Assignment: NRS 428 Topic 2 Epidemiology and Communicable Diseases

Assignment: NRS 428 Topic 2 Epidemiology and Communicable Diseases

Assignment: NRS 428 Topic 2 Epidemiology and Communicable Diseases 

Write a paper (2,000-2,500 words) in which you apply the concepts of epidemiology and nursing research to a communicable disease. Refer to “Communicable Disease Chain,” “Chain of Infection,” and the CDC website for assistance when completing this assignment.
Epidemiology Paper Requirements

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1.Describe the chosen communicable disease, including causes, symptoms, mode of transmission, complications, treatment, and the demographic of interest (mortality, morbidity, incidence, and prevalence). Is this a reportable disease? If so, provide details about reporting time, whom to report to, etc.
2.Describe the social determinants of health and explain how those factors contribute to the development of this disease.
3.Discuss the epidemiologic triangle as it relates to the communicable disease you have selected. Include the host factors, agent factors (presence or absence), and environmental factors. Are there any special considerations or notifications for the community, schools, or general population?
4.Explain the role of the community health nurse (case finding, reporting, data collection, data analysis, and follow-up) and why demographic data are necessary to the health of the community.
5.Identify at least one national agency or organization that addresses the communicable disease chosen and describe how the organizations contribute to resolving or reducing the impact of disease.
6.Discuss a global implication of the disease. How is this addressed in other countries or cultures? Is this disease endemic to a particular area? Provide an example.
A minimum of three peer-reviewed or professional references is required.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center.

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Assignment: NRS 428 Topic 2 Epidemiology and Communicable Diseases Sample


Communicable diseases are among the common public health problems that often cause a stir if stringent measures are not adopted to avert their spread. They are often caused by various microorganisms including bacteria, viruses, and fungi. They easily spread from one individual through contact with either body fluids, contact with contaminated surfaces, foods, or even air. Consequently, they cause a burden to health care in terms of cost, mortality, and morbidity associated with them. Among the various communicable diseases, influenza is an example. The purpose of this paper is to address various issues regarding influenza such as causes, signs and symptoms, modes of transmission, complications, treatment, and social determinants of health, epidemiology, roles of community health nurses, the global implication of influenza, and role of national agencies in reducing the spread of influenza.

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Causative Agent

Influenza is a communicable viral infection affecting the upper and lower respiratory tract. It is majorly caused by influenza virus types A, B, C, and D (CDC, 2022). These types of influenza have other subtypes that contribute to influenza. Upon transmission, the influenza virus lodges into the respiratory and triggers an immune reaction or replicates in the epithelial lining that can lead to viral syndrome and inflammation (Mohan et al., 2019).  Luckily, the influenza virus causes an acute infection that is self-resolving within a week in immunocompetent individuals.

Mode of Transmission

Influenza, like other communicable diseases, is easily transmitted from one person to another.  According to CDC (2021), transmission through respiratory droplets expelled from the respiratory tract or mouth during talking, sneezing, or coughing is the most common. Another way is through direct contact with contaminated surfaces and then touching the nose or the eyes with contaminated hands. Moreover, transmission can occur in asymptomatic individuals and up to five to seven days after infection (Zanobini et al., 2022). Its transmission and spread are influenced by the season with rapid and efficient transmission experienced during the winter and autumn seasons in temperate regions (Mohan et al., 2019). Children and adults are the most affected.


Influenza is a major public health issue as it is easily transmitted by asymptomatic individuals infecting others who further re-infect others easily. In the process, various strains are transmitted. Influenza is a seasonal condition experienced majorly in the northern and southern hemisphere countries during winter and autumn.  Northern hemisphere countries experience influenza outbreaks between October and March while the southern hemisphere countries between April and August (Zanobini et al., 2022).

 Children and elderly populations are at increased risk of the severe form of the disease and are associated with an increased risk of death from the influenza epidemic (CDC, 2021). Because outbreaks of influenza coincidentally occur with the circulation of other respiratory pathogens, getting the exact number through laboratory and surveillance has been a challenge. Various influenza has occurred and been reported since 1970, however, the most memorable occurred in the 2015-16 season with reported 25 million illnesses, 310,000 influenza-related hospitalizations, and 12,000 death (CDC, 2021). Due to the first spreading nature of influenza and its related health burden, reporting the cases is mandatory during the outbreaks. All cases and suspects are always reported to the healthcare providers including nurses, physicians, and public health offices as well as other healthcare facilities. Surveillance for new infections is done while treatment and prevention strategies are put in place.

Signs, Symptoms, and Complications

 The presentation of influenza ranges from mild to severe depending on the comorbidities, age, natural immunity, and vaccination status. Mild cases present with signs and symptoms such as cough, runny nose, sore throat, congested eyes, headache, myalgia, fatigue, and fever (Zhu et al., 2022). According to Mohan et al. (2019), severe cases often present with tachycardia, hypotension, shortness of breath, and loss of consciousness, and may require ventilatory support.

