Explain what the reporting protocol would be if an outbreak were to occur in your community.

This is the third revision for this paper. The paper is good but needs some minor adjustment please see below for corrections. Please read all instructions carefully thank you for your time and effort, keep the format the same just add to it in more detail.

Corrections as follows:

12/1/15-It is well stated that cases of tuberculosis in San Diego, between 2007-2012, were either from Mexico or had a link to Mexico. The extent and the impact of the outbreak are not described. More details are needed in discussing the disease outbreak

12/1/15-Living or traveling in countries that have high rates of tuberculosis is expertly identified as an epidemiological determinant of the outbreak in San Diego. There are not any other details given of the determinants of the increase in cases between 2007-2012. More analysis of the determinants of the outbreak need to be discussed.


With the increased mobility of human populations, diseases can quickly spread around the world. In addition, changes in vaccination practices have indicated an increase in communicable diseases that were once thought to be under control. These global health issues present new problems for community health officials. In this task, you will analyze a specific, recent outbreak of a global communicable disease that has crossed international borders (i.e. TB outbreak, Haiti to U.S.). Choose one of the following communicable disease outbreaks to address in your task:
• avian influenza
• measles
• respiratory syndrome coronavirus
• meningococcal disease
• tuberculosis
• malaria

Note: If you are a California student, please contact your course mentor.

A. Analyze the selected communicable disease outbreak (suggested length of 2–3 pages) by doing the following:
1. Describe a specific, communicable disease outbreak.

Note: This may include the name of the disease, countries involved, date discovered, and date the disease reached certain countries.
2. Analyze the epidemiological determinants of the outbreak.
a. Discuss the route of transmission of the disease causing the outbreak.
b. Discuss any risk factors involved.
3. Discuss how the outbreak could affect your community at a systems level (i.e., how it will affect the functioning of schools, local government, businesses, hospitals).
4. Explain what the reporting protocol would be if an outbreak were to occur in your community.
5. Develop a plan for how you would report about the outbreak to key stakeholders in your community.
6. Discuss strategies (e.g., patient education strategies, community education strategies) that you would recommend to prevent an outbreak in your community.


Paper for corrections
Tuberculosis TB is a contagious disease that mainly affects the lungs. Nonetheless, it can affect other parts of the body. Pathogenesis of tuberculosis began by the research work of Theophile Laennec in the early 19th century. It was then advanced by Jean-Antoine Villemin in 1865 who demonstrated the transmissibility of Mycobacterium tuberculosis infection. The tubercle bacillus as the etiologic agent was discovered in 1882 by a German microbiologist known as Robert Koch at a time when 1 of every 7 deaths in Europe was caused by TB. The tuberculin skin test was developed by Clemens von Pirquet in 1907 that was later used to demonstrate infection in asymptomatic children. Thereafter, in the late 19th and early 20th century, sanatoria were developed for treatment of tuberculosis.
The United States-Mexico Border Health Commission (2014) reports an increased transmission of Tuberculosis especially along the border of Mexico and United States. According to the US officials, a drug resistant tuberculosis case is usually connected to Mexico. In the year between 2007 and 2012, the San Diegos multidrug-resistant TB cases were either from Mexico or had a link to Mexico based on a restrain of the disease. This is according to Health and Human Agencies report which oversees many people who work on both sides of the border. The increased transmission of TB has been attributed to inadequate access to health care and hence poor health outcomes.
Epidemiological Determinants of the outbreak
According to Goldmann (2000), tuberculosis is mainly spread through droplets infection. This occurs when a person infected by TB coughs, exhales or sneezes fluid droplets containing tubercle bacilli. This aerosol is inhaled by a susceptible person and taken through the nasal passages and lungs. The person can then acquire the disease. However, the disease is not highly contagious, only one in three close contacts with an infected person is likely to be infected.
The epidemiological determinants of an outbreak
Frequent and prolonged contact with an infected person can make a person contract the disease (Goldmann, 2000). One infected persons can release huge numbers of the virus and therefore, the chances of getting the disease are very high. The risk factors as suggested by Goldmann (2000) include:
a) Weakened immune system
There are a number of medications that can weaken a body’s immune system hence making the body vulnerable to Tuberculosis. Medications such as chemotherapy for cancer, drugs used in the treatment of rheumatoid arthritis, psoriasis among others weaken the immune system. Other diseases such as HIV/AIDS and diabetes also weaken body defensive mechanism. A weakened immune system allows easy transmission of the infection.
Traveling or living in some areas
Living or travelling in countries that have high rates of tuberculosis creates avenues for contracting the disease. It is recommended that those who plan to stay for long periods in endemic countries should take a 2-step tuberculin skin test (TST) or just a single interferon-y release assay(IGRA); either QuantiFERON TB test or T-SPOT TB test.
Poverty and substance abuse
People who have been affected and cannot access medical services are likely to transmit the disease to many other people. Further, use of drugs and alcohol weaken the immune system of any individual. This association is mediated by overcrowding, poorly ventilated housing, smoking and poor social capital.

