An Epidemic in the Community
To prepare for this Discussion, visit the CDC Wonder site in this week’s resources. https://wonder.cdc.gov/ Investigate the incidence and prevalence of TB in your community. My County is TALBOT. https://dph.georgia.gov/sites/dph.georgia.gov/file... What information did you find? Analyze how your community compares to county, state, or national data for the same topic. Was the incidence and prevalence of each higher or lower than you expected?
Consider the following scenario: This is Debbie’s first year working as a nurse at the local health department in a rural county. Most of her days are spent in the clinic seeing clients who often do not have health insurance.
Over the past month, Debbie has noticed that several young Hispanic men have come to the health department, each diagnosed with tuberculosis. Debbie is concerned about what the outbreak of tuberculosis among the migrant workers could mean for the community. Through a community health profile, Debbie identifies the group of migrant farm workers as being at highest risk for contracting tuberculosis.
Using the Epidemiologic Triangle concept, consider the relationship among causal agents, susceptible persons, and environmental factors. Then, respond to the following:
- As a BSN-prepared community health nurse, what steps should Debbie take next?
- Considering economic and social considerations within the community, what are the primary, secondary, and tertiary interventions that Debbie might use in managing this outbreak?
- Can similar interventions be applied to your community and its TB prevalence?
- What considerations need to be addressed within your community that are different form Debbie’s community?
By Day 3
Post your response to this Discussion.
Support your response with references from the professional nursing literature.
Notes Initial Post: This should be a 3-paragraph (AT LEAST 230-350 WORDS) response. Be sure to use evidence from the readings and include in-text citations. Utilize essay-level writing practice and skills, including the use of transitional material and organizational frames. Avoid quotes; paraphrase to incorporate evidence into your own writing. A reference list is required. Use the most current evidence (USUALLY </= 5 YEARS OLD).
Read two or more of your colleagues’ postings from the Discussion question.
Respond to at least two colleagues. Your responses should be substantial and should contribute to the Discussion. Support with evidence, if indicated.
Debbie is facing many challenges that could lead to a severe TB outbreak in her small community. To start, she can initiate a necessary detailed assessment that would include questions and observations concerning potential and existing environmental exposures (Stanhope & Lancaster 2016). With education being a critical step in the process, she will need to educate all of the migrant workers she sees on how fast the disease can spread. Most migrant workers live in close quarters with other family members or friends. Further educating these people as well, that a simple cough, sharing eating utensils, cups, or a simple handshake can spread this disease, will be essential to controlling the spread of this disease further into their community.
Now Debbie must focus on the community and how to manage the potential outbreak.
With a primary, secondary and tertiary plan in mind, she must act quickly (Stanhope & Lancaster, 2016). The host is the Hispanic migrant worker, and the agent is TB, so the challenge becomes the environment. She could start with a town meeting and educate the community on the levels of prevention as well as basic understandings of the disease. Providing everyone with a flyer describing the illness, how it spreads and how to prevent it from the primary level would also be another resource. Trying to counsel the community in small groups or individuals would not work because time is of the essence in this case.
From the secondary level, she could host an open house where the community could come in for free screenings, vaccine updates, TB skin testing and hand out masks, in hopes of early detection to help stop the spread.
For tertiary prevention, she could provide follow up care to those that did test positive by Directly Observed Therapy (DOT), which is when a nurse visually observes a TB patient taking a TB medication (Stanhope & Lancaster, 2016). She could also plan to have a nurse on site at the farms or work in conjunction with the nurses that are employed by farms to ensure the medications are taken correctly by those affected by TB. Being a public health nurse, she would collaborate with her team at the Health Department to provide interventions and care as needed.
The data for Tuberculosis in Florida that I found with the Centers for Disease Control and Prevention (2017) in the years 2013-2017 there were 325 people tested positive for TB. The people with the highest data was Black or African American, Non-Hispanic Females age 25-34 and Males age 25-34. The data proposed for this population shows this group most likely became infected through illicit drug use. Living in close quarters such as prison, sharing pipes, and drug paraphernalia, while some also have a co-infection like Hepatitis B/C or even HIV are a couple of notable findings. Diagnosing tuberculosis is more complicated in a high-risk population, such as people who use illicit drugs ("Tuberculosis (TB)," 2018).
Prevention, diagnosis, and treatment of this disease have the same underlying cause and effect; however, each populations’ plan could differ. Without ignoring the diagnosis of TB, you must move into the "how" the disease was transmitted. For Debbie's situation it is environmental, so the question about illicit drug use would not be ruled out. In my city, I could use the same interventions if ever faced with an outbreak like Debbie. For the tertiary prevention portion in my community, I would involve the health department for medication management, continued education, support, the teaching of standard precautions about infection control and the benefits of adhering to treatment plans (Stanhope & Lancaster, 2016). Education is a crucial factor in every community to prevent the spread of any disease that could quickly become an epidemic.
Stanhope, M., & Lancaster, J. (2016). Public health nursing: Population-centered health care in
the community (9th ed.). St. Louis, MO: Elsevier.
Tuberculosis (TB). (2018, September 18). Retrieved March 5, 2019, from
Centers for Disease Control and Prevention. (2017). CDC Wonder: Online Tuberculosis
Information System (OTIS) Data. Retrieved from https://wonder.cdc.gov/tb.html
Tuberculosis is a disease that is caused when a bacterium called Myco-bacterium tuberculosis infects the lungs. It can also affect other organs when a person who has not had treatment coughs or sneezes and fills the air with droplets infecting anyone in their path (Green, 2014). According to the CDC, roughly one-fourth of the world’s populace are diseased with TB. There were 1.3 Million TB-related demises worldwide. Tb can be one of the chief causes of killers with individuals with HIV infections. In the united states, there are 2.9 cases per 100,000 persons compared to the 2.8 cases in Arizona. Nearly 186 cases in Arizona out of the 9.287 total in the united states (Data & Statistics | TB | CDC). With Tb loving to live in a more damp dark, a dusty area one would not think it would be more prevalent in Arizona versus other states. (Data & Statistics | TB | CDC). Epidemiology is the science that supports us in comprehending the strength of the association among exposures and health effects (Stanhope & Lancaster, 2016). The Epidemiological triangle is an instrument used to assist in finding a solution of public health problems like in this case TB. (Stanhope & Lancaster, 2016). Using the epidemiological triangle, we understand that the Infectious agent, in this case, is the bacteria tuberculosis microbe. The host is the are the young Hispanic men in this week’s post. The environment in this scenario is that the migrant farm was the worker who put them in a position where they were at high risk for contracting tuberculosis. The Primary step in treating Tb would be to treat the patients; in this case, the farm workers. The second step would be to check their family and make sure none of them have TB. If they do one would also have to treat them, Then I would find out who has the family been in contact with and were and start tracing all the places they have been checking for Tb. Then I would advertise on the news and social media the concern regarding Tb and inform the community what the symptoms of TB were providing a helpline for those who have the infection of this specific bacteria. I think this intervention can be applied in any community and I would not do anything different.
Green, N. A. (Ed.). (2014, January). Tuberculosis (for Teens). Retrieved March 5, 2019, from https://kidshealth.org/en/teens/tuberculosis.html
Data & Statistics | TB | CDC. (n.d.). Retrieved from https://www.cdc.gov/tb/statistics/default.htm
Stanhope, M., & Lancaster, J. (2016). Public health nursing: Population-centered health care in the community. Retrieved March 6, 2019.