MPH Review: Round 2 Flashcards
Define Public Health
Science and art of preventing disease, prolonging life, and promoting health and efficiency through organized community effort- Winslow
What are the two fundamentals of Epidemiology
Diseases do not occur by chance
Diseases are not distributed randomly through a population- indicates how/why the disease process occurred
What are the objectives of epidemiology?
Identify etiology and risk factors Determine extent within a community Study history and prognosis of disease Evaluate existing and new preventative/therapeutic measures Foundation for policy
What were the three most prevalent disease in 1910?
What were the three most prevalent diseases in 2010?
Pneumonia/Influenza, TB, GI
Heart Dz, CA, Other
Mortality from all diseases declined by _% between 1900 and 2010?
54%
What are today’s risk factors for causing death?
Heart Dz
CA
CVA
COPD
What are today’s lifestyle risk factors?
Tobacco/ETOH Nutrition Obesity Inactivity Exposures
What do immunizations do?
Prevents: DIDOST Invasion Destruction Damage Over stimulation Opportunistic infections Toxin susceptibility
What are the 3 types of immunity?
Active- developed Abs/response from exposure or vaccine leading to memory
Passive- Abs transferred as immune globulins and only last a short time w/out memory.
Herd- protection from those around w/ Abs/response cells and prevent diseases from developing
What are the three components of vaccines?
Adjuvant- enhances vaccine to reduce amount of active component required and fewer doses due to stronger immune response
Residual- materials used to grow virus or bacteria in a vaccine
Preservatives/Stabilizers: prevent contamination and maintain potency in multi-dose vials
What are the three forms of adjuvant in vaccines?
Shingris
Heplisav
FLUAD
What is the primary form of adjuvant used in US vaccines?
Alum
What are the three types of residual materials found in vaccines?
ABX
Egg protien
Gelatin
What are the four types of preservatives/stabilizers used in vaccines?
Thimerosal
Formaldehyde
MSG
Pheyoxyethanol
For PTs ages 2-59mon, what is the standard vaccine schedule for pneumoccocal vaccines?
PCV 13- 2, 4, 6, 12-15mon
What is the catch up dose schedule for pneumococcal vaccines in non compromised PTs?
1-4 doses depending on age and past doses
1-2 doses for kids 60-71 months with underlying conditions
If PPSV23 has been given previously, how long must be waited prior to giving PCV 13 in a compromised, hemoglobinopathy, asplenia, renal failure/syndrome PT?
8 wks
Then 5 years before giving PPSV 23
If PCV 13 series is completes or at least one dose is given at 6yrs or older, what is the next step for vaccinations?
None are needed
What form of the pneumococcal vaccine is given to PTs w/ Diabetes, Heart Dz or Lung Dz?
PPSV 23
What is the vaccine regiment for immune compromised, HIV, hemoglobinopathy, asplenia, chronic renal failure/syndrome?
PCV 13 Wait 8 wks PPSV 23 Wait 5 yrs PPSV 23
What is the pneumococcal vaccine schedule for PTs with CSF leaks or cochlear implants?
PCV 13
Wait 8wks
PPSV 23
Define Contraindication to a vaccine
Condition that increases the risk of a serious adverse reaction
What are the four true contraindications?
Anaphylactic reaction
Encephalopathy
Pregnancy
Immunocompromised
Define Precaution
Condition that may increase the risk of an adverse reaction or affect the vaccines ability to produce immunity
What are the four precautions?
Prior allergic reaction
Illness
Pregnancy/breast feeding
Hx of Guillain-Barre
Which vaccines are recommended during pregnancy?
Optimally, when are these given?
Inactivated influenza
Tdap
During every pregnancy
27-36wks
Define Adverse Reaction
Effect caused by vaccine
Confined to local injection site
Body reactions of fever, malaise, irritable, rash
Gelatin, eggs, ABXs reactions
Define Adverse events
Any event following a vaccination
May be a true reaction or coincidence
Adverse events after vaccines include ?
Inflammation Hypersensitivity Cellulitis SIRVA Derm
What are the four types of dermatologic adverse events from vaccines?
Benign Cutaneous Eruption- Generalized vaccinia Non-viral pustulosis Accrurual papuloveicular eruption Erythema multiforms
What is the name of the adverse reaction from smallpox vaccine involving the heart?
Myopericarditis
What are the five forms of nurological adverse events from vaccines?
Acute Disseminated Encephalomyelitis
Transverse myelitis
Gullain-Barre Syndrome
Brachial Plexus Neuritis
Febrile seizure
What year and act lead to the creation of VAERS?
National Childhood Vaccines Injury Act of 1986
What are the three things VAERS helps detect?
