Annals of SBV

labour Induction. The American Journal Of Maternal /Child

• In case of uterine hyperstimulation appropriate Nursing. 2007.(Dec;2007).
and timely intervention6. 8. Jayne klossner N. Introductory maternity nursing . Philadelphia :
• Continuous monitoring of women with lippincott williams and wilkins ;2006. P 255-257.
partograph8. 9. Adele pillitteri . maternal and child health nursing care of the Emerging and re-emerging disease
• Check pre induction score. child bearing and child rearing family. 5th edition Lippincott
2007 .p564
• Documentation of indications for induction Elavarasi.R, ArunaDevi. M, Ruma Shanthini.K, Guna.S *
10. Deitra leonard lowdermilk . maternity and womens health
of labour4. care 9th edition . Missouri; Elsevier ;2007. P 947-951
• Monitor the women with cardiotocography. 11. Marie Elizabeth . midwifery for nurses 1st edition New
• Assessment of the progress of labour22. Delhi: CBS publishers ; 2010 . P 283-86 Abstract
• The nurse should be able to give support and 12. Susan mattson . core curricullam for materal and newborn
encouragement to the woman to help her cope nursing. 3rd edition Philadelphia; Elsevier : 2004 . P 290 The spectrum of infectious disease is changing rapidly in conjunction with dramatic societal and environmental
13. Shirish sheth. Essential of obstetrics. 1st edition New Dehi
with the contractions, and appropriate pain :jaypee brothers ; 2004 . p 274-80
changes. Worldwide, explosive population growth with expanding poverty and urban migration is occurring;
relief should be available if it is required17. 14. Helen varney. Nurse midwifery. London : jones and bartlette international travel and commerce are increasing; and technology is rapidly changing, all of which affect
• Good communication between the team ublishers ; 1987 . p 201 the risk of exposure to infectious agents. Infectious diseases are emerging, re-emerging, and increasing in
members. 15. Shela balakrisnan . textbook of onstetrics 2nd edition the United States, taking a toll in both morbidity and mortality. A major cause of the emergence of new
Hyderabad ; paras medical publishers . 2013 . p558-563. diseases is environmental change (for example, human encroachment into wilderness areas and increased
16. Yurtsever S. Labor Induction.2013. human traffic through previously isolated areas). The re-emergence of some diseases can be explained
17. Bukola F.Unmet need for Induction of Labor in Africa:
Conclusion: secondary analysis 2012.(Aug 31,2012).
by evolution of the infectious agent (for example, mutations in bacterial genes that confer resistance to
18. David Rakel. Reproduction (2012) .p25 antibiotics used to treat the diseases). In partnership with representatives from health departments, other
Labor induction appears to be a safe alternative 19. Mackenzie IZ. Reproduction. 2006. ( June 1 2006). P34. federal agencies, medical and public health professional associations, and international organizations has
to spontaneous labor. Regardless of the method 20. Induction of Labor:Balancing risk.2015 sep;16 .p320 developed a strategic plan to address emerging infectious disease threats. The plan contains four goals
employed, it is essential that the patient and her 21. National guideline clearing house. Induction of Labor.2010 that emphasize surveillance, applied research, prevention and control, and public health infrastructure.
obstetrician understand the rationale for inducing Nov.(Revised 2014 March).. To ensure sustainability, plan implementation will be approached in stages, as a long-term endeavor with
22. Lawani OL.Obstetric outcome and significance of Labor
labor, the risks of the method chosen, and the options induction: The new England Journal of Medicine.2014 (Dec;
emphasis on extramural programs. As health-care reform proceeds priority should be given to strengthening
that will be considered in case of failed induction. 16 ). partnerships between health-care providers, microbiologists, and public health professionals to detect and
The goal of labor induction must always be to ensure 23. Andrew M Kaunitz , Luis Sanchez. Induction of labour. control emerging and re-emerging infectious diseases.
the best possible outcome for mother and newborn23. 2012.p225
Practitioners need to apply clinical judgement and 24. Induction of Labor-Post dates Pregnancy. The new England Key words: emerging, environment, infectious disease
evidence-based medicine to justify that induction is Journal Medicine.
25. Walker KF.Induction of Labor; Advanced maternal age;
superior to continuation of pregnancy. The benefit Perinatal outcome. 2012 Dec;11
of induction over the continuation of a pregnancy is 26. Robin Weiss. Ways to induce Labor :medically.1990.
not always clear, but there are some tools to evaluate Introduction Emerging & Re-emerging zoonotic diseases, food
the likelihood of a successful vaginal delivery24,25. borne and waterborne diseases & diseases caused by
In particular, perinatal nurses have a wide array of Infectious diseases are dominant public health multi resistant organism constitute the major threats
skills useful to laboring women’s comfort and coping problem even in the 21st Century and world’s in India. In the first half of 2014, Ebola caused over
that can be further developed through maintaining leading cause of death for children and adolescents. 200 deaths in West Africa and over 500 people
normal physiologic processes without unnecessary WHO estimates 25% of the total 57 million annual contracted Middle East Respiratory Syndrome
technologic interference. deaths that occur worldwide are caused by microbes (MERS).2 There were more than 145 fatal cases of
and this proportion is significantly higher in the MERS.
References: developing country1. In 1997, WHO formulated
world health day theme focusing on these issue as There has been a remarkable progress in the
1. Labour induction : The low down on natural approaches “Emerging Infectious Diseases- Global Alert: prevention, control and even eradication of infectious
from a midwife .2013Aug;27.
2. Andrew Kim, Jefferson H, Harman. Current trends in
Global Response”8 diseases (Smallpox) with improved hygiene &
cervical ripening and Labor induction.1999.(Aug 1 1999). development of antimicrobials and vaccines.
3. Abigail H Natenson .Inducing labour at home:Is it right The burden of morbidity and mortality associated However, tragically, with optimism came a false
for you. with infectious diseases falls most heavily on people sense of security, which has helped many diseases
4. Elizabeth Johnson eparsoneault .Elective induction of labour in developing countries, and particularly on infants to spread with alarming speed.2
and early term delivery. and children (about three million children die each
5. Lisa Hanson, Leona Vandeuesse. Supporting Labour
Progress towards Physiologic Birth . Journal of Perinatal &
year from malaria and diarrheal diseases alone)4.
Neonatal Nursing. June 2014.Vol 28. P101-107.
6. Debiani arora. 12 ways to induce labour naturally .2014 Dec; * R.Elavarasi, ArunaDevi.M Ruma Shanthini.K, Guna.S Asst.Professors., Dept. of Community Health
09. Nursing, KGNC, Puducherry 607402, India.
7. Katheen Rice Simpson. Perinatal Patient Safety: Elective

