How you play it safe in a pandemic infection

Mostly it’s common sense, as there is no treatment or prevention vaccine available.

Not to go in places where you will have a chance to get the infection. This means any gathering which is beyond your own control.

Going to movies, public games or going to church.

Not to make unnecessary trips or travel outside your house. Make a list of what you need to do during the day and do everything in one go.

Not to touch unnecessary objects unless you are losing a balance and have to grab to something to stabilize yourself.

Not to use bathroom facilities outside your home.

When you come home wash your hands, rinse mouth and nose.

Use outdoor clothes and do not mix them in house clothing and take other preventive measure as deem necessary.

School Programs

Activity in schools kindergarten to 8th grade

150 minutes per week activity

Beverages availability & Choices of foods

School activity program 2 to 3 days a week

“Health is social Investment”

Pakistan currently ranks 26th in the world for under-5 child mortality rates. The under-5 mortality rate (per 1000 live births) has reduced from 141 in 1990 to 89 in 2012, but is much slower than the goal of reducing it to 46 by 2015

Pakistan Population 177 million
Life Expectancy 67.2 Yrs
Infant Mortality Rate/1000 63.3
Mortality Rate under 5/1000 89
Population Avg. Annual % Growth 2.1

2010-11 Stats

Health & Nutrition Expenditure Rs. 42 Billion
Health Expenditures as % of GDP 0.23


Healthcare Facilities

Health Manpower 2008-09 2009-10 2010-11
Registered Doctors 133,925 139,555 144,901
Registered Dentists 9,013 9,822 10,508
Registered Nurses 65,387 69,313 73,244
Population per Doctor 1,212 1,183 1,222
Population per Dentist 18,010 16,914 16,854
Population per Bed 1,575 1,592 1,701

Source: Ministry of Health


Common causes of early death includes the following

  • Childhood diseases
  • Communicable diseases
  • Diarrhea
  • Infant and maternal mortality
  • Malaria
  • Measles
  • Severe malnutrition
  • Tetanus
  • Tuberculosis

Contributing Factors:

Antibiotics without prescription and self medication


Funding shortage

Government policies

Illiteracy among rural mothers

Lack of quality control

Law and order

Pollution  air – water – land

Shortage of health care facilities

Shortage of health care workers

Unsafe drinking water


Food Safety as salmonella and Campylobacter infections reported through common food items such as

  • Lettuce
  • Spinach
  • Melons
  • Eggs
  • Mushrooms
  • Water

Campylobacter is a bacterial pathogen that causes fever, diarrhea, and abdominal cramps.  It is the most commonly identified bacterial cause of diarrhea illness in the world.  These bacteria live in the intestines of healthy birds, and most raw poultry meat has Campylobacter on it.  Eating undercooked chicken, or other food that has been contaminated with juices dripping from raw chicken is the most frequent source of this infection.


Wash produce. Rinse fresh fruits and vegetables in running tap water to remove visible dirt and grime. Remove and discard the outermost leaves of a head of lettuce or cabbage. Because bacteria can grow well on the cut surface of fruit or vegetable, be careful not to contaminate these foods while slicing them up on the cutting board, and avoid leaving cut produce at room temperature for many hours. Don’t be a source of food borne illness yourself. Wash your hands with soap and water before preparing food. Avoid preparing food for others if you yourself have a diarrhea illness. Changing a baby’s diaper while preparing food is a bad idea that can easily spread illness.

Don’t cross-contaminate one food with another. Avoid cross-contaminating foods by washing hands, utensils, and cutting boards after they have been in contact with raw meat or poultry and before they touch another food. Put cooked meat on a clean platter, rather back on one that held the raw meat.

Cook meat, poultry and eggs thoroughly. Using a thermometer to measure the internal temperature of meat is a good way to be sure that it is cooked sufficiently to kill bacteria. For example, ground beef should be cooked to an internal temperature of 160o F. Eggs should be cooked until the yolk is firm.

Refrigerate leftovers promptly. Bacteria can grow quickly at room temperature, so refrigerate leftover foods if they are not going to be eaten within 4 hours. Large volumes of food will cool more quickly if they are divided into several shallow containers for refrigeration.


Report suspected food borne illnesses to your local health department. The local public health department is an important part of the food safety system. Often calls from concerned citizens are how outbreaks are first detected. If a public health official contacts you to find out more about an illness you had, your cooperation is important. In public health investigations, it can be as important to talk to healthy people as to ill people. Your cooperation may be needed even if you are not ill.

Diseases from Farm Animals

Cattle manure may contain germs that can make people, especially young children, very sick. To best protect yourself from getting sick, wash your hands with soap and running water after visiting a farm and after having contact with farm animals.

