PRACTICAL CONCEPTS IN EPIDEMIOLOGY Susceptibility and response
CAUSATION OF DISEASE o genetic composition, nutritional
Disease has been classically described as the and immunologic status,
result of an epidemiologic triad anatomic structure, presence of
disease or medications, and
EPIDEMIOLOGIC TRIAD psychological makeup
ENVIRONMENT
Extrinsic factors that affect the agent and
the opportunity for exposure
Physical factors such as geology and
climate, biologic factors such as insects
that transmit the agent, and
socioeconomic factors such as crowding,
sanitation, and the availability of health
services
Product of an interaction of the human host, an
infectious or other type of agent, and the
environment that promotes the exposure.
AGENT
Infectious microorganism or pathogen,
virus, bacterium, parasite, microbe.
The agent should be present for the
disease to occur YET PRESENCE OF
AGENT ALONE is not sufficient enough to
cause a disease.
There are factors that influence whether
exposure to an organism will result in
disease.
o pathogenicity and dose
chemical and physical injury
chemical
o L-tryptophan – eosinophilia-
myalgia syndrome
Physical
o repetitive mechanical forces -
carpal tunnel syndrome COMPONENT CAUSES AND CAUSAL PIES
epidemiologic triad -> inadequate model for NCDs
HOST must be susceptible
human susceptibility is determined by a
variety of factors
genetic background
nutritional characteristics
immunologic characteristics
Host = human who can get the disease component causes
factors intrinsic to host = risk factors sufficient cause
o behavior influences necessary cause
susceptibility or response to the
causative agent MODES OF TRANSMISSION
o sexual practices, hygiene, and DIRECT TRANSMISSION
other personal choices, age, sex direct contact
Infection, genetics, noninfectious
INDIRECT TRANSMISSION environmental causes
can occur through a common vehicle Inappropriate immune responses
such as a contaminated air or water
supply, or by a vector such as the SIGNS AND SYMPTOMS
mosquito SIGNS
Objective and measurable
o Vital signs:
temperature (Usually
37 º C)
o Heart rate - 60-100 beats per
minute
o Breathing rate- 12 to 18 breaths
per minute
o Normal blood pressure
o Diagnostic tests
Blood tests
(Antibodies)
SYMPTOMS
Subjective
o Nausea, Pain scale
Memory bias, lack of precision
Scale: Wong-Baker Faces - a pain-rating
scale
SKIN
portal of entry for infectious agents
scratch or injury
streptococci or staphylococci, fungi
(tinea)
Skin --> not exclusive portal of entry CLASSIFICATION OF DISEASES
o many of these agents, and INFECTIOUS
infections --> can be acquired Communicable infectious
through more than one route Noncommunicable infectious
DISEASE IATROGENIC
Any condition in which the normal structure or medical procedures
functions of the body are damaged or impaired flesh-eating bacteria
Physical injury and disabilities are not classified as NOSOCOMIAL
diseases from hospitals
But can be the cause of disease ZOONOTIC
animals
Signs and symptoms start; however
NONINFECTIOUS general for specific diagnosis
INHERITED Pathogen continues to multiply
o Genetic (Sickle cell anemia)
CONGENITAL PERIOD OF ILLNESS
o Present at or before birth Obvious and severe signs and symptoms
(Down syndrome) of disease
DEGENERATIVE
o Progressive, irreversible PERIOD OF DECLINE
(Parkinson’s Disease) Signs and symptoms decline
NUTRITIONAL DEFICIENCY Number of pathogen decreases
o Lack of nutrients (scurvy) Vulnerable for secondary infection
ENDOCRINE PERIOD OF CONVALESCENCE
Malfunction of glands (hypothyroidism) Return to normal function
Some disease may cause permanent
NEOPLASTIC damage to body
Cancer
IDIOPATHIC
No known cause (Idiopathic juxtafoveal
retinal telangiectasia, fibromyalgia)
ASPECTS/ IN THE DISEASE PROCESS
ETIOLOGY
o Genetic
o Acquired
PATHOGENESIS
o Process of infection to disease
o Mechanism of disease
development
ACUTE VS. CHRONIC
MORPHOLOGIC CHANGES ACUTE DISEASE
structural and associated functional Duration: Short
alterations in cells or tissues that are Incubation: days
characteristic of the disease or its
etiology
FUNCTIONAL DERANGEMENTS AND CLINICAL
SIGNIFICANCE
morphologic changes and distribution in
different organs or tissues → influence
normal function
Determine clinical features, prognosis of
disease
PERIOD OF DISEASE
INCUBATION PERIOD
No signs, no symptoms
Initial entry of pathogen, increase in
number
PRODROMAL CHRONIC DISEASES
Duration: long may be transmitted to animals, which
Incubation: months, years then acts as temporary reservoirs for
infection
Mycobacterium tuberculosis in dogs
HUMANS GET INFECTED WITH ZOONOTIC
INFECTION THROUGH:
1. Direct contact with the infected animal
2. Indirect contact with the infected animal
3. Vectors
a. biological (participates in the
pathogen life cycle - site to
complete or multiply)
i. transmitted through
bites, wound
INFECTIVITY VS. COMMUNICABILITY b. mechanical
INFECTIVITY i. “transports” e.g. flies
Ability of pathogens to infect
4. Food contamination
proportion of exposed persons who
become infected
COMMUNICABILITY
“Infectious period”
Time of infectious agent may be
transferred
PATHOGENICITY
proportion of infected individuals who
develop clinically apparent disease
VIRULENCE
proportion of clinically apparent cases
that are severe or fatal
ZOONOTIC DISEASES
Transmitted from animals to humans
ZOONOSIS
a disease that occurs when a pathogen is
transferred from a vertebrate animal to
a human; however, sometimes the term
is defined more broadly to include
diseases transmitted by all animals
(including invertebrates)
ZOONOSES DEFINITIONS
ANTHROPOZOONOSES
main reservoir is non-human vertebrate
animals
bovine tuberculosis,rabies, leptospirosis
ZOOANTHROPONOSES
mainly affect people
