Avian Influenza

Avian Influenza

Avian influenza (flu) is a threat that has been discussed since 2003 when humans in Asia began to become infected and die. The virus has gone through many changes since it was first detected, which is a concern for fear that a novel virus will occur that will sustain a human to human transmission which would lead to a avian flu pandemic (Guterman, 2005).

This paper will discuss the reason for this community health issue, the description of the problem, background factors, local data, nursing interventions, and Orem's nursing model.

Reason

Community health nurses are concerned as the threat of a pandemic flu is due. In the 20th century there were 3 pandemics of flu, predicated is flu pandemic for the 21st century, if not avian flu it will be flu (PandemicFlu.gov, 2006). The concern has been that since the year 2003, East Asia has experienced an avian flu that has emerged as a novel virus that has been steadily increasing in humans and animals. Another concern is that in the small clusters of people who have been infected over three quarters of those have died (World Health Organization, 2007; Guterman, 2005). Concern is a sustained human to human transmission of the avian flu which will lead to a pandemic (Guterman, 2005).

Description

Most of the deaths will occur in the young and elderly. No vaccine is available and what vaccines are available for flu will most likely not be effective. No one will have immunity. A threat of a pandemic will impact on a global, regional, national, and local economic level overnight, not for just a short time but over months, possibly even a year. Public health will have no borders; a pandemic will be global (Guterman, 2005).

Background Factors

Infectious diseases are the number one reason for deaths of people worldwide. A pandemic is an epidemic that strikes several continents at the same time. Avian flu originates in wild aquatic birds that show no illness, they just become reservoirs. Wild aquatic birds can transmit the virus to domesticated birds such as geese and chickens. The virus undergoes changes that can allow the spread to humans, pigs, and other mammals. When the virus gets in the lungs of other mammals, including humans, it can mix with other genes that are already present in other flu viruses and the virus adapts into a new virus to which nobody is immune. This new virus is what known as a novel virus. A novel virus can sustain human to human transmission, when this happens a pandemic will evolve (CDC, 2005; Guterman, 2005). The threat increases due to international travel and trade. The travel time to North America to anywhere in the world is less than the incubation period of any known infectious disease (CDC, 2006). Washington State is a center location for international travel which causes concern for avian flu and the potential to distribute the disease more than other states.

Local Data

Everyday thousands of Asians travel into Washington State. Local major airports are Seatac with an estimated 1200 Asians, Portland 900, and Vancouver and British Columbia 4,000 everyday. In one week, that is over 42,000 Asians everyday that fly into Washington State. Washington State is just one little corner up in the Pacific Northwest of the entire United States. According to the CDC, the United States could expect greater than 200,000 deaths. Washington State would incur 5,000 of those deaths, 10,000 to 24,000 requiring hospitalization, and 480,000 to 1, 119,000 in need of healthcare (Washington State Department of Health, 2007).

Community Health Nursing

A primary intervention for community health nurses is surveillance of flu. Community health nurses need to be aware of current break outs, monitor for any changes in the virus, so that the infection can be conquered and contained before spreading any place else can occur (CDC, 2007). Isolation and quarantine becomes very important, businesses and the public need to understand that when advised to stay at home with potential infections this needs to be taken seriously. Word needs to get out to the public and be on the agenda of every school board, food distributor, manufacturing plant, investment firm, mortuary, and state legislator. The culture must be changed that if they have the flu they need to stay at home. Respiratory etiquette needs to be practiced in all seasons not just in the flu season. Practice to cover coughs and wash hands at all times. Sneeze stations available in hospitals currently need to be implemented in all public gathering areas. Strategy guides are available to prepare the community for potential outbreak of influenza, these needs to be distributed throughout the community and practiced.

Orem's Nursing Model

Orem's nursing model can easily be adapted for use for the community for a potential avian flu pandemic. A self-care deficit exists in preparing the community how to take care of themselves and protect their families. The goal is to promote activities towards the prevention of flu. Promotion of personal health through education and strategies to decrease spreading of viruses is