Page 58 Ann. SBV, Jan-June2015;4(1) Ann. SBV, Jan-June2015;4(1) Page 59

 Annals of SBV Emerging and re-emerging disease

Emerging Diseases: Hemorrhagic 2003 Corona virus SARS Disease Infectious Agent Contr ibuting
1977 Hantaan virus fever with renal Factors
The term “emerging infectious diseases” refers to syndrome(HFRS) viral genome
diseases of infectious origin whose incidence in Pandemic mutation
humans either has increased within the past two 1980 HTLV-1 T-cell lymphoma- 2009 H1N1 A(H1N1) 2009 enabled
decades or threatens to increase in the near future. luekemia influenza infection of
Chikungunya Chikungunya virus new mosquito
They are caused by a newly evolved organism or 1982 E coli O157:H7 HUS The emerging infectious diseases account for 26 per vectors and
an organism that has undergone a mutation resulting cent of annual deaths worldwide. Nearly 30 per cent expanded
in a new strain; they may result from the introduction 1982 Borrelia Lyme disease of 1.49 billion disability-adjusted life years (DALYs) transmission
of the organism to humans from another species; or burgdoferi are lost every year to diseases of infectious origin.4
they may result from dissemination of the organism evolution of
from its existence in a small, circumscribed range of 1982 HTLV-2 Hairy cell Re-Emerging Disease: new strain
infection (which may not even be apparent or cause leukemia of bacteria
only slight illness) to susceptible populations.6 “Re-emerging infectious diseases are those diseases Vibrio cholera 0139 combining
1983 HIV AIDS that once were major health problems globally or in Cholera (bacterium) increased
These include new, previously undefined diseases a particular country and then declined dramatically, virulence and
as well as old diseases with new features. These new 1983 H.Pylori Peptic ulcer but are again becoming health problems for a long-term
features may include the introduction of a disease disease significant proportion of the population” 2 survival in the
to a new location or a new population (e.g. it may environment
present in youth where previously it was only seen Bovine spongiform It often appear in epidemic proportions E.g.: TB,
in the elderly); new clinical features, including 1986 BSE agent encephalopathy in Cholera, Dengue, Malaria, H1N1 influenza, Ebola2 inadequate
resistance to available treatments; or a rapid increase cattle(Mad cow control in
in the incidence and spread of the disease. 14 disease) Re-emerging infectious diseases may occur Cryptosporidium water supply;
because of the development of resistance to Cryptosporidiosis parvum(protozoan) international
Examples of Emerging Infectious 1988 HHV- 6 Exanthemsubitum antimicrobial agents (as with gonorrhea), breakdown travel; increased
Diseases: in public health measures (as with tuberculosis), and use of child-care
Enterically other reasons. Also included under the umbrella of facilities
In the past 20 years, at least 30 new diseases have 1988 Hepatitis E virus transmitted emerging infectious diseases are agents that already
emerged to threaten the health of hundreds of non-A, non-B existed and were widespread in humans but are urbanization,
millions of people. hepatitis newly recognized (e.g., herpes virus 6, now known international
to cause roseola) and association of an infectious Dengue Fever Dengue Virus travel, and
Year Agent Disease Parentally agent with a chronic illness (e.g., Helicobacter pylori inadequate
identified 1989 Hepatitis C virus transmitted and peptic ulcer disease).15 vector-control
non-A, non-B measures
1973 Rota virus Infantile diarrhea hepatitis The re-emergence of some diseases can be
explained by the failure to immunize enough Corynebacterium interruption of
Aplastic crisis in Vibrio cholera O New strain individuals, which results in a greater proportion Diphtheria diptheriae(bacterium) immunization
program due
1975 Parvovirus chronic hemolytic 1992 139 associated with of susceptible individuals in a population and an to political
anemia epidemic cholera increased reservoir of the infectious agent. Increases changes
in the number of individuals with compromised
1976 cryptosporidium Acute and chronic 1992 Bartonella Cat scratch immune systems (due to the stress of famine, war, living close to
diarrhea henselae diseases crowding, or disease) also explain increases in the H5N1 influenza influenza H5N1 H5N1-infected
incidence of emerging and re-emerging infectious virus poultry
Ebola hemorrragic Association with diseases.18
1977 Ebola virus fever 1995 HHV-8 kaposi’s sarcoma in drug resistance;
AIDS patients The disease in question involves all the major Plasmodium favorable
Malaria
Legionella Legionnaries’ modes of transmission i.e. spread either from species (protozoan) conditions for
1977 pneumophillia disease 1996 Prion CJD person to person, by insects or animals or through mosquito vector
contaminated water or food.22
1997 Influenza A Avian fly(bird flu)
virus(H5N1)

