4. Avian influenza and food safety
4.1. Impact of bird flu
- Chicken (duck, goose...) is a popular food, a specialty dish of people across the country.
- The nutritional value of chicken is very high.
- Consumption demand: very large, just after pork.
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- Impact on consumer psychology: very worrying.
- Reduced income of livestock farmers.
- Reduce economic development in agriculture, industry, trade and tourism...
4.2. Can bird flu be transmitted to humans through food?
- Bird flu is not transmitted to humans through food.
Reason:
+ Influenza virus is transmitted through the respiratory tract.
+ Chicken dishes are always cooked, while the resistance of influenza viruses to
very weak temperature: 70 0 C was destroyed.
- There is an opinion that: chicken meat does not spread the flu virus to humans through food, but can cause illness in humans through direct contact with sick chickens or when preparing chicken.
Chicken is only dangerous when:
+ Diseased chicken, dead chicken.
+ Chicken meat contaminated with microorganisms, soaked in chemical additives.
- The UK Food Standards Agency has advised that it is safe to eat chicken in affected areas as bird flu is transmitted through contact with infected live poultry. Professor PENNINGTON (FSA advisor) has also determined that people must “breathe” the virus from infected poultry to be infected. Therefore, the FSA recommends that tourists avoid poultry markets when travelling in Asia.
4.3. Mechanism of disease spread
For an epidemic to spread, all three of the following links are needed:
Source of disease Transmission route Receptor block
4.3.1. Source of disease: Sick poultry
Sick poultry shed viruses through secretions and feces.
4.3.2. Transmission route : Respiratory tract Method of virus spread:
+ Contact: inhaling viruses from poultry, dust, air.
+ Chicken eggs: eggshells contaminated with feces contain viruses.
+ Dust, wind: spread viruses in dust, chicken feathers...
+ Chicken cages, equipment for confining and transporting chickens, barns... contaminated with feces and secretions of chickens with viruses.
+ Infected migratory birds: excrete the virus through their droppings to areas they fly through or land on.
4.3.3. Susceptibility : can everyone get sick?
- There is no vaccine to prevent the disease.
- There is no specific medicine.
4.4. Disease prevention measures:
4.4.1. Treatment of disease sources
- Identify the outbreak.
- With bird flu outbreak: completely destroy all chickens, ducks, and birds within a 3 km radius (animals).
y).
- For human epidemics: Must be isolated and treated in hospital.
4.4.2. Handling of transmission routes
- Spray chemicals, disinfect and sterilize chicken coops, tools, and leftover food.
- Disinfect air, sunlight, spray chemicals.
4.4.3. For the sensory block
- For poultry: Prohibit trading and moving from the epidemic area to and from outside the epidemic area.
- For humans: Avoid contact with poultry, when in contact must wear protective gear, 6 must-have devices:
+ Mask
+ Glasses
+ Hat
+ Cloak
+ Rubber gloves
+ Rubber boots, used for labor protection when in contact with poultry, must be disinfected and sterilized after reuse.
Increase body resistance: Personal hygiene, disinfect nose and throat, improve nutrition and diet.
Specific vaccine (if available).
4.5. Coordination measures of the food safety sector
4.5.1. Under the direction of the government, inter-sectoral coordination in work
- Quarantine (main station):
+ Discovery
+ Prevent poultry transportation
+ Isolation
- Check (market, traffic):
+ Discovery
+ Prevent
4.5.2. Coordinate the collection and destruction of dead poultry, sick chickens, environmental treatment, and disinfection of barns (veterinary)
4.5.3. Public education and propaganda
- Don't worry or panic.
- Clean and disinfect the home environment.
- Hygiene to prevent respiratory diseases, clean the environment in areas with bird flu and people with flu.
- Each consumer becomes a "smart consumer":
+ Know how to choose live, healthy chickens (in a safe area): Chickens run and walk normally. Red comb, normal anus. Feathers and skin are smooth, bright, healthy, no bruises, eat rice and other foods normally. No discharge from nose and mouth.
