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Introduction
The focus of this paper is on the Center for Disease Control (CDC) vaccination program on seasonal influenza. The study aims at investigating the effectiveness of the program in terms of seeking long-term and viable solutions to seasonal influenza. This will be achieved by exploring various peer-reviewed literature that has been devoted towards evaluating CDC operation, especially those targeting vaccination programs of both affected and vulnerable populations.
Background
The CDC seasonal influenza vaccination program is not only an important component for the VHAS disease prevention initiative but also an essential undertaking as far as health promotion is concerned. This is largely since seasonal influenza results in substantial mortality and morbidity rates in the United States of America (Communicable Disease Epidemiology Section, 2008). Both current and past studies on seasonal influenza have revealed that the infection has been gaining firm ground over the years. It is against this backdrop that the Center for Disease Control (CDC) developed a long term program that would assist in addressing the chronic. Additionally, seasonal influenza vaccination has proven to be the only means through which individuals are protected against seasonal influenza and its resultant complications. The vaccination also results in a reduction in the rate of transmission of seasonal influenza to third parties like patients, health care, family members and other members of the public. Consequently, vaccination of medical personnel can further hinder the transmission of the same to visitors, co-workers, family members and patients. This has compelled CDC to develop seasonal influenza vaccination as its main agenda. Another significant feature of the CDC seasonal vaccine is that it is not only cost-effective but also safe for controlling and preventing the spread of influenza.
The spread of influenza
Seasonal influenza is spread when a person who has been infected with flu sneezes, coughs or simply talks and as a result, releases the flu virus into the environment. As such, it is a highly infectious disease that can be transmitted easily through infected air. The virus in the air spreads through the lungs, nose or throat of an individual and starts to multiply and thus causing influenza symptoms.
According to research carried out by CDC, seasonal influenza is by far and large, transmitted via indirect, direct or through individuals coming into contact with large droplets of the influenza virus. In some cases, transmission occurs through inhalation of fine cough droplets.
A study conducted by CDC in the state of Florida indicated that seasonal influenza may sometimes be transmitted from one person to another in a more direct way contrary to earlier perceptions.. This is either direct or largely acquired via analysis of the flu outbreak in medical facilities and other settings like colleges, buses, trains, aeroplanes and cruise ships among others. Even though there is limited knowledge on the same, the epidemiologic pattern observed during the same period was consistent with the transmission through close contact with individuals who have been infected with seasonal influenza (Center for Disease Control and Prevention, 2001). This fact seems to be parallel and in line with previous research studies that have been conducted in the recent past. Therefore, if seasonal influenza can be spread through varied ways as already mentioned, then it implies that there is every need and concern to contain this infection at least in the meantime as part
Droplets transmission
Moreover, seasonal influenza is mostly transmitted through droplets. This mode of transmission involves individuals coming into contact with the mucous membrane of either the mouth or the nose or even the conjunctivae of an infected individual. This is because large droplets containing the virus require near the contact between the recipient and the source. This is because large droplets are not suspended in the air for a long period in addition; they only travel through short distances (Palese, 2006). CDC programs have indicated that the three feet have been used as a guide to estimate the short distance under which large droplets can be transmitted. But for the case of practical purpose, the same distance should range between three to six feet. Therefore, to prevent transmission of seasonal influenza via large droplets, ventilation and proper air handling do not help much. But based on the epidemiologic patterns of seasonal influenza transmission, large droplet transmission through sneezing or coughing has been traditionally considered as one of the major modes through which the flu is transmitted.
Airborne transmission
Seasonal influenza can further be transmitted airborne. Droplets nuclei or small particles containing the influenza virus are transmitted through the air. Therefore, proper ventilation and special handling of air are required to prevent the spread of the flu.
