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Module 10 Flashcards

1
Q

Epidemiology

A

The investigation of how health events in a population are patterned or distributed

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2
Q

Purpose of Epidemiology

A

Purpose is to provide a basis for developing:

  1. prevention strategies for groups at risk
  2. disease control measures for affected groups
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3
Q

Descriptive Epidemiology

A

concerned with WHAT WHO WHERE and WHEN

Focuses on the frequency and distribution of states of health within a population

*focus of this class

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4
Q

Analytic Epidemiology

A

concerned with HOW and WHY

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5
Q

Examples of What in Descriptive Epidemiology

A

What is the health event

what is the disease

what is the outcome

how severe is it

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6
Q

Examples of Who in Descriptive Epidemiology

A

Who are at risk

who is ill

(person)

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7
Q

Examples of Where in Descriptive Epidemiology

A

Where did the health event occur

How widespread is the illness

(place)

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8
Q

Examples of When in Descriptive Epidemiology

A

When did the health event happen

how long did the illness last

(time)

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9
Q

Characteristics included in the WHO/person of descriptive epidemiology

A

Age, gender, ethnicity

genetic predisposition

concurrent disease

diet and exercise

risk taking behaviors such as smoking

socio economic status

marital status

education and occupation

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10
Q

Characteristics included in the WHERE/place of descriptive epidemiology

A

Presence of agents or vectors

climate and geography

population density

economic development

customs and practices of the area

medical care and access

regional crime and unemployment rates

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11
Q

Characteristics of the WHEN/time of descriptive epidemiology

A

Calendar time

time since an event

physiologic cycles

age (time since birth)

seasonality

temporal trends

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12
Q

Basic Measures of Descriptive Epidemiology

A

Counts

Ratio

Proportion

Attack Rate

Prevalence

Prevalence Rate

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13
Q

Counts

A

simplest measure to describe how many cases

ex: 20 colds occurred

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14
Q

Ratio

A

relationship between two counts, numerator is not included in the denominator

(# those that are ill, divided by [compared to] # those that are not)

ex: 1:3 ratio of sick to healthy

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15
Q

Proportion

A

relationship between two counts

numerator is included in the denominator, part of a whole

(# of those that are ill divided by everyone)

ex: 20/100

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16
Q

Attack Rate

A

Number of persons that develop a disease divided by the number of persons exposed to the causative agent (used commonly in food Bourne illness investigations or flu outbreaks)

ex: Developed/Exposed = 5 w food poisoning / 20 total exposed
* exposed includes those who developed disease

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17
Q

Prevalence

A

Number of cases of a disease or health condition divided by the total population at a particular time

cases / total pop at a certain time

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18
Q

Prevalence Rate

A

(# of cases / population at a time) x K (constant that is 1000 or 10000)

allows for comparisons between groups or regions on a certain date!!!

something may seem worse initially but the prevalence rate can reveal that is not always the case

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19
Q

Incidence Rate

A

(# of cases / population at RISK) x K at a certain time

People who die from a disease or become immune to the disease fall out of the population at risk!!!

People who die from a disease or who recover from a disease fall out of the pool of prevalent cases because they no longer are counted as having the disease

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20
Q

Prevalence is a function of the ____ of disease and the ____ of disease

A

Incidence and Duration

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21
Q

A town has a population of 3600.
In 2003, 400 residents of the town are diagnosed with a disease.
In 2004, 200 additional residents of the town are diagnosed with the same disease. The disease is lifelong but it is not fatal.

calculate the prevalence in 2003?
calculate the prevalence In 2004?
calculate the incidence in 2004?
K=1000

A

2003 - 400/3600 x 1000 = 111 per 1000

2004 - 600 / 3600 x 1000 = 167 per 1000

Incidence of 2004: 200/3200 x 1000 = 63 per 1000

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22
Q

Analytic Epidemiology

A

Focuses on the CAUSES AND ASSOCIATIONS of states of health within a population (HOW AND WHY)

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23
Q

Things Identified or Determined in Analytic Epidemiology

A

ID causative agents, characteristics of agents, geographic patterns

Determine mode of transmission, contributing factors

involves hypothesis testing

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24
Q

3 Essential Characteristics examined in analytic epidemiology to determine how and why are …

A

Agent

Host

Environment

(The epidemiological triangle)