Detect and eliminate sick chickens or flu if: Chickens have difficulty breathing, stretch their necks to breathe. Chicken feathers are ruffled, head and comb are purple. Walk slowly, unsteadily, walk in circles. Fluid flows from nose and mouth.
+ Know how to choose “fresh” chicken: Natural color from ivory white to bright yellow. Intact skin, no stains or bruises. Fresh yellow chicken meat, no bleeding or blood clots. Normal taste, no foul odor.
Detect and eliminate diseased chicken meat: Reddish purple meat, congestion. Reddish purple comb, with many dark yellow spots. Foul, fishy smell.
- Eat poultry and well-cooked eggs. Do not eat raw eggs, poached eggs, fried eggs, etc.
4.6. Implementation organization
- There are specific instructions for facilities according to state regulations.
- Take measures to thoroughly isolate the outbreak: announce the scope of the outbreak.
- Clearly define the functions of departments and branches in directing the containment and suppression of the epidemic.
- Support funding and chemical supplies for epidemic prevention activities.
5. Environmental sanitation to prevent flu
As we know, influenza is an acute infectious disease caused by a virus for which there is currently no specific treatment.
The most important thing in dealing with the environment during a flu epidemic is to communicate to everyone to follow the following content:
- General environmental sanitation.
- Water treatment.
- Waste treatment.
- Handling of feces and dead animals.
- Handling medical instruments, linen and patient equipment.
- Transporting patients.
- Handling of deceased patients.
- Air disinfection.
- Surface disinfection.
- Disinfect means of transport.
5.1. Environmental sanitation
- Mobilize community forces to organize general cleaning at home, village roads, and alleys (during the epidemic, general cleaning is carried out daily, within a radius of 3km from the epidemic center).
- Clear sewers, ditches, and bushes.
5.2. Water source treatment
- Use clean water sources. During an epidemic, disinfect water sources with Cloramin B: 20-30g/1m3 of water.
- If using tap water, increase the amount of Cloramin B by one and a half times the normal amount.
5.3. Waste treatment
After collection, garbage must be classified: inorganic garbage, organic garbage.
- Inorganic waste such as: nylon, bottles, jars, iron,.... must be kept separately for recycling and must be disinfected first.
- Organic waste such as: Vegetables, fruits, leftover food... can be used to feed livestock. Note that the food must be boiled or soaked in Cloramin B for 30 minutes. Unused remaining food must be put in a double-layer plastic bag, tied tightly at the neck, and burned or buried deep.
- The above types of garbage must be kept in sealed plastic bags or in covered bins.
5.4. Treatment of feces, waste, and dead animals
- Human excreta must be managed in hygienic latrines: if the latrine is dry, lime powder must be added daily. Septic tank latrines and flush latrines must be added with Cloramin B. Absolutely do not defecate in fields, ponds, lakes, rivers, streams...
- Patient waste must not be thrown away indiscriminately but must be disinfected before being buried at the bottom of the pit, and a layer of lime powder must be spread on the surface of the pit.
- Clothes, towels... must be soaked in Cloramin B for 30 minutes before washing. When it is sunny, open the door to ventilate the house, dry clothes, blankets, and curtains in the sun to kill the virus. Do not stay or sleep in an air-conditioned room during an epidemic.
- Dead animals must be put in a plastic bag, tied tightly at the neck, buried deep (cover the bottom of the hole with plastic and sprinkle lime powder above and below), and it is best to burn it.
5.5. Handling of medical instruments, linen and patient equipment
- Medical instruments: Reusable instruments must be sterilized immediately before being transferred to the cleaning and sterilization chamber according to regulations.
- Tools used for patients: must be cleaned and disinfected with soap and disinfectants every day when dirty. Each patient must have their own tools for hygiene and nutrition.
5.6. Transporting patients
Transport the patient by specialized vehicle. After transporting the patient, the vehicle must be disinfected with a common disinfectant.
