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2024 SEM 1 BIOSTAT & EPIDEM (LEC) > outbreak investigation > Flashcards

outbreak investigation Flashcards

1
Q

this is when a disease shows up more often than normal in a specific area.

A

epidemic
- also called disease outbreaks

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2
Q

Why is reliable surveillance important in managing epidemics?

A

It helps determine the usual rates of disease, making it possible to identify when rates are considerably elevated.

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3
Q

surveillance is the entire process of ___, ___, ___ and ___ data on the ____ and the ____

A

collecting
analyzing
interpreting
record data

incidence of death, diseases and injuries
prevalence of certain conditions

*it is important to promote and safeguard the public health

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4
Q

this is considered the foundation of disease control and efforts

A

surveillance

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5
Q

Who is responsible for disease surveillance in the U.S.?

A

The CDC (Centers for Disease Control and Prevention).

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6
Q

it is the federal agency responsible for the surveillance of most types of acute diseases and the investigation of outbreaks.

A

the Centers for Disease Control
and Prevention (CDC)

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7
Q

When does the CDC handle disease outbreaks?

A

if requested by a state or if an outbreak has the potential to affect more than one state.

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8
Q

Who handles disease outbreaks within a single state?

A

The state government.
- they manage health issues within their own boarders

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9
Q

how does the data for disease surveillance are passed down

A

from local and state governments to the CDC
- which evaluates the data and works with the state and local agencies about further investigation and control of any problems discovered

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10
Q

What allows the federal government to respond to interstate disease outbreaks?

A

The U.S. Constitution’s jurisdiction over interstate commerce.

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11
Q

What happens if a disease has interstate implications?

A

The CDC is a first responder and acts immediately without waiting for a state request

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12
Q

federal gov vs state gov

A

federal gov: (CDC)
Handles outbreaks that start in one state and spread to others or could spread to others.

state gov:
Take care of outbreaks that stay within their own state.

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13
Q

outbreaks that originated in one state and have spread to other states or have the potential to do so

A

interstate implications

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14
Q

how to create a surveillance system

A

*this is the first step in creating a surveillance system

  1. development of surveillance system requires clear objectives regarding the disease or conditions to be covered
    (infectious disease, side effects of vaccines, elevated leads)
  2. to clarify goals: objectives for each surveillance item should be clear, including surveillance of an infectious disease. (measure vaccine effectiveness, check for side effects, track progress on health goals).
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15
Q

it is a set of rules used to decide if someone has a particular disease.

A

case definition

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16
Q

case definition is based on

A

Clinical findings: Symptoms or signs of the illness.

Laboratory results: Test results that confirm the disease.

Epidemiologic data on time: Information about when, where, and who is affected.

Characteristics of affected persons:

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17
Q

What are the two types of surveillance intensity?

A

Active: Proactively collecting data.
- more labor intensive and costly
- seldom done on a routine basis
[recording of diseases by periodically scouting for information, actively seeking out cases and data.]

Passive: Waiting for reports to come in.
- most surveillance is conducted on a routine basis
[recording of diseases that come to knowledge, typically through routine reporting mechanisms.]

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18
Q

What are the two possible durations for surveillance?

A

Ongoing: Continuous monitoring.
Time-limited: Monitoring for a specific period.

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19
Q

What kinds of data analysis should be planned?

A

analysis of incidence
prevalence
case fatality
costs, or quality-adjusted life years.

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20
Q

How should the findings of the surveillance system be shared?

A

Through the internet
Other publication venues

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21
Q

Why is a pilot test important?

A

To test the system in a small area before full implementation.

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22
Q

What should be done after the system becomes operational?

A

Continually evaluate and improve the system.

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23
Q

who are given forms and instructions to record any reportable disease cases they come across.

A

passive surveillance

physicians
clinics, labs
hospitals
* they are asked to report cases of diseases.
* healthcare providers report diseases based on what they notice, without being actively followed up.

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24
Q

Requires direct follow-ups with healthcare providers to gather data on diseases.

