HEALTH EDUCATION

OBJECTIVES
At the end of the module, the students should be able to:

1. Differentiate physical health from mental health;

2. Enumerate different factors essential for maintaining and promoting good health;
3. Describe the important roles of essential nutrients such as carbohydrates, proteins, fats,
minerals and vitamins in the proper functioning of the body;
4. Cite at least five among the top infectious disease killers and list measures on how they
could be prevented;
5. suggest simple ways to observe and follow at home to prevent common home accidents
such as falls, burns, cuts and bruises, and drowning;
6. Demonstrate in class how to treat injuries in the home such as cuts, bruises, and burns.

INTRODUCTION

Health education is defined as the principle by

which individuals and groups of people learn to
behave in a manner conducive to the promotion,
maintenance, or restoration of health. Education
for health begins with people. It hopes to
motivate them with whatever interests they may
have in improving their living conditions. Its aim
is to develop in them a sense of responsibility for
health conditions for themselves as individuals, as
members of families, and as communities. In communicable disease control, health
education commonly includes:

1. an assessment of what is known by a population about a disease,

2. an assessment of habits and attitudes of the people as they relate to spread and frequency
of the disease, and
3. the presentation of specific means to remedy observed deficiencies. Health education is
also an effective tool that helps improve health in developing nations. It not only teaches
prevention and basic health knowledge but also conditions ideas that re-shape everyday
habits of people with unhealthy lifestyles in developing countries. This type of conditioning
not only affects the immediate recipients of such education but also future generations will
benefit from an improved and properly cultivated ideas about health that will eventually be
ingrained with widely spread health education.

Health education is included in the curriculum of most schools. A comprehensive health

education curriculum consists of planned learning experiences which will help students
achieve desirable attitudes and practices related to critical health issues. Some of these are

(1) emotional health and a positive self image

(2) appreciation, respect for, and care of the human body and its vital organs;
(3) physical fitness;
(4) health issues of alcohol, tobacco, drug use and abuse;
(5) health misconceptions and quackery;
(6) effects of exercise on the body systems and on general well being;
(7) nutrition and weight control;
(8) sexual relationships,
(9) the scientific, social and economic aspects of community and ecological health;
(10) communicable and degenerative diseases including sexually transmitted diseases;
(11) disaster preparedness;
(12) safety and driver education;
(13) life skills;
(14) choosing professional medical and health services; and
(15) choices of health careers.

What is health? In 1948, the

World Health Organization
(WHO) defined health as “a state
of complete physical, mental,
and social well-being and not
mer ely the absence of disease
or infirmity." In 1986 the World
Health Organization in the Ottawa Charter for Health Promotion said health is "a resource
for everyday life, not the objective of living. Health is a positive concept emphasizing
social and personal resources, as well as physical capacities

1.1. Aspects of health

Physical health. Physical fitness

is good body health, and is the
result of regular exercise, proper
diet and nutrition, and proper
rest physical recovery. A strong
indicator of the health of
localized population is their
height-weight, which generally
increases with improved
nutrition and health care. This is
also influenced by the standard
of living and quality of life.
Genetics also plays also a major
role in people's height. The study
of human growth, its regulators,
and implications is known as
Auxology.

Mental health. Mental health refers to an individual's emotional and psychological well-
being. "A state of emotional and psychological well-being in which an individual is able to
use his or her cognitive and emotional capabilities, function in society, and meet the ordinary
demands of everyday life."

One way to think about mental health is by looking at how effectively and successfully a
person functions. Feeling capable and competent; being able to handle normal levels of
stress, maintain satisfying relationships, and lead an independent life; and being able to
"bounce back," or recover from difficult situations, are all signs of mental health. A
combination of physical, emotional, social and most importantly mental well-being is vital to
achieve overall health.

Did you know.. That sucking on your thumb helps fight depression, that's why babies suck
on their thumb.
1.2. Determinants of health The LaLonde report suggested that there are four general
determinants of health including:
a. human biology,
b. environment,
c. lifestyle, and
d. healthcare services.

Thus, health is maintained and improved not only through the advancement and application
of health science, but also through the efforts and intelligent lifestyle choices of the
individual and society. A major environmental factor is water quality, especially for the
health of infants and children in developing countries.
Did you know... that about 5 million children die every year due to diarrhea, which is
attributed to dirty water due to pollution Source: WHO

Studies show that in developed countries, the lack of neighbourhood recreational space that
includes the natural environment leads to lower levels of neighbourhood satisfaction and
higher levels of obesity; therefore, lower overall well-being. Therefore, the positive
psychological benefits of natural space in urban neighborhoods should be taken into account
in public policy and land use.

1.2. Health maintenance

Achieving health and remaining healthy is an active process. Effective strategies for staying
healthy and improving one's health include the following elements:
A. Nutrition
Nutrition (also called nourishment or aliment) is the provision, to cells and organisms, of
the materials necessary (in the form of food) to support life. Many common health problems
can be prevented or alleviated with good nutrition. The diet of an organism refers to what it
eats. Poor diet can have an injurious impact on health, causing deficiency diseases such as
scurvy, beriberi, and kwashiorkor; health-threatening conditions like obesity and metabolic
syndrome, and such common chronic systemic diseases as cardiovascular disease, diabetes,
and osteoporosis.

