Discussion 1.1: Health and Disease
Discussion 1.1: Health and Disease
Influenza
Influenza is a highly contagious respiratory illness with droplet means of transmission that presents a potential public health threat. Influenza A and B virus subtypes, classified based on hemagglutinin and neuraminidase receptors, have the potential to cause human infections ( Samuel et al., 2019). The antigenic components of these receptors determine the infecting viral strain of the influenza virus and thus are an important basis for the development of influenza vaccines and effective antiviral therapies (Samuel et al., 2019). The antigens are prone to immunologically significant variations and antigenic drifts owing to rapid viral gene mutations which put into jeopardy the efficacy of existing vaccination (Samuel et al., 2019). The challenges from rapid antigenic drifts warrant annual vaccination with the development of vaccines that match predicted current or emerging viral strains. The purpose of this paper is to explore the accuracy of an immunity screening test based on the effectiveness of a flu vaccine developed in the past year. The need for this test has been warranted by a potential outbreak of a fatal new strain of flu. Concerns about the preparedness to handle the possible outbreak will also be addressed.
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Accuracy of the Immunity Screening Test
The influenza vaccine is an effective intervention that significantly reduces disease burden, preventable hospitalization, and mortality. Annual vaccination is recommended especially among high-risk individuals such as healthcare workers, children, expectant mothers, existing comorbidities, and the elderly (Restivo et al., 2018). Vaccinating healthcare professionals minimizes their risk of contracting as well as nosocomial transmission of the infection to their patients (Restivo et al., 2018). The variation in the effectiveness of vaccination in conferring immunity against influenza is determined by various factors. These include the level of antigenic match between the strains included in the vaccine and the circulating strains, duration after vaccination, age of the individual, and type of vaccine (Feng et al., 2018). The type of population studied during vaccine development also determines the efficacy of the vaccine in the general population (Restivo et al., 2018). These are important considerations during immunity screening testing which determines the effectiveness of administered influenza vaccines.
The accuracy of immunity screening tests varies depending on various evidence-based indicators and factors. These include specificity, sensitivity, reliability, and validity of the given test (Shreffler et al., 2022). It is important to inquire about factors that influence the sensitivity and specificity of immunity tests such as the sample collection method, specimen storage and transport, type of specimen, media used, quality control, level of compliance with recommended test procedures, and patient population-specific interpretation of test findings (Ryu et al., 2018). Cross-reactivity with other viruses should be identified to rule out the possibility of false positive or negative results. The possibility of new strains from antigenic drifts due to the use of immunity screening tests from past years may impede the detection of circulating new variants. Test results should be valid and reliable by being consistent and reproducible in determining the immunity status across the population.
Concerns on Potential Impact of New Flu Strain on Outbreak Preparedness
The new flu strain may necessitate the adoption of various mitigation strategies. These include setting up surveillance networks to detect the potential circulation of the new strain, studying the characteristics of the new strain, and optimization of vaccine types and yields (Rockman et al., 2022). The outbreak may increase the uptake of optimized vaccines that antigenically match the new strains and the use of antiviral chemoprophylaxis such as oseltamivir (Robson et al., 2019). Infection prevention control measures such as handwashing hand sanitization, respiratory etiquette, and source control through isolation of confirmed cases can also be adopted by medical personnel, clients, and healthcare agency.
Conclusion
Influenza is an infectious respiratory illness that presents a public health threat due to its outbreak potential. Challenges in its prevention are attributed to rapid viral antigenic drifts with frequent emergence of new strains. These variations affect the effectiveness of existing vaccines which warrant annual influenza vaccination with vaccines optimized with circulating strains. The accuracy of immunity screening tests is integral in determining the immunity status of individuals to guide tailored appropriate preventive and therapeutic interventions.