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25
Agent
bacteria, virus, fungi, parasite
26
Host
human or animal harboring agent
27
Environment
physical, biological, social, and cultural factors facilitating the transmission of the agent from host to host
28
Early influence on epidemiology came from....
religion
29
Hippocrates and Epidemiology
first looked at health and disease from environmental and behavior perspectives
30
Miasma Theory
poisoning from foul vapors
31
Edward Jenner and Epidemiology
"Father of Immunology" 1798 Demonstrated small pox vaccination effectiveness
32
Germ Theory
microorganisms cause disease
33
John Snow and Epidemiology
1850 ID source of cholera epidemic to contaminated well in london
34
Florence Nightingale and Epidemiology
1850s examined and tracked environmental conditions to recovery rates of soldiers in the crimean war
35
Chronic Disease Epidemiology
outcomes related to exposure modifying behavior can control risk factors
36
Human Genome Project
New bio medical technologies can examine genetic risks
37
3 Important Triumphs in Epidemiology
1. Small pox eradication thru vaccinations in 1967 to 1980 when it was declared dead by WHO 2. cig smoking found to be major lung cancer, emphysema, and CV disease cause 1951-1963 3. ID of auto immune deficiency syndrome (AIDS) and predicted that cause from STI. Development of prevent measures before the virus was ID'ed - 1981-1983
38
5 Important Epidemiologic Models
1. Epidemiologic Triangle 2. Wheel Model 3. Web of Causation 4. Chain of Infection 5. Stages of Disease (natural history of disease)
39
Epidemiologic Triangle
most simple epidemi model Factors that influence health status are: 1. intrinsic Factors (host factors) 2. Extrinsic factors (agent and environment)
40
The epidemiologic triangle occurs ...
over time
41
Host Factors
Intrinsic factors that are the hosts ability to resist a particular infectious disease causing agent (the body forms antibodies that react with a foreign antigen and makes them harmless)
42
Examples of Host Factors
Genetic Susceptibility Immutable characteristics: age, gender, race, sex Acquired characteristics: immunological status lifestyle factors immunity status
43
Acquired Immunity
resistance to infectious agent developed from previous exposure from disease or immunization Can be active passive or cross
44
Active Immunization/Immunity
Administration of an antigen that can produce an antibody (vaccinations) providing more long term resistance type of acquired immunity
45
Passive Immunization/Immunity
transfer of specific antibody that provides short term resistance type of acquired immunity ex: immunoglobins (Hep A, Rabies, Tetanus); Antiserum (Ebola, Snake Anti Venom); Breastmilk
46
Cross immunity
immunity to one agent provides a person with immunity to another agent ex: Edward Jenner noticed that milkmaids exposed to cow pox did not get small pox
47
Natural Immunity
innate resistance to infectious agent
48
Herd Immunity
immunity level present in a population that has a protective effect on the population
49
Extrinsic Factor Types
Biological Chemical Physical Nutrient Genetic Psychological
50
Biological Agent
bacteria virus fungi parasite
51
Chemical Agent
heavy metals toxic chemicals pesticides
52
Physical Agents
radiation heat and cold machinery
53
Nutrient Agent
basic dietary components needed to survive
54
Genetic Agent
Transmitted from child to parent through genes
55
Psychological Agent
stressful circumstances in the environment
56
Important characteristics of Extrinsic Agents?
Infectivity Pathogenicity Virulence
57
Infectivity
ability of agent to multiply, enter the host, and produce disease
58
Pathogenicity
measures the proportion of people who develop the disease after infection
59
Virulence
ability of agent to produce a pathological reaction resulting ins severe disease or death
60
Herd Immunity is note necessarily a ___ factor, it is partly a ____ factor
host; environmental
61
Environmental Factors
Extrinsic 1. Physical (Climate) 2. Biological Environment (living plants, animals, human pop distrib) 3. Socioeconomic Factors (working conditions, codes, laws, herd immunity)
62
Wheel model of causation
used to investigate: acute and chronic diseases infectious and non infectious processes why some populations stay healthy while others become ill
63
Compartments and their Sizes in the Wheel Model of Causation
Genetic Core surrounded by the Host (human) 3 sections of social environment, biological environment, and physical environment surround it The relative size of the various compartments change depending on the specific problem under consideration
64
Patterns of Disease
Epidemic Endemic Sporadic Hyperendemic Pandemic
65
Epidemic
Occurrence of disease in excess of normal expectation arises when: 1. host, agent, and environmental factors are not in balance 2. new agent 3. change in existing agent (infectivity, pathogenicity, virulence) 4. change in number of susceptible hosts in the population 5. environmental changes that affect transmission of the agent or growth of the agent
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Endemic
constant and persistent presence of disease in a geographic region or population (ex: malaria in africa)
67
Sporadic
problems with an irregular pattern; occasional cases at irregular intervals (food borne illness)
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Hyperendemic
persistently high number of cases (lyme disease in new jersey)
69
Pandemic
epidemic spread of disease across geographic regions, countries, or continent's (SARS to canada and the US)
70
Web of Causation