In general, eating a wide variety of fresh, whole (unprocessed), foods have proven favorable
compared to monotonous diets based on processed foods. In particular, the consumption of
whole-plant foods slows digestion and allows better absorption, and a more favorable
balance of essential nutrients per Calorie, resulting in better management of cell growth,
maintenance, and mitosis (cell division), as well as better regulation of appetite and blood
sugar. Regularly scheduled meals (every few hours) have also proven more wholesome than
infrequent or haphazard ones.
Nutrients. There are seven major classes of nutrients: major classes of nutrients:
carbohydrates, fats, fiber, minerals, protein, vitamins, and water. These nutrient classes can
be categorized as either macronutrients (needed in relatively large amounts) or
micronutrients (needed in Smaller quantities). The macronutrients are carbohydrates, fats,
fiber, proteins, and water. The micronutrients are minerals and vitamins.

The macronutrients
(excluding fiber and
water) provide energy,
which is measured in
Joules or kilocalories.
Vitamins, minerals,
friber, and water do not
provide energy, but are
necessary for the
regulation of important
body processes.
Molecules of
carbohydrates and fats
consist of carbon,
hydrogen, and oxygen atoms. Carbohydrates range from simple monosaccharides (glucose,
fructose, galactose) to complex polysaccharides (starch). Fats are triglycerides, made of
various fatty acid monomers bound to glycerol. Some fatty acids, but not all, are essential in
the diet: they cannot be synthesized in the body. Protein molecules contain nitrogen atoms
in addition to the elements of carbohydrates and fats. The nitrogen-containing monomers of
protein are amino acids, and they include some essential amino acids. They fulfil many roles
other than energy metabolism; and when they are used as fuel, getting rid of the nitrogen
places a burden on the kidneys.

Other micronutrients include antioxidants and phytochemicals Most foods contain a mix of
some or all of the nutrient classes, some nutrients are required regularly, while others are
needed only occasionally. Poor health can be caused by an imbalance of nutrients, whether
an excess or a deficiency.

Minerals. Dietary minerals are the chemical elements required by living organisms, other
than the four elements carbon, hydrogen,
nitrogen and oxygen that are present in
common organic molecules. The term
"mineral" is archaic, since the intent is to
describe simply the less common elements
in the diet: heavier than the four just
mentioned; including several metals; and
often occurring as ions nitrogen, and oxygen
th in the body. Some dietitians recommend that these be supplied from foods in which they
occur naturally, or at least as complex compounds, or sometimes even from natural
inorganic sources (such as calcium carbonate from ground oyster shells). On the other hand,
minerals are often artificially added to the diet as supplements, the most famous being
iodine in iodized salt.

Macrominerals. Many
elements are essential in
quantity; also called "bulk
minerals". Some are
structural, but many play a
role as electrolytes.
Elements with
recommended dietary
allowance (RDA) greater
than 200 mg/day are the
following, in alphabetical
order (with informal or folk-
medicine perspectives in
parentheses):
 Calcium, a common
electrolyte, but also structural (for muscle and digestive system health, builds bone,
neutralizes acidity, clears toxins, helps blood stream)
 Chlorine as chloride ions; very common electrolyte; see sodium, below
 Magnesium, required for processing ATP and related reactions(builds bone, causes
strong peristalsis, increases flexibility, increases alkalinity)
 Phosphorus, required component of bones; essential for energy processing
 Potassium, a very common electrolyte (heart and nerve health)
 Sodium, a very common electrolyte; not generally found in dietary supplements,
despite being needed in large quantities, because the ion is very common in food:
typically as sodium chloride, or common salt
 Sulfur for three essential amino acids and therefore many proteins (skin, hair, nails,
liver, and pancreas)
Trace minerals. Many elements are required in trace amounts, usually because they play a
catalytic role in enzymes.[51 SOmns s.[5] Some trace mineral elements (RDA < 200
mg/day) are, in alphabetical or alphabetical order:
 Cobalt required for biosynthesis of vitamin_B12 famil B12 family of Coenzymes
 Copper required Component of many redox enzymes including cytochrome c
oxidase
 Chromium required for sugar metabolism.
  lodine required for the biosynthesis of thyroxin; needed in larger quantities than
others in this list, and sometimes classified with the macro minerals.
 Iron required for many enzymes, and for hemoglobin and some other proteins.
 Manganese (processing of oxygen)
 Molybdenum required for xanthine oxidase and related oxidases.
 Nickel present in urease
 Selenium required for peroxidase (antioxidant proteins) Vanadium (Speculative:
there is no established RDA for vanadium. No specific biochemical function has
been identified for it in humans, although vanadium is found in lower organisms.)
 Zinc required for several enzymes such as carboxypeptidase liver alcohol
dehydrogenase, carbonic anhydrase

Vitamins. As with the minerals discussed above, twelve vitamins are recognized as
essential nutrients, necessary in the diet
for good health. (Vitamin D is the
exception: it can alternatively be
synthesis are in the skin, in the presence
of UVB radiation.) Certain vitamin
compounds that are recommended in the
diet, such as carnitine are indispensable
for survival and health: but these are not
strictly "essential" because the human
body has some capacity to produce of different them from other compounds.. Moreover,
thousands of different phytochemicals have recently been discovered in food (particularly
in fresh vegetables) which may have desirable properties including antioxidant activity.
Other essentials not classed as vitamins include essential amino acids choline, essential
fatty acids, and the minerals discussed in the preceding section.

FAMILY SOURCES POSSIBLE BENEFITS

Flavonoids Berries General antioxidant, oxidation of

LDLs, prevention of
arteriosclerosisand heart disease
Isoflavones Soy, red clover, kudzu root General antioxidant, prevention of
arteriosclerosis and heart disease,
easing symptoms of menopause,
cancer prevention
Isothiocyanates Cruciferous vegetables Cancer prevention
Monoterpenes Citrus peels, essential oils, Cancer prevention, treating
herbs,spices, green plants, gallstones.
athmosphere
Organosulfur compounds Chives , garlic, onions Cancer prevention, lowered LDLs,
 assistance to the immune system
Saponins Beans, cereals, herbs Hypercholesterolemia,
Hyperglycemia,Antioxidant,cancer
prevention, Anti inflammatory

Capsaicinoids All capsicum(chile) peppers Topical pain relief, cancer

prevention, cancer cell apoptosis.

