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HEALTH PROTECTION ASSIGNMENT

Section A will test your understanding of infection control and outbreak management using a related case-study while section B will assess your ability to evaluate the impact of environmental hazards and how you respond to such threats using a related case-study.

SECTION A: SURVEILLANCE FOR SHIGA TOXIN-PRODUCING E. COLI (STEC)

Case Study
Shiga toxin-producing Escherichia coli (STEC) is a group of E. coli bacteria that produce powerful toxins, which can cause severe illness. In the UK, the commonest serogroup of STEC is 0157 (STEC 0157), which can cause bloody diarrhoea and haemolytic uraemic syndrome (HUS). STEC is a notifiable disease under the Public Health (Control of Diseases) Act 1984 and the Health Protection (Notification) Regulations 2010.

Question 1: Discuss the burden and population health impacts of STEC 0157 for a named country of your choice, supported by relevant evidence. You should consider any inequalities in exposure and outcomes, using specific examples as appropriate.

Scenario
On 15 April 2019, a clinical microbiologist at a local hospital in the north-east of England notifies the Health Protection Team (HPT) of a case of presumptive Shiga toxin-producing E. coli (STEC) 0157 in an 8-year-old child with a two-day history of being unwell with bloody diarrhoea and abdominal pain. The family of the child were interviewed and it was identified that the child had visited an open farm event on 7 April 2019, where they had direct contact with lambs, goats and ponies.

On 19 April, the HPT was notified of a second case of presumptive STEC 0157 in a 2-year-old with HUS. The family confirmed that the child had visited the same open farm event.

Question 2: Based on this information, describe what immediate public health actions need to be taken by the HPT to (i) interrupt transmission of infection from the children with diarrhoea and (ii) establish monitoring for further cases. (10 marks)

Question 3: Critically evaluate the evidence you have so far to generate a hypothesis for the likely source of STEC 0157 infection and how it has been transmitted to the children. Use the chain of infection model as a framework for your answer. Explain how the deficiencies noted by the Environmental Health Team could affect the chain of infection.

Question 4: Produce an outbreak management plan, identifying your control measures by order of priority. Your plan should discuss relevant policies, ethical considerations, and should conclude with how you would manage the end of the outbreak.

SECTION B: AMBIENT AIR POLLUTION AND RISING ASTHMA AND COPD RATES

Case study
More than 80% of people living in urban areas that monitor air pollution are exposed to air quality levels that exceed the World Health Organization (WHO) limits. While all regions of the world are affected, populations in low-income cities are the most impacted. Long term exposure to air pollution has serious health effects including cardiovascular and respiratory diseases, as well as loss of life expectancy.

Question 1: Discuss the short and longer-term health impacts arising from ambient air pollution in a named country of your choice, supported by relevant evidence. You should include an account of sources of pollution in this context, and consider any inequalities in exposure and outcomes, using specific examples as appropriate.

Question 2: Provide an evidence-based summary of effective interventions to reduce harm from ambient air pollution in the context given in the scenario, with recommendations for a local plan, taking account of relevant policies.

Question 3: Prepare an outline of your radio interview and the key points that you would wish to convey to the public at this stage. Consider the social context of this scenario and consider which interventions you might choose to mention in your interview. You can expect to be asked about air quality guidelines for particulate matter, methods for monitoring air quality , and also the next steps to be taken by the council.

Attachment:- HEALTH PROTECTION ASSIGNMENT.rar