Page 60 Ann. SBV, Jan-June2015;4(1) Ann. SBV, Jan-June2015;4(1) Page 61

 Annals of SBV Emerging and re-emerging disease

Emerging Diseases: Hemorrhagic 2003 Corona virus SARS Disease Infectious Agent Contr ibuting
1977 Hantaan virus fever with renal Factors
The term “emerging infectious diseases” refers to syndrome(HFRS) viral genome
diseases of infectious origin whose incidence in Pandemic mutation
humans either has increased within the past two 1980 HTLV-1 T-cell lymphoma- 2009 H1N1 A(H1N1) 2009 enabled
decades or threatens to increase in the near future. luekemia influenza infection of
Chikungunya Chikungunya virus new mosquito
They are caused by a newly evolved organism or 1982 E coli O157:H7 HUS The emerging infectious diseases account for 26 per vectors and
an organism that has undergone a mutation resulting cent of annual deaths worldwide. Nearly 30 per cent expanded
in a new strain; they may result from the introduction 1982 Borrelia Lyme disease of 1.49 billion disability-adjusted life years (DALYs) transmission
of the organism to humans from another species; or burgdoferi are lost every year to diseases of infectious origin.4
they may result from dissemination of the organism evolution of
from its existence in a small, circumscribed range of 1982 HTLV-2 Hairy cell Re-Emerging Disease: new strain
infection (which may not even be apparent or cause leukemia of bacteria
only slight illness) to susceptible populations.6 “Re-emerging infectious diseases are those diseases Vibrio cholera 0139 combining
1983 HIV AIDS that once were major health problems globally or in Cholera (bacterium) increased
These include new, previously undefined diseases a particular country and then declined dramatically, virulence and
as well as old diseases with new features. These new 1983 H.Pylori Peptic ulcer but are again becoming health problems for a long-term
features may include the introduction of a disease disease significant proportion of the population” 2 survival in the
to a new location or a new population (e.g. it may environment
present in youth where previously it was only seen Bovine spongiform It often appear in epidemic proportions E.g.: TB,
in the elderly); new clinical features, including 1986 BSE agent encephalopathy in Cholera, Dengue, Malaria, H1N1 influenza, Ebola2 inadequate
resistance to available treatments; or a rapid increase cattle(Mad cow control in
in the incidence and spread of the disease. 14 disease) Re-emerging infectious diseases may occur Cryptosporidium water supply;
because of the development of resistance to Cryptosporidiosis parvum(protozoan) international
Examples of Emerging Infectious 1988 HHV- 6 Exanthemsubitum antimicrobial agents (as with gonorrhea), breakdown travel; increased
Diseases: in public health measures (as with tuberculosis), and use of child-care
Enterically other reasons. Also included under the umbrella of facilities
In the past 20 years, at least 30 new diseases have 1988 Hepatitis E virus transmitted emerging infectious diseases are agents that already
emerged to threaten the health of hundreds of non-A, non-B existed and were widespread in humans but are urbanization,
millions of people. hepatitis newly recognized (e.g., herpes virus 6, now known international
to cause roseola) and association of an infectious Dengue Fever Dengue Virus travel, and
Year Agent Disease Parentally agent with a chronic illness (e.g., Helicobacter pylori inadequate
identified 1989 Hepatitis C virus transmitted and peptic ulcer disease).15 vector-control
non-A, non-B measures
1973 Rota virus Infantile diarrhea hepatitis The re-emergence of some diseases can be
explained by the failure to immunize enough Corynebacterium interruption of
Aplastic crisis in Vibrio cholera O New strain individuals, which results in a greater proportion Diphtheria diptheriae(bacterium) immunization
program due
1975 Parvovirus chronic hemolytic 1992 139 associated with of susceptible individuals in a population and an to political
anemia epidemic cholera increased reservoir of the infectious agent. Increases changes
in the number of individuals with compromised
1976 cryptosporidium Acute and chronic 1992 Bartonella Cat scratch immune systems (due to the stress of famine, war, living close to
diarrhea henselae diseases crowding, or disease) also explain increases in the H5N1 influenza influenza H5N1 H5N1-infected
incidence of emerging and re-emerging infectious virus poultry
Ebola hemorrragic Association with diseases.18
1977 Ebola virus fever 1995 HHV-8 kaposi’s sarcoma in drug resistance;
AIDS patients The disease in question involves all the major Plasmodium favorable
Malaria
Legionella Legionnaries’ modes of transmission i.e. spread either from species (protozoan) conditions for
1977 pneumophillia disease 1996 Prion CJD person to person, by insects or animals or through mosquito vector
contaminated water or food.22
1997 Influenza A Avian fly(bird flu)
virus(H5N1)

