Block 3: Aetiology and Transmission of Communicable Diseases

Plymouth Marjon University | Health Protection MPH Module

📄 Course Overview ✨ Share Your Feedback

Overview
#1 Infectious Agents
#2 Modes of Transmission
#3 Reservoirs & Vectors
#4 Case Study: Measles
Activities

Welcome to Block 3: Aetiology and Transmission of Communicable Diseases

This block explores the biology of infectious agents, their modes of transmission, and the role of reservoirs and vectors in disease spread. You'll also examine a case study on the transmission dynamics of a vaccine-preventable disease, such as measles or polio.

Image from: Han, J. J., Song, H. A., Pierson, S. L., Shen-Gunther, J., & Xia, Q. (2023). Emerging infectious diseases are virulent viruses—Are we prepared? An overview. Microorganisms, 11(11), 2618. https://doi.org/10.3390/microorganisms11112618

📖 Read More

World Health Organization (WHO): Communicable Diseases Overview

Understanding Infectious Agents

Overview

Infectious agents are microorganisms that cause disease. They include bacteria, viruses, parasites, and fungi. Each type has unique characteristics that influence how they spread and cause illness.

Why This Matters

Understanding the biology of infectious agents is essential for developing effective prevention and control strategies.

Key Concepts

Bacteria: Single-celled organisms that can cause diseases like tuberculosis and cholera.
Viruses: Tiny infectious agents that require a host to replicate, such as influenza and HIV.
Parasites: Organisms that live on or in a host, causing diseases like malaria and schistosomiasis.
Fungi: Can cause infections like athlete's foot and candidiasis, particularly in immunocompromised individuals.

Critical Insights

Here are three contemporary insights into the role of infectious agents in public health:

Antimicrobial Resistance (AMR): The rise of drug-resistant bacteria, such as MRSA and multidrug-resistant tuberculosis, poses a significant threat to global health. AMR complicates treatment protocols, increases healthcare costs, and underscores the need for novel antibiotics and stewardship programs.
Emerging and Re-emerging Viruses: The COVID-19 pandemic highlighted the rapid spread of novel viruses in a globalized world. Similarly, re-emerging viruses like Zika and Ebola demonstrate the importance of robust surveillance systems and rapid response mechanisms to prevent outbreaks.
Climate Change and Infectious Diseases: Climate change is altering the distribution of infectious agents. For example, warmer temperatures expand the habitats of vectors like mosquitoes, increasing the spread of diseases such as malaria and dengue fever. Understanding these dynamics is critical for future public health planning.

Reflection

How do the characteristics of different infectious agents influence their transmission and control?

📖 Read More

CDC: Types of Infectious Agents
WHO: Antimicrobial Resistance

Modes of Disease Transmission

Overview

Diseases can spread through various modes, including direct contact, indirect contact, airborne transmission, and vector-borne transmission. Understanding these modes is critical for effective disease control.

Why This Matters

Identifying the mode of transmission helps in designing targeted interventions to prevent disease spread.

Key Concepts

Direct Contact: Transmission through physical contact with an infected person or their bodily fluids.
Indirect Contact: Transmission via contaminated surfaces or objects.
Airborne: Spread through respiratory droplets or aerosols, as seen with tuberculosis or COVID-19.
Vector-Borne: Transmission through vectors like mosquitoes (e.g., malaria) or ticks (e.g., Lyme disease).

Critical Insights

Airborne Transmission in Indoor Settings: The COVID-19 pandemic underscored the importance of ventilation and air filtration in reducing airborne transmission. This has led to a reevaluation of building designs and public health guidelines for indoor spaces.
Role of Fomites in Indirect Transmission: While fomites (contaminated surfaces) were initially emphasized during COVID-19, recent evidence suggests their role may be less significant than previously thought. This highlights the need for evidence-based prioritization of control measures.
Vector-Borne Diseases and Urbanization: Rapid urbanization and climate change are expanding the habitats of disease vectors like mosquitoes, increasing the risk of diseases such as dengue and Zika in previously unaffected areas.

Reflection

What are the challenges in controlling diseases with different modes of transmission?

📖 Read More

Reservoirs and Vectors in Disease Spread

Overview

Reservoirs are natural habitats where pathogens live and multiply, while vectors are organisms that transmit pathogens from reservoirs to humans. Both play a critical role in the epidemiology of infectious diseases.

Why This Matters

Understanding reservoirs and vectors is key to breaking the chain of transmission for many diseases.

