Stimulated contact tracing and exposure assessment.

Running Head: Simulated contact tracing and Exposure assessment
Simulated contact tracing and Exposure assessment                  
PUBH621 Epidemiology: Assessment Task 2
Simulated contact tracing and Exposure assessment
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NOTIFIABLE DISEASE
Notifiable Diseases are the infectious diseases which are necessary to be notified to the government healthcare organizations (Centers for Disease Control and Prevention [CDC], 2019).
Reporting of these diseases is compulsory as per the state regulations and legislations. Therefore they vary from one state to other. There are certain internationally notifiable diseases like plague, yellow fever and cholera. They are mandatory to be reported by WHO’s global health regulations. In Australia, the notifiable diseases include blood borne diseases, gastrointestinal diseases, sexually transmissible diseases, listed human diseases, vaccine preventable diseases, vector borne diseases, zoonoses and other bacterial diseases (Department of Health, 2019).
CONTACT TRACING IN EPIDEMIOLOGY
Contact Tracing is the process of identifying the people having infectious diseases, identifying the extent of exposure, making them aware and implementing required measures to control them (World Health Organization, 2019). The primary aim of contact tracing is to identify the index case, identify the close contacts with the infected person suspected to have active TB, and counsel these people to perform their assessment and treatment.
Recommended steps for contact tracing in Australia
The contact tracing may be started when a Contact Tracing Officer detects the person likely to have notifiable health condition or who is in close contact with the infected person (Centre for Disease Control and Prevention, [CDC] 2016). The contact tracing officers provide education and awareness about the TB infection and help prevent the disease. Initial screening of suspected cases is done and those found positive in reports of pathological examinations like Sputum Smear Test and other radiological examinations are assessed for environmental and behavioral factors leading to infection. The contacts in close household are included in AFB smear microscopy, screening and further follow up. On the basis of clinical judgment, the subjects are grouped into high, medium and low risk groups. Proper documentation of results is attached to the health records of the patient.
Figure showing steps in Contact Tracing on basis of Index Case Infectivity (Source: Centre for Disease Control Department of Health, 2016)
CONTACT TRACING GUIDELINES FOR NT AND VICTORIA
In North Territory, the contact tracing is performed at large scale in schools, prisons, nursing homes and work places. Special considerations are there for pregnant women, multidrug resistant people, immune-compromised people, neonates, airplane passengers and children (Department of Health and Human Services, 2015). A two step assessment process is followed for the high risk groups working at Emergency Theaters and Bronchoscopy Theatres and TB clinics (Centre for Disease Control Department of Health, 2016). The workers confirmed with Mantoux Test <10 nm are suggested to undergo regular screening. TB Education Program is recommended to attend for all the government staff, volunteers and the students. The workers are provided to attend the TB screening compulsorily.
There is a provision of community screening, and free of cost screening for all the government and private sector workers. Latent TB Infection (LTBI) is treated for the stable and mobile communities. In NT, special considerations are there for assessment of indigenous people, overseas people, migrants, fishermen and international students. The primary professionals and organizations responsible for contact tracing are nurses, community health workers, Charles Darwin University, NT schools, Australian Quarantine and Inspection Services, Customs department and Department of Immigration and Citizenship (DIAC) (Department of Health, 2019). In North Territory legislation, there is Notifiable Disease Act to direct the contact tracing activities for TB.
In Victoria, the TB contact tracing is managed and implemented by state level Victorian Tuberculosis Program which includes the assessment, education, planning, implementation and prevention of TB without any charges (Victoria State Government, 2019). Anyone who is identified to have TB or related symptoms are referred to the TB Program. Once notified, a government Nurse is allotted to the patient for helping in compliance with the treatment, provide support and measure the extent of contact tracing. Contact Investigations involve IGRA testing or Tuberculin. Victorian Statutory Requirement specifies that TB has to be notified by the healthcare professionals within 5 days of diagnosis. There are sate level and national policies and protocols for TB infection control. The legislative provisions involve Public Health and Well Being Regulations 2009, and Medical Treatment Act (Victoria State Government, 2019). Advanced approaches like Strain Genotyping and Social Network Modeling are followed at Victoria. The principles are mostly based on environmental factors and index cases...