In most cases, influenza causes an acute self-resolving disease within a week. However, some risk factors such as immunosuppression, being elderly or having a child, being pregnant female, and the presence of comorbidities such as heart failure and diabetes increase the risk of complications. Some of the complications include secondary bacterial pneumonia, myositis, acute respiratory distress, myocarditis, and multiorgan failure (Zhu et al., 2022). Death completes the list.


Influenza infection is always mild and self-limited in healthy individuals without comorbidities as they require no treatment. During outbreaks cases that require treatment often benefit from antivirals such as oseltamivir, zanamivir, amantadine, and rimantadine are used against influenza A and B (CDC, 2022). The high-risk groups who are at risk of severe infection may benefit from such treatment as well as prevention. Those who develop from severe infection can benefit from admission into the intensive care unit for ventilatory support, monitoring, and receiving other advanced treatment accordingly. According to Mohan et al. (2019), vaccination with the vaccine is the cornerstone to preventing the spread and risk of severe disease, especially during the winter season.

Social Determinants of Health

The occurrence, risk, and spread of influenza are highly influenced by social determinants which are either individual or environmental-related. Genetics, health and age-related complications, and immunity are individual factors (CDC, 2022). Environmental factors include but are not limited to living arrangements, work, education, income, access to quality care, and social status. Response to disease and patient outcomes are directly influenced by education level, income level, access to quality care, and social interactions (Mohan et al., 2019). For instance, individuals with upstream of the aforementioned factors are likely to seek health services as opposed to those downstream. Besides, social interaction, living standards, and neighborhood influence the spread of influenza. According to CDC (2022), overcrowded neighborhoods with low income and poor living standards are associated with the increased spread of influenza. Therefore, social determinants of health must always be addressed when dealing with influenza pandemics to aid in intervention and curb the spread of the virus while improving the health outcomes of the population.

Epidemiologic Triad

Agent Factors

            Influenza disease is caused by various influenza types A, B, C, and D, with A and B the most common. The causative virus rapidly replicates in the epithelial lining of the upper and lower respiratory tract causing an immune reaction. Point mutation and recombination events in the genome form part of antigenic drift responsible for virus survival (CDC, 2022). The virus also spreads rapidly through respiratory droplets with viral particles remaining suspended in the air after coughing and sneezing and can infect many people thereafter. Asymptomatic people can also spread the virus without symptoms (Zhu et al., 2022). Therefore, influenza viruses A and B are agents for an epidemiologic triangle.

Host Factors

            Influenza is an RNA virus encoded with 11 proteins that use the host cellular machinery to replicate. Various host and virus factors play a role to promote or suppress the replication of the virus. Humans are the known host while the virus replicates in the lungs. Certain factors including being unvaccinated, presence of comorbidities, children below 5 years, elderly aged above 65 years, and pregnant females are mostly affected (Zhu et al., 2022). Symptoms of flu infection always start within 1 to 4 days of contracting the infection. Symptoms are self-limited within seven days in healthy individuals.

Environmental Factors

            Environmental factors may influence or curb the spread, survival, and replication of the virus. Downstream environmental factors such as overcrowding, congested households, poorly ventilated housing, and poor sanitation facilitate the spread of influenza viruses (Zanobini et al., 2022). On other hand, the spread of influenza is less in well-ventilated, less crowded houses, and clean environments.

Role of a Community Health Nurse in Influenza Surveillance

Demographic data is important for the health of a community. Health policies and regulations on communicable diseases and endemic diseases rely upon this demographic data. At the direct clinical level, demographic data gives important information about patient susceptibility to disease and response to treatment. At the pupation level, demographic data is important in planning, future investments, and health services and resource distortion. Sources of demographic data such as the United States Census reports and the Bureau of Labor Statistics can be used to target the distribution of resources to the community and the implementation of assistance programs to respond to epidemics and pandemics.

Disease surveillance involves a continuous process of collecting large volumes of health data and information from various sources, analyzing this data, and interpreting it for appropriate health measures. For many contagious and potentially epidemic-causing diseases, the national disease surveillance systems require reporting and notification whenever cases are encountered in clinical and community settings. Influenza in the 20th century was associated with pandemics that claimed millions of lives globally. Influenza is not a nationally notifiable disease. Influenza is usually a seasonal illness but, in some states, this disease is notifiable to local state health departments. For example, in Minnesota, the Minnesota Department of Health (MDH) requires reporting of influenza cases in some circumstances.

Nurses are important players in the inter-professional teams that ensure disease surveillance and prevention for infection prevention and control. According to a Delphi study by Beggs-Yeager et al. (2021), community health nurses play a vital role in establishing a trusting relationship with their respective communities. This enables them to perform contact tracing and follow-up of positive cases to ensure active surveillance of flu outbreaks in highly susceptible populations. Community health nurses play a critical role in the health of a community in the prevention of flu outbreaks. Community health nurses can offer leadership in the interdisciplinary teams charged with surveillance. Through local engagement, community health nurses can assist in developing productive community-based programs and reach multiple communities through the use of technology and telehealth approaches. Therefore, they have to understand the ethics of disease screening and referrals. Community health nurses also need to participate in nursing research and policy development to empower them for community health and disease surveillance. Decisions regarding this coordination of care for established flu cases among high-risk populations need an evidence-based approach and best practices. Ideally, nursing practice and training for community health nurses should include nursing leadership, data systems, technology utilization, evidence-based practice (EBP), disease epidemiology, and policy making. 