Page 60 Ann. SBV, Jan-June2015;4(1) Ann. SBV, Jan-June2015;4(1) Page 61

 Annals of SBV Emerging and re-emerging disease

Meningitis,
antibiotic-resistant monitoring systems to serve as part of the overall
Necrotizing
Fasciitis (Flesh- Group A Mycobacterium
pathogens;
immunocompromised
detection system.
Eating Disease), Streptococcus uncertain Tuberculosis Tuberculosis populations
(malnourished, HIV-
Toxic-Shock (bacterium) (Bacterium) infected, poverty • In addition to partnership in global monitoring,
Syndrome, And -stricken) WHO is working in countries to strengthen
Other Diseases complex national disease detection and response through
refusal to interactions improved surveillance systems, and specialized
vaccinate based between the training in epidemic preparedness and response.
on fears the virus, birds and • A final role of WHO in this partnership is to
vaccine is not other animals,
safe; other mosquitoes, help ensure a coordinated global response to
pertussis Bordetella West Nile
possible factors:
Encephalitis
West Nile Virus and the infectious diseases of international importance,
(whooping pertussis decreased environment; often with the technical expertise of the WHO
cough) (bacterium) vaccine efficacy emergence in
or waning U.S. and other Collaborating Centres or other centres of
immunity regions likely excellence9.
among due to global
vaccinated travel Global Initiative to Emerging Infectious Diseases:
adults WHO collaborating centres:
Polio (Infant insecticide
Poliovirus – resistance; “Emerging and re-emerging infections reflect The first global monitoring system is that of
Paralysis) yellow fever yellow fever virus
urbanization; the constant struggle of microorganisms to the WHO Collaborating Centres, specialized
breakdown in civil strife survive” Laboratories and institutions with expertise in
public health infectious disease diagnosis and epidemiology.
Rabies Rabies Virus measures; Factors in Emerging and Re-emerging • Establishment of the Division of Emerging and
changes in land
use; travel
Disease: other Communicable Diseases Surveillance and • Not able to fully respond to global needs.
Control (EMC), by WHO (1995)9 • Failed to keep up with changes in technology
Rift Valley
RVF Virus –
Factors that influence the emergence or re-emergence and were unable to provide the diagnostic
Fever (RVF) of infectious diseases include social and behavioral • Strengthen national and international capacity support necessary to confirm the etiology of
changes, climate changes, environmental alteration, in the surveillance and control of communicable disease outbreaks.
failure to
political upheaval, migration and transport, natural diseases, including those that represent new, • Not enough Collaborating Centres in
vaccinate;
Rubeola
Measles Virus failure to
disasters, travel, demographic shifts, the erosion of emerging and re-emerging public health developing countries to ensure regional self-
(Measles)
receive second public health infrastructure decreasing surveillance, problems, for which it ensures a timely and sufficiency10.
dose of vaccine prevention and control, decline in experts in areas effective response8.
of infectious diseases, economics, and health care International Health Regulations (IHR):
dam advances and technology20 Role of WHO:
construction; The International Health Regulations, or IHR
Schistosoma ecological The other factors also responsible for emergence and When a significant public health event takes place, (2005), represent an agreement between 196
Schistosomiasis
Species (Helminth) changes re-emergence of infectious diseases are: WHO’s comprehensive global alert and response countries including all WHO Member States to
favoring snail system ensures that information is available and work together for global health security.21 The IHR
host • Unplanned and under-planned urbanization response operations are coordinated effectively21. help countries to prevent, detect, inform about and
human • overcrowding and rapid population growth respond to public health events in facilitated.23
population • Poor sanitation The system includes the following functions:
movements into • Inadequate public health infrastructure Three diseases are covered by the IHR – cholera,
endemic areas • Resistance to antibiotics - Event-based surveillance, multi-hazard rapid risk plague and yellow fever.
due to political
conflict; • Increased exposure of humans to disease vectors assessment and event-based risk communications;
Trypanosomabrucei
Trypanosomiasis
(Protozoan)
diagnosis is and reservoirs of infection in nature Through International Health Regulations,
very difficult, • Rapid and intense international travel - Critical information and communications countries have agreed to build their capacities to
and current
treatments • Practice of modern medicine and relaxation in platforms for decision support; and detect, assess and report public health events. WHO
have severe immunization practices plays the coordinating role in IHR and, together
secondary • Deforestation - Operations and logistics platforms for any with its partners, helps countries to build capacities.
effects • Failure to control carriers or breakdown in WHO response to international public health risks21. It also includes specific measures at ports, airports
water and sanitation systems and ground crossings to limit the spread of health
• Changes in genetic makeup of the pathogen The World Health Organization, as one of the risks to neighboring countries, and to prevent
• High risk human behavior partners in this global effort, is strengthening global unwarranted travel and trade restrictions so that
• Channeling of funds to other problems7 traffic and trade disruption is kept to a minimum.21

