Epidemiology Module 1

Question 1

What is public health?

Answer 1

combination of sciences, skills, and beliefs directed to the maintenance and improvement of the HEALTH OF ALL THE PEOPLE through collective or societal actions

Question 2

What is the focus of public health?

Answer 2

protect, promote, restore health of the population

Question 3

What are the four aspects of public health?

Answer 3

1. population 2. multi-disciplinary 3. prevention 4. health promotion

Question 4

What are the core functions of public health?

Answer 4

assessment, policy development, and assurance

Question 5

What are the tools of public health?

Answer 5

surveillance, implementation of research findings, dissemination of guidelines, development of effective PH interventions, public policy

Question 6

Basic health science (subjects, goals, and examples)

Answer 6

cells, tissues, animals. to understand mechanisms. examples: toxicology, immunology

Question 7

Clinical science (subjects, goals, and examples)

Answer 7

patients. improve diagnosis and treatment. examples: internal medicine, pediatrics

Question 8

Public Health (subjects, goals, and examples)

Answer 8

Populations. prevention and promotion. examples: epidemiology

Question 9

What are the levels of prevention?

Answer 9

1. primary - prevention
2. secondary - early detection
3. tertiary - reducing impact

Question 10

What are the core disciplines of public health?

Answer 10

biostats, epidemiology, environmental health, health policy and management, social and behavioral sciences

Question 11

What is epidemiology?

Answer 11

The study of the distributions and determinants of disease in human populations. The study of the distribution and determinants of health-related states or events in specified populations and the application of this study to the control of health problems.

Question 12

What are the modes of disease transmission?

Answer 12

direct (person-to-person), indirect (common vehicle or vector)

Question 13

How is immunity acquired?

Answer 13

active vs passive

Question 14

What is herd immunity?

Answer 14

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.

Question 15

What are the types of diseases?

Answer 15

communicable, non-communicable

Question 16

What is acute vs chronic disease?

Answer 16

acute - short induction and latency, chronic - long induction and latency

Question 17

What is the epidemiologic triad of disease?

Answer 17

host, vector, agent, environment

Question 18

What is a vector?

Answer 18

a living carrier that transports and infectious agent from an infected individual or its wastes to a susceptible individual, its food, or immediate surroundings

Question 19

What are types of agents?

Answer 19

biologic, chemical, physical, nutritional

Question 20

What are the 5 objectives of epidemiology?

Answer 20

1. study natural history of disease, 2. determine distribution 3. identify etiology, 4. evaluate existing and new preventative and therapeutic measures and modes of health care delivery, 5. provide foundation for developing public policy

Question 21

How do you study the natural history of disease?

Answer 21

Onset to resolution or death. Define disease. Treatment. Outcomes. Time course.

Question 22

How do you determine distribution?

Answer 22

Person, place, time. Identify trends. Surveillance (active or passive)

Question 23

What are the types of disease occurrence?

Answer 23

endemic, epidemic, pandemic

Question 24

What is the purpose of understanding frequency and distribution?

Answer 24

generate hypotheses about determinants and determine impact in the population

Question 25

What is etiology?

Answer 25

identify cause. Usually clinical observations --> descriptive studies --> analytic studies

Question 26

Who was John Graunt and what was his important epidemiological contribution?

Answer 26

1600s. scientific revolution. "laws of mortality" that described patterns of disease and death. first epidemiologist. Noted patterns of disease through tabulating bills of mortality

Question 27

Who was James Lind and what was his important epidemiological contribution?

Answer 27

1700s. scurvy experiments. compared experimental and control group, then followed up results.

Question 28

Who was William Farr and what was his important epidemiological contribution?

Answer 28

1800s. founder of modern epi. collected data and analyzed data. standardized mortality rate. described state of health, determinants, applied knowledge

Question 29

Who was John Snow and what was his important epidemiological contribution?

Answer 29

1800s. Cholera Broad St. Pump. Mapped distribution, collected data on unaffected and affected, influenced public health action. Also analyzed water companies. Near perfect model of epidemiological study: organized observations, recognized natural experiment, conducted quantitative analysis

Question 30

What was the streptomycin tb trial in the 1940s?

Answer 30

controlled clinical trial of streptomycin for tb. randomization, precise and objective endpoint, blind, ethics of withholding treatment

Question 31

What were Doll and Hill's studies on smoking and lung cancer?

Answer 31

case-control study. a new prospective study surveying smoking habits and death

Question 32

What was the Framingham study in 1947?

Answer 32

cohort study. foundation for current ideas about risk factors for ischemic heart disease. healthy adults from same town, stable pop. sufficient people with/without risk factors. ongoing

Question 33

How are outbreak investigations undertaken?

Answer 33

1. define cases 2. confirm cases 3. establish background rate 4. examine descriptive epidemiology 5. generate and test hypotheses 6. collect and test environment 7. implement control 8. disseminate info

Question 34

What are the three types of outbreaks and how does their distribution look?

Answer 34

1. point source: exposed over a brief time to same source (normal distribution); 2. continuous common source: same source over prolonged time (rises gradually and might plateau); 3. propagated outbreak: spreads from person-to-person (multiple peaks getting progressively taller 1 incubation period apart)

Question 35

How was the ebola outbreak addressed?

Answer 35

1st in South Sudan and DRC 1. defined case simultaneously with control measures (case definition for DRC different tha nSudan ecause lab-confirmed cases were available); 2. contact tracing; 3. find active and recovered cases; 4. investigate cause, presentation, control; 5. mode of infection; 6. search for recent and active cases, trade routes, structured study to identify contributing factors (injections at hospital!). 2nd outbreak in West Africa in cities, global media coverage