents
6. Hospital acquired infections (e.g. MRSA)
7. Burden on long-term conditions (e.g. HIV/AIDS)
8. **Viral cause of certain cancers **(e.g. cervical cancer)

Question 4

Define: incubation period

Answer 4

Also called ‘subclinical period’. Time between infection and onset of symptoms. Duration may be affected by infecting dose.

Assists to determine when infection occurred and duration of follow-up or exclusion of contacts

Question 5

Define: latent period

Answer 5

Time between infection and beginning of infectiousness.

Typically shorter than the incubation period i.e. meaning there is a period of subclinical infectiousness.

Question 6

Define: infectious period

Answer 6

The period during which a case is infectious.

Useful to identify exposed contacts.

Question 7

Reveal to see the image of the infectious, latent, incubation periods.

Answer 7

https://www.researchgate.net/figure/Key-time-periods-of-COVID-19-infection-the-latent-or-exposed-period-before-the-onset-of_fig2_346194172

Question 8

What is the mnemonic for CD outbreak framework?

Answer 8

Intro - BUPF

8 Cs
* Context - TCCRRRETM
* Convene - team, stakeholders
* Confirm - O>E, artefacts
* Case definition - tppl
* Collect data - case report form, active, epi
* Control - cases, contacts, community, env
* Communicate - CHO, media, case/contact
* Conclude - monitor, report, debrief

Question 9

Which communicable diseases use Post-exposure Prophylaxis (PEP)?

Answer 9

Anthrax - vaccine, ABx
Diphtheria - DTP + ABx
Measles - immunoglobulin, vaccination
HIV - HAART
Hep A - immunoglobulin, vaccination
Hep B - immunoglobulin, vaccination
iGAS - ABx
IMD - ABx
Pertussis - ABx
Plague - ABx
Rabies/lyssavirus - HRIG, vaccination
Tetanus - tetanus immunoglobulin, DTP vaccine
Varicella zoster - immunoglobulin, vaccination

Question 10

What is required for the CMO to declare a CDINS?

Answer 10

A communicable disease threat or outbreak with the potention to:

1. overwhelm capacity of affected jurisdiction to manage the incident
2. affect multiple jurisductions
3. scale/potential severy to require national coordination
4. cause public concern

Question 11

What is the national incident centre (NIC)?

Answer 11

Department of Health and Aged Care’s emergency response centre.

Coordinates national responses to health emergencies by organising response and recovery operations between:
* Australian Government, and S/T government health authorities
* other Commonwealth operations centres
* the international health community.

Question 12

When is the NIC activated?

Answer 12

Activated by the CMO when a significant event or emerging threat is identified. E.g:

• CD outreaks, such as pandemic
• chemical, biological or radiological incidents
• earthquakes or floods causing mass casualties
• emergencies requiring deployment of Australian medical personnel

Examples of when activated: JEV 2022, Mpox 2022, COVID-19 pandemic, White Island volcano 2019, National bushfire crisis 2019, Measles outbreak Samoa 2019, QLD/VIC floods 2011, Tropical Cyclone Yasi 2011, Christchurch earthquake 2011, Pakistan floods 2010, Pacific tsunami 2009

Question 13

What is an easy way to remember which diseases have a CDNA SoNG?

Answer 13

“Very Risky Bugs Might Cause Serious Global Threats”

(Vaccine-preventable, Respiratory, Bloodborne/STIs, Mosquito/zoonotic, Critical/emerging, Gastrointestinal, Toxins/Invasive)

Question 14

Which disease require active monitoring of contacts?

Answer 14

Typically required for high-consequence infectious diseases:

• Viral haemorrhagic fevers (e.g. Ebola, Marburg, Lassa) - high mortality
• Resp disease of pandemic potential (e.g. SARS, MERS, novel influenza) - rapid asymptomatic transmission; potential for widespread outbreaks
• Other zoonotic / emerging infectious diseases (e.g. mpox, plague) - risk of human-to-human spread, especially in close contact or healthcare settings
• Bacterial diseases (e.g. IMD, Diphtheria) - potential for rapid spread in crowded or close-contact environments
• TB - selective active monitoring (e.g. household or congregate settings)

Question 15

Which disease have elimination status in Australia?

Answer 15

Measles, polio, rubella