Page 62 Ann. SBV, Jan-June2015;4(1) Ann. SBV, Jan-June2015;4(1) Page 63

 Annals of SBV Emerging and re-emerging disease

Meningitis,
antibiotic-resistant monitoring systems to serve as part of the overall
Necrotizing
Fasciitis (Flesh- Group A Mycobacterium
pathogens;
immunocompromised
detection system.
Eating Disease), Streptococcus uncertain Tuberculosis Tuberculosis populations
(malnourished, HIV-
Toxic-Shock (bacterium) (Bacterium) infected, poverty • In addition to partnership in global monitoring,
Syndrome, And -stricken) WHO is working in countries to strengthen
Other Diseases complex national disease detection and response through
refusal to interactions improved surveillance systems, and specialized
vaccinate based between the training in epidemic preparedness and response.
on fears the virus, birds and • A final role of WHO in this partnership is to
vaccine is not other animals,
safe; other mosquitoes, help ensure a coordinated global response to
pertussis Bordetella West Nile
possible factors:
Encephalitis
West Nile Virus and the infectious diseases of international importance,
(whooping pertussis decreased environment; often with the technical expertise of the WHO
cough) (bacterium) vaccine efficacy emergence in
or waning U.S. and other Collaborating Centres or other centres of
immunity regions likely excellence9.
among due to global
vaccinated travel Global Initiative to Emerging Infectious Diseases:
adults WHO collaborating centres:
Polio (Infant insecticide
Poliovirus – resistance; “Emerging and re-emerging infections reflect The first global monitoring system is that of
Paralysis) yellow fever yellow fever virus
urbanization; the constant struggle of microorganisms to the WHO Collaborating Centres, specialized
breakdown in civil strife survive” Laboratories and institutions with expertise in
public health infectious disease diagnosis and epidemiology.
Rabies Rabies Virus measures; Factors in Emerging and Re-emerging • Establishment of the Division of Emerging and
changes in land
use; travel
Disease: other Communicable Diseases Surveillance and • Not able to fully respond to global needs.
Control (EMC), by WHO (1995)9 • Failed to keep up with changes in technology
Rift Valley
RVF Virus –
Factors that influence the emergence or re-emergence and were unable to provide the diagnostic
Fever (RVF) of infectious diseases include social and behavioral • Strengthen national and international capacity support necessary to confirm the etiology of
changes, climate changes, environmental alteration, in the surveillance and control of communicable disease outbreaks.
failure to
political upheaval, migration and transport, natural diseases, including those that represent new, • Not enough Collaborating Centres in
vaccinate;
Rubeola
Measles Virus failure to
disasters, travel, demographic shifts, the erosion of emerging and re-emerging public health developing countries to ensure regional self-
(Measles)
receive second public health infrastructure decreasing surveillance, problems, for which it ensures a timely and sufficiency10.
dose of vaccine prevention and control, decline in experts in areas effective response8.
of infectious diseases, economics, and health care International Health Regulations (IHR):
dam advances and technology20 Role of WHO:
construction; The International Health Regulations, or IHR
Schistosoma ecological The other factors also responsible for emergence and When a significant public health event takes place, (2005), represent an agreement between 196
Schistosomiasis
Species (Helminth) changes re-emergence of infectious diseases are: WHO’s comprehensive global alert and response countries including all WHO Member States to
favoring snail system ensures that information is available and work together for global health security.21 The IHR
host • Unplanned and under-planned urbanization response operations are coordinated effectively21. help countries to prevent, detect, inform about and
human • overcrowding and rapid population growth respond to public health events in facilitated.23
population • Poor sanitation The system includes the following functions:
movements into • Inadequate public health infrastructure Three diseases are covered by the IHR – cholera,
endemic areas • Resistance to antibiotics - Event-based surveillance, multi-hazard rapid risk plague and yellow fever.
due to political
conflict; • Increased exposure of humans to disease vectors assessment and event-based risk communications;
Trypanosomabrucei
Trypanosomiasis
(Protozoan)
diagnosis is and reservoirs of infection in nature Through International Health Regulations,
very difficult, • Rapid and intense international travel - Critical information and communications countries have agreed to build their capacities to
and current
treatments • Practice of modern medicine and relaxation in platforms for decision support; and detect, assess and report public health events. WHO
have severe immunization practices plays the coordinating role in IHR and, together
secondary • Deforestation - Operations and logistics platforms for any with its partners, helps countries to build capacities.
effects • Failure to control carriers or breakdown in WHO response to international public health risks21. It also includes specific measures at ports, airports
water and sanitation systems and ground crossings to limit the spread of health
• Changes in genetic makeup of the pathogen The World Health Organization, as one of the risks to neighboring countries, and to prevent
• High risk human behavior partners in this global effort, is strengthening global unwarranted travel and trade restrictions so that
• Channeling of funds to other problems7 traffic and trade disruption is kept to a minimum.21