Agencies and Organizations for Influenza Control

In the United States, the US centers for disease control and prevention (CDC) has the overall role of oversight and coordination of prevention and control of communicable diseases. CDC has a program termed the CDC Influenza Division International Program that collaborates with interventional partners to ensure capacity building, disease pandemic response, and seasonal influenza control. This program’s core activities include maintaining surveillance of influenza and laboratory capacity building. 

The National Association of County and City Health Officials (NACCHO) whose headquarters are located in Washington DC strengthens local health departments in many states to promote the prevention and control of influenza. As a result, school influenza vaccination programs are steered by local health departments. NACCHO also collaborates with other organizations to promote vaccination against influenzas among older adults. NACCHO also empowers local health departments by providing support, resources, peer exchange facilitations, and learning opportunities to control and prevent influenza. 

The National Center for Immunization and Respiratory Diseases (NCIRD) whose mission is to prevent disease, death, and disability through immunization, has various divisions and branches such as Bacterial Diseases, Influenza, Viral Diseases, and Immunization Services (CDC, 2022b). This agency has allocated a specific division for influenza prevention and control. Their collaborative actions with the CDC and WHO among other agencies and domestic partners aim at promoting global influenza control and prevention of new variants from causing pandemics. Seasonal flu and novel influenza infections can cause epidemics and pandemics.

Global Implications of Influenza

The world health organization (WHO) through the Global Influenza Program (GIP) mandates various nations through their national departments and ministries of health to form National Influenzas Centers that guide coordinate, and support influenza prevention and control activities. The Global Influenza Surveillance and Response System (GISRS) has been in action for the past 70 years to steer sharing of data and benefits among WHO member states through surveillance and reporting. According to WHO, seasonal influenza causes up to 650,000 deaths from flu infections alone annually. Seasonal Influenza virus subtypes: A, B, C, and D. Type A is known to cause pandemics while others cause mild and self-resolving infections. Infants, aged, pregnant, and patients with comorbidities are at greater risk of mortality from this illness. In many countries including the UK, Canada, and Australia, the surveillance is coordinated by the national influenzas centers and coordinated globally by the WHO. Areas in temperate climates have epidemics, especially during winter (WHO, n.d.). In tropical regions such as tropical Africa and South America, influenza infection is endemic and occurs throughout the year. 


            Influenza is among the most common communicable disease and is a public health concern. Apart from stretching the ever-limited resources, influenza is associated with morbidity and mortality, especially in immunocompromised individuals. The diseases also spread rapidly through respiratory droplets and contact with contaminated surfaces. Preventing the spread of influenza is a public health priority, however, the output of other healthcare providers is paramount to protecting population health. Community health nurses play important coordination roles in influenza prevention, control, and management and thus require good nursing leadership, research, and technology skills. Their knowledge in policymaking and disease epidemiology also comes in handy in cases of influenzas epidemics and pandemics. Influenza surveillance in the US involves national projections and state-based reporting systems. CDC, NACCHO, and NCIRD have vital influenza preventive and control programs and activities. In tropical regions and temperate areas, influenza remains an endemic and seasonal epidemic problem respectively.


Beggs-Yeager, C., Sharts-Hopko, N., & McDermott-Levy, R. (2021). The role of nurses in surveillance to enhance global health security: A delphi study. Nursing Outlook, 69(6), 1021–1029.

CDC. (2021, August 26). Background and epidemiology.

CDC. (2022, October 11). Flu treatment. Centers for Disease Control and Prevention.

CDC. (2022, September 23). Influenza Division International Program.

Mohan, P., Mohan, S. B., & Dutta, M. (2019). Communicable or noncommunicable diseases? Building strong primary health care systems to address the double burden of disease in India. Journal of Family Medicine and Primary Care, 8(2), 326–329.

WHO. (n.d.). Influenza (seasonal). Who. int. Retrieved October 17, 2022, from

Zanobini, P., Bonaccorsi, G., Lorini, C., Haag, M., McGovern, I., Paget, J., & Caini, S. (2022). Global patterns of seasonal influenza activity, duration of activity, and virus (sub)type circulation from 2010 to 2020. Influenza and Other Respiratory Viruses, 16(4), 696–706.

Zhu, W., Li, X., Dong, J., Bo, H., Liu, J., Yang, J., Zhang, Y., Wei, H., Huang, W., Zhao, X., Chen, T., Yang, J., Li, Z., Zeng, X., Li, C., Tang, J., Xin, L., Gao, R., Liu, L., … Wang, D. (2022). Epidemiologic, clinical, and genetic characteristics of human infections with influenza A(H5N6) viruses, China. Emerging Infectious Diseases, 28(7), 1332–1344.

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