Direct transmission
Seasonal influenza can further be transmitted from one person to another through direct contact. Direct contact can either be through fomites, skins or hands preceded by auto-inoculation of mucus from the respiratory system. However, according to research carried out by CDC in Florida, there is limited data that supports transmission of seasonal influenza virus either through direct or indirect contact. However, every person needs to wash his or her hands as this is likely to reduce the transmission rate (Dayton et al., 2008). Additionally, for health personnel use of a respirator and surgical masks can further assist in preventing the transmission of the influenza virus. This is because the use of these protective devices discourages direct facial contact in addition to followed autoinoculation.
Implications involved in controlling the spread of seasonal influenza and its pathogenesis
Seasonal influenza is an infectious disease that attacks the respiratory tract. The virus infects the respiratory cell via receptors that are found in the non-ciliated cells located at the upper part of the respiratory system. Alternatively, the infection can also occur in the lower part of the respiratory tract. However, no experimental or natural evidence fully exhibits that seasonal influenza can also attack the gastrointestinal system.
CDC recommended preventable measures
as already noted, the speared of seasonal influenza can be rapid especially in crowded settings where affected individuals mingle freely with other people. Therefore, it is indeed necessary to put in place preventive measures that can keep the infection at bay. The latter will not only reduce the morbidity rate. Preventive measures will also scale down the disease burden in terms of medical expenses. It is against this background that the Center for Disease Control (CDC) recommends that all individuals should cover their mouths while coughing. Affected persons are also requested to use disposable tissues when sneezing or blowing their noses. Additionally, it is important to discard the used tissues immediately. Most importantly, people should wash their hands using soap and warm water for about 20 seconds. But if there are no soaps and water, alcohol-based hand sanitizers can be used as disinfectants. Most importantly, people should not share water bottles, drinking glasses, toothbrushes and eating utensils.
Finally, apart from the above recommended preventative measures, CDC further suggests that surfaces such as those used for eating, children and adult play toys, landline and mobile phones, handrails and door handles among others should be cleaned with either household cleaner or bleach solution. However, if disinfectants are not available, it is highly recommendable that warm water and soap should be used to sterilize surfaces.
At this point, it is also imperative to mention the fact that various research studies conducted by CDC documents that some of the symptoms of seasonal influenza include sore throat, body aches, cough and nausea, running nose, high fever, as well as vomiting that may be accompanied by diarrhea. The center highlights the importance of seeking immediate medical attention once the aforementioned symptoms are noted.
Treatment of seasonal influenza
Previous studies by CDC recommended the importance of antiviral treatment in reducing further complications of the risk of complications that result from seasonal influenza. These complications include death, pneumonic attach and even respiratory failure. As a result, it is important for individuals who are infected or who are suspected to have contracted the disease to start antiviral treatment as soon as possible.
Experiment on seasonal influenza transmission control
Outbreaks of seasonal influenza in the United States have been prevented and controlled through a number of set strategies. These strategies include seasonal influenza vaccination. Both medical personnel, as well as affected patients, have been targeted in this program. Furthermore, there have been programs to facilitate early detection of the influenza virus in healthcare facilities. Besides, antiviral treatments for individuals who are ill and prophylactic medication for those who are susceptible to the virus have been initiated and implemented in various locations. Additionally, there have been implementations of administrative mechanisms to prevent the spread of seasonal influenza in medical facilities (Draper et al., 2008). These administrative measures include educating both staff and patients, restricting visitors in addition to courting the medical personnel responsible for an outbreak unit. Isolating infected patients in cohort units in addition to emphasizing the importance of practicing proper hand hygiene, are other administrative mechanisms that have been successfully applied in the health care facilities to curb transmission of seasonal influenza from one person to another.
Objectives
The purpose of this program review is to identify the effectiveness of the seasonal vaccination program that has been promoted by the CDC. The program review is on the success story of vaccination against the spread of seasonal influenza in healthcare facilities.