Vitamin deficiencies may result in disease conditions: goiter, Sucry, osteoporosis,

impaired immune system disoreders of cell metabolism, certain forms of cancer,
symptoms of premature aging and poor psychological (including eating disorder), among
many others. Excess of some vitamins is also dangerous to health (notably vitamin A); and
defieciency or excess of minerals can also have serious health consequences.

The following table presents Illness caused by improper nutrients consumption:

NUTRIENTS DEFIENCIENCY EXCESS

Energy Starvation Obesity, diabetes mellitus,
Cadiovascular disease.
Simple Carbohydrates Marasmus starvation Obesity
Complex Carbohydrates Marasmus Starvation Obesity
Saturated fat/trans fat None Cardiovascular disease
Unsaturated fat Rabbit Starvation Obesity
Cholesterol None Cardiovascular disease
Protein Marasmus Ketoacidosis, Rabbit
Starvation, Kidney disease
Sodium Hyponatremia Hypernatremia, Hypertension
Iron Anemia Cirrhosis, heart disease
Iodine Goiter, hypothyroidism Iodine, Toxicity (goiter
hypothyroidism)
Vitamin A Xerophthalmia and Night Hypervitaminosis A
Blindness (cirrhosis, hair loss, birth
defects
Vitamin B1 Beri-Beri
Vitamin b2 Cracking of skin and
Corneal Unclearation
Niacin Pellagra Dyspepsia, cardiac
arrhythmias, birth defects
Vitamin B 12 Pernicous Anemia
Vitamin C Scurvy Diarrhea causing dehydration,
Hypervitaminosis D
(dehydration, vomiting,
constipation)
Vitamin E Hypervitaminosis E
 (anticoagulant:excessive
bleeding)
Vitamin K Hemorrhage

The French "paradox

It has been discovered that people living in France live longer. Even though they consume
more saturated fats than Americans, the rate of heart disease is lower in France than in
North America. A number of explanations have been suggested:

 Reduced consumption of processed carbohydrate and other junk foods.

 Ethnic genetic differences allowing the body to be harmed less by fats.[citation
needed]
 Regular consumption of red wine.
 Living in a mild climate requires the body to produce less heat, allowing a slower,
and therefore healthier, metabolic rate.
 More active lifestyles involving plenty of daily exercise especially walking; the
French are much less dependent on cars than Americans are.
 Higher consumption of artificially produced trans-fats by Americans, which has
been shown to have greater ipoprotein effects per gram than saturated fat.

B. Exercise

Exercise is the performance of movements in order to develop or maintain physical fitness

and overall health. It is often directed toward also honing athletic ability or skill. Frequent
and regular physical exercise is an important component to prevention of some diseases of
affluence such as cancer, heart disease cardiovascular disease, Type 2 diabetes, obesity and
back pain.
Exercises are generally grouped into three types depending on the overall effect they have
on the human body:
  Flexibility exercises such as stretching improve the motion of muscles and joints
 .

 Aerobic exercises such as walking and running focus increasing cardiovascular

endurance and muscle density.

 Anaerobic exercises such as weight training or sprinting increase muscle mass and
strength.

Physical exercise is considered important for maintaining physical fitness including:

1. Healthy weight;

2. Building and maintaining healthy bones, muscles, and joints:

3. Promoting physiological well-being;

4. Reducing surgical risks; and

5. Strengthening the immune system.

Proper nutrition is just as, if not more, important to health as exercise. When exercising it
becomes even more important to have good diet to ensure the body has the correct ratio of
macronutrients whilst providing ample micronutrients; this is to aid the body with the recovery
process following strenuous exercise. When the boay falls short of proper nutrition, it gets into
starvation mode developed through evolution and depends onto fat content for survival.

C. Hygiene
Hygiene is the practice of
keeping the body clean to
prevent infection and illness,
and the avoidance of contact
with infectious agents.
Hygiene practices include
1. Bathing,
2. Brushing and flossing teeth
3. washing hands specially
before eating
 4. washing food before it is eaten,
5. cleaning food preparation utensils and surfaces before and after preparing meals, and
many others.
This may help prevent infection and illness. By cleaning the body, dead skin cells are
washed away with the germs, reducing their chance of entering the body.

D. Stress Management

Prolonged psychological stress may negatively impact health, such as by weakening the
immune system. Stress management is the application of methods to either reduces stress or
increase tolerance to stress which include the ff:

1. Relaxation techniques are physical methods used to relieve stress.

2. Psychological methods include cognitive therapy, meditation, and positive thinking

which work by reducing response to stress.

3. Improving relevant skills and abilities builds confidence, which also reduces the stress
reaction to situations where those skills are applicable.

4. Reducing uncertainty, by increasing knowledge and experience related to stress-causing

situations, has the same effect.

5. Learning to cope with problems better such as improving problem solving and time
management skills, may also reduce stressful reaction to problems.

6. Repeatedly facing an object of one’s fears may also desensitize the fight or flight response
with the respect to that stimulus—e.g facing bullies may reduce fear or bullies.

E. Health

Health care is the prevention, treatment, and management of illness and the preservation of
mental and physical well-being through the services offered by the medical, nursing, and
allied health professions.

Workplace wellness programs

Workplace wellness programs are recognized by an increasingly large number of
companies for their value in improving the health and well-being of their employees, and
for increasing morale, loyalty, and productivity. Workplace wellness health presentations,
wellness newsletters access to health coaching, tobacco cessation programs and training
related to nutrition, weight and stress management. Other programs may include health
risk assessments health screenings and body mass index monitoring.