References
Feng, S., Cowling, B. J., Kelly, H., & Sullivan, S. G. (2018). Estimating Influenza Vaccine Effectiveness With the Test-Negative Design Using Alternative Control Groups: A Systematic Review and Meta-Analysis. American journal of epidemiology, 187(2), 389–397. https://doi.org/10.1093/aje/kwx251
Restivo, V., Costantino, C., Bono, S., Maniglia, M., Marchese, V., Ventura, G., Casuccio, A., Tramuto, F., & Vitale, F. (2018). Influenza vaccine effectiveness among high-risk groups: A systematic literature review and meta-analysis of case-control and cohort studies. Human vaccines & immunotherapeutics, 14(3), 724–735. https://doi.org/10.1080/21645515.2017.1321722
Robson, C., Rupa Baskar, S., Booy, R., Ferguson, P., Gilroy, N., Kok, J., Sandaradura, I., & Dwyer, D. (2019). Influenza: Overview on prevention and therapy. Australian Prescriber, 42(2), 51. https://doi.org/10.18773/austprescr.2019.013
Rockman, S., Taylor, B., McCauley, J. W., Barr, I. G., Longstaff, R., & Bahra, R. (2022). Global pandemic preparedness: Optimizing our capabilities and the influenza experience. Vaccines, 10(4), 589. https://doi.org/10.3390/vaccines10040589
Ryu, S. W., Suh, I. B., Ryu, S. M., Shin, K. S., Kim, H. S., Kim, J., Uh, Y., Yoon, K. J., & Lee, J. H. (2018). Comparison of three rapid influenza diagnostic tests with digital readout systems and one conventional rapid influenza diagnostic test. Journal of clinical laboratory analysis, 32(2), e22234. https://doi.org/10.1002/jcla.22234
Samuel, R., & Miller, J. (2019). Is the influenza vaccine effective in decreasing infection, hospitalization, pneumonia, and mortality in healthy adults? The Journal of the Oklahoma State Medical Association, 112(3), 86–87. https://pubmed.ncbi.nlm.nih.gov/31379394/
Shreffler, J., & Huecker, M. R. (2022). Diagnostic Testing Accuracy: Sensitivity, Specificity, Predictive Values, and Likelihood Ratios. In StatPearls. StatPearls Publishing.
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Introduction
Imagine that you are representing the staff in the health care agency where you work. In anticipation of a possible outbreak of a deadly new strain of flu, the administration has decreed that all staff must present documentation of adequate immunity against this new flu before gaining access to any patient care settings. The required flu vaccine and immunity test have only been developed and marketed in the past year.
Discussion Guidelines
Initial Post
In your initial post answer the following questions:
- As the staff representative concerned for the rights and safety of your constituents, what questions would you raise about the accuracy of the immunity screening test?
- Based on your general understanding of disease processes, what concerns would you have about this new flu strain in terms of its impact on staff, clients, and the agency’s readiness to handle an outbreak?
Response Post(s)
Reply to at least two classmates’ initial posts by Sunday.
Submission
Post your initial and follow up responses and review full grading criteria on the Discussion 1.1: Health and Disease page.
Lesson 2: Effects of Aging on Health and Disease
The second concept covered this week is the physiological effects of aging. Two specific groups are examined: neonates or infants through the adolescent period, and older adults. The extensive list of learning outcomes is covered in the presented materials.
Learning Outcomes
At the end of this lesson, you will be able to:
Concepts of Altered Health in Children
- Growth and DevelopmentCharacterize the use of percentiles to describe growth and development during infancy and childhood
- Describe the major events that occur during prenatal development from fertilization to birth
- Define the terms low birth weight, small for gestational age, and large for gestational age
- InfancyExplain how the common health care needs of the premature infant differ from the health care needs of the term newborn or infant
- Early ChildhoodDiscuss the common health problems of early childhood
- Middle to Late ChildhoodCharacterize the growth and development that occurs during the early school years
- Discuss the common health problems of middle to late childhood
- AdolescenceCharacterize the physical and psychosocial changes that occur during adolescence
Concepts of Altered Health in Older Adults
- The Older Adult and Theories of AgingDefine young-old, middle-old, and old-old and characterize the changing trend in the older adult population
- Discuss theories of biologic aging
- Physiologic Effects of AgingDescribe the process of bone loss that occurs with aging
- Identify the common changes in blood pressure regulation that occur with aging
- Describe changes that occur in the gastrointestinal tract with aging
- Explain the significance of decreased lean body mass on interpretation of the glomerular filtration rate (GFR) using serum creatinine levels
- Functional Problems Associated with AgingList five symptoms of depression in older adults
- Name a tool that can be used for assessing cognitive function
- Explain the difference between delirium and dementia
- Drug Therapy in the Older AdultList five factors that contribute to adverse drug reactions in the older adult
Before attempting to complete your learning activities for this week, review the following learning materials:
Learning Materials
Use the PowerPoints to review the material on Altered Health in Children and Adults.
Review the following presentations. Note: the videos have no audio.
Concepts of Altered Health in Children Presentation
Download the PowerPoint version of Concepts of Altered Health in Children Presentation (PPT) if you require an accessible copy of the video.
Concepts of Altered Health in Older Adults Presentation
Download the PowerPoint version of Concepts of Altered Health in Older Adults Presentation (PPT) if you require an accessible copy of the video.