Selection criteria
The criteria for program review for this particular vaccination initiative is based on random selection. The data used is found on the CDC website and other academic journals on the importance of vaccination against the spread of seasonal influence not only from patients and medical personnel but also from health officers, their colleagues, and other patients. Statistical data is obtained and observed from National Health Interview Surveys, National Immunization Survey (NIS), Behavioural Risk Factor Surveillance System (BRFSS), and the national 2009 HINI flu Survey (NHFS). Children aged between six months and above were the participants used for the review of the CDC vaccination program.
The subjects were divided into two categories namely those who fall under the generally recommended group and those who are at high risk of contracting seasonal influenza. The reviewed CDC program was analyzed following programs that vaccinate persons against seasonal influenza in the United States of America. The outcome measures were based on the comparative statistical data and results before the program was established and during the years of its spread and transmission in health facilities. Since the implementation of the CDC program, it has been noted that cases of seasonal influenza have significantly reduced.
Search strategy applied for identification of the studies to be used
The information for this program review was searched using two methods. To begin with, journals were located by mechanical and electronic access. Additionally, relevant materials that were available on the CDC website and other lists of relevant articles were used as the basic data for the process of reviewing the CDC program on seasonal influenza vaccination.
Methods of review
Four studies were selected for purpose of review since they directly pointed at the CDC program on seasonal influenza as well as explicitly stated the impact of the vaccine on the spread of seasonal influence. The studies also highlighted some of the most important results on the same and had sound conclusions and recommendations. The quality and credibility of data presented in these materials were assessed through research procedures applied and the location of the sources (Kilbourne, 2006). The data in the studies were carefully selected based on the principle of selecting negative and positive results and impacts of evaluating the CDC program on seasonal influenza. Age groups in addition to groups of the risks were included in the analysis description. This is because they pointed out the results of the program implementation in the different layers of the identified population and their identified needs.
Description of the studies
As mentioned in the review methodology, four studies were applied for purpose of studying the CDC program on seasonal influenza. The study titled findings from case studies of state and local immunization programs which were aimed at analyzing the USA existing programs (Fairbrother et al, 2000). These programs included even those that operate in other states. The study also involved analyzing the effectiveness of the vaccination program based on the purchasing custom power. The study was carried out via interviews with vaccination program directors, officials, and officials among other relevant health care personnel. The results indicated that both the local and state government has a role to play in the successful implementation of seasonal influenza programs promoted by the CDC (Briss et al, 2004).
Consequently, Furlow et al (2011) carried another study in 43 and the District of Columbia. This study was carried out to understand the vaccination coverage. The results indicated that even though people aged 6 months and above received approximately 163 million vaccine doses between August 2010 and February, the vaccination still has room for improvement. The study differentiated the vaccination coverage not only by race, ethnicity and month but also by age (Ehrenstein et al, 2006).
Another study by Madjid et al (2009) on the other hand considered a population that suffered from both coronary heart disease and cardiovascular diseases in addition to reasons that prevented them from being vaccinated. Even though CDC programs advise such patients to be vaccinated, the number of taken preventive measures in the discussed sample still remains very low. Therefore, it is evident that the CDC program on seasonal influenza does not impact individuals in the health facility with heart diseases.
On the other hand, Smith and Pickering (2009) evaluated the work of the advisory committee on immunization practices (ACIP), subjected to the director of the Centers for Disease Control and Prevention. This study considered the committee structure, process in addition to the applied practices. The major aim of this particular study was to evaluate the work of ACIP supervised by the CDC. The results of this particular study pointed out CDCs professionalism and the ability to advise on seasonal influenza and how to prevent it. The provided recommendations concluded that the CDC program is still at its developing stage and therefore the CDC assistance needs to be enhanced (Fauci, 2006).