Key Concepts

Reservoirs: Can be humans, animals, or environmental sources (e.g., soil, water).
Vectors: Include mosquitoes, ticks, and fleas, which transmit diseases like malaria, Lyme disease, and plague.
Control Strategies: Targeting reservoirs and vectors through vaccination, environmental management, and vector control.

Critical Insights

One Health Approach: The interconnectedness of human, animal, and environmental health is increasingly recognized. For example, controlling zoonotic diseases like rabies requires collaboration between public health, veterinary, and environmental sectors.
Vector Resistance to Insecticides: The widespread use of insecticides has led to resistance in mosquito populations, complicating efforts to control diseases like malaria. Innovative approaches, such as genetically modified mosquitoes, are being explored as alternatives.
Environmental Reservoirs and Climate Change: Climate change is altering the distribution of environmental reservoirs, such as water bodies for cholera-causing bacteria. This necessitates adaptive public health strategies to address shifting disease patterns.

Reflection

How can targeting reservoirs and vectors reduce the burden of communicable diseases?

📖 Read More

Case Study: Transmission Dynamics of Measles

Overview

Measles is a highly contagious vaccine-preventable disease. This case study explores its transmission dynamics, the role of vaccination, and strategies for outbreak control.

Why This Matters

Measles serves as a model for understanding the importance of herd immunity and vaccination in controlling infectious diseases.

Key Concepts

Transmission: Airborne spread through respiratory droplets.
Herd Immunity: Requires high vaccination coverage to prevent outbreaks.
Outbreak Control: Rapid case identification, isolation, and vaccination campaigns.

Critical Insights

Vaccine Hesitancy and Measles Resurgence: Despite the availability of an effective vaccine, measles outbreaks are increasing globally due to vaccine hesitancy and misinformation. Addressing these challenges requires targeted public health communication strategies.
Impact of Conflict and Displacement: Measles outbreaks are more common in conflict zones and among displaced populations due to disrupted healthcare systems and low vaccination rates. This highlights the need for integrated humanitarian and public health responses.
Economic Burden of Measles Outbreaks: Measles outbreaks strain healthcare systems and economies, particularly in low-resource settings. Investing in vaccination programs is cost-effective and prevents long-term economic losses.

Reflection

What lessons can be learned from measles outbreaks for controlling other vaccine-preventable diseases?

📖 Read More

WHO: Measles Fact Sheet
CDC: Measles Outbreaks

Activities

This section consolidates your learning through practical activities and reflections. Complete these tasks to reinforce your understanding of the block's topics.

Activity 1: Analyze a case study of a disease outbreak and identify the mode of transmission.
Activity 2: Develop a strategy to control a vector-borne disease in a specific region.
Activity 3: Participate in a group discussion on the challenges of achieving herd immunity.

📖 Review: Review the Sway presentation below for a summary of Block 3 content.

📖 Check Your Understanding

Check Your Understanding

Scenario: A community reports a sudden increase in malaria cases. What is the most likely mode of transmission?

A. Vector-borne transmission via mosquitoes.

B. Airborne transmission through respiratory droplets.

C. Direct contact with infected individuals.

Correct! Malaria is primarily transmitted through the bite of infected mosquitoes.

Incorrect. Malaria is not transmitted through respiratory droplets.

Incorrect. Direct contact is not a mode of transmission for malaria.

📖 Further Reading and Resources

Hawker, J., Begg, N., & Reintjes, R. (2019). Communicable disease control and health protection handbook (4th ed.). Wiley. [Marjon e-book]

Han, J. J., Song, H. A., Pierson, S. L., Shen-Gunther, J., & Xia, Q. (2023). Emerging infectious diseases are virulent viruses—Are we prepared? An overview. Microorganisms, 11(11), 2618. https://doi.org/10.3390/microorganisms11112618

Other Content: Reading List and Resources | HP Appendix A: Case Studies | HP Appendix B: Historical Cases | Assessment Information | More available at course homepage

