Parks UTA
Epidemiology
Field that studies distribution & timing of diseases (infectious & non-infectious); determines etiology, transmission, and susceptible populations
Etiology
study of the causes of disease
Morbidity
Morbidity rate
#/pop; %
Mortality
Mortality rate
#/pop; %
Prevalence
no. individuals at certain time
Incidence
no. of new cases
Patterns of Incidence
Sporadic, Endemic, Epidemic, Pandemic
Sporadic
occurs occasionally w/o regional concentration (random) i.e. Tetanus, rabies, plague
Endemic
constantly present in certain region (usually at low levels) i.e. Malaria, Ebola, chicken pox
Epidemic
larger than normal amount of cases i.e. Influenza, West Nile
Pandemic
epidemic that is cross continental i.e. Virulent influenza, Ebola, etc. (COVID)
NNDSS (in the U.S.)
All cases MUST be reported by physicians Ex: West Nile, HIV, measles, etc. Studies track notifiable disease to determine risks
CDC
publishes Morbidity and Mortality Weekly Report (MMWR) Provides physicians and health-care workers with updates on public health issues and latest data on notifiable diseases
John Snow
father of epidemiology; cholera in London 1854
Florence Nightingale
Determined many deaths were from poor sanitation, not battle
Joseph Lister
used epidemiology data of handwashing for better healthcare practices (carbolic acid/aseptic conditions)
Common source
single source for all infected indiv. Broad Street water pump
Point source
common source that exists for short-time (< pathogen incubation) potato salad
Continuous source
continuous contamination sewage from upstream of cholera in London
Intermittent source
on and off rainfall runoff
Propagated
direct or indirect person to person contact no single source
Observational
not manipulated Descriptive Analytical Cohort Method Case-control Cross-sectional
Experimental
subjects are manipulated; clinical trials; ethical concern, best evidence for etiology, double-blind studies
Descriptive
gathers info about disease outbreak
Includes interviews & examination of medical records (family history)
Helps develop hypothesis for etiology/causation
Analytical
selects group to evaluate hypothesis Retrospective – data from past groups (history)
Prospective – date from current subjects moving forward (looking at it as it is going forward
Cohort method
group-based examines individuals who share a particular characteristic Prospective or retrospective
Case-control
group-based compares groups w/ disease to group w/o Commonly retrospective
Cross-sectional
group-based group is randomly selected, compares disease and no disease at a point in time Looks for associations of measurable variable(s) and the disease
Non-living
soil, water; Ex. Clostridium spp. in soil
Living
humans, animals; Ex. Viruses, enteric microbes
Carriers
living reservoirs (Long persisting pathogens must live somewhere)
Passive
transmits mechanically; is not infected - failing to wash hands
Active
infected host transmits during incubation or convalescence - transmission before/after fever Asymptomatic – active carrier w/o symptoms - early HIV, typhoid Mary aka Mary Mallon
Definitive host
Parasitic infection: preferred host; parasite reaches sexual maturity
Intermediate host
Parasitic infection: can include one or more; parasite goes through immature life cycle stages
Contact transmission
Direct contact transmission – person to person - Vertical – mother to child - Horizontal – other person to person contact - Droplet – transmission in droplets at 1 meter or less Indirect contact transmission – fomite to person - Ex. Sexually transmitted = direct & horizontal - Ex. Birth = direct & vertical - Ex. Cough @ short range = direct & droplet - Ex. Cough onto desk = indirect
Vehicle transmission
through water, food, or air Ex. Aerosols; Hantavirus Ex. Longer lasting droplets; tuberculosis
Vector Transmission: Mechanical transmission
animal vector (not infected) carries pathogen from one host to another; - Mechanical vector ; Ex. fly that lands on feces & food,arthropod
Vector Transmission: Biological transmission
pathogen reproduces in vector that transmits pathogen from one host to another - Biological vector ; Ex. mosquitoes that pick up West Nile
Quarantined
isolation of infected or exposed individuals to prevent transmission of the disease - Duration is determined by incubation period & evidence of infection
healthcare-associated infections (HAI)
Nosocomial: Commonly introduced through contaminated medical equipment (e.g. catheters, respiratory ventilators, etc.)
Agencies Monitoring Global Health
WHO, CDC, EU Health Security Committee - Provide logistical support and response in case of epidemic/pandemic - Identify emerging & re-emerging diseases
Emerging infectious disease
new to population or shown increase in prevalence in last 20 yrs Ex: Ebola (2015), Coronavirus (2020)
Re-emerging infectious disease
increase after period of decline Ex: drug resistant tuberculosis Ex: measles; decline in vaccinations