Farm animals including cows, sheep, pigs, chickens and goats, can pass diseases to people. As you know, farm animals are not like house pets and do not have places to rest or eat that are away from where they pass manure. Therefore, you should thoroughly wash your hands with running water and soap after contact with them or after touching things such as fences, buckets, and straw bedding, that have been in contact with farm animals, adults should carefully watch children who are visiting farms and help them wash their hands well.


Like other animals, wild animals and primates can get diseases. Some of these diseases, called zoonoses, can cause illness in people. Since wild animals (including monkeys, raccoons, and skunks) can carry diseases that are dangerous to people, One should discourage direct contact with wildlife.

Baylisascaris Infection (raccoon roundworm): A parasitic disease associated with raccoons.

Brucella Infection (brucellosis): A bacterial disease associated with bison, deer, and other wild animals.

Giardia Infection (giardiasis): A parasitic disease associated with animals and their environment (including water).

Hantavirus Pulmonary Syndrome (hantavirus): A rare viral disease associated with some types of wild mice.

Herpes virus Infection (B virus): A deadly viral disease associated with macaque monkeys.

Histoplasma Infection (histoplasmosis): A fungal disease associated with bat guano (stool).

Lymphocytic Choriomeningitis: A viral disease associated with rodents and house mouse.

Mycobacterium tuberculosis Infection (TB): A bacterial disease associated with deer, elk, and bison.

Plague (Yersinia pestis Infection): A rare bacterial disease associated with wild rodents and fleas.

Rabies: A viral disease associated with wildlife especially raccoons, skunks, and bats.

Tularemia: An infectious disease associated with wildlife especially rodents, rabbits, and hares.

Incubation period may last up to one year

Air Travel may spread infections such as

Mosquitos Zika virus, Malaria, Dengue fever

Scorpion bite


In March 2003, reports of healthcare workers with unexplained pneumonia in Vietnam initiated an international investigation of the infection that came to be known as severe acute respiratory syndrome (SARS)

On February 23, 2003, a 78-year-old Canadian woman returned from a visit to Hong Kong. While there, she had unknowingly been infected with SARS-CoV during her stay at a hotel in Kowloon (5). After returning to Toronto, the patient’s condition worsened, and she died at home. SARS developed in her son, and he was hospitalized with respiratory distress on March 7. Before his death on March 13, he infected two other patients and one healthcare worker, all of whom subsequently exposed others to the infection before SARS was eventually recognized.


Avian influenza

Measles a virus that mainly spreads by direct contact with airborne respiratory droplets as encephalitis (brain swelling) or severe respiratory illness.



AIDS is a serious disease that represents the late clinical stage of infection with human immunodeficiency virus (HIV). HIV progressively damages the immune system. Without an effective immune system, life-threatening infections and other noninfectious conditions related to failing immunity (such as certain cancers) eventually develop.


MERS CoV Middle East Respiratory Syndrome Corona Virus  Travel warnings to Saudi Arabia

African sleeping sickness, African trypanosomiasis for International Travel)


Heavy rainfall and infectious diseases

In the past, outbreaks of water-borne diseases such as Cryptosporidium and Escherichia coli, have been linked to heavy rainfall events. Increased water stress and may experience a rise in the incidence of water-related diseases as people are forced to rely on increasingly contaminated sources of fresh water for all of their daily needs—drinking, cooking, bathing, and irrigation.

As scientific evidence continues to mount that the earth’s climate is rapidly changing, it is clear that global warming is no longer just a prediction.

Rising oceans, stronger hurricanes, prolonged droughts, and more intense heat waves are signs of the already discernable impacts that global warming is having worldwide. Global average surface temperatures have increased by about one degree Fahrenheit since the beginning of the 20th century, and the five hottest years on record have all occurred within the last decade. With the atmospheric concentration of carbon dioxide (CO2) now higher than at any point in the last 420,000 years, widespread consensus within the scientific community points to the burning of fossil fuels as the primary cause of this warming of the planet. Unless emissions of heat-trapping greenhouse gases are reduced, temperatures will increase by an additional 2.5 to 10.4 degrees Fahrenheit during the next 100 years

Recent research also suggests that global warming will adversely affect public health in a number of important ways. The 2003 European heat waves resulted in a

surge of heat-related deaths. Across the United Kingdom, France, Italy, the Netherlands, Portugal, and Spain, the heat waves that occurred during the summer of 2003 are estimated to have caused at least 22,000 excess deaths, with some arguing that this figure could be revised upward by as much as an astounding 50–100 percent.

In the United States, a seven-day (July14–20) heat wave in Chicago during the summer of 1995 resulted in 485 heat-related deaths 1970 Clean Air Act, as recently as 2002 approximately 146 million people in the United States lived in counties that did not meet air quality standards for at least one regulated pollutant Ozone levels, for example, are likely to increase because higher temperatures accelerate the rate at which ground-level ozone (the main component of smog) is formed.

