June21, 2014.

Epidemicsand infectious diseases raise severe threats to the health, socialand economic stability of society. There is a need for seriousmanagement methods in the initial investigation of the source, causalagents, the locality and the target population. Effective earlypreparations and diagnosis should be chosen to understand infectiousdisease. Such public health emergency raises serious moral andpractical challenges when evaluating the most effective containmentstrategy. In particular, individual intervention practices adoptedcreate adverse repercussions on the economy and the civil libertiesof individuals. As such, governments should be ready with effectivelegislation and regulations that are applied during emergency caseswithout infringing or creating moral and practical challenges.

Lessonslearned on Infectious Disease management as revealed in the book

‘TheDemon in the Freezer’

Inthe book ‘TheDemon in the freezer,’ manylessons are leant about infectious disease control. The author givesdifferent accounts of anthrax and smallpox infections and deliberatesmore on perception held by the American public in regard to epidemicsand fears of bioterrorism. In most cases of infectious diseasesillustrated in the book, the author elucidates on various measuresand procedures used by the CDC and the USAMRIID in assessing andanalyzing the infection cases. Great lessons are learned from themedical practitioners and the government in the management of theinfections (Preston,2002).

Inall cases of infections, the highly experienced team (CDC and theUSAMRIID) is involved in assessing the population at risk, preventivemeasures, assessing the likelihood of an outbreak and deliberating onapproaches to adopt to limit the disease spread. Infections wereassessed on the basis of host (the infected person i.e. Stephen whodied of anthrax), the agent causing the infection i.e. bacteria orvirus and the environment in which the individual was living. Forexample, after Stephen died of anthrax, the CDC team conducted anautopsy on the victim’s body to assess the nature of the diseaseand causal organism (Reich, 2003).

Thefirst step taken by the medics in the narration ‘demon in thefreezer,’ was to identify the disease to avoid secondary infectionthrough the dead body. In all the cases of infections, the medicsfirst considered whether the victims had died of common illness, thenthey considered the source of infectious disease, compared findingsto emerging diseases and then considered if epidemic cases were, as aresult, of bioterrorism. In addition to recognizing the infectiousdisease, the medic teams involved in the assessment of potentiallyepidemiological clues surrounding the infections. In this case, thepathologist looked for clues such as the number of casualties fromother medical facilities, mortality rate of the disease and theuncommonness of the disease. In addition, the team assessed the causeof the disease, multiple epidemics, rate of infection, presence ofdead animals, geographic location and the direct evidence from thevictim’s body (Preston,2002).

Duringthe investigations, the CDC team prepared themselves well by gettingall the necessary personnel, equipments and laboratory facilities. Inthe second step, the team did critical diagnosis on the victims’bodies to ascertain the disease outbreak. Afterward, the team made adefinitive diagnosis based on the historical, laboratory, clinicaland epidemiological information available about the condition. In thefourth step, the team engaged in establishing the definition of thedisease by assessing the symptoms the victims had prior their deaththis was necessary in comparing and counting cases of exposures. Themedical team then assessed all individuals who had come into contactwith the victims coworkers, family, members and health facilitiespreviously attended. In the fifth step, the CDC team developedexposure data by obtaining information from individuals who hadsimilar symptoms (Preston,2002).

After,assessing the disease and its possible causes, methods of controllingthe infectious disease were evaluated and implemented to avoidfurther infections spread. They later developed hypothesis tounderstand the connection between the sources of infection, spreadand the potential risks associated with the disease. Lastly, theconclusion was formulated and communicated to the relevant medicaland public fraternities to notify them on the dangers of theinfectious disease and its route (Preston,2002).Overall, as a way of efficient management of the infectious diseases(smallpox and anthrax), the medical teams did early investigations,analyzed and diagnosed the infections, and notified the properauthorities on time.

Moraland practical Concerns on current methods of managing InfectiousDiseases

Inthe modern world, the management and control of infectious diseasesare faced with adverse moral and practical concerns. In most cases,vaccines are used to prevent and safeguard community members againstinfectious diseases however, vaccines have had major ethicalcontroversies related to their development, control and use (Reich,2003). The development of effective preventive measures such asvaccines for ameliorating infectious diseases are confronted bymoral issues that affect their access, research and testing. In mostcountries, there are mandate policies by governments that requirevaccinations for vulnerable groups like children in the community.

