Module 5.2 - Environmental Sanitation 2.pdf

3.2 ENVIRONMENTAL SANITATION Prepared by: Lianne S. Decano, MSN, RN  INTRODUCTION Environmental Health preventing illness through managing the environment and by changing people’s behavior to reduce exposure to biological and non- biological agents of disease Envir...

3.2 ENVIRONMENTAL SANITATION Prepared by: Lianne S. Decano, MSN, RN  INTRODUCTION Environmental Health preventing illness through managing the environment and by changing people’s behavior to reduce exposure to biological and non- biological agents of disease Environmental Sanitation study of all factors in man’s physical environment which may have a deleterious effect on man’s well-being SAFE SOURCES OF WATER  SAFE WATER SOURCES Unsafe Water Sources Water coming from DOUBTFUL SOURCES (Open Dug Wells & Unimproved Springs) shall not be allowed for drinking water unless treated through proper container disinfection.  SAFE WATER SOURCES Unsafe Water Sources Water Quality and Monitoring Surveillance – RHU must formulate an operational plan for quality and monitoring surveillance every year. Examination of drinking water shall be performed only in private and government laboratories duly accredited by the Department of Health Certification of potability is issued by the Secretary of Health or his duly authorized representative  SAFE WATER SOURCES Unsafe Water Sources Water Quality and Monitoring Surveillance – RHU must formulate an operational plan for quality and monitoring surveillance every year. Examination of drinking water shall be performed only in private and government laboratories duly accredited by the Department of Health Certification of potability is issued by the Secretary of Health or his duly authorized representative PROPER EXCRETA SYSTEM  PROPER EXCRETA AND SEWERAGE SYSTEM LEVEL 1 Non-water carriage toilet facility – no water is necessary to wash the waste into the receiving space (e.g. Pit Latrines) Toilet Facilities requiring small amount of water to wash the waste (e.g. pour flush toilet and aqua prives)  PROPER EXCRETA AND SEWERAGE SYSTEM LEVEL2 commonly used on site toilet facilities of the water carriage type (water-sealed and flush type with septic vault/ tank disposal facility)  PROPER EXCRETA AND SEWERAGE SYSTEM LEVEL 3 Water carriage types of toilet facilities connected to septic tanks and or to Sewerage System or Treatment Plant used in High End Villages and Condominiums Rural areas use Blind Drainage or collection type of disposal facility. SAFE FOOD PRACTICES  SAFE FOOD PRACTICES Food Establishment must have sanitary permit No person shall be employed in food establishment without any health certificate No person shall be allowed to work in food handling while affected by a communicable disease such as boils, infected wounds, respiratory infection, diarrhea and GI upset After properly washing the Utensils, Immersion for at least half a minute in clean hot water 77C, or lukewarm water with 55-100ppm of chlorine solution for one minute, or steam for 15 minutes to 77C or 5 minutes to 200C  SAFE FOOD PRACTICES 4 RIGHTS IN FOOD SAFETY Right Source Buy Fresh meat, fish, fruits and vegetables Look at the Expiry Dates Avoid buying canned foods with dents and broken seals Use water only from clean and safe sources When in doubt with water sources boil for at least 2 minutes (running boiling)  SAFE FOOD PRACTICES 4 RIGHTS IN FOOD SAFETY Right Preparation Avoid Contact between raw foods and cooked foods Always buy Pasteurized milk and fruit juices Wash vegetables well if to be eaten raw Always wash hand and kitchen utensils before and after preparing food Sweep kitchen floors to remove food droppings  SAFE FOOD PRACTICES 4 RIGHTS IN FOOD SAFETY Right Cooking Cooking food thoroughly and ensure that the temperature on all parts of the food should reach 70 degrees centigrade Eat cooked food immediately Wash hands thoroughly before and after eating  SAFE FOOD PRACTICES 4 RIGHTS IN FOOD SAFETY Right Storage All cooked food should be left at room temperature for NOT more than 2 hours Be sure