1.4 Public Health

Public Health is the science and art of preventing disease, prolonging life and promoting
health through the organizead efforts and informed choices of society, organizations,
public and private, communities and individuals.” It is concerned with threats to the
overall health of a community based on population health analysis. The focus of public
health intervention is to prevent rather than treat a disease through surveillance of cases
and the promotion of healthy behaviours. In addition to these activities, in many cases
treating disease can be vital to preventing it in others, such as during outbreak of an
infectious disease. Vaccination programs and distribution of condoms are examples of
public measures.

1.5. Role of science in Health

Health science is the branch of science focused on health, and it includes many sub-
disciplines. There are two approaches to health science: the study and research of the
human body and health- related issues to understand how humans (and animals) function,
and the application of that knowledge to improve health and to prevent and cure diseases.

Lesson 2. Infectious/Communicable Diseases

An infectious disease is a clinically evident disease resulting from the presence of
pathogenic microbial agents, including pathogenic viruses, pathogenic bacteria, fungi,
protozoa, multi-cellular parasites, and aberrant proteins known as prions. These pathogens
are able to cause disease in animals and/or plants. Transmission of an infectious disease
may occur through one or more of diverse pathways including physical contact with
infected individuals. These infecting agents may also be transmitted through liquids, food,
body fluids, contaminated objects, airborne inhalation, or through vector-borne spread.
2.1. Common Communicable Diseases

Some of the most common communicable diseases affecting many people are the
following: A. Cholera is a bacterial disease that affects the intestinal tract. It is caused by a
germ called Vibrio cholerae. Although only a few cases are recognized in the United States
each year, epidemic levels of cholera have recently been reported in parts of Central and
South America.

Who gets cholera?

While cholera is a rare disease in the U.S., those who may be at risk include people
traveling to foreign countries where outbreaks are occurring and people who consume raw
or undercooked seafood from warm coastal waters subject to sewage contamination. In
Both instances, the risk is small.

How is the germ spread?

The cholera germ is passed in the stools. It is spread by eating or drinking food or water
contaminated by the fecal waste I countries of an infected person. This occurs more often
in underdeveloped countries lacking adequate water supplies and proper sewage disposal.
What are the symptoms of cholera?
People exposed to cholera may experience mild to severe diarrhea, vomiting and
dehydration. Fever is usually absent.
How soon do symptoms appear? The symptoms may appear from a few hours to five
days of exposure.

What is the treatment for cholera?

Because of the rapid dehydration that may result from severe diarrhea, replacement of
fluids by mouth or by the intravenous route is critical. Antibiotics, such as tetracycline, are
also used to shorten the duration of diarrhea and shedding of the germs in the feces.

Is there a vaccine for cholera?

A vaccine is available and is sometimes recommended for travellers to certain foreign
countries where cholera is occurring. However, the vaccine offers only partial protection
(50 percent) for a short duration (two to six months). Some physicians feel that foreign
travellers almost never contract cholera and that use of the current vaccine cannot be
justified.

How can cholera be prevented? The single most important preventive measure is to avoid
consuming uncooked foods or water in foreign countries where cholera occurs unless they
are known to be safe or have been properly treated.

B. Dengue fever (breakbone fever, dengue hemorrhagic fever)

Dengue Fever is a mosquito-borne disease caused by a virus. The disease is mainly tropical
in origin but occasionally residents or visitors from other countries may arrive in this
country with dengue. Although cases originating unknown, epidemic levels have recently
been reported in parts of in the United States are virtually the Caribbean and Central
America.

Who gets dengue fever?

Dengue fever may occur in people of all ages who are exposed to infected mosquitoes. The
disease occurs mainly in tropical Asia and the Caribbean, usually during the rainy seasons
in areas with high numbers of infected mosquitoes.

How is dengue fever spread? Dengue fever is spread by the bite of infected Aedes
mosquitoes.

What are the symptoms of dengue fever?

Dengue fever is characterized by the rapid development of a fever that may last from five
to seven days with intense headache, joint and muscle pain and a rash. The rash develops
on the feet or legs three to four days after the beginning of the fever. The hemorrhagic form
of dengue fever is more severe and associated with loss of appetite, vomiting, high fever,
headache and abdominal pain. Shock and circulatory failure may occur. Untreated
hemorrhagic dengue results in death in up to 50 percent of cases.
 How soon do symptoms appear?
Dengue fever may occur from three to 14 days after exposure to an infected mosquito,
commonly within four to seven days.

Does past infection with dengue virus make a person immune?

Infection with one of the four strains of dengue virus usually produces immunity to that
strains of dengue virus usually produces immunity to that strain but does not provide
protection against the other strains.

What is the treatment for dengue fever?

There is no specific treatment available. Intravenous fluids and oxygen therapy are often
used for patients who experience shock during their illness.

What can be done to prevent the spread of dengue fever?

Since cases of dengue appearing in New York are imported, control measures are limited to
advising travelers to affected areas to minimize exposure to infected mosquitoes. Use of
mosquito netting and repellants may be helpful in minimizing exposure.

C. Influenza (Flu)

The flu is a contagious respiratory illness by influenza viruses. It can cause mild to severe
illness, and at times can lead to death. Some people, such as older people, young children,
and people with certain health conditions, are at high risk for serious flu complications.

Every year in the United States, on average:

 5% to 20% of the population gets the flu
 More than 200,000 people are hospitalized from flu complications, and ;
 About 36,000 people die from flu.
The best way to prevent this illness is by getting a flu vaccination.

What are the symptoms of the flu?

