Case study: infectious disease

1
Case study infectious disease

• Professor Anne Johnson FMedSci Head, Department
  of Primary Care and Population Sciences, Royal
  Free and University College Medical School,
  London

2
Background

• Globally
• infections cause over a fifth of all deaths
• a million children die each year from diseases
  preventable through vaccination
• In the UK, infectious diseases account for
• over 10 of deaths
• one in three GP consultations
• New infectious diseases one per year

3
Public health measures relating to infectious
disease

• Prevention through vaccination
• Surveillance
• Control strategies

4
Prevention through vaccination

• Aims of vaccination
• to protect individuals
• to protect vulnerable or at-risk individuals
• to achieve population immunity
• Concerns about safety of vaccines
• Free riders

5
Prevention through vaccination

• Three broad approaches to vaccination policy
• voluntary
• incentivised
• quasi-mandatory
• Conclusions
• No justification for moving beyond voluntary
  system in UK for childhood vaccination

6
Surveillance

• Population surveillance using anonymised data
• Conclusion acceptable for predicting trends
• Notifiable disease surveillance using identifying
  data
• Conclusion acceptable for avoiding harm to
  others if invasion of privacy is minimised

7
Surveillance

• Global surveillance of infectious diseases is
  vital
• Problems if countries do not have capacity or do
  not cooperate
• Conclusions
• UK should enhance surveillance capacities of
  developing countries
• WHO should explore virus isolates as public
  good
• WHO should impress social responsibilities on
  pharmaceutical companies

8
Control

• Quarantine and isolation are at the top of the
  intervention ladder
• Conclusion ethical justification involves
  weighing the harm principle with consent and
  avoiding intrusive interventions

9
Information and communication

• Effective communication is crucial
• Risks should not be downplayed or overstated
• Conclusions
• Government should ensure the timely provision of
  information about outbreaks
• Those who report research have a duty to
  communicate findings in a responsible manner