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Epidemiology > Global patterns of disease - infectious > Flashcards

Global patterns of disease - infectious Flashcards

1
Q

Why is human evolution slower than viruses and bacteria?

A

Human generation time (approx 25 yrs) is long, for influenza this is 2-3 days

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2
Q

What is the average time taken to develop a new drug?

A

15 years

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3
Q

How long does it take to produce and release a vaccine?

A

3 months to make but 8 years to trial

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4
Q

What are the 3 origins of human infections?

A

Ancestors
wildlife
livestock

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5
Q

What is the percentage of infections spread by zoonosis?

A

60-70

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6
Q

What changes in the world are leading to greater rates of transmission?

A

Increasing population

Transport- e.g. planes

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7
Q

What is epidemiology?

A

Quantifying the occurrence of disease in population

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8
Q

What does case mean in epidemiology?

A

Person with a disease or health problem

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9
Q

What is prevalence?

A

It is the frequency of disease in a population at a given point in time.

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10
Q

How is prevalence calculated?

A

Number of cases in a population/number of people in a population (at given time)

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11
Q

What does prevalence tell us?

A

The burden of disease in a population

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12
Q

What is incidence?

A

Number of new cases arising over a given time

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13
Q

What can prevalence tell us about the risk of developing disease?

A

How likely you are to develop a disease during a given time period

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14
Q

Which measures and tools are needed to estimate incidence?

A

Define time, total risk population and an accurate test to determine if the person has the disease

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15
Q

Why might it be difficult to measure whether a case is new or old?

A

Chronic conditions - can’t tell whether it is new or old

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16
Q

How does incidence influence the development of policies?

A

One incidence has reached 0, outbreak is over and places can reopen

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17
Q

Why might prevalence increase even if incidence stays the same?

A

If people with the condition are surviving- e.g. use of medication

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18
Q

What is mortality?

A

Number of deaths from a particular disease in a given time

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19
Q

If mortality and incidence are equal, what does that mean about the epidemic?

A

The epidemic is stable

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20
Q

How is mortality calculated?

A

deaths from a disease in a given time/ population at start of time period

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21
Q

What is the negative aspect of people with disease living longer?

A

The transmission increases and incidence increases

Prevalence also increases

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22
Q

What is morbidity?

A

Number of cases of ill health, complications and side effects related to a specific condition over a particular time period.

23
Q

What is the unit for mortality?

A

number of deaths per 1000 per year

24
Q

What are the leading causes of death?

A 
heart disease
cerebro-vascular disease
respiratory infection
HIV/AIDS
COPD
25
Q

Which country has the highest mortality rate?

A

Swaziland (30.83)

Sierra Leone, Zambia, Angola, Lesotho also high

26
Q

What causes the majority of deaths in third world countries?

A

malnutrition

27
Q

Which systems can be used to give scores of morbidity?

A

APACHE II, SAPS II/III, Glasgow Coma Scale, PIM2, SOFA

28
Q

How can morbidity scores be useful?

A

Help to decide the type of treatment

29
Q

What are the main types of infectious disease?

A 
Lower respiratory infection
HIV/AIDS
Diarrhoeal disease
TB
Malaria
Measles
30
Q

What is the leading cause of death in Sub Saharan Africa?

A

Infectious disease

31
Q

Why are death rates important?

A

Important to assess how good the health system is in a country
Allows specific public health sectors to be targeted

32
Q

Where did SARS virus originate from, which animal from, and which year was the outbreak?

A

Origin was the bat is central Asia

2003

33
Q

What was the origin of the West Nile Virus, which year was the outbreak?

A

Birds (crow/rooks)

1999

34
Q

Does the West Nile Virus have a high or low infectious rate?

How close is the vaccine to being produced?

A

High infection rate

Vaccine is near clinical trial end

35
Q

Where did MERS virus originate from and where is its incidence high?

A

Camels

Middle East

36
Q

How does malaria increase its genetic variability?

A

Mutations and recombination of gametes, plasmid transfer

37
Q

Why is hard to target a vaccine for Plasmodium (causes malaria)?

A

It has lots of antigens and each one is different

38
Q

Does ebola transmit fast or slow?

A

slow

39
Q

Why can transmission of ebola be prevented even though it is very contagious?

A

Symptoms develop before you become infectious so person can be isolated

40
Q

How is ebola transmitted?

A

Blood, saliva, urine, semen (body fluids) and through contact with contaminated surfaces e.g. soiled cloth

41
Q

What are the public health measures taken in regards to ebola?

A
  • Identify, isolate and follow up contacts of an infected person
  • Isolation of contacts for 21 days
  • Border controls are ineffective
  • House control not used
42
Q

Which animal did Zika virus originate from?

Where did it emerge?

A

Rhesus monkey

South America

43
Q

What is the risk of infection of Zika virus in pregnant women?

A

1 in 100 in 1st trimester

1 in 1000 in whole pregnancy

44
Q

What type of virus is Zika and which animal transmits it?

A

flavivirus

mosquitoes

45
Q

What other viruses is Zika related to?

A

Yellow virus
Dengue virus
West Nile virus
(They are all arboviruses)

46
Q

How can Zika Virus be transmitted between people?

A

Sexually

47
Q

What steps are taken when a new epidemic emerges?

A
  • To indicate emergence of infectious disease - look morbidity/mortality in space and time
  • Look through databases to find similarities in cases to identify aetiology
  • Diagnostic tests development
  • Follow the routes of infection
  • Ensure the public are aware of new information - avoidance/precaution
  • Identify ways to reduce mortality/morbidity
48
Q

What is the basic reproductive number (R0)?

A

average number of secondary cases emerging from a primary one

49
Q

What does it mean if R0 is less than 1 or above 1?

A

The disease will become extinct if less than 1

If greater than 1 than means transmission occurs and could lead to an epidemic

50
Q

What factors affect R0?

A
  • incubation period
  • infectiousness
  • How long infectiousness lasts
  • is acquired immunity important
51
Q

What are the prevention and control policies for Influenza?

A
  • Minimise morbidity/mortality
  • Buy time to wait for vaccine
  • Minimise duration
  • Minimise impact on economy
    Minimise prevalence to stop healthcare collapsing
52
Q

What are some neglected tropical diseases?

A

Leishmaniasis and African Trypanosomiasis
(Protozoan)

Schistosomiasis, Lymphatic Filariasis, Onchocerciasis, Dracunculiasis, Ascariasis-Trichuriasis- Hookworm (Helminth)

Leprosy, Trachoma, Buruli Ulcer (Bacterial)

53
Q

What does the graph for infection growth look like over time?

A

increases slowly, then exponential growth. Eventually levels off as the number of people susceptible is very low. Eventually rise due to mutation.

54
Q

Why is it hard to find vaccines against RNA viruses?

A

No proofreading mechanisms so high mutation rate

Epidemiology (17 decks)

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