A

active surveillance
(phone calls, visits, or electronic contacts)
- Public health authorities actively reach out to institutions regularly (often weekly) to gather required data.

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25
Q

Infectious vs. Non-Infectious Diseases

A

Infectious diseases are reported more rapidly.
Other diseases (like injuries, chronic conditions) have slower and less widespread reporting systems. These systems develop based on specific problems.

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26
Q

Challenges of Disease Surveillance

A

Funding & Support:
Surveillance systems need strong government funding and support to start and maintain.
Most systems begin as small-scale demonstration projects before expanding nationwide.

Cancer Registries:
While some states have cancer registries, there is no national registry for cancer in the U.S.

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27
Q

Used to track fatal diseases, but they often have inaccuracies.

A

Death Certificates
- They are not reported quickly enough for detecting disease outbreaks.

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28
Q

What percentage of disease cases are reported in passive surveillance?

A

The percentage varies but can range from 30% to 62% of cases.

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29
Q

What is the purpose of baseline data in disease surveillance?

A

To track usual disease patterns, so unusual changes can be noticed and investigated.

baseline rates and patterns of diseases can be known only if there is a regular reporting and surveillance system

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30
Q

how can the epidemiologists study the patterns of disease

A

by the time and geographic location of cases
the characteristics of the person involved

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31
Q

A long-term trend that shows how a disease changes over time, often revealing bigger public health issues.

A

secular trend (long-term)

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32
Q

The percentage of people who die from a disease.

A

case fatality ratio

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33
Q

Regular reporting and surveillance help track usual disease patterns.

A

Baseline Data
- Unusual changes in patterns can signal outbreaks or issues with reporting.

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34
Q

When do respiratory diseases like flu typically peak?

A

In winter and early spring, when people spend more time indoors.

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35
Q

Why do insect-borne diseases peak in summer?

A

Insects like mosquitoes and ticks are more active in warm weather, and people are outside more.

36
Q

What is the peak season for waterborne gastrointestinal diseases and the peak for outbreaks attributable to recreational water?

A

May to August, as warm weather helps bacteria grow in food and water.

June to October for the recreational water.

37
Q

When do recreational drownings occur most frequently?

A

On weekends, when more people are swimming.

38
Q

what does it depends when many infectious diseases show a strong seasonal variation, with periods of highest incidence

A

usually depending on the route of spread

39
Q

how to determine the usual number of cases or rates of disease

A

epidemiologists must therefore incorporate any expected seasonal variation into their calculations.

40
Q

this disease have a much higher incidence in the winter and early spring in the Northern Hemisphere.

A

infectious disease that are spread by the respiratory route

41
Q

this disease have a strong predilection for the summer or early autumn

A

disease that are spread by insect or arthropod vectors

42
Q

this disease are most common in the summer, partly because of the ability of the organisms to multiply more rapidly in food and water during warm weather

A

Infectious diseases that are spread by the fecal-oral route

43
Q

advantage of using the epidemiologic year when plotting the incidence of a disease

A

it puts the high-incidence months near the center of a graph and avoids having the high-incidence peak split between the two ends of the graph, as would occur with many respiratory diseases if they were graphed for a calendar year.

[Using the epidemiologic year helps to group the highest disease rates in the middle of a graph, making it easier to see patterns without splitting the peaks across the edges, as can happen with diseases that peak at different times of the year.]

44
Q

outbreaks that originated in one state and have spread to other states or have the potential to do so

A

Interstate Implications

45
Q

outbreaks confined within one’s state borders

A

Intrastate Implications
*each state government has jurisdiction over these matters

46
Q

it allows epidemiologists to detect deviations from usual patterns, prompting them to investigate whether an epidemic is occurring or if other factors (like reporting changes) are responsible for observed changes.

A

Establishing Baseline Data in disease surveillance

47
Q

this analyze trends in specific times of the year, often attributing them to disease detection or reporting, and records significant health events throughout the years.

