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Epidemiology > Epi > Flashcards

Epi Flashcards

1
Q

The survival of microbial pathogens w/in a human populations is due to what?

A

the ability for the pathogen to:

  1. Escape from one host
  2. Survive and disperse in the external environment
  3. Invade another host
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2
Q

Mechanisms of infections

A
  1. Contact infection:
    a. Congenital
    b. Sexual
    c. other
  2. Air-borne infection (mainly through inhalation)
  3. water and food-borne infection (mainly via ingegestion)
  4. Trauma-mediated infection
    a. Implantation
    b. Injection
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3
Q

Contact Infection

A

Infection that requires direct person-to-person contact; may involve indirect contact through contaminated articles.

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4
Q

Congenital Contact infection

A

Being born w/ infection, either through being Transmitted across the placenta or acquired from the mother during birth.
-most infections cant cross the placenta barrier except for some
Ex: HIV, rubella, syphilis, toxoplasmosis, cytomegalovirus.
-Gonorrhea acquired during delivery.

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5
Q

Sexual Contact Infection

A

From one person to another directly by mucous membrane contact or shared body fluids.
Ex: STIs, hep b, HIV

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6
Q

Other Contact infections

A
  • Non-sexual: 1 on 1 contact such as hugging, shaking hands
  • Autoinfection: infection on one-self such as E.coli, and boils
  • Fomites: acquired through contact w/ articles contaminated by another person such as athletes foot, cold sores (sharing cups!!)
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7
Q

Air-borne infections

A

Transmitted mainly by the disposition of the moist mucous membrane of the nose pharynx, trachea, and bronchial tree during inhalation.
-must be present in sufficiently small particles that can be easily transmitted through the air.
a. Air-borne droplets
b. Air-borne dried particles
Ex: Diptheria, TB, whooping cough, measles, flu, the common cold

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8
Q

Air-borne Droplets

A

Droplets from a sneeze or cough (aerosol cloud of droplets can be seen and felt). However, mainly saliva is heavy so it drops quickly to the floor.

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9
Q

Air-Borne dried particles

A

Main Vehicle for transmission of air-borne infection.
derived from nasal mucus or septum (the actual site of infection), which in moist form can spread easily on skin, handkerchiefs, clothing, bedding, etc. when dried and disturbed, dried particles are released into the atmosphere ( motes). Can see motes in sunlight shafts, and allows the infection to occur over much greater ditances.

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10
Q

Water and food-borne infections

A

Results from ingestion of faecally contaminated food or water; infections affect small or large intestines, but some can spread to other body parts (polio or typhoid)

  • Dysentery (shingella dysenteraie)
  • Cholera (vibrio cholerae)
  • Typhoid (Salmonella Typhi)
  • Poliomyelitis (virus)

Proper water treatment( filtration, chlorination, routine monitoring) and correct sewage treatment and disposal are central to good public health. (not always possible for developing communities)

  • Can break down due to natural or artificial disasters.
  • proper hygiene is important in food preparation and processing.
  • Gastroenteritis in NZ
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11
Q

Trauma-mediated infection

A

Infection through trauma where skin integrity of the body is lost. Two types: Implantation and Injections

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12
Q

Implantation trauma-mediated infection

A

accidental trauma to deliberate surgical procedures expose sterile tissue to pathogens. Ex: Staphylococcus aureus, pseudomonas aeruginosa, haemolytic streptococci.
Serious tissue damage may also create ideal conditions for germination of the spores introduced pathogenic obligate anaerobes ex: Clostridium perfringens or tetani.

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13
Q

Injections Trauma-mediated infection

A

penetrations of skin introducing micro-organism into under-lying tissues w/o major disruption of outer body layers.
-Natural: usually infected by vectors. Ex: malaria (plasmodium spp) Bubonic plague (yersinia pestis), dengue fever, yellow fever.
Animal bites the puncture rather than rip ex: rabies

-Artificial: From on person to another via needles, syringes, blood to blood products. infections that can spread this way are Hep-B and C, HIV malaria.

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14
Q

Epidemiology

A

the study of the factors and mechanisms that influence the distribution and frequency of disease.

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15
Q

Incidence

A

of new cases of a disease in a specific period of time. a good measure of the progress of disease outbreaks.