Place of Residence or Workplace.
Contact with ill people is an exposure to the TB bacteria. For instance, a person working in a health facility is more exposed to the bacteria. Those who live in nursing homes and in immigration centers are also vulnerable to the disease.
The Effect of the Outbreak at Community Level
The outbreak of Tuberculosis can affect learning in schools. Consequently, schools will have to close down to stop further spread of the disease among the students. On the other hand, hospitals will have an influx of patients infected and this will affect the operations of the hospital. On its part, the government will also have to channel more funds to mitigate the outbreak; this could be more that the amount budgeted for emergency. On the other hand, business especially the pharmaceuticals may thrive due to high demand for drugs.
Reporting Protocol to Key Stakeholders
According to California Code of Regulation title 17, I shall immediately report the facts by telephone to the local health Department in case of any knowledge about the outbreak of Tuberculosis or unusual incidence of infectious disease. This has to reach the TB control program within 24 hours of identification. The report has to be made whether or not the disease is listed in section 2500. This has to be reported immediately for epidemiologic investigation.
Reporting Plan to Key Stakeholders
According to the National TB controllers Association (2004), the first step is to report the outbreak to the Local Health Department. This basically involves the Local TB controller who will consult with the state TB controller /program manager to make decision to initiate ORP. The state health officer will be informed by the State TB Controller who will consult with the state epidemiologist and State TB nurse consultant. The public health laboratory representative is the consulted to conduct routine and specialized testing.
Strategies of Preventing an Outbreak
To keenly detect and report persons who have been infected with TB. Health care workers especially those providing primary health care are the key contributors to the detection and report to the jurisdictional public health agency for surveillance. Secondly, stern action of preventing TB among the substantial population of U.S. residents with LTBI should be taken. This should involve identifying settings with high risk for contraction of TB and putting up effectiveinfection-control measure to reduce the vulnerability of the transmission. Lastly, preventing prolonged close contacts of the community members with the infected persons will minimize the chances for further spreading of the disease.
Tuberculosis is a contagious disease which requires effective policies and measures to mitigate its spread. Apparently, the risk factors should be avoided to minimize the chances of contracting the disease. Any noted case of TB should be reported to relevant bodies with immediate effect to avoid the disease from spreading to many people..

Bastida, E., Brown III, H. S., & Pagán, J. A. (2008). Persistent disparities in the use of health care along the US–Mexico border: an ecological perspective. American Journal of Public Health, Vol. 98(11), p.1987.
California Code of Regulation,(1996). Title 17, Section2501, Public health
Goldmann, D. A. (2000). Transmission of viral respiratory infections in the home. The Pediatric infectious disease journal, Vol. 19(10), pp.97-102.
National TB Controllers Association / CDC Advisory Group on Tuberculosis Genotyping. (2004).Guide to the Application of Genotyping to Tuberculosis Prevention and Control. Atlanta, GA:
Taylor, Z & Bluberg, H. (2005). Controlling Tuberculosis in the United States. Recommendations from the American Thoracic Socciety. CDC, and the InfectiousDiseases Society of America. Vol. 54(1), pp.1-81
United States-Mexico Border Health Commision.(2014). Acess to Health Care n the US-Mexico
Border Region: Challenges and Opportunities.Retrieved on 20th October 2015 from:www.borderhealth.org
US Department of Health and Human Services, CDC; Retrieved on 20th October 2015. From https://www.cdc.gov

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