New/rare events- post-Hep B alopecia
Increased rates of known events- post-measles thrombocytopenia
PT risk factors- myopericarditis
Define Latency Period
Define Incubation Period
Time from infection to infectiousness, shorter than incubation period
Time from infection and onset of Sxs but transmission can occur
Define fine Communicable Period
Time period an agent can be transferred from infected host to susceptible host
Incubation and Communicable period of Measles
14 days for rash
From 4 days prior to 4 days after rash
Incubation and Communicable period of Hep A
28-30 days
Latter half of incubation to few days after juandice onset
Incubation and Communicable period of Smallpox
7-17 days
Onset of fever Sxs to separation of the scabs
What events take place during a “Quarantine”?
Individual- ASx healthy but exposed
Duration- incubation period
Location- home
Basis of Action- rarely used, police power
What events take place during an “Isolation”?
Individual- sick
Duration- communicable period
Location- hospital
Basis of Action- common, standard
What are the three parts to the epidemiologic triad?
What is the other, fourth part?
Susceptible Host
Causative agent
Environment
Vector
Define Primary/Definitive Host
Organism that a pathogen reaches maturity and reproduces in
Define Secondary/Intermediate Host
Organism that harbors a sexually immature parasite and is required for completion of life cycle
Define Dead End/Accidental Host
Organisms that don’t allow transmission to a definitive host (humans/horses for West Nile)
Define Natural Reservoir
Organisms/environment that a pathogen naturally lives and reproduces or one that is depended upon for survivial
A reservoir is usually what key thing for a parasite?
Living host of a certain species often without causing disease
Define Carrier
Organism that has become infected with a pathogen but doesn’t show any S/Sxs
Define Convalescent Carriers
Capable of spreading diseases following a period of illness
What are the modes of transmission
Direct: contact, droplet
Indirect: airborne, vehicle, vector
What are three microbes transmitted through direct contact?
Herpes
Syphilis
Hookworm
What are three microbes transmitted through droplet spread?
How far do they travel?
Pertussis
Meningococcal
Mumps
Less than 1 meter
What are three microbes that are transmitted by vehicle borne?
Salmonella
HCV
MRSA
What are three microbes that are transmitted by mechanical and biological vector borne?
Mechanical: Shigellosis/Bacillary dysentery, Plague
Biological: malaria, dengue
What type of transmission is a fly carrying shigella from latrines to food?
Indirect vector borne, mechanical transmission
What type of transmission is staphylococcal poisoning from a single meal?
Indirect vehicle borne transmission, single exposure
What type of transmission is a person sneezing on you in the hallway?
Direct transmission, droplet spread
What type of transmission is a cook with poor hand washing and contaminates a salad?
Indirect vehicle borne transmission
What type of transmission is a person with TB who repeatedly coughs on a plane?
Airborne transmission
What type of transmission is a child with impetigo who hugs you?
Direct transmission, person-to-person
Define Incidence
Number of new cases of a disease that occur in a specific time period on a population
What is the numerator and denominator of incidence
Numerator: number of new cases of a disease
Denominator: average population at risk during a time interval
Incidence is a measure of events and thus a measure of ?
Risk
Define Incidence Density
Number of new events per person-time
Define Prevalence
Proportion of people in a population who have a disease at a specific point in time
Define Point Prevalence
Prevalence of a disease at a single point in time
A proportion
Define Period Prevalence
All cases during a certain period
Incidence is the ?
Prevalence is the ?
Risk of getting a Dz
Odds of having it in a population
What is the prevalence equation
P= Incidence x Dz Duration
High prevalence can indicate what two things
Low prevalence can indicate what three things
High risk/incidence
Prolonged survival w/out cure
Low incidence
Rapidly fatal
Rapid recovery
Define Herd Immunity
Appicable to contagious dseases, indirect protection from dzs for those not immune
Define Herd Immunity Threshold
Reached when critical proportion of the population becomes immune and Dz may no longer persist
Define Basic Reproduction Number
Average number of new cases in a susceptible, well mixed population
What is measles’ Ro and HIT?
What is pertussis’ Ro and HIT?
What is influenza Ro and HIT?
12-18 92-95%
12-17 92-94%
1.5-1.8 33-44%
Quarantine is covered by what Executive Order and for which diseases?
EO 13295 TB Cholera Diphtheria Plague Smallpox Yellow fever HVFs SARS
What are the four groups of people that fall under the exclusion from work?
Health care
Day care
Food handler
Law enforcement
What is the mission of Occupational Health
Promote health and safety of the workplace and community by focusing on education and surveillance aiming to restore health and productivity
What is the primary role of occupational health in a military setting?
Protect service members and DoD civilians
What are the four reasons for Occupational Health
Compliance w/ laws
Healthy workforce
Maintain productivity
Decrease costs
What is the purpose of OSHA
1970
Federal laws governing OccHealth
Created NIOSH
What is the purpose of ExecOrder 12196
1980
Required compliance w/ OSHA except for military battlefield noise
What is the purpose of CFR 1910 and 1960
Labor laws providing standards for working environments
What is the purpose of DODI 6055.5M
Medical surveillance, recognize health risks and hearing conservation
What is the purpose of service regulations
Documents that provide legal and regulatory base of army Occupational safety and health program
_____ are HEPA filter surgical masks
N-95 respirators/TB masks