Epidemiology

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Epidemiology

• Concepts and Terms

2
Homeostasis

• Define
• Major systems
• Communication

3
Holistic View

• Health vs. Disease
• Wellness Model (health focus)
• Awareness
• Education
• Growth
• Treatment Model (disease focus)
• Signs
• Symptoms
• Disability
• Death

4
Definitions

• Pathogen
• Disease
• Morbidity
• Mortality
• Symptoms
• Signs
• Etiology
• Pathogenicity

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Symbiosis
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Microbiotica

• Normal
• Resident
• Acquired 1st months of life
• Lifetime population
• Transient
• Competition
• Immune
• Opportunistic
• Immune suppression
• Change in competition
• Change site of residence
• Pathogens
• Contamination
• Food
• Air
• Water
• Infection

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Ecological Fitness
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Immune Defense
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Portals of Entry

• Skin
• Mucous Membranes
• Open body cavities
• Placenta
• Parenteral
• SC
• IM
• IV

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Adhesion

• Adhesion factors
• Protein ligands
• Examples
• Fimbria
• Flagella
• Glycocalyx
• Binding
• Glycoproteins
• Mannose
• Galactose
• Each other Biofilms
• Avirulence
• No adhesion factors
• No binding

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Disease Process

• Incubation
• Prodromal
• Illness
• Decline
• Convalescence

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Pathogenicity

• Virulence Factors
• Plasmids
• Resistance to Ab
• Extracellular enzymes
• Coagulase
• Hemolysins
• Toxins
• Exotoxins
• Cytotoxin
• Neurotoxin
• Enterotoxin
• Endotoxins Lipid A
• Avoid phagocytosis
• Capsules
• Motility
• Change lysosome fxn
• Increased WBC destruction

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Toxins
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Sequella to Injury
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Portals of Exit
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Sources of Disease

• Reservoirs
• Animals
• Zoonotic
• Human carriers
• Nonliving
• Soil
• Water
• Food

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Host Life Cycles

• Life Cycle
• L1
• L3
• Adult
• Hosts
• Definitive
• Intermediate
• Secondary
• Incidental
• Dead-End
• Stages
• Infectious
• Diagnostic

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Transmission of Disease

• Contact
• Direct
• Indirect (Fomites)
• Droplet
• Vehicle
• Air
• Food
• Water
• Body fluids
• Vector
• Mechanical
• Flies
• Roaches
• Biological
• Lice
• Mosquitoes
• Ticks

Lyme Disease
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Classification of Disease

• Stages
• Acute
• Chronic
• Subacute
• Latent
• Types
• Communicable
• Contagious
• Non-communicable
• Source
• Primary
• Secondary
• Region
• Local
• Systemic
• Focal

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Disease Diagnosis

• 5 Components
• Epidemiology
• Etiology
• Pathophysiology
• Clinical Manifestations
• Outcome

COPE
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Kochs Postulates

• 1) Pathogen for every disease
• 2) Isolate and grown in pure culture
• 3) Cause disease in healthy susceptible host
• 4) Reisolate pathogen from experimental host
• Exceptions
• Culture issues (temp, pH, O2)
• Multifactoral causes
• Ethical concerns (primates)

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Epidemiological Approaches

• Descriptive
• Disease data
• Analytical
• Kochs Postulates
• Retrospective
• Experimental
• Testing hypothesis

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Epidemiology

• Epidemiology
• Define
• Factors
• Predisposing
• Precipitating
• Questions
• Where, When, How, Why, and Who
• Related Terms
• Frequency
• Incidence
• Prevalence
• Outcomes
• Morbidity
• Mortality
• Geography
• Endemic
• Epidemic
• Pandemic
• Sporadic

Herpes D Virus (HDV)
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Hospital

• Nosocomial
• Sources
• Exogenous
• Endogenous
• Iatrogenic

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CDC Reportable Diseases (examples)

• Viral /Bacterial
• HIV
• Anthrax
• Influenza
• Pertussis, Diphtheria
• TB, Leprosy
• Botulism, Tetanus
• Hepatitis
• E. coli, Salmonella, Shigella
• STDs
• Cholera
• Mumps, Measles, Rubella
• Legionella
• Small Pox
• Tularemia
• Toxic Shock
• Leptospirosis
• Vector Borne
• Lyme

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Public Health Groups

• CDC
• WHO
• US Departments
• Agriculture
• Health

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Biohazard Risk Groups
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Major Etiologic Categories

• Genetic
• Sickle Cell Anemia
• CF
• MD
• Hemophilia A
• Acquired
• Infectious
• Traumatic
• Iatrogenic
• Nosocomal
• Multifactoral
• CAD
• DM
• Cancer
• Congenital Heart Disease
• Hypertension
• Emphysema

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Various Classification of Disease

• Anatomical
• Organ
• System
• Developmental (age)
• Neonatology
• Pediatrics
• Adolescent
• Adult
• Geriatrics
• Etiological

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Etiology, DAMNIT ! (DAMNIT-V)

• D Degenerative, Developmental
• A Anomaly, Accident, Autoimmune
• M Metabolic, Mechanical, Mental
• N Neoplasia, Nutrition, Neurological
• I Infectious, Immune, Iatrogenic,
  Idiopathic, Inherited, Inflammatory,
  Ischemic
• T Trauma, Toxins, Toxicities
• V Vascular

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My Possible Problem List

• Location
• Gross
• Histological
• Physiological
• Remember DAMNIT-V

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Clinical Manifestations

• Symptoms /Syndrome
• Patient Report
• Subjective
• Related Terms Prodromal, Insidious, Latent
• Signs
• Health care exam
• Observable phenomena
• Objective
• Diagnostic Criteria
• Laboratory results
• Imaging
• Biopsy

Digital Thermal Imaging
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Medical Records

• S
• O
• A
• P

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Outcome

• Expected
• Prognosis
• Actual
• Cure
• Remission
• Exacerbation
• Complication
• Sequella
• Palliative
• Death

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Stress

• Define
• Stressor examples
• Positive
• Negative
• Types
• Major
• Minor
• Symptoms
• GAS
• Alarm (ANS)
• Resistance (H-P-A axis)
• Exhaustion ( feedback)

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Stress Related Disorders

• Immune Autoimmune, Neoplasia
• Cardiovascular HT, CAD, Dysrhythmias
• Respiratory Asthma, URTI, TB
• Renal Interstitial cystitis
• Neurologic Depression, MS, Headache
• GI Diarrhea, IBS, Eating Disorders
• Endocrine DM, Hyperthyroidism
• Reproductive Infertility
• Musculoskeletal RA, SLE, Chronic Fatigue
• Integumentary Eczema, Acne, Urticaria, Herpes

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Adaptation

• Define
• AKA
• Compensatory mechanisms
• Homeostatic Mechanisms
• Control Systems
• Regulatory systems
• Homeostatic Control and Feedback
• Limits
• Energy use
• Efficient (overshoot, undershoot)
• Effective (prolonged response ? change feedback)

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De-stress

• Sleep
• Exercise
• Diet
• Medical Check-ups
• Energy
• Attitude
• Stressed is Desserts spelled backwards!