Sexually Transmitted Diseases and how Automated disease diagnosis and monitoring can help

From the Communicable Disease Prevention and Control Act (Section 27), venereal diseases refer to ailments like gonorrhoea, granuloma, chlamydia, chancroid, syphilis, lymphopathia venereum and inguinale (Public Health Law Research, 2014). Established by the California Department of Public Health (CDPH), the California Regulations and Reportable Disease Information Exchange refer to a safe system used for automated disease diagnosis and monitoring. A number of certain conditions and diseases are authorized by State regulations and rules to be stated by laboratories and healthcare providers to the state healthcare agencies.

The mission CPDH pursues is the enhancement of the efficacy of surveillance exercises as well as the quick identification of health occurrences amid public via the gathering of timely and up-to-date surveillance information across the State. This provides a platform for reporting as well as collection of health conditions in real time throughout the year. CPDHs and LHDs (or Local Health Departments) are both allowed to use recent infections and laboratory results for disease monitoring, case management operations and public health examinations (California Department of health, 2017b).

California is quite distinct in the sense that, unlike a large number of the other states and the government, it possesses different subject-specific codes in place of just one code broken down into numbered headings. Breaking the law into titles or codes is a form of organization for the law. The state’s legislative arm promulgates new laws to serve as modifications to the various codes, in order to ease the law-checking process and to determine the identity of the present law.

A different document which states regulations which have been officially accepted by state agencies is called the California Code of Regulations (CCR). State bodies develop laws so as to enforce laws which have been decreed by the legislative arm of the State. Reportable diseases refer to those diseases which are seen as very important to public health. National, state and local agencies (e.g. state and country health offices) demand that these specific diseases should be reported whenever diagnosed by laboratories or doctors.

Reporting provides an opportunity for the gathering of statistics showing the frequency of occurrence of the disease. This aids researchers in identifying disease patterns and to follow disease epidemics. This information will help to prevent or manage later epidemics (California Department of Public Health, 2012a) The CDPH program, which is organized and run by the “California Disease Emergency Response” (CDER) Program under the “Division of Communicable Disease Control” (DCDC), is broadly used by LHDs as well as healthcare personnel in California.

Furthermore, more than 350 laboratories automatically submit their results to state public health databases via CDPH through CDPH ELR (Electronic Laboratory Reporting) systems. As at now, all of the LHDs (61 in number) located within California apply CDPH somehow and LHDs apply the program for monitoring of all the report-worthy communicable infections.

An organizational framework has been created by the Secretary of the California Department of Corrections and Rehabilitation (CDCR) which helps ensure the effective and efficient management of every aspect of the rehabilitative system as well as the inclusion of care, discipline, rehabilitation, custody, treatment, training and lastly employment for every inmate and parolee (California Department of Public Health, 2012a). The carrot – incentives and sticks – punishments and enforcements are all identified within the regulation. Training programs are available for Technical Assistance and personnel.

The major objective of the STD Control Branch is the reduction of the rate of transmission and the effect of viral hepatitis and STDs within California. This Branch backs the preventive measures via the provision of guidance, technical assistance, safety net support, leadership, training and surge capacity across the State which helps improve service delivery. This objective is achieved by collaboration with the local health officers and the private and public sector stakeholders (Brown, 2017; California Department of health, 2017a).

There exists a generic responsibility of every employer which is to create written procedures and systems for preserving the safety and health of the workers, which is determined after proper discussion with the health and safety representative or joint health and safety committee, if they exist.

Some of these procedure and measures include (California Department of health, 2017b); • Safe work activities; • Safe working conditions; • Proper hygienic procedures and the utilization of hygienic facilities; • The management of infections (California Department of Public Health, 2012a) In line with Californian laws, healthcare personnel have to report specific diseases or medical conditions to the community health officer handling the location in which the patient lives (Cal.

Code Regulations, title 17, § 2500.) The local and State health offices are mandated by law to carry out infectious disease examinations and interventions. When a disease report is received, the community health officer then has to take whatever measures are necessary to investigate and control the reported condition, disease or outbreak (Cal. Code Regulations, title 17, § 2501.) In the same vein, community health officers have to develop outbreak and case reports on the individual and submit them to the State Department of Public Health.

It is compulsory to provide confidential health information regarding the individual’s ailment to the community health officer that gathers this information for use in preparing the case reports (Cal. Code Regulations, title 17, § 2502(g)). The power of the community health officers as regards to communicable and reportable infections is clearly written in the Health and Safety Code, § 120175 (California Department of Public Health. (2012b).

One or more times annually, the procedures and systems guiding the safety and health of the workers will be revised and reviewed based on new practices and knowledge. The employer, from proper talks with the health and safety representative or the joint health and safety committee, assuming they are present, will create, implement and make available educational and training programs on the new safety and health procedures and systems for those workers which it is relevant for.

An employer or the Regulation for Health Care and Residential Facilities makes it compulsory for every worker to use or wear certain forms of protective clothing, device or equipment and the worker will be educated on the care, limitations and use of these before they are allowed to wear or utilize them at first and continuously. Every worker must take part in this training and instruction.

The employer should be reminded about the importance of being able to explain the training procedures and is thus enjoined to note the trained workers, the dates the training was carried out and the materials used during the training. In line with the Occupational Health and Safety Act, a worker is mandated to work in accordance with this Act and its guidelines and to wear and utilize any protective equipment, clothing or devices mandated by the employer (California Department of Public Health, 2012a).

STI case management is made up of proper therapy, counselling and extracting of contact details after which determination of the way they’ll be informed of their possible exposure and need to be evaluated and treated will be carried out. Co-infection is a situation where a person has at least two STIs at the same time.

A number of other information sources and documents talked about a method of contact tracing which involves a negotiated system where the case is meant to tell his/her contacts of the infection and enjoin them to see a doctor as soon as possible for evaluation. An agreement is made that contacts which have not seen a doctor for evaluation in a pre-agreed time duration will be called by the public health personnel or the health care provider (Brown, 2017).

This part of the rules affects insurers, health care specialists, players, health product developers, health plans and health provider organizations as there are situations when while working on an STI case investigation, an investigator, sometimes, irrespective of his/her best efforts, cannot get across to individuals. The recorded name, address details or telephone numbers might be wrong or incomplete. In the same vein, the person might have moved away and is no longer traceable.

Furthermore, the available resources are limited most times and might be better and more effectively used by focusing on the other contacts or cases. At a particular point, a decisions need to be taken whether to spend more on this investigation. The official might need to conclude that continuous efforts won’t likely turn out successful in getting across to the individual and thus that individual will be declared “lost to follow up”.

Before this declaration is made, the investigator has to make sure that several methods have been employed over a significant amount of time i.e. weeks, to reach this individual. These methods could include daytime and evening phone calls, work or home visits as well as continuous and official mail letters. Certain new methods are text messaging, internet and email.

Irrespective of methods, the individual’s confidential health information has to be kept secure except when in need by a public health administration for use in lowering the danger of a virulent or communicable infection to the general public. In the case of persons diagnosed with HIV and infectious syphilis, more intensive efforts and greater lengths of time need to be taken into consideration because of the more serious illnesses involved.

An example is, in the case of those diagnosed with HIV, the researcher could decide to try contacting the person every 6 months with.