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The poorest result was achieved for shigella. Only three disease types were noted to have correct percentage rates above 80, those being HIV/AIDS, hepatitis B, and influenza. More than 50% of participants could not correctly identify the aetiology for 8 of the 25 diseases. These results may reflect the visible public profile of specific diseases such as HIV/AIDS. Regardless, the results reflect poor overall knowledge. Paramedic knowledge of the modes of transmission of infectious diseases was also assessed. The majority of the sample correctly identified the transmission modes of HIV/AIDS (85.9%), with the poorest result found for polio (6.4%). For 15 of the 25 infectious diseases, over 50% of respondents could not identify correct modes of transmission. Only modes of transmission for three diseases were noted as having correct percentage rates higher than 80, those being for HIV/AIDS, salmonella and influenza. Disturbingly, a proportion of participants either did not know or incorrectly identified modes of transmission for hepatitis B (20.4%) and C (30.2%). These diseases are widely regarded and documented as high-risk occupational hazards for health care workers performing exposure prone procedures. The results suggest paramedics in this study had poor knowledge of how infectious diseases are transmitted. Paramedics with poor knowledge of agents causing disease and poor knowledge of how disease is transmitted are hampered in their ability to prevent cross-infection . Patients who present with diagnosed infectious diseases require specific care. Over half the participants incorrectly identified the aetiology for 8 diseases, some of which require the application of specific additional infection control precautions. The understanding of disease aetiology and modes of transmission are vital components in understanding disease epidemiology and form two components of the concept widely recognised in infection control as the ‘Chain of Infection This concept illustrates the manner in which infectious diseases remain endemic in populations, and from time to time lead to epidemics and pandemics. Further, it underpins the rationale for the use of precautions taken for particular infections . In the present study, participants were asked to identify, using a true/false format, the correct components of the ‘Chain of Infection’. Only 46.2% of participants correctly identified the six components of the ‘Chain of Infection’, with 19.4% reporting that they did not know. This result illustrates poor overall knowledge of the basic mechanism of cross infection.

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