Chapter 2: Path to Modern Epidemiology

Acute

Severe disease with sudden onset and shoort duration of symptoms

Childbed fever

A uterine infection, usually of the placental site, after childbirth

Cholera

Acute infectious disease characterized by watery diarrhea, loss of fluid and electrolytes, dehydration, and collapsing.

Chronic

Disease that persists over a long peiod

Epidemiologic methods

Mathematical formulas, models, and techniques used in the analysis of epidemiologic data

Father of Epidemiology

John Snow

Germ theory

Theory that bacteria, viruses, germs, or pathogens can cause disease.

Isolation

Separates people who have a specific infectious illness from those who are healthy

Multifactorial etiology

Two or more factors can cause a disease

Quarantine

Separates and restricts the movement of people who aren’t sick yet but have been exposed to an infectious agent

Typhoid fever

Statistics

Science of collecting, analyzing, presenting, and interpreting data

Vaccine

A substance designed to stimulate immunity against a disease, typically derived fromfrom an inactivated or weakened form of the agent

Vital statistics

Data about a populations’ vital events such as the number of births, deaths, marriages, divorces, etc

Political Arithmetic

Older term for Statistics

Vitamins

Organic components in food that are needed in very small amounts for metabolism, growth, and maintaining good health

London Zoo’s Lion Discovery

In 1889, Lion cubs diagnosed with rickets were cured by feeding them crushed bone, milk, and cod liver oil

What is Elmer McCollum known for

Introduced the idea of using letters to describe vitamins. He had two main categories of “factors” (vitamins): A and B. Within the A factor, there was a heat-stable version and a heat-labile version

Difference between McCollum’s “A” and “B” factors

The A factor was fat soluble (butter) whiles the B factor was water soluble (rice).

The A factor was divided into two more categories. The first was heat-stable and cured rickets, the other was heat-labile and cured xerophthalmia.

The heat-stable rickets curing “sub factor” is now known as Vitamin D

The heat-labile xeropthlamia curing “sub factor” is now known as Vitamin A

How was rickets cured back then

Cod liver oil. They didn’t know why it worked until Elmer McCollum “discovered” Vitamin D

What made someone more susceptible to Rickets

Vitamin D deficiency, not going outside

Vitamin B use

Used to treat beriberi and pellagra

When did public health and epidemiology studies start in the US?

1800s

Origin of public health inthe US

1798 Act for the Relief of Sick and Disabled Seamen: Provided relief for sick and disabled seamen and established military hospitals in major cities

When was the first “Quarantine health convention” in the US? WHat was discussed?

1857

Typhus, cholera, and yellow fever prevention was discussed. The health of incoming immigrants were also discussed

1878 Congress’s Quarentine Laws

Congress specified the federal role in quarantining following outbreaks of cholera from incoming immigrants from Europe

Public Health Service (PHS) Act of 1944

Established that the PHS was responsible for preventing the introduction, transmission, and spread of infection diseases from other countries into the United States

When was the US Public Health Service founded?

1902

What happened in 1906

The Pure Food and Drug Act was passed and standard methods of water analysis were adopted

What happened in 1913?

The pasteurization of milk was shown to be effective in controlling the spread of disease, and the Harvard School of Public Health was established

When were immunization standards put in place?

In the early 1900s when smallpox, measles, diphtheria, pertussis, and influenza started to blow up (epidemic)

How has the population focused on by public health shifted?

From the military to the general population

What are threats to human health outside of the body?

Climate change, such as heat waves, extreme weather events, reduced air quality, and climate-sensitive diseases

History of Health Boards in the US

In 1855, Louisiana was the first state to establish a board of health, but it only functioned in New Orleans

In 1869, Massachusetts was the first state to create a state level health board

Much later the National Cancer Institute, the National Institute on Aging, the National Institute of Allergy and Infectious Diseases, the National Institute of Environmental Health Sciences, and the Centers for Disease Control and Prevention (CDC) were created

CDC Function

Controls communicable disease outbreaks and promotes mass immunization. The CDC’s Epidemic Intelligence Service (EIS) leads epidemiologic investigations, conducts surveillance studies, interacts with the public, and produces scientific presentations and publications

Disease Information Objectives: Assessment

Identify who is at greatest risk for experiencing the public health problem

Identify where the public health problem is greatest

Identify when the public health problem is greatest

Monitor potential exposures over time

Monitor intervention-related health outcomes over time

Disease Information Objectives: Cause

Identify the primary agents associated with diseases, disorders, and conditions

Identify the mode of transmission

Combine laboratory evidence with epidemiologic findings

Disease Information Objectives: Clinical Picture/Natural History

Identify who is susceptible to the disease

Identify the types of exposures capable of causing the disease

Describe the pathologic changes that occur, the stage of subclinical disease, and the expected length of this subclinical phase of the disease

Identify the types of symptoms that characterize the disease

Identify probable outcomes (recovery, disability, or death) associated with different levels of the disease

Disease Information Objectives: Evaluation

Identify the efficacy of the public health program

Measure the effectiveness of the public health program