5.7. Handling of deceased patients
- The patient must be embalmed on site according to epidemic prevention regulations, disinfected with Cloramin B and Formalin chemicals, transferred to the burial or cremation site by private vehicle and ensured compliance with regulations to prevent infection.
- Deceased patients must be buried within 24 hours, preferably cremated.
5.8. Disinfection of polluted air
- Using Formalin vapor: heat 36-40% concentration of Formalin diluted at a ratio of 1/1, dosage 8-10g/m3 of space.
- A simpler method is to use an enamel tray containing a diluted Formalin solution in the above ratio, use an alcohol lamp or gas to heat the solution until it evaporates. Close the door tightly and let the solution contact for at least 4 hours, then use Ammonia to deodorize or open the door wide for ventilation.
- Use a high-performance, broad-spectrum disinfectant solution from Anios (France) in the form of a ULV sprayer (fontan).
- Ultraviolet lamps can be used to disinfect the air in sick rooms or isolation rooms.
5.9. Surface disinfection
Use 5% Cloramin B solution (5g Cloramin B powder/1 liter of water to wipe or spray on contaminated surfaces (including floors, walls, equipment, sinks, etc.) or use dibromite at a concentration of 5 - 10g/liter to wipe or spray for disinfection (from 150 - 300ml/m2 of earthen walls, 100ml/m2 of wooden or cement walls, contact time 60 minutes).
5.10. Disinfection of means of transport
Means of transporting patients such as: airplanes, trains, cars, boats, stretchers... After transporting patients, they must be disinfected by fumigating with Formalin or ultraviolet rays in closed compartments, then wiping or spraying the floor surface, vehicle walls, seats... after 60 minutes, they can be washed with clean water.
6. Care
6.1. Comments
- Observe skin, toenails, fingernails.
- Count breathing rate, breathing pattern, hypersecretion.
core.
- Pulse and blood pressure monitoring: 30 minutes/time; 1 hour/time; 3 hours/time depending on the patient's condition
- Measure temperature.
- Infectious, respiratory and pain syndromes.
- Consciousness, movement.
- View medical records for: Diagnosis, medication prescription, nutritional testing requirements
and other tracking requirements.
6.2. Care planning
- Ensure ventilation.
- Circulation monitoring.
- Monitor complications.
- Carry out medical orders.
- Monitor vital signs.
- Care of organ systems.
- Health education.
6.3. Implement the plan
6.3.1. Ensure ventilation
- Place the patient on his back, head tilted to one side.
- Give oxygen if there is respiratory failure.
6.3.2. Circulation monitoring:
- Take pulse, blood pressure, and temperature immediately after the patient enters the hospital.
- Prepare IV fluids, blood pressure medications, and IV equipment.
- Closely monitor pulse and blood pressure: 30 minutes/time; 1 hour/time; 3 hours/time depending on the patient's condition.
6.3.3. Monitoring of complications
- Superinfection
- Cardiovascular
- Nerves
- Myositis
6.3.4. Execution of orders
- Medicine
- Testing
- Monitor vital signs
6.3.5. Care of organ systems
- Let the patient rest until the fever goes away.
- Keep warm.
- Cold compress when the patient has a high fever.
- Clean skin, eyes, nose, mouth.
- Disinfecting excreta.
- Feeding: Liquid food, food rich in vitamin C.
6.3.6. Health education
- Instruct patients (if conscious) and their families on departmental regulations.
- Wear a mask when in contact with others.
- Limit crowded gatherings during an epidemic.
- Clean nose and throat.
- Avoid catching a cold and overworking.
Vaccine.
6.4. Rating: Rated as good care when.
- Fever decreases, patient sweats a lot, urinates a lot, signs of pain, sore throat gradually improve and disappear completely after 7 - 10 days.
- The patient is no longer tired and can eat and sleep.
