Epidemiology Chapters 1,2,3 – Flashcards
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Epidemiology
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study of distribution and determinants of health-related states or events in a human population aimed at prevention and control of outbreaks
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Population
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groups of people who share common characteristics such as personal, geographical, and time
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Experimental Epidemiology
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experimenters have total control over all circumstances
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Observational Epidemiology
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experimenters have no control over any circumstances
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Two Branches of Observational Epidemiology
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Descriptive and Analytical
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Descriptive Epidemiology
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collects information to characterize and summarize a health event or problem Who Where When
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Analytical Epidemiology
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rely upon comparisons of groups to determine potential risk factors How and Why
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Disease
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any disorder of body functions or systems
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Infectious Disease
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illness caused by a specific infectious agent resulting from transmission from host to host
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Communicable Infectious Disease
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spread from host to host, can be highly contagious or less contagious
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Noncommunicable Infectious Disease
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infectious diseases not spread from host to host -can be caused by individual's normal flora -ingestion of preformed toxins -caused by organisms present in environment
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Examples of noninfectious disease
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-congenital/hereditary disease (hemophilia, down syndrome, heart disease) -allergies/inflammatory disease -degenerative disease -metabolic diseases -cancer
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Epidemic
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health-related state or event in a defined population above the expected amount over a given period of time
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Endemic
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Persistent, usual, expected-related state or event in a defined population over a given period of time
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Pandemic
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Epidemic affecting large number of people, many countries, continents, or regions
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Examples of factors that affect ability to eradicate infectious diseases
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-medical expertise is not always available -infectious agents are highly adaptable -uknown or rare disease can become significant due to human intervention(technology, habitat removal) -immigration and international travel -biowarfare
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Public Health Service
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Focuses on populations and are mostly concerned with disease prevention
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Medical Care Services
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Focuses on individuals and diagnosis and treatment of a disease
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Epidemiologist Activities
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-Collect data on a population through surveillance systems or descriptive epidemiological studies -Generate hypotheses about relationships between exposure and disease -Test hypotheses using analytical epidemiological studies -Take action through community intervention to end health problem and prevent reccurence
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Health Care Practitioner
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-Collect data on individual patient by gathering medical history or doing a physical exam -Make a differential diagnosis -Test the diagnosis by conducting studies or tests -Take action by prescribing medicine or treatment specific to the diagnosis
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Who Where and When
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Descriptive studies
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Who Where When How and Why
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Analytical studies
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What can cause disease?
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-infectious agents -genetic make-up -lifestyle choices -environment
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Primary focus of Epidemiology
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identify causes of disease and how disease is spread, and prevention
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Branches of Public Health
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-preventive medicine -health education -controlling communicable diseases -sanitation -monitoring environmental conditions
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James Lind
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-First clinical epidemiologist -Performed clinical research to determine ways to prevent scurvy -had control and test groups
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William Farr
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-established national system for recording cause of death in UK -standardized mortality which is measure of number of deaths in population per time
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John Snow
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-Studied cholera in London and used scientific method to find the cause -made a map to determine central cause -first to implement descriptive/quantitative epidemiology
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Framingham Heart Study
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-Purpose was to identify contributors to coronary heart disease -First cohort study -resulted in identification of factors that put people at high risk for developing heart disease
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Bogalusa Heart Study
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-studied early natural history of cardiovascular disease -long term prospective cohort study -started with 16,000 people from birth to 45 years old -found risk factors can be identified at early ages through public health programs can be eliminated
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primary prevention
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useful in control of the distribution, frequency, severity of disease -focuses on preventing new cases by removing factors that cause changes in disease development
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Examples of primary prevention
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-Health education -immunization -wearing hard hats -seatbelts
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Secondary prevention
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stopping disease after its begun, involves screening, early detection, and treatment, aims to prevent more disease
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Tertiary Prevention
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Aims to improve health of people who are incurable, have a chronic disease
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Hippocrates
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"father" of environmental epidemiology -provided accurate descriptions of tetanus, typhus -used scientific method to study disease
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Egyptians
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-Practiced public health intervention -recognized diet and nutrition impacted health -understood importance of cleanliness and its link to disease -had prevention methods such as mosquito nets, surgeries
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Romans
