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POPH192 > Lecture 36 -Outbreaks > Flashcards

Lecture 36 -Outbreaks Flashcards

1
Q

What influences the spread of disease

A
  1. Properties of the agent
  2. Sources of infection
  3. Biological reservoirs
  4. Host factors
  5. Exposure variation
  6. Environment
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2
Q

Three elements of the epidiomological triangle

A
  • Host - descriptive epidemiology
  • Environment - Environmental investigation
  • Agent - Laboratory investigation
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3
Q

Infectious agents

A

Bacteria, viruses, fungi, protozoa, parasitic worms

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4
Q

what is Infection

A

Entry of microbiological agent into a higher order host and its mutliplication within the host
- Infestation - external surface only e.g. lice or scabies

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5
Q

what is Infectivity

A

ability of an organism to invade and multiply in a host (secondary attack rate)

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6
Q

Pathogenicity

A

Ability of an organism to produce clinical symptoms and illness (proportion of those exposed who get ill)

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7
Q

What is virulence

A

Ability of an organism to produce serious disease

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8
Q

Transmission types

A
  • Direct
  • Indirect
  • Airborne
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9
Q

Direct transmission

A

Touch or inhaling infectious secretions

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10
Q

Indirect transmission

A

Through a vehicle
- Inanimate - fomites (bedding, clothes)
- Live - vector (mosquitos)

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11
Q

Airborne transmission

A

Droplet nuclei smaller than 5 micrometer e.g tuberculosis

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12
Q

The infectious process

A
  1. Incubation period
  2. Clinical disease
  3. Recovery
    - Latent - not able to spread
    - Infectious period - spreading of the disease
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13
Q

what is Outbreak / epidemic

A

Unexpected increase in the incidence of a disease
- Occurencr of cases one excess of those expected
- Epidemic limited to a localised increase in the incidence of disease
- Epidemic arising in an area that had no cases for a long time

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14
Q

What is endemic

A
  • Constant presence of a disease or infectious agent within a geographical area ir population group e.g. malaria is endemic
  • Holoendemic
  • Hyperendemic
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15
Q

Holoendemic

A

Intense disease all year round children mainly infected, most adults immune

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16
Q

Hyperendemic

A

Intense disease with time periods of no transmission e.g. during the dry season - persistent disease with all ages infected

17
Q

What is pandemic

A

Disease affects a large number of people and crosses many international boundaries

18
Q

What is a disease cluster

A

Aggregation of relatively uncommon events or diseases in space and/or in time that are thought to be greater than could be expected by chance
- Usually rare non-infectious diseases

19
Q

Who recognises an outbreak

A
  • Members of community
  • Media
  • Clinicians
  • Local public health agencies
  • National public health agencies
  • Academic organisations
20
Q

Key steps in outbreak investigation

A
  • Preparation - ready to response
  • Surveillance - looking at the numbers
  • Confirmation
  • Outbreak description - Person, place, time
  • Outbreak investigation
    1. Analytic
    2. Environmental
    3. Laboratory
  • Outbreak control
  • Outbreak communication
  • Outbreak documentation
21
Q

Types of outbreaks

A
  1. Common source
    - Point source e.g. common event
    - Continuous common source - exposure begins and continues
    - Intermittent source
  2. propagated source (person to person)
  3. Mixed e.g. source then propagated
22
Q

Why investigate outbreaks

A
  • To stop further illness
  • prevent further outbreaks
  • Address public concerns
  • Identify new disease agents or transmission mechanisms
23
Q

The outbreak crytosporiodiosis - Surveillance, confirmation and description

A
  • Early reports from social media - gastro possible link to drinking water
  • Formal notification of one case 11 days after onset of symptoms
  • More notifications of cases from hospital
24
Q

Crypto - outbreak investigation

A

Analytic:
- We knew the causative agent but didn’t know where it came from
- Investigation of cases using an expanded questionnaire
- developed a case definitions; primary and secondary
Laboratory:
- samples sent to lab - detection
- Whole genome sequencing

25
Q

Crypto - outbreak control

A
  • Boil water notice - no new primary cases
  • Environmental and lab investigation continued
26
Q

Crypto geospatial mapping - Outbreak communication

A
  • Distribution of cases was rapid and distributed
  • Localised contamination event in distal reticulation
  • Water contamination prior to the two mile water treatment
27
Q

Crypto - outbreak outcome

A
  • Crypto outbreak
  • Likely environment contamination into the lake which was the source of the drinking water
  • No protozoal barrier on the drinking water
  • Boil water implementation stopped the outbreak
  • Huge media and political interest
28
Q

Planning for pandemic in NZ

A
  • Plan for it
  • keep it out - border control
  • Stamp it out - early recognition
  • Manage it - delay the increase
  • Recover from it

POPH192 (23 decks)

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