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16
Q

Prevalence

A

of ppl infected by disease at any one time. a good measure of how seriously the disease is affecting the population.

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17
Q

Morbidity Rate

A

of cases of a disease in relation to totally pop. size usually expressed as # of cases/100,000 ppl/ year

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18
Q

Mortality Rate

A

of deaths caused by a particular disease. usually expressed as # of cases/100,000 ppl/ year

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19
Q

Types of Epidemiology investigations

A
  1. Descriptive epidemiology
  2. Analytical epidemiology
  3. Experimental epidemiology
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20
Q

Descriptive epidemiology

A

studies a wide range of data collected, including # of cases, location, time frames of an outbreak, and details of ppl affect (age, gender, race, socio-economic status, occupation, marital status, etc. )
Patterns:
-Who is more susceptible? (age, race, gender)
-Socio-economic status? are they under-nourished individuals or living in over-crowded or sub-standard housing?
-Occupation info taces back to a factory, slaughterhouse, or hide-processing plant
-If the outbreak is primarily with stick farmers and vets, likely to be an animal sources
-Geographic distribution may indicate contaminated water supply, where a certain vector is located, and restaurant where a Hepatitis carrier works.

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21
Q

Analytical epidemiology

A

Focuses on establishing quantitative relationships in epidemiology. Looking for factors that might lead to an outbreak. ex: blood transfusion vs those who didn’t get transfusions to establish a link to hep c infection outbreak

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22
Q

Experimental epidemiology

A

The development of a hypothesis about a disease then can be tested. The use of prophylactic antibiotic therapy to reduce meningococcal disease in identified at-risk groups.

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23
Q

Sporadic disease

A

A disease that occurs occasionally w/in a pop. There are long periods of time when completely absent from pop.
ex: tetanus and botulism

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24
Q

Endemic disease

A

A disease that’s constantly present w/in a pop. # of cases fluctuates over time but never reaches zero. Ex: chickenpox and the common cold

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25
Q

Epidemic disease

A

A short-term increase in the occurrence of a disease in particular pop.
Ex: flu or whooping cough

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26
Q

Pandemic disease

A

is an epidemic of international or global distribution.
Ex: HIV in 1980’s
Spanish flu in 1919 (killed more ppl that WWI)

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27
Q

Public Health Organisations (PHO)

A

widespread recognition of the importance of controlling infectious diseases. There are local, national, international, and global levels.

  • WHO
  • CDC
  • CDC Welly
  • Local reporting
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28
Q

WHO

A

Organization based in Geneva. Develops, coordinates, and implements programs to improve health in 100 countries

  • set health standards
  • assist member countries to mount effective control and immunization programs
  • maintains surveillance for potential epidemics
  • Collects, analyses, and distributes data relation to human health
  • provides training and research programs for health personnel, especially in developing countries.
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29
Q

Center for Disease Control (CDC)

A

US public health, but also functions internationally. Primary functions are to monitor, control, and prevention of infectious diseases. Played a major role in the investigation of the epidemiology of HIV/AIDS

30
Q

Communicable Disease Centre (CDC Welly)

A

Linked to the Ministry of Health and responsible for gathering and disseminating data relating to infectious diseases in NZ.
Also monitors overseas trends and provides advance warning of potential influence on NZ.
-produces relevant publications including monthly summary of recent infectious disease data in NZ in NZ public health report.

31
Q

Local reporting

A

Under Health ACT 1956, clinicians are required to report all cases of those diseases classified as “notifiable” to MoH. Notifiable diseases updated 2017.
-Local authorities Ex: getting salmonella from the restaurant, to shut it down.

32
Q

Local infection

A

Invading micro-organisms limited to small area of the body. Ex: conjunctivitis, boils

33
Q

Systemic (generalized) infection

A

Micro-organisms are distributed throughout the body by blood or lymphatic system.
Ex: Typhoid fever

34
Q

Bacteremia

A

Presence of bacteria in the blood

35
Q

Septicemia

A

bacteria multiplying in blood

36
Q

Primary Infection

A

Infection which causes initial illness

37
Q

Secondary Infection

A

caused by an opportunist after primary infection has weakened the body’s defenses.
-2ndary infections of skin and respiratory tract are common, and sometimes more dangerous than primary.
Ex: Steptoccal bronchopneumonia following Whooping cough, measles, or flu

38
Q

Sub-clinical (inapparent) infection

A

does not cause any noticeable illness. Asymptotic. Ex: Hep B. typhoid mary

39
Q

Communicable diseases

A

any disease thats spreads directly from one person to another, directly or indirectly

40
Q

Non-communicable diseases

A

caused by normal flora or by organisms that reside outside the body
-tetanus

41
Q

Contagious diseases

A

Easily spread from one person to another

-chickenpox

42
Q

Acute diseases

A

Develops rapidly but generally lasts only a short time.

