Epidemiology & Public Epidemiology & Public HealthHealth

I. Descriptive TermsI. Descriptive Terms

A. ____________________ – Study of frequency and A. ____________________ – Study of frequency and distribution of diseases.distribution of diseases.

1. World’s Population1. World’s Population

a. Crowdinga. Crowding

b. Social Unrestb. Social Unrest

c. rapid transportation of c. rapid transportation of diseasesdiseases

d. Mass distribution of food & d. Mass distribution of food & supplies supplies that may contain that may contain pathogens.pathogens.

B. ___________ – Disease that are constantly present in a B. ___________ – Disease that are constantly present in a given population.given population.

C. ___________ – Usually large number of cases in a C. ___________ – Usually large number of cases in a population.population.

(Flu & Pneumonia).(Flu & Pneumonia).

D. ___________ – Fraction of people who have the D. ___________ – Fraction of people who have the disease in a given population.disease in a given population.

(100 people out of 5,000: City)(100 people out of 5,000: City)(100 people out of 1,000:Rural)(100 people out of 1,000:Rural)

E. ___________– Number of cases developing the out of E. ___________– Number of cases developing the out of 100 people exposed.100 people exposed.

F. ___________– Number of cases divided by the F. ___________– Number of cases divided by the population at risk.population at risk.

(Flu is increasing)(Flu is increasing)

G. ___________– Number of cases dying from the disease.G. ___________– Number of cases dying from the disease.(AIDS, Ebola is increasing)(AIDS, Ebola is increasing)

H. ___________– Number of new cases in a specific time H. ___________– Number of new cases in a specific time period in a given population.period in a given population.

I. ___________– Total number of existing cases in a given I. ___________– Total number of existing cases in a given population.population.

J. Communicable Disease – Diseases that can be J. Communicable Disease – Diseases that can be transmitted from person to person (Flu, measles).transmitted from person to person (Flu, measles).

K. ___________ Non transmitted. (Pneumonia-inhalation of K. ___________ Non transmitted. (Pneumonia-inhalation of normal flora).normal flora).

L. ___________– Subsides rapidly – FluL. ___________– Subsides rapidly – Flu

M. ___________– Symptoms persists (Maybe for years)M. ___________– Symptoms persists (Maybe for years)1 ___________– have symptoms1 ___________– have symptoms2. ___________ – no symptoms2. ___________ – no symptoms

N. ___________ – remains inactive for a period of time.N. ___________ – remains inactive for a period of time.(cold sore).(cold sore).

II. Spread of DiseasesII. Spread of Diseases

A. RequirementsA. Requirements

1. Suitable ___________ to live & multiply.1. Suitable ___________ to live & multiply.

2. Mode of ___________ to next host.2. Mode of ___________ to next host.

3. Appropriate ___________ to enter new host.3. Appropriate ___________ to enter new host.

B. ReservoirB. Reservoir

___________ or source of an organism___________ or source of an organism

a. ___________ – Salmonellaa. ___________ – Salmonella

b. ___________ - Rabiesb. ___________ - Rabies

c. ___________ l - Botulism, Tetanic. ___________ l - Botulism, Tetani

C. CarrierC. Carrier

___________ people and ___________ the disease___________ people and ___________ the disease

a. Short terma. Short term

b. Chronicb. Chronic

D. ___________ DiseaseD. ___________ Disease

Transmitted to humans by ___________ - RabiesTransmitted to humans by ___________ - Rabies

E. How can disease spreadE. How can disease spread

1. ___________ Transmission1. ___________ Transmission

a. ___________ in environment – Syphilis – close a. ___________ in environment – Syphilis – close intimate intimate contact.contact.

b. ___________– Infectious dose- Shigella – only 100b. ___________– Infectious dose- Shigella – only 100

c. ___________– less than 1 meterc. ___________– less than 1 meter

1. ___________, coughing, ___________, singing1. ___________, coughing, ___________, singing

2. ___________– schools, barracks2. ___________– schools, barracks

beds & desks are more then 4 ft beds & desks are more then 4 ft apart (8-apart (8- 10)10)

3. ___________ 3. ___________

4. ___________– Mother to newborn – 4. ___________– Mother to newborn – Syphilis, Syphilis, Rubella, HerpesRubella, Herpes

