Population Health Outbreak Investigations

Question 1

epidemiologic triad

Answer 1

interconnectedness of host, environment, and agent factors that contribute to disease outbreaks

Question 2

what are the steps to an adaptive response to outbreaks

Answer 2

1. disease control
2. non-pharmaceutical interventions
3. pharmaceutical interventions

Question 3

disease control measures

Answer 3

early detection
contact tracing
health care prevention/control
clinical care

Question 4

non-pharmaceutical interventions

Answer 4

wash hands
cover coughs
clean surfaces
ventilation
masks
closing schools/businesses

Question 5

pharmaceutical interventions

Answer 5

specific treatments and vaccines

Question 6

what are the routes of outbreak transmission

Answer 6

direct contact
aerosols
indirect contact
parenteral

Question 7

epidemic curves

Answer 7

measures the timeline of disease course

disseminated vs point source

Question 8

disseminated epidemic curve

Answer 8

propagated spread of an index case (curve increases over time)

cases spread exponentially from person to person

Question 9

point source epidemic curve

Answer 9

no propagation (bell curve increases then decreases)

all cases originated from a single source

no person to person transmission

Question 10

prevalence

Answer 10

all cases that are present at one point in time

includes new and old cases (total # cases at one point in time)

Question 11

incidence

Answer 11

new cases that occur during a given time interval

Question 12

what does time at risk depend on

Answer 12

type of population (dynamic vs static)

Question 13

when does an individual contribute to the risk of disease in a population

Answer 13

during the time it is susceptible to getting the disease while its a part of that population

only included from the time the individual enters the population until they leave OR get the disease

Question 14

crude mortality

Answer 14

total # deaths in a population / entire population

Question 15

cause specific mortality

Answer 15

deaths from disease / entire population

Question 16

case fatality for disease

Answer 16

deaths from disease / # cases of disease

Question 17

proportionate mortality for disease

Answer 17

deaths from disease / total # deaths in a population

Question 18

2x2 risk table

Answer 18

diagrams disease incidence vs exposure

a: exposure + disease
b: exposure + no disease
c: no exposure + disease
d: no exposure + no disease

total exposed = a + b
total not exposed = c + d

Question 19

risk ratio (relative risk)

Answer 19

risk of disease in exposed group / risk of disease in unexposed group

(a/a+b) / (c/c+d)

Question 20

attributable risk (risk difference)

Answer 20

risk of disease in exposed group - risk of disease in unexposed group

(a/a+b) - (c/c+d)

Question 21

odds ratio

Answer 21

odds of developing disease

ad / bc

Question 22

what are the steps of an outbreak investigation

Answer 22

1. verify diagnosis
2. define a case
3. determine the magnitude of the problem
4. describe the host patterns
5. describe spatial patterns
6. describe temporal patterns
7. data analysis
8. working hypothesis
9. intensive follow up
10. disseminate results