Page 62 Ann. SBV, Jan-June2015;4(1) Ann. SBV, Jan-June2015;4(1) Page 63

 Annals of SBV Emerging and re-emerging disease

CDC’s Plan to Prevent Emerging Objectives support for early detection, confirmation and • Maintain awareness of unusual disease clusters,
Infectious Diseases: communication.12,22 outbreaks, or illnesses, and be especially alert for
• Enhance epidemiologic and laboratory capacity. unexplained deaths in young people.
CDC will implement the plan in coordination with: • Improve CDC’s ability to communicate Community Health Nurse in Action: • Institute or participate in immunization
electronically with state and local health programs for adults and children, educate
• State and local health departments (for departments, health-care professionals, and Community health nurse plays an important role in patients about the importance of immunization,
surveillance) others. the prevention of emerging and re-emerging diseases and facilitate access to and availability of
• Academic centers and other federal agencies • Enhance the nation’s capacity to respond and in the care of persons and families who have immunizations for those who need it.
(for research) to complex infectious disease threats such diseases, it include, • Use techniques to enhance client adherence
• Health-care providers and organizations (for the internationally, including outbreaks that may 1. Support, interpret, and disseminate the to medication regimens to prevent treatment
development and dissemination of guidelines) result from bioterrorism. recommendations made by leading agencies. failure and development of microbial resistance.
• International organizations (for outbreak • Provide training opportunities in infectious 2. Collaborate with other professions and • Participate in environmental cleanliness
responses overseas)11. disease epidemiology and diagnosis throughout policymaking groups in mutual support, programs in the community and in the
the world19 endorsement, and evaluation of global institution; this can encompass such items as
Goals of CDC Plan: strategies to prevent or reduce the threat of adequate ventilation, air pollution, and basic
Prevention and Control: Emerging emerging microbial diseases. public health measures such as safe water,
1. Surveillance and Response Diseases 3. Communicate with other nursing groups and elimination of places where birds roost and
2. Applied research Objectives recommend that they develop and disseminate sources of standing water, and rodent control.
3. Infrastructure and Training to their own constituencies polices and • Examine prescribing practices to ensure
4. Prevention and control • Implement, support, and evaluate programs standards to prevent the spread of emerging appropriate use of appropriate antibiotics.
for the prevention and control of emerging infections. • Be an advocate for clients about environment.
Surveillance and response: infectious diseases. 4. Identify mechanisms to promote appropriate • Obtain thorough patient histories, including
Objectives • Develop, evaluate, and promote strategies to prescriptions and use of anti-microbial agents. an assessment of travel history, recreational
• Strengthen infectious disease surveillance and help health-care providers and other person’s 5. Address strategies to enhance host resistance activities, and potential
response. behaviors that facilitate disease transmission. and immune competence • Exposures in the workplace, home, and
• Improve methods for gathering and evaluating • Support and promote disease control and 6. Take leadership in major initiatives to focus community; for example manner in which
surveillance data. prevention internationally.20 on preventive strategies. workplace clothing in certain environments
• Ensure the use of surveillance data to improve 7. Serve as a clear voice among policy makers is handled can be important in transmitting
public health practice and medical treatment. Target Areas for the support of public health, advocating infections and toxins to the home.
• Strengthen global capacity to monitor and support for public education, public health • Assess diet practices (for example, the use of
respond to emerging infectious diseases.19 • Antimicrobial resistance infrastructure and policies that protect the unpasteurized milk) and teach clients about
• Foodborne and waterborne diseases environment and promote ecological balance.16 proper nutrition and food handling.
Applied Research: • Vector borne and zoonotic diseases • Promote breast-feeding in countries in which
• Diseases transmitted through blood transfusions there is a high risk of contamination of milk or
Research is essential in efforts to understand, or blood products Nurses may act to prevent or intervene include infant formula.
prevent, control, and respond to new and reemerging • Chronic diseases caused by infectious agents the following: • Train local people in health education and
infectious diseases. • Vaccine development and use practices with use of culturally acceptable and
Objectives • Diseases of persons with impaired host defenses • Educate clients about risks and personal locally accessible material and practices.17
• Diseases of pregnant women and newborns hygiene, which can include guarding against
• Develop, evaluate, and disseminate tools for • Diseases of travelers, immigrants, and tick exposure; cooking meat thoroughly and Role of research in prevention of emerging and
identifying and understanding emerging refugees.20,22 eating thoroughly cooked meat; using safer sex re-emerging diseases:
infectious diseases. techniques; washing one’s hands after using the • Reestablish extramural program to support
• Identify the behaviors, environments, and host toilet, changing diapers, or exposure to fecal emerging infectious disease prevention and
factors that put persons at increased risk for Prevention and control: Re emerging diseases matter; and appropriate use of antibiotics to control activities
infectious diseases and their sequelae. • Early diagnosis and prompt treatment decrease inappropriate use of over-the-counter • Initiate prevention effectiveness studies to assess
• Conduct research to develop and evaluate • Vector control measures &Prevention of drugs and inappropriate requests for antibiotics impact of food preparation guidelines.
prevention and control strategies in the target epidemics, for malaria from a provider. • To develop a comprehensive computerized
areas.19 • DOTS - for tuberculosis • Use of infection control procedures; it is infectious disease database.
• Research initiatives for treatment regimens and important that nurses have the ability to • Provide more funds to the health care
improved diagnostics, drugs and vaccines institute appropriate controls and to educate professionals on researches based on emerging
• Strengthening epidemiological surveillance patients, visitors, family, and personnel about diseases.
and drug-resistance surveillance mechanisms infection control and appropriate hand washing.
Infrastucture and Training: and procedures with appropriate laboratory

