Public Health: Microbiology in the Context of Public Health Policy

Public Health: Microbiology in the Context of Public Health Policy

Public health microbiology is the field that bridges microbiology and public health. It focuses on understanding the role of microorganisms in human health, disease prevention, and the development of public health policies.   Public health policy is a set of laws, regulations, and actions that are implemented to promote health and wellness in society. Public health policies can include formal legislation, community outreach, and other actions.  Effective public health policies can: Prevent the spread of disease, protect vulnerable populations, create environments that support healthy lifestyles, and ensure equitable access to medical resources. 

Public health microbiology is a vital field that informs public health policy, helping to protect populations from infectious diseases and promoting health on a global scale. The integration of microbiological insights into public health policies ensures that interventions are evidence-based, effective, and responsive to emerging threats.

Public health microbiology plays an increasingly important role in addressing complex challenges such as antimicrobial resistance, emerging infectious diseases, and the impact of environmental changes on human health.

Organizations such as the World Health Organization, Centers for Disease Control and Prevention, Food and Drug Administration, and other governmental and non-governmental agencies play a large role in public health policy. These organizations perform research and implement education and health initiatives for a population—creating laws and policies that ensure the society has nutritious food to eat, clean water to drink, vaccines for the sick, and access to health care.

Some examples of public health initiatives in India include Janani Shishu Suraksha Karyakram (JSSK), which provides free drugs, diagnostics, blood, diet, transport, and drop back home and Rashtriya Bal Swasthya Karyakram (RBSK), which provides services for newborns.

Infectious diseases are illnesses caused by harmful agents (pathogens) that get into your body. The most common causes are viruses, bacteria, fungi and parasites. Infectious diseases usually spread from person to person, through contaminated food or water and through bug bites.

Infectious diseases can be viral, bacterial, parasitic or fungal infections

Viral infections – AIDS, Chickungunya, Rabies, Viral Hepatitis, Mumps, Covid 19, Nipah

Bacterial infections – Typhoid, Typhus fever, Cholera, Tuberculosis

Fungal infections – Candidiasis, Aspergillosis, Blastomycosis

Parasitic infections – Amoebiasis, Malaria, Toxoplasmosis

Transmissible spongiform encephalopathies or prion diseases – caused by faulty proteins that cause other proteins, usually in brain, damaged and cause disease – Kuru, Creutzfeldt-Jakob disease

Even though infectious disease may spread to anyone, those who have a weakened immune are at an increased risk with transmissible diseases.

• Those with suppressed or compromised immune systems, such as those receiving cancer treatments, living with HIV or on certain medicines.
• Young children, pregnant people and adults over 60.
• Those who are unvaccinated against common infectious diseases.
• Healthcare workers.
• People traveling to areas endemic to malaria, dengue virus and Zika viruses.

Depending on the type of infection, there are many ways that infectious diseases can spread.

·From person to person when you cough or sneeze.

·From close contact with another person

·By sharing utensils or cups with other people.

·On surfaces like doorknobs, phones and countertops.

·Through bug (mosquito or tick) or animal bites.

·From contaminated or improperly prepared food or water.

·From working with contaminated soil or sand (like gardening).

·From mother to fetus.

·From blood transfusions, organ/tissue transplants or other medical procedures.

Epidemiology - This is the study of the complex relationships among hosts and infectious agents.   This is the study of how and why infectious diseases emerge and spread among different populations, and what strategies can prevent or contain the spread of disease at the population level.

The WHO defines infectious diseases as pandemics, epidemics or endemic diseases based on a disease's rate of spread.

Epidemic – This is a sudden and unexpected increase in the number of disease cases in a specific geographical area. Yellow fever, smallpox, measles, and polio are examples.

Pandemic – This occurs when a disease’s growth is exponential, covers a wide area, affecting several countries and populations.  This is an epidemic that has spread to multiple countries or continents and affects many people. The World Health Organization (WHO) declares a pandemic when a disease is growing exponentially. Covid 19 is an example

Endemic - A disease outbreak is endemic when it is consistently present but is limited to a particular region. This refers to a disease that is constantly present in a specific region or population. For example, malaria in Kenya is considered endemic.