to use tightly sealed containers for storing of foods. Be sure to store food under hot conditions (at least 60 degrees centigrade) or in Cold conditions (below or equal to 10 degrees centigrade) Foods for infants should always be freshly prepared and not be stored Reheat strored food before eating to at least 70 degrees centigrade “WHEN IN DOUBT, THROW IT OUT”  FOOD AND WATERBORNE DISEASE PREVENTION AND CONTROL PROGRAM Food and Waterborne Diseases (FWBDs) -group of illnesses characterized by diarrhea, nausea, vomiting with or without fever, abdominal pain, headache, and body malaise. -acquired through the ingestion of food or water contaminated by disease-causing microorganisms -WATERBORNE, INFLUENZA, LEPTOSPIROSIS AND DENGUE (WILD) DISEASES Vision: A Food and waterborne disease free Philippines Mission: To reduce the burden of FWDs and outbreaks through case management, lab diagnosis, health promotion, policy development, logistics management, research and M&E, and surveillance and interagency collaboration Goal: Reduced morbidity and mortality due to FWBDs including outbreaks  PROPER DISPOSAL  PROPER DISPOSAL PROPER SOLID WASTE MANAGEMENT refers to satisfactory methods of storage, collection and final disposal of solid waste Refuse is a general term applied to solid and semi solid waste material other than human excreta: a.Garbage – refers to leftover vegetable, animal and fish material and have the tendency to decay, thus giving off foul odors. b. Rubbish – refers to waste materials such as bottles, broken glass, porcelain, tin cans, pieces of metal and other wrapping materials.  PROPER DISPOSAL PROHIBITED ACTS ON SOLID WASTE MANAGEMENT ACT Open Burning of Solid Wastes Open Dumping Burying on flood prone areas Squatting in Landfills Operation of Landfills on any aquifer, groundwater reservoir or watershed Construction of any establishment within 200 meters from a dump or landfill  PROPER DISPOSAL CATEGORIES OF HEALTHCARE WASTE Black – Non-infectious Dry Waste Green – Non-infectious wet Waste Yellow – Infectious / Pathological waste Orange – Radioactive Red – Sharps  PROPER DISPOSAL MAJOR LAW REGULATIONG SANITATION IN THE PHILIPPINES PD 856 SANITATION CODE OF THE PHILIPPINES PD 825 ANTI LITTERING LAW RA 9003 SOLID WASTE MANAGEMENT ACT RA 8749 CLEAN AIR ACT RA 9275 CLEAN WATER ACT RA 9512 NALT ENVIRONMENTAL AWARENES ACT EO 26 NATL SMOKING BAN RA 10611 FOOD SAFETY ACT RA 6969 TOXIC SUBSTANCES AND HAZARDOUS AND NUCLEAR WASTE CONTROL ACT Vector Borne and Vermin Control Program PREPARED BY: Lianne S. Decano, MSN, RN  Zoonosis -any disease or infection that is naturally transmissible from vertebrate animals to humans. Vector -are infections transmitted by the bite of infected arthropod species DENGUE  AEDES BORNE VIRAL DISEASE PREVENTION AND CONTROL PROGRAM Vision: Aedes-borne Viral Disease-free Philippines Mission: Reduced disease burden of Dengue, containment and prevention of transmission of Chikungunya and Zika Goal: To reduce the disease burden of dengue, and to contain and prevent transmission of chikungunya and zika  AEDES BORNE VIRAL DISEASE PREVENTION AND CONTROL PROGRAM Mode of Transmission: Vector Borne through a Mosquito Bite. Aedes aegypti (white and black stripes) -bites between 6:00 to 8:00 a.m. and 4:00 to 8:00 p.m. night exposed containers that can be filled with water makes a breeding site Causative Agent: DENV I, DENV2, DENV3 and DENV4  DENGUE: SCREENING Rumpel-Leeds Test (Tourniquet Test/ Capillary Fragility Test -reliable only during the febrile phase (false negative during toxic stage); -positive if there are more 20 petechial spots inside a 1-inch square in the antecubital fossa  DENGUE: diagnostics Dengue Rapid Test -serologic examination for presence of DENV antibodies  DENGUE: treatment regimen Rumpel-Leeds Test (Tourniquet Test/ Capillary Fragility Test -reliable only during the febrile phase (false negative during toxic stage); -positive if there are more 20 petechial spots inside a 1-inch square in the antecubital fossa  AEDES BORNE VIRAL DISEASE PREVENTION AND CONTROL PROGRAM Phases of Dengue Infection a.Febrile Phase · last 2-7 days ·Mild haemorrhagic manifestations like petechiae and mucosal membrane bleeding (e.g nose and gums) ·Monitoring of warning signs  AEDES BORNE VIRAL DISEASE PREVENTION AND CONTROL PROGRAM Phases of Dengue Infection b.Critical Phase either improve or deteriorate. Defervescence (between 3 to 7 days) -body temperature (fever) drops to almost normal (between 37.5 to 38°C). If improved- Dengue without Warning Signs, If patient deteriorates- Dengue with Warning. Severe dengue may follow near the time of defervescence between 24 to 48 hours.  