The flu usually starts suddenly and may include these symptoms:

 Fever (usually high)

 Headache
 Extreme tiredness
 Dry cough
 Sore throat
 Runny or stuffy nose
  Muscle aches
 Stomach symptoms, such as nausea, vomiting, and diarrhea, may occur in children but
are rare in adults.
Are some people at higher risk for complications than others from getting the flu?

Some of the complications caused by flu include pneumonia, dehydration, and worsening of
chronic medical conditions, such as congestive heart failure, asthma or diabetes. Children may
get sinus problems and are infections.

How is the flu spread?

The flu is spread in respiratory droplets released by coughing and sneezing. It usually spreads
from person , though occasionally people may be infected by touching something withg virus on
it and then touching their mouth or nose.

When and for how long is a person able to spread the flu?

People with flu are contagious (able to infect others) beginning one day before getting
symptoms. Adults remain contagious up to seven days after getting sick and children can remain
contagious for even longer. That means that you can give someone the flu before you know
you’re sick as well as when you are sick.

Cold versus Flu

What is the difference between a cold and the flu?

The flu and the common cold are both respiratory illnesses but they are caused by different
viruses. Because colds and flu share many symptoms, it can be difficult (or even impossible) to
tell the difference between them based on symptoms alone. Special tests can be carried out, when
needed, to tell if a person has the flu: these tests usually must be done within the first few days of
illness.

What are the symptoms of the flu versus the symptoms of a cold?

In general, the flu is worse than the common cold, and symptoms such as fever, body aches,
extreme tiredness and dry cough are more common and intense. Colds tend to develop gradually,
while the flu tends to start very suddenly. Colds are usually milder than the flu. People with
colds are more likely to have a runny or stuffy nose. Colds generally do not result in serious
health problems, such as pneumonia, bacterial infections, or hospitalizations.

Preventing the Flu

What can I do to protect myself against the flu?

The single best way to prevent the flu is to get a flu vaccination each fall. There are two types of
vaccines:

 The "flu shot" is an inactivated vaccine (containing killed virus) that is given with a
needle. The flu shot is approve for use in people older than 6 months, including healthy
people and people with chronic medical conditions.
 The nasal-spray flu vaccine is a vaccine (sometimes called LAIv for “Live Attenuated
Influenza Vaccine”) made with live, weakened flu viruses that do not cause the flu. LAIV
is approved for use in healthy people 2 years to 49 years of age who are not pregnant.
 Children aged 6 months-8 years should receive 2 doses of vaccine if they have not been
vaccinated previously at any time with either the flu shot or nasal-spray flu vaccine.
Children aged 6 months -8 years who received only 1 dose in their first year of
vaccination should receive 2 doses the following year.
About two weeks after vaccination, antibodies develop that protect against influenza virus
infection. Full vaccines will not protect against illness caused by other viruses, such as the
common cold.

Who should get the flu vaccine?

All persons, including School-aged children, who want to reduce the risk of becoming ill with
influenza or of transmitting influenza to others should get the flu vaccine. In other words, when
there is an adequate supply, everyone should get the flu vaccine.

Those people at greatest risk for complications of the flu and those most likely to get or spread
the flu should be vaccinated with the flu vaccine as soon as it is available. These include:

 Children aged 6 months up to their 19th birthday;

 Persons aged ≥ 50 years;
 Children and adolescents (aged 6 months--18 years) who are receiving long-term aspirin
therapy and who therefore might be at risk for experiencing Reye syndrome after
influenza virus infection;
 Women who will be pregnant during the influenza season; Adults and children who have
chronic lung, heart, kidney, liver, blood, or metabolic disorders (including diabetes);
 Adults and children who have immune system suppression (including immune system
suppression caused by medications or by HIV);
 Adults and children who have any condition (for for example cognitive dysfunction,
spinal cord injuries, seizure disoders or other neuromuscular disorders) that can
compromise respiratory function or the handling of respiratory secretions or that can
increase the risk for aspiration;
 Residents of nursing homes and other chronic-care facilities;
 Health care personnel; Healthy household contacts (including children) and caregivers of
children aged ≤ 59 months (i.e., aged < 5 years) and adults aged ≥ 50 years; and
  Healthy household contacts (including children) and caregivers of persons with medical
conditions that put them at higher risk for severe complications from influenza.

Who should NOT be vaccinated?

There are some people who should not be vaccinated. They include:

 People who have a severe allergy to chicken eggs;

 People who have had a severe reaction to an influenza vaccination in the past;
 People who developed Guillain-Barré syndrome (GBS) within six weeks of getting an
influenza vaccine previously;
 Children less than 6 months of age;
 People who are sick with a fever. (These people can ger vaccinated once their symptoms
lessen. People with a mild illness can usually get the vaccine.)
Can antiviral medications prevent the flu?

Four antiviral drugs (amantadine, rimantadine, oseltamivir, a zanamivir) are licensed by the U.S.
Food and Drug Administration (FDA) for treatment and prevention of the flu. Antiviral drugs o
not a substitute for influenza vaccination. All of these drugs are available only by prescription
and are different in terms of who can take them, how they are given, dosages based on age or
medical conditions, and side effects. In addition, some influenza virus types or subtypes may be
resistant to certain antiviral drugs. Your doctor can help decide whether you should take an
antiviral drug and which one yo u should use.

D. Malaria

Malaria is a mosquito-borne disease caused by

any one of four different blood parasites, called
Plasmodia. The disease is transmitted to people
by the Anopheles mosquito. This disease is a
leading cause of debilitating illness, with over
200 million cases each year from around the
world. Almost all of the cases reported in New
York State each year are acquired in foreign
countries. However, a few locally acquired
cases have occurred on Long Island and in
Queens.

Who gets malaria?

