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Class 1 > Lecture 36: Outbreaks, Epidemics and Clusters > Flashcards

Lecture 36: Outbreaks, Epidemics and Clusters Flashcards

1
Q

How many stages are there that describe the epidemiological transition (changing pattern of disease)?

A

5

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2
Q

Describe the epidemiological transition

A

The birth rate and death rate are high and the total population is low and then the death rate falls so population begins to increase and then birth rate falls and the total population keeps increasing and then plateaus

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3
Q

What happens in stage one of the epidemiological transition?

A

birth rate and death rate are high

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4
Q

What happens in stage 5 of the epidemiological transition?

A

birth rate is very low and death rate is low

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5
Q

Where do high and low income countries sit in terms of stages on the epidemiological transition? Why is this?

A

High income countries are at level 5 because there is improved living conditions and low income countries are at level 1 due to infectious diseases and newborn and maternal problems due to inadequate care

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6
Q

What does vector-borne mean?

A

infections coming from mosquitos

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7
Q

What does zoonotic mean?

A

infections coming from other animals

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8
Q

What are infections coming from other animals called?

A

zoonotic

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9
Q

What is one health?

A

The interaction between human, animals and the environment and how we can work better with agriculturalists, vets, climate change people to improve health

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10
Q

What 6 things influence the spread of disease?

  • ______ of the agent
  • _______ of infection
  • biological _______
  • ________ factors
  • ________ variation
  • ________
A
  • properties of the agent
  • sources of infection
  • biological reservoirs
  • host factors
  • exposure variation
  • environment
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11
Q

One of the things that influences the spread of disease is the properties of the agent. What is meant by this?

A

how virulent it is, how it is transmitted, does it mutate

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12
Q

One of the things that influences the spread of disease is the sources of infection. What is meant by this?

A

where does it come from - does it come from soil, water, insects, animals

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13
Q

One of the things that influences the spread of disease is biological reservoirs. What is meant by this?

A

can it be present in an animal that don’t get infected, they just pass it on?

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14
Q

One of the things that influences the spread of disease is host factors. What is meant by this?

A

is the host immunosuppressed, are they malnourished, or really healthy

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15
Q

One of the things that influences the spread of disease is exposure variation. What is meant by this?

A

are people contracting the disease in a closed environment like a plane? it will spread faster if it is

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16
Q

One of the things that influences the spread of disease is the environment. What is meant by this?

A

has climate change impacted the environment ie. is it warmer so mosquitos are more likely to be present

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17
Q

What three things contribute to the epidemiological triangle and what three things do these make up?

A
  1. the host
  2. the agent
  3. the environment
    - the host and the agent make up the transmission part of the triangle
    - the agent and the environment make up the survival part of the triangle
    - the host and the environment make up the immunity part of the triangle
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18
Q

What is meant by the “host” in the epidemiological triangle?

A

descriptive epidemiology - describing data

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19
Q

What is meant by the “agent” in the epidemiological triangle?

A

laboratory investigation - determining what the agent is

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20
Q

What is meant by the “environment” in the epidemiological triangle?

A

environmental investigation into what caused the disease eg. rainfall

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21
Q

What can we learn from the epidemiological triangle?

A
  • what (agent)
  • who (person/population)
  • where (place)
  • when (time)
  • why/how (causes, risk factors and modes of transmission)
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22
Q

What are some examples of infectious agents?

A 
bacteria
viruses
fungi
protozoa
helminths (parasitic worms)
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23
Q

Define infection

A

entry of a microbiological agent into a higher order host and its multiplication within the host

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24
Q

Define infestation and give an example

A

multiplication of a microbial agent on (only) the surface of a higher order host and multiplication eg. lice

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25
Q

Define infectivity

A

the ability of an organism to invade and multiply in a host - defines the secondary attack rate

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26
Q

Define pathogenicity

A

the ability of an organism to produce clinical symptoms and illness - defines the proportion of those exposed who get ill

27
Q

Define virulence

A

the ability of an organism to produce serious disease - defines the case-fatality rate

28
Q

What are the three modes of transmission?

A
  • direct
  • indirect
  • airborne
29
Q

What is meant by direct transmission of disease?

A

touching or inhaling infectious secretions such as saliva, respiratory droplets, urine, faeces, other body fluids

30
Q

What is meant by indirect transmission of disease?

A

it always involves either another object which can either be inanimate such as bedding, clothes, utensils, food, water, soil; or live via a vector such as mosquitos or ticks

31
Q

What is meant by airborne transmission of disease?

A

droplet nuclei travel in the air

32
Q

What are the three parts to the infectious process?

