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AIDS
Acquired immune deficiency syndrome (AIDS) is a slowly progressing disease, which occurs as a result of the human immune system’s damage made by the human immunodeficiency virus (HIV). HIV pandemic continues for more than 30 years worldwide. It was identified in 1984 after the discovery of human retroviruses. In Miami, Florida (zip code 33128), AIDS rates increased from 43.7 in 2013 to 51.6 in 2015 (“Florida Department,” 2016). According to the recent epidemiological data, AIDS is aggravated by the existing socio-economic problems, including the lack of proper living conditions, social support, and poverty. The disease transmission ways include sexual, parenteral (blood products or instrumentation), transplacental, and household (toothbrushes, razors, or needles for tattooing) ones.
Groups at risk are homo- and bisexual people, prostitutes, drug addicts, patients with hemophilia, children of sick parents, and patients who are often transfused with blood. It is reported that Hispanics and African Americans are at higher risk of HIV and AIDS, and the survival rates among them are lower. AIDS contributes to the spread of discrimination since the first cases of this disease were identified among men having sex with men, drug users, and sex industry workers (Dale et al., 2016). Therefore, in the eyes of the community residents, AIDS and HIV look like a disease of “bad people”.
There is a robust scientific prevention measure, including the reduction of new HIV diagnoses among adolescents and adults. Another goal stated by Healthy People 2020 is to decrease the number of HIV transmissions in bisexual and gay males. According to one of the initiatives, the plan of action involves “increase the proportion of substance abuse treatment facilities that offer HIV / AIDS education, counseling, and support” (“HIV,” 2016, para. 25). It is also essential to increase HIV testing and AIDS prevention. Consistent with the mentioned options, Florida Department of Health in Miami-Dade initiates the following strategies:
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Optimization of prevention, diagnosis, treatment, and care for patients with HIV / AIDS;
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Creation of effective and sustainable health systems;
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Introduction of the innovative therapeutic approaches into practice;
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Elimination of inequalities and discrimination and advocacy for human rights.
Hepatitis A
Hepatitis A is a liver disease caused by the hepatitis A virus and expressed in inflammation. A fecal-oral mechanism of the spread of the virus was detected only during the Second World War. In 1941-1942 years, jaundice became a problem for British troops in the course of military operations in the Middle East, when the virus disabled about ten percent of personnel (Tiwaskar, 2015). Since then, the UK and the US began in-depth studies of the mentioned problem. In Miami and worldwide, hepatitis A is closely related to the lack of safe water, inadequate sanitation, and poor personal hygiene (“Hepatitis program,” 2016). As a rule, among the sources of the virus, there are sick people. Children aged three to 12 years, especially in organized groups, are the most susceptible to hepatitis A, while those under one year practically do not get sick. Most people over the age of 35 have active immunity to hepatitis A since their blood has antibodies to the virus.
Hepatitis A may cause critical social and economic effects in the communities. To restore the health of people and return them to work, school, and daily life, it is possible to spend several weeks and months. In most cases, the infection penetrates the group, be it school or a military unit, and remains for a long time in it, causing hepatitis A in individual members (“Hepatitis program,” 2016). Adults are characterized by isolated and unrelated cases of hepatitis, which are called sporadic and at times, can be quite significant in frequency. As a rule, the source of infection cannot be established in such cases.
The review of the goals stated by Healthy People 2020 did not reveal strategies regarding hepatitis A. Therefore, Miami’s response and prevention initiatives rely on the guidelines of the state and official health care organizations. According to the state’s regulation, every hepatitis A case is to be reported to Epidemiology, Disease Control, and Immunization Services. Following the recommendations provided by the Centers for Disease Control and Prevention (CDC), vaccination is widely used in Miami (“Hepatitis program,” 2016). However, the factor limiting vaccination coverage is the relatively high cost of the vaccine, vaccination-related activities, and outbreak management. Because of the mentioned challenge, some categories of people cannot access vaccination in time, which increases their risk of developing this disease.
Influenza A
Influenza A is an acute and highly contagious disease prone to spreading epidemically. It is clinically manifested by severe toxicosis and catarrhal phenomena on the part of the respiratory tract (Kallewaard et al., 2016). Variability of the virus antigens leads to the formation of new types of viruses with their subsequent selection under the influence of immunological factors of the population. For example, there are A/H5N1, A/H1N1, and so on (Kallewaard et al., 2016). In connection with these, influenza A viruses have the greatest variety of types, virulence, and contagiously and can cause epidemics on a country-by-country scale. Since 1977, the epidemics of influenza A began to occur almost every year.
Speaking of the impact of influenza A on the community, it should be noted that the incidence of this disease is moderate, since no significant outbreaks may be noted in recent years. On the contrary to HIV and AIDS, it does not have a negative image and is not associated with one or the other population. Influenza A affects both children and adults, yet the former may have more exacerbations (“Influenza,” 2016). As a rule, it occurs in the fall and spreads due to weather conditions. It is recommended to thoroughly wash one’s hands with soap and water, especially after coughing or sneezing. Trying to avoid close contact with ill people and avoiding touching the eyes, nose, or mouth, since the infection is transmitted in this way composes another important precaution.
Healthy People 2020 program provides no goals for combating influenza A. Nevertheless, the Miami Health Department follows the guidelines by the CDC Advisory Committee on Immunization Practices (ACIP). It recommends not to use live attenuated influenza vaccine (LAIV) in 2017 and 2018 due to its reduced effectiveness. Instead, it promotes the use of vaccination by recombinant influenza vaccine (RIV) or the inactivated influenza vaccine (IIV) (“Influenza,” 2016). In the view of the recent hurricane Irma, the mentioned resource points out that 172 outbreaks were reported in Florida. Thus, the best way to prevent influenza A is to apply vaccination every fall. More to the point, it is emphasized that there is a need to increase the awareness of the community, explaining the role of vaccination and potential consequences in case of the disease development.
References
Dale, S. K., Bogart, L. M., Galvan, F. H., Wagner, G. J., Pantalone, D. W., & Klein, D. J. (2016). Discrimination and hate crimes in the context of neighborhood poverty and stressors among HIV-positive African-American men who have sex with men. Journal of Community Health, 41(3), 574-583.
Florida Department of Health in Miami-Dade County HIV/AIDS surveillance. (2016).
Hepatitis program. (2016).
HIV. (2016).
Influenza. (2016).
Kallewaard, N. L., Corti, D., Collins, P. J., Neu, U., McAuliffe, J. M., Benjamin, E.,… Vorlaender, M. K. (2016). Structure and function analysis of an antibody recognizing all influenza A subtypes. Cell, 166(3), 596-608.
Tiwaskar, M. (2015). Hepatitis A vaccine. RGUHS Journal of Medical Sciences, 5(1), 21-26.
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