Infectious Disease Prevention & Treatment

The prevention and control of infectious disease is essential to achieving a healthy population. One of the principal public health activities of the 20th century has been a significant reduction in the incidence of selected infectious diseases. The development and widespread use of childhood vaccines have also had a significant impact on the reduction of infectious diseases.

Despite these successes, infectious diseases continue to pose an important public health problem. Today, the issue of emerging and re-emerging infectious diseases is at the forefront of public health concern. A number of newly recognized diseases, including West Nile Virus, Legionnaires’ disease, toxic shock syndrome, Lyme disease, human immunodeficiency virus (HIV) infection, hantavirus, and new foodborne infections have been well documented, as has the emergence of antimicrobial resistance. Many infectious diseases, which threaten the health of the general population, are preventable and controllable. The prevention of infectious diseases requires  multidisciplinary interventions involving public health professionals, medical practitioners, researchers, community-based organizations, volunteer and private groups, industrial representatives, and educational systems.

HIV & Sexually Transmitted Diseases (STDs)
While syphilis and gonorrhea have seen a decline in the last several years, there has been a rise in Chlamydia, which is already Burlington County’s most common sexually transmitted disease. As of December 31, 2005 there were just over 1,000 cases of HIV / AIDS in Burlington County. The highest prevalence of cases occurs in those aged 40-49.
Hepatitis C
Hepatitis C has also seen a dramatic increase over the last several years, becoming the most commonly reported infectious disease in the county. There were 39 reported cases in 2002, which rose to 117 in 2005. These numbers represent newly diagnosed cases of hepatitis C. This increase in numbers most likely reflects improvements in testing, diagnosis, and reporting. However, because most hepatitis C infections show no signs or symptoms, many more county residents are infected with the virus, but have never been tested. Unlike hepatitis A and B, there is no vaccine available against hepatitis C. Treatments are available but are not always effective and are not easily tolerated.
Chart of Reported Cases of Hepatitis C and Lyme Disease in Burlington County
Vector-Borne Diseases
While West Nile Virus has seen a remarkable decrease in the last several years, with no human cases in Burlington County in 2006, Lyme disease has seen a significant increase in reported cases. In 2002, 26 cases of Lyme disease were reported. By 2005, 160 cases had been reported. In fact, all of the tick-borne diseases, including Babesiosis, Ehrlichiosis and Rocky Mountain Spotted Fever, have been on the rise in the county.

Goals & Objectives
  • Overall Goal: Promote the prevention and treatment of infectious diseases including HIV, sexually transmitted infections, hepatitis C, vector-borne diseases and other emerging infections
  • Outcome Objectives / Indicators
    • Increase the testing of high-risk individuals in Burlington County for HIV
    • Decrease the number of clients repeatedly treated for STDs
    • Decrease the number of acute hepatitis C cases in Burlington County
    • Decrease the number of vector borne diseases in Burlington County
    • Enhance capacity of public health emergency response in Burlington County as measured by Medical Reserve Corps membership and exercise evaluations
  • Impact Objectives
    • Increase number of individuals tested for HIV in Burlington County
    • Provide individual counseling for all clients requesting STD testing
    • Increase outreach to schools on HIV and STDs
    • Identify risk factors in all cases of acute hepatitis C reported to the Burlington County Health Department (BCHD)
    • Provide education to all individuals diagnosed with hepatitis C in Burlington County
    • Post educational materials on vector-borne diseases in all county parks and municipal buildings in Burlington County
    • Increase healthcare provider awareness of vector-borne diseases beyond Lyme disease
    • Increase membership in the Burlington County Medical Reserve Corps
    • Plan, implement, and evaluate at least one major public health emergency exercise each year
Risk Factors
  • Exposure to pathogen
  • High risk behaviors
  • Lack of knowledge
  • Lack of preparation and planning
  • Susceptibility
Potential Barriers
  • Desensitized Public
  • Limited resources (personnel and funding)
  • Politics
  • State and federal policies / regulations regarding HIV testing
  • Time constraints
Strategies & Resources Available
Suggested Interventions
  • Utilize community health workers to increase awareness of HIV testing among high risk groups in Burlington County
  • Promote the Centers for Disease Control and Prevention (CDC) guidelines on HIV testing to all healthcare providers in Burlington County
  • Integrate evidenced-based “best practice” counseling program into BCHD STD clinics
  • Partner with Burlington County schools to develop and implement STD outreach program for school-aged children in the county   
  • Ensure all individuals diagnosed with hepatitis C receive educational materials and proper referrals
  • Identify probable risk factors for all cases of acute hepatitis C
  • Develop and disseminate outreach materials on vector-borne diseases
  • Explore potential environmental control measures to reduce the tick population in Burlington County
  • Conduct a public health emergency exercise at least annually
  • Educate youth and adults
  • Educate teachers and other educators
  • Develop action steps for residents
  • Target high risk groups for education
  • Partner with schools, faith based organizations and physicians
  • Grant funding dependent on health education
  • Get the statistics out
  • Infectious disease control in non-healthcare settings
  • Coordination – local, county , state, and federal
  • Develop publicity campaign for Burlington County’s Medical  Reserve Corps
Resources Available
Knowledge to Behavior Change
The CHIP group working on this issue felt that any messages developed had to have impact. One way to do this was to have knowledge become behavior change.