The methodological quality of included studies
Even though the study carried out by Fairbrother et al (2000) is relevant for this particular program review, the results can still be doubted on the basis that statistical data was avoided. Additionally, the interviews were biased in the sense that they were conducted by officials who were only interested in the successful outcome of the study. As a result, the outcomes cannot be credible because they are not only objective but also prejudiced. On the other hand, the results of the study carried out by Furlow et al (2011), are more reliable. This is because they were not objective and also unprejudiced.
However, in some cases, it can be argued that the results were influenced by a confidence interval, low sample, half-width and high standard error characterized by the irrelevance of the results. On the other hand, a study by Madjid et al (2009) was influenced by the limitations that are usually characterized by telephone interviews. Consequently, the results of the study can also be questioned on the basis of whether individuals who were against the vaccination program experienced lower or higher vaccination rate in addition to whether they exhibited distinct health-related behavior or complications as a result of the specificity of the data collected (Centers for Disease Control and Prevention, 2007).
Results
The data of the study indicated that the CDC program is not only relevant in curbing the spread of seasonal influenza but also effective. However, more efforts should be put in creating awareness on how the effectiveness of the CDC program on seasonal influenza.
Discussion
From the previewed studies on the CDC program on seasonal influenza, it was evident that older children were not aware of the importance of vaccination in preventing and controlling the spread of influenza. Furthermore, they lacked sufficient knowledge on its effectiveness (Salgado, 2002). On the other hand, the number of vaccinated persons has increased since the program commenced the implementation phase (Draper, 2008). The results further indicated that cases related to mortality in the USA have significantly reduced. Nevertheless, a lot has to be done to increase the effectiveness of the program and also to widen the vaccination coverage.
Conclusion
In practical terms, CDC should aim at devising mechanisms that will contribute towards increasing awareness and consequently, the value of the program. It may not be possible to successfully implement the program without highlighting its significance to the affected populations. Therefore, the program should aim at increasing the number of vaccinated individuals between August 2011 and February 2012. In the theoretical aspect, the CDC vaccination program should be evaluated based on its cost-effectiveness as well as efficiency.
References
Briss, P. et al (2004). Developing and using the guide to community preventive services: lessons learnt about evidence based public health. Annual review public health 25, 281-302.
Center for Disease Control and Prevention (2001). Seasonal flu. Web.
Center for Disease Control and Prevention (2007). Hospital pandemic influenza planning checklist. Web.
Communicable Disease Epidemiology Section (2008). Triggers and actions for influenza pandemic response in Wisconsin. Web.
Dayton, C. et al. (2008). Integrated plan to augment surge capacity 23(2), 113-120.
Draper, H. et al. (2008). Healthcare workers attitudes towards working during pandemic influenza: A multi method study. BMC Public Health.
Ehrenstein, B.P. et al. (2006). Influenza pandemic and professional duty: Family or patients first? A survey of hospital employees. BMC Public Health, Fairbrother, G. et al (2000). Findings from the case studies of states and local immunization programs. American journal of preventive m medicine, 19 (3), 54 77.
Fauci A. (2006). Pandemic influenza threat and preparedness. Emerging Infectious Diseases, 2012 (1):7377.
Furlow, C. et al (2011). Interim results: state-specific influenza vaccination coverage-United States, August 2010-february 2011.MMWR. Morbidity & Mortality Weekly Report 60 (22), 737-743.
Kilbourne, E. D. (2006). Influenza Pandemics of the 20th Century. Emerging Infectious Diseases 12 (1), 9-14.
Madjid, M. et al (2009). Factors contributing suboptimal vaccination against influenza. Texas heart institute journal 26(6), 546-552.
Palese, P. (2006). Making better influenza virus vaccines? Emerging Infectious Diseases, Texas heart institute journal 26(6), 546-552.
Salgado C.D. et al (2002) Influenza in the acute hospital setting. Lancet Infect Dis, 2:145-55.
Smith, J.D. & Pickering, L. (2009). Immunization policy development in the United States: the role of advisory committee on the immunization practices. Annals on internal medicine 150(1), 45-49.
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