Any person residing in or traveling to a country where malaria is prevalent is at risk for
contracting the disease. Malaria is currently a problem in tropical or subtropical areas of Asia,
Africa and Central and South America. Most black Africans show a natural resistance to some
species of malaria. Otherwise, susceptibility to malaria is universal.

How is malaria spread?

Malaria is spread by the bite of an infected Anopheles mosquito. With certain malaria species,
dormant forms can be produced which may cause relapses of malaria months to years later.
Malaria may also be transmitted by transfusion of blood from infected people or by the use of
contaminated needles or syringes.

What are the symptoms of malaria?

Symptoms include fever, chills, sweats and headache, and in some instances may progress to
jaundice, blood coagulation defects, shock, kidney or liver failure, central nervous system
disorders and coma. Cycles of chills, fever and sweating occurring every one, two or three days
is a good indicator of malaria in a person recently returning from a tropical

How soon do symptoms occur?

The time between the infective mosquito bite and the development of malaria symptoms can
range from 12 to 30 days depending on the type of Plasmodia involved. One strain of
Plasmodium, called P. vivax, may have a prolonged incubation period of eight to 10 months.
When infection occurs by blood transfusion, the incubation period depends on the number of
parasites transferred but is usual less than two months.

When and for how long is a person able to spread malaria?

Untreated or inadequately treated cases may be a source of mosquito infection for one to three
years depending on the strain of Plasmodium. Direct person-to-person transmission does not
occur stored blood products can remain infective for 16 days.

What is the treatment for malaria?

Due to the changing pattern of drug-resistant strains, current recommendations can be obtained
from your local, county or state health department. What can be done to prevent the spread of
malaria? Since malaria is not native to the United States, exposure to American citizens occurs
most frequently during foreign travel to malarious areas. It is very important to contact health
officials to determine the proper preventive drug therapy. The liberal and frequent use of
mosquito repellents as well as using a bed net can be very effective in preventing mosquito bites.

E. Pertussis (whooping cough)

Pertussis, or whooping cough, is a highly contagious bacterial infection that causes an

uncontrollable, violent cough lasting several weeks or even months. It is caused by a bacterium
that is found “the mouth, nose and throat of an infected person. Pertussis may begin with cold-
like symptoms or a dry cough that progress episodes of severe coughing.

Who gets pertussis?

Pertussis can occur at any age. Children who are too young to be fully vaccinated and those who
have not have not yet completed the primary fully vaccination series are at highest risk for severe
illness. Since the 1980s, the number of reported pertussis cases has gradually increased in the
Uniteds States. In 2005, over 25,000 cases of pertussis cases were reported in the United states
the highest number reported cases since 1959. Approximately 60 percent of the cases were in
adolescents and adults and may be result of decreasing immunity in this population.

How is pertussis spread? Pertussis is primarily spread from person to person by direct contact
with mucus or droplets from the nose and throat of infected individuals. Frequently, older
siblings who may be harboring the bacteria in their nose and throat can bring the disease home
and infect an infant in the household.

What are the symptoms of pertussis?

Pertussis begins as a mild upper respiratory infection. Initially, symptoms resemble those of a
common cold, including sneezing, runny nose, low-grade fever and a mild cough. Within two
weeks, the cough becomes more severe and is characterized by episodes of numerous rapid
coughs followed by a crowing or high pitched whoop. A thick, clear mucous may be discharged
from the nose. These episodes may recur for one to two months, and are more frequent at night.
Older people or partially immunized children generally have milder symptoms.

How soon after infection do symptoms appear? The incubation period is usually seven to ten
days with a range of four to 21 days and rarely may be as long as 42 days.

When and for how long is a person able to spread pertussis?

If untreated, a person can transmit pertussis from onset of symptoms to three weeks after the
onset of coughing episodes. The period of communicability is reduced to five days after
treatment with antibiotics.

What are the complications associated with pertussis

Major complications of pertussis are more common among infants and young children and may
include pneumonia, middle ear infection, loss of appetite, sleep disturbance, syncope (temporary
loss of consciousness), dehydration, seizures, encephalopathy (a disorder of the brain), apneic
episodes (brief delay in breathing and death.

What is the treatment for pertussis?

The recommended antibiotics for the treatment and postexposure prevention of pertussis include
azithromycin (Zithromax), (Zithromax), erythromycin and clarithromycin (Biaxin). Alternately,
trimethoprim- sulfamethoxazole (Bactrim) can be used.

Does past infection with pertussis make a person immune?

Neither vaccination nor natural infection with pertussis guarantees lifelong protective immunity
against pertussis. Since immunity decreases after five to ten years from the last pertussis vaccine
dose, older children, adolescents and adults are at risk of becoming infected with pertussis and
need vaccination.

What is the vaccine for pertussis?

Infants and Children

The childhood vaccine for pertussis is usually given in combination with diphtheria and tetanus.
Immunization authorities recommend that DTaP (diphtheria, tetanus, acellular pertussis) vaccine
be given at two, four, and six and 15 to 18 months of age and between four and six years of age.
Pre-teens and Adolescents In 2005, a new vaccine was approved as a single booster vaccinato
for adolescents and adults called Tdap (tetanus, diphtheria, ai acellular pertussis).

The preferred age for routine vaccination with Tdap is 11 or against tetanus, diphtheria, and
pertussis if they have completed adolescents, aged 11 through 18 should receive a single dose of
Tdap instead of Td (tetanus, diphtheria) for booster immunization recommended childhood
DTP/DTaP vaccination series.

