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Public Health Assignment: Case Study of Giardia outbreak

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Task

Public Health Assignment: The case study will require you to address the topic “Giardia outbreak” and prepare an overview, or case, about the issue in the Australian community, the population or group most affected, the characteristics of this group that are most relevant in planning public health initiatives to address the issue, the agencies or institutions involved in addressing the issue, and an evaluation of existing initiatives that can be found in the literature.

Answer

Introduction
This public health assignment explores the case study of Giardia Outbreak which is a gastroenteritis infection outbreak caused by a parasite called Giardia Lamblia which is also known as Giardia intestinalis. This parasite is a single-celled organism that gets inside a human’s intestine and hampers the nutrients absorption process of the body. This infection can pass from one human to another very easily. The most common symptoms of Giardia infection are diarrhea, bloating, stomach cramps, nausea, fatigue and loose stools. The infections show their effects in an infected human body from 3 to over 25 days. Giardia infection can enter the human body in different ways. The organism is present in the feces of infected human and animals. If anyone swallows polluted water, eats contaminated uncooked food or vegetables etc. All these practices can lead Giardia organism in the human body and affect the digestive process. (Einarsson et al., 2016).

Giardia infection is also known as Giardiasis. Every year more than 280 million case gets registered worldwide. In Australia approximately 600,000 people get infected. According to several statistics, the prevalence of this infection in Australia is estimated between 2% to 7%. NSW (New South Wales, Australian State) and remote communities are mostly affected by this infection. (Ryan et al., 2019)

Population At Risk
In New South Wales, Australia, approximately 3.75 giardiasis cases detected per 10,000 citizens annually. In Western Australia every year more than 700 cases get reported. Majorly of these cases includes Infants and children under the age of 5 years. According to various researches, Children are mostly affected because of bad toilet habits. From children, this infection gets communicated to adults. Childcare worker, parents are likely to get infected because they might be in contact with the infected child during changing clothes or nappies. Many factors plays important role in the spread of the infection. Demographic factor, cultural factor, occupational factor etc. (Zajaczkowski et al., 2019).

The infection rate is quite high in remote indigenous communities. The infection rate in these is 15% to 36% whereas the National prevalence rate is 2% to 7%. Among indigenous children of these communities, the infection rate is 32 to 65%. Due to high exposure to giardia, children prone to malnutrition and chronic gastrointestinal disease. In the northern territory of Australia, 80% of the population lives in remote areas. The main reason for the spread of infection in these areas is overcrowded places, improper housing planning and poor personal hygiene. Families in these areas do not have proper resources and arrangements of housings. They don’t have a proper toilet system in their houses. The improper toilet system leads to poor toilet habits which cause infection in the community. Infected mammals are also the reason for the spread of this infection. Infection is also found in native and domestic animals. The children and parents of these communities are in direct contact with these mammals for their livelihood which causes the spread even more. The infection gets transmitted easily from children to their parents. As they are in direct contact with their children. As giardia infection is a waterborne disease, the infection caused due to the intake of contaminated water (Xiao et al., 2018). In these ingenious communities, there is no proper supply of pure water. The population of the communities are depending on natural sources as their water sources. Ponds, rivers, wells cover the major portions of their water needs. Families use these natural resources even for their drinking purposes. These water resources may contain feces of contaminated animals and humans. So major population of these communities are at higher risk of getting affected by giardia. Improper toilet habits are also a major cause of this infection. If a person does not follow hygienic habits it can lead to infection. These communities also use food from farms and vegetation. Sometimes they eat uncooked food or food which is washed by the contaminated water. The livelihood of the people living in these areas depends totally on wildlife and natural resources. So there are chances that parents get infected from contaminated animals, contaminated water or vegetables. Although this infection can affect at any age children are more prone to it due to poor habits and personal hygiene (Mazumdar et al., 2020).