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-placed huge importance on public health -focused on disease prevention -established public health systems like sewers, public baths, public restrooms -emphasized physical fitness and cleanliness
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Girolamo Fracastorious
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-proposed Germ Theory -identified ways infections are transmitted -first to make science backed statement on nature of infections, diseases, bacteria and germs
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Francesco Redi
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-Tested spontaneous generation by using scientific method -used raw meat and jars partially open -concluded spontaneous generation not supported
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Louis Pasteur
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-proved spontaneous generation is false -used experiment to prove bacteria cannot arise from a sterile broth -opened up world of microbiology
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John Graunt
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Created observational epidemiology -used empirical observations of causes of death -compiled first mortality tables;father of demography -classified and categorized deaths with causes
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Health
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state of complete physical mental and social well-being, not merely absence of a disease or affirmity
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Physical health
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A state of physical fitness
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Mental Health
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State of emotional/physiological well-being/able to use cognitive or emotional capabilities, function in society, meet the demands of life
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Disease
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abnormal condition of an organism that impairs bodily functions
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Quality of Life
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Measurement representing overall feeling of well-being
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health-related QOL
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measures both physical and mental health/indicator of health resources needed
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the Natural History of Untreated Disease
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1. Incubation Period (no signs or symptoms) 2. Prodromal Period (vague symptoms) 3. Invasive Period (most severe symptoms) 4. Decline Period (declining signs/ symptoms) 5. Convalescence Period
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Clinical Course of a Treated Disease
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1. No disease (may be susceptible) 2. Has disease (no symptoms/too early to detect) 3. Has disease (no symptoms/disease detectable) 4. Has disease (symptoms/detectable) 5. Outcome (recovery, damage, death)
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natural history of a disease
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what occurs when a disease goes untreated
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clinical course of a disease
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what occurs when a disease is treated
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Reservoirs of Infections
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sites in which organisms can persist/maintain ability to infect, essential for new human infections to occur
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Human Reservoirs
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individuals who harbor an infectious agent ex. tuberculosis, small pox
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Animal Reservoir
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pathogenic microorganisms may infect both humans/animals -diseases transmitted under natural conditions
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Zoonoses
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vertebrate animals transmit diseases to humans under natural conditions
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Nonliving Reservoirs
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soil, water (ex. botchalism)
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Human Disease Transmission
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from a reservoir of disease to a host
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contact transmission
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kissing, sex, spit, blood
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Vehicle transmission
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contaminated food, water
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Fomites
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contaminated nonliving objects
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Vector transmission
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mosquitos, ticks, leeches, lice
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Air transmission
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Dust or droplets
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Mechanical Vectors
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insects passively spreading pathogens
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Biological vectors
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pathogens carry out some portion of its life in a vector before infection will transmit
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Spontaneous Generation
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microorganisms arise from non-living things
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Germ Theory of Disease
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microorganisms can invade other organisms and cause disease
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Kochs Postulates
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1. suspected organism isolated from infectious animal and grown in pure culture 2. Organisms are injected into healthy animals 3. one animal sickens or may die, and a pure culture is isolated 4. isolated pure culture specimens are the same -identification of a disease agent requires growing the organism
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Risk
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probability of how likely it is that someone will get a disease if a certain condition exists can increase or decrease due to -genetic -behavioral -environmental -combo of these
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The following risk scenarios can be seen
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1. person affect by risk factor gets disease 2. person affected by risk factor does not get disease 3. person not affected by risk factor gets disease 4. person not affected by risk factor does not get disease
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sufficient cause
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always produces a disease (rarely seen)
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component cause
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Contributing cause, group of causes working together to be a sufficient casue (most common)
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direct relationship
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one factor is directly associated with a disease
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indirect relationship
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many factors work together (AIDS)
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4 types of casual relationships
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1. necessary and sufficient 2. necessary but not sufficient 3. sufficient but not necessary 4. neither sufficient or necessary
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Necessary and Sufficient
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HIV to AIDS factor has no influence and person will not get disease
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Necessary but not Sufficient
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ex. Tuberculosis -several factors and only one is required for disease
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Sufficient but not Necessary
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ex. lung cancer if never smoked in life -factor causes disease, person may get even without the factor present
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Neither sufficient or necessary
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multiple factors that all contribute to some disease
