HESC 401 Epidemiology Ch. 1 and 2 notes
HESC 401 Epidemiology Ch. 1 and 2 notes HESC 401
Cal State Fullerton
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This 4 page Class Notes was uploaded by Natalie Azzouni on Wednesday September 28, 2016. The Class Notes belongs to HESC 401 at California State University - Fullerton taught by Archana McEligot in Fall 2016. Since its upload, it has received 10 views. For similar materials see Epidemiology in Health and Human Services at California State University - Fullerton.
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Date Created: 09/28/16
Epidemiology Ch. 1 and 2 Quiz Review th Textbook: Epidemiology by Leon Gordis – 5 edition CHAPTER 1: 1 Define epidemiology. -study of distribution and determinants of health related states or events in specified populations and the application of this study to control health problems. -study of how disease is distributed in populations and the factors that influence or determine this distribution. Objectives of Epidemiology- 1- identification of causes (etiology) and risk factors of a disease 2- determine extent of disease found in community 3- study natural history and prognosis of the disease 4- evaluate existing and newly developed health care programs 5- provide data and info to create public policy related to disease prevention and health promotion 1 2 What are the key terms in the definition of epidemiology? -etiology= the cause of a disease and the relevant risk factors -distribution= frequency of disease. How often/ how much. -determinants= causes of disease. -control= how to stop or control disease. 3 Understand changes in health problems during the last century. -Leading cause of death in US- 1900= Pneumonia and influenza, tuberculosis, Diarrhea and enterisis (infectious diseases) 2009= Heart disease, cancer, chronic lower respiratory disease (chronic diseases) -Longer life expectancy today because of decreases in infant mortality and in mortality from childhood diseases. 4 Contrast the different types of prevention. -Primary: those who are well and have not gotten disease ex: immunizations, health promotion programs, exercise, not drinking -Secondary: disease is present, but no clinical signs of disease ex: screening for cancer (pap-test every year) catches disease at early stage and increase likelihood of quick recovery -Tertiary: aimed at those who already have disease to reduce impact ex: treatment and rehab 5 Identify the relationship between epidemiology and clinical practice? -epidemiology= population as a whole -clinical practice= individuals. Commonly known as medicine, nursing, or dealing with patients in hospital or health care setting and is intricately related and relies on epidemiology. The following aspects of clinical practice relies heavily on epidemiology- diagnosis, prognosis, therapy/treatment. -Prognosis = how long someone will have to live or how they will “do” after a diagnosis is based on epi studies. 6 What role did John Snow play in epidemiology? -John Snow investigated and discovered the true cause of cholera deaths in London, England, 1854. -Snow realized cholera was transmitted through contaminate -“Shoe-leather” epidemiology- going from house to house counting all deaths from cholera in each house and determining which company supplied water to each house. CHAPTER 2- 1. What are the modes of disease transmission? Person to person= direct. Common vehicle like air, water, bug = indirect. -Host, Agent, Environment: -Host= age, gender, genetics, immunologic profile, previous disease, occupation, marital status. Agent= Nutrients, allergens, radiation, biologic, microbes, psychological experiences, chemical (poison, alcohol, smoke). Environment= air pollution, radiation, crowding, neighborhood, vector (can bring the host and agent together like mosquito for malaria). 2. Distinguish clinical and subclinical disease -Clinical= characterized by signs and symptoms. -Nonclinical: (not visible) Subclinical= disease that is not clinically apparent and is not destined to become clinically apparent. This type of disease is often diagnosed by serologic (antibody) response or culture of the organism. Subclinical can help prevent the spread of disease if recognized and also track the burden of disease in a population. Preclinical= not clinically apparent, but will lead to disease Persistent= an infection that persists for years and may become apparent as an adult Latent: does not manifest in any way, but only seen in genetic material of host. 3. Define endemic, epidemic and pandemic -Endemic= the usual or baseline status of disease in a population -Epidemic= occurrence of disease in a population that’s higher than normal rate. -Pandemic= an epidemic that affects the world. 4. Understand the concept of herd immunity and incubation period -Herd Immunity= the resistance of a group of people to an attack by a disease to which a large proportion of the members of the group are immune. If most people are immune, the entire population is likely to be protected. -Incubation Period= the period/time or interval between when an individual gets the disease to when they actually show the symptoms. During incubation period, person may not show any signs of illness and may feel fine. 5. List the steps of investigating an outbreak 1- establish the existence of an outbreak: define numerator (cases), clinical features aka is the disease known? Cultural aspects? Are causes partially understood? Define denominator- who is susceptible to getting disease? Determine whether observed cases exceeds expected number. Calculate attack rates. 2- verify the diagnosis: ensure problem has been properly diagnosed and be certain that the increase in diagnosed cases is not the result of a mistake in the lab (for outbreak infectious or toxic chemical agents) 3- define and identify cases: establish a case definition that includes clinical info about disease, characteristics of people who are affected, info about location and specific time when outbreak occurred. 4- describe and orient the data in terms of person, place, and time- descriptive epidemiology= characterizing an outbreak by time, place, and person. 5- develop hypotheses- based on existing knowledge of disease, analogy to diseases of known etiology, and findings from investigation of the outbreak. Should address source of agent, mode of transmission, and exposures associated with disease. Should be proposed in a way that can be tested. 6- evaluate hypotheses- all evidence and lab data should be consistent with initial hypothesis and no other hypothesis fits the data 7- refine hypotheses and carry out additional studies- what questions remain unanswered? 8- implement control and prevention measures- stop current epidemic and establish measures that would prevent similar outbreaks in the future. Control source of pathogen, interrupt transmission, control host response to exposure. 9- communicate findings- prepare final report. 6. Calculate an attack rate and investigate the cause of the food- borne outbreak- calculate attack rate for people who ate a certain item (exposed) and an attack rate for those who did not eat it (unexposed) Divide # who became ill and consumed item by the total # of people who consumed that item. Attack rate = # of new cases occurring in a given time period / population at risk at the start of the time period. # of people at risk who develop a certain illness / total # of people at risk
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