ADULTS

For adults who are 19 through 64 years of age and have not previously received dose of Tdap, a
single dose of Tdap should replace a single dose of Td for booster immunization if the most
recent tetanus toxoid-containing vaccine was received at least ten re years earlier. Adults in close
contact with an infant aged under 12 months who have not previously received Tdap should
receive a dose of Tdap; an interval as short as two years since the most recent Td is suggested.

Healthcare personnel in hospitals and ambulatory care settings with direct patient contact who
have not previously received Tdap should receive a dose of Tdap; an interval as short as two
years since the most recent Td is recommended. In New York State, pertussis vaccine is required
of all children born after 1/1/2005 who will be enrolled in pre-kindergarten programs and
schools. Tdap vaccine is required for children born on or after 1/1/1994 and enrolling in the sixth
grade.

What can be done to prevent the spread of pertussis?

The single most effective control measure is maintaining the highest possible level of
immunization in the community. Treatment stay away from young children and infants until
properly treated appropriate antibiotics, such as Zithromax, will shorten the ne a person can
spread pertussis to five days after the beginning Treatment of people who are close contacts of
pertussis cases is Treatment. People who have or may have pertussis should also an important
part of prevention.

What is parapertussis?

Parapertussis is a bacterial illness that is similar t to pertussis (whooping cough) but is not as
common and generally causes less severe symptoms. Up to 40 percent of all cases of
parapertussis will present with no symptoms. Very young infants (less than six months of age)
may have a more severe course of parapertussis than older persons. Parapertussis is spread
through the air in drop produced during coughing and sneezing. A person can be infected with
parapertussis and pertussis at the same time. Parapertussis can be distinguished from pertussis by
certain laboratory tests. Antibiotic treatment should be started as soon as parapertussis is
suspected. All infants less than six months of age should receive antibiotics as a preventive
measure if they have been in contact with a person who has parapertussis.

F. Pneumococcal Disease (includes pneumococcal pneumonia, pneumococcal meningitisand

pneumococcal bacteremia)

Pneumococcal disease is a bacterial infection caused by the bacteria Streptococcus pneumoniae,

also called pneumococcus. It may cause middle ear infection, pneumonia, meningitis
(inflammation of the coverings of the brain and spinal column) or bacteremia (a bloodstream
infection).

Who gets pneumococcal disease?

Although anyone can get pneumococcal disease, it occurs more frequently in infants, young
children, African Americans, some Native American populations, the elderly or in people with
serious underlying medical conditions such as chronic lung, heart or kidney disease. Others at
risk include alcoholics, diabetics, people with weakened immune systems and those without a
spleen. infection occur anytime but most often during the winter and early spring when
respiratory illnesses are more common. Data suggests pneumococcal conjugate vaccine (PCV7)
has reduced use invasive disease among children and their adolescent and adult household and
close contacts.

How is the disease transmitted?

Pneumococcus is spread by airborne or direct exposure to respiratory droplets from a person who
is infected or carrying the bacteria.

How soon after exposure do symptoms occur?

The incubation period may vary, but, it is generally one to three days.

What are the symptoms?

Symptoms generally include an abrupt onset of fever and shaking or chills. Other symptoms may
include headache, cough, chest pain, disorientation, shortness of breath, weakness and
occasionally a stiff neck.

What are the complications associated with pneumococcal disease?

Death occurs in 14 percent of hospitalized adults with invasive disease. Neurologic

complications and/or learning disabilities can occur in meningitis patients. Hearing impairment
can result from recurrent otitis media. How is pneumococcal disease treated? Prompt treatment
with antibiotics, such as penicillin or a cephalosporin, is usually effective. However, penicillin-
resistant strains of pneumococcus are increasingly being reported throughout the United States.

Does past infection with pneumococcal disease make a person immune?

Past infection with pneumococcus does not provide lifelong immunity against pneumococcal
disease reoccurring due to the many types pneumococcal bacteria.

Is there a vaccine to prevent infection?

Yes. There are two types of vaccines currently in use. The pneumococcal conjugate vaccine
(PCV7) contains protection against seven types of pneumococcal bacteria. The pneumococcal
Ine polysaccharide vaccine (PPV23) contains protection from 23 of pneumococcal bacteria. Both
vaccines are safe and reduces disease occurrence.

Pneumococcal conjugate vaccine is recommended for all children less than 24 months old and
for children between 24 and 59 months old who are at high risk of disease.

All adults who are older than 65 years of age and persons who are two years and older and at
high risk for disease (e.g, sickle cell disease, HIV infection, or other conditions that weaken the
immune system) should receive the pneumococcal polysaccharide vaccine.

In New York State, pneumococcal conjugate vaccine (PCV7) is required for pre-kindergarten
attendance for children born on or after 1/1/08.

What can be done to prevent the spread of pneumococcal disease?

One of the most effective control measures is maintaining the highest possible level of
immunization in the community.

G. Tuberculosis (TB)

Tuberculosis is a bacterial disease usually affecting the lungs (pulmonary TB). Other parts of the
body can also be affected, for example lymph nodes, kidneys, bones, joints, etc. (extrapulmonary
TB). Approximately 1,300 cases are reported each year in New York State.

Who gets tuberculosis?

Tuberculosis can affect anyone of any age. People with weakened immune systems are at
increased risk.

How is tuberculosis spread?

Tuberculosis spread through the air when a person with untreated pulmonary TB coughs or
sneezes. Prolonged exposure to a person with untreated TB usually is necessary for infection to
occur.

What is the difference between latent tuberculosis infection and tuberculosis disease?

Latent tuberculosis infection (LTBI) means the person has the TB germ in their body (usually
lungs), but has yet to develop obvious Symptoms. In latent TB, the person has a significant
reaction to the Mantoux skin test with no symptoms of tuberculosis, and no TB organisms found
in the sputum. Tuberculosis disease indicates the person has symptoms, a significant reaction to a
Mantoux skin test and organisms found in the sputum. In order to spread the TB germs, a person
must have TB disease. Having latent TB infection is not enough to spread the germ. Tuberculosis
may last for a lifetime as an infection, never developing into disease.