2. ___________ ___________ 2. ___________ ___________ a. Passing through an ___________ object a. Passing through an ___________ object

(___________).(___________).Clothing, tabletops. DoorknobsClothing, tabletops. Doorknobs

3. ___________ or ___________– Infect the GI tract3. ___________ or ___________– Infect the GI tract

4. ___________ 4. ___________ a. ___________– 1 or 2 microorganism in a small a. ___________– 1 or 2 microorganism in a small

droplet.droplet.b. May stay ___________ ___________.b. May stay ___________ ___________.c. ___________(skin cells)c. ___________(skin cells)d. Usual Conditionsd. Usual Conditions

1. ___________ - good ventilation, except 1. ___________ - good ventilation, except highly highly infectious agents (chicken pox, infectious agents (chicken pox, measles).measles).

2. ___________ – bad because of movements 2. ___________ – bad because of movements pumps air around.pumps air around.3. ____ – Pathogens may grow in AC water & 3. ____ – Pathogens may grow in AC water & spread when turned on.spread when turned on.4. Difficult to control4. Difficult to control

5. ___________ 5. ___________

a. ___________, ___________, a. ___________, ___________,

b. ___________ – insect controlb. ___________ – insect control

6. ___________– may determine the outcomes of the 6. ___________– may determine the outcomes of the disease.disease.

a. ___________ bladder infection, no GI infection if a. ___________ bladder infection, no GI infection if ingested.ingested.

b. ___________ – hand shake- only infect if ingested.b. ___________ – hand shake- only infect if ingested.

Respiratory – coughing – inhaledRespiratory – coughing – inhaled

c. ___________ (injection) - fleas, rodentsc. ___________ (injection) - fleas, rodents

Bubonic plague – lymphBubonic plague – lymph

7. Other influencing Factors7. Other influencing Factors

a. ___________ {Period – length of time to exposure to tie of a. ___________ {Period – length of time to exposure to tie of symptomssymptoms

1. AIDS –long1. AIDS –long

2. Typhoid Fever – exposed to drinking water2. Typhoid Fever – exposed to drinking water

b. ___________– small vs large amountsb. ___________– small vs large amounts

1. typhoid Fever – 1,000,000 for symptoms1. typhoid Fever – 1,000,000 for symptoms

c. ___________ – Prior exposurec. ___________ – Prior exposure

1. Herd immunity – majority of population has 1. Herd immunity – majority of population has immunity – non immunity – non immune protected.immune protected.

d. ___________, ___________, ___________d. ___________, ___________, ___________

e. ___________ e. ___________

1. ___________ may be by ___________ – Africans immune to 1. ___________ may be by ___________ – Africans immune to malaria because RBC’s lack receptors.malaria because RBC’s lack receptors.

f. ___________f. ___________

III. Infectious Disease SurveillanceIII. Infectious Disease Surveillance

A. ___________A. ___________

1. ___________1. ___________

2. ___________2. ___________

3. ___________–Morbidity & Mortality Weekly 3. ___________–Morbidity & Mortality Weekly ReportReport

(MMRW)(MMRW)

4. Reports ___________4. Reports ___________

a. 52 new diseasesa. 52 new diseases

1. Malaria1. Malaria

2. Aids2. Aids

5. ___________5. ___________

a. TBa. TB

b. Chicken Poxb. Chicken Pox

c. Measlesc. Measles

d. Mumpsd. Mumps

B. ___________B. ___________ 1. Health Labs, Public School, 1. Health Labs, Public School, HospitalsHospitals

2. Report disease back to the CDC2. Report disease back to the CDC

C. ______________________– WHOC. ______________________– WHO

1. Targets disease for eradication1. Targets disease for eradication

IV. Infectious Disease ControlIV. Infectious Disease Control

A. ___________A. ___________

B. ___________– Hot bed for contagious diseasesB. ___________– Hot bed for contagious diseases

1. Young children- little ___________1. Young children- little ___________

2. Updates on ___________2. Updates on ___________

3. ___________ & ___________ Trained Staff3. ___________ & ___________ Trained Staff