Australia is quite popular among travellers all across the world. These travellers hike around different places on the continent. As per case studies, Travelers are also getting highly infected with the infection. During their travel, many hikers use natural resources to fulfil their water and food needs. So there are chances that they may get exposed to the infection easily. Their hygiene habits and usage of contaminated water or vegetation can lead to infection among them. Swimming in contaminated water also exposes to the infection as the person is in direct contact with the contaminated water. The majority of the cases are similar to the language, education status & indigenous status. In some cases, the household’s works in any house can become the reason for the infections as they do the house works and indirect contact of children and people living in the house (Dunn and Juergens, 2020).

Planning Initiatives
As Giadrisis is a communicable disease and Australia contributes a large number of cases. Proper planning and initiatives are always needed to aware the citizens and also to keep a count on the cases. These planning initiatives also help citizens to get recover from the infection. As the main risk group is children and infants. Initiatives should be a plan in a way to aware the parents about the infection and how it gets spread. Personal hygiene plays a vital part in awareness. It is very important to educate people to maintain their personal hygiene, washing hands after toilet, less use of natural water where the contamination risk is higher. These practices not only help in stopping the infection to spread but also maintain a healthy lifestyle. The communities which are living in remote areas are highly affected. So government and healthcare bodies need to take steps to provide them pure water and food supply. Proper toilets and infrastructure should be provided to the people living in remote areas. Initiatives should be able to trace the contacts of the infected person. Travellers also need to get aware of the infection and how it spreads and practices to avoid the infection. Various health promotion activities and campaigns also plays important role in order to aware people of the infection and maintain a healthy lifestyle habit. Proper sampling and testing also help in slowing down the pace of infection. Several medical & health organizations perform various testing techniques in order to examine the samples. Testing is done by collecting the stool of giardia antigen (Sheludchenko et al., 2016). As the infected people take time to show the symptoms it is very essential to plan the diagnosis and treatment process in a way to minimize the risk of spreading of infection among other people in contact. There is no vaccine or major medicines in order to cure an infectious person, good sanitization and proper travelling habits help an individual to recover from the infection. Travellers should keep filtered water containers or bottles in order to avoid drinking contaminated water. They should keep sanitizing or wash their hands in order to avoid infection. Also, travellers should arrange or manage a proper place to do their toilet practices. As faeces of infected can cause the infection to others. Travellers should also carry their packaged food to avoid the risk of eating contaminated food (Asher et al., 2016).

As per the statistics, annual cases come on a peak between January to April.

Giardiasis is caused by Giardia duodenalis and two assemblages A & B that causes human infection. Studies show that as compared to female more males are exposed to the infection. The reason of virus is more exposed to males because in most households of these communities male member goes out to earn a livelihood (Ryan and Zahedi, 2019).

Australia reports a large number of cases so it is really important that a proper organization of healthcare bodies should implement the plans to avoid the citizens away from the infection.

There are many health organizations currently working in order to keep the infection under control. They do various surveys and studies which keeps the data and potential structure of the infection. The data survey practices involve a deep study and research in order to understand the culture of the infection. As a majority of the infection is spread among children. These organizations study the behavior and lifestyle of people living in remote or smaller areas. There are some government and also private NGO's which takes part in making people aware of the infection. AIHW (Australian Institute of health and welfare), WEHI are the major health care organization which keeps a tab on the infection. WEHI has advanced genome technology to study the virus. This technology keeps track of the infection. They also study the invasion and reasons for the invasion of the virus in the host’s body.

Although the organization and some private NGO's have planned different initiatives to control the infection. But due to difficult circumstances and unavoidable situation, these organizations are not very successful in order to stop the infection. To stop the spread of the infection proper testing centres and health awareness centres are needed to educate the citizen about the virus. Not only the education but also provide infrastructure and facilities to the traveller, people living in remote communities, etc. (Zahedi et al., 2020).