</> HTML code for the page above

<div style="text-align: center; padding: 20px; background-color: #003e50; color: white; border-radius: 10px;">
<h1 style="margin-bottom: 5px;"><strong>Block 3: Aetiology and Transmission of Communicable Diseases</strong></h1>
<p style="font-size: 18px;">Plymouth Marjon University    |    Health Protection MPH Module </p>
</div>
<div style="display: flex; justify-content: center; gap: 15px; margin: 20px 0;"><a style="text-decoration: none; color: #003e50;" href="#">📄 Course Overview</a> <a style="text-decoration: none; color: #003e50;" href="#">✨ Share Your Feedback</a></div>
<div class="enhanceable_content tabs">
<ul>
<li>
<h4><span style="background-color: #005f73;"><a style="background-color: #005f73; color: #dcdcdc; text-decoration: none;" href="#tab-1">Overview</a></span></h4>
</li>
<li>
<h4><span style="background-color: #2a9d8f;"><a style="background-color: #2a9d8f; color: #dcdcdc; text-decoration: none;" href="#tab-2">#1 Infectious Agents</a></span></h4>
</li>
<li>
<h4><span style="background-color: #2a9d8f;"><a style="background-color: #2a9d8f; color: #dcdcdc; text-decoration: none;" href="#tab-3">#2 Modes of Transmission</a></span></h4>
</li>
<li>
<h4><span style="background-color: #2a9d8f;"><a style="background-color: #2a9d8f; color: #dcdcdc; text-decoration: none;" href="#tab-4">#3 Reservoirs & Vectors</a></span></h4>
</li>
<li>
<h4><span style="background-color: #2a9d8f;"><a style="background-color: #2a9d8f; color: #dcdcdc; text-decoration: none;" href="#tab-5">#4 Case Study: Measles</a></span></h4>
</li>
<li>
<h4><span style="background-color: #e76f51;"><a style="background-color: #e76f51; color: #dcdcdc; text-decoration: none;" href="#tab-6">Activities</a></span></h4>
</li>
</ul>
<div id="tab-1" style="background-color: #ecf0f1; padding: 15px; border-radius: 5px;">
<h3>Welcome to Block 3: Aetiology and Transmission of Communicable Diseases</h3>
<p>This block explores the biology of infectious agents, their modes of transmission, and the role of reservoirs and vectors in disease spread. You'll also examine a case study on the transmission dynamics of a vaccine-preventable disease, such as measles or polio.</p>
<p><img style="display: block; margin-left: auto; margin-right: auto;" role="presentation" src="https://www.mdpi.com/microorganisms/microorganisms-11-02618/article_deploy/html/images/microorganisms-11-02618-g001.png" alt="" width="50%" height="50%" /></p>
<p style="text-align: center;"><span style="font-size: 8pt;">Image from: Han, J. J., Song, H. A., Pierson, S. L., Shen-Gunther, J., & Xia, Q. (2023). Emerging infectious diseases are virulent viruses—Are we prepared? An overview. Microorganisms, 11(11), 2618. <a href="https://doi.org/10.3390/microorganisms11112618" target="_blank" rel="noopener">https://doi.org/10.3390/microorganisms11112618</a> </span></p>
<ul>
<li><strong>Activity:</strong> Introduce yourself in the discussion forum and share your thoughts on the challenges of controlling communicable diseases.</li>
<li><strong>Resource:</strong> <a style="color: #007bff; text-decoration: none;" href="#">Block 3 Handbook</a></li>
</ul>
<div style="background-color: #f9f9f9; padding: 15px; border-radius: 5px; margin-top: 20px;">
<h4 style="font-size: 18px; margin-bottom: 10px;">📖 Read More</h4>
<ul>
<li>World Health Organization (WHO): <a href="https://www.who.int/health-topics/communicable-diseases" target="_blank" rel="noopener">Communicable Diseases Overview</a></li>
</ul>
</div>
</div>
<div id="tab-2" style="background-color: #ecf0f1; padding: 15px; border-radius: 5px;">
<h3>Understanding Infectious Agents</h3>
<h4><strong>Overview</strong></h4>
<p>Infectious agents are microorganisms that cause disease. They include bacteria, viruses, parasites, and fungi. Each type has unique characteristics that influence how they spread and cause illness.</p>
<h4><strong>Why This Matters</strong></h4>
<p>Understanding the biology of infectious agents is essential for developing effective prevention and control strategies.</p>
<h4><strong>Key Concepts</strong></h4>
<ul>
<li><strong>Bacteria:</strong> Single-celled organisms that can cause diseases like tuberculosis and cholera.</li>