While long term exposure to ozone is linked to the development and exacerbation of chronic lung diseases, even short-term exposure to relatively low ozone concentrations can cause lung inflammation, acutely decreased lung function, and respiratory impairment.

In recent decades, spring flowering, and thus the allergenic pollen season, has advanced at a rate of nearly a day per year.

In Europe, spring events such as leaf unfolding advanced by six days, while autumn events such as leaf coloring have been delayed by nearly five days in the last 35 years.

Experimental studies have demonstrated significant increases in pollen production resulting from exposure to increased CO2 concentrations

Combined with the observed doubling of pediatric asthma prevalence within the past twenty years,

The fastest and most affordable way to curb greenhouse gas emissions is to increase energy efficiency. Replacing older home appliances such as refrigerators and washing machines with more efficient models; improving heating and cooling systems; better insulating both commercial and residential buildings; and replacing old lighting systems with new advanced lighting systems that use compact fluorescent or LED bulbs—all these actions can drastically reduce energy use without having to sacrifice functionality or comfort.

Wind turbine and Solar energy is another renewable energy source capable of making a significant contribution to meeting U.S. energy needs renewable energy production is the harnessing of both geothermal heat energy and ocean tides and currents for electricity generation.

Global warming

Consequences of global warming include receding waters, food supply, changing climate and bird migration

Health challenges

Older population double in 2050 brings Increased demands and opportunities

Health challenges such as the Ebola outbreak, together with the wider impact of conflict, environmental degradation, climate change and the frequency of natural disasters put the progress made against NTDs under significant threat. Yet NTDs are markers, agents and drivers of poverty. Controlling and eliminating NTDs can make a proportionately greater contribution than any other investment – more health for less money.

Case history

Ecuadorian whipworms (Trichuris trichiuria) Humans worldwide (600 million) are infected with Ascaris lumbricoides and Trichuris trichiura; the eggs of these roundworms (nematode) are “sticky” and may be carried to the mouth by hands, other body parts GI symptoms

The man appeared confused and had swelling over his right eye. His parents told doctors that he’d also been having pain in his groin for a week. An MRI of his head showed numerous cysts in the outer layer of his brain (known as the cerebral cortex), as well as in his brain stem, according to the report, published today (March 27) in The New England Journal of Medicine. He also had cysts in his right eye and testes. [27 Oddest Medical Case Reports]

The Challenge

Around the world nearly 98 million girls are not in school. Globally, 1 in 3 women will experience gender-based violence in her lifetime. In the developing world, 1 in 7 girls is married before her 15th birthday, with some child brides as young as 8 or 9. Each year more than 287,000 women, 99 percent of them in developing countries, die from pregnancy- and childbirth-related complications.

While women make up more than 40 percent of the agriculture labor force only 3 to 20 percent are landholders. In Africa, women-owned enterprises make up as little as 10 percent of all businesses. In South Asia, that number is only 3 percent. And despite representing half the global population, women comprise less than 20 percent of the world’s legislators.

Although the statistics above make for grim reading, an important underlying cause of all these deaths is poverty. The World Health Organization (WHO) and others repeatedly point out that many of these diseases are “diseases of poverty.”

However, some diseases are now not only the result of poverty, but have been contributing to poverty—a nasty feedback loop. In the case of malaria, for instance, the WHO notes that,

Malaria has significant measurable direct and indirect costs, and has recently been shown to be a major constraint to economic development.

… Annual economic growth in countries with high malaria transmission has historically been lower than in countries without malaria. Economists believe that malaria is responsible for a “growth penalty” of up to 1.3% per year in some African countries.

… The indirect costs of malaria include lost productivity or income associated with illness or death.

… Malaria has a greater impact on Africa’s human resources than simple lost earnings. Although difficult to express in dollar terms, another indirect cost of malaria is the human pain and suffering caused by the disease. Malaria also hampers children’s schooling and social development through both absenteeism and permanent neurological and other damage associated with severe episodes of the disease.

The simple presence of malaria in a community or country also hampers individual and national prosperity due to its influence on social and economic decisions. The risk of contracting malaria in endemic areas can deter investment, both internal and external and affect individual and household decision making in many ways that have a negative impact on economic productivity and growth.


Some countries find it more difficult than others to confront threats to public health security effectively because they lack the necessary resources, because their health infrastructure has collapsed as a consequence of under-investment and shortages of trained health workers, or because the infrastructure has been damaged or destroyed by armed conflict or a previous natural disaster. With rare exceptions, threats to public health are generally known and manageable.


For years, 30,000 red and white balloons flooded into the blue sky above Gibraltar each September, symbols of the joy and pride of the small community jutting into the sea as it celebrated its National Day.