Epidemiology

Presented by: Group 5

ACTIVITY
EPIDEMIOLOGIC TRIAD OR TRIANGLE
• Traditional model for infectious (communicable) disease
Susceptibility
(weak immune
system)

External agent:
Infectious
microorganism or Climate, unsafe
pathogen, water, poor
chemical hygiene practice
contaminants, or
physical forces
EPIDEMIOLOGIC PROCESS & INVESTIGATION
Conducting epidemiologic investigations
Defining disease outbreak Review of surveillance data
• One of the core functions of epidemiology is • Outbreaks may be detected during regular
detecting disease outbreak. conduct and timely analysis of surveillance data.
• Disease outbreak – “the occurrence of cases of • Reveals an increase in reported cases or an
disease in excess of what would normally be unusual clustering of cases by time and place.
expected in a defined community, geographical
area or season.” (WHO, 2012)
• It could be uncovered from review of surveillance
data, observation of single events or clusters by
clinicians, laboratory technicians and infection
control practitioners, and reports from patients or
members of the community.
EPIDEMIOLOGIC PROCESS & INVESTIGATION
Conducting epidemiologic investigations
Observation of single events or clusters
• Reviewing exposure information from individual
case reports to look for common factors can
uncover infections related to particular
exposures.
• Reviewing laboratory patterns of organisms can
sometimes detect clusters of disease caused by
the same organisms, such as hospital acquired
infections.
• Reports by clinicians on suspicious infections can
also trigger further investigation and prompt
response.
Reports from patients or members of the
community
• Another reporting source for apparent clusters of
disease or health condition is patients or
members of the community.
• Example: an individual may call the hospital or
health department and report severe diarrhea
and other symptoms of food poisoning after
attending a party.
EPIDEMIOLOGIC PROCESS & INVESTIGATION
Steps in disease outbreak investigation
Includes planning for: (a) scientific or technical issues, and (b) management
1. Prepare for field work
and operation issues.

2. Establish the existence

Verify that the cases or cluster of cases is indeed an outbreak.
of an outbreak

(a) To ensure that the disease has been properly identified, since control
measures are often disease-specific
3. Verify the diagnosis
(b) To rule out laboratory error as the basis for the increase in reported
cases

4. Construct a working case A case definition is a tool for classifying someone as having or not having the
definition disease (or condition) of interest. In outbreak setting, specify time & place.

Investigators may perform: (a) Passive surveillance (e.g. spending out

5. Find cases systematically information about the “outbreak”) and asking for reports of similar cases, (b)
and record information active surveillance (e.g. visiting facilities to collection information about the
“outbreak”)
EPIDEMIOLOGIC PROCESS & INVESTIGATION
Steps in disease outbreak investigation
Characterize the outbreak by time, place, and person. It provides a
6. Perform descriptive
comprehensive characterization of the outbreak such as trends over time,
epidemiology geographic distribution, and the population affected by the disease.

It may address the source of the agent, the mode of transmission, or the
7. Develop hypotheses exposures that caused the disease, depending on what is already known
about the disease or condition.

Hypotheses are evaluated in one of two ways: (a) comparing the

8. Evaluate hypotheses
hypotheses with the established facts or (b) using analytic epidemiology to
epidemiologically
quantify relationships and assess the role of chance.

Sometimes, the results of the analytic epidemiology are unrevealing. In

9. As necessary,
which, there is a need to rethink the hypothesis by considering new modes
reconsider, refine, and re-
of transmission, getting a more specific control group, or other
evaluate hypotheses characteristics of agent and host factors.
EPIDEMIOLOGIC PROCESS & INVESTIGATION
Steps in disease outbreak investigation
Laboratory studies confirm the findings from the analytic epidemiologic
10. Compare and reconcile studies. Environmental studies can explain why the outbreak occurred.
with laboratory and/or The combination of analytic epidemiology studies, laboratory results
environmental studies and environmental studies give a complete picture of the outbreak
investigation and guide appropriate public health action.

11. Implement control and The primary goal of outbreak investigation is the control of the outbreak
prevention measures and prevention of more cases.

It is important to determine whether the prevention and control measures

12. Initiate or maintain are working in terms of declining number of cases; as well as checking
surveillance whether the outbreak has spread to other areas where control measures
would need to be initiated too.

At the end of the investigation, there is a need to summarize the findings

and its outcome in a report, and to communicate this report through oral
13. Communicate findings briefing to local authorities and as a written report with scientific format of
introduction, background, methods, results, discussion, and
recommendations.
Quiz