<li><strong>Viruses:</strong> Tiny infectious agents that require a host to replicate, such as influenza and HIV.</li>
<li><strong>Parasites:</strong> Organisms that live on or in a host, causing diseases like malaria and schistosomiasis.</li>
<li><strong>Fungi:</strong> Can cause infections like athlete's foot and candidiasis, particularly in immunocompromised individuals.</li>
</ul>
<h4><strong>Critical Insights</strong></h4>
<p>Here are three contemporary insights into the role of infectious agents in public health:</p>
<ol>
<li>
<p><strong>Antimicrobial Resistance (AMR):</strong> The rise of drug-resistant bacteria, such as MRSA and multidrug-resistant tuberculosis, poses a significant threat to global health. AMR complicates treatment protocols, increases healthcare costs, and underscores the need for novel antibiotics and stewardship programs.</p>
</li>
<li>
<p><strong>Emerging and Re-emerging Viruses:</strong> The COVID-19 pandemic highlighted the rapid spread of novel viruses in a globalized world. Similarly, re-emerging viruses like Zika and Ebola demonstrate the importance of robust surveillance systems and rapid response mechanisms to prevent outbreaks.</p>
</li>
<li>
<p><strong>Climate Change and Infectious Diseases:</strong> Climate change is altering the distribution of infectious agents. For example, warmer temperatures expand the habitats of vectors like mosquitoes, increasing the spread of diseases such as malaria and dengue fever. Understanding these dynamics is critical for future public health planning.</p>
</li>
</ol>
<h4><strong>Reflection</strong></h4>
<p>How do the characteristics of different infectious agents influence their transmission and control?</p>
<div style="background-color: #f9f9f9; padding: 15px; border-radius: 5px; margin-top: 20px;">
<h4 style="font-size: 18px; margin-bottom: 10px;">📖 Read More</h4>
<ul>
<li>CDC: <a href="https://www.cdc.gov/diseasesconditions/index.html" target="_blank" rel="noopener">Types of Infectious Agents</a></li>
<li>WHO: <a href="https://www.who.int/news-room/fact-sheets/detail/antimicrobial-resistance" target="_blank" rel="noopener">Antimicrobial Resistance</a></li>
</ul>
</div>
</div>
<div id="tab-3" style="background-color: #ecf0f1; padding: 15px; border-radius: 5px;">
<h3>Modes of Disease Transmission</h3>
<h4><strong>Overview</strong></h4>
<p>Diseases can spread through various modes, including direct contact, indirect contact, airborne transmission, and vector-borne transmission. Understanding these modes is critical for effective disease control.</p>
<h4><strong>Why This Matters</strong></h4>
<p>Identifying the mode of transmission helps in designing targeted interventions to prevent disease spread.</p>
<h4><strong>Key Concepts</strong></h4>
<ul>
<li><strong>Direct Contact:</strong> Transmission through physical contact with an infected person or their bodily fluids.</li>
<li><strong>Indirect Contact:</strong> Transmission via contaminated surfaces or objects.</li>
<li><strong>Airborne:</strong> Spread through respiratory droplets or aerosols, as seen with tuberculosis or COVID-19.</li>
<li><strong>Vector-Borne:</strong> Transmission through vectors like mosquitoes (e.g., malaria) or ticks (e.g., Lyme disease).</li>
</ul>
<h4><strong>Critical Insights</strong></h4>
<ol>
<li>
<p><strong>Airborne Transmission in Indoor Settings:</strong> The COVID-19 pandemic underscored the importance of ventilation and air filtration in reducing airborne transmission. This has led to a reevaluation of building designs and public health guidelines for indoor spaces.</p>
</li>
<li>
<p><strong>Role of Fomites in Indirect Transmission:</strong> While fomites (contaminated surfaces) were initially emphasized during COVID-19, recent evidence suggests their role may be less significant than previously thought. This highlights the need for evidence-based prioritization of control measures.</p>
</li>
<li>
<p><strong>Vector-Borne Diseases and Urbanization:</strong> Rapid urbanization and climate change are expanding the habitats of disease vectors like mosquitoes, increasing the risk of diseases such as dengue and Zika in previously unaffected areas.</p>
