Chapter 15. Epidemiology andNosocomial Infections
Epidemiology: the study of
diseases occur and
they aretransmitted in populations. CDC (Centers for Disease Control and Prevention) isthe epidemiological center of the Untied States that compiles an annual nationallist of "notifiable diseases", i.e.
disease cases physicians are required toreport. (Epidemiological studies include non-infectious diseases as well, e.g.cancer, heart diseases, mental health and smoking-related diseases.)
Epidemiological measures of disease:
cases per 100,000 people in a period of time, measuring if the disease is still spreading or isdisappearing);
(total number of people having the disease, measuringhow widespread a disease is in a population at a time point);
(number of disease cases in a population per year);
(number of death due to adisease in a population per year)
Pioneers of epidemiology: John Snow (made the first epidemiological map thatidentified the source of the 1849 London cholera outbreak); Ignaz Semmelweis(prevented childbirth death by instituting hand-washing); Florence Nightingale(wrote the first statistical study that lowered war-time soldier death frominfection).
Classifying infectious diseases:
diseases (diseases that occur in a short period of time, e.g. West Nile virus outbreak in NYC);
diseases (diseasesthat constantly present in a local population, e.g. Lyme disease);
diseases (worldwide occurrence, e.g. flu).
Methods of epidemiological studies
Descriptive studies: Careful collection of geographic, demographic, andtemporal information of a disease
Analytical studies: Statistical analysis of association and correlation between disease factors and disease cases, in order to identify the diseasecause(s). For example, do a case group-control group comparison
Experimental studies: Comparison of a treatment group with a control(untreated, with placebo) group
Modes of disease transmission
Direct contact: person-to-person. e.g., AIDS
Indirect contact: transmission through a
(non-living objects, e.g.,shared utensils in hospital).
Droplet: coughing, sneezing, etc. Droplets contain "droplet nuclei", whichare dried mucus embedded with microbes.
Vehicle transmission: waterborne (e.g., cholera), airborne (e.g., TB;
, e.g, dusts, contain live bacteria, endospores, fungal spores andnaked viruses), and foodborne (e.g., botulinum toxin)