Epidemics and Outbreaks: Lecture 1.1- Week 1
Epidemics and Outbreaks: Lecture 1.1- Week 1 ASM 201
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This 4 page Class Notes was uploaded by Alexandra Picha on Wednesday June 22, 2016. The Class Notes belongs to ASM 201 at Arizona State University taught by Dr. Megan Jehn in Summer 2016. Since its upload, it has received 9 views. For similar materials see Epidemics and Outbreaks in Anthropology (Science and Mathematics) at Arizona State University.
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Date Created: 06/22/16
ASM 201: Epidemics and Outbreaks Lecture 1.1: Introduction and History of Epidemiology Epidemiology: The study of the distribution and determinants of health and disease in human populations to enable health services to be planned rationally, disease surveillance to be carried out, and preventative and control programs to be implemented and evaluated. Distribution Frequency of disease occurrence may vary from one population group to another. - Disease and illness are not randomly distributed. - Need to identify the patterns and figure out what explains the distribution. Determinants Factors or events that are capable of bringing out a change in health. - Biologic Agents: bacteria, viral - Chemical Agents: carcinogens (ex. Tobacco smoke) - Lifestyle: stress, drinking, sedentary lifestyle, high-fat diet - Social: conditions in which people are born, grow, live, work and age Why is epidemiology the basic science of public/global health? Epidemiology can help figure out: - What causes disease? - How does disease spread? - What prevents disease? - What works in controlling disease? Epidemiology is a tool for public health action to promote and protect the public’s health based on science, causal reasoning and a dose of common sense. Types of Epidemiology: Descriptive Epidemiology: Examining the distribution of a disease in a population and observing the basic features of its distribution in terms of place, time, and person. - Typical study design: community health survey (cross-sectional study, descriptive study). What, Who, When, Where? Analytic Epidemiology: Testing a specific hypothesis, by conducting an epidemiologic study that relates the exposure of interest to the disease of interest. - Key Feature: comparison group - Typical study design: cohort, case-control, clinical trials. Why, How? Need for Epidemiology Reappearance of old diseases. Emergence of new diseases. ASM 201: Epidemics and Outbreaks Modern epidemics (obesity, smoking, violence) “Why treat people’s illnesses without changing what makes them sick in the first place?” –W.H.O Objectives of Epidemiology Investigate the etiology of disease and modes of transmission. Determine the extent of disease problems in the community. Study the natural history and prognosis of disease. Evaluate both existing and new preventive and therapeutic measures and modes of health care delivery. Provide a foundation for developing public policy and regulatory decision. Epidemiologic Triad of Disease: Host: demographics, genetics, occupation, marital status, immune status, social condition Agent: biologic (bacteria, virus, etc.), chemical (poison, alcohol), physical (trauma, radiation), nutritional (lack, excess) Environment: temperature, crowding, neighborhood, water, air pollution Defining Features of Epidemiology Epidemiology deals with populations Epidemiology involves measurements Epidemiologic studies involve comparison Epidemiology is fundamentally interdisciplinary Causality is the central concern of Epidemiology! ASM 201: Epidemics and Outbreaks Most fundamental aim of Epidemiology: to identify etiologic (causal) associations between exposure and outcomes Exposure ------?------ Outcome Causal claims are frequent in the literature and picked up by the media. Causal claims are often inconsistent and contradictory! Reports often are inconsistent, but give epidemiologists clues as to what is going on so we can dig a little deeper. Hippocrates, the First Epidemiologist (460 to 377 BC) “On Airs, Waters, and Places.” He observed that environmental and behavioral factors would be associated with disease. He noted that malaria and yellow fever most commonly occurred in swampy areas. Introduced terms like epidemic and endemic. th th 15 to 17 Century, John Graunt (London, 1662) Published the “Natural and Political Observations Made Upon the Bills of Mortality.” Weekly report on birth and mortality Noted patterns of disease occurrence: - Higher mortality for men vs. women - Seasonal variation - High infant mortality Recognized value of routinely collected data on human illness. Known as the Columbus of Statistics. th 18 Century, Edward Jenner (1749-1823) Jenner attempted to give a dairymaid, exposed to a mild case of cowpox in her youth, a case of cowpox by cutting her arm and rubbing some of the infectious “grease” into the wound. She did not get ill He subsequently invented a vaccination for smallpox. 19 thCentury, John Snow (1813-1858) An English physician and modern-day father of Epidemiology. He used scientific methods to identify the cause of the epidemic of cholera in London in 1854. He believed that it was the water pump on Broad Street that was the cause. The removal of the pump handle ended the outbreak. John Snow’s Contributions Hypothesized that cholera was a water-borne infectious disease and transmitted through the mouth. ASM 201: Epidemics and Outbreaks Mapped the geographic distribution of cholera cases. Collected data on drinking water habits of those affected AND unaffected so that he could make a comparison. Recommended a public health measure to prevent disease. 20 thCentury 1918-1919: Pandemic influenza killed 50 to 100 million persons globally (Spanish Flu) Smallpox eradication (Fun Fact: [Not in notes, just cool to know] Only two laboratories in the WORLD have a smallpox sample, one being the CDC in Atlanta!) Shift to chronic diseases - Framingham Study (ongoing since 1948) investigates risk factors for coronary heart disease. - Publication of U.S. Surgeon General’s report “Smoking and Health” (1964)- identified deleterious effects of smoking upon health. 21 Century Expanded to focus on quality of life and the burden of disease. Expanding role of epidemiology in bioterrorism. Major infectious disease outbreak! SARS, H1N1, Ebola 25 Most Meaningful Jobs That Pay Well: #19 Epidemiologist- 88% feel the job is meaningful -Released by Forbes
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