</li>
</ol>
<h4><strong>Reflection</strong></h4>
<p>What are the challenges in controlling diseases with different modes of transmission?</p>
<div style="background-color: #f9f9f9; padding: 15px; border-radius: 5px; margin-top: 20px;">
<h4 style="font-size: 18px; margin-bottom: 10px;">📖 Read More</h4>
<ul>
<li>WHO: <a href="https://www.who.int/news-room/fact-sheets/detail/vector-borne-diseases" target="_blank" rel="noopener">Vector-Borne Diseases</a></li>
<li>CDC: <a href="https://www.cdc.gov/coronavirus/2019-ncov/science/science-briefs/sars-cov-2-transmission.html" target="_blank" rel="noopener">Modes of COVID-19 Transmission</a></li>
</ul>
</div>
</div>
<div id="tab-4" style="background-color: #ecf0f1; padding: 15px; border-radius: 5px;">
<h3>Reservoirs and Vectors in Disease Spread</h3>
<h4><strong>Overview</strong></h4>
<p>Reservoirs are natural habitats where pathogens live and multiply, while vectors are organisms that transmit pathogens from reservoirs to humans. Both play a critical role in the epidemiology of infectious diseases.</p>
<h4><strong>Why This Matters</strong></h4>
<p>Understanding reservoirs and vectors is key to breaking the chain of transmission for many diseases.</p>
<h4><strong>Key Concepts</strong></h4>
<ul>
<li><strong>Reservoirs:</strong> Can be humans, animals, or environmental sources (e.g., soil, water).</li>
<li><strong>Vectors:</strong> Include mosquitoes, ticks, and fleas, which transmit diseases like malaria, Lyme disease, and plague.</li>
<li><strong>Control Strategies:</strong> Targeting reservoirs and vectors through vaccination, environmental management, and vector control.</li>
</ul>
<h4><strong>Critical Insights</strong></h4>
<ol>
<li>
<p><strong>One Health Approach:</strong> The interconnectedness of human, animal, and environmental health is increasingly recognized. For example, controlling zoonotic diseases like rabies requires collaboration between public health, veterinary, and environmental sectors.</p>
</li>
<li>
<p><strong>Vector Resistance to Insecticides:</strong> The widespread use of insecticides has led to resistance in mosquito populations, complicating efforts to control diseases like malaria. Innovative approaches, such as genetically modified mosquitoes, are being explored as alternatives.</p>
</li>
<li>
<p><strong>Environmental Reservoirs and Climate Change:</strong> Climate change is altering the distribution of environmental reservoirs, such as water bodies for cholera-causing bacteria. This necessitates adaptive public health strategies to address shifting disease patterns.</p>
</li>
</ol>
<h4><strong>Reflection</strong></h4>
<p>How can targeting reservoirs and vectors reduce the burden of communicable diseases?</p>
<div style="background-color: #f9f9f9; padding: 15px; border-radius: 5px; margin-top: 20px;">
<h4 style="font-size: 18px; margin-bottom: 10px;">📖 Read More</h4>
<ul>
<li>CDC: <a href="https://www.cdc.gov/globalhealth/healthprotection/fieldupdates/fall-2019/reservoirs.html" target="_blank" rel="noopener">Reservoirs of Infection</a></li>
<li>WHO: <a href="https://www.who.int/news-room/fact-sheets/detail/vector-borne-diseases" target="_blank" rel="noopener">Vector-Borne Diseases</a></li>
<li>WHO: <a class="inline_disabled" href="https://www.who.int/news-room/questions-and-answers/item/one-health" target="_blank" rel="noopener">One Health Approach</a></li>
<li> UKHSA: <a class="inline_disabled" href="https://www.gov.uk/government/publications/uk-one-health-report-joint-report-on-antibiotic-use-antibiotic-sales-and-antibiotic-resistance" target="_blank" rel="noopener">UK One Health Report Nov 2023</a></li>
</ul>
</div>
</div>
<div id="tab-5" style="background-color: #ecf0f1; padding: 15px; border-radius: 5px;">
<h3>Case Study: Transmission Dynamics of Measles</h3>
<h4><strong>Overview</strong></h4>
<p>Measles is a highly contagious vaccine-preventable disease. This case study explores its transmission dynamics, the role of vaccination, and strategies for outbreak control.</p>
<h4><strong>Why This Matters</strong></h4>
<p>Measles serves as a model for understanding the importance of herd immunity and vaccination in controlling infectious diseases.</p>