Public health Microbiology

Public health microbiology is an interdisciplinary field that includes many different specialties, such as: Clinical microbiology, Food microbiology, Water microbiology, and Environmental microbiology and impacts public health policies and disease control strategies in many ways. 

Identifying causes - Public health microbiology research identifies the exact causes of diseases, which can lead to specific strategies for prevention. 

Developing interventions - Public health microbiology research leads to the development of interventions like vaccines, water purification techniques, and drugs. 

Controlling the spread of disease - Public health microbiology research helps to identify targets for control strategies, such as proper hygiene, sanitary conditions, and vector control. 

Understanding the human-animal-environment interface - Public health microbiology research helps to understand the role of animals in the spread of disease, and how to apply that knowledge to diagnostic skills. 

Generating epidemic intelligence - Public health microbiology requires the work of laboratory scientists, epidemiologists, and clinicians to generate, analyze, and communicate epidemic intelligence. 

Role of Microbiology in Public Health policy

Environmental Microbiology and Public Health - Microbial contamination of natural resources can lead to outbreaks of waterborne or foodborne diseases.  Public health policies related to environmental health, such as water treatment standards, waste management, and air quality regulations are important to protect communities from microbial infections.

Epidemiology and Outbreak Investigation - Epidemiological investigations are done where the source, transmission routes, and risk factors of infectious diseases are studied. Laboratory confirmation of pathogens is essential for accurate diagnosis and understanding of disease dynamics.  During a disease outbreak, public health microbiologists work closely with epidemiologists to identify the causative agents, trace the outbreak's origin, and develop strategies to control its spread.

Infectious Disease Surveillance - Microbiologists play a key role in identifying and monitoring infectious diseases within populations through the detection, identification, and tracking of pathogens responsible for outbreaks and epidemics based on laboratory-based accurate and timely data.  Public health policies are often informed by microbial surveillance, which helps in identifying emerging diseases, monitoring the spread of infections, and assessing the effectiveness of control measures.

Vaccine Development and Immunization Programs - Understanding the genetic makeup and behavior of pathogens helps in designing effective vaccines.  Public health policies prioritize vaccination as a key preventive measure against infectious diseases. It has to be ensured that vaccines are safe, effective, and widely available and vaccines are the backbone of immunization programs that protect public health.

Antimicrobial Resistance (AMR) - Antimicrobial resistance is a growing public health threat where microorganisms evolve to resist antimicrobial agents, such as antibiotics, antivirals, and antifungals. It is very important to detect, monitor and understand the mechanisms of resistance.  Public health policies are developed to address AMR by promoting the prudent use of antimicrobials and supporting research on new treatments/

 

Microbiological Techniques in Public Health

Diagnostic Microbiology involves the identification of pathogens through various techniques, such as culture, microscopy, molecular methods (e.g., PCR), and serology. Accurate diagnosis is essential for effective treatment and control of infectious diseases.  Public health policies often mandate the use of specific diagnostic tests for certain diseases, ensuring that accurate and timely information is available for disease control efforts.

Molecular epidemiology uses genetic techniques to track the spread of pathogens and understand their evolution. Techniques such as whole-genome sequencing, phylogenetic analysis, and genotyping help public health authorities identify the source of outbreaks, monitor the spread of antimicrobial resistance and develop targeted interventions.

Surveillance Systems such as the Centers for Disease Control and Prevention's (CDC) National Notifiable Diseases Surveillance System (NNDSS), rely on microbiological data to monitor the incidence and prevalence of infectious diseases.  These systems are critical for detecting emerging threats and evaluating the effectiveness of interventions. Public health policies often mandate the reporting of specific diseases to these surveillance systems.

Biostatistics and Data Analysis is essential for analyzing microbiological data and interpreting its implications for public health. Statistical methods are used to assess disease trends, evaluate interventions, and model potential outbreaks.  Public health policies are shaped by the insights gained from biostatistical analysis, ensuring that resources are allocated effectively and interventions are based on robust data.

There are several Challenges and Considerations in Public Health Microbiology such as Emerging and Re-Emerging Infectious Diseases, Antimicrobial Resistance (AMR), lack of Laboratory Capacity and Infrastructure in many parts of the world and Ethical and Social Considerations in the use of human and animal subjects in research, the equitable distribution of resources, etc