C. HospitalC. Hospital

1. ______________________– Infection during 1. ______________________– Infection during hospitalizationhospitalization

a. ___________- 1 million cases = 6 Billion a. ___________- 1 million cases = 6 Billion dollars/yr.dollars/yr.

b. Hospital population is ___________b. Hospital population is ___________c. Bacteria by accidentc. Bacteria by accident

1. ___________1. ___________

2. Open wounds - ___________2. Open wounds - ___________3. ___________cleaned tools3. ___________cleaned tools

2. Maybe ___________ by the staff.2. Maybe ___________ by the staff.

3. ___________drug resistance3. ___________drug resistance

The Progress of an InfectionA. Pathogenicity

1. _______ or opportunistic pathogens2. ________ and virulence factors

B. Step one -Becoming __________ Portals of entry

C. Step Two - ____________ to the host

1. How pathogens attach (___________).

D. Step three - ______________ host defenses

1. How microbes escape phagocytosis

a. __________________

b. ___________or ________ formation

c. Survival ________ phagocytes after ingestion

Establishment of InfectionEstablishment of Infection

In order to cause disease pathogen In order to cause disease pathogen must follow a series of stepsmust follow a series of steps________________________________________________________________________Delivery of _______________ moleculesDelivery of _______________ molecules

Establishment of InfectionEstablishment of Infection

AdherenceAdherence Pathogen must adhere to Pathogen must adhere to

host cells to establish host cells to establish infectioninfection

Bacteria use _________Bacteria use _________ Often located at the top of Often located at the top of

______ or _____________ or _______ Binding of __________ to Binding of __________ to

host cells receptors is highly host cells receptors is highly specificspecific

Often _____________ type Often _____________ type of cell to which bacteria of cell to which bacteria can attachcan attach

ColonizationColonizationOrganism must _________ in order to colonizeOrganism must _________ in order to colonizeNew organisms must ___________ with New organisms must ___________ with

established organisms for nutrients and spaceestablished organisms for nutrients and spaceNew organism must also overcome New organism must also overcome

_______________ products produced by existing _______________ products produced by existing organisms as well as host immune responsesorganisms as well as host immune responses

Microbes have developed counterstrategies Microbes have developed counterstrategies including rapid turnover of piliincluding rapid turnover of piliSome organisms produce iron-binding molecules Some organisms produce iron-binding molecules

called ___________________called ___________________ Compete with host proteins for circulating ironCompete with host proteins for circulating iron

Establishment of InfectionEstablishment of Infection

Establishment of InfectionEstablishment of Infection

DeliverDelivery of effector molecules to y of effector molecules to host cellshost cells After colonization some bacteria After colonization some bacteria

are able to deliver molecules are able to deliver molecules _____________ to host_____________ to host

Induce changes to recipient Induce changes to recipient cell that includecell that include

_________ of microvilli_________ of microvilli _________ uptake of bacterial _________ uptake of bacterial

cell.cell.

Causing disease1. How virulence factors contribute to tissue damage

a. Extracellular enzymes (exoenzymes)i. ____________ii. ____________iii. ____________v. ____________; ____________

b. Bacterial toxins: A potent source of cellular damage

i. ____________ii. ____________iii. ____________iv. ____________v. ____________vi. ____________

c. Inducing an injurious host response

Distribution of pathogenDistribution of pathogen Infections often described according to distribution within Infections often described according to distribution within

the bodythe body____________

Infection limited to small areaInfection limited to small area Example: boilExample: boil

____________ or generalizedor generalized Agent has spread or disseminated throughout the bodyAgent has spread or disseminated throughout the body Example:measlesExample:measles

____________ Toxins circulating in bloodToxins circulating in blood

____________ Viruses circulating in bloodViruses circulating in blood

____________ Acute life-threatening illness causes by infectious agent or their Acute life-threatening illness causes by infectious agent or their

products circulating in bloodproducts circulating in blood

Principles of Infectious DiseasePrinciples of Infectious Disease

Signs and symptoms: Warning signals of disease1. Sign 2. Symptom3. Syndrome4. Signs and symptoms of inflammation

a. ____________b. Granulomas and ____________c. Lymphadenitisd. ____________e. Lesion

5. Signs of infection in the blooda. ____________b. Leukopeniac. Septicemia____________that go unnoticeda. ____________ b. ____________ or inapparent

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