AEDES BORNE VIRAL DISEASE PREVENTION AND CONTROL PROGRAM Phases of Dengue Infection c. Recovery Phase ·next 48 to 72 hours in which the body fluids go back to normal. ·Some patients may have classical rash of “isles of white in the sea of red”. ·The White Blood Cell (WBC) usually starts to rise soon after defervescence but the normalization of platelet counts typically happens later  DENGUE:prevention PRIMARY Environmental screening Destruction of breeding places of mosquitoes Vector control and extermination especially in areas with stagnant and dirty water Use of mosquito repellants containing DEET (diethyltoluamide) Use of mosquito nets while sleeping Indoor spraying with residual insecticides  AEDES BORNE VIRAL DISEASE PREVENTION AND CONTROL PROGRAM FOLLOW THE 4-S against DENGUE 1.Search and Destroy Mosquito Habitats Cover water drums and pails to prevent water from accumulating in them. Replace water in flower vases at least once a week. Clean gutters from leaves and debris to prevent water from becoming stagnant. Collect and dispose all unusable tin cans, jars, bottles, and other items that can collect and hold water. 2. Self-Protect Wear long pants and long-sleeved tops. Use mosquito repellant regularly.  AEDES BORNE VIRAL DISEASE PREVENTION AND CONTROL PROGRAM FOLLOW THE 4-S against DENGUE 3. Seek Early Consultation Consult a physician immediately if fever persists or keeps recurring after 2 days, and/or any of the other symptoms appear. 4. Say Yes to Fogging Only when there is an impending outbreak or a hotspot. MALARIA  MALARIA: Prevention PRIMARY Vector control and extermination especially in areas with flowing water Use of mosquito repellants containing DEET (diethyltoluamide) Use of mosquito nets while sleeping Indoor spraying with residual insecticides Chemoprophylaxis as prescribed by the CDC and the WHO  MALARIA: Diagnostics Malarial Blood Smear (MBS) -confirmatory serologic testing done in the community  MALARIA CONTROL PROGRAM Vision: A malaria-free Philippines by 2030 Mission: By 2022, malaria transmission will have been interrupted in all provinces except Palawan, 75 provinces will have been declared malaria-free, and the number of indigenous malaria cases will be reduced to less than 1200, Malaria caused by the Plasmodium parasite through the bite of the female Anopheles mosquito. People infected with malaria may experience kidney failure, seizure, coma, and may die, if left untreated. Modes of Transmission: P. falciparum, P. vivax, P. ovale, and P.malariae. LEPTOSPIROSIS  leptospirosis: diagnostics Microscopic Agglutination Test (MAT) -confirmatory serologic testing Acute illness (1st week) -whole blood and serum Convalescent illness (after 1st week) -serum +/- urine  leptospirosis:prevention PRIMARY -Chemoprophylaxis with doxycycline might be effective in preventing clinical disease and could be considered for people at high risk and with short-term exposures.  leptospirosis:prevention PRIMARY Avoid wading, swimming, bathing, swallowing, or submersing head in potentially contaminated freshwater (rivers, streams). Avoid contact with floodwater, and do not eat food contaminated with floodwater. If exposure cannot be avoided, wear appropriate personal protective equipment (PPE) (rubber boots, waterproof coveralls/ clothing, gloves).  