model that shows direct and indirect causal relationships displays more complex interrelationships that can increase or decrease the risk of disease!!! *can get very complex among multiple things like cardiovascular disease for example
71
Direct Causal Associations
no intermediate factor and is more obvious ex: exposure to staph pathogens results in illness
72
Indirect Causal Associations
involves one or more intervening factors and is often much more complicated ex: a high fat diet is assoc with polyps and polyps are associated with colon cancer
73
Web of Causation model States that...
1. Disease never results from a single cause | 2. disease develops as a result of chains of causation
74
Web of Causation model is used when ...
A complete understanding of the causal mechanism is not prerequisite to the development of effective measures of prevention or control
75
Chain of Infection
Infectious Agent --> Reservoir --> Portal of Exit --> mode of Transmission --> portal of entry --> susceptible host --> infectious agent repeat
76
Reservoir
dont confuse with host habitat in which an infectious agent usually lives, grows, and multiplies can include animals, humans, and the environment may or may not be the source from which an agent is transmitted
77
Human Reservoirs
Also known as "Carriers" carriers are persons that may be asymptomatic but capable of transmitting the agent to others chronic carrier continuously harbors an agent (Hep B, Typhus) after an initial infection
78
Zoonoses
animal reservoirs animals can be host, vector, or source of certain infections and disease Zoonosis/zoonoses is an infectious organism in VERTEBRATE animals that can be transmitted to humans through direct contact, fomite, or vector The word comes from Zoon (animal) Noses (Ill) ex: rabies, cat scratch fever
79
Other than zoonoses, what else is an animal reservoir?
diseases transmitted by (vector) insects (ex; lyme disease)
80
Environmental reservoirs
can be vehicle or airborne for example\ plant, soil, water (ex: e coli and tetanus)
81
Examples of the many diseases that are zoonoses
``` Aids Amebiasis Anthrax Bovine Papular Stomatitis Brucellosis California Encephalitis Cat Scratch Fever colorado tick Fever Cowpox Dengue Fever Dermatophilosis Leprosy Lyme Disease Pasteurellosis Plague Q Fever Rabies Rat Bite Fever Rickettsial Pox Rocky mounntain spotter fever salmonellosis shigellosis streptococcus infections tetanus trichinosis tularemia yellow fever zoonotic scabies ```
82
Portal of Entry
the path by which agent enters susceptible host usually the same portal they exit (ex: TB and flu) others include: skin and the mucus membrane
83
Enteric Pathogenic Atgents
"Fecal-Oral" portal of entry agents
84
Portal of Exit
the path by which an agent leaves the source usually corresponds to the site at which the agent is localized (eg TB and flu) exit the respiratory tract some blood borne agents can exit by crossing the placenta (ex: rubella and syphilis)
85
Common Portals of Entry/Exit
respiratory oral reproductive intravenous urinary skin gastrointestinal conjunctival transplacental
86
Modes of Transmission
Vertical Horizontal (Direct or Indirect [vehicle, vector, airborne]) Vector (mechanical or biological)
87
Vertical transmission
passing of infection from parent to offspring ex: sperm, placenta, breastmilk, contact in vaginal canal during birth
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Horizontal Transmission
person to person spread can be direct or indirect
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Direct Horizontal Transmission
direct contact droplet spread (touching, kissing, biting, sexual intercourse, coughing, sneezing, large droplets in close proximity)
90
Indirect horizontal Transmission
can be vehicle, vector, or airborne
91
Vehicle Borne Indirect Horizontal Transmission
nonliving intermediary such as a fomite, food, water, or infectious bodily fluids that convey the infectious agent from the reservoir to a susceptible host
92
Vector Borne Transmission
transmission via insect (mosquitoes, flies, ticks, spiders) Does not cause disease but transmits it to the susceptible host can be mechanical vector or biological vector
93
Airborne Indirect Horizontal Transmission
transmitted via dust and fine particles known as aerosols ex: TB, legionnaires, influenza
94
Fomite
an inanimate object contaminated with the infectious agent
95
Mechanical Vector
uninfected insect carries the agent
96
Biological Vector
infected insect carries pathogen
97
Natural history of Disease (Stages of Disease over Time)
1. Stage of Susceptibility 2. Preclinical or Presymptomatic Stage 3. Clinical Stage 4. Stage of Recovery, Disability, or Death
98
Stage of Susceptibility
first stage no disease present (pre-pathogenesis)
99
Preclinical or Presymptomatic stage
second stage biological onset, no signs or symptoms (pathogenesis) there is an incubation and latency period within this
100
Clinical Stage
third stage signs and symptoms, medical care is sought, diagnosis is made (pathogenesis)
101
Stage of Recovery, Disability or Death
stage 4 treatment (resolution)
102
Primary Prevention can help in what part of the natural course of disease
susceptible hosts pre-exposure
103
Secondary Prevention can help in what part of the natural course of diseases
Subclinical Disease Stage to clinical illness stage
104
Tertiary Prevention can help in what part of the natural course of disease
stage of recovery, disability, or death
105
Subclinical Disease Stage marks...
the beginning of pathological process and changes within the body it is then followed by onset of symptoms then diagnosis sought which is then followed by the clinical illness stage

NURS322 (13 decks)

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