EPIDEMIOLOGY (CDC)

James Lind (1700)

Is the study of the distribution and determinants of health- -Designed first experiments to use concurrently treated control group
related states or events in specified populations, and the
application of this study to control of health problems. Edward Jenner (1749-1823)
-Pioneered clinical trials for Vaccination to control spread of smallpox
Greek words:
-epi “upon” William Farr (1800)
-demos “people” -Given the task for medical statistics in London and Wales
-logos “study” -The “Father of Modern Vital Statistics and Surveillance”

The science which deals with that falls upon people Ignas Semmelweis (1840)
Study (scientific, systematic, data-driven) of the -Pioneered hand washing to help prevent the spread of septic infections in
Distribution (frequency, pattern) and mothers following birth
Determinants (causes, risk factors) of
Specified populations (patient is community, individuals John Snow (1854)
viewed collectively), and application of this study to control of -“Father of field Epidemiology”
health problems.
Mary Mallon
HISTORY OF EPIDEMIOLOGY -A cook responsible for most famous outbreak of carrier-borne disease in
Typhoid.
Hippocrates (460-375 BC)
-The Greek physician who is known as the “Father of 19th and 20th Centuries
Medicine”
o 1800 – Epidemiological methods began to be applied in the investigation
Thomas Sydenham (1624-1689) disease occurs.
-Recognize as founder of clinical medicine and epidemiology o 1940 – Epidemiologist extended their methods to non-infectious disease.
-Emphasized detailed observations of patients and accurate o Health workers applied epidemiologist methods to eradicate naturally
record keeping occurring smallpox worldwide.
o Extended to the studies of injuries and violence.
John Graunt (1662) o 1990 – Molecular and genetic epidemiology took root.
-Published a landmark analysis of mortality data in 1662
EPIDEMIOLOGIST

Is a public health scientist, who is responsible for carrying out all useful and effective activities needed for successful epidemiology practice.
Are public health professionals who investigate patterns and causes of disease and injury.

EPIDEMIOLOGY USES

Epidemiology and the information generated by epidemiologic methods have been used in many ways:

-Assessing the community’s health

-Making individual decisions
-Competing the clinical picture
-Searching for cause

CORE EPIDEMIOLOGIC FUNCTIONS

Public health surveillance

-is the ongoing, systematic collection, analysis, interpretation, and dissemination of health data to help guide public health decision making and action.

Field investigation
-Or report of a cluster is investigation by the public health department.

Analytic studies
-Methods are used in combination – with surveillance and field investigations providing clues or hypotheses about causes and modes of transmission.

o Design – includes determining the appropriate research strategy and study design writing justifications and protocols.
o Analysis – it progresses to calculation of rates and creation of comparative tables.
o Interpretation – involves putting the study findings into perspective, identifying the key take-home messages, and making recommendations.
 DESCRIPTIVE EPIDEMIOLOGY
Evaluation- is the process of determining, as systematically and
objectively as possible, the relevance, effectiveness, efficiency, and The 5W’s of descriptive epidemiology:
impact of activities with respect to established goals. What – health issues concern
Who – person
"Effectiveness”- refers to the ability of a program to produce the Where – place
intended or expected results in the field When – time
Why/How – causes, risk factors, modes of transmission
"Efficiency”- refers to the ability of the program to produce the intended
results with a minimum expenditure of time and resources.

Linkages- field epidemiology is often said to be a "team sport." ANALYTICAL EPIDEMIOLOGY

Policy development- definition of epidemiology ends with the Comparison group - Key feature of analytic epidemiology.
following phrase: " and the application of this study to the control of the purpose of an analytical study in epidemiology is to identify and
health problems." quantify the relationship between exposure and a health.

Epidemiologic studies fall into two categories:

THE EPIDEMIOLOGIC APPROACH
EXPERIMENTAL STUDIES
As with all scientific endeavors, the practice of epidemiology relies on -The investigator determines through a controlled process the exposure
the systematic approach. In very simple terms, the epidemiologist: for each individual (clinical trial) or (community trial).

Counts cases or health events OBSERVATIONAL STUDIES

Divides the number of cases -The epidemiologist simply observes the exposure and diseases status of
Compares these rates over time or different group of people each study participants.
3 COMMON TYPES OF OBSERVATIONAL STUDIES

Cohort study
Case-control study
Cross-sectional study

the purpose of an analytic study in epidemiology is to identify and quantify the

relationship between an exposure and a health

CONCEPT OF DISEASE OCCURRENCE

Epidemiologic triad or triangle – the traditional model for infectious disease.

Agent
-Originally referred to an infectious microorganism or pathogens.

Host
-Refers to the human who can get the disease.

Environment
-Refers to extrinsic factors that affect the agent and opportunity.

NATURAL HISTORY AND SPECTRUM OF DISEASE

CHAIN OF INFECTION
EPIDEMIC DISEASE OCCURRENCE

RESERVOIR OF AN INFECTIOUS AGENT

Sporadic
-refers to a disease that occurs infrequently and irregularly.
Is the habitat in which the agent normally lives, grow, and multiplies.
o Human reservoir
Endemic
o Animal reservoir
-refers to the constant presence and/or usual prevalence of a disease of
o Environmental reservoir
infectious agent in a population.

PORTAL OF EXIT
Hyperendemic
-refers to persistent, high levels of disease occurrence.
Is the path by which pathogens leaves its host.
Epidemic
MODE OF TRANSMISSION
-refers to an increase, often sudden, in the number of cases of a disease
above what is normally expected.
An infectious agent may be transmitted from its natural reservoir to a
susceptible host.
Outbreak
-carries the same definition of epidemic, but is often used for a more
Different Classifications:
limited geographic area.
o Direct - droplet
o Indirect - Airborne , Vehicle
Cluster
-refers to an aggregation of cases grouped in place and time that are
PORTAL OF ENTRY
suspected to be a greater than the number.

Refers to the manner in which a pathogen enters a susceptible host.

Pandemic
-refers to an epidemic that has spread over several countries or
HOST
continents, usually affecting a large number of people.

The final link in the chain of infection.

Epidemics can be classified according to their manner of spread through a population:

Common-source

Point
-if the group is exposed over a relatively brief period, so that everyone who become ill does so within one incubation period.

Continuous
-the range of exposures and range of incubation periods tend to flatten and widen the peaks of the epidemic curve.

Intermittent
-Often has a pattern reflecting the intermittent nature of the exposure.

PROPAGATED OUTBREAK

Is a result from transmission from one person to another.

MIXED EPIDEMICS

Features of both common-source epidemics and propagated epidemics.

OTHER

Some epidemics are neither common-source in its usual sense nor propagated from person to person.