VALUATION
1. Can you describe the types of flu currently circulating?
2. Can you draw a diagram of the transmission of influenza type A?
3. Could you explain the mechanism of influenza A transmission and measures to prevent influenza A?
4. How do you treat the environment to prevent flu?
5. How do you present your assessment, plan, and implement a care plan for patients with Type A influenza?
Lesson 15
CHICKENPOX PATIENT CARE
TARGET
1. Present the concept, epidemiological characteristics, clinical symptoms, and complications of chickenpox.
2. Describe the method of planning care for patients with chickenpox.
CONTENT
1. Concept
Chickenpox is a highly contagious acute infectious disease, capable of causing epidemics, caused by a type of virus. The disease is characterized by fever, blister-like rash on the skin and mucous membranes.
2. Causes
Caused by the Chickenpox virus, this is a DNA virus with poor resistance to external conditions.
3. Epidemiology
3.1 Source of disease : The patient is highly contagious from the time the rash first appears until 5 days after the last rash appears.
3.2 Transmission route: Through the respiratory tract.
3.3 Perception - immunity
- Perception: Children are highly perceptive, age of greatest perception: 7 months to 7 years old.
- Immunity: After recovery, there is lasting immunity.
3.4. Epidemic characteristics : The disease increases slightly in autumn, winter and spring, often causing epidemics in groups of children.
4. Clinical symptoms:
4.1. Incubation period: 2 weeks
4.2. Initial stage : 1 day, the patient has mild fever, loss of appetite, headache, fatigue.
4.3. Full-blown stage : 6 - 8 days
+ Whole body: Mild fever or no fever
+ Rash:
- Characteristics of the rash: Very shallow blisters on the skin surface with different sizes (small as a pinhead, big as a pea).
- Blisters contain a clear fluid, which becomes cloudy after 24 hours.
- The rash does not appear in any order.
- Location of rash: Usually seen on facial skin, hairy skin, not seen on the soles of the feet or palms of the hands.
- The blisters quickly subside after 1 - 2 days, form brown scabs and leave no scars, then another outbreak appears (thus on the same patch of skin there are many different ages of chickenpox rash).
5. Complications
- Pyoderma due to secondary infection
- Pneumonia
- Encephalitis
6. Care
6.1. Comments
- Observe skin, toenails, fingernails, count breathing rate, breathing pattern, and hypersecretion.
- Monitor pulse and blood pressure every 30 minutes, every hour, every 3 hours depending on the patient's condition.
- Rash status: Location and characteristics of the rash.
- Temperature monitoring.
- Monitor consciousness and movement.
- View medical records for diagnosis, medication orders, tests, nutritional requirements, and other follow-up requirements
6.2. Planning
- Ensure ventilation.
- Circulation monitoring.
- Monitor complications.
- Carry out medical orders.
- Care of organ systems
- Health education
6.3. Implement the plan
+ Ensure ventilation:
- Place the patient on his back, head tilted to one side.
- Monitor breathing for hypersecretion.
+ Circulation monitoring:
- Take pulse, blood pressure, temperature immediately upon contact with the patient and report to the doctor.
- Closely monitor pulse and blood pressure: every 30 minutes, every 1 hour, every 3 hours depending on the patient's condition.
+ Monitor and prevent complications:
- Secondary infection causes pyoderma.
- Pneumonia.
- Encephalitis.
+ Execute the order:
- Medication: Do not use Aspirin to reduce fever in children.
- Test.
- Monitor vital signs.
+ Care of organ systems:
- Apply cold compress if the patient has a high fever.
- Daily personal hygiene, cutting toenails and fingernails.
- Seizures: Keep the patient safe, give anticonvulsants.
- On-site: clean daily with diluted potassium permanganate.
- Nutrition: Do not abstain excessively. Give the patient foods rich in protein and vitamins.
+ Health education:
- Instruct patients (if conscious) and their families on departmental regulations.
- Detect and isolate sick children 9 days from the appearance of the rash.
- Newborns and pregnant women at risk of disease: Inject globulin, with a dose of 3 - 6 ml/intramuscular injection
6.4. Evaluation
It is considered good care when after 1 week, most of the chickenpox rashes crust over and move to the recovery stage, without any complications.