A

Evaluating Time Trends in disease surveillance

48
Q

refers to the periodic increase or decrease in disease incidence, usually depending on the disease’s route of spread, with certain diseases peaking during specific seasons.

A

Seasonal Variation in infectious diseases

49
Q

for a given disease runs from the month of lowest incidence in one year to the same month in the next year.

A

Epidemiologic Year
for example, from July 2024 to July 2025.or example, from July 2024 to July 2025.

50
Q

What does Thermophilic mean?

A

hermophilic refers to organisms that are attracted to or thrive in high-temperature environments, derived from
“thermo” (temperature)
“philic” (attracted to).

51
Q

It involves classifying health crises under specific levels (endemic, epidemic, pandemic) and setting the epidemic threshold for a disease in relation to its location of origin.

A

Identification and Documentation of Outbreaks

52
Q

How is surveillance used in the context of bioterrorism?

A

to locate and monitor bioterrorism, tracking diseases like anthrax, botulism, plague, smallpox, tularemia, and viral hemorrhagic fever.

53
Q

What is the meaning of “Bio” and “Terrorism” in the context of bioterrorism?

A

“Bio” means life
“terrorism” refers to acts of injustice or violence intended to cause fear or harm.

54
Q

Why is surveillance important after introducing public health interventions?

A

helps determine if major interventions, like new vaccines, have achieved the intended changes in disease patterns. It tracks effectiveness and identifies failures.

55
Q

What are signs of failure in public health interventions?

A

A lack of change in disease rates
An increase in disease rates after an initial decrease
An increase in disease within a recently vaccinated group

56
Q

How does data on disease patterns help in setting disease control priorities?

A

Data on disease patterns for the current time and recent past helps government and voluntary agencies establish priorities for disease control efforts. The severity of the disease, which can be determined through good surveillance, is a critical factor.

57
Q

What is important to check when setting disease control priorities?

A

It is important to check the frequency count or quantity of who is sick to help establish control priorities.

58
Q

How does the study of changing disease patterns help epidemiologists?

A

By studying the patterns of occurrence of a particular disease over time in populations and subpopulations, epidemiologists can better understand how disease patterns are changing.

59
Q

the unusual occurrence of a disease in a population or geographic area.

A

Epidemic

60
Q

refers to when a disease is consistently present in a particular locale at a constant level.

A

Endemic

61
Q

is a disease outbreak in an animal population.

A

Epizootic

62
Q

it is when a disease is present at a particular locale for a specific animal species at a constant level.

A

Enzootic

63
Q

is a key epidemiologic indicator used to investigate acute disease outbreaks, helping to identify exposures that contributed to illness.

A

Attack Rate

64
Q

attack rate formula

A

index card

65
Q

What is the first step in investigating an epidemic?

A

establish the diagnosis, which involves identifying the nature of the illness or problem by examining the symptoms.

66
Q

Why is establishing the diagnosis crucial in investigating an epidemic?

A

Establishing the diagnosis is crucial because many cases are resolved by correctly identifying the disease, which may show that the disease occurrence is not unusual after all.

67
Q

What is the Epidemiologic Case Definition?

A

The epidemiologic case definition is a list of specific criteria used to determine whether a person has the disease of concern. It is not the same as a clinical diagnosis but provides consistent criteria for epidemiologic investigations.

68
Q

Why is the case definition important in an epidemic investigation?

A

The case definition is especially important if the disease is unknown, as it helps establish consistent criteria for identifying cases before definitive diagnoses are available.

69
Q

What are some criteria for establishing an epidemiologic case definition?

A

A total eosinophil count greater than 1000 cells/uL.
Generalized myalgia (muscle pain) severe enough to limit normal activities.
Exclusion of other neoplastic or infectious conditions that could explain the syndrome.

70
Q

How is it determined if an epidemic is occurring?

A

An epidemic is considered to be occurring if the number of cases exceeds the usual number, which can only be assessed if ongoing surveillance provides data on typical case numbers. A completely new disease or syndrome typically meets the criteria for an epidemic.