<h4><strong>Key Concepts</strong></h4>
<ul>
<li><strong>Transmission:</strong> Airborne spread through respiratory droplets.</li>
<li><strong>Herd Immunity:</strong> Requires high vaccination coverage to prevent outbreaks.</li>
<li><strong>Outbreak Control:</strong> Rapid case identification, isolation, and vaccination campaigns.</li>
</ul>
<h4><strong>Critical Insights</strong></h4>
<ol>
<li>
<p><strong>Vaccine Hesitancy and Measles Resurgence:</strong> Despite the availability of an effective vaccine, measles outbreaks are increasing globally due to vaccine hesitancy and misinformation. Addressing these challenges requires targeted public health communication strategies.</p>
</li>
<li>
<p><strong>Impact of Conflict and Displacement:</strong> Measles outbreaks are more common in conflict zones and among displaced populations due to disrupted healthcare systems and low vaccination rates. This highlights the need for integrated humanitarian and public health responses.</p>
</li>
<li>
<p><strong>Economic Burden of Measles Outbreaks:</strong> Measles outbreaks strain healthcare systems and economies, particularly in low-resource settings. Investing in vaccination programs is cost-effective and prevents long-term economic losses.</p>
</li>
</ol>
<h4><strong>Reflection</strong></h4>
<p>What lessons can be learned from measles outbreaks for controlling other vaccine-preventable diseases?</p>
<div style="background-color: #f9f9f9; padding: 15px; border-radius: 5px; margin-top: 20px;">
<h4 style="font-size: 18px; margin-bottom: 10px;">📖 Read More</h4>
<ul>
<li>WHO: <a href="https://www.who.int/news-room/fact-sheets/detail/measles" target="_blank" rel="noopener">Measles Fact Sheet</a></li>
<li>CDC: <a href="https://www.cdc.gov/measles/cases-outbreaks.html" target="_blank" rel="noopener">Measles Outbreaks</a></li>
</ul>
</div>
</div>
<div id="tab-6" style="background-color: #ecf0f1; padding: 15px; border-radius: 5px;">
<h3>Activities</h3>
<p>This section consolidates your learning through practical activities and reflections. Complete these tasks to reinforce your understanding of the block's topics.</p>
<ul>
<li><strong>Activity 1:</strong> Analyze a case study of a disease outbreak and identify the mode of transmission.</li>
<li><strong>Activity 2:</strong> Develop a strategy to control a vector-borne disease in a specific region.</li>
<li><strong>Activity 3:</strong> Participate in a group discussion on the challenges of achieving herd immunity.</li>
</ul>
<p><strong>📖 Review:</strong> Review the Sway presentation below for a summary of Block 3 content.</p>
<details style="border: 1px solid #d1d1d1; border-radius: 5px; background-color: #34495e; color: white; margin-bottom: 10px;">
<summary style="cursor: pointer; display: flex; align-items: center; gap: 10px; list-style: none; padding: 15px; height: 20px; font-size: 18px; background-color: #5f6b7f; color: white;"><span>📖 Check Your Understanding</span></summary>
<div style="border-top: 1px solid #d1d1d1; margin-top: 10px; padding: 15px; background-color: #f9f9f9; color: black;">
<div style="margin: 50px 15%; background-color: #d6eaf8; padding: 30px; border-radius: 12px;">
<h4 style="text-align: center; color: #003d4f; padding-bottom: 10px; border-bottom: 2px solid #003d4f; font-size: 20px;"><strong>Check Your Understanding</strong></h4>
<div style="padding: 20px 0;">
<p><strong>Scenario:</strong> A community reports a sudden increase in malaria cases. What is the most likely mode of transmission?</p>
<div style="padding-left: 20px;">
<p><a id="q1-option1" style="color: #003d4f; text-decoration: none;" href="#q1-dialog1">A. Vector-borne transmission via mosquitoes.</a></p>
<p><a id="q1-option2" style="color: #003d4f; text-decoration: none;" href="#q1-dialog2">B. Airborne transmission through respiratory droplets.</a></p>
<p><a id="q1-option3" style="color: #003d4f; text-decoration: none;" href="#q1-dialog3">C. Direct contact with infected individuals.</a></p>
</div>
<div id="q1-dialog1" class="enhanceable_content dialog" style="padding: 10px; background-color: #d4edda; border: 2px solid #28a745; border-radius: 8px; margin-top: 10px;">