Proper sample collections and testing centres need to increase their facilities and technology to do the testing. Not only the testing it is also important for the organization to under the behavior of the infection. Improvement of research is needed on the basis of demographics, occupational and cultural background. All the researches and studies should be done in keeping these aspects as the centre of study. With the help of these aspects, the organizations and the NGO’s or working bodies will be able to understand the infection process of the virus. Also, health care organizations need to help the government in developing remote areas. Pure water and food supply are required to keep citizens or the population from getting infected. The initiatives developed by the healthcare organizations need to active all the time so that people know the importance of a healthy lifestyle. As both cause and the treatment of the infection directly depends on personal hygiene it is important to educate and make the citizens aware of the process. Personal hygiene is something that cannot get developed in a day or two. So the organization needs to plan initiatives that not only tell people to follow good hygienic habits for a certain period of time but also maintain them. So these healthcare organization and private bodies which are working for public health need to plan the initiatives by keeping a longer duration in mind (Koehler et al., 2018).

Conclusion
In Australia, many citizens got infected with Giardia infection. It is really important not only for the organization but also for the people to understand how this virus spread and what habit they should follow in order to keep them and their families away from the infection. Healthcare bodies and organizations should also keep the track of the behavior of the infection and should plan the solution accordingly. It is very important for people to know the importance of personal hygiene and health practices. People also not only need to educate themselves but they should also teach good personal hygiene habits to their children. People can only beat this infection by educating themselves and also contribute their efforts to the various health organization and bodies.

References
Asher, A.J., Hose, G. and Power, M.L., 2016. Giardiasis in NSW: identification of Giardia duodenalis assemblages contributing to human and cattle cases, and an epidemiological assessment of sporadic human giardiasis. Infection, Genetics and Evolution, 44, pp.157-161.

Dunn, N. and Juergens, A.L., 2020. Giardiasis. In StatPearls [Internet]. StatPearls Publishing.

Einarsson, E., Ma’ayeh, S. and Svärd, S.G., 2016. An up-date on Giardia and giardiasis. Current opinion in microbiology, 34, pp.47-52.

Koehler, A.V., Rashid, M.H., Zhang, Y., Vaughan, J.L., Gasser, R.B. and Jabbar, A., 2018. First cross-sectional, molecular epidemiological survey of Cryptosporidium, Giardia and Enterocytozoon in alpaca (Vicugna pacos) in Australia. Parasites & vectors, 11(1), pp.1-8.

Mazumdar, S., Fletcher?Lartey, S.M., Zajaczkowski, P. and Jalaludin, B., 2020. Giardiasis notifications are associated with socioeconomic status in Sydney, Australia: a spatial analysis. Australian and New Zealand journal of public health, 44(6), pp.508-513.

Ryan, U. and Zahedi, A., 2019. Molecular epidemiology of giardiasis from a veterinary perspective. Advances in parasitology, 106, pp.209-254.

Ryan, U., Hijjawi, N., Feng, Y. and Xiao, L., 2019. Giardia: an under-reported foodborne parasite. International Journal for Parasitology, 49(1), pp.1-11.

Sheludchenko, M., Padovan, A., Katouli, M. and Stratton, H., 2016. Removal of fecal indicators, pathogenic bacteria, Adenovirus, Cryptosporidium and Giardia (oo) cysts in waste stabilization ponds in Northern and Eastern Australia. International journal of environmental research and public health, 13(1), p.96.

Xiao, S., Hu, S., Zhang, Y., Zhao, X. and Pan, W., 2018. Influence of sewage treatment plant effluent discharge into multipurpose river on its water quality: a quantitative health risk assessment of Cryptosporidium and Giardia. Environmental Pollution, 233, pp.797-805.

Zahedi, A., Odgers, T., Ball, A., Watkinson, A., Robertson, I. and Ryan, U., 2020. Longitudinal analysis of Giardia duodenalis assemblages in animals inhabiting drinking water catchments in New South Wales and Queensland–Australia (2013–2015). Science of The Total Environment, 718, p.137433.

Zajaczkowski, P., Mazumdar, S., Conaty, S., Ellis, J.T. and Fletcher-Lartey, S.M., 2019. Epidemiology and associated risk factors of giardiasis in a peri-urban setting in New South Wales Australia. Epidemiology & Infection, 147.

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