Page 64 Ann. SBV, Jan-June2015;4(1) Ann. SBV, Jan-June2015;4(1) Page 65

 Annals of SBV Emerging and re-emerging disease

CDC’s Plan to Prevent Emerging Objectives support for early detection, confirmation and • Maintain awareness of unusual disease clusters,
Infectious Diseases: communication.12,22 outbreaks, or illnesses, and be especially alert for
• Enhance epidemiologic and laboratory capacity. unexplained deaths in young people.
CDC will implement the plan in coordination with: • Improve CDC’s ability to communicate Community Health Nurse in Action: • Institute or participate in immunization
electronically with state and local health programs for adults and children, educate
• State and local health departments (for departments, health-care professionals, and Community health nurse plays an important role in patients about the importance of immunization,
surveillance) others. the prevention of emerging and re-emerging diseases and facilitate access to and availability of
• Academic centers and other federal agencies • Enhance the nation’s capacity to respond and in the care of persons and families who have immunizations for those who need it.
(for research) to complex infectious disease threats such diseases, it include, • Use techniques to enhance client adherence
• Health-care providers and organizations (for the internationally, including outbreaks that may 1. Support, interpret, and disseminate the to medication regimens to prevent treatment
development and dissemination of guidelines) result from bioterrorism. recommendations made by leading agencies. failure and development of microbial resistance.
• International organizations (for outbreak • Provide training opportunities in infectious 2. Collaborate with other professions and • Participate in environmental cleanliness
responses overseas)11. disease epidemiology and diagnosis throughout policymaking groups in mutual support, programs in the community and in the
the world19 endorsement, and evaluation of global institution; this can encompass such items as
Goals of CDC Plan: strategies to prevent or reduce the threat of adequate ventilation, air pollution, and basic
Prevention and Control: Emerging emerging microbial diseases. public health measures such as safe water,
1. Surveillance and Response Diseases 3. Communicate with other nursing groups and elimination of places where birds roost and
2. Applied research Objectives recommend that they develop and disseminate sources of standing water, and rodent control.
3. Infrastructure and Training to their own constituencies polices and • Examine prescribing practices to ensure
4. Prevention and control • Implement, support, and evaluate programs standards to prevent the spread of emerging appropriate use of appropriate antibiotics.
for the prevention and control of emerging infections. • Be an advocate for clients about environment.
Surveillance and response: infectious diseases. 4. Identify mechanisms to promote appropriate • Obtain thorough patient histories, including
Objectives • Develop, evaluate, and promote strategies to prescriptions and use of anti-microbial agents. an assessment of travel history, recreational
• Strengthen infectious disease surveillance and help health-care providers and other person’s 5. Address strategies to enhance host resistance activities, and potential
response. behaviors that facilitate disease transmission. and immune competence • Exposures in the workplace, home, and
• Improve methods for gathering and evaluating • Support and promote disease control and 6. Take leadership in major initiatives to focus community; for example manner in which
surveillance data. prevention internationally.20 on preventive strategies. workplace clothing in certain environments
• Ensure the use of surveillance data to improve 7. Serve as a clear voice among policy makers is handled can be important in transmitting
public health practice and medical treatment. Target Areas for the support of public health, advocating infections and toxins to the home.
• Strengthen global capacity to monitor and support for public education, public health • Assess diet practices (for example, the use of
respond to emerging infectious diseases.19 • Antimicrobial resistance infrastructure and policies that protect the unpasteurized milk) and teach clients about
• Foodborne and waterborne diseases environment and promote ecological balance.16 proper nutrition and food handling.
Applied Research: • Vector borne and zoonotic diseases • Promote breast-feeding in countries in which
• Diseases transmitted through blood transfusions there is a high risk of contamination of milk or
Research is essential in efforts to understand, or blood products Nurses may act to prevent or intervene include infant formula.
prevent, control, and respond to new and reemerging • Chronic diseases caused by infectious agents the following: • Train local people in health education and
infectious diseases. • Vaccine development and use practices with use of culturally acceptable and
Objectives • Diseases of persons with impaired host defenses • Educate clients about risks and personal locally accessible material and practices.17
• Diseases of pregnant women and newborns hygiene, which can include guarding against
• Develop, evaluate, and disseminate tools for • Diseases of travelers, immigrants, and tick exposure; cooking meat thoroughly and Role of research in prevention of emerging and
identifying and understanding emerging refugees.20,22 eating thoroughly cooked meat; using safer sex re-emerging diseases:
infectious diseases. techniques; washing one’s hands after using the • Reestablish extramural program to support
• Identify the behaviors, environments, and host toilet, changing diapers, or exposure to fecal emerging infectious disease prevention and
factors that put persons at increased risk for Prevention and control: Re emerging diseases matter; and appropriate use of antibiotics to control activities
infectious diseases and their sequelae. • Early diagnosis and prompt treatment decrease inappropriate use of over-the-counter • Initiate prevention effectiveness studies to assess
• Conduct research to develop and evaluate • Vector control measures &Prevention of drugs and inappropriate requests for antibiotics impact of food preparation guidelines.
prevention and control strategies in the target epidemics, for malaria from a provider. • To develop a comprehensive computerized
areas.19 • DOTS - for tuberculosis • Use of infection control procedures; it is infectious disease database.
• Research initiatives for treatment regimens and important that nurses have the ability to • Provide more funds to the health care
improved diagnostics, drugs and vaccines institute appropriate controls and to educate professionals on researches based on emerging
• Strengthening epidemiological surveillance patients, visitors, family, and personnel about diseases.
and drug-resistance surveillance mechanisms infection control and appropriate hand washing.
Infrastucture and Training: and procedures with appropriate laboratory