<p><strong>Correct!</strong> Malaria is primarily transmitted through the bite of infected mosquitoes.</p>
</div>
<div id="q1-dialog2" class="enhanceable_content dialog" style="padding: 10px; background-color: #f8d7da; border: 2px solid #dc3545; border-radius: 8px; margin-top: 10px;">
<p><strong>Incorrect.</strong> Malaria is not transmitted through respiratory droplets.</p>
</div>
<div id="q1-dialog3" class="enhanceable_content dialog" style="padding: 10px; background-color: #f8d7da; border: 2px solid #dc3545; border-radius: 8px; margin-top: 10px;">
<p><strong>Incorrect.</strong> Direct contact is not a mode of transmission for malaria.</p>
</div>
</div>
</div>
</div>
</details>
<details style="border: 1px solid #d1d1d1; border-radius: 5px; background-color: #34495e; color: white; margin-bottom: 10px;">
<summary style="cursor: pointer; display: flex; align-items: center; gap: 10px; list-style: none; padding: 15px; height: 40px; font-size: 18px; background-color: #5f6b7f; color: white;"><span>📖 Further Reading and Resources</span></summary>
<div style="border-top: 1px solid #d1d1d1; margin-top: 10px; padding: 15px; background-color: #f9f9f9; color: black;">
<p><span>Hawker, J., Begg, N., & Reintjes, R. (2019). </span><i>Communicable disease control and health protection handbook (4th ed.)</i><span>. Wiley. [<a class="inline_disabled" href="https://library.marjon.ac.uk/cgi-bin/koha/opac-detail.pl?biblionumber=59833" target="_blank" rel="noopener">Marjon e-book</a>]</span></p>
<p>Han, J. J., Song, H. A., Pierson, S. L., Shen-Gunther, J., & Xia, Q. (2023). Emerging infectious diseases are virulent viruses—Are we prepared? An overview. Microorganisms, 11(11), 2618. <a href="https://doi.org/10.3390/microorganisms11112618" target="_blank" rel="noopener">https://doi.org/10.3390/microorganisms11112618</a> </p>
</div>
</details>
</div>
</div>
<p> </p>
<p> </p>
<div style="background-color: #5f6c7f; color: white; padding: 10px; border-radius: 5px; margin-bottom: 15px;"><span style="color: #ffffff;"><strong>Other Content:</strong> <a style="color: #ffffff;" title="Reading List and Resources" href="$WIKI_REFERENCE$/pages/ged3572a741a84c78f3331d127792acca" data-course-type="wikiPages" data-published="true" data-api-endpoint="https://marjon.instructure.com/api/v1/courses/198/pages/ged3572a741a84c78f3331d127792acca" data-api-returntype="Page">Reading List and Resources</a>  |  <a style="color: #ffffff;" title="HP Appendix A: Case Studies" href="$WIKI_REFERENCE$/pages/geac2f0b1b9eff42c3614f995ae8a58f6" data-course-type="wikiPages" data-published="false" data-api-endpoint="https://marjon.instructure.com/api/v1/courses/198/pages/geac2f0b1b9eff42c3614f995ae8a58f6" data-api-returntype="Page">HP Appendix A: Case Studies</a>   |   <a style="color: #ffffff;" title="HP Appendix B: Historical Cases" href="$WIKI_REFERENCE$/pages/gce5e73fb478636359c7f772ddf3677f3" data-course-type="wikiPages" data-published="false" data-api-endpoint="https://marjon.instructure.com/api/v1/courses/198/pages/gce5e73fb478636359c7f772ddf3677f3" data-api-returntype="Page">HP Appendix B: Historical Cases</a>   |   <a style="color: #ffffff;" title="Assessment Information" href="$WIKI_REFERENCE$/pages/gf2cb7f97d2be6f21b0fbc926c4f32aec" data-course-type="wikiPages" data-published="true" data-api-endpoint="https://marjon.instructure.com/api/v1/courses/198/pages/gf2cb7f97d2be6f21b0fbc926c4f32aec" data-api-returntype="Page">Assessment Information</a>    |    More available at <a style="color: #ffffff;" title="Home Page" href="$WIKI_REFERENCE$/pages/g52029984a423c3138b6856c8873f841c" data-course-type="wikiPages" data-published="true" data-api-endpoint="https://marjon.instructure.com/api/v1/courses/198/pages/g52029984a423c3138b6856c8873f841c" data-api-returntype="Page">course homepage</a></span></div>
<footer style="text-align: center; padding-top: 5px; padding-right: 20px; padding-bottom: 5px; background-color: #f1f1f1; margin-top: 20px; font-family: Arial, sans-serif;">
<p style="margin: 0; color: #555;"><span style="font-size: 10pt;">This course is designed and maintained by [Your Name/Institution].</span></p>
</footer>