Diseases Flashcards
Bowel cancer
Age standardised incidence
- 69.3 / 100,000
age standardised mortality
- 26.7/ 100,000
Mortality 30% higher in most deprived areas compared to least deprived for males.
Depression
1 in 6 adults UK
Most prevelant mental health disorders
High contributor to DALYs
Women > men
Suicide
Age standardised mortality of 10.7 per 100,000
Men > women - males account for 3/4 of deaths
Dementia
3% -70-74
11% - 80-84
30% - 90-94
Psychosis
0.7% across all ages
Men > women
Parkinson’s
0.2% lifetime prevelance
Increasing with age
4/5 per 100,00 - 30-39
1700 per 100,000 - 80-84 (2% of age group)
CVD
Accounts for 1/4 of all deaths
Age standardised death rate 250/100,000
Men > women
Deaths from CVD 3x higher in most deprived areas
Stroke
100,000 strokes annually
Equal men/women
Significant cause of disability
CHD
14% males & 8% female deaths
Breast cancer
Most common cause of cancer
15% of all new cancer cases
Incidence highly related to age
Lifetime risk is 15% in women
Coverage of screening - 65.3% (dropped below 70% since covid)
Over diagnosis
False positives
Lung cancer
13% of all new cancer cases
21% of cancer deaths
Matches levels of smoking, higher in men, then peak in women after. Now declining.
Possible targeted screening recommended
Prostate cancer
13% of new cancers
80% survive to 10 years
Screening with PSA not recommended
Cervical cancer
1 in 142 women diagnosed in their lifetime
Worse in deprived areas
Reduced since screening program
Relative reduction of 87% for vaccinated 12-13 YOs
Asthma
12% prevalence
Occupational - ~ 10% adulte onset, commonest industrial lung disease in developed countries
COPD
4th leading cause of death worldwide
Second largest cause of emergency admissions in the UK
Increasing in women to now equal rates
Diabetes
8.6% of 16+ in UK
Higher in south Asian and black ethnicities
Increasing with age
Diphtheria
Average 2-11 cases annually
Asylum seeker outbreak 2022 - 50 cases. Predominantly cutaneous.
Diagnosis - swab
Reservoir- humans and cattle (ulcerans)
Transmission - droplets or contact (human or animal), consumption of unpasteurised milk
Notifiable
Control- vaccine, treatment and micro clearance, swab and vaccinate contacts.
Pertussis
Whooping cough
9 cases 2022
Few outbreaks- started vaccinating pregnant women in 2012
Diagnosis - swabs
Reservoir- humans
Transmission - droplets
Notifiable
Control- vaccine - child and pregnant women
Treat, isolate, offer abx and vaccine to vulnerable household contacts.
Tetanus
4 cases 2022
Major cause of morbidity in Africa and Asia (umbilical stump)
Diagnosis- serum for toxin
Reservoir - intestines and spores in soil from faeces
Transmission- spores into open wounds, needles
Control- vaccine preventable
Look for source
Polio
No cases since mid 90s
Only present in a few countries world wide
Diagnosis- viral detection
Reservoir - humans
Transmission- faecal oral
Notifiable
Control - vaccine
H. Influenzae
Few hundred cases annually
Mostly adults
Most non invasive
Diagnosis- PCR
Reservoir- humans
Transmission- droplets
Meningitis- Notifiable
Control- vaccine, chemoprophylaxis
Pneumococcus
Multiple strains
Issue in vulnerable (asplenic)
Diagnosis- culture
Reservoir - humans
Transmission- droplet
Enhances surveillance
Control- vaccine
Neisseria meningitidis
Seasonal epidemics, meningitis belt - Sahara
Student epidemics
Diagnosis- culture/PCR
Reservoir - humans
Transmission- person to person
Notifiable
Control- vaccine
TB
Notification rate 7.8/100,000
Low incidence country (<10)
More urban areas
Most deprived people
Inclusion health groups
People born outside of UK
Pre Covid- leading cause of ID death globally
Diagnosis- culture
Reservoir - humans and animals
Transmission- prolonged contact
Notifiable
Control- vaccine in children in higher rate areas, or parents/grandparents born in TB endemic country
Treat, DAT, screening
Mumps
Viral
Notifiable
Control- vaccine
Measles
Virus
368 cases 2023
Recent peak of cases 2023/2024
Diagnosis- serum
Reservoir- humans
Transmission- direct contact with case, 10/15 mins in a room, R ~15
Notifiable
Control- vaccine, isolation.
Rubella
Virus
No cases 2020/2021
Reservoir - humans
Transmission- contact
Notifiable
Control- vaccine
Human papilloma virus
3.2% of women harbour 16/18
Chronic infection- 80-90% cleared in 24 months
Reservoir - humans
Transmission- contact
Cancer registries
Control- screening and vaccination
Nosocomial infections
MRSA
C-Diff
Mandatory surveillance in trusts
Control- hygiene, PPE, micro clearance
GI infections
Campylobacter - most common bacteria infection. Poultry, cattle, some pets. - human to human transmission uncommon.
Cholera - rare in UK, isolation and hygiene most important. Vaccine but not very good, not recommended
Cryptosporidium- children, autumn peak, farm animals and humans, hand hygiene, isolation etc
Shigellae
Salmonella - multiple animals/burds, common outbreaks, vaccinate poultry, hygiene, isolation.
Typhoid/paratyphi- endemic in developing countries, mostly travel related, Notifiable, sanitation, hygiene, isolate.
Norovirus- seasonal winter, isolate/ hygiene
E. coli
0157 toxin producing - diarrhoea illness - HUS
Food borne outbreaks
Reservoir- Cattle
Transmission- contaminated water, humans, animal
Notifiable
Control - Hygiene, food practices, isolate
Hepatitis
A & E - acute limiting illness, person to person, faecal oral, food. Endemic in developing countries. A- failure in small numbers
B- chronic, carriage rate in UK 0.5%. BBV, vaccine to high risk groups. D co infection
C- chronic, complex treatment, BBV. Strategy to eradicate.
0.14% UK
11.8% PWID
Need to reduce re infection rate
Flu
A/B/C
A- most epidemics, most severe.
Winter outbreaks, worse in vulnerable. Droplet
Annual vaccine for at risk
Legionella
Bacteria
Environmental water
Aerosols
Notifiable
HIV
Just over 100,00 people living with HIV in the UK- 89% are suppressed.
UK meeting- 90-90-90 target
Incidence decreasing but prevelance increasing
Almost half of people accessing HIV care are 50yrs +
95% sexual transmission- 48% men/woman and 46% man/man
Vector borne diseases
Malaria - anopheles
Travel advice- Awareness, Bite prevention, Chemoprophylaxis, Diagnosis
Dengue - aedes - day biters
Lyme - ticks
Scabies
Mite infestation
Outbreaks where people live in close proximity- care homes, hospitals, prisons
Not Notifiable - estimate 1/50 long term care facilities will exp an outbreak annually
Treat, isolate, clean sheets etc
Vaccine preventable diseases
Available vaccines
Cholera
COVID-19 (corona virus)
Dengue
Diphtheria
Hepatitis
Haemophilus influenzae type b (Hib)
Human papillomavirus (HPV)
Influenza
Japanese encephalitis
Malaria
Measles
Meningococcal meningitis
Mumps
Pertussis
Pneumococcal disease
Poliomyelitis
Rabies
Rotavirus
Rubella
Tetanus
Tick-borne encephalitis
Tuberculosis
Typhoid
Varicella
Yellow Fever