71
Q

What are the three key factors used to characterize an epidemic?

A

An epidemic is characterized by time, place, and person using the criteria in the case definition.

72
Q

Why is it important to establish a case definition before data collection in an epidemic investigation?

A

determines the data needed to classify persons as affected or unaffected, so data collection should not start until it is established.

73
Q

How is the time dimension of an epidemic described?

A

time dimension is best described by an epidemic time curve, which plots time on the x-axis and the number of new cases on the y-axis. Time units on the x-axis should be smaller than the probable incubation period.

74
Q

What questions should be considered regarding the type of exposure in an epidemic?

A

Was the exposure from a single source or spread from person to person?
What was the probable route of spread (e.g., respiratory, fecal-oral, skin-to-skin, body fluids, or vectors)?
When were affected persons exposed, and what was the incubation period?
Were there secondary cases (person-to-person transmission)?

75
Q

Why is it important to define the location of cases in an epidemic?

A

Defining the location of cases is important because geographic clustering may provide clues about the source or spread of the disease. However, other data is often needed to complete the interpretation.

76
Q

How can a spot map help in an epidemic investigation?

A

A spot map shows where each affected person lives, works, or attends school, which can help in identifying patterns or sources of the epidemic.

77
Q

What are some important characteristics of persons affected by an epidemic?
A: Important characteristics include:

A

Age, gender, race, ethnicity, and religion
Source of water, milk, or food
Immunization status
Type of work or schooling
Contacts with other affected persons

78
Q

What is the source of infection in an epidemic?

A

The source of infection refers to the person (index case) or vehicle (such as food or water) that initially introduced the infection into the affected community.

79
Q

What are the different patterns of spread in an epidemic?

A

Common-source pattern: Infection comes from a single source.
Propagated pattern: Infection spreads from person to person.
Mixed pattern: A combination of both common-source and propagated patterns.

80
Q

What are the modes of transmission (MOT) in an epidemic?

A

Modes of transmission include:

Respiratory
Fecal-oral
Vector-borne
Skin-to-skin contact
Exchange of body fluids (e.g., serum)
Contact with fomites (objects like soiled sheets or doorknobs that can carry organisms)

81
Q

What is the purpose of testing a hypothesis in an epidemic investigation?

A

Testing a hypothesis involves using statistical tests (e.g., Z-test, T-test) and laboratory studies to confirm or refute epidemiologic hypotheses, providing evidence for the source, spread, and mode of transmission of the disease.

82
Q

What are some laboratory methods used to test hypotheses in an epidemic investigation?

A

Cultures from patients and, if appropriate, from vehicles like food or water.
Stool examination for ova and parasites.
Serum tests for antibodies (acute and convalescent samples to check for an increase in antibodies).
Tests for non-microbiological agents, such as toxins or drugs.

83
Q

Why might control measures be initiated before the source and route of spread are known in an outbreak?

A

Control measures may be initiated immediately due to public demand for action, even before the source and route of spread are confirmed. However, efforts should aim not to interfere with the ongoing investigation.

84
Q

What are some general control measures that can be taken during an outbreak?

A

Sanitation: Improving cleanliness and hygiene to prevent further spread.
Prophylaxis: Administering preventive treatments or vaccines.
Diagnosis and treatment: Identifying and treating affected individuals.
Control of disease vectors: Reducing or eliminating the organisms (e.g., mosquitoes) that spread the disease.

85
Q

Why is follow-up surveillance important after an outbreak?

A

Follow-up surveillance is crucial to detect subsequent outbreaks and to evaluate the effectiveness of the control measures implemented during the outbreak.

86
Q

What is the difference between active and passive surveillance in post-outbreak monitoring?

A

Active surveillance is more reliable than passive surveillance because it involves actively seeking out cases and data, while passive surveillance relies on reports from healthcare providers or other sources.

2024 SEM 1 BIOSTAT & EPIDEM (LEC) (12 decks)

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