Page 64 Ann. SBV, Jan-June2015;4(1) Ann. SBV, Jan-June2015;4(1) Page 65

 Annals of SBV

4. Fauci AS. Infectious diseases: considerations for the 21st

• To receive support from national research century. Clin Infect Dis 2001; 32 : 675-85
agencies on control of vector, and environmental 5. Claire V. Broome, Emerging Infectious Diseases, Centers for
factors that lead to infectious disease emergence. Disease Control and Prevention, Atlanta, GA, USA, Vol. 4,
• Increase research on surveillance and control; No. 3, July–September 1998;358-59. Community mental health initiatives
costs and benefits of prevention, control and 6. Bhatia R, Narain JP, Plianbangchang S. Emerging infectious
diseases in East and South-East Asia. In: Detels R, Sullivan
treatment; diagnostic tests. Z. Ramaprabhu, I.Malini Pon Angel *
SG, Tan CC, editors. Public health in East and South-east
• Based on the research evidences increased Asia. Berkeley, USA: University of California Press; 2012.p.
priority of personal and community health 43-78
practices relevant to disease transmission 7. Morse, S.S. 1995. Factors in the emergence of infectious Abstract
• Promote in nursing education and curricula diseases. Emerging Infectious Diseases [Serial online], 1(1).
a population-based, epidemiologic, system Available http://www.cdc.gov/ncidod/EID/index.htm. June Mental health services in India are neglected area which needs immediate attention from the Government,
1999;
approach for nursing practice and research.16 8. WHO (1997), World Health Day Report 1997.
policymakers, and civil society organizations. Despite, National Mental Health Programme since1982and
9. WHO (1996), The World Health Report 1996. National Rural Health Mission, there has been very little efforts so far to provide mental health services
10. WHO (1999), Removing Obstacles to Healthy Development, in rural areas. With increase in population, changing life-style, unemployment, lack of social support and
Conclusion WHO Report on Infectious diseases. increasing insecurity, it is predicted that there would be a substantial increase in the number of people
11. Park K . Textbook of Preventive and Social Medicine. 22ndt suffering from mental illness in rural areas. Considering the mental health needs of the rural community
For a country of size and population of India, the ed. Jabalpur: Bhanot; 2013.310-13. and the treatment gap, it is an attempt to remind and advocate for rural mental health services and suggest
12. Morbidity and Mortality weekly report (MMWR), Centers
emerging infections remain a real challenge. A for Disease Control and Prevention (CDC) September 11,
a model to reduce the treatment gap.
meaningful response must approach the problem at 1998 / Vol. 47 / No. RR-15.
the systems level. A comprehensive national strategy 13. Kenrad E N, Carolyn M W, Neil M H, Graham. Infectious Key words: Mental Health; Policy; Rural; Services; Treatment Gap; National Mental Health Program;
on infectious diseases addressing the challenges of Disease Epidemiology. Maryland: AN Aspen; 2001. p District Mental Health Programme; National Rural Health Mission.
emerging and re-emerging infections cutting across 301-48. URL available from, http://www.ias.ac.in/jbioscii.
all relevant sectors, both governmental and non- (03.05.2013)
14. Morse SS. Factors in the emergence of infectious diseases.
governmental, should be in place. Emerging Infect Dis 1995; 1( 1 ):7-15.
Introduction Meaning: need for community mental
15. Morse SS. Examining the origins of emerging viruses. In: health intiatives
Identification of national centre of excellence Morse SS, editor. Emerging viruses. New York: Oxford Health is “a state of complete physical, social, and
and their capacity building is of critical importance. University Press, 1993: 10-28. mental well being and not merely the absence of Mental illness constitutes nearly one sixth of all
These centres of excellence should be encouraged to 16. Felissa.LC, Elaine L, Emerging Infectious Disease: Nursing disease or infirmity”[1,2] Nevertheless, our health health-related disorders. With the population
develop networking and partnerships between public Reponses; 1996, Nursing Outlook, 44(4), pg.no. 164-168. system is pre-occupied with curative health care increase, changing values, life-style, frequent
17. 17. Pope AM, Snyder MA, Mood LH, editors. Nursing,
health organizations to improve their individual health and the environment. Institute of Medicine,
services and disease prevention, with little attention disruptions in income, crop failure, natural
scientific capacity, share best practices and expand Washington, DC: National Academy Press, 1995. on social and mental well being. Among these, calamity(drought and flood), economic crisis,
collective knowledge base. Concerted efforts are also 18. Joseph D et.al, Emerging and Re-emerging Infectious mental health and wellbeing is the most neglected unemployment, lack of social support and increasing
needed to develop advanced counter measures such Diseases; 2012, pg.no.3-5 one[3,4] particularly in rural areas.[5,6]. Silence on insecurity, it is fearfully expected that there would
as surveillance tools, diagnostic tests, vaccines and 19. Centers for Disease Control. Addressing emerging infectious mental health services in rural India in the National be a substantial increase in the number of people
disease threats: a prevention strategy for the United States
therapeutics through basic, translational and applied Rural Health Mission (NRHM) is a serious matter suffering from mental illness in rural areas.[9] Among
(executive summary). MMWR 1994:43;1-18. Report
research. Sensitive rapid response mechanisms at No.:RR-5. of concern. The omission of mental health in the priority non-communicable diseases in India, mental
various levels of health service are the cornerstone 20. Dash AP, Bhatia R, Sunyoto T & Mourya DT, Emerging NRHM mission document becomes even more illness constitutes 26 percent share in the burden
to detect public health threats and respond quickly and Re-emerging arboviral Diseases in Southeast Asia; J serious in the backdrop of the uneven performance of disease and available data suggest that there
enough to protect valuable human lives. National Vector Borne Dis 50, June 2013, pp.77-84. of the National Mental Health Program (NMHP, would be a sharp increase in this incoming years.
commitment and comprehensive efforts are necessary 21. World Health Organization. strengthening health security 1982) and District Mental Health Programme Projections suggest that the health burden due to
by implementing the international health regulations (2005)
at all levels of health services in order to meet the (DMHP) which is operational in only 125 districts mental disorders will increase to 15% of Disability
available at http://www.who.int/ihr/alert_and_response/en/
threat of emerging and re-emerging infections. 22. Goel N, Gurpeet H & Swami H, How to deal with Emerging out of 626 districts of India. With various flaws Adjustment Life by Year (DALY ) by2020.[10,11]
and Re-Emerging infectious diseases globally. The Internet and implementation constraints in the NMHP and
References: Journal of Biological Anthropology. 2006. 1(1), pp.no.14-18. DMHP, there has been very little efforts so far to Despite NRHM initiatives and improvement,
23. World Health Organization. Alert, response, and capacity improve the rural mental health services.[7,8] general health services in rural area are not adequate
1. Altizer, S., et al. (2013) Climate Change and Infectious building under the International Health Regulations and are struggling with infrastructural, human
Diseases: From Evidence to a Predictive Framework (abstract) (IHR),2nd ed; 2008. available at: http://www.who.int/ihr/
http://www.sciencemag.org/content/341/6145/514.abstract publications/9789241596664/en/
resources and other problems. Only 31.9 percent of
2. Institute of Medicine. Emerging infections: microbial threats all government hospital beds are available in rural
to health in the United States.Washington, DC: National
Academy Press, 1992
3. CDC. Adoption of hospital policies for prevention of * Mr. Z. Ramaprabhu, Lecturer, Miss.I.Malini Pon Angel, Asst. Lecturer Dept. of Mental Health Nursing,
perinatal group B streptococcal disease -- United States, KGNC, Puducherry 607402, India.
1997. MMWR 1998;47:665-70.

Page 66 Ann. SBV, Jan-June2015;4(1) Ann. SBV, Jan-June2015;4(1) Page 67