leptospirosis:prevention PRIMARY Avoid wading, swimming, bathing, swallowing, or submersing head in potentially contaminated freshwater (rivers, streams). Avoid contact with floodwater, and do not eat food contaminated with floodwater. If exposure cannot be avoided, wear appropriate personal protective equipment (PPE) (rubber boots, waterproof coveralls/ clothing, gloves).  LEPTOSPIROSIS: Prevention PRIMARY Pest control and extermination especially rodents Do not eat food that may have been exposed to rodents and possibly contaminated with their urine.  LEPTOSPIROSIS: COMPLICATion Leptospirosis during pregnancy can cause fetal complications including fetal death or abortion. The case fatality rate for leptospirosis is approximately 5%–15% among patients with severe illness. FILARIASIS  FILARIASIS: DIAGNOSTICS Nocturnal Blood Examination -identification of microfilariae in a blood smear by microscopic examination. -blood collection should be done at night to coincide with the appearance of the microfilariae  FILARIASIS: prevention PRIMARY environmental screening destruction of breeding places of mosquitoes  FILARIASIS: prevention PRIMARY Vector control and extermination especially in areas with stagnant and dirty water Use of mosquito repellants containing DEET (diethyltoluamide) Use of mosquito nets while sleeping Indoor spraying with residual insecticides  FILARIASIS:treatment Hetrazan -Diethylcarbamazine citrate (DEC) -given early or in the acute phase only  FILARIASIS CONTROL PROGRAM -a comprehensive approach and universal access to quality health services such as mass treatment programs integrated with parasitic control programs and elimination campaigns Vision: Healthy and productive individuals and families for filariasis-free Philippines Mission: Elimination of Filariasis as public health problem thru a comprehensive approach and universal access to quality health services SCHISTOSOMIASIS  SCHISTOSOMIASIS a parasitic disease caused by worms called blood flukes. often spread through poor personal hygiene or exposure to water contaminated with the parasite Schistosoma, such as during farming or fishing. The disease is endemic or prevalent in various places across Luzon (especially Cagayan province), Visayas (especially Samar and Leyte islands), and Mindanao.  schistosomiasis Definitive -Man, Dogs, Pigs, Cats, Carabaos, Cows, Rodents and Monkey Intermediate Host -Oncomelania Hupensis Quadrasi  schistosomiasis Definitive -Man, Dogs, Pigs, Cats, Carabaos, Cows, Rodents and Monkey Intermediate Host -Oncomelania Hupensis Quadrasi  SCHISTOSOMIASIS: manifestations -Most individuals develop symptoms only months or even years after infection. -Symptoms mostly depend on the species of blood fluke and where in the body the fluke lays most of its eggs. Schistosoma japonicum typically settles in blood vessels around the intestines, which is why its symptoms usually include abdominal pain, loss of appetite, diarrhea (with or without blood), and constipation  SCHISTOSOMIASIS: manifestations -In more severe cases, it can spread to the nervous system and cause symptoms like convulsions, speech disturbances, and blurring of vision. -A subset of patients can develop symptoms a week to a month after getting the parasite. These individuals can experience flu-like symptoms that include fever, headache, fatigue, muscle pain, coughing, diarrhea, and abdominal pain.  schistosomiasis: diagnostics Stool/Urine Examination -Collect the stool/urine in a dry, clean, leakproof container. -Make sure no water, soil, or other material gets in the container  schistosomiasis: prevention PRIMARY Practice four rights of food safety Proper waste disposal Water sanitation Contact precautions  schistosomiasis: prevention PRIMARY Avoid swimming or wading in freshwater Drink only from a safe water source; if unsure, boil drinking water for at least one minute; Take a bath using only safe water Practice proper personal sanitation measures, especially when defecating.  schistosomiasis: prevention PRIMARY Chemoprophylaxis periodic, targeted treatment with praziquantel (Biltricide)  Thank you! There are so many people out there who will tell you that you can’t. What you’ve got do is turn around and say, “Watch me!” ASHLEY PURDY