Public Health

HEALTH - so many aspects

Personal Health

Two dimensions of Health The Well-being axis FEEL WELL

FEEL BAD

The Disease axis MAIN FOCUS NO DISEASE

DISEASE

Public Health and Disasters

Four Health Domains • • • •

PERSONAL HEALTH HEALTH MARKET MEDICAL HEALTH PUBLIC HEALTH

PUBLIC HEALTH Always at a POPULATION level

HEALTH

FACTORS +

Risk Factors

MAIN FOCUS

Salutogenic Factors

ANALYSIS PLAN IMPLEMENTATION EVALUATION

PUBLIC HEALTH • Communicable Diseases RISK FACTORS: Infectious agens MAIN FOCUS

• Non communicable Diseases RISK FACTORS: Behaviour

The Work for Health The Disaster Application

• Health Promotion • Health Protection • Disease Prevention

PUBLIC HEALTH

• Treatment, Cure, Care • Rehabilitation

MEDICINE

Consequences for Population • Destruction of infrastructure – Water and Sanitation – Food supply – Transportation, Electricity

• Regular Health Care reorganised • Mental Health • Bioterrorism

Structural Public Health Problems • Water – Drinking Water – Waste water • Food – Access – Contamination • Temporary Housing • Rats, Lice, Blowflies • Other zoonoses

Infectious diseases • Increased Susceptibility; Immunological system depressed • Increased Dissemination; Living close together • Normally occurring in the population • Seldom diseases starting up • Bioterrorism

Importance of Previous Vaccinations • • • •

Polio Tetanus Diphtheria Measles

• Start up vaccination program

Main Ways of Dissemination • • • • • • •

Man to man; Direct, indirect, faeces Man to food products to Man Man to water to Man Man to Blowflies to food to Man Rats to food and water to Man Rats to Lice to Man Other zoonoses

Drinking Water ♦ Drinking Water System ♦ Local Wells ♦ Surface Water

• Lack of Water (you will need more than 1 litre per day) • Water Contamination

Waste Water

• Waste water system crashed • Waste water contamination of drinking water

Water contamination • • • •

Salmonella Shigella Cholera Viruses; Enteroviroses, Hepatitis

Food • Lack of food – Basic 1500 cal/day; 35 g protein per day, vitamins

• Contamination of food – Temperature for storage – Hand wash – Rats, insects

• Main way of contamination: ♦ MAN – FOOD – MAN

Contamination ♦ Food Product Infection • Bacteria – Salmonella, Shigella, Enteropatogenic E Coli

• Viruses – Hepatitis A

♦

Food Product Poisening =

Toxic Products produced on food by Bacteria • Staphylococci enterotoxin

Housing; living close together • • • •

Man to man dissemination of infectious agens Food preservation, lack of refrigerators Lack of clean water Humans and animals with severe infectious diseases • Dead humans and animals • Zoonoses

Zoonoses Disease transmitted from animal to man • Direct contact • Transmitted via mosquitoes, lice, tics, flies (vector) • Transmitted via food or water

Examples of zoonoses • • • • • • • • •

Bird flu Campylobacterios Ehec Nephropatia epidemica Tic born infections (Borelia, TBE) Listeriosis Salmonellosis Psitacosis Rabies

Reactive Mental Disturbances 1 • Not very pronounced, mass panic seldom • Confusion, Amnesia • Depressive, Apatia, Mutism • Hysterical • Psychosomatic (heart, stomach, headache) • Psychotic

Reactive Mental Disturbances 2 • • • •

Talk to someone who is objective, support Treat as a very normal reaction Sleep, rest Back to activities as soon as possible

• Less problems with Children • Do not move children from their parents