Principles of Public Healt notes CLASS 3

Principles of Public Healt notes CLASS 3 - Epidemiology 1...

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Epidemiology  1 Surveillance Purpose of Surveillance in PH Describe trends & natural history of problem Detect epidemics Detail patterns of disease Plan & set program priorities Detect rare but important cases of disease 2 Surveillance Surveillance: Four Steps 1. Collection of data 2. Interpretation of data 3. Dissemination of information 4. Action - control & prevent problems Surveillance reports are descriptive 3 Surveillance Surveillance System Attributes 1
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Simple Flexible Acceptable (participation) Sensitive Representative Timely Cost 4 Surveillance - 2002 Notifiable Disease AIDS Chlamydia Giardia Gonorrhea HIV Infection Lyme Disease Salmonellosis Syphilis # Cases 42,745 834,555 21,206 351,852 63,000 23,763 44,264 32,871 5 Surveillance Surveillance systems Many systems resulted from local/national emergencies Asian influenza (1957) Toxic Shock Hantavirus E. coli 0157:H7 West Nile Virus 6
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Epidemiology John Snow & Broad Street Pump (1854) Traced source Charted frequency & distribution 7 3
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8 9 Broad Street Pump Water Co. Southwark & Vauxhall Co. Lambeth Co. Rest of London Deaths per 10,000 Homes 315 37 59 10
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< 11 12 5
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What is Epidemiology? Greek: "epi," meaning on or upon "demos," meaning people "logos," meaning the study of Causes, frequency & distribution Provides the most compelling evidence for measuring environmental risk to humans 13 What is Epidemiology? Who got sick? What was the specific risk? When did it take place? Where were did they get sick? Why is it occurring? How can we do something to get rid of it? Epidemiology differs from medicine 1) it is preventative 2) focuses on the population Epidemiology-single best science tying together environmental exposure and human disease 14 Epidemiological Studies Have provided critical links: Toxic shock Leukemia Heart disease Lung cancer, heart attacks & low birth weight with smoking Legionnaire's disease 15 7
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Legionnaires' Disease July 1976 American Legion convention Pneumonia, aches, fever 150 cases & 20 deaths ( happens with several days ) Hotel Bellevue-Stratford Disease was only contained within the hotel CDC gets involved, and traced it to be in the cooling system (it was airborne) 16 Legionnaires' Disease Higher rates among certain individuals Evidence suggested airborne Not person to person Bacteria eventually identified Hotel was searched for source Helped with past 17 Uses of Epidemiology Identify causes of disease Complete clinical picture of disease Identify new syndromes Measure efficacy of therapy/prevention Monitor health of region (surveillance) ID high risk groups ID risk factors Study trends over time (predictive) Investigate outbreaks 18
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Uses of Epidemiology For every day decisions: Stop smoking Take stairs Eat salad Don't share needles Use condoms, PPE, repellant Epidemiology provides strong evidence but not proof -too many unknowns Epidemiology gives rise to new syndromes, and efficacy of treatments 19 Comparison is Primary Tool Compare using frequency & distribution (flu) 1. Time happens during fall/winter 2. Place urban vs rural vs suburban 3. Personal births, deaths, clinical data, marriages 20 9
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