Theimplementation of these programs is often met by harsh ethicaldebates where some individuals disagree their implementations basedon their philosophical and religious beliefs. For instance, agovernment directive to have all school going children be vaccinatedagainst polio in Kenya was met with rebel by a religious cult whorefused to have their kids vaccinated. In such a case, thevaccination control was seen as infringing on individuals’ libertyand autonomy. In another case, a vaccine developed to prevent STDamong young girls raised heated debates about the morality of thevaccine being given to one sex and that the vaccine would promotepromiscuity at the expense of moral abstinence (Reich, 2003).

Themanagement and prevention of infectious diseases are also faced withmoral and practical dilemma when it comes to testing and in theresearch of new vaccines. For years, researchers have struggled withthe ethical dilemma of whom to involve in vaccine trials this oftenleads to low level testing of vaccines that in turn affects theeffectiveness in preventing myriads of infectious diseases (Reich,2003). For instance, in the development of a preventive vaccine forTB, the current BCG vaccines still fall short of the expected levelof testing because, its testing on individuals with compromisedimmune systems have never been successful. In other cases,development and testing of a vaccine expose victims to stigma forinstance in the case of HIV and STDs vaccines.

Anothermajor concern in the management of infectious disease is gettinginformed consent from victims when administering vaccines. Civilrights group and lawmakers believe that the success of any vaccineadministration lies on informed consent on the community involved.Strategic containment of particular infectious disease involvesapproaches that might ordinarily be viewed as immoral (Reich, 2003).In most scenarios of infectious diseases, infected victims arecommonly separated from other community members. In such a case, theapproach used creates social separation and marginalization which isa moral concern to the community. Long durations of separation,affects and infringe on individual rights of association.

Inaddition, social separation is discriminatory and concernsdistributive justice. Quarantine and isolation are controversialmethods that have been used since olden times in the containment ofcontagious diseases (Reich, 2003). When applied as managementmethods, such approaches infringe on several moral, legal andpersonal liberties. Coercive health separation has been used insignificant infectious diseases by many governments in the modernsociety i.e. EBOLA and bird flu. However, governments should come upwith more effective measures of managing such infectious diseases bydeveloping adequate legal and government infrastructure for propermanagement strategies that will not cause social disruption.Isolation and quarantine should be used when other means areimpossible or through voluntary consent.

Workplace and School environment present dilemma in the management ofinfectious diseases. These places are important institutions whereindividuals acquire knowledge and derive livelihood. As such, anymanagement measure intended for infectious disease controls that seekto close such places might lead to severe economic problems. In theevent of closing such areas, the governments might not be able tocompensate for the lost income, and, therefore, other methods ofdisease containment should be sought (Reich, 2003). Indeed, there areseveral moral and practical concerns associated with modern diseasemanagement methods. Therefore, the government should have adequatemechanisms of addressing communicable and infectious diseases toavoid social and economic disruptions that would create more problemsin the society (Reich, 2003).


Effectiveepidemic control and management requires a multifaceted approachright from early diagnosis, considering moral and practical concerns,and effective implementation of control programs. Epidemics creategreat and urgent challenges that must be addressed adequately and intime to limit the spread of the disease. First step is to recognizethe condition to avoid secondary infection, afterwards, a definitivediagnosis of the disease based on the historical, laboratory,clinical and epidemiological information is made. Afterward,assessments of the disease and its possible causes, methods ofcontrolling the infectious disease are evaluated and implemented toavoid further spread. Overall, the management of infectious diseasesrequires early investigations, analyzing the criticalness of theinfection and notifying the relevant authorities on time.

However,in the implementation of management strategies for infectiousdisease, particular moral and practical concerns need to be assessed.When applied as infectious disease control methods, particularprocedures like quarantine and isolation infringes several moral,legal and individual liberties. As such, governments should come upwith more effective measures of managing infectious diseases bydeveloping adequate legal and government infrastructure for propermanagement methods that will not cause social disruption. Isolationand quarantine should be used when other means are impossible orthrough voluntary consent


PrestonRichard, 2002,‘TheDemon in the Freezer,’New York City Random House.

ReichDS. 2003, ‘Modernizing local responses to public healthemergencies: Bioterrorism, epidemics, and the Model State EmergencyHealth Powers Act.’ Journalof Contemporary Health Law and Policy.19(2):379–414.[PubMed]

TordaA. 2006, ‘Ethical issues in pandemic planning.’ MedicalJournal of Australia.185(10):S73–S76.[PubMed]