What are the symptoms of tuberculosis?

The symptoms of TB include a low-grade fever, night sweats, fatigue, weight loss and a
persistent cough. Some people may not have obvious symptoms.

How soon do symptoms appear?

Most people infected with the germ that causes TB never develop active TB. If active TB does
develop, it can occur two to three months after infection or years later. The risk of active disease
lessens as time passes.

When and for how long is a person able to spread tuberculosis?

A person with TB disease may remain contagious until he/she has been on appropriate treatment
for several weeks. However, a Person with latent TB infection, but not disease, cannot spread the
infection to others, since there are no TB germs in the sputum.

What is the treatment for tuberculosis?

People with latent TB infection should be evaluated for a course of preventive therapy, which
usually includes taking antituberculosis medication for several months. People with active TB
must complete a course of treatment for SIX months or more. Initial treatment includes at least
four anti-TB drugs, and medications may be altered based on laboratory test results. The exact
medication plan must be determined by a physician. Directly observed therapy (DOT) programs
are recommended for all TB patients to help them complete their therapy.

What can be the effect of not being treated for tuberculosis?

In addition to spreading the disease to others, an untreated person may become severely ill or die.

What can be done to prevent the spread of tuberculosis?

The most important way to stop the spread of tuberculosis is for TB patients to cover the mouth
and nose when coughing, and to take all the TB medicine exactly as prescribed by the physician.

What is multidrug-resistant tuberculosis (MDR-TB)?

This refers to the ability of some strains of TB to grow and multiply even in the presence of
certain drugs which would normally kill them.

What is extensively drug-resistant tuberculosis (XDR-TB)?

Extensively drug-resistant TB (XDR-TB) is a subset of MDR-15 “which the strains of TB

bacteria are resistant to several of the best second-line drugs for TB. These strains are very
difficult to treat XDR-TB cases make up approximately 10 percent of MDR-TB cases.

Who gets MDR-TB?

TB patients with drug sensitive disease may develop drug resistant tuberculosis if they fail to
take anti-tuberculosis medications as prescribed, as well as TB patients who have been
prescribed an ineffective treatment plan. TB cases diseased with MDR-TB can transmit the drug
resistant infection to other individuals.

What is the treatment for multidrug-resistant tuberculosis?

For patients with disease due to drug resistant organisms, expert consultation from a specialist in
treating drug resistant TB should be obtained. Patients with drug resistant disease should be
treated with drugs to which their organisms are susceptible. The effectiveness of treatment for
latent infection with MDR-TB is uncertain.

What can be done to prevent the spread of MDR-TB?

Ensuring people with MDR-TB take all their medication and teaching patients to cover their
mouth and nose when coughing and sneezing can reduce the risk of spread of MDR-TB. In
addition, directly observed therapy should be used to ensure patients complete the recommended
course of therapy.

Typhoid Fever

What is typhoid fever? Typhoid fever is a bacterial infection of the intestinal tract and
occasionally the bloodstream. It is an uncommon disease with only 30-50 cases occurring in
New York each year. Most of the cases are acquired during foreign travel to underdeveloped
countries. The germ that causes typhoid is a unique human strain of Salmonella called
Salmonella typhi. Outbreaks are rare.

Who gets typhoid fever? Anyone can get typhoid fever but the greatest risk exists to travellers
visiting countries where the disease is common. Occasionally, local cases can be traced to
exposure to a person who is a chronic carrier.

How is the germ spread?

Typhoid germs are passed in the feces and, to some extent, the urine of infected people. The
germs are spread by eating or drinking water or foods contaminated by feces from the infected
individual.

What are the symptoms?

Symptoms may be mild or severe and may include fever, headache constipation or diarrhea,
rose-coloured spots on the trunk and an enlarged spleen and liver. Relapses are common.
Fatalities are less than 1 percent with antibiotic treatment.

How soon do symptoms appear?

Symptoms generally appear one to three weeks after exposure.

For how long can an infected person carry the typhoid germ?

The carrier stage varies from a number of days to years. Only about 3 percent of cases go on to
become lifelong carriers of the germ and this tends to occur more often in adults than in children.

How is typhoid treated?

Specific antibiotics such as chloramphenicol, ampicillin or ciprofloxacin are often used to treat
cases of typhoid.

Should infected people be isolated?

Because the germ is passed in the feces of infected people, only people with active diarrhea who
are unable to control their bowel habits (infants, certain handicapped individuals) should be
isolated. Most infected people may return to work or school when they have recovered, provided
that they carefully wash hands after toilet visits. Children in daycare, health care workers, and
persons in other sensitive settings must obtain the approval of the local or state health department
before returning to their routine activities. Food handlers may not return to work until three
consecutive negative stool cultures are confirmed.

Is there a vaccine for typhoid?

A vaccine is available but is generally reserved for people traveling to underdeveloped countries
where significant exposure may occur. Strict attention to food and water precautions while
traveling such countries is the most effective preventive method.

A. Physical Health
 - Physical health refers to our body health. To be physically fit, it will pertain to a
person's nutrition, activity level, diet, and sleep cycle. You can identify someone's
physical health by basing on their height, weight and them being able to do daily
activities. 
B. Mental Health
- Mental health refers on how effectively and successfully a person functions. This refers
on a person's emotional and psychological well being. You can monitor someone's
mental health on how well they function in the society, if they are capable of using their
cognitive and emotional capabilities, and able to meet the ordinary demands of
everyday life. 
C. Nutrition 
-