A
  • the incubation period
  • the clinical period/the disease period
  • the recovery period
33
Q

What is meant by the latent part of the infectious process?

A

when you are infected but you can’t spread the disease

34
Q

What is meant by the infectious period of the infectious process?

A

This is before the symptoms begin and it stops before you have recovered. This spans both the incubation period and the recovery period

35
Q

When are you most infectious?

A

in the first few days after developing the disease

36
Q

Define an outbreak/epidemic

A

An unexpected rise in the incidence of a disease - this can be limited to a localised increase in the incidence of disease or rising in an area that had no cases for a long time, This can also be defined as two or more cases identified from a common source or cases in excess of the expected number in a given time or place

37
Q

Define endemic

A

the constant presence of a disease or infectious agent within a geographical area or population group

38
Q

What are two types of endemic? Define them and state who is mainly affected

A
  • holoendemic - intense diseases all year round, children mainly affected, most adults immune
  • hyperendemic - intense disease with time periods of no transmission such as during the dry season, persistent diseases with all ages infected
39
Q

Define pandemic

A

when a disease affects a large number of people and crosses many international boundaries

40
Q

Infections are often reported in clusters. Define clusters

A

an aggregation of relatively uncommon events or disease in space and/or time that are though to be greater than could be expected by chance

41
Q

What sort of diseases are usually reported as clusters?

A

rare non-infectious diseases such as HIV/AIDS

42
Q

Define primary case

A

the first case

43
Q

Define index case

A

the first case that is recognised by the health organisations

44
Q

What is the secondary attack rate?

A

the transmission or spread from the initial case

45
Q

Define R0

A

how many people will one person spread the disease to

46
Q

Who recognises an outbreak? (6)

A
  • members of the community
  • media
  • clinicians
  • local public health agencies
  • national public health agencies
  • academic organisations
47
Q

Why do we need to investigate outbreaks? (6)

  • to ______ and ______ further illness
  • to prevent further ________ from other similar _______
  • to address _______ ______ and involve the _____ in disease _______
  • to reduce _______ and _________ costs
  • to identify new mechanisms of ________ of known ________
  • to identify new or emerging _________ agents
A
  • to stop and prevent further illness
  • to prevent further outbreaks from other similar sources
  • to address public concerns and involve the public in disease control
  • to reduce direct and indirect costs
  • to identify new mechanisms of transmission of known diseases
  • to identify new or emerging disease agents
48
Q

What are the 8 outbreak investigation steps?

A
  • preparation
  • surveillance
  • confirmation
  • outbreak description
  • outbreak investigation
  • outbreak control
  • outbreak communication
  • outbreak documentation
49
Q

What are three parts to the outbreak investigation?

A
  • analytic epidemiology component
  • environmental component
  • laboratory component
50
Q

What three things describe an outbreak?

A

the person (who), the place (where) and the time (when)

51
Q

What are the three types of outbreaks?

A
  • common source
  • propagated source
  • mixed
52
Q

What are the three types of common source outbreaks? Give an example for each

A
  • point source (eg. from a common event such as all the cases attended the same wedding
  • continuous common source (eg. continually contaminated water supply)
  • intermittent source (eg. only contaminated water supply after heavy rainfall)
53
Q

Give an example of propagated source outbreaks

A

person to person such as within a household or institution

54
Q

What is meant by mixed outbreaks?

A

point source then propagated person to person

55
Q

What does an epidemic curve graph?

A

the number of cases of a disease over time

56
Q

What does a common (point) source epidemic curve look like and why?

A

it is bell shaped because not everyone exposed at the same time gets unwell at the same time

57
Q

What does a continuous) source epidemic curve look like and why?

A

constant high cases over time because the infectious disease is not identified and people and people continue to get sick

58
Q

What does an intermittent source epidemic curve look like?

A

small groups of cases with blocks of no cases intermittently

59
Q

What does a propagated source epidemic curve look like?

A

one case and then more cases and then lots of cases because one case spreads it to people who spread it to more people and then they spread it to more people

60
Q

What is the plan for pandemics?

A
  • plan for it
  • keep it out
  • stamp it out
  • manage it
  • recover from it
61
Q

One of the steps to managing pandemics is to keep it out. What is meant by this?

A

border control, preparation, communication, surveillance, self-isolation

62
Q

One of the steps to managing pandemics is to stamp it out. What is meant by this?

A

early recognition, case finding, contact tracing and isolation

63
Q

One of the steps to managing pandemics is manage it. What is meant by this?

A

delay the increase by infection control, triage, treatment, closure of institutions, bracing the health system and the public

Class 1 (37 decks)

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