Epidemiology Flashcards by Math Ematics

Study of disease, injury and death

Epidemiology

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According to CDC, it is the study
(scientific, systematic, and data-driven) of
the distribution and determinants of
health-related states and events (not
just disease) in specified populations
(neighborhood, school, city, state, country, global)

 According to WHO, it is the study of
the distribution and determinants of
health-related states or events
(including disease), and the application
of this study to the control of diseases
and other health problems

Epidemiology

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Refers to descriptive epidemiology
 When (time), Where (place), Who
(person)

Distribution

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incidence, prevalence
and mortality rates

Frequency

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time, place, person

Pattern

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Refers to analytic epidemiology
 Causes, risk factors, modes of
transmission (why and how)
 Causes - agents
 Risk factors - exposure to sources
 Examples: smoking, obesity, high blood
pressure, diabetes, infections, genetics

Determinants

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Veni, vidi, vici

(I came, I saw, I conquer)

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Theory of four body humors produced
within the body
 Earth - blood and brain
 Air - phlegm and lungs
 Fire - black bile and spleen
 Water - yellow bile and gallbladder

Hippocrates (460 BCE - 370 BCE)

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Seeds of disease

Girolamo Fracastoro (Circa 1476 - 1553)

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Disease as an external thing called an
ens which could attack any organ of the
body

Paracelsus and JB van Helmont

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First to demonstrate microorganisms

Antoni van Leeuwenhoek (1632 - 1723)

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 Germ Theory, germ cause disease
 Developed vaccine against anthrax and
biological treatment for rabies

Louis Pasteur (1822 - 1895)

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one germ can cause
one disease

Biological specificity

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 Perfected methods for growing pure
colonies of bacteria
 Developed autoclaves for sterilizing
equipment
 Introduced photography to demonstrate
what he had seen through his microscope
 Identified some of the key disease-

Robert Koch (1843 - 1910)

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Antiseptic surgery which developed into
aseptic surgery

Joseph Lister (1827 - 1912)

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 Named the disease syphilis in a poem
 Notion of seeds of disease

Girolamo Fracastoro (1476

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His study on cholera reinforced his notion
that it was not transmitted by miasma
but through contaminated water

John Snow (1813 - 1858)

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First thorough notion of a germ theory
of disease
 Studied yeast, bacteria, and viruses

Louis Pasteur (1882

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Use of carbolic acid dressings to
disinfect surgical wounds

 Introduced aseptic technique

Joseph Lister (1827

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Discovered causative organisms of
tuberculosis and cholera

Robert Koch

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Study led to a better understanding of the
nature of viruses and their relationship
to the cells of the organism they
invade

Martinus Beijerinck

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 Influenced microscopy, tissue staining, embryology, chemotheraphy and
immunology
 Theory of the chemical nature of
antigens and antibodies (lock and key)

Paul Ehrlich (1854 - 1915)

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Developed a polio vaccine that used an
attenuated strain of the virus

Albert Sabin (1906

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 Coined the term prion and came up with
the theory behind how these misfolded
proteins cause grave disease

 Stanley Prusiner (1942)

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 Worked on the retroviruses, of which HIV is the most significant

 Francoise Barre-Sinoussi (1947)

-- includes the study of the frequency, patterns, and causes of health-related states or events in populations, and the application of that study to address public health issues

Basic science of public health, epidemiology

Microbes: bacteria, virus, fungi, protozoa

Agent

The human capable of developing the disease: genetics, ethnicity, socioeconomic status, sex, and gender

Host

- Lead and heavy metals - Air pollutants and other asthma triggers

Environmental exposures

- Foodborne illness - Influenza and pneumonia

Infectious diseases

- Increased homicides in a community - National surge in domestic violence

Injuries

- Localized or widespread rise in a particular type of cancer - Increase in a major birth defect

Non-infectious disease

- Hurricanes Katrina and Rita (2005) - Haiti earthquake (2010)

Natural disasters

- World Trade Center (2001) - Anthrax release (2001)