-flu

43
Q

Chronic diseases

A

develops more slowly and is likely to be continuous or recurrent for long periods.
-TB, thypoid (mary)

44
Q

Latent diseases

A

the causative agent remains inactive for long periods of time, and becomes active to produce symptoms of the disease
ex: Cold sores from Herpes simple virus, shingles.

45
Q

Reservoirs of infection

A 
Sites in which viable infection agents remain alive and from which new infections of individuals may occur. 
A) Living Reservoirs
1. Human
2. Animal
3. Insect (vectors)
B) Non-living reservoirs: surviving in environment between hosts
1. Soil
2. Air
3. Food
D. Water
46
Q

Living Reservoirs: Human

A
  • the main reservoir of infection for other ppl.
  • Obviously sick people but controlled by isolation and treatment to minimize spread.
  • Carriers: ppl with only mild illness or with no signs of illness. “ Asymptomatic” can still pass pathogens
  • Transient Carrier: when the disease is communicable during incubation or recovery period but shows no signs of disease.
  • Chronic Carrier: Where the infections persist for long periods of time. Ex: TB, gonorrhea, Hep-b, MRSA, typhoid
47
Q

Living Reservoirs: Animal

Zoonoses!

A

mainly occurs in wild or domestic animals that can be transmitted to humans (zoonoses).

  • acquired through handling animals, animal products, and receiving bites from blood-sucking insects that prey on both humans and animals.
  • Major reservoir due to the fact of 150 recognized zoonoses
    ex: rabies, anthrax, brucellosis, leptospirosis, toxoplasmosis, bubonic plague, yellow fever
  • complicates disease control, more difficult to eradicate diseases.
48
Q

Living Reservoirs: Insect Vectors

A
  • Sucking Mamminlain blood as food meets the demands of laying many eggs (protein-demanding) making only email insects doing the biting.
  • a disease transmitted but vector but mico-organisms have complex life cycles in which the human host is only one part.
  • Fleas: Bubonic plague
  • Mosquitoes: malaria, yellow fever, filariasis, dengue fever, Ross River fever
  • Bed: Chagas’ disease
  • tsetse flies: sleeping sickness
  • Body lice: epidemic typhus
  • Ticks (arachnids): Rocky mountain spotted fever, q fever, and lyme disease.
  • Mites (arachnids): scrub typhus
49
Q

Non-living reservoirs: soil

A
  • clostridium botulinum spores
  • clostridium tetani spores
  • certain fungi that can cause mycoses (coccidioidomycosis)
  • infective stages of larger parasitic organisms (nematodes)
50
Q

Non-living reservoirs: air

A
  • just “passing through” but a major reservoir of human infectious diseases because it is continually being contaminated by:
  • dust from soil
  • dust from humans ( skin scales, dried nasal mucus and sputum)
  • droplets from coughs and sneezes
  • droplets and dried particles from other body products (gastro-intestinal tract, infected wounds)
51
Q

Non-living reservoirs: food

A
  • Primary reservoir: disease being transmitted directly from the animal being eaten ex: salmonella in eggs or chickens, parasitic worms (tape worms, flukes, and nematodes) from poorly cooked beef or pork.
  • Secondary reservoir: when food itself becomes contaminated by new organisms that reproduce. Ex: staphylococcal food poisoning.
52
Q

Non-living reservoirs: water

A
  • in places human sewage disposal is inadequate and water treatment is poor or absent.
    -pathogenic org. comes directly from diseased digestive tracts, followed by drinking contaminated water
    EX: dysentery, cholera, typhoid, poliomyelitis, hep-A, giardiasis, cryptosporidiosis, leginnaire’s disease, amoebic meningitis.
    -during natrual disasters and major social upheaval, water and sweage can be disrupted. Epidemics of water-borne disease can quickly cause more suffering than original disaster.
53
Q

Nosocomial infections

A 
hospital-acquired infections.
-infections that were not present upon admission. 
-Constant  hazard w/in hospital environment and may occur:
patient to patient
staff to patient
patient to staff
staff to staff
auto-infection
54
Q

Main Categories of hospital-acquired infections?

A

(variations between one location to another and different times of year)

  1. UTI
  2. Surgical wound infections
  3. Respiratory tract infections
  4. blood, skin, and other infections
55
Q

UTI

A
  • accounts for 40-50% of all nosocomial infections
  • associated with urinary catheterization (contaminated cath., inadequately cleaned insertion site, movement of organisms from leaky connections.
  • very common
56
Q

Surgical wound infections

A

Post-op surgical wound infection accounts for 15-25% of nosocomial infections.

  • exposes sterile tissue to air/instruments/personnel that can carry pathogenic organisms.
  • Long complex surg. increase the risk of subsequent post-op infections
  • Amputations and bowel surg especially likely to cause post-op infection
57
Q

Respiratory Tract infection

A

15-30% if nosocomial infections.
-related to the use of respiratory devices that administer air/O2/medication to the lungs.
-Pathogens grow in fluid reservoirs of cold mist and warm steam humidifiers. organisms can dispense during normal operation.
Ex: babies, ICU (those on ventelators),

58
Q

Blood, Skin, and other infections

A

10-20% nosocomial infections.

  • Bacteremia and septicemia are usually associated with IV catheterization.
  • Burn pt and neonates are especially prone to skin infections.
59
Q

Where do most micro-organisms that cause nosocomial infections come from?

A

Primarily micro-organisms from pt. own normal flora, from other pt. normal flora, and from normal flora of the staff.

60
Q

About half of all nosocomial infections are caused by which 4 bacteria?

A

Escherichia coli, Staphylococcus aureus, Streptococcus pyogenes, Pseudomonas aeruginosa

other 50% from a wide range:
-Staphylococcus epidermidis
-klebsiella spp
-Enterobacter spp
ect.
61
Q

Current/ recent infectious disease problems in NZ

A

-a total of 16,305 notifiable diseases in 2016
-Rheumatic fever
-TB
-Meningococcal disease
-food-borne disease
-mMRSA
HIV/AIDS( only AIDS on notifiable disease in NZ list)

62
Q

Nz immunization schedule was last updated what year?

A

oct 2020

63
Q

What vaccines are part of the immunization schedule when a woman is pregnant?

A

Influenza

Tetanus/Diptheria/pertussis

64
Q

What vaccines are part of the immunization schedule at the age of 6 weeks?

A

Rotavirus

Diphtheria/tetanus/Pertussis/polio/Hep B/ Haemophilus influenza type B

Pneumococcal

65
Q

What vaccines are part of the immunization schedule at the age of 3 months?

A

Rotavirus

Diphtheria/tetanus/Pertussis/polio/Hep B/ Haemophilus influenzae type B

66
Q

What vaccines are part of the immunization schedule at the age of 5 months?

A

Diphtheria/tetanus/Pertussis/polio/Hep B/ Haemophilus influenzae type B

Pneumococcal

67
Q

What vaccines are part of the immunization schedule at the age of 12 months?

A

MMR (Measles/mumps/rubella)

Pneumococcal

68
Q

What vaccines are part of the immunization schedule at the age of 15 months?

A

Haemophilus influenzae type B

MMR

Varicella (chickenpox)

69
Q

What vaccines are part of the immunization schedule at the age of 4 years?

A

Diphtheria/tetanus/Pertussis/polio

70
Q

What vaccines are part of the immunization schedule at the age of 11-12 years?

A

Diphtheria/tetanus/Pertussis

Human Papillomavirus (HPV)

71
Q

What vaccines are part of the immunization schedule at the age of 45 years?

A

Diphtheria/tetanus/Pertussis

72
Q

What vaccines are part of the immunization schedule at the age of 65 years?

A

Diphtheria/tetanus/Pertussis

Zoster (shingles)

Influenzae

Epidemiology (1 decks)

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