M1: Epidemiological Surveillance Flashcards
The amount of a particular disease that is usually present in a community.
Baseline/Endemic Level of Disease
4 examples of Rare disease that a single case warrants epidemiologic investigation
(RaP ChoP)
- rabies
- plague
- cholera
- polio
3 diseases occur more commonly so that only
deviations from the norm warrant investigation
- flu
- stroke
- dengue
refers to a disease that occurs frequently
and irregularly
Sporadic
refers to the (constant presence and/or usual prevalence) of a disease or infectious agent in a population within a geographic area
Endemic
3 examples of (endemic diseases)
(MaZE)
- Malaria
- Elephantiasis
- Zika Virus
refers to the persistent, (high levels) of disease occurrence
Hyper-endemic
increase in the case of what is expected
Epidemic
It is like an epidemic, but limited in geographic area
Outbreak
aggregation of cases grouped in place and time
Cluster
spread over countries or continents
Pandemic
Epidemics occur when an ___ and ______
are present in adequate numbers
Agent, Susceptible host
5 Epidemic may result from
( I FACE)
- Increase in viral agents
- Factors that increase exposure
- Agent in a foreign setting
- Change in susceptibility
- Enhanced transmission
13 Steps in epidemiologic investigation of an outbreak
- Prepare for fieldwork
- Establish the existence of an outbreak
- Verify the diagnosis
- Construct a working case
- Find cases systematically
- Perform descriptive epidemiology
- Develop hypotheses
- Evaluate hypotheses
- Re-evaluate hypotheses
- Compare studies
- Implement control and prevention measures
- initiate or maintain surveillance
- Communicate findings
When you become a field investigator, you should have knowledge of:
o scientific issues
o investigative issues
o managerial issues
o management issues
Types of existing data to look for during an outbreak
o surveillance systems o hospital records o registries o statistics o survey
to ensure that the disease has been (properly identified), since control measures are often disease-specific
VERIFICATION OF DIAGNOSIS
a standard set of (criteria for deciding) whether an
individual should be classified as having the health condition of interest
WORKING SPACE DEFINITION
2 Types of surveillance
- Passive surveillance
2. Active Surveillance
3 STEPS IN DESCRIPTIVE EPIDEMIOLOGY
- Identifying
- Gathering
- Describe systematically characteristics of people
affected by disease
3 Epidemic patternS
(Pro CoMix)
● common
● propagated
● mixed
4 EPIDEMIC CURVES
(BIn ClaP)
- Classical
- Inverted
- Point
- Bell-shaped
Characteristic of a Classical curve ● Onset ● Exposure ● Transmission ● Incubation ● Type of cause ● Exhaustion
● Sudden ● Mass ● Common vehicle ● Short ● Primary ● Slow
Characteristic of Inverted Epidemic curve ● Onset ● Exposure ● Transmission ● Incubation ● Type of cause ● Exhaustion
● Staggering ● Progressive ● Propagated ● Long ● Secondary (expose to primary) ● Rapid
Characteristics of Point Epidemic Curve ● Onset ● Exposure ● Transmission ● Incubation ● Type of cause ● Exhaustion
● sudden ● massive ● common vehicle ● short ● primary ● Very Rapid
Characteristics of Bell-shaped Epidemic Curve ● Onset ● Exposure ● Transmission ● Incubation ● Type of cause ● Exhaustion
● Sudden ● Mass ● Common vehicle ● Short ● Primary & secondary ● Short
The epidemic curve of an _____ outbreak often has a pattern reflecting the ____ of the exposure.
intermittent common-source, intermittent nature
Case-patients may have been exposed over a period of (days, weeks, or longer)
COMMON SOURCE OUTBREAKS
In a ______ the range of
exposures and range of incubation periods tend to
flatten and widen the peaks of the epidemic
continuous common-source outbreak
results from transmission from one person to another. Usually, transmission is by direct person-to-person contact, as with syphilis.
propagated outbreak
3 How propagated outbreak spread
(Double Vs)
- Direct person to person (Syphilis)
- Vehicle born (Hep. B or HIV)
- Vector-borne (Yellow fever by mosquitoes)
In propagated outbreaks, cases occur over _____ incubation period
More than one
includes both common-source and propagated outbreak characteristics. For example, people infected through a common-source outbreak might later transmit the disease through direct contact with others.
Mixed epidemic
may result from sufficient prevalence of infection in host species, sufficient presence of (vectors), and sufficient (human-vector interaction)
Zoonotic or vector-borne outbreaks
provides information on the (geographic extent of a
problem). Also demonstrate (clusters or patterns) that provide important etiologic clues
Spot Map of a place
Ongoing systematic collection and analysis of data which is needed to be disseminated and put into action
SURVEILLANCE
6 OBJECTIVES OF SURVEILLANCE
(DE UAAP) 1. Estimate magnitude 2. Understand natural history of disease 3. Detect outbreaks 4. Assess quality of health care system 5. Assess safety of drugs 6. Plan and research \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ Basically to detect outbreak and plan. They also have to assess drugs and health care
4 INGREDIENTS FOR SURVEILLANCE SYSTEM
(MoLE B) ● Motivated people ● Efficient Communication ● Basic Knowledge ● Laboratory Support
9 DISEASE SURVEILLANCE TASK
(DIEHARD O.A) ● Establish objectives and date ● Data collection ● Organize data ● Analysis and interpretation ● Hypothesis ● Recommend ● Implement ● Disseminate ● Assessment
Minimum data collection in surveillance
(DONA)
- Diagnosis
- Age, sex. Address
- Onset of symptoms
- Name
3 What to calculate when you have the data
- Rates
- Ratios
- Proportions
3 What to prepare when you have the data
- Tables
- Graphs
- Charts
3 General Principles when analyzing data
- Identify high risk groups
- Compare and contrast levels of transmission
- Identify factors that relate to disease transmission
Tips when COMPARING data
Present vs past
National Vs International
Tips when UTILIZING Data
previous data and other studies
Tips when MENTIONING data
programs, demography, environmental and etiologic agents
3 TYPES OF SURVEILLANCE
● Passive surveillance
● Active surveillance
● Sample surveys
Required by law, Overall prevalence, There may be under reporting or under detection for poor countries and The population may be unknow.
PASSIVE SURVEILLANCE
Little attention is given to individual health workers
who report the information
PASSIVE SURVEILLANCE
The data requested of each health worker is _____.
Nonetheless, passive surveillance is often _____
because there are few incentives for health workers to report
Passive, incomplete
Enhanced surveillance system, Systematic data collection, Source of data is already existing, More time and resource
Sentinel Surveillance
Selects, either randomly or intentionally, a small group
of health workers from whom to gather data
Sentinel Surveillance
Detailed data on cases of illness because the health
care workers have agreed to participate and may
receive incentives
Sentinel Surveillance
2 IMPORTANCE OF SURVEILLANCE
- determine whether measures are working
2. to know whether the outbreak has spread outside its original area
2 ways on How to communicate findings after surveillance
- Oral briefing
2. Written report
Testing of health individuals especially those who are
high risk for early detection of disease
SCREENING
4 PRINCIPLES OF SCREENING
- The Choice of disease to be screened
- The nature of the screening test
- The availability of a treatment
- The costs of the screening.
Guidelines for disease screening
(SIRA)
- Age
- Specific lab test & Diagnostic
- Risk Factors
- Intervals
When is it too early to screen
- Progression of disease
2. External Influence
When is it a good time to screen
- Pathological changes
- Symptoms
- When patient contacts doctor
When is it too late to screen
- During diagnosis
2. When cured or dead