Terrorism

widely use  Describes the basic epidemiology of a disease

Descriptive

Used to study the disease further

Analytic

Test a hypothesis

Experimental

Describe the occurrence of the disease  Data collected by time, place, and person

Descriptive Epidemiology

describes the occurrence of disease over a prolonged period (years)  Trend of tetanus in the United States since 1920 shows a gradual and steady decline

Secular

indicate a change in the antigenic characteristics of the disease agent  Change in antigenic structure of the prevalent influenza A virus every 2 to 3 years

Periodic

Food-borne disease outbreaks occur more frequently in the summer

Seasonal

A sudden increase in occurrence due to prevalent factors

Epidemic occurence of disease

the level of influenza activity that signalled the start and end of the annual influenza season

Seasonal Threshold

the week in which positivity rate was above the weekly average positivity rate for that year and which continued for three consecutive weeks

Start/onset

- first week in which the positivity rate was below the average weekly positivity rate for that year which continued for three consecutive years

End

the period in which weekly influenza positive rates were above the average influenza positivity rate for a particular surveillance year for at least three consecutive weeks

Influenza season

the level above which influenza activity was higher than most years

Alert threshold

Sites or places to consider  Where the individual was when disease occurred  Where the individual was when he or she became infected from the source  Where the source became infected with the etiologic agent

Epidemiologic Data by Place

 Age  Sex  Occupation  Personal habits  Socioeconomic status  Immunization history  Presence of underlying disease

Epidemiologic Data of Infected Person

Analyzes disease determinants for possible causal relations

Analytic Epidemiology

Starts with the effect (disease) and retrospectively investigates the cause that led to the effect

Case-control or Case Comparison

individuals with the disease

Case group

members similar to the case group without the disease

Comparison (control) group

Prospectively studies two populations

Cohort Method

had contact with the suspected causal factor (blood transfusion) under study

Population 1

similar group that has had no contact with the factor

Population 2

To determine the relationship between a disease and variables present  A population is surveyed over a limited time period

Cross-sectional

One or more selected factors are manipulated  The effect of the manipulation will either confirm or disprove the hypothesis  Group 1 with the disease - given a new drug  Group 2 with the disease - not given the new drug

Experimental Epidemiology

 Identify factors relevant to an outbreak  Identify control and prevention measures  Data are collected and collated according to time, place, and person and analyzed and inferences are drawn

Epidemiologic Investigation

Steps: 1. Confirm the existence of the epidemic 2. Look for cases, verify diagnosis - case definition  Confirmed, suspected, probable case 3. Identify population at risk 4. Develop hypothesis 5. Develop control and prevention measures 6. Continue surveillance activities

Epidemiologic Investigation

living organisms or nonliving sites (soil, water)

Reservoirs

an individual capable of transmitting a pathogen without displaying symptoms

Carriers

harbors and transmit the pathogen but is not infected

Passive carriers

infected and transmit the pathogen (symptomatic or asymptomatic)

Active carriers

person to person transmission (touching, kissing, sexual

Direct

one meter or less distance

Droplet transmission

involves inanimate objects called fomites

Indirect

transmission of pathogens through vehicles such as water, food, air  Aerosols float in the air  Droplet nucleus can travel long distances

Vehicle Transmission

Vector Transmission

Refers to the occurrence of new cases of disease or injury in a population over a specified period of time  Although some epidemiologists use incidence to mean the new number of new cases in a community  Others use incidence to mean the number of new cases per unit of population

Incidence of Disease

Defined as any departure, subjective or objective from a state of physiological or psychological well-being  In practice, morbidity encompasses disease, injury and disability

Morbidity

The relative magnitude of two quantities or a comparison of any two values  Calculated by dividing one interval or ratio scale variable by the other  The numerator and denominator need not be related

Ratio

Comparison of a part to whole  Its numerator is included in the denominator

Proportion

